ANATOMY - Upper limb p1 Flashcards
(205 cards)
1
Q
How many muscles attach to the scapula
A
17
2
Q
what are the 3 surfaces of the scapula?
A
costal (anterior)
lateral
posterior
3
Q
what does the acromion of the scapula articulate with?
A
clavicle
4
Q
which muscle attaches to the supraglenoid tubercle of the scapula?
A
biceps brachii long head
5
Q
which muscle attaches to the infraglenoid tubercle of the scapula?
A
triceps brachii long head
6
Q
which muscles attach to the coracoid process of the scapula (3)
A
pec major
coracobrachialis
short head bicep
7
Q
what muscle attaches to the subscapular fossa?
A
subscapularis
8
Q
which muscles in general originate from the posterior surface of the scapula
A
rotator cuff muscles
9
Q
supraspinatous fossa vs infraspinatous fossa - which is more convex
A
supraspinatous
10
Q
what is the prominent feature of the posterior scapula
A
spine
11
Q
what are the 2 articulations with the scapula
A
glenohumeral joint
acromioclavicular joint
12
Q
are scapula fractures common
A
no (+ usually indicate severe trauma)
13
Q
do scapula fractures tend to be displaced or undisplaced and why
A
undisplaced as mm hold in place
hence dont req fixation
14
Q
what type of bone is the clavicle
A
long bone
15
Q
functions clavicle (3)
A
attach upper limb to trunk
protect underlying NV structures
transmit forces from UL to axial skeleton
16
Q
what does the large facet of the clavicle articulate with
A
sternum (–> sternoclavicular joint)
17
Q
what attaches to the conoid tubercle of the clavicle
A
conoid ligament (medial part coracoclavicular ligament)
18
Q
what attaches to the trapezoid line of the clavicle
A
trapezoid ligament (lateral part of coracoclavicular ligament)
19
Q
which 1/3 of the clavicle has the majority of fractures
A
middle 1/3 (80%)
20
Q
most common mechanism for clavicular fracture
A
FOOSH
21
Q
mx clavicular fracture
A
conservative or orif
22
Q
which nerve may have to be sacrified during ORIF of clavicle
A
supraclavicular nn
23
Q
what does humerus articulate with proximally
A
glenoid fossa scapula (GH joint)
24
Q
what does humerus articulate with distally
A
head of radius + trochlear notch ulna (elbow joint)
25
which 3 fossa on the humerus articulate with the radius and ulna during flexion and extension
olecranon fossa
coronoid fossa
radial fossa
26
what direction are supracondylar fractures of the humerus
transverse
oblique
27
which aa can be damaged by supracondylar fractures and what syndrome does it lead to
brachial aa
Volkmans ischaemic contracture
28
which 3 rotator cuff muscles attach to the greater tuberosity of the humerus?
supraspinatus
infraspinatus
teres minor
29
which nerve and vessel pass over the surgical neck of the humerus
axillary mm
posterior circumflex aa (and vv)
30
which 3 muscles attach to the intertubercular groove of humerus (and how to remember)
pec major
teres major
lat dorsi
a lady between 2 majors
31
what muscle runs through the intertubecular groove of humerus?
long head of biceps
32
what muscle attaches to the lesser tuberosity of the humerus
subscapularis
33
which muscles attach to the anterior shaft of the humerus (4)
coracobrachialis
deltoid
brachialis
brachioradialis
34
which muscle attach to the posterior shaft of the humerus?
