Upper Limb MSK Flashcards

1
Q

Name the 5 superficial back muscles.

A
  1. Trapezius
  2. Latissimus dorsi
  3. Leavator scapuli superioris
  4. Rhomboid minor
  5. Rhomboid major
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2
Q

What is the innervation of trapezius?

A

Cn 11 - accessory

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3
Q

What is the action of trapezius?

A

Elevates the scapula and rotates it during abduction of the arm.

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4
Q

Which rhomboid muscle lies most superiorly?

A

Rhomboid minor lies superior to major.

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5
Q

Name the 4 rotator cuff muscles

A
  1. Supraspinatus
  2. Infraspinatus
  3. Subscapularis
  4. Teres minor
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6
Q

What is the function of the rotator cuff muscles?

A

To give the shoulder joint additional stability.

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7
Q

Where do the rotator cuff muscles originate from and insert?

A

Origin: scapula, insertion: humeral head.

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8
Q

What is the function of deltoid?

A

To abduct, flex and extend the arm.

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9
Q

What are the 3 heads of the triceps?

A
  1. Long head (most medial).
  2. Lateral head.
  3. Medial head.
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10
Q

What is the innervation of triceps?

A

The radial nerve.

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11
Q

What is the action of teres minor?

A

External rotation.

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12
Q

What is the action of subscapularis?

A

Internal rotation.

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13
Q

What is the innervation of the deltoid muscle?

A

Axillary nerve.

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14
Q

What is the function of latissiums dorsi?

A

Adduction!

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15
Q

What is the action of triceps?

A

Extension of the forearm.

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16
Q

What is the axilla?

A

An area underneath the shoulder joint at the junction between the upper limb and thorax.

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17
Q

Name 5 things contained wihin the axilla.

A
  1. Fat.
  2. Lymph nodes.
  3. Axillary artery.
  4. Axillary vein.
  5. Brachial plexus.
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18
Q

What spinal nerve roots form the brachial plexus?

A

C5 - T1.

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19
Q

What are divisions of the brachial plexus?

A

Roots -> Trunk -> Divisions (anterior and posterior) -> Cords -> Branches.

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20
Q

What are the 5 main branches of the brachial plexus?

A
  1. Musculocutaneous.
  2. Axillary.
  3. Median.
  4. Radial.
  5. Ulnar.
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21
Q

What are the nerve roots for the musculocutaneous branch?

A

C5, 6, 7.

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22
Q

What muscle does the musculocutaneous nerve enter?

A

Coracobrachialis.

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23
Q

What are the nerve roots for the axillary branch?

A

C5, 6.

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24
Q

What are the nerve roots for the median branch?

A

C6, 7, 8, T1.

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25
Q

What are the nerve roots for the radial branch?

A

C5, 6, 7, 8, T1.

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26
Q

What are the nerve roots for the ulnar branch?

A

C8, T1.

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27
Q

What are the names of the 3 trunks of the brachial plexus?

A
  1. Superior trunk.
  2. Middle trunk.
  3. Inferior trunk.
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28
Q

What nerve roots contribute to the superior trunk?

A

C5, C6.

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29
Q

What nerve roots contribute to the middle trunk?

A

C7.

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30
Q

What nerve roots contribute to the inferior trunk?

A

C8, T1.

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31
Q

What are the names of the 3 cords of the brachial plexus?

A
  1. Lateral cord.
  2. Posterior cord.
  3. Medial cord.
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32
Q

What does the musculocutaneous nerve give motor innervation to?

A

Anterior flexors - brachialis, biceps brachii and coracobrachialis - BBC.

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33
Q

What does the musculocutaneous nerve give sensory innervation to?

A

Lateral forearm.

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34
Q

What does the axillary nerve give motor innervation to?

A

Abductors of the arm at the shoulder - teres minor, long head of triceps and deltoid.

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35
Q

What does the axillary nerve give sensory innervation to?

A

Innervates the skin over the lower deltoid.

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36
Q

What would be the effect of damage to the axillary nerve?

A

Unable to abduct the arm 15-90 degrees. Loss of sensation over the lower deltoid region.

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37
Q

What does the median nerve give sensory innervation to?

A

Lateral palm of the hand and the lateral 3.5 fingers.

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38
Q

What does the median nerve give motor innervation to?

A

Flexors in the anterior forearm, the thenar muscles and the lateral two lumbricals in the hand.

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39
Q

What does the radial nerve give motor innervation to?

A

Triceps brachii, responsible for extension at the elbow. It also innervates extensor muscles in the posterior compartment of the forearm.

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40
Q

What does the radial nerve give sensory innervation to?

A

Skin on the posterior side of the forearm and the posterior aspect of the hand.

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41
Q

What does the ulnar nerve give sensory innervation to?

A

Medial 1.5 fingers and the medial palm.

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42
Q

What does the ulnar nerve give motor innervation to?

