Upper Limbs Flashcards
How many types of synovial joints are there? What are they?
1) ball and socket
2) hinge
3) pivot
4) plane
5) saddle
6) condyloid
How many types of synovial joints are there in the shoulder joints? What are they?
1) ball and socket
2) plane
3) saddle
What are the upper limbs designed for?
mobility and manipulation (completion of a task)
The upper limb is divided into…..
shoulder, arm, forearm, and hand regions
The arrangement of joints and increased range of motion of the upper limbs allow for what?
bilateral coordination of crude and fine motor skills
How are fine motor skills achieved?
directly through the hand and fingers, but range of motion and strength at the more proximal joints are necessary for proper positioning of the hand
more mobility = ________ stability
less
more mobility = less stability
What is another name for shoulder?
pectoral girdle
How is the upper limb attached to the rest of the body (proximally and posteriorly)?
proximally, the shoulder is compromising the manubrium of the sternum, the clavicles, and the scapulae, which forms an incomplete bony ring that connects the upper limb to the axial skeleton
posteriorly, the bony ring is supported by muscular attachments between the scapula and vertebral column
Where do you have the most dexterity?
fingers
What are the palpable points for the scapula?
Posteriorly, the medial and inferior borders of the scapula can be palpated as well as the spine (T3 level), superior angle (T2 level), and inferior angle (T7 level)
Following the spine out laterally to the point of the shoulder- here it becomes the acromion
The articulation between the distal clavicle and acromion (acromioclavicular joint) can be palpated anteriorly and the coracoid process just inferomedial to the acromioclavicular joint
What are the 2 axillary folds? What are they made up of? What do they provide?
The anterior axillary fold is made up of the lateral border of the pectoralis major muscle, while the posterior axillary fold is made up of the lateral borders of latissimus dorsi and teres major muscles
These folds provide anterior and posterior boundaries for the axilla
What are the proximal humeral bony landmarks?
the greater tubercle found just inferolateral to the acromion
What are the medial humeral bony landmarks?
the intertubercular groove can be palpated and the lesser tubercle most medially
the long head of the biceps brachii tendon lies in the
intertubercular groove
What are the distal humeral bony landmarks?
the medial and lateral epicondyles are easily palpated and serve as common tendon attachment sites for the forearm flexors and extensors, respectively
At the elbow, what process is easily palpable?
the olecranon process is easily palpable posteriorly
How can the radial head be found?
passive or active pronation/supination, the radial head can be located just distal to the lateral epicondyle
What is another name for anterior elbow?
cubital fossa
What is easily palpable or seen at the anterior elbow (cubital fossa)?
the biceps brachii tendon can be palpated easily with active elbow flexion
the brachial artery pulse can be found just medial to the biceps tendon
superficially, the median cubital vein may be visible through the skin (site for venus puncture)
What can you find in your wrist region/ be able to palpate?
both ulnar and radial styloid processes can be palpated with abduction and adduction of the hand, respectively
the radial artery pulse is found just lateral to the flexor carpi radialis tendon and the wrist
on the dorsum of the hand, the anatomical snuff box boundaries can be easily visualized with active thumb abduction and extension
the scaphoid bone and radial styloid process can be palpated within this space
In the hand, the thenar and hypothenar eminences represent the underlying intrinsic thumb and fifth digit (pinky) muscles, respectively
What are the boundaries and carpal bones of the snuffbox?
The floor of the snuffbox is made up of the scaphoid and trapezium carpal bones, which are located between the radial styloid process proximally and the base of the 1st metacarpal distally
Which carpal bone breaks the easiest?
the scaphoid bone
What does a fossa on bone mean?
depression
Bones of the upper limb (proximal to distal) include:
the clavicle, scapula, humerus, radius, ulna, carpal bones, metacarpals, and phalanges
What is the clavicle? Talk about its general location
an S-shaped bone that acts as a strut to connect the upper limb to the axial skeleton
medially, the clavicle is convex anteriorly and articulates with the manubrium (sternal end)
laterally, the clavicle is concave anteriorly and flattens to articulate with the acromion process (acromial end)
What are the scapular borders and angles? Where can you seen them best?