medial and lateral head of triceps
35
which nerve and vessel are at risk with a mid shaft fracture of the humerus
radial nn ---> wrist drop
profunda brachii aa
36
which is larger - medial or lateral epicondyle humerus
medial
37
which nerve passes through groove on medial epicondyle humerus
ulnar nn
38
which part of humerus articulates with radius
capitulum
39
what is Volkmann's ischaemic contracture
uncontrolled flexion hand due to flexor mm becoming fibrotic and short
40
which nerves can be damaged in supracondylar humeral fracture (3)
anterior interossous, ulnar and radial nn
41
which classification is used for supracondylar fracture
Gartland
42
Gartland criteria 1
minimally displaced
43
Gartland type 2
displaced by intact posterior cortex
44
Gartland type 3
completely off ended
45
Mx Gartland criteria type 1
conservative mx
46
Mx Gartland criteria type 2 + 3
surgery - bionical fused K wired
47
2 articulations of the ulna
proximally - humerus at elbow joint + radius at prox RU Joint
distally - distal RU joint
48
which muscle attaches to the olecranon
triceps brachii
49
which muscle articulates with the coranoid processes ulnar tuberosity
brachialis
50
which part of the ulna is most likely to fracture
shaft
51
3 surfaces and 3 borders of the ulna
surfaces - ant, post, med
borders - post, interosseous, ant
52
what are the 4 articulations of the radius
elbow joint - head radius + capitulum humerus
prox RU Joint - radial head + radial notch ulna
wrist joint - end radius + carpal bones
distal RU joint - ulnar notch radius with ulna head
53
which side of radial head is thicker - medial or lateral
medial
54
which muscle attaches to radial tuberosity
biceps brachii
55
what muscle attaches to lateral shaft of radius
pronator teres
56
name of 8 carpal bones
scaphoid
lunate
triquentrum
pisiform
hamate
capitate
trapezoid
trapezium
57
2 aa supplying scaphoid bone
dorsal carpal brachial aa
superficial palmar arch
58
boxers fracture
5th metacarapl neck fracture
59
bennetts fracture
fracture 1st MC base by forced hyperabduction thumb
60
how many metacarpals per hand
5
61
how many phalanges per hand
14
62
anterior border axilla
pec major + minor
63
lateral border axilla
intertubecular sulcus humerus
64
posterior border axilla
scapularis
teres major
latissimus dorsi
65
medial border axilla
serratus anterior
thoracic wall
66
contents axilla (lateral to medial)
short head biceps
coracobrachialis
brachial plexus
axillary aa
axillary vv
axillary LN
67
which space is in the posterior wall of the axilla
quadrangular space
68
what bounds the quadrangular space?
teres minor
teres major
triceps
surgical neck of humerus
69
contents quadrangular space?
axillary nn
posterior circumflex humeral aa (branch of axillary aa)
70
what bounds the clavipectoral triangle?
pec major
deltoid
clavicle
71
contents clavipectoral triangle?
cephalic vv
medial + lateral pectoral nn
72
what 4 muscles constitute the pectoral region?
pec major
pec minor
serratus anterior
subclavius
73
pectoralis major origin/insertion
anterior medial clavicle + anterior sternum, superior 6 CC + aponeurosis EO muscle (2 heads) --> intertubercular sulcus humerus
74
actions pectoralis major
adduct + medial rotate UL
draws scapular anteriorinferiorly
clavicular head flexes shoulder
75
innervation pectoralis major
lateral and medial pectoral nerves
76
origin/insertion pectoralis minor
3-5th ribs --> corocoid process
77
action pectoralis minor
stabilises scapula by drawing anteroinferiorly
78
innervation pectoralis minor
medial pectoral nerve
79
origin/insertion serratus anterior
lateral aspect ribs 1-8 --> costal surface medial border scapula
80
action serratus anterior
rotates scapula + holds scapula against ribcage
81
innervation serratus anterior
lateral thoracic nerve
82
damage to lateral thoracic nn leads to...
winging scapula
83
origin/insertion subclavius
junction of 1st rib + CC --> inferior middle 1/3 clavicle
84
action subclavius
anchors + depresses clavicle
85
innervation subclavius
nerve to subclavius
86
what are the 2 extrinsic muscles of the shoulder?
