Anatomy Upper Limb

Question 1

What are the contents of the cubital fossa? (Mnemonic)

Answer 1

• Medial to lateral
• MY: Median nerve
• BOTTOM: Brachial Artery
• TURNED: Tendon of bicep
• RED: Radial Nerve

Question 2

Mnemonic for the muscles supplied by the radial nerve

Answer 2

• B: Brachioradialis
• E: Extensors
• S: Supinator
• T: Triceps

Question 2

Which cord of the brachial plexus does the radial nerve come from?

Answer 2

The posterior cord

Question 3

Mnemonic for the brachial plexus organisation

Answer 3

• The: Terminal nerves
• Castrated: Cords
• Dog: Divisions
• Turns: Trunks
• Rabid: Roots

Question 3

Which cord of the brachial plexus does the ulnar nerve come from?

Answer 3

The medial cord

Question 4

• All muscles in the posterior compartment of the forearm are innervated by which nerve?
• What is the common origin of all the muscles in the posterior compartment of the forearm?

Answer 4

• The radial nerve
• The lateral epicondyle and supraepicondylar ridge of the humerus.

Question 4

Which cord of the brachial plexus does the medial nerve come from?

Answer 4

The medial and Lateral cords

Question 5

What are the origin, insertion, innervation and action of Pectoralis Major

Answer 5

• Origin: The anterior surface of the sternal half of the clavicle. Half of the anterior surface of the sternum. The cartilage of all the true ribs
• Insertion: All the fibres end in a flat tendon which is inserted into the bicipital groove of the humerus
• Innervation: There is dual motor innertavtion from the medial pectoral nerve and lateral pectoral nerve
• Actions; Adducts and medially rotates the arm.

Question 5

What are the nerve roots of the brachial plexus?

Answer 5

C5, C6, C7, C8, T1

Question 6

What is the origin, insertion, innervation action and arterial supply of: Pectoralis Minor

Answer 6

Pectoralis Minor

• Origin: 3rd to 5th ribs, near their costal cartilages
• Insertion: The coracoid process of the scapula
• Innervation: Medial Pectoral Nerve
• Artery: Pectoral branch of the thoracoacromial trunk
• Actions: Stabilises the scapula by drawing it inferiorly and anteriorly against the thoracic wall.

Question 6

Describe the dermatomes of the anterior side of the upper limb

Question 7

What are the Origin, Insertion, Arterial supply, Innervation, Actions and Antagonists of the serratus anterior.

Answer 7

Serratus Anterior:

• the outer surfaces of the upper 8 or 9 ribs
• Insertion: The medial border of the scapula, all along the anterior edge
• position: deep to subscapularis
• Artery: Upper part: lateral thoracic artery. Lower part: thoracodorsal artery
• Innervation: Long thoracic nerve (from brachial plexus roots 5, 6, 7)
• Actions: protracts (moves forwards) the scapula

Question 7

Describe the dermatomes of the posterior side of the upper limb

Question 8

What are the origin, insertion, arterial supply, innervation and actions of the subclavius muscle?

Answer 8

Subclavius

• Origin: first costal cartilage of first rib
• Insertion: Subclavian groove of the clavicle
• Arterial supply: the clavicular branch of the thoracoacromial trunk
• Innervation: nerve to the subclavius
• Actions: pulls the clavicle in a downward direction. If the clavicle breaks, it protects the underlying brachial plexus and subclavian vessels

Question 8

Anterior forearm superficial muscles - they originate on the medial epicondyle of the humerus

Question 9

What is the Origin, Insertion, Arterial supply, Innervation, Actions and antagonists of Latissimus Dorsi?

Answer 9

Latissimus Dorsi

• Origin: spinous process of thoracic T7-L5
• Origin: thoracolumbar fascia
• Origin: Iliac crest
• Origin: Inferior 3 or 4 ribs
• Origin: inferior angle of the scapula
• Insertion: the intertubercular groove of the humerus
• Artery: thoracodorsal branch of the subscapular artery
• Innervation: thoracodorsal nerve (from the posterior cord of the brachial plexus
• Action: Adducts, extends and internally rotates the arm
• Antagonists: Deltiod, trapezium

Question 9

Intermediate muscles of the anterior forearm

Question 10

What are the Origin, Insertion, Arterial Supply, Innervation, Actions and Antagonists of the Trapezius muscle?

