Anatomy - Upper limb

Question 1

What is the origin of the brachial plexus?

Answer 1

anterior rami of C5 to T1

Question 2

What are the sections of the brachial plexus?

Answer 2

roots, trunks, divisions, cords, branches

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Question 3

where are the roots of the brachial plexus?

Answer 3

posterior triangle
exits from IV foramina
between scalenus anterior and medius

Question 4

where are the trunks of the brachial plexus?

Answer 4

posterior to the middle third of the clavicle
upper and middle trunks are superior to the subclavian artery
lower trunk passes over the 1st rib posterior to the subclavian artery

Question 5

where are the divisions of the brachial plexus?

Answer 5

axilla

Question 6

what are the cords of the brachial plexus related to ?

Answer 6

axillary artery (second part)

Question 7

what is erbs paralysis?

Answer 7

damage to the upper nerve roots (c5, c6)
Motor affection (waiters tip) - arm adduction, internal rotation and forearm extension
sensation affection - loss of sensation of radial side of arm and forearm

Question 8

which muscles are affected in erbs paralysis?

Answer 8

arm adduction - supraspinatus and deltoid
arm internal rotation (paralysis of external rotators) - infraspinatus and tires minor
forearm extension and pronation (loss of flexors and supinators) - biceps, brachialis, brachioradialis

Question 9

what is klumpkes paralysis?

Answer 9

injury to the lower trunk (c8, t1)
motor affection - claw hand deformity
sensory affection - loss of sensation over the ulnar border of the forearm and hand

Question 10

what muscles are affected in klumpkes paralysis?

Answer 10

claw hand
intrinsic muscles of hand
paralysis of wrist flexors (except FCR)
hyperextension of MCP joints with flexion of IP joints

Question 11

what is the origin of pec major?

Answer 11

clavicular head - medial half of anterior surface of clavicle
sternocostal head - anterior sternum, upper 6 costal cartilages, EOA

Question 12

what is the insertion of pec major?

Answer 12

humerus (lateral ITG)

Question 13

what is the action of pec major?

Answer 13

adduction and medial rotation of the arm (all)
clavicular head - flexion of the arm
sternocostal head - extends the flexed arm
acts as accessory respiratory by elevating ribs

Question 14

what is the innervation of pec major?

Answer 14

medal (c8-t1) and lateral (c5-c7 pectoral nerves)

Question 15

what is the origin of trapezius?

Answer 15

spinous processes C7-T12
occipital protuberance
ligamentum nuchae

Question 16

what is the insertion of trapezius?

Answer 16

clavicle and scapula (acromion and spine)

Question 17

what is the action of trapezius?

Answer 17

rotating scapula

Question 18

what is the innervation of trapezius?

Answer 18

accessory nerve CNXI

Question 19

what is the origin of serrates anterior?

Answer 19

ribs 1-9

Question 20

what is the insertion of serrates anterior?

Answer 20

scapula (ventral, medial)

Question 21

what is the action of the serratus anterior?

Answer 21

prevents winging of scapula

Question 22

what is the innervation of serratus anterior?

Answer 22

long thoracic nerve (c5-c7)

Question 23

what is the origin of deltoid?

Answer 23

lateral clavicle, scapula

Question 24

what is the insertion of deltoid?

Answer 24

humerus (deltoid tuberosity)

Question 25

what is the action of deltoid?

Answer 25

anterior fibres - flexion and medial rotation posterior fibres - extension and lateral rotation middle fibres - major abductor of the arm beyond 15 degrees

Question 26

what is the innervation to deltoid?

Answer 26

axillary nerve (c5, c6)

Question 27

what are the rotator cuff muscles?

Answer 27

subscapularis, supraspinatus, infraspinatus, teres minor

Question 28

what is the origin of subscapularis?

Answer 28

ventral scapula

Question 29

what is the insertion of subscapularis?

Answer 29

humerus (LT)

Question 30

what is the action of subscapularis?

Answer 30

internal rotation of the arm anterior stability

Question 31

what is the innervation to subscapularis?

Answer 31

upper and lower sub scapular nerves

Question 32

what is the origin of supraspinatus?

Answer 32

superior scapula (supraspinatus fossa)

Question 33

what is the insertion of supraspinatus?

Answer 33

humerus (GT)

Question 34

what is the action of supraspinatus?

Answer 34

abduction, externally rotation arm providing stability

Question 35

what is the innervation to supraspinatus?

Answer 35

supra scapular nerve

Question 36

what is the origin of infraspinatus?

Answer 36

dorsal scapula (infraspinatus fossa)

Question 37

what is the insertion of INFRAspinatus?