trapezius
latissimus dorsi
87
origin/insertion trapezius
skull, nuchal ligament + SP C7-T12 --> clavicle, acromion, spine of scapula
88
action trapezius - upper fibres
elevate scapula + rotate during abduction of arm
89
action trapezius - middle fibres
retract scapula
90
action scapula - lower fibres
pull scapula inferiorly
91
innervation trapezius
CN XI
(also proprioceptor fibres C3/4)
92
latissimus dorsi origin/insertion
SP T7-11, iliac crest, thoracocolumbar fascia + inferior 3 ribs
--> tendon that inserts onto intertubercular sulcus humerus
93
action latissimus dorsi
extend, adduct + medial rotate UL
94
innervation latissimus dorsi
thoracodorsal nn
95
what are the 3 deep extrinsic muscles of the back
levator scapulae
rhomboid minor
rhomboid major
96
origin/insertion levator scapulae
TP C1-4 --> medial border of scapula
97
action levator scapula
elevates scapula
98
innervation levator scapula
dorsal scapular nerve
99
origin/insertion rhomboid minor
SP C7-T1 --> medial border scapula at level of spine
100
action rhomboid minor
retracts and rotates scapula
101
innervation rhomboid minor
dorsal scapular nerve
102
origin/insertion rhomboid major
SP T2-5 --> medial scapula
103
action rhomboid major
retracts + rotates scapula
104
innervation rhomboid major
dorsal scapular nerve
105
origin/insertion deltoid
lateral 1/3 clavicle, acromion, spine scapula --> deltoid tuberosity humerus
106
action anterior fibres deltoid
flex + med rotate shoulder
107
action posterior fibres deltoid
extend + lat rotate shoulder
108
action middle fibres deltoid
major arm abductor after 15'
109
innervation deltoid mm
axillary nn
110
origin/insertion teres major
post surface of inferior angle scapula --> medial lip intertubercular groove humerus
111
action teres major
adduct, extend shoulder + medially rotate arm
112
innervation teres major
lower subscapular nerve
113
what are the 4 rotator cuff muscles
subscapularis
supraspinatus
infraspinatus
teres minor
114
supraspinatus orign/insertion
supraspinatous fossa scapula --> GT humerus
115
action supraspinatus
abducts arm 0-15'
assists abduction up to 90'
116
innervation supraspinatus
suprascapular nerve
117
origin/insertion infraspinatous
infraspinatus fossa scapula --> GT humerus
118
action infraspinatus
laterally rotates arm
119
innervation infraspinatus
suprascapular nn
120
origin/insertion teres minor
posterior surface scapula --> GT humerus
121
action teres minor
laterally rotates arm
122
innervation teres minor
axillary nn
123
origin/insertion subscapularis
subscapular fossa scapula --> lesser tubercle humerus
124
innervation subscapularis
upper + lower subscapular nn
125
action subscapularis
medially rotates arm
126
which rotator cuff muscle is most commonly affected in rotator cuff tendonitis ?
supraspinatus
127
what 3 ligaments strengthen the SC joint?
interclavicular ligament
costoclavicular ligament
anterior + posterior sternoclavicular ligament
128
outer and inner layers of SC joint capsule?
outer is fibrous (from epiphysis of clavicle to the articular disc)
inner is synovial membrane (prod fl)
129
aa supply SC joint?
internal thoaracic + suprascapular aa
130
innervation SC joint
medial supraclavicular nn (C3+ 4)
nn to subclavius (C5+6)
131
does the SC joint more commonly dislocate anteriorly or posteriorly?
anteriorly
132
in children, what additional fracture occurs with SC joint dislocation?
epiphyseal plate fracture
133
what type of joint is the AC joint?
plane synovial joint
134
where does the AC joint extend between?
lateral end of clavicle to acromion of the scapula
135
what muscle fibres reinforce the posteioer aspect of the AC joint capsule?
trapezius
136
which ligament suspends the upper arm from the clavicle?
coracoclavicular ligament
137
what are the 2 parts of the coracoclavicular ligament?
conoid ligament (coracoid process --> conoid tubercle clavicle)
trapezoid ligament (coracoid process --> trapezium line clavicle)
138
aa supply AC joint
suprascapular aa
thoraco-acromial aa
139
suprascapular aa is a branch of
SCA
140
thoraco-acromial aa is a branch of?
axillary aa
141
inn AC joint
suprascapular + lateral pectoral nn
142
what is the name for a AC joint dislocation?
separated shoulder
143
what type of joint is the glenohumeral joint?
ball and socket joint
144
what structure deepens the glenoid fossa?
glenoid labrum
145
where does the coracoacromial ligament extend between?
acromion + coracoid process scapula
146
role coracoacromial ligament shoulder
prevents superior dislocation of the humeral head
147
which ligament is the main source of stability of the shoulder?
glenohumeral ligament
148
role of glenohumeral ligament?
prevents shoulder dislocating anteriorly
149
what are the 3 shoulder bursa?
subcoracoid bursa
subscapular bursa
subacromial bursa
150
which muscle does the subacromial bursa lie superficial to?