Answer 10

Trapezius muscle

• Origin: external occipital protuberance, the nuchal ligament and the spinous processes of C7 all the way down to T12.
• Insertion: posterior side of the lateral third of the clavicle, the acromion process and the spine of the scapula
• Artery: transverse cervical artery
• Nerve: accessory nerve (motor) spinal nerves C3 and C4
• Actions: rotation, retraction, elevation and depression of the scapula
• Antagonists: serratus anterior, latissimus dorsi

Question 10

Deep muscles of the anterior forearm

Question 11

What are the Origin, Insertion, Arterial supply, innervation and actions of Levator Scapulae?

Answer 11

Levator Scapulae

• Origin: The posterior side of the transverse processes of C1 to C4 vertebrae
• Insertion: Superior part of the medial border of the scapula
• Arterial supply: Dorsal scapular artery
• Innervation: Cervical nerves C3 and C4, and the dorsal scapular nerve (C5)
• Actions: Elevates the scapula and tilts its glenoid cavity inferiorly by rotating the scapula.

Question 11

Superficial muscles of the posterior forearm

Question 12

What are the Origin, Insertion, Arterial Supply, Innervation, Actions and Antagonists of the Rhomboid Major muscle?

Answer 12

Rhomboid major

• Origin: spinous processes of T2 to T5 vertebrae
• Insertion: Medial border of the scapula
• Arterial supply: dorsal scapular artery
• Innervation: dorsal scapular nerve
• Actions; Retracts the scapula and rotates it to depress the glenoid cavity. It also fixes the scapula to the thoracic wall
• Antagonist: Serratus anterior muscle

Question 12

Deep muscles of the posterior forearm

Question 13

What are the origin, insertion, arterial supply, innervation, action and antagonist of Rhomboid minor?

Answer 13

Rhomboid minor:

• Origin: nuchal ligaments and spinous processes of C7-T1
• Insertion: medial border of the scapula
• Arterial supply: Dorsal scapular artery
• Innervation: Dorsal Scapular nerve
• Actions: Retracts and rotates the scapula, and fixes the scapula to the thoracic wall
• Antagonist: Serratus anterior

Question 14

* What is the name of the main shoulder joint? * What is the name of the medial joint of the clavicle?

Answer 14

* The glenohumeral joint * The sternoclavicular joint

Question 14

* The long head of the biceps originates from.... * The short head of the biceps originates from... * The biceps insert on (2)

Answer 14

* The long head of the biceps originates from teh supraglenoid tubercle of the scapula. * The short head of the biceps originates from the coracoid process of the scapula. * The bicpes insert on the radial tuberosity and bicipital aponeurosis (into the deep fascia of the anteror forearm)

Question 15

* Which 4 muscles form the rotator cuff? * Which bones do the rotator cuff muscles originate from and insert on, and what is the main purpose of the rotator cuff?

Answer 15

* Supraspinatus, Infraspinatus, Subscapularis and teres minor * The rotator cuff muscles originate on the scapula and inset onto the humerus. They stabilize the glenohumeral (shoulder) joint by holding the head of the humerus in the shallow glenoid fossa of the scapula. During abduction of the arm, the rotator cuff muscles keep the humeral head from riding up out of the glenoid fossa.

Question 16

What is the origin, insertion, arterial supply, innervation and action of Teres Major?

Answer 16

Teres Major: * Origin: posterior side of the inferior angle of the scapula * Insertion: intertubercular sulcus of the humerus * Arterial Supply: subscapular and circumflex scapular arteries * Innervation: Lower subscapular nerve (C6 and C7) * Actions: Internal rotation (medial rotation) of the humerus

Question 17

What are the origin, insertion, innervation, arterial supply and action of the Deltoid?

Answer 17

Deltiod: * Origin: Lateral third of the clavicle, the acromion and the scapula spine * Insertion: the deltiod tuberosity on the humerus (on the lateral surface of the shaft) * Innervation: the axilliary nerve * Arterial supply: posterior circumflex humeral artery * Action: Abduction of the arm, the anterior fibres flex and medially rotate the arm, the posterior fibres extend and laterally rotate the arm.

Question 18

What is the origin, insertion, innervation and nerve roots and action of supraspinatus?

Answer 18

Supraspinatus: * Origin: supraspinous fossa of the scapula * Insertion: Greater tuberosity of the humerus (very top of the humerus, on the anterior side) * Nerve: suprascapular nerve * Nerve roots: C4, C5, C6 * Action: Abduction of the arm. Stabilises the shoulder joint as one of the rotator cuff muscles.