A

Muscles of the hand, flexor carpi ulnaris (flexes and adducts the hand at the wrist) and medial half of the flexor digitorum profundus (flexes the fingers).

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43
Q

What is the cubital fossa?

A

An area of transition between the arm and forearm

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44
Q

What is the action of brachialis?

A

Flexion of the elbow joint.

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45
Q

Biceps brachii: what is the origin of the short head?

A

Coracoid process of the scapula

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46
Q

What is the action of biceps?

A

Flexion of the elbow joint and supination of the forearm.

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47
Q

Name 3 nerves closely related to the humerus.

A
  1. Radius.
  2. Ulnar.
  3. Axillary.
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48
Q

What is the main muscle to abduct the shoulder 0-15 degrees?

A

Supraspinatus.

49
Q

What is the main muscle to abduct the shoulder 15-90 degrees?

A

Deltoid.

50
Q

What are the main muscle(s) that abduct the shoulder greater than 90 degrees?

A

Trapezius and serratus anterior.

51
Q

Name 4 superficial muscles in the anterior compartment of the forearm?

A
  1. Pronator teres.
  2. Flexor carpi radialis.
  3. Palmaris longus.
  4. Flexor carpi ulnaris.
52
Q

What nerve innervates flexor carpi ulnaris?

A

Ulnar nerve (C8-T1).

53
Q

What is the action of flexor carpi ulnaris?

A

Flexion and adduction at the wrist.

54
Q

What nerve innervates palmaris longus?

A

Median nerve (C6-T1)

55
Q

What is the action of palmaris longus?

A

Flexion at the wrist.

56
Q

What nerve innervates flexor carpi radialis?

A

Median nerve (C6-T1)

57
Q

What is the action of flexor carpi radialis?

A

Flexion and abduction at the wrist.

58
Q

What nerve innervates pronator teres?

A

Median nerve (C6-T1).

59
Q

What artery is the brachial artery a continuation of?

A

The axillary artery.

60
Q

What arteries does the brachial artery branch into?

A

The radial and ulnar arteries.

61
Q

Name 3 deep muscles in the anterior compartment of the forearm.

A
  1. Flexor digitorum profundus.
  2. Flexor pollicis longus.
  3. Pronator quadratus.
62
Q

What is the action of flexor digitorum profundus?

A

It flexes the interphalangeal joints and the metacarphophalangeal joints.

63
Q

What is the action of flexor pollicis longus?

A

It flexes the interphalangeal joints and the metacarphophalangeal joints of the thumb.

64
Q

What is the action of pronator quadratus?

A

It pronates the forearm.

65
Q

What are the 3 main groups of bones in the hand?

A
  1. Carpal bones.
  2. Metacarpals.
  3. Phalanges.
66
Q

How many phalanges does each finger have?

A

3.

67
Q

How many phalanges does the thumb have?

A

2.

68
Q

How many carpel bones are there? What are they?

A

8.
Scaphoid, Lunate, Triquetrum, Pisiform, Trapezium, trapezoid, Capiate, Hamate
(Some Lovers Try Positions That They Can’t Handle)

69
Q

Why is the skin of the palm adherent to the underlying connective tissue?

A

To prevent the skin from slipping off the hand whilst gripping.

70
Q

What is the carpal tunnel?

A

A space between the flexor retinaculum and the carpal bones.

71
Q

What structures pass through the carpal tunnel?

A

Flexor tendons - Flexor Digitorum and Superficialis, Flexor Pollicus Longus and Median nerve

72
Q

What is the cause of carpal tunnel syndrome?

A

Swelling of the tendons increases the pressure in the tunnel and compresses on the median nerve.

73
Q

What arteries form the superficial palmar arch?

A

The ulnar artery and a small contribution from the radial artery.

74
Q

What intrinsic hand muscles are innervated by the median nerve?

A

The 3 thenar muscles and the lateral 2 lumbricles.

75
Q

Where are the thenar muscles located?

A

At the base of the thumb.

76
Q

What is the action of the thenar muscles?

A

Fine movements of the thumb.

77
Q

Name the 3 thenar muscles.

A
  1. Abductors pollicis brevis.
  2. Flexor pollicis brevis.
  3. Opponens pollicis.
78
Q

Where do the abductors pollicis brevis and flexor pollicis brevis insert?

A

The lateral aspect of the 1st phalanx of the thumb.

79
Q

What is the action of opponens pollicis?

A

It opposes the thumb by medially rotating and flexing the metacarpal

80
Q

Where are the hypothenar muscles attached?

A

The little finger. They are mirror images of the thenar muscles.

81
Q

What nerve innervates the hypothenar muscles?

A

The deep branch of the ulnar nerve.

82
Q

Name the 3 hypothenar muscles.

