Upper limb lectures Flashcards

1
Q

Anterior wall of axilla is formed by?

A

> Pectoralis major muscles

> Pectoralis minor muscle

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2
Q

Posterior wall of axilla is formed by?

A

Latissimus dorsi muscle

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3
Q

Medial wall of axilla is formed by?

A

> The thoracic wall

> Serratus anterior muscle

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4
Q

Lateral wall of axilla is formed by?

A

Intertubercular groove of the humerus

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5
Q

The axillary artery is a continuation of which artery?

A

Subclavian artery

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6
Q

At which anatomical point does the axillary artery begin?

A

Outer border of the 1st rib

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7
Q

The axillary artery begins beyond the axilla as which vessel?

A

The brachial artery

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8
Q

At which anatomical position does the brachial artery begin?

A

The lower border of the teres major

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9
Q

If there is profuse bleeding of the upper limb what could be done?

A

Compression of the axillary artery

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10
Q

If there is enlargement of the axillary lymph nodes what does this indicate?

A

An infection of the upper limb

Or indication of breast cancer in the lateral quadrant of the breast

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11
Q

What is the brachial plexus?

A

A major network of nerves which innervate the upper limb

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12
Q

Which nerves make up the brachial plexus?

A

The ventral rami of C5, C6, C7, C8 and T1

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13
Q

Which nerve roots form the upper trunk of the brachial plexus?

A

C5 and C6

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14
Q

Which nerve roots form the middle trunk of the brachial plexus?

A

C7

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15
Q

Which nerve roots form the inferior trunk of the brachial plexus?

A

C8 and T1

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16
Q

What is Erb’s point and what is its clinical significance?

A

> A landmark of the brachial plexus on the upper trunk.

> Located about 1 inch (2.5 cm) above the clavicle at about the level of the sixth cervical vertebra. The point is the location of an angle between the posterolateral border of the sternocleidomastoid muscle and the clavicle.

> Electrical stimulation at Erb’s point causes contractions of the biceps, deltoid, and other arm muscles.

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17
Q

Nerve network of the upper limb overview?

A

Roots –> Trunks –> Divisions – > Cords –> Terminal branches

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18
Q

What can cause Erb’s palsy?

A

Undue seperation (hyper-extension) of the head from the shoulder:
> Anaesthesia
> Fall on shoulder
> Birth injury

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19
Q

How would an individual present with Erb’s Palsy?

A

“Waiter’s tip appearance”:
> Upper limb medially rotated
> Flexed wrist

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20
Q

Which nerves are affected in Erb’s palsy?

A

Ventral nerve roots C5, C6:
> Suprascapular nerve
> Musculocutaneous nerve
> Axillary nerv

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21
Q

Which muscle are affected in Erb’s palsy?

A

Atrophy of :
> Deltoid muscle
> Biceps brachii muscle
> Brachialis muscle

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22
Q

Injury to the lower trunk of the brachial plexus is called?

A

Klumpke’s palsy

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23
Q

Klumpke’s palsy - Muscles affected?

A

> Intrinsic muscles of the hand

> Ulnar flexors of the wrist and fingers

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24
Q

Klumpke’s palsy - Cause?

A

Undue abduction of the arm:

> Hanging injury

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25
Q

Klumpke’s palsy - Clinical presentation?

A

“claw hand,” in which:
> The forearm is supinated

> The metacarpophalangeal joints are hyperextended

> The fingers are flexed

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26
Q

In the upper limb the Lateral cord is produced from?

A

1) Superior trunk (C5, C6)

2) Middle trunk (C7)

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27
Q

In the upper limb the posterior cord is produced from?

A

1) Superior trunk (C5, C6)
2) Middle trunk (C7)
3) Inferior trunk (C8, T1)

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28
Q

In the upper limb the medial cord is produced from?

A

Inferior trunk (C8, T1)

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29
Q

Major branches of the brachial plexus?

A

1) Musculocutaneous nerve
2) Axillary nerve
3) Radial nerve
4) Median nerve
5) Ulnar nerve

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30
Q

Action of the musculocutaneous nerve?

A

The motor fibers innervate:
> Biceps brachii muscle
> Coracobrachialis muscle
> Brachialis muscle

Sensory terminal branch (Lateral cutaneous nerve of the forearm), it innervates the lateral surface of the forearm.

