UPPER LIMB

Question 1

pec major

Answer 1

origin: ant surface of medial half clavicle
ant surf,lat part of sternum
2-6 costal cartilages
aponeurosis of external oblique
insertion: lateral lip of bicipital groove

nerve:medial and lateral pectoral nerve

action:adduction, medial rotation, flexion ( at shoulder joint)

Question 2

pec minor

Answer 2

origin:3,4,5 ribs

insertion: medial margion,superior surface of coracoid process

nerve: medial(pierces) and lateral pectoral nerve

action:protraction of scapula with serratus ant
depresses shoulder

Question 3

subclavius

Answer 3

origin:junction of first rib and costal cartilage
insertion:inferior surface of the middle third of clavicle
nerve: subclavius nerve
action:steadies clavicle during shoulder joint movement

Question 4

serratus anterior

Answer 4

origin:8 fleshy digitations from outer surfaces of upper 8 ribs
insertion:medial border of scapula
nerve:long thoracic nerve
action:protraction of scapula(punching)
Clinical Aspect:
Paralysis of the serratus anterior muscle after an injury to the long thoracic nerve, or during removal of the breast tumor leads to:
1. Weakened protraction of the scapula
2. Winging of the scapula. Inferior angle and medial border become prominent when pushing hands against wall.

Question 5

clavipectoral fascia*

Answer 5

enclose:
superiorly: subclavius
inferiorly: pec.minor and cont as suspensory ligament of axilla
medially;1st rib
laterally: coracoid process

pierced by: CALL
cephalic vein
acromiothoracic vessel(thoraco-acromial)
lymphatics to apical nodes
lat.pec nerve

Question 6

polands syndrome

Answer 6

hypoplasia of chest wall muscles
ipsilateral hypoplasia of arm and hand
clinical:
sternocostal head of pec major and pec minor absent
may have absence of nipple areolar complex

Question 7

trapezius

Answer 7

nerve: ventral rami c3,c4
action:
upper fibers:elevates scapula
middle fibers:retract scapula
upper+lower+ serratus ant:rotatae scapula for overhead abduction at shoulder joint

Question 8

latissimus dorsi

Answer 8

nerve: posterior cord brachial.p
action:extension,medial rotation at glenohumoral joint
adduction and climbing at shoulder joint

Question 9

rhomboideus minor and major

Answer 9

nerve: c5
action: retract scapula

Question 10

levator scapulae

Answer 10

Scapulothoracic joint: Draws scapula superomedially, rotates glenoid cavity inferiorly;
Cervical joints: Lateral flexion of neck (ipsilateral), extension of the neck
nerve:ventral rami of the nerves C3 and C4, dorsal scapular nerve

Question 11

supraspinatus

Answer 11

origin: medial 2/3 of supraspinous fossa
insertion:upper psrt of greater tubercle of humerus
nerve: suprascapular nerve
action:initiates abduction at shoulder joint(15 degrees)

Question 12

infraspinatus

Answer 12

origin: medial2/3 infraspinatus fossa
insertion: middle part of greater tubercle
nerve: suprascapular nerve
action:lateral rotation at shoulder joint

Question 13

teres minor

Answer 13

origin: upper 2/3 lateral border scapula
insertion: lowest part of greater tubercle
nerve: axillary nerve
action: lateral rotation at shoulder joint

Question 14

teres major

Answer 14

origin: lower 1/3 of lateral border scapula
insertion: medial lip of bicipital groove
nerve: lower subscapular nerve
action:medial rotation and adduction at shoulder joint

Question 15

subscapularis

Answer 15

origin: medial 2/3 of subscapular fossa
insertion: lesser tubercle
nerve: upper and lower subscapular nerves
action:medial rotation and adduction at shoulder joint

Question 16

rotator cuff muscles (SITS)

Answer 16

supraspinatus
infraspinatus
teres minor
subscapularis

Question 17

deltoid

Answer 17

origin:
ant fibers: anterior border,lateral 1/3 clavicle
middle fibers: lat margion acromion process
post.fibers: lower lip of crest of spine (scapula)
insertion: V shape deltoid tuberosity on humerus
nerve: axillary nerve
action:
ant: flexion and medial rotation
middle:abduct arm(15-90)
post: extension and lateral rotation