a triangular bone characterized by medial, lateral, and superior borders and superior and inferior angles
scapular structures are often best appreciated from lateral, posterior, and anterior views
What can you find in the lateral view of the scapula?
the glenoid fossa serves as the shallow socket portion of the glenohumeral (shoulder) joint, which articulates with the head of the humerus laterally
supraglenoid and infraglenoid tubercles are located superior and inferior to the fossa
What can you find in the lateral view of the scapula?
the glenoid fossa serves as the SHALLOW socket portion of the glenohumeral (shoulder) joint, which articulates with the head of the humerus laterally
supraglenoid and infraglenoid tubercles are located superior and inferior to the fossa
What can you find in the posterior view of the scapula?
the scapula is unevenly divided posteriorly into supraspinous and infraspinous fossae by a ridge of bone called the spine of the scapula
the spine extends laterally and ends at the acromion process (point of the shoulder)
What can you find in the anterior view of the scapula?
the scapula has a concave anterior surface called the subscapular fossa
arising from the neck of the scapula of the anterior superior surface is the beak-like coracoid process
the suprascapular notch lies medial to the root of the coracoid process
What is another name for arm or brachium?
humerous
What is the largest bone of the upper limb?
humerous
What type of bone is the humerous?
long bone
What humeral structures can you see proximally?
a round head (ball portion of the shoulder joint) that is covered with articular cartilage
the anatomical neck lies between the head and greater/lesser tubercles—two bony prominences that serve as muscle attachment sites
the greater tubercle is positioned more superolaterally, whereas the lesser is more inferomedially
the intertubercular groove (sulcus; bicipital groove) lies between the tubercles
extending inferiorly from the greater and lesser tubercle are the lateral and medial lips of the intertubercular groove
the surgical neck is found just distal to the tubercles
What are the characteristics of the humeral shaft?
primarily smooth, except for a small midshaft deltoid tubercle laterally and a spiral (radial) line posteriorly
What humeral structures can you see distally?
a spool-shaped medial condyle (trochlea) and a rounded lateral condyle (capitulum) that articulate with the ulna and radius
superior to the condyles are the medial and lateral epicondyles
the coronoid and radial fossae are located between the epicondyles anteriorly and the olecranon fossa posteriorly
What is the difference between the anatomical neck and surgical neck on the humerus bone?
the anatomical neck is where the humeral shaft attaches to the epiphysis, whereas the surgical neck is an area on the humeral shaft that is more likely to fracture
What are the bones of the forearm?
the ulna medially and the radius laterally
these bones articulate proximally at the elbow with the humerus and distally at the wrist with the carpal bones
they are connected along their length by an interosseous membrane
What is another name for the forearm?
antebrachium
Describe the ulnar features
characterized proximally by a large trochlear notch framed anteriorly by the coronoid process and posteriorly by the olecranon process, a shallow radial notch, and a raised ulnar tuberosity
the trochlear notch articulates with the trochlea of the humerus, while the radial notch articulates with the head of the radius
distally, the ulna tapers into a head and styloid process
Describe the radial features
characterized proximally by a head, neck, and raised radial tuberosity
the head articulates with the capitulum of the humerus
distally, the radius expands and possesses a styloid process
How many carpal bones are there?
8 bones, 2 rows (4 in each)
T/F:
the proximal row of the carpal bones articulate with the ulna
FALSE
What are the bony structures of the hand?
carpal and metacarpal bones make up the bony structure of the hand (palm and dorsum)
What are the bony structures of the fingers (digits)?
phalanges form digits 1-5
How are carpal bones arranged?
into proximal and distal rows
Bones of the proximal row contribute to which joint? Be specific
the wrist (radiocarpal) joint
What can you find in the proximal row of the carpal bones?
from lateral to medial (radial to ulnar), the proximal row consists of the scaphoid, lunate, triquetrum, and pisiform.
