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6. MSK > Upper Limb Surface Anatomy > Flashcards

Upper Limb Surface Anatomy Flashcards

1
Q

What can abnormal bone projections be a sign of?

A

Fracture non-union or degenerative joint changes.

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2
Q

What is muscle wasting an indication of?

A

Long standing nerve lesion.

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3
Q

What information can be gained by the pulse to a limb?

A

The quality of blood supply.

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4
Q

What are the three main aspects of surface anatomy?

A

Bones, muscles, and neurovascular structures.

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5
Q

What are the five broad groups of muscles of the upper limb?

A

Flexors of the arm, extensors of the arm, flexors of the forearm, extensors of the forearm, and muscles of the hand.

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6
Q

What is a pulse point?

A

Where a superficial artery can be palpated against a bony structure.

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7
Q

What is the pectoral girdle bony landmark?

A

The bones that connect the upper limb to the axial skeleton. Formed of the scapula and clavicle.

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8
Q

Where is the jugular notch?

A

Immediately above the sternum in the inferior neck.

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9
Q

What are the borders of the jugular notch?

A

Laterally - the sternal ends of the right and left clavicle.

Inferiorly - the manubrim of the sterum.

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10
Q

What causes the palpable elevation at the acromioclavicular joint?

A

The acromial end of the clavicle rising slightly higher than the acromion.

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11
Q

How can the spine of the scapula be palpated?

A

Follow from the acromion in an inferior-medial direction around the back of the patient.

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12
Q

How can the medial border of the scapula be palpated?

A

The spine of scapula ends near where it joins the medial border of the scapula at level T3 vertebra.

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13
Q

Where can the inferior angle be felt of the scapula?

A

Moving inferiorly from the medial border of the scapula.

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14
Q

How can the lateral border of the scapula be traced?

A

Moving superolaterally from the scapular inferior angle.

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15
Q

Why can palpating the lateral border of the scapula be challenging? And how can this be dealt with?

A

The teres major and minor cover it. Asking the patient to retract their shoulder could help.

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16
Q

Why is palpating the clavicle important?

A

Any abnormal contours suggest clavicular fractures. Most likely between medial 2/3 and lateral 1/3

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17
Q

Why can’t the glenohumeral joint be palpated?

A

Because the bony structures are covered by protective muscles and ligaments.

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18
Q

What bony structures distal to the glenohumeral joint can be palpated with adduction of the arm?

A

Less tubercle (anterior) and greater tubercles of the humerus. The gap between them is the intertubecular groove.

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19
Q

What creates the rounded contour of the shoulder?

A

The greater tubercle of the humerus and the deltoid muscle.

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20
Q

Why is the shaft of the humerus difficult to palpate?

A

It is deep down. Can be felt through thin muscle of the elderly.

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21
Q

When do the medial and lateral epicondyles of the humerus produce their distinctive shape?

A

When the elbow is fully extended.

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22
Q

What can be felt on the posterior side of the elbow at the tip of the elbow?

A

The olecrannon.

23
Q

What can be palpated distally to the olecrannon?

A

Posterior border of the ulna.

24
Q

Why is the ulnar nerve vulnerable to damage?

A

As it runs superficially posteriorly to the medial epicondyle.

25
Q

What can trauma to the elbow region cause?

A

A tingling sensation - funny bone.

26
Q

Where can the head of the ulna be palpated?

A

In the distal forearm, superficially on the medial aspect of the wrist, on the dorsal side.

27
Q

What bony point projects from the head of the ulna?

A

Ulnar styloid process.

28
Q

Where can the distal aspect of the radial shaft be felt?

A

On the lateral side of the forearm. Its styloid process is visible on the lateral surface of the dorsal forearm before the wrist joint.

29
Q

What is the wrist joint made of?

A

The articulation of the radius and 3 proximal carpal bones: scaphoid, lunate and triquetrum.