Question 18

quadrangular space

Answer 18

above: teres minor
below:teers major
medial:long head tricepss
lateral: surgical. neck humerus
passing through:axillary nerve, posterior circumflex humeral vessels

Question 19

upper triangular space

Answer 19

above: teres minor
below:teres major
lateral:long head triceps
passing through: circumflex scapular artery

Question 20

lower triangular space

Answer 20

above:teres major
medial: long head triceps
lateral:humerus shaft
passing through: radial nerve,profunda brachii vessels

Question 21

gently pricking on skin over deltoid to test?

Answer 21

fracture of surgical neck-> axillary nerve injury-> loss of abduction-> sensory loss over deltoid muscle (upper lateral cutaneous nerve)

Question 22

biceps brachii

Answer 22

origin:
short head:tip of coracoid process
long head:supraglenoid tubercle

insertion: form bicipital aponeurosis and insert at radial tuberosity

nerve: musculocutaneous n

action: strong supinator when forearm is flexed,flex at elbow joint, short head flex arm

Question 23

corachobrachialis

Answer 23

origin: tip of coracoid process
insertion:middle mrdial surface humerus
nerve: musculocutaneous nerve
action:weak flexor of arm

Question 24

brachialis

Answer 24

origin:lower part of humerus shaft
insertion:coronoid process and ulnar tuberosity
nerve: musculocutaneous nerve and radial nerve on the lateral part
action: weak flexion of forearm

Question 25

brachial artery

Answer 25

beginning: from axillary artery
extent: lower border teres major- neck of radius
termination: divide into radial and ulnar arteries

Question 26

triceps brachii

Answer 26

origin:
long head:infraglenoid tubercle
medial head:posterior syrface humerus below radial groove
lateral head:lateral lip of radial groove
insertion:posterior,superior surface olecranon process
nerve:radial nerve
action: powerful extensor

Question 27

anterior compart forearm
superficial-PFPFF
deep-FFP

Answer 27

palmaris longus
flexor carpi radialis
pronator teres
flexor carpi ulnaris
flexor digitorum superficialis

flexor digitorum profundus
flexor pollices longus
pronator quadratus

Question 28

posterior compart
superficial- ABE5
deep- SAE3

Answer 28

anconeus
brachioradialis
ext.carpi radialis longus
ext.carpi radialis brevis
ext.carpi ulnaris
ext.digitorum
ext.digiti minimi

supinator
abductor pollicis longus
ext.pollicis longus
ext.pollicis brevis
extensor indicis

Question 29

Flexion

Answer 29

Anterior fibres of deltoid
clavicular fibres of pectoralis major

Question 30

Extension

Answer 30

Posterior fibres of deltoid
teres major

Question 31

Medial Rotation

Answer 31

Anterior fibres of deltoid
Pectoralis Major
Teres Major
Subscapularis
Latissimus dorsi

Question 32

Lateral Rotation

Answer 32

Posterior fibres of deltoid
Infraspinatus
Teres minor

Question 33

Abduction

Answer 33

Supraspinatus muscle abducts up to 15C
Middle fibres of deltoid abduct up to 90C to 120C
Overhead abduction
Upper and lower fibres of trapezius
Serratus anterior muscle

Question 34

what is the cutaneous nerve supply for the pectoral region?

Answer 34

1. supraclavicular nerve(c3,c4)- divides into medial,intermediate,lateral branches.supply just inferior to clavicle
2. ant and lat cute branches from 2-6 intercostal nerves

Question 35

deltopectoral groove

Answer 35

intermuscular groove between the deltoid and pectoralis major.
- transversed by cephalic vein and delto-pectoral grp of lymph nodes
- deltoid branch of thoracoacromio artery

Question 36

What are the arteries taking part in scapular anastomosis

Answer 36

Connecting, the certain subclavian artery and their corresponding axillary artery forming circulatory anastomosis around the scapula. It allows for blood to flow past the joint in case of occlusion, damage, or pinching.