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xOSPE > Upper Limbs > Flashcards

Upper Limbs Flashcards

1
Q

What are the 8 carpal bones (2 rows from lateral to medial)?

A
  • 1st row: scaphoid, lunate, triquetrum, pisiform
  • 2nd row: trapezium, trapezoid, capitate, hamate

Straight line to pinky, here comes the thumb

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2
Q

What does the pectoralis major do, what is it innervated by and how do you test it?

A
  • Adducts, flexes and medially rotates the humerus
  • Innervation: medial and lateral pectoral nerve
  • Adduct against resistance with elbow flexed
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3
Q

What is the function of the pectoralis minor and what is it innervated by?

A
  • Stabilise the scapula

* Innervation: medial pectoral nerve

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4
Q

What is the function of the subclavius (part of the anterior chest wall)?

A

Stabilise and depress the clavicle

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5
Q

What is the function of the serratus anterior, what is it innervated by and how do you test it?

A
  • Laterally rotates the scapula and protracts the scapula against the ribcage
  • Long thoracic nerve
  • Ask the patient to push out their arm (medially against your hand) whilst you place your other hand on the posteriolateral aspect of their chest to feel the muscle
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6
Q

What happens if the long thoracic nerve is damaged?

A
  • Damaged nerve no longer allows the serratus anterior to hold the scapula in a protracted state against the ribcage
  • Allows the scapula to protrude
  • ‘Winged scapula’
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7
Q

What do the extrinsic shoulder muscles comprise?

A
  • Superficial: Latissimus dorsi, Trapezius

* Deep: Levator scapulae, Rhomboid major, Rhomboid minor

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8
Q

What is the function of the latissimus dorsi and trapezius?

A
  • Latissimus dorsi - Extend, adduct and medially rotate the upper limb
  • Trapezius - elevate and rotate, retract and depress the scapula
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9
Q

What nerves innervate the latissimus dorsi and trapezius?

A
  • Latissimus dorsi - Long scapular nerve

* Trapezius - Accessory nerve (XI)

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10
Q

What is the function of the levator scapulae, rhomboid major and rhomboid minor?

A
  • Levator scapulae - elevation of the scapula
  • Rhomboid major - retracts and medially rotates the scapula
  • Rhomboid minor - retracts and medially rotates the scapula
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11
Q

Which nerves innervate the levator scapulae, rhomboid major and rhomboid minor?

A
  • Levator scapulae - Dorsal scapular nerve
  • Rhomboid major - Dorsal scapular nerve
  • Rhomboid minor - Dorsal scapular nerve
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12
Q

What do the intrinsic shoulder muscles comprise (for the purpose of the OSPE)?

A 
• Deltoid
• Teres major
• Rotator cuff muscles: 
- Subscapularis
- Supraspinatous
- Infraspinatous
- Teres minor
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13
Q

What is the function of the deltoid and teres major?

A
  • Deltoid - abducts the arm

* Teres major - adducts, retracts and medially rotates the humerus

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14
Q

What are the functions of the rotator cuff muscles

A
  • Subscapularis - medially rotates the arm
  • Supraspinatous - abducts the humerus
  • Infraspinatous - laterally rotates the arm
  • Teres minor - laterally rotates the humerus
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15
Q

Which nerves innervate the deltoid, teres major and rotator cuff muscles?

A
  • Deltoid - axillary nerve
  • Teres major - lower subscapular nerve
  • Subscapularis - upper and lower subscapular nerves
  • Supraspinatous - suprascapular nerve
  • Infraspinatous - suprascapular nerve
  • Teres minor - axillary nerve
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16
Q

How do you test the supraspinatous, infraspinatous and teres minor simultaneously and what movement is this?

A

Lateral rotation and abduction

  • Ask patient to put arms behind neck
  • Apply resistance
  • Palpate rotator cuff muscles
17
Q

How do you test the teres major and subscapularis simultaneously and what movement is this?