Is the radius medial or lateral?
lateral
Is the ulna medial or lateral?
medial
What are the 3 bones that articulate with the wrist joint?
scaphoid, lunate, and triquetrum (there’s also pisiform in the proximal row of carpal bones but it does not reach the distal radius)
What can you find in the distal row of the carpal bones?
consists of the trapezium, trapezoid, capitate, and hamate
What does the distal row of carpal bones articulate with?
the bases of the five metacarpal bones
What are the bony characteristics of the metacarpals?
metacarpals have a proximal base, middle shaft, and distal head
What does the metacarpals head articulate with?
the base of the proximal phalanges
What are the bony characteristics of the phalanges and where are they found?
proximal, middle, and distal phalanges are found in digits two through five, while the first digit (thumb or pollex) only has a proximal and distal phalanx
What are the types of synovial joints you DON’T see in the carpals?
ball and socket joint + pivot joint
Joints of the upper limb include….
all joints of the shoulder complex, elbow (humeroradial and humeroulnar), forearm (proximal and distal radioulnar), and hand (wrist, intercarpal, CMC, MCP, and IP)
What supports the upper limb joints and permit a wide range of movement?
a series of ligaments and capsular structures
Shoulder complex joints include:
1) glenohumeral
2) acromioclavicular
3) sternoclavicular
What type of synovial joint is the glenohumeral joint? Where does it sit?
ball and socket between the head of the humerus and shallow glenoid fossa
What is the glenohumeral joint supported by?
a joint capsule, glenohumeral and coracohumeral ligaments, and rotator cuff muscles
the joint is deepened by fibrocartilaginous glenoid labrum
What is the glenohumeral joint movement like? What makes it vulnerable to injury?
permits flexion, extension, abduction, adduction, medial rotation, lateral rotation, and circumduction
its wide range of motion makes it vulnerable to injury
What type of synovial joint is the acromioclavicular joint? Where does it sit?
plane joint between the acromion and the acromial end of the clavicle
What is the acromioclavicular joint supported by?
a joint capsule, directly by the acromioclavicular ligament and indirectly by the coracoclavicular ligament (conoid and trapezoid portions)
What is the acromioclavicular joint movement like?
permits rotation of the acromion on the clavicle during scapular movement
What type of synovial joint is the sternoclavicular joint? Where does it sit?
saddle joint (functionally ball and socket) between the manubrium and the sternal end of the clavicle
What is the sternoclavicular joint supported by?
a joint capsule and anterior/posterior sternoclavicular, interclavicular, and costoclavicular ligaments
has an articular disc
What is the sternoclavicular joint movement like?
permits clavicular elevation, depression, and anterior/posterior movement during humeral movement
MIDTERM MATERIAL:
What does the coracohumeral ligament prevent?
upward displacement of humeral head
What type of synovial joint is the elbow joint and what is it supported by?
hinge-shaped joint, supported by a fibrous capsule
What does the elbow joint movement permit? What is this movement supplied by?
allows for flexion and extension movements
supplies by anastomoses around joint (from brachial, profunda brachii, radial and ulnar arteries) and median, radial, and ulnar nerves
The elbow joint is made up of 2 joints. What are they called?
1) humeroradial
2) humeroulnar
What does the humeroradial joint articulate?
between the capitulum and radial head
What is the humeroradial joint supported by?
radial collateral and annular ligaments (also supports proximal radioulnar joint by maintaining position of radial head in radial notch of ulna)
What does the humeroulnar joint articulate?
between the trochlea and trochlear notch
What is the humeroulnar joint supported by?
the ulnar collateral ligament (anterior, posterior, and oblique bands)
What type of synovial joint does the forearm have? What does this allow in terms of movement? How is it supported?
pivot-type joint allows for pronation and supination
supported by a fibrous capsule and ligaments
What are the 2 forearm joints?
proximal radioulnar and distal radioulnar
What does the proximal radioulnar joint articulate? What is its movement?