Supraspinatus
151
movements shoulder joint
extension
flexion
abduction
adduction
internal rotation
external rotation
152
muscles involved in shoulder extension (3)
posterior deltoid
latissimus dorsi
teres major
153
muscles involved in shoulder flexion (3)
coracobrachialis
anterior deltoid
pectoralis major
154
muscles involved in shoulder abduction (4)
0-15' - supraspinatus
15-90' - middle deltoid
>90' - trapezius, serratus anterior
155
muscles involved in shoulder adduction (3)
pectoralis major
teres major
latissimus dorsi
156
muscles involved in internal rotation shoulder (5)
subscapularis
pectoralis major
latissimus dorsi
teres major
anterior deltoid
157
muscles involved in external/lateral rotation shoulder (2)
infraspinatus
teres minor
158
factors contributing to stability shoulder (4)
rotator cuff mm
glenoid labrum
ligaments
biceps tendon (minor humeral head depressor)
159
aa supply glenohumeral joint
anterior + posterior circumflex humeral aa
160
what are the anterior + posterior circumflex humeral aa a branch of?
axillary aa
161
innervation glenohumeral joint
axillary, suprascapular + lateral pectoral nn
162
what % of shoulder dislocations are anterior
95%
163
Hills Sachs lesion
impaction fracture of posterolateral humeral head against shoulder
164
Bankart lesion
detachment of anteroinferior labrum + avulsion fracture
165
which nerve may be damaged in a shoulder dislocation?
axillary nn
166
which 3 mm make up the anterior arm compartment?
biceps
brachialis
coracobrachialis
167
innervation of mm in anterior arm
musculocuteanous nn C,5,6,7
168
arterial supply of mm in anterior arm
brachial aa
169
biceps reflex root
C6
170
which muscles is the coracobrachialis deep to?
biceps
171
origin/insertion coracobrachialis
coracoid process scapula --> medial side humeral shaft at level of deltoid tubercle
172
action coracobrachialis
flex arm at shoulder
weak adduction shoulder
173
origin/insertion biceps
short head - coracoid process scapula
long head - supraglenoid tubercle scapula
to tuberosity via the aponeurosis
174
action biceps brachii
supination forearm
flexion arm and elbow + shoulder
175
origin/insertion brachialis
medial + lateral humeral shaft --> ulnar tuberosity
176
action brachialis
flex elbow
177
innervation brachialis
musculocutaneous nn
also contrib from radial nn
178
which tendon of the biceps is more likely to rupture
long head
179
what sign do you get with a biceps tendon rupture?
popeye sign
180
origin tricep - medial head
humerus, inferior to radial groove
181
origin tricep - lateral head
humerus, superior to radial groove
182
origin triceps - long head
infraglenoid tubercle
183
insertion triceps
tendon onto olecranon
184
action triceps
extends arm at elbow
185
innervation triceps mm
radial nn
186
triceps reflex nn root
C7
187
what muscles are in the anterior forearm - superficial layer (4)
Flexor carpi ulnaris
palmaris longus
flexor carpi radialis
pronator teres
188
what muscles are in the anterior forearm - intermediate layer (1)
flexor digitorum superficialis
189
what muscles are in the anterior forearm - deep layer (3)
flexor pollicis longus
flexor digitorum profundus
pronator quadratus
190
innervation mm anterior forearm
mostly median nn
except FCU + medial half FDP= ulnar nn
191
actions anterior forearm mm
pronation, flexion wrists and fingers
192
common origin point muscles superficial flexor compartment forearm
medial epicondyle humerus
193
pronator teres origin/insertion
medial epicondyle + coronoid process ulna --> midshaft radius
194
action pronator teres
pronation forearm
195
innervation pronator teres
median nn
196
origin/insertion flexor carpi radialis
medial epicondyle --> base MC 2 + 3
197
action FCR
flex + abduct wrist
198
innervation FCR
medial nerve
199
origin/insertion Flexor carpi ulnaris
medial epicondyle humerus + olecranon ulnar --> pisiform bone, hook hamate + base 5th MC
200
action FCU
flexion + adduction wrist
201
innervation FCU
ulnar nn
202
origin/insertion palmaris longus
medial epicondyle --> flexor retinaculum wrist
203
action palmaris longus
flexion wrist
204
innervation palmaris longus
median nn
205
what % population is palmaris longus absent in?
15%
