Upperlimb Flashcards
Brachialis
Origin:
Lower half of anterior surface of humerus
Insertion
On anterior surface of coronoid process of ulna including ulnar tuberosity.
Nerve
Mostly musculocutaneous nerve and also by radial nerve in lateral
Action
Flexion of forearm in all positions
Biceps brachii
Origin
Long head: from supraglenoid tubercle of scapula
Short head:from Coracoid process of scapula.
Insertion
Both head join to form a belly and the tendon attached to posterior part of radial tuberosity.
Nerve
Musculocutaneous nerve.
Action
Supination of forearm when elbow is flexed
Flexion of forearm when elbow is extended
Parts of deltoid
Anterior unipinnate part
Posterior unipinnate part
Middle multipinnate part
Origin of deltoid
Anterior part: upper and anterior border of lateral 1/3rd of clavicle
Middle part: Lateral margin of acromion
Posterior part: lower lip of crest of spine of scapula
Insertion of deltoid
Deltoid tuberosity of humerus
Nerve supply of deltoid
Axillary nerve
Root value of axillary nerve
C5 and C6
Action of deltoid
Anterior unipinnate: Flexion and medial rotation
Posterior unipinnate: extension and lateral rotation
Middle(acromial fibre): abduction of arm from 15 to 90
Intramuscular injection in the deltoid
It should be given in the lateral aspect of deltoid 2.5-5 cm below acromion process to avoid injury to axillary nerve.
Anconeus
Origin
From the back of lateral epicondyle by a separate tendon other than common extensor tendon
Insertion
Lateral side of olecranon process and upper fourth of posterior surface of ulna
Nerve
Nerve to anconeus
Action
Weak extensor of elbow joint
Origin of triceps brachii
Long head: infraglenoid tubercle
Lateral head: Above spiral groove in the posterior part of shaft of humerus.
Medial head: below spiral groove in the posterior part of shaft of humerus.
Insertion of triceps
Posterior part of superior surface of olecranon process of ulna
Nerve supply of triceps
Radial nerve
Nerve to long head arises from radial nerve in axilla
Nerve to lateral head arises from radial nerve in radial groove
Nerve to medial head arises from radial nerve in radial groove through nerve to anconeus
Action of triceps
Powerful extensor of elbow joint
Injury to radial nerve in radial groove
Extension of elbow and triceps reflex not completely lost because nerve to long head arises from radial nerve in axilla.
Supinator
Origin
Supinator crest of ulna
Insertion
Upper 1/3rd of lateral surface of radius
Nerve
Radial nerve and posterior interosseus nerve
Action
Supination of forearm
Serattus anterior
Origin
A series of eight digitations
First digitation arise from first and second ribs
All other digitation arise from corresponding ribs
Insertion
Costal surface of scapula along medial border.
First digitation - superior angle
Next two- medial border
Lower five- inferior angle of scapula
Nerve
Long thoracic nerve
Action
Powerful protractor of scapula
Winging of scapula
Paralysis of serratus anterior due to injury to long thoracic nerve.
Protraction of scapula for punching is weakened.
Inferior angle and medial border of scapula becomes unduly prominent when the person pushes against the wall. This condition is called winging of scapula.
Supraspinatus
Origin
Supraspinatus fossa
Insertion
Superior facet of greater tubercle of humerus
Nerve
Suprascapular nerve
Action
Initiates abduction of arm up to 15
Pronator quadratus
Origin
Lower 1/4th of anterior surface of ulna
Insertion
Lower 1/4th of anterior surface of radius
Nerve
Anterior interosseous nerve
Action
Chief pronator of forearm
Course of cephalic vein
It starts from lateral part of dorsal venous arch of hand.
It crosses the roof of anatomical snuff box.
Passes upward through radial part of forearm.
passes lateral border of biceps brachii.
Finally pierces the deep fascia exactly at the lower border of pectoralis major.
It passes through the deltopectoral groove till infraclavicular fossa.
It the pierces clavipectoral fascia and drains to first part of axillary vein to form subclavian vein.
How blood from cephalic vein reach basilic vein
A large amount of blood is shunted to basilic vein through median cubical vein.
Cephalic vein is accompanied by
Lateral cutaneous nerve of forearm
Speciality of cephalic vein
It is known as preaxial vein of upper limb and corresponds to great saphenous vein of lower limb
Course of basilic vein
Starts at medial border of dorsal venous arch.
Passes through back of medial part and then enters the anterior part of forearm and moves above through medial border of biceps.
It pierces the deep fascia and opens to brachial veins to become continuous with axillary vein at lower border of trees major.