between the radial head and radial notch of the ulna
allows for rotation of the head in the notch
What is the proximal radioulnar joint supported by and supplied by?
the annular ligament
supplied by elbow anastomoses and musculocutaneous, median, and radial nerves
Which forearm joint is more stable? Which one has more mobility?
proximal radioulnar - more stable
distal radioulnar - more mobility
What does the distal radioulnar joint articulate? What is its movement?
between the ulnar head and ulnar notch of the radius with an articular disc
the ulna is relatively fixed, allowing the radius to move during pronation/supination
What is the distal radioulnar joint supported by and supplied by?
weak anterior and posterior ligaments and the interosseous membrane
supplied by anterior and posterior interosseous arteries and nerves
Where does pronation and supination occur?
at the proximal and distal radioulnar joints
How does pronation/supination work- how is it supported?
supported by annular ligament
the the distal radioulnar joint, the distal radius is parallel to the ulna in the supinated position and crosses anterior and medial to the ulna in the pronated position
the palm of the hand faces anterior when the forearm is supinated and posteriorly when the forearm is pronated
The wrist and hand are made up of a collection of small synovial joints that permit fine movement at the wrist and fingers, including…..
flexion, extension, abduction, adduction, and opposition (1st/5th digits only)
What are the wrist and hand joints supplied by collectively?
by the carpal arterial arches and associated digital branches and radial, median, and ulnar nerves
The wrist holds the radiocarpal joint. What does it articulate?
between the radius and proximal row of carpal bones (minus pisiform)
the ulna does not contribute to this joint, which is supported by radial and ulnar collateral ligaments of the wrist and radiocarpal ligaments (palmar and dorsal)
The hand is a collection of what joints? How are they supported?
intercarpal, CMC, MCP, and IP joints
supported by fibrous capsules and ligaments
Where is the potential site for nerve compression in the hand?
pisohamate ligament creates an osseofibrous tunnel (Guyon’s canal) through which the deep branch of the ulnar nerve travels
Deep to the skin of the upper limb lies a________ ______ that contains varying amounts of loose connective and adipose tissues
superficial fascia
Deep to the skin of the upper limb lies a superficial fascia that contains varying amounts of loose connective and adipose tissues
What travels in the superficial fascia?
superficial veins, lymphatic vessels, and cutaneous nerves, which is continuous with the superficial fascia of the neck and trunk
Deep to the superficial fascia is a _____ _____
deep fascia
What are the dividing regions of the deep fascia?
deltoid, pectoral, axillary, clavipectoral, brachial, antebrachial, and palmar
Is the deep fasciae continuous with each other?
yes
What creates the rigid compartments of the arm (anterior and posterior) and forearm (anterior and posterior)?
Medial and lateral intermuscular septa project internally to attach to bone and create the rigid compartments
What does the pectoral fascia cover? What is it continuous with?
the pectoralis major muscle
continuous with the axillary fascia
The clavipectoral fascia lies deep to the ______ _______ ________ , encapsulates the pectoralis minor and subclavius muscles, and is continuous superiorly with the deep cervical fascia
pectoralis major muscle
The clavipectoral fascia lies deep to the pectoralis major muscle, encapsulates the pectoralis minor and subclavius muscles, and is continuous superiorly with the deep cervical fascia
What is continuous with the brachial fascia? What does the brachial fascia contain?
deltoid, pectoral, and axillary fascia
contains the muscles of the arm in anterior and posterior compartments.
Talk about the forearm and hand fascia compartments
Distally, the brachial fascia continues into the forearm as the antebrachial fascia, also arranged in anterior and posterior compartments
At the wrist, the antebrachial fascia thickens into an anterior flexor retinaculum and posterior extensor retinaculum, which function to maintain tendon position at the wrist
The fascia of the palm thickens into the palmar aponeurosis, which further compartmentalizes the hand
Venous drainage of the upper limb occurs…..
through a superficial and deep venous network
What travels in the superficial network of venous drainage?
