Upper Limb Nerves, Muscles, Vessel Flashcards
Erector Spinae Muscle
Iliocostalis
Longissimus
Spinalis
All innervated by dorsal rami of spinal nn.
Unilateral and bilateral action
Lateral flexion of head and vertebral column
Extension of head and vertebral column
Scapular Movement
Retraction
Protraction
Elevation
Depression
Rotation - glenohumeral joint point superior or inferior
Posterior Muscle - Axial to pectoral girdle
Trapezius
Levator scapulae
Rhomboid major
Rhomboid minor
Trapezius
Elevates scapula
Retracts scapula
Depress scapula
accessory nerve innervation
Levator Scapulae
Elevates scapula
Dorsal Scapular n. innervation
Rhomboid minor
Superior to Rhomboid major
Retracts scapula
Dorsal Scapular n. Innervation
Rhomboid Major
Inferior to minor
Retracts scapula
Dorsal Scapular n. Innervation
Anterior Muscle - Axial to pectoral girdle
Serrartus anterior
Pectoralis minor
Serratus anterior
holds scapula to body
Protracts scapula
Rotates scapula
Long thoracic nerve c5,6,7
Paralysis of serratus anterior
Winging of the scapula
Pectoralis minor
Protracts scapula
Elevates ribs when scapula is stationary to assist in inhalation
Medial pectoral n. Innervation
Axial skeleton to humerus muscle
Pectoralis major
Latissimus Dorsi
Pectoralis major
Adducts arm (shoulder)
Medically rotates arm (shoulder)
Medial pectoral n.
Lateral pectoral n.
Innervation
Latissimus dorsi
Adducts arm (shoulder)
Extends arm (shoulder)
Medially rotates arm (shoulder)
Thoracodorsal n. Innervation
Muscles Pectoral girdle to humerus
ROTATOR CUFF
Subscapularis
Supraspinatus
Infraspinatus
Teres minor
Teres major
Deltoid
Rotator Cuff
SITS muscles
Supraspinatus
Infraspinatus
Teres minor
Subscapularis
Supraspinatus
Abducts arm (shoulder)
Suprascapular nerve innervation
Infraspinatus
Lateral rotation of arm (shoulder)
Suprascapular nerve innervation
Teres minor
lateral rotation of arm (shoulder)
Axillary nerve innervation
Subscapularis
Medial rotation of arm (shoulder)
Upper Subscapular n. Lower Subscapular n. Innervation
Teres major
Starts posterior and moves anterior
Adducts arm (shoulder)
Extends arm (shoulder)
Medial rotation of arm (shoulder)
Low Subscapular innervation
Deltoid
Anterior - flex arm (shoulder) and medial rotation of arm (shoulder)
Middle - Abducts arm (shoulder)
Posterior - Extends arm (shoulder) lateral rotation of arm (shoulder)
Axillary nerve innervation
Biceps Brachii
Short head, long head
Forearm flexion when supinated
Supination of forearm (radioulnar)
Slight arm flexion (shoulder)
Musculocutaneous nerve innervation
Coracobrachialis
Flexion of arm (shoulder)
Adducts arm (shoulder)
Musculocutaneous nerve innervation
Brachialis
Flexes forearm (elbow)
Musculocutaneous nerve innervation
Posterior arm muscles
Extensors
Triceps brachii
-long head
-lateral head
-medial head
Triceps brachii
Extends forearm (elbow)
Extends arm (shoulder) long head only
Radial nerve innervation
Forearm muscle identification
Anterior forearm - flexor
Posterior forearm - extensor
Tendon related to thumb - radialis and abducts wrist, pollicis
Tendon related to pinky - ulnaris and adducts wrist, 2-5 digitorum
Anterior forearm
Pronates forearm and flex wrist and digits
8 muscles
All innervated by median nerve besides 1 1/2 by ulnar
Superficial anterior forearm
Pronator teres
Flexor carpi radialis
Palmaris longus
Flexor carpi ulnaris (ulnar nerves)
Flexor digitorum superficialis
P(2)F(3)P(4)F(5)
Pronator teres
Pronatees the forearm
Flexes the elbow
Median nerve innervation
Flexor carpi radialis
Flexes wrist
Abducts wrist
Median nerve innervation
Palmaris longues
Flexes wrist
Median nerve innervation
Flexor carpi ulnaris
Flexes wrist
Adducts wrists
Ulnar nerve innervation
Flexor digitorum superficialis
Flexes digits 2-5
Flexes wrist
Median nerve innervation
Deep anterior forearm muscle