A
  1. Abductor digiti minimi.
  2. Flexor digiti minimi.
  3. Opponens digiti minimi.
83
Q

How many lumbrical muscles are there in each hand?

A

4 - each associated with a finger.

84
Q

What is the innervation to the lumbrical muscles.

A
  • The medial 2 = deep branch of ulnar nerve.

- The lateral 2 = median nerve.

85
Q

What is the origin of the lumbricals?

A

The flexor digitorum profundus tendon.

86
Q

What is the action of the lumbricals?

A

Flexion of the metacarphophalangeal joint and extension of the interphalangeal joints.

87
Q

What covers the flexor tendons?

A

A fibrous flexor sheet that fans out into synovial sheaths.

88
Q

What is the importance of the synovial sheath that covers the flexor tendons?

A

It reduces friction in flexion and extension.

89
Q

What is the innervation to the interossei muscles?

A

The deep branch of the ulnar nerve.

90
Q

What is the action of the dorsal interossei muscles?

A

They abduct the fingers at the MCP Joint, Innervated by the Ulnar Nerve ON THE BACK OF THE HAND

PAD, DAB

91
Q

What is the action of the Palmar interossei muscles?

A

they adduct the fingers at the MCP joint, also innervated by the ulnar nerve THEY pull their respective finger towards the middle finger (medially) ON THE PALM,

PAD, DAB

92
Q

Which muscles in the forearm are supplied by the ulnar nerve?

A
  • Flexor carpi ulnaris.

- Medial flexor digitorum profundus.

93
Q

Define pronation.

A

Turning the hand so the palm is facing down.

94
Q

Define supination.

A

Turning the hand so the palm is facing up.

95
Q

Which muscles are responsible for pronation?

A

Pronator teres and pronator quadratus.

96
Q

What nerve innervates the muscles of the posterior compartment of the forearm?

A

The radial nerve.

97
Q

What are muscles of the posterior compartment of the forearm commonly known as?

A

Extensors - their general function is to produce extension at the wrist and fingers.

98
Q

What is the action of brachioradialis?

A

Flexion at the elbow.

99
Q

Where do the tendons of extensor carpi radialis longus and brevis insert?

A

The metacarpal bones 2 and 3.

100
Q

What is the action of extensor digitorum?

A

Extension of the medial four fingers at the MCP and IP joints.

101
Q

What is the action of extensor digiti minimi?

A

Extension of the little finger.

102
Q

What is the action of extensor carpi ulnaris?

A

Extension and adduction of the wrist.

103
Q

What tendons forms the lateral wall of the anatomical snuffbox?

A
  1. Extensor pollicis brevis.

2. Abductor pollicis longus.

104
Q

What tendon forms the medial wall of the anatomical snuffbox?

A

Extensor pollicis longus.

105
Q

What bone forms the floor of the anatomical snuffbox?

A

Scaphoid.

106
Q

What artery, nerve and vein lie in the anatomical snuffbox?

A
  • Radial artery.
  • Branch of the radial nerve.
  • Cephalic vein.
107
Q

What are the movements of the elbow joint?

A
  1. Extension of triceps brachii.

2. Flexion of brachialis, biceps brachii and brachioradialis.

108
Q

What is the dermatome of the thumb?

A

C6.

109
Q

What is the dermatome of the middle and index fingers?

A

C7.

110
Q

What is the dermatome of the ring and little fingers?

A

C8.

111
Q

What does the head of the radius articulate with?

A

The capitulum of the humerus.

112
Q

Contraction of the triceps will result in what action at the elbow?

A

Extension.

113
Q

What nerve are muscles of the anterior forearm innervated by? What are the two exceptions?

A

All but two are innervated by the Median Nerve, except the Flexor Digitorum Profundus and the Flexor Carpi ulnaris (they are both innervated by the ulnar nerve)

114
Q

Where do pretty much all of the anterior flexor muscles of the forearm originate?

A

MEDIAL epicondyle of the Humerus (AM)

115
Q

Where do pretty much all of the posterior extensor muscles of the forearm originate?

A

LATERAL epicondyle of the Humerus (PEL)

116
Q

What artery mainly provides the Deep perfusion of the palm of the hand?

A

The radial artery

117
Q

What structures does the cubital fossa contain?

A

Mnemonic for contents of the cubital fossa – Really Need (radial nerve) Beer To (biceps tendon) Be At (brachial artery) My Nicest (median nerve).

118
Q

Briefly describe venous drainage up the arm

A

Starts with - Cephalic vein on the Thumb /Lateral side and Basilic vein on the Medial/Pinkie side, ==> Join to from the Axillary Vein at the Antecubital Fossa, ==> Subclavian vein ==> Internal Jugular vein ==> SVC

119
Q

What passes through the quadrangular space? (the space between the Humerus head and Long head of the triceps, and Teres Major and Minor)

A

The Axillary nerve and the circumflex humeral artery and vein.