Superficially, the cephalic vein and basilic vein travel superiorly from the dorsum of the hand to drain into the axillary vein
The cephalic vein travels laterally and the basilic medially
Multiple, small tributary veins drain into these two main superficial veins, and they are connected at the cubital fossa by the median cubital vein
The cephalic vein travels along the….
lateral forearm and arm and within the deltopectoral groove before piercing the costocoracoid membrane and clavipectoral fascia to drain into the proximal portion of the axillary vein
The basilic vein travels along the…..
medial forearm and pierces the brachial fascia midway along the arm to join the brachial vein
The merging of the basilic and brachial veins forms what vein?
axillary vein
What is the function of perforating veins?
Multiple perforating veins pierce the deep fascia of the upper limb along the course of the superficial veins to connect superficial to deep veins
Both superficial and perforating veins have valves to ensure—under normal conditions—unidirectional blood return toward the heart
T/F;
Deep veins of the upper limb travel with all major upper limb arteries and branches and typically carry the same name
TRUE
MIDTERM MATERIAL;
Where does cephalic vein run in relation to the deltopectoral groove? Additionally, what does it drain into?
The cephalic vein runs laterally in the deltopectoral groove and drains into the proximal axillary vein
MIDTERM MATERIAL:
What is a common site for venipuncture?
median cubital vein
MIDTERM MATERIAL;
Where does the basilic vein run in relation to the brachial fascia? What does it join to form the axillary vein?
The basilic vein runs medially, pierces brachial fascia, and joins the brachial vein to form the axillary vein
Are there lymph nodes in the fingers? Where does the first lymph node start and what is it called?
No, lymph nodes don’t start until your elbow
the first lymph node is called the trochlear lymph node and its on the medial side of your elbow
T/F:
Lymphatics of the upper limb are closely associated with the venous system
true
Where do superficial lymphatic vessels travel and drain?
travel with the cephalic and basilic veins and drain into associated lymph nodes
Where do lymphatics that travel with the cephalic vein primarily drain into first and thereafter? What about partial drainage?
apical axillary lymph nodes first before being drained by the subclavian lymphatic trunk
those that travel with the basilic vein partially drain into the cubital nodes located just superior to the medial epicondyle
From the cubital nodes, efferent lymph vessels travel to where along deep veins?
Hint: think in terms of the superficial lymphatic vessels
the humeral axillary nodes
Fill in the blanks:
The deep lymphatic vessels travel with deep veins in the upper limb, which first drain into ________, then _______, and finally _______, before being drained by the subclavian lymphatic trunk. ______ and _______ lymph nodes drain those respective regions of the upper limb.
The deep lymphatic vessels travel with deep veins in the upper limb, which first drain into humeral axillary nodes, then central axillary nodes, and finally apical axillary nodes, before being drained by the subclavian lymphatic trunk. Pectoral and subscapular axillary lymph nodes drain those respective regions of the upper limb.
MIDTERM MATERIAL T/F:
Humeral (lateral) axillary lymph nodes are the first to receive lymph from the upper limb. Therefore, any infection (lymphangitis) will be drained there first
TRUE!
MIDTERM MATERIAL:
What nodes receive lymph from the breast and are commonly biopsied when breast carcinoma is present?
pectoral nodes
Upper limb structures receive arterial blood supply from branches of the…..
hint: there are 5 arteries
subclavian, axillary, brachial, ulnar, and radial arteries
Describe the arterial supply flow
The subclavian, axillary and brachial arteries are continuous with one another, with the brachial artery bifurcating into the radial and ulnar arteries which later converge in the hand
MIDTERM MATERIAL:
The axillary artery is divided into how many parts that correspond to the position of the pectoralis minor?
3
What marks the transition from axillary to brachial arteries?
the inferior border of teres major
Upper limb structures are innervated by branches of the….
brachial plexus, a collection of anterior primary rami from C5–C8 and T1
What is the first major plexus? 2nd?
1= cranial plexus
2nd= brachial
What part of the brachial plexus gives rise to the main nerves?
the cords
What part of the brachial plexus gives rise to the divisions?
trunks
What are the 5 nerves of the brachial plexus?