Answer 37

humerus (GT)

Question 38

what is the action of infraspinatus?

Answer 38

provides stabiliy externally rotates armh

Question 39

what is the innervation to infraspinatus?

Answer 39

supra scapular nerve

Question 40

what is th origin of teres minor?

Answer 40

scapula (dorsolateral)

Question 41

what is the insertion of teres minor?

Answer 41

humerus (GT)

Question 42

what is the action of teres minor ?

Answer 42

provides stability external rotation of arm

Question 43

what is the innervation to teres minor?

Answer 43

axillary nerve

Question 44

what are the borders of the triangular interval?

Answer 44

superior - teres major medial - triceps (long head) lateral - triceps (lateral head)

Question 45

what are the structures in the triangular interval?

Answer 45

radial nerve deep artery of the arm (profound brachii)

Question 46

what are the borders of the triangular space?

Answer 46

superior - teres minor inferior - teres major lateral - triceps (long head)

Question 47

what structures are within the triangular space?

Answer 47

circumflex scapular aretry

Question 48

what are the borders of the quadrangular space?

Answer 48

superior - teres minor inferior - teres major medial - triceps (long head) lateral - humerus (medial border)h

Question 49

what are the structures in the quadrangular space?

Answer 49

axillary nerve posterior circumflex artery humeral artery

Question 50

how many parts are there to the axillary artery and what divides it?

Answer 50

3 parts pec minor

Question 51

what are the branches of the axillary artery?

Answer 51

screw the lawyer save a patient I superior thoracic artery II thoracoacromial artery, lateral thoracic artery III subscapular artery, anterior humeral circumflex artery, posterior humeral circumflex artery

Question 52

what is the largest branch of the axillary artery?

Answer 52

subscapular

Question 53

what is the course of the superior thoracic artery?

Answer 53

medial to serrates anterior and pec muscles

Question 54

what is the course of the thoracoacromial artery?

Answer 54

four branches 1. deltoid 2. acromial 3. pectoralis 4. clavicular (DAB C)

Question 55

what is the course of the lateral thoracic artery?

Answer 55

descends to serrates anterior

Question 56

what is the course of the subscapular artery?

Answer 56

two branches, thoracodorsal and circumflex scapular (triangular space)

Question 57

what is the course of the anterior humeral circumflex artery?

Answer 57

blood supply to the humeral head: arcuate artery lateral to bicipital groove

Question 58

what is the course of the posterior humeral circumflex artery?

Answer 58

branch in the quadrangular space accompanying the axillary nerve

Question 59

what is the surface marking of the coracoid?

Answer 59

2cm inferior to the junction between the middle and lateral thirds of the clavicle

Question 60

structures attaches to the coracoid process?

Answer 60

ligaments (3) 1. coracoclavicular (trapezoid/conoid) 2. coracohumeral 3. coracoacromial muscles (3) 1. pec minor (insertion) 2. coracobrachialis (origin) 3. short head of biceps (origin)

Question 61

muscles inserted in the bicipital groove?

Answer 61

PLT sandiwch teres major (medial lip) latisimus dorsi (floor) pec major (lateral lip) *tendon of long head of biceps runs in the groove

Question 62

which muscles cause shoulder joint abduction?

Answer 62

supraspinatus (0-15 degrees) deltoid middle fibres (15-90 degrees) trapezius and serrates anterior over 90 degrees (upward rotation of the scapula and lateral rotation of humerus)

Question 63

factors decreasing the stability of the shoulder joint?

Answer 63

shallow glenoid lax capsule with few ligaments interior aspect not supported due to presence of quadrangular space

Question 64

main stabiliser of the shoulder?

Answer 64

rotator cuff muscles

Question 65

what static restraints stabilise the shoulder?

Answer 65

GAANG-C glenoid labrum articular version articular conformity negative intra-articular pressure capsule (posterior capsule and rotator interval) glenohumeral ligaments

Question 66

what are the dynamic restraints of the shoulder?

Answer 66

joint concavity compression (rotator cuff) proprioception

Question 67

what are synovial joints?

Answer 67

freely moving joints, articulating bony surfaces are covered in hyaline articular cartilage and separated by synovial fluid (lubricant)w

Question 68

what does synovial fluid do?

Answer 68

lubrication aids metabolite transport into cells

Question 69

what is synovial fluid made by ?

Answer 69

synovial membrane

Question 70

what does the axillary nerve give motor and sensory supply to ?

Answer 70

motor: teres minor, deltoid sensory - lower half deltoid (regimental patch)