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31
Q

Nerve root source of axillary nerve?

A

C5, C6

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32
Q

Nerve root source of long thoracic nerve?

A

C5, C6, C7

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33
Q

Nerve root source of thoracodorsal nerve?

A

C6, C7, C8

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34
Q

Nerve root source of Subscapular?

A

C5, C6

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35
Q

Which artery is produced from the subclavian artery?

A

Axillary artery

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36
Q

Which artery branches from the axillary artery and passes around the distal humerus?

A

Anterior circumflex humeral artery

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37
Q

Which artery branches from the axillary artery and along the scapular bone?

A

The sub scapular artery

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38
Q

Which branch of the brachial artery passes behind the humerus?

A

The profunda brachii artery

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39
Q

Which artery is produced from the axillary artery?

A

The brachial artery

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40
Q

Which artery is formed by the profunda brachii artery?

A

Radial recurrent artery

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41
Q

What are the two main branches of the brachial artery?

A

The radial artery and the ulnar artery

42
Q

Which branch of the ulnar artery passes between the radial and ulnar bones?

A

The anterior interosseous artery

43
Q

Which superficial vein is found over the top of the biceps brachii?

A

The cephalic vein

44
Q

Which vein is found deep in the upper arm?

A

The axillary vein

45
Q

Which vein drains into the axillary vein?

A

The basilic vein

46
Q

Which vein passes along the ulnar bone side?

A

The basilic vein

47
Q

Which vein connects the cephalic and basilic vein?

A

The median cubital vein

48
Q

Which vein passes along the radial bone?

A

The cephalic vein

49
Q

Which vein is not always present in the upper limb?

A

The median cubital vein

50
Q

The pulses of the upper limb?

A
> The axillary pulse
> Brachial pulse, mid arm
> Brachial pulse in the cubital fossa
> Radial pulse 
> Ulnar pulse in distal forearm 
> Radial pulse in the anatomical snuffbox
51
Q

Type of the joint is the AC joint?

A

Synovial plane

52
Q

Type of the joint is the SC joint?

A

Synovial saddle

53
Q

Type of the joint is the GH joint?

A

Synovial ball and socket

54
Q

What is important for shoulder movement?

A

Scapular movement

55
Q

Movements of the scapula?

A
> Elevation
> Depression
> Adduction (Retraction)
> Abduction (Protraction)
> Upward rotation 
> Downward rotation
56
Q

Muscles of the pectoral girdle?

A

> Trapezius
Latissimus dorsi
Serratus anterior

57
Q

Which muscles of the shoulder allow the elevation of the scapular?

A

1) Descending (superior) trapezius*
2) Levator scapulae
3) Rhomboids

58
Q

Which muscles of the shoulder allow the depression of the scapular?

A

1) Ascending (Inferior) trapezius*
2) Pectoralis minor
3) Serratus anterior (Inferior part)

59
Q

Which muscles of the shoulder allow the abduction (Protraction) of the scapular?

A

1) Serratus anterior*

2) Pectoralis minor

60
Q

Which muscles of the shoulder allow the adduction (Retraction) of the scapular?

A

1) Middle trapezius*
2) Rhomboids
3) Latissimus dorsi

61
Q

Which muscles of the shoulder allow the upwards rotation of the scapular, elevation glenoid cavity?

A

1) Descending (Superior) trapezius*
2) Serratus anterior (inferior part)*
3) Inferior trapezius

62
Q

Which muscles of the shoulder allow the downwards rotation of the scapular, depressing glenoid cavity?

A

1) Latissimus dorsi*
2) Levator scapulae
3) Rhomboids
4) Pectoralis minor

63
Q

What is the articulating surface of the scapular in which the humerus sits in?

A

The glenoid cavity

64
Q

What is the role of the fibrocartilage role within the joint?

A

Acts as a shock absorber.

Can be damaged with repetitive movement

65
Q

What makes the glenoid cavity deeper?

A

The labrum

66
Q

What can be found on the surface of the proximal humerus in the GH joint?

A

Articular cartilage

67
Q

Which ligaments are attached to the acromium process?

A

1) Coracoacromial ligament
2) Coracoclavicular ligament
3) Coracohumeral ligament

68
Q

Which ligaments are attached to the proximal humerus?