1) musculocutaneous nerve
2) axillary
3) median
4) radial
5) ulnar
What are the 3 cords of the brachial plexus?
1) lateral
2) posterior
3) medial
What are the divisions of the brachial plexus?
anterior and posterior
What are the trunks of the brachial plexus?
upper, middle, lower
What are the roots (rami) of the brachial plexus?
C5 + C6 innervated to upper trunk
C7 innervated to middle trunk
C8 and T1 innervated to lower trunk
What is the brachial plexus divided into five parts from proximal to distal?
rami, trunks, divisions, cords, and terminal branches (nerves)
Cords and branches of the brachial plexus is contained within the…..
axilla
What are terminal branches regarding the brachial plexus?
Each cord terminates in two terminal branches. The median nerve (C5–C8, T1) is made up of the lateral and medial roots.
Where does the lateral cord of the brachial plexus divide into?
the lateral root of the median nerve and musculocutaneous nerve (C5–C7)
Where does the medial cord of the brachial plexus divide into?
the medial root of the medial nerve and ulnar nerve (C8–T1)
Where does the posterior cord of the brachial plexus divide into?
axillary (C5–C6) and radial (C5–C8, T1) nerves
Cutaneous innervation of the upper limb is
relayed primarily through branches of the…..
brachial plexus terminal nerves as well as supraclavicular (C3–C4) and intercostobrachial (T2) nerves
Postganglionic sympathetic fibers travel with branches to provide general visceral _______ and general visceral ______ innervation to upper limb structures.
afferent, efferent
Postganglionic sympathetic fibers travel with branches to provide general visceral afferent and general visceral efferent innervation to upper limb structures.
T/F:
Parasympathetic fibers do travel in the upper limb.
FALSE!!!!
What is the dermatome for supraclavicular nerve?
C3 and C4
What is the dermatome for lateral brachial cutaneous nerve?
C5 and C6
What is the dermatome for posterior brachial cutaneous nerve?
C5, C6, C7, C8
What is the dermatome for lateral antebrachial cutaneous nerve?
C6 and C7
What is the dermatome for radial nerve superficial branch/radial nerve?
C6, C7, C8
What is the dermatome for intercostobrachial nerve?
T12
What is the dermatome for medial brachial cutaneous nerve?
C8, T1
What is the dermatome for medial antebrachial cutaneous nerve?
C8, T1
What is the dermatome for posterior antebrachial cutaneous nerve?
C5, C6, C7, C8
What is the dermatome for ulnar nerve?
C8, T1
What is the dermatome for median nerve?
C6, C7, C8
The muscles of the upper limb are organized into specific compartments or regions. What are they?
shoulder, arm, forearm, and hand
What is the most proximal portion of the upper extremity?
shoulder region
What does the shoulder connect to?
upper limb and the trunk
Muscles of the shoulder complex include….
anterior and posterior axioappendicular muscles and intrinsic scapular muscles
What makes up the anterior axioappendicular muscles?
pectoral region
What makes up the superficial back muscles?
posterior axioappendicular muscles
Movements at the shoulder complex include….
elevation, depression, rotation, protraction and retraction of the scapula and flexion, extension, abduction, adduction, medial (internal) rotation, lateral (external) rotation, and circumduction of the humerus (arm)
What are the names of the anterior axioappendicular muscles?
1) pectoralis major
2) pectoralis minor
3) serratus anterior
4) subclavius
What are the names of the posterior axioappendicular muscles?
1) trapezius
2) latissimus dorsi
3) rhomboid major and minor
4) levator scapulae
What is the trapezius innervated by?
accessory nerve (cranial nerve XI)
What are the 3 parts of the trapezius muscle and what does each part do?
1) upper: elevates and rotates the scapula up
2) middle: retracts the scapula
3) lower: depresses and rotates the scapula up
What are the intrinsic axioappendicular (scapular) muscles?
