Upper limb prosection book Flashcards
(42 cards)
What muscles are involved in forward flexion of shoulder?
Anterior fibres of deltoid
Describe important features of scapula
-Supraspinous fossa
-Infraspinous fossa
-Coracoid process
-Acromion
-Spine of scapula
Describe ‘painful arc’
-Usually inflammation supraspinatous tendon
-Due to degeneration/trauma
-Painful abduction arm between 60-120 degrees
What is the brachial plexus?
-Network of nerves that originates in neck and extends into axilla
-Gives rise to most of nerves that supply upper limb
What are the 5 regions of the brachial plexus?
Roots
Trunks
Divisions
Cords
Branches
Describe the origins of the brachial plexus
Originates from ventral rami c5-T1
How many branches are there from divisions of brachial plexus?
None: all branches exit brachial plexus before or after the divisions
How many branches from roots of brachial plexus?
3:
-Dorsal scapular nerve from C5
-Nerve to subclavius from c5 and c6
-Long thoracic nerve c5-c7
What is the nerve roots of long thoracic nerve?
Long thoracic nerve of bell
C5,6,7 bells in heaven
How many branches from trunks of brachial plexus? Where are they from?
1
-suprascapular nerve (upper trunk)
Draw a line diagram of brachial plexus and label branches
label branches
Name salient parts of humerus
Greater tubercle
Lesser tubercle
Intertubercular (bicipital) groove
Medial epicondyle
Trochlea (medial: we like trotsky more than stalin)
Capitulum
Name muscles attaching to humerus
Pec major
LD
Teres major
Deltoid (deltoid tuberosity)
How would you localise humerus as left or right?
With humeral head pointing inwards, capitulum and trochlea point forwards
What are the boundaries of the axilla?
Apex: cervicoaxillary canal (convergence of clavicle, scapular, first rib)
Anterior: pec major and minor
Base: axillary fascia
Posterior: subscapularis, teres major, lat dorsi (superior to inferior)
Medial: thoracic wall and serratus anterior
Lateral: intertubercular groove of humerus
What are contents of axilla?
-Axillary artery and branches
-Axillary vein
-Axillary lymph nodes
–> 1: below pec minor
–> 2: behind pec minor
–> 3: above pec minor
-Brachial plexus: cords and branches
-Fat
Structures that pierce clavipectoral fascia
Two in:
-Cephalic vein
-Lymphatic vessels
Two out:
-Thoraco-acromial trunk
-Lateral pectoral nerve
What is the clavipectoral fascia?
Thin layer fibrous tissue surrounding pec minor
-Superiorly attaches to clavicle and inferiorly to axillary fascia
What nerves could be damaged with humeral fracture?
-Axillary nerve as it passes close to neck of humerus in quadrangular space
-Radial nerve as it winds around shaft of humerus at junction between proximal 2/3rds and distal 1/3rd
-Ulnar nerve as it passes behind medial epicondyle
-Median nerve in supracondylar fracture
What structures make up roof of cubital fossa?
Bicipital aponeurosis, deep fascia of forearm, subcut tissue, skin
Where does the median cubital vein lie relative to bicipital aponeurosis?
Superficial to it
Describe the anatomy of the cubital tunnel
-Roof: aponeurotic expansion of two heads flexor carpi ulnaris
-Spans from medial epicondyle of humerus to olecranon process of ulna
-Floor: medial collateral ligament of elbow
-medial border of olecranon process to medial epicondyle
What is clinical significance of cubital tunnel?
-Ulnar nerve passes through cubital tunnel as it runs behind medial epicondyle
-Ulnar nerve can be compressed within cubital tunnel
-This results in ulnar nerve symptoms and signs within forearm and hand and is termed cubital tunnel syndrome
What happens to tendons FDS and FDP?
-FDS tendon splits to insert into middle phalanges
-FDP tendon passes through this split in FDS to insert into base of distal phalanx