Flexor digitorum profundus (half innervated by ulnar nerve)
Flexor pollicis longus
Pronator quadratus
Flexor digitorum profundus
Flexes digits 2-5
Flexes wrist
Median nerve (2&3)
Ulnar nerve (4&5)
Flexor pollicis longus
Flexes Pollux
Flexes wrist
Median nerve innervation
Pronator quadratus
Pronates forearm
Median nerve innervation
Posterior forearm
Supinators of forearm and extensor of wrist and digits
Radial nerve innervation
Superficial posterior forearm muscle
brachioradialis (not an extensor)
Extensor carpi radialis longus
Extensor carpi radialis brevis
Extensor digitorum
Extensor digiti minimi
Extensor carpi ulnaris
Anconeus
Brachioradialis
Flexes elbow
Radial nerves innervation
Extensor carpi radialis longus
Extends wrist
Abducts wrist
Radial nerve innervation
Extensor carpi radialis brevis
Extends wrist
Abducts wrist
Radial nerve innervation
Extensor digitorum
Extends digits 2-5
Extends wrist
Radial nerve innervation
Extensor digiti minimi
Extends digit 5
Extends wrist
Radial nerve innervation
Extensor carpi ulnaris
Extends wrist
Adducts wrist
Radial nerve innervation
Anconeus
Extends elbow
Radial nerve innervation
Deep posterior forearm muscle
Supinator
Abductor pollicis longus
Extensor pollicis brevis
Extensor pollicis longus
Extensor indicis
Supinator
Supinates forearm
Radial nerve innervation
Abductor pollicis longus
Abducts pollux
Extends pollux
Radial nerve innervation
Extensor pollicis brevis
Extends Pollux
Radial
Extensor Pollicis longus
Extends Pollux
Radial nerve innervation
Extensor indicis
Extends digit 2
Radial nerve innervation
Hand muscles
5 of 20 muscles are innervated by median nerve the rest are innervated by ulnar nerve
Thénar eminence
Hypothenar eminence
Lumbricals
Adductor pollicis
Palmar and Dorsal interosseous
Eminences
Flexor, abductor, opponens
Abductor digiti minimi
Abducts digits 5
Ulnar nerve innervation
Flexor digiti minimi brevis
Flexes digit 5
Ulnar nerve innervation
Opponents digiti minimi
Opposes digit 5
Ulnar nerve innervation
Abductor pollicis brevis
Abducts Pollux
Median nerve innervation
Flexor pollicis brevis
Flexes Pollux
Median nerve innervation
Opponens Pollicis
Opposes Pollux
Median nerve innervation
Lumbricals
1-4 from lateral to medial
1&2 by median nerve 3&4 by ulnar nerve
Flex at the MP joint & extends at the IP joint
Adductor pollicis
Adducts Pollux
Ulnar nerve innervation
Palmar interosseous muscle
Adduction of the digits (PAD)
ulnar nerve innervation
Dorsal interosseous
Abduction of the digits (DAB)
Ulnar nerve
Special Areas
Triangle of auscultation
Cubital fossa
Carpal tunnel
Anatomical snuffbox
Triangle of auscultation
Trapezius, medial border of scapula, latissimus dorsi
Cubital fossa
Pronator teres (medial)
Brachioradialis (lateral)
Line between the epicondyles of humerus (superior)
Floor
Brachialis
Supinator
Tendon of biceps brachii
Brachial artery
Median nerve
Median cubital vein lies superficial to everything
Carpal tunnel
4 tendons of flexor digitorum profundus
4 tendons of flexor digitorum superficialis
Tendon of flexor pollicis longus
Median nerve
Carpal bones and flexor retinaculum
Anatomical Snuffbox
Abductor pollicis longus tendon & extensor pollicis brevis tendon ( anterior)
Extensor pollicis longus tendon (posterior)
Radial artery
Arteries upper limb
Right
Left ventricle - ascending aorta - arch of aorta - brachiocephalic trunk - right subclavian artery
Left
Left ventricle- ascending aorta - arch of aorta - left subclavian artery
Blood supply
Subclavian passes lateral border of rib 1 to become axillary artery, axillary passes throw inferior border of teres major to become brachial artery, brachial artery splits into radial and ulnar artery, radial contributes to deep palmar arch ulnar splits into interosseous and superficial palmar arch.
