Upper Limb 6 Flashcards

0
Q

Trace the arteries of the upper limb.

A

Brachiocephalic trunk of heart - Subclavian a over first rib, under clavicle - axillary a (most superficial) - brachial artery after over teres major (profunda brachii goes unda) - branches to 1. Ulna on pinky side–>superficial palmar arch, 2. radial on thumb side–>deep palmar arch.

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1
Q

What are the four divisions of the upper limb and describe them.

A

Shoulder: pectoral, scapular, deltoid

arm: segment between the glenohumeral joint and elbow joint
forearm: between elbow and proximal wrist joints
hand: wrist to distal phalanx

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2
Q

The ___________ artery is deep to the ulnar and radial arteries.

A

Posterior interosseus artery

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3
Q

What are the branches of the axillary artery?

A
  1. Superior thoracic
  2. Thoracoacromial; lateral thoracic
  3. Subscapular-scapular circumflex, thoracodorsal; anterior humeral circumflex; posterior humeral circumflex
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4
Q

What structure divides the axillary artery into 3 division?

A

Pectoralis minor

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5
Q

The subclavian artery passes over ___________ and becomes the axillary artery.

A

First rib

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6
Q

What structure creates a division between the axillary artery and brachial artery?

A

Teres major

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7
Q

What are the major superficial veins of the upper limb?

A

Cephalic (from deltopectoral groove) joins the basillic vein via the median cubical vein in the cubital fossa

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8
Q

What do the cephalic and basilic veins originate from (distally)?

A

Dorsal venous network (arch) of the hand

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9
Q

Where does the median cubital vein lie?

A

In the cubital fossa

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10
Q

Name the muscles that arise from the vertebral column and connect the upper limb to the trunk?

A

Trapezius, levator scapulae, latissimus dorsi and rhomboids

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11
Q

One of the muscles that arise from the spine and connect the upper limb to the trunk does not receive innervation from the brachial plexus. Name it.

A

Trapezius (accessory n)

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12
Q

Name the mm that arise from the thoracic wall and connect the upper limb to the trunk. Which one is deepest?

A

Pectoralis major/minor, subclavius, serratus anterior (deepest)

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13
Q

For what two nerves is the pectoralis minor a landmark?

A

Medial and lateral pectoral n

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14
Q

Explain how the lateral and medial pectoral nerves are named and what is the discrepancy?

A

They are named from their anatomical relationship with the axillary artery in the brachial plexus. However, the lateral n lies more medially when it pierces the pectoralis major and the medial n lies more laterally when it pierces the pec major/minor

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15
Q

Name the muscles of the scapular region. Which mm are not a rotator cuff muscle?

A

Subscapularis, supraspinatus and infraspinatus, teres major/minor, deltoid
Deltoid and teres major are not rotator cuff mm

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16
Q

What is the function of the rotator cuff mm?

A

Stability and movement

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17
Q

Which aspect of the shoulder joint is not reinforced by the rotator cuff mm and what is this clinically important?

A

Below the glenoid cavity (inferior aspect). It can cause the shoulder to dislocate and the humerus to fall below the cavity.

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18
Q

What structures pass thru the quadrangular space?

A

Axillary nerve and posterior humeral circumflex artery

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19
Q

What structures pass thru the triangular space?

A

Radial nerve and profunda brachii artery

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20
Q

Which muscles form the walls of the axilla? (Post, med, ant)

A

Posterior: subscapularis, teres major, lattisimus dorsi
Anterior: pectoralis major/minor, subclavius
Medial: anterior serratus, intercostal mm

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21
Q

Which bones make up the borders to the axilla?

A

Ant: clavicle
Med: first rib
Post: scapula

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22
Q

What are the two compartments of the upper limb?

A

Anterior: flexor
Posterior: extensor

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23
Q

What two fascial structures define the two compartments of the arm?

A

Lateral and medial intermuscular septa

24
Q

Name 3 muscles in the anterior compartment of the arm, their action and innervation.

A

Coracobrachialis: flexion and adducts arm
biceps brachii: flexes and supinates forearm
brachialis: flexes arm and forearm
Musculocutaneous nerve innervates them all.

25
Q

Name 2 muscles in the posterior compartment of the arm, it’s action and what innervates it

A

Triceps brachii: extends arm and forearm
Anconeus: extends elbow
Radial n

26
Q

In the flexor compartment, which arm muscles cross over the elbow joint? How does this attachment affect the action of these mm?

A

Biceps and brachialis

In addition to flexing the elbow, the biceps is a powerful supinator

27
Q

The splitting of the brachial artery occurs _______ to the cubital fossa.

A

Deep

28
Q

Name the two muscles that form the boundaries of the cubital fossa.

A

Lateral: brachioradialis
Medial: pronator teres

29
Q

Which of the 3 major nerves found passing from the arm into the forearm is NOT found within the cubital fossa?