1) deltoid
2) teres major
3) supraspinatus
4) infraspinatus
5) teres minor
6) subscapularis
What does the deltoid innervate?
the axillary nerve
What are the 3 regions of the deltoid and what does each part do?
1) anterior: flexes and medially rotates the arm
2) middle: main abductor of the arm
3) posterior: extends and laterally rotates the arm
What is teres major movement? What is it innervated by?
adducts and medially rotates the arm and assists in arm extension
innervated by the lower subscapular nerve
What is the supraspinatus movement and what is it innervated by?
initiates and assists in arm abduction
innervated by the suprascapular nerve
What is the infraspinatus movement and what is it innervated by?
laterally rotates the arm
innervated by the suprascapular nerve
What is the teres minor movement and what is it innervated by?
laterally rotates the arm
innervated by the axillary nerve
What is the subscapularis movement and what is it innervated by?
adducts and medially rotates the arm
innervated by the upper and lower subscapular nerves
MIDTERM MATERIAL:
What is a reliable landmark on males, but not females? Where is it?
the nipple can be found within the 4th intercostal space
MIDTERM MATERIAL:
What travels in the triangular space?
circumflex scapular artery
What travels in the quadrangular space?
the axillary nerve and the posterior humeral circumflex artery
What travels in the triangular interval (lower triangular space)?
profunda brachii artery and the radial nerve
The axilla is a…..
pyramid-shaped space that spans between the root of the neck and arm
MIDTERM MATERIAL:
What are the axilla boundaries?
1) anterior
2) posterior
3) medial
4) lateral
5) apex
6) base
What does the anterior axilla boundary include?
subclavius, pectoralis major and minor (anterior
axillary fold) muscles, and overlying fascia
What does the posterior axilla boundary include?
the scapula and subscapularis, latissimus dorsi,
and teres major (posterior axillary fold) muscles
What does the medial axilla boundary include?
the serratus anterior muscle and underlying ribs
What does the lateral axilla boundary include?
the intertubercular groove of the humerus
What does the apex axilla boundary include?
the superior border of the scapula, clavicle, and first
rib (cervicoaxillary canal)
What does the base axilla boundary include?
skin and axillary fascia
What is the main bone of the arm?
humerus
What does the humerus span?
between the shoulder (glenohumeral) and elbow (humeroradial, humeroulnar, and proximal radioulnar) joints
Brachial fascia divides the arm into….
anterior and posterior compartments
T/F:
Muscles of the arm cross both the shoulder and elbow joints; thus, some act at both joints
true!
Muscles of the arm ________ and ________ the arm and flex, extend, and ________ the forearm.
flex, extend, supinate
Muscles of the arm flex and extend the arm and flex, extend, and supinate the forearm.
The anterior arm muscles are primarily _______ of the forearm, but can also flex the arm.
The anterior arm muscles are primarily flexors of the forearm, but can also flex the arm.
All anterior compartment muscles are innervated by…..
the musculocutaneous nerve (C5–C7)
Branches from the brachial artery serve which compartment?
anterior arm
What are the 3 muscles a part of the anterior arm?
1) biceps brachii
2) coracobrachialis
3) brachialis
How many heads does the biceps brachii muscle have? Name the head(s)
two-headed muscle (short and long heads)
What are the functions of the biceps brachii muscle?
1) flex the arm
2) supinate the forearm and flex the forearm when it is supinated
3) resist anterior glenohumeral dislocation
Functions of coracobrachialis?
assists in flexion and adduction of arm and resists anterior glenohumeral dislocation
Which muscle is the primary flexor of the forearm (any position)?
brachialis
What 2 muscles are a part of the posterior arm?
