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Musculoskeletal > Clinical Anatomy of the Upper Limb > Flashcards

Clinical Anatomy of the Upper Limb Flashcards

1
Q

What makes up the shoulder girdle?

A

Clavicle/scapula, sternoclavicular joint, acromioclavicular joint, glenohumeral joint

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2
Q

What are the bones of the upper limb?

A

Shoulder girdle, humerus, elbow joint, radius/ulna, wrist (radio-carpal joint), carpus, MCPs, MCs, IPs

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3
Q

What muscle group move the shoulder girdle?

A

Superficial muscles of the back (e.g trapezius)

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4
Q

What is the origin and insertion of trapezius?

A 
Origin = T12 spinous process
Insertion = occiput and scapular spine
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5
Q

What innervates trapezius?

A

Accessory nerve (CN XI)

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6
Q

What are the functions of trapezius?

A

Elevates and depresses scapula

Retracts scapula

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7
Q

What are some pathologies that can affects the glenohumeral joint?

A

OA/RA, dislocation, adhesive capsulitis

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8
Q

What is the function of the labrum of the shoulder?

A

Increases capture of humeral head - increases stability

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9
Q

What do the rotator cuff muscles do as a whole?

A

Stabilise the shoulder girdle and move the arm

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10
Q

What are the four rotator cuff muscles?

A

Supraspinatus, infraspinatus, teres minor, subscapularis

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11
Q

What are some features of supraspinatus?

A

Originates from supraspinous fossa
Innervated by suprascapular nerve (C5/6)
Abducts arm

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12
Q

What are some features of infraspinatus?

A

Originates from infraspinous fossa
Innervated by suprascapular nerve (C5/6)
Externally rotates arm

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13
Q

What are some features of teres minor?

A

Originates from dorsal surface of lateral scapular border
Innervated by axillary nerve
Externally rotates the arm

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14
Q

What are some features of subscapularis?

A

Originates at anterior surface of scapula (scapular fossa)
Innervated by upper and lower subscapular nerves (C5/6)
Internally rotates the arm

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15
Q

Where are the insertions of the rotator cuff muscles?

A

Greater tuberosity of humerus = supraspinatus, infraspinatus and teres minor
Lesser tuberosity of humerus /shoulder capsule = subscapularis

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16
Q

What pathology may affects the rotator cuff muscles?

A

Susceptible to tears and impingement

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17
Q

What are the origins of the deltoid muscle?

A

Clavicle, acromion and scapular spine

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18
Q

Where does the deltoid insert, and what action does it perform?

A

Inserts at deltoid tuberosity on lateral aspect of humerus

Abducts the arm

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19
Q

What innervates the deltoid muscle?

A

Axillary nerve (C5/6)

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20
Q

What are the origins and insertion of the biceps brachii?

A 
Origins = coracoid process (short head) and labrum/glenoid (long head)
Insertion = tuberosity of radius
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21
Q

What innervates the biceps brachii, and what action does the muscle perform?

A

Innervated by musculocutaneous nerve (C5/6)

Flexes elbow and supinates forearm

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22
Q

What is the biceps brachii susceptible to?

A

Tendonitis

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23
Q

What are some pathologies that affect the elbow joint?

A

Fracture = radial neck/shaft, supracondylar process (especially children), olecranon
Bursitis = olecranon bursa
OA/RA and dislocation
Ligament tears or strains

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24
Q

What ligaments are present at the elbow joint?

A

Medial collateral, lateral collateral, annular

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25
Q

Where is the site of insertion for all the extensor muscles of the forearm?

A

Lateral epicondyle of humerus

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26
Q

What compartment of the forearm is the extensor compartment?

A

Dorsal compartment

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27
Q

Where is the site of insertion for all the flexor muscles of the forearm?

A

Medial epicondyle of the humerus

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28
Q

What compartment of the forearm is the flexor compartment?

A

Volar compartment

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29
Q

What bony features of the forearm are visible in supination?

A

Radial head, radial shaft, radial tuberosity, interosseous membrane, radial styloid, ulna styloid

30
Q

What bony features of the forearm are visible in pronation?

A

Olecranon fossa, coranoid process, ulna shaft

31
Q

What pathologies may affect the wrist?

A

OA/RA, dislocation, fractures (distal radius, scaphoid)

32
Q

What are the to groups of muscles that act on the hand?

A 
Intrinsic = located in hand, responsible for fine motor functions of hand
Extrinsic = located in anterior and posterior forearm, control finger flexion/extension and wrist movement
33
Q

What are the intrinsic muscles of the hand?

A

Thenar muscles, hypothenar muscles, interossei muscles, lumbrical muscles

34
Q

What muscles make up the thenar muscles?

