18 - MSK Shoulder to Hand

Question 1

which ligaments stablize the bones f the pectoral girdle

Answer 1

acromioclavicular ligament
coracoclavicular ligament
coracoacromial ligament

(names after the bones they bind together)

Question 2

What would happen if ligrament was damaged

Answer 2

sprain
shoulder seperation

Question 3

What is a shoulder dislocation

Answer 3

synovial joint no longer communicates
force
- hyperabducted

pectralis major draws humerus medially

Question 4

Which nerves from the brachial plexus are at risk of injury in a shoulder dislocation

Answer 4

musculotaneous nerve (antibrachium)
axillary nerve (brachium)

Question 5

what are the roattor cuff muscles

Answer 5

arise from the scapula to insert around the head of the humerus

stabalize the glenohumeral joint and contribute to circumduction of the shulder

SITS
- supraspinatus (initiate abduction) suprascapular nerve
- infraspinatus supracapular nerve
- teres minor axillary nerve
- subscapularis subscapular nerve
no muscles at the bottom

Question 6

what are the muscles moving the radius and ulna

Answer 6

posterior extension
triceps brachii (3 tendons) radial nerve

anterior flexor musculocutaneous nerve
- brachialis
- biceps brachii

Question 7

what does the bicipital aponeurosis do

Answer 7

aid in flexion of the forearm
attatched to ulna

Question 8

What does the true tendon do

Answer 8

insert upon radial tuberoisity (bump on radius)
when put forearm in pronation, bump gets folded over

allows for supination of the forearm

Question 9

What is the bicep muscle known as

Answer 9

screwdriver muscle
- flex elbow
- turning elbow

Question 10

What does the brachial artery do

Answer 10

supplies the structures of the arm, forearm and hand

Question 11

What are the two functions of the biceps brachii
What is it innervated by

Answer 11

true tendon: supination of forearm (radio-ulnar joint)
aponeurosis: flexion of forearm (elbow)

innervataed by musculocutaneous nerve

Question 12

What does the tricep muscle do
What is it innervated by

Answer 12

extension of the forearm (elbow)
innervated by radial nerve
- radial groove runs through

Question 13

What would a humeral fracture result in

Answer 13

peripheral nerve injuries
- axillary (proximal, high up)
- radial
- median (distally)

because of radial groove

Question 14

Where do the superficial muscles of the anterior flexor compartment of the forearm arise from

Answer 14

arise from medial epicondyle

Question 15

What are the anterior superficial muscles moving the forearm

Answer 15

pronator teres (pronation of forearm)
- attatched to radius
flexor carpi radialis (flexion of carpus)
palmaris longus
flexor carpi ulnaris (ulnar deviation when contracted)

innervated by the medial nerve
except for flexor carpi ulnaris (ulnar nerve)

Question 16

Which muscles faciliate pronation of the forearm

Answer 16

pronator teres: superficial, proximal, strong
- median nerve
pronator quadratus: deep, distal, weak
- median nerve

position of radial tuberoistity follows

Question 17

What muscles faciliate flexion of the carpus (wrist)

Answer 17

flexor carpi radialis: wrist flexion, radial deviation
- median nerve
flexor carpi ulnaris: wrist flexion, ulnar deviation
- ulnar nerve

independently these muscles cause radial or ulnar deviation of the wrist

Question 18

What are the deep muscles moving the digits and thumbs of the anterior compartment

Answer 18

flexor digitorum superficialis (median nerve)
- sends tendon to intermediate phalanx
flexor digitrum produndus (ulnar nerve)
- sends tendons to distal phalanx

FDS –> capral –> FLDP –> finger tips

flexor pollicis (median nerve)

arise from interosseous membrane

Question 19

What is the flexor digitorum produndus

Answer 19

flex distal interphalageal joint
- median and ulnar nerve

arises from the bones and interosseus membrane of the forearm

Question 20

What is the flexor digitorum superficialis

Answer 20

flexion of proximal interphalangeal joint
- median nerve

Question 21

Where do the superficial muscles of the posterior (extensor) compartment arise from
What innervates

Answer 21

lateral epicondyle of the humerus

radial nerve

Question 22

What are the superficial muscles of the posterior compartments

Answer 22

extensor carpi radialis and ulnaris - extend the carpals
- circumduct the wrist
radialis: start as arm muscle fr radial deviation
ulnaris: extension of carpals

extensor digitorum - extend the digits
- extend the interphalangeal joints
- extend the MCP joints
- extend the radio-carpal joint
(crosses the interphalangeal joints, metacarpophalangeal joints and carpals)

Question 23

Where do the deep muscles of the posterior (extensor) compartment arise from
What innervates

Answer 23

bones and interosseus membrane

radial nerve

Question 24

What are the deep muscles of the posterior compartments

Answer 24

abductor pollicis - abducts the thumb
extensor pollicis - extends the thumb

come off radius

Question 25

What is epicondylitis What are the types

Answer 25

excessive forces that cause injury to the tendinous insertion sites medial epicondyle: constantly extending the wrist, contracting flexi-carpal muscles to keep wrist straight (golfers elbow) lateral epicondylitis: extensor carpi muscles contracting (tennis elbow)

Question 26

What is cubital tunnel syndrome (funny bone)

Answer 26

compression of the ulnar nerve (c8-t1) in the cubital tunnel can lead to sensory and motor - loss of sensation in the cutaneous distribution (palm and pink/ring finger) of the ulnar nerve (front and back of hand) - weakinging of muscles of the hand and forearm having an action on the digits

Question 27

What can happen after fall on out-stretched hand (FOOSH)

Answer 27

fracture in the distal radius (colle's fracture) radius absorbing most at fall because biggest at distal (ulna big at proximal) results in dinner fork deformity

Question 28

What are the carpal bones

Answer 28

scaphoid - at base of thumb capitate - in centre - median nerve comes through) pisiform and hamate - form the ulnar canal - have ligament running through to create ulnar canal (ulnar nerve goes through and into palm muscles to innervate)

Question 29

What is the carpal tunnel

Answer 29

where the digital flexor tendons and the median nerve enter the hand - floor = carpal bones - roof = transverse carpal ligament

Question 30

What is the transverse carpal ligament

Answer 30

aka flexor retinaculum roof of hand (palm side): keep all tendons down

Question 31

What is the ulnar canal

Answer 31

form between pisiform and hamate (hook) deep to pisi-hamate ligament

Question 32

What would happen if there were a scaphoid fracture (FOOSH)

Answer 32

proximal segment of the scaphoid is prone to avascular necrosis - death of bone inflammed, funny colours --> death "to the elbow we go" pain in anatomical snuffbox

Question 33

What is carpal tunnel syndrome

Answer 33

injury to median nerve through the carpal tunnel - loss of sensation in the cutaneous distribution of the median nerve (thumb, 2, 3) - muscles weakening of the intrinsic muscles of the thumb and hand (abduction and flexion of thumb) Floor = carpal bones Roof = transverse carpal ligament due to inflammation of the digital flexor tendons (tendinitis) recurrent branch: nerve takes uturn

Question 34

What are clinicla tests to confirm carpal tunnel

Answer 34

tinel's sign (pressing down on nerve) tingle or pain down cutaneous distribution when extreme flexion (phalen's test), more pressure on median nerve