1) triceps brachii
2) anconeus
Which muscles are the primary extensors of the forearm, but can also extend the arm?
posterior arm muscles
All posterior compartment muscles are innervated by the…..
radial nerve (C5–C8, T1)
Branches from the profunda brachii artery serve which arm compartment?
posterior arm
How many heads does the triceps brachii muscle have? Name the head(s)
three-headed muscle (long, lateral, and medial heads)
Function of triceps brachii?
extends the arm (long head) and the forearm
Function of anconeus
assists in terminal extension of the arm and stabilizes the elbow
Cutaneous innervation of the arm is mediated primarily by……
inferior lateral brachial cutaneous (from radial), medial brachial cutaneous, and posterior brachial cutaneous (from radial) nerves
What are the main dermatomes in the arm?
C5–C6 and T1–T2
What bones make up the forearm?
radius and ulna
What does the forearm span?
between the elbow and wrist
Antebrachial fascia divides the….
forearm into anterior and posterior compartments
Muscles of the forearm cross the…..
elbow, wrist, and hand joints; thus, some act at more than one joint
What are the functions of the forearm muscles?
flex, extend, pronate, and supinate the forearm; flex, extend, abduct (radial deviation), and adduct (ulnar deviation) the hand; and assist in flexion and extension of digits two through five and flexion, extension, and abduction of the first digit (thumb)
Anterior forearm muscles are primarily ______ of the hand and digits, but can also assist in flexion and pronation of the forearm
flexors
Anterior forearm muscles are primarily flexors of the hand and digits, but can also assist in flexion and pronation of the forearm
Anterior compartment muscles are primarily innervated by the……
median nerve (C5–C8, T1)
The ulnar nerve (C8–T1) innervates……
one and a half anterior forearm muscles
Branches from the radial and ulnar arteries serve which compartment?
anterior forearm
Anterior forearm muscles are divided into:
superficial, intermediate, and deep groups
What are the superficial forearm muscles?
1) pronator teres
2) flexor carpi radialis
3) palmaris longus
4) flexor carpi ulnaris
What are the functions of the intermediate forearm muscle?
assists in hand flexion and flexes the second through fifth proximal interphalangeal (PIP) and metacarpophalangeal (MCP) joints
What does the intermediate forearm innervate?
the median nerve
What are the deep forearm muscles?
1) flexor digitorum profundus
2) flexor pollicis longus
3) pronator quadratus
What are the superficial posterior forearm muscles?
1) brachioradialis
2) extensor carpi radialis longus
3) extensor carpi radialis brevis
4) extensor digitorum
5) extensor digiti minimi
6) extensor carpi ulnaris
What are the deep posterior forearm muscles?
1) supinator
2) outcropping muscles (just know its deep muscles)
2A) abductor pollicis longus
2B) extensor pollicis longus
2C) extensor pollicis brevis
2D) extensor indicis
What is the cubital fossa?
a triangular-shaped region on the anterior elbow surface
What are the cubital fossa boundaries?
bound medially by the pronator teres, laterally by the brachioradialis, and superiorly by an imaginary line through the medial and lateral epicondyles of the humerus
What is a common area for drawing blood samples?
cubital fossa
The main dermatomes in the arm are….
C5–C8 and T1
What is the distal most portion of the upper limb and is connected to the forearm at the wrist?
hand
The hand is made up of_____ rows of carpal bones, _____ metacarpals, and a total of _____ phalangeal bones
2, 5, 14
The hand is made up of 2 rows of carpal bones, 5 metacarpals, and a total of 14 phalangeal bones
The hand can be separated into three compartments. What are they?
1) thenar eminence (first digit muscular mass)
2) hypothenar eminence (fifth digit muscular mass)
3) central compartment
The deep fascia of the hand—palmar aponeurosis—covers the ______________ and further separates it from the thenar and hypothenar eminences
central compartment
The deep fascia of the hand—palmar aponeurosis—covers the central compartment and further separates it from the thenar and hypothenar eminences
Hand movements include……
flexion, extension, abduction, and adduction of the digits as well as opposition of the first and fifth digits
What represents the midline of the hand?
the third digit
MIDTERM MATERIAL:
Thumb abduction and adduction occur in the…….
sagittal plane when standing in anatomical position
MIDTERM MATERIAL:
Thumb extension and flexion occur in the….
frontal (coronal) plane when standing in anatomical position