A

Opponens pollicis, flexor pollicis brevis, abductor pollicis brevis

35
Q

What function do the thenar muscles have, and what innervates them?

A

Move the thumb

Innervated by median nerve

36
Q

What muscles make up the hypothenar muscles?

A

Abductor digiti minimi (main one) and flexor digiti minimi brevis

37
Q

What movements do the interossei muscles carry out?

A 
All flex at MCP joints and extend at IP joints 
Dorsal interossei (x4) = abduct fingers at MCP joints
Palmar interossei (x4) = adduct fingers at MCP joints
38
Q

What nerve innervates the interossei muscles?

A

The ulnar nerve

39
Q

How many lumbricals are there?

A

Four = one for each finger

40
Q

Where do the lumbricals allow movement of?

A

Crucial for finger movement = link flexor and extensor tendons

41
Q

What is the innervation of the lumbricals?

A

Median nerve = lateral two

Ulnar nerve = median two

42
Q

What are the extrinsic muscles of the hand?

A 
Flexor tendons (flexor digitorum profundus)
Flexor pulleys = annular ligaments, cruciate pulleys
43
Q

What action does the flexor digitorum profundus perform?

A

Extensor flexor muscle of the fingers = flexes fingers at DIPs

44
Q

What nerves innervate the flexor digitorum profundus?

A 
Anterior interosseous nerve (branch of median nerve - C8,T1) = second and third digits
Ulnar nerve (C8,T1) = fourth and fifth digits
45
Q

Where does the flexor digitorum profundus pass?

A

Through carpal tunnel, trained to metacarpals/phalanges by a pulley system

46
Q

What are the two most biochemically important annular ligaments?

A

A2 and A4 = critical to preventing bowstringing

47
Q

What structures do some of the annular ligaments overlie?

A 
A1 = MP joint
A3 = PIP joint
A5 = DIP joint
48
Q

What annular ligament is most commonly involved in trigger finger?

A

A1

49
Q

What is the function of the cruciate pulleys?

A

Function to prevent sheath collapse and expansion during digital motion

50
Q

How many cruciate pulleys are there at the level of the joints?

A

3

51
Q

What is the function of the palmar fascia?

A

Separates the palmar muscle bellies and flexor tendons from the skin

52
Q

What is the palmar fascia susceptible to?

A

Hypertrophy and fibrosis (Dupuytren’s contracture)

53
Q

What forms the deep and superficial palmar arches in the hand?

A

The radial and ulnar arteries

54
Q

What does the superficial palmar arch give rise to?

A

The common digital arteries

55
Q

How are the radial and ulnar digital arteries named?

A

Named after the side of the digit they are on (not the artery they originate from)

56
Q

What are the three peripheral nerves that supply the hand?

A

Median, ulnar and radial nerves

57
Q

Where does the muscular aspect of the median nerve supply?

A

Flexors of forearm and LOAF muscles

Tested at abductor pollicis brevis

58
Q

Where does the median nerve supply cutaneous sensation to?

A

Radial 3 and a half digits

Tested at tip of index finger and base of thenar muscles

59
Q

Where does the muscular aspect of the ulnar nerve supply?

A

Small intrinsic muscles of the hand

Tested at abductor digiti minimi

60
Q

Where does the ulnar nerve provide cutaneous sensation to?

A

Ulnar 1 and a half digits

Tested at dorsum and volar aspects of little finger

61
Q

Where does the muscular part of the radial nerve supply?

A

Extensors of forearm

Tested at extensor digitorum communis (extensor indicis)

62
Q

Where does the radial nerve supply cutaneous sensation to?

A

Variable portion dorsum of hand

Tested at dorsum of first webspace

63
Q

What forms the cubital tunnel?

A

Formed by two heads of flexor carpi ulnaris muscle

64
Q

Where does the ulnar nerve pass?

A

Posterior to medial epicondyle, then enters cubital tunnel and goes underneath arcuate ligament

65
Q

What causes cubital tunnel syndrome?

A

Compression of the ulnar nerve

66
Q

Where does the median nerve pass through the carpal tunnel?

A

At the level of the wrist

67
Q

What are the boundaries of the carpal tunnel?

A

Carpal bones = dorsal, medial and lateral constraints

Flexor retinaculum/transverse carpal ligament

68
Q

What causes carpal tunnel syndrome?

A

Compression of the median nerve

69
Q

What forms the brachial plexus?

A

Ventral rami of C5-8 and T1 nerve roots

70
Q

Where does the brachial plexus pass?

A

Proceeds through neck, then the axilla and into the arm

71
Q

What does the brachial plexus give rise to?

A

Peripheral nerves of the entire upper limb

72
Q

What is the order of structures in the brachial plexus?

A

Roots, trunks, divisions, cords, branches

Musculoskeletal (57 decks)

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