Upper limb sheet 5

Question 1

Ask your model to demonstrate eating an apple
What movement is occurring at the wrist joint? Identify planes and axes for each movement. Explain which muscles are producing this movement.

Answer 1

Flexion then extension as wrist moves away

Sagittal plane, mediolateral axis

Flexors = flexor carpi ulnaris/ radialis, flexor digitorum (profundus + deep), flexor pollicis longus

Extensors = extensor carpi radialis (longus/ brevis), extensor carpi ulnaris, extensor indicis, pollicis (longus/ brevis) , digitorum

Question 2

Explain local and global stabiliser with example( s)in the upper limb or lower limb

Answer 2

Local = stabilises one atatchment to allow movement of required muscle

Global = stabilises body position rather than muscle

E.G. lev scap wants to side flex and elevate scapula, lower fibres of trap fix scapula to allow for efficient side flexion

Question 3

Explain the attachments, morphology and actions of Latissimus Dorsi. Name the nerve supply.

Answer 3

Large flat muscle with a spiralized tendon

Origin: Spinous process of T6-T12, posterior iliac crest, lumbar vertebrae via thoracodorsal fascia

Insertion: Intertubercle groove of humerus

Actions: Depression of scapula, shoulder ext, medial rotation and adduction

Nerve: thoracodorsal nerve

Question 4

Explain the attachments, morphology and actions of Supraspinatus. Name the nerve supply.

Answer 4

Smallest of the rotator cuff muscles, travels under acromion

Origin: Supraspinatus fossa of scapula

Insertion: Greater tuberosity of humerus, superior facet

Actions: Abduction (0-15), then assists deltoid further, stabilises humerus

Nerve: suprascapular nerve

Question 5

Classify the 1st Carpometacarpal joint of the thumb and articular surfaces. Identify two ligaments associated with the joints of Thumb or fingers.

Answer 5

Synovial saddle joint

Proximal joint facet of 1st metacarpal and distal trapezium bone

dorsal/ palmar carpometacarpal ligaments

Question 6

What is the root value of Axillary nerve and which muscles group does it supply? What is the course of this nerve?

Answer 6

C5,6

Deltoid, teres minor

Brachial plexus to posterior shoulder

Question 7

Identify and where possible palpate the olecranon process or medial epicondyle and lateral epicondyle. Name the muscle that attaches here.

Answer 7

Olecranon - tricep insertion
Medial epicondlye - pronator teres origin
Lateral epicondyle - extensor carpi radialis brevis

Question 8

List the muscles responsible for flexion/extension at the Elbow.

Answer 8

Flexors = brachialis, brachioradialis, pronator teres, biceps brachii

Extensors = triceps, anconeus

Question 9

Explain common flexor origin and identify the contraction

Answer 9

Common origin of wirst flexors, from the common flexor tendon