Which nerve is preferred for cardiac catheterisation
Basilic vein
Origin of palmaris longus
Medial epicondyle of humerus by common flexor origin
Insertion of palmaris longus
It passes superficial to flexor retinaculum and terminates in palmar aponeurosis
Nerve of Palmaris longus
Median nerve
Action of palmaris longus
It flexes wrist and makes palmar aponeurosis tense
Where is palmar interissei attached
Metacarpal bones
Palmar interossei helps in
Adduction of fingers
Palmar interossei uni or bipinnate
Unipinnate
Origin and insertion of first palmar interossei
Origin
Medial aspect of first metacarpal
Insertion
Medial aspect of proximal phalanx of thumb and dorsal digital expansion
2nd palmar interossei
Origin
Medial aspect of 2nd metacarpal
Insertion
Medial part of proximal phalanx and dorsal digital expansion
3rd palmar interossei
Origin
Lateral aspect of fourth metacarpal
Insertion
Proximal phalanx and dorsal digital expansion of ring finger
4th palmar interossei
Origin
Lateral aspect of 5th metacarpal
Insertion
Proximal phalanx and dorsal expansion of little fingers
Additional muscle which helps to adductor the thumb
Adductor pollicis
It has oblique head which arises from second and third metacarpal
And transverse head which arises from third metacarpal.
Nerve supply of palmar interossei
Deep branch of ulnar nerve
All dorsal interossei are uni or bipinnate
Bipinnate
Dorsal interossei helps in
Abduction
Dorsal interossei helps in
Abduction
Dorsal interossei helps in
Abduction
1st dorsal interossei
Origin
Adjacent sides of first and second metacarpal
Insertion
Lateral side of proximal phalanx and dorsal digital expansion of index finger
2nd interossei
Origin
From adjacent side of 2nd and 3rd metacarpal
Insertion
Lateral aspect of proximal phalanx and dorsal digital expansion of middle finger
3rd dorsal interossei
Origin
From adjacent sides of 3rd and 4th metacarpal
Insertion
Medial aspect of proximal phalanx and dorsal digital expansion of middle finger
4th dorsal interossei
Origin
Adjacent side of 4th and 5th metacarpal
Insertion
Medial aspect of proximal phalanx and dorsal digital expansion of ring finger
Origin of lumbricals
Lumbricals 1 and 2
Unipinnate
Lateral side of lateral two tendons of fdp
Lumbricals 3 and 4
Bipinnate
Adjacent sides of medial 3 tendons of fdp
Insertion of lumbricals
The tendon cross metacarpophalangeal joint and attach to lateral part of dorsal digital expansion of corresponding digits from 2 to 5
Nerve supply of lumbricals
First 2 lumbricals is by median nerve
3 and 4 lumbricals by deep branch of ulnar nerve
Anatomical snuff box
Posterolateraly
Tendon of abductor pollicis longus
Tendon of extensor pollicis brevis
Posteromedially
Tendon of extensor pollicis longus
Floor: scaphoid and trapezium
Roof: skin and superficial fascia
Content: Radial artery
Pulsation of radial artery can be felt in snuff box
Boundaries of cubital fossa
Laterally
Medial boundary of brachioradialis
Medially
Lateral boundary of pronator trees
Base
Imaginary line joining the epicondyle of humerus
Apex
Meeting point
Floor
Brachialis above and Supinator below
Roof
Deep fascia and bacipital aponeurosis in the medial side
Contents of cubital fossa
MBBS
From medial to lateral
Median nerve
Brachial artery
Tendon of biceps brachii
Superficial branch of radial nerve
Applied aspect of cubital fossa
Median cubital vein for IV and blood samples
Brachial pulse
Root value of musculocutaneous nerve
C5 C6 C7
Musculocutaneous nerve continues as
Lateral cutaneous nerve of forearm
Musculocutaneous nerve continues as
Lateral cutaneous nerve of forearm
Musculocutaneous nerve continues as
Lateral cutaneous nerve of forearm
Origin of axillary artery
Outer part of first rib as a continuation of subclavian artery
Origin of axillary artery
Outer part of first rib as a continuation of subclavian artery
Origin of axillary artery
Outer part of first rib as a continuation of subclavian artery
Termination of axillary artery
By becoming brachial artery at lower border of there major
Termination of axillary artery
By becoming brachial artery at lower border of there major
How is axilary artery divided
Into 3 parts by pectoralis minor
First part superior to muscle
Second part posterior to muscle
Third part inferior to muscle
First part : superior thoracic artery
Second part: lateral thoracic artery and thoracic acromial artery
Third part: subscapular anterior and posterior circumflex numeral.