A

Ulnar n

30
Q

Which muscles are found in the superficial group within the flexor compartment? Which is not innervate by the median nerve?

A

Pronator teres, *Flexor carpi radialis, Flexor carpi ulnaris, Palmaris longus, Flexor digitorum superficialis, *Brachioradialis

31
Q

Name the mm of the deep group of the flexor compartment. What is the innervation?

A

Flexor digitorum profundus-median and ulnar n

flexor pollicis longus, pronator quadratus- anterior interosseus of median n

32
Q

Which muscle of the deep group of the flexor compartment is the most medial?

A

Flexor digitorum profundus

33
Q

Name the muscles of the superficial group of extensor compartment and what innervation do they share?

A

Brachioradialis, extensor carpi radialis longus, extensor carpi radialis brevis, extensor digitorum, extensor digiti minimi, extensor carpi ulnaris
Radial n

34
Q

Name the muscles of the deep extensors and their innervation

A

Supinator, abductor pollicis longus, extensor pollicis longus/brevis, extensor indicis
Radial n

35
Q

Which vessel passes into the extensor compartment to supply the muscle?

A

Posterior interosseus artery (deep branch of ulnar)

36
Q

What other artery pierces the interosseus membrane to assist in supplying these muscles?

A

Anterior interosseus art

37
Q

The dorsal carpal arch arises from the ________ artery

A

Fusion of anterior and posterior interosseus arteries

38
Q

The radial artery passes thru the _________ at the base of the thumb and then passes to the palmar surface to contribute to the formation of the ___________ arch.

A

Snuff box

Deep palmar arch

39
Q

What structure forms the roof of the carpal tunnel?

A

Flexor rentinaculum

40
Q

Which nerve is irritated in the carpal tunnel syndrome?

A

Median

41
Q

Which nn supply the thenar muscles? Name the muscles

A

The median nerve

Abductor pollicis brevis, flexor pollicis brevis, opponens pollicis

42
Q

Names the hypothenar muscles and the nerve that supplies them.

A

Abductor digiti minimi, flexor digiti minii, opponens digit minimi
Ulnar n

43
Q

What is the functional significant of the tendons of the deep digital flexors piercing the tendons of the superficial digital flexors?

A

The tendons of the deep flexors extend to the distal phalanges; therefore, in order to reach this destination, they must piece the superficial to extend the middle phalanges.

44
Q

Which two lumbricals are innervated by the median n? What innervates the remaining?

A

1st and 2nd lumbricals

Ulnar n

45
Q

All interossei are innervated by the ______ nerve

A

Ulnar

46
Q

Which artery is responsible for forming the majority of the superficial palmar arch? The deep arch?

A

Superficial: ulnar
Deep: radial

47
Q

The deep palmar arch lies deep to which tendons of the hand?

A

Long flexor tendons

48
Q

What are attachments of the deltoid? Innervation and action?

A
Clavicle, acromion, scapular spine to deltoid tuberosity of humerus
Axillary n
Anterior fibers: flex arm
Intermed: powerful abductor
Post: flex arm
49
Q

What are the attachments for the supraspinatus? Innervation and action?

A

Supraspinatus fossa to greater tuberosity of the humerus
Suprascapular n
Stabilizes and prevents head of humerus from slipping down from the glenoid cavity; abducts the arm a little

50
Q

What are the attachments of the infraspinatus? Innervation and action?

A

Infraspinous fossa to greater tuberosity of humerus
Suprascapular n
Stabilize shoulder and laterally rotate arm

51
Q

What are the attachments for teres minor? Innervation and action?

A

Lateral border of scapula to greater tuberosity of humerus
Axillary n
Stabilize shoulder and laterally rotate arm

52
Q

What are the attachments for subscapularis? Innervation?

A

Subscapular fossa to LESSER tuberosity of the humerus

Subscapular n

53
Q

Name attachments, Innervation and action of pectoralis major

A
  1. Clavicle
  2. Sternum and costal cartilage
  3. Rectus sheath
    Inserts onto the humerus (crest of greater tuberosity)
    Medial and lateral pectoral nn
    Addiction and internal rotation
54
Q

Name attachments, innervation and action of pectoralis minor

A

Ribs 3-5 to coracoid process
Medial pectoral n
Draws scapula down, rotates glenoid inferiorly and assists in respiration

55
Q

Name attachment, Innervation and action of serratus anterior

A
Ribs 1-9 to medial border of scapula on anterior side
Long Thoracic n
Superior: lowers raised arm
Whole: draws scapula forward
 inferior: rotates scapula laterally
56
Q

Name attachment, Innervation and action of teres major

A

Inferior angle of scapula to anterior crest of lesser tuberosity of the humerus
Lower subscapular n
Internal rotation, adduction, extension

57
Q

The bifurcation of the brachial artery occurs ________ to the bicipital aponeurosis and __________ to the tendon of the biceps brachii.

A

Deep

Superficial