30
Q

Which two carpal bones are easy to palpate?

A

The pisiform and hook of hamate on the medial, palmar side of the hand.

31
Q

Why is it easier to palpate bony structures on the dorsal surface of the hand, rather than the palmar surface?

A

Because the palm has thick palmar fascia but the dorsum doesn’t.

32
Q

How can the heads of metacarpals be exposed?

A

By clenching your fist.

33
Q

What does the axillary fossa (armpit) lie between?

A

Two muscular projections: pectoralis major forms the anterior axillary fold and latissimus dorsi and teres major that form the posterior axillary fold.

34
Q

Which three muscles are easily palpatable in the arm?

A

The deltoid, biceps brachii and triceps brachii muscles.

35
Q

How is the deltoid viewed?

A

It helps form the rounded contour of the shoulder. Its insertion is clearly visible on the superolateral region of the arm. It prevents the tubercles of the humerus being palpated in abduction of the arm.

36
Q

How is the biceps brachii viewed?

A

A visible bulge seen on the anterior aspect of the arm and the belly becomes more prominent with the arm flexed and supinated against resistance.

37
Q

How is the triceps brachii viewed?

A

The long, lateral and medial heads form bulges on the posterior aspect of the arm and are identifiable when the forearm is extended against resistance. Tendon is easily palpated as it attaches to the olecranon.

38
Q

How is the cubital fossa viewed?

A

It is the visible, triangular-shaped hollow on the anterior surface of the elbow joint.

39
Q

How can the biceps brachii tendon be palpated in the cubital fossa?

A

Flexing the elbow joint. It can be followed to become the bicipital aponeurosis where it passes obliquely over the medial nerve and brachial artery.

40
Q

Which three muscles can be palpated in the forearm?

A

The flexor-pronator muscles originating from medial epicondyle of humerus visible on anterior aspect of forearm.
The extensor-supinator muscles originating from the lateral epicondyle of the humerus, seen on posterior aspect of forearm.
The brachioradialis visible on anterolateral aspect of forearm.

41
Q

How is the palmaris longus palpated in the wrist?

A

With 1st and 5th digits opposed. Lies superior to flexor retinaculum.

42
Q

What is visible on the palmar aspect of the hand?

A

Thenar and hypothenar eminences. Formed by muscles of the thumb then little finger.

43
Q

What tendons are visible on the back of the hand?

A

Extensor digitorum muscles in wrist extension.

44
Q

What is an arterial pulse?

A

Palpable expansion of the arteries from contraction of the heart.

45
Q

What are the three major pulses of the upper limb?

A

Brachial pulse, radial pulse and ulnar pulse.

46
Q

How is the brachial pulse felt?

A

Place two fingers over the medial region of the cubital fossa, immediately medial to the tendon of the biceps brachii. Flexing the arm then firmly pressing medial to the biceps before extending arm can help find the pulse.

47
Q

How is the radial pulse felt?

A

Place two/three fingers over the lateral aspect of the anterior wrist, lateral to the flexor carpi radialis tendon. Pulse felt as artery is compressed against the radius.

48
Q

How is the ulnar pulse felt?

A

Place two/three fingers over the medial aspect of the anterior wrist, lateral to the flexor carpi ulnaris tendon. Can be difficult to palpate.

49
Q

What are the two main superficial veins of the upper limb?

A

Cephalic and basilic.

50
Q

Where do the cephalic and basilic veins originate?

A

From the dorsal venous network on dorsal surface of the hand.

51
Q

What is the route of the cephalic vein?

A

It arises on the lateral aspect of the wrist, ascends the lateral part of the forearm and arm and drains into the axillary vein.

52
Q

What is the route of the basilic vein?

A

Originates on the medial aspect of the wrist, ascends the medial part of the forearm and arm and becomes the axillary vein.

53
Q

Where do the cephalic and basilic veins connect?

A

In the cubital fossa.

6. MSK (30 decks)

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