A

Medial rotation, adduction and retraction of the upper arm

  • Ask patient to put hands as far up behind their back as possible
  • Apply resistance
  • Palpate rotator cuff muscles
18
Q

What are the anterior muscles of the arm and their functions?

A
  • Biceps brachii - superficial flexor and main supinator of forearm
  • Brachialis - main flexor of the forearm
  • Coracobrachialis - assists in flexion and adduction of humerus
19
Q

Which nerves innervate the anterior muscles of the arm (and what is the main artery)?

A
  • All innervated by the musculocutaneous nerve (C5, 6, 7)
  • Brachialis has some innervation from the radial nerve (C5-T1)
  • Brachial artery
20
Q

What is the posterior muscle of the arm and its function?

A

Triceps brachii - extension of the forearm

21
Q

Which nerves innervate the superficial muscles of the anterior compartment of the forearm?

A

All median nerve, except FCU - ulnar nerve

22
Q

Which nerve innervates the intermediate layer of muscle of the anterior forearm (flexor digitorum superficialis)?

A

Median nerve

23
Q

Which nerves innervate the deep muscles of the anterior compartment of the forearm?

A
  • FPL - median nerve
  • FDP - ulnar nerve (medial 2 tendons) + median nerve (lateral 2 tendon)
  • PQ - median nerve
24
Q

What are the superficial, intermediate and deep muscles of the anterior compartment of the forearm?

A
  • Pronator teres
  • FCR
  • FCU
  • Palmaris longus

• Flexor digitorum superficialis

  • Flexor pollicis longus
  • Flexor digitorum profundus
  • Pronator quadratus
25
Q

What are the borders of the anatomical snuffbox?

A
  • Medial - tendon of ‘Extensor pollicis longus’
  • Lateral - tendons of ‘Extensor pollicis brevis’ and ‘Abductor pollicis longus’
  • Floor - scaphoid and trapezium bone
26
Q

What are the superficial muscles of the posterior compartment of the forearm (beginning laterally)?

A
  • Brachioradialis
  • Extensor carpi radialis longus
  • Extensor carpi radialis brevis
  • Extensor digitorum
  • Extensor digiti minimi
  • Extensor carpi ulnaris
  • Anconeus
27
Q

What are the deep muscles of the posterior compartment of the forearm (beginning laterally)?

A
  • Supinator
  • Abductor pollicis longus
  • Extensor pollicis brevis
  • Extensor pollicis longus
  • Extensor indicis
28
Q

Which nerve innervates the posterior muscles of the forearm?

A

Radial nerve

29
Q

What are the intrinsic muscles of the hand and what are they innervated by?

A
  • Interossei (flex MCP, extend IP) - ulnar nerve
  • Lumbricals (flex MCP, extend IP) - median nerve (2 + 3) and ulnar nerve (4 + 5)
  • Thenar muscles (flexor pollicis brevis, abductor pollicis brevis, opponens pollicis) - median nerve (recurrent branch)
  • Hypothenar muscles (flexor digiti minimi brevis, abductor digiti minimi, opponens digiti minimi) - ulnar nerve (deep branch)
  • Adductor pollicis - ulnar nerve
30
Q

Which nerve innervates the SCM?

A

Accessory nerve (XI)

31
Q

If there is damage of the ulnar nerve at the wrist, you get ‘ulnar claw’. What is this and why does this occur?

A

• Loss of interossei muscles (normally flex MCP and extend IP joints)
=> hyperextension of MCP joints
=> flexion of IP joints
• Intact lumbricals of 2+3 (median) - extension maintained
• Lost lumbricals of 4+5 (normally flex MCP and extend IP joints)
=> extension lost in 4+5
=> greater flexion in 4+5 by flexor digitorum profundus possible

32
Q

The biceps reflex tests which nerve segments?

A

C5, C6 (musculocutaneous)

33
Q

Which artery supplies the posterior compartment of the arm?

A

Profunda brachii artery (branch of brachial artery)

34
Q

The triceps reflex tests which nerve segments?

A

C7, 8 (radial nerve)

xOSPE (7 decks)

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