Brachial artery
Gives off deep brachial artery traveling with radial nerve to posterior arm
Radial and ulnar arteries
Brachial artery branches into radial (lateral) and ulnar (medial)
Radial empties into deep palmar arterial arch
Ulnar empties into superficial palmar arterial arch
Ulnar immediately gives off to common interosseous then travels along the medial before entering the palm
Anastomoses
Arterial anastomoses- different arteries serving same territory
Venous anastomoses- abundant, more than one vein draining the same tissue
Venous return from upper limbs
Deep veins
Accompany arteries
Predominantly deep to muscles
Forearm has two vein per artery
Venae comitantes
Superficial veins
Located subcutaneous just deep to skin
Cephalic vein - travels lateral in forearm and arm, drain into axillary
Basilic vein - travels medial in arm and forearm, drain join brachial venae comitantes to form axillary vein
Median cubital vein
Connection between the basilic and cephalic veins
Lies anterior to the cubital fossa and bicipital aponeurosis
Commonly used for venipuncture
Venous return flow chart
Dorsum venus anastomoses-cephalic, basilic-axillary-subclavian (internal jugular joins)-brachipocephalic (r and l)-superior vena cava-right atrium
Spinal nerves
Dorsal root - Afferent (sensory)
Ventral root - Efferent (Motor)
Joins to form spinal nerve and splits into dorsal ramus and ventral ramus
Dorsal ramus innervates the erector spinal and the ventral ramus innervates the rest of the upper body - for unit 3 its the upper limbs.
8 cervical nerves (7 vertebrae)
12 thoracic
5 lumbar
5 sacral
1 coccygeal
Spinal nerve names
C1-7 spinal nerves - located superior to the vertebrae they exit out of
C8 spinal nerves - exit below C7 vertebrae
T1 and inferior spinal nerves - inferior to the corresponding vertebrae naming
Ventral Rami
All except T1-T12 merge to form plexuses
Brachial plexus C5-T1
T1 -T12 inter coastal nerves
Brachial Plexus
C5-T1
Musculocutaneous (C5-7)
Median (C5-T1)
Ulnar (C8-T1)
Radial (C5-T1)
Axillary (C5-6)
Muscuolocutaneous Nerve
C5-7
Direct continuation of the lateral cord
Pierces through coracobrachialis muscle
Runs between the biceps brachii and Brachialis
Entire anterior arm
Median Nerve
C5-T1
Formed from ventral rami
Formed 1/2 by lateral cord and 1/2 by medial cord
Enters forearm by passing through cubital fossa
Runs between flexor digitorum superficialis and flexor digitorum profundus in anterior forearm innervates all but 1 1/2 muscles of the anterior forearm and only 5 intrinsic hand muscles
Ulnar nerve
Formed from the ventral rami from spinal cord levels C8-T1
Direct continuation of medial cord
Runs posterior to the medial epicondyle
Runs medially within the anterior forearm
Innervates 1 1/2 muscles in anterior forearm and innervates all but 5 intrinsic hand muscles
Radial Nerve
Formed from ventral rami from spinal cord levels C5-T1
Direct continuation of the posterior cord
Passes posterior to the humerus within the radial groove
Innervates all of the posterior upper limb muscles
Axillary Nerve
C5-C6
Branch off the posterior cord
Passes posterior to the humerus around surgical neck
Deltoid and teres minor innervation
Innervation exceptions for median vs ulnar
Ulnar nerve innervates flexor carpi ulnaris and half of flexor digitorum profundus
Median nerve innervates all of the other forearm muscles m
Long thoracic nerve
C5-C7
Innervates the serratus anterior
Thoracodorsal nerve
C6-C8 branches off posterior cord
Innervates latissimus dorsi