A

1) Glenohumeral ligament

2) Coracohumeral ligament

69
Q

What are the bursae in the shoulder?

A

1) Subacromial bursa
2) Subcoracoid bursa
3) Subscapular bursa

70
Q

Which bursa is usually continuous with the synovial cavity of the glenohumeral joint cavity?

A

The subscapular bursa

71
Q

Muscles of the rotator cuff?

A

1) Supraspinatus
2) Subscapularis
3) Infraspinatus
4) Teres minor

72
Q

Which degree of movement is there in abduction of the shoulder and how is this achieved?

A

> 180 degrees

> First 120 degrees is achieved by movement of the humerus
The rest of the 60 degrees is made up from rotation of the scapula

73
Q

Which movements do the biceps brachii muscle perform?

A

1) Flex the shoulder
2) Flex the elbow
3) Supinates the forearm

74
Q

Which movements do the brachialis muscle perform?

A

Flexes the elbow

75
Q

Which movements do the coracobrachialis muscle perform?

A

1) Flexes the shoulder

2) Adducts the shoulder joint

76
Q

Which nerve stimulates the Biceps brachii, brachialis and coracobrachialis muscles?

A

The musculocutaneous nerve C5, C6 and C7

77
Q

Which nerve stimulates the Biceps brachii muscle?

A

The musculocutaneous nerve C5, C6 and C7

78
Q

Which nerve stimulates the brachialis muscle?

A

The musculocutaneous nerve C5, C6 and C7

79
Q

Which nerve stimulates the coracobrachialis muscle?

A

The musculocutaneous nerve C5, C6 and C7

80
Q

Which head of the biceps brachii is found more medial?

A

The biceps brachii short head

81
Q

Which head of the biceps brachii is found more lateral?

A

The biceps brachii long head

82
Q

Which muscle is the main extensor of the elbow joint?

A

The triceps brachii

83
Q

Which head of the triceps attaches to the scapula?

A

The Triceps brachii longus

84
Q

Which head of the triceps is found most lateral?

A

The triceps brachii lateral

85
Q

Which head of the triceps is found most medial?

A

The triceps brachii medius

86
Q

What is found between the smooth “horse shoe section” of the triceps brachii?

A

The triceps brachii tendon

87
Q

Which ligament does the radius sit and rotate within?

A

The angular ligament of the radius

88
Q

Which ligament is found of the lateral aspect of the elbow joint?

A

The radial collateral ligament

89
Q

Which ligament is found of the medial aspect of the elbow joint?

A

The ulnar collateral ligament, Three parts:

1) Posterior
2) Transverse
3) Anterior

90
Q

Where does the tendon of the triceps tendon attach?

A

The olecranon process of the ulna bone

91
Q

Where does the radius sit on the ulna bone?

A

The radial notch within the annular ligament

92
Q

What is the large groove like aspect of the proximal ulna that forms the elbow joint?

A

The trochlear notch

93
Q

Which aspect of the radial bone sits in the radial notch of the ulna?

A

The radial tuberosity

94
Q

Dorsal muscles?

A

1) Trapezius
2) Levator scapulae
3) Rhomboids
4) Latissimus dorsi

95
Q

The role of the ventral musculature (Pectoralis major and serrates anterior)?

A

Adduction of the shoulder

Serratus anterior also plays a role in the protraction of the scapulae

96
Q

The main role the deltoid on the shoulder?

A

Involved in almost all movements of the arm at the glenohumeral joint. Chiefly, abduction of the shoulder

97
Q

The main roles of the short scapular muscles: Posterior group on the shoulder (Supraspinatus,, infraspinatus, teres minor, teres major)?

A

1) Abduction

2) Lateral rotation

98
Q

The main roles of the short scapular muscles: anterior group on the shoulder (Subscapularis)?

A

Internal: Medial rotation

99
Q

Muscles in flexion of the elbow?

A

1) Biceps brachii = Antagonist of the triceps brachii and allows supination of the forearm
2) Brachialis = Powerful flexor
3) Brachioradialis = Strong flexor only in the mid position

100
Q

Which movements is the radius involved in which the ulna is not?

A

Articulating at the superior and inferior radioulnar joint the radius is able to move around the ulna allowing supination and pronation

101
Q

Which muscles antagonise the supination of the forearm?

A

1) Pronator teres

2) Pronator quadratus