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Clinical anatomy of the upper limb Flashcards

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1
Q

What is involved in the shoulder girdle?

A 
Clavicle
Scapula
Steroclavicular joint
Acromioclavicular joint
Glenohumeral joint
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2
Q

What are common pathologies of the shoulder?

A 
OA
Impingement
Rotator cuff tears 
Adhesive capsulitis
Instability - atraumatic, traumatic, dislocations
Biceps tendonitis
Labral tears
ACJ dislocation
Humeral neck and shaft fracture
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3
Q

What are common elbow pathologies?

A

OA
Lateral and medial epicondylitis
Cubital tunnel syndrome
Supracondylar, olecranon, radial head/neck and forearm fractrure

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4
Q

What are common wrist pathologies?

A

OA
Carpal tunnel syndrome
Distal radius, scaphoid and carpal fractures and dislocations

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5
Q

What are common hand pathologies?

A 
OA
RA
Duptryen's contracture
Trigger finger
Finger injuries: tendons, fractures
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6
Q

What determines the different grades of ACJ dislocations?

A

Amount of soft tissue damage - if coracoclavicular ligaments rupture the clavicle will displace superiorly

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7
Q

What is the origin of the trapezius?

A

Spinous process T1-T12

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8
Q

What is the insertion of the trapezius?

A

Occipit and spine of scapula

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9
Q

What is the innervation of the trapezius?

A

Spinal accessory nerve

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10
Q

What is the action of the trapezius?

A

Elevates and depresses scapula

Retracts scapula

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11
Q

What movements are the first to go and last to come back in adhesive capsulitis (frozen shoulder)?

A

External rotation first to go

Internal rotation last to come back

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12
Q

What is the function of the labrum?

A

Increases capture of the humeral head and so increases stability

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13
Q

What is the insertion of the supraspinatous?

A

Greater tuberosity of humerus

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14
Q

What is the origin of the supraspinatous?

A

Supraspinatous fossa

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15
Q

What is the innervation of the supraspinatous?

A

Suprascapular nerve (C5/6)

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16
Q

What is the function of the supraspinatous?

A

Abducts arm

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17
Q

What is the origin of the infraspinatous?

A

Infraspinatous fossa

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18
Q

What is the insertion of the infraspinatous?

A

Greater tuberosity of humerus

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19
Q

What is the innervation of the infraspinatous?

A

Suprascapualr nerve (C5/6)

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20
Q

What is the function of the infraspinatous?

A

External rotation of arm

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21
Q

What is the origin of the teres minor?

A

Dorsal surface of lateral border of scapula

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22
Q

What is the insertion of the teres minor?

A

Greater tuberosity of humerus

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23
Q

What is the innervation of the teres minor?

A

Axillary nerve (C5/6)

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24
Q

What is the function of the teres minor?

A

External rotation of the arm

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25
What is the origin of the subscapularis?
Anterior surface of the scapula
26
What is the insertion of the subscapularis?
Lesser tuberosity of humerus
27
What is the innervation of the subscapularis?
Upper and lower subscapular nerve (C5/6)
28
What is the fuction of the subscapularis?
Internal rotation of arm
29
What pathologies can occur with the rotator cuff muscles?
Tears | Impingement
30
What is the gold standard investigation for rotator cuff pathologies?
USS
31
What is the origin of the deltoid?
Clavicle Acromion Spine of scapula
32
What is the insertion of the deltoid?
Deltoid tuberosity on lateral aspect of humerus
33
What is the innervation of the deltoid?
Axillary nerve (C5/6)
34
What is the function of the deltoid?
Abduction of arm
35
How can the motor function of the deltoid be tested?
Make an arc
36
What is the origin of the biceps brachii?
Short head: coracoid process | Long head: labrum/ glenoid
37
What is the insertion of the biceps brachii?
Tuberosity of radius
38
What is the innervation of the biceps brachii?
Musculocutaneous nerve (C5/6)
39
What is the function of the biceps brachii?
Main function: supination | Secondary function: flexion (chief flexor of elbow is brachialis)
40
What pathology can occur with the biceps brachii?
Tendonitis at insertion point
41
What is a SLAP tear?
Tear of labrum where biceps tendon anchors to the labrum
42
What is a bankart tear?
A tear in the inferior, anterior labrum
43
What is the extensor mechanism of the elbow?
Triceps muscle and tendon that inserts onto the olecranon
44
In what age group are supracondylar fractures common?
Children
45
What are the main ligaments in the elbow?
Medial collateral Lateral collateral Annular ligaments wraps around the radial head
46
What is the common insertion of the extensor muscles of the forearm?
Lateral epicondyle
47
What is the common insertion of the flexor muscles of the forearm?
Medial epicondyle
48
What occurs with the radius when the arm is in pronation?
Radial head rotates against the capitellum of the distal humerus - it crosses the ulna
49
What side of the arm is the radius?
Thumb side - will articulate with the lunate and scaphoid
50
What side of the arm is the ulna?
Pinky side - will articulate with the pisiform/ triquetrum
51
What is a colles fracture?
Distal radial fracture - extraarticular fracture which is dorsally displaces
52
What areas of bone are susceptible to AVN?
Those with a retrograde blood supply - femoral head, talus and scaphoid
53
How can you feel the anatomical snuffbox?
Ulnar deviation of hand
54
What ligaments form the anatomical snuffbox?
Tendons of extensor pollicus longus and abductor pollicus longus
55
What are the thenar muscles of the hand?
Opponens pollicus, flexor pollicis brevis, abductor pollicis brevis
56
What innervates the thenar muscles?
Recurrent medial nerve
57
What are the hypothenar muscles of the hand?
Abductor digiti minimi | Flexor digiti minimi brevis
58
What innervates the hypothenar muscles?
Ulnar nerve
59
What is the function of the interossei muscles?
Move fingers, flex MCPJs and IPJs
60
What innervates the interossei muscles?
Ulnar nerve
61
What is the function of the dorsal interossei's?
DAB - abduct at MCPJs
62
What is the function of the palmar interossei's?
PAD - adduct at MCPJs
63
What is the function of the lumbrical muscles?
Link extensor and flexor tendons
64
What is the innervation of the lumbricals?
Lateral: median nerve Medial: ulnar nerve
65
What is the function of the FDS?
Flexes fingers at PIPJs
66
What innervates the FDS?
Median nerve (C7/8 T1)
67
What is the function of the FDP?
Flexes fingers at the DIPJs
68
What is the innervation of the FDP?
Median nerve laterally | Ulnar nerve medially
69
What are the A2 and A4 ligaments needed for?
Critical to prevent bowstringing - most important
70
What are the A1, A3 and A5 ligaments needed for?
Overlie the MP, PIP and DIP joints
71
What pathology is A1 trigger involved in?
Trigger finger
72
What is the function of the cruciate pulleys?
Funcion to prevent sheath collapse and expansion during digitial motion - 3 total at the level of the joints
73
What is the palmar fascia?
Separates the palmar muscle bellies and flexor tendons from the skin
74
What pathology can occur with the palmar fascia?
Hypertrophy and fibrosis | Metaplasia in palmar fascia turns it into fibroblasts in dupuytren's disease
75
What are the 3 peripheral nerves of the hand?
Median Ulnar Radial
76
What muscles does the median nerve supply?
``` Flexors of forearm LOAF muscles (lumbircals, opponens pollicus, abductor pollicus brevis and flexor pollicus brevis) ```
77
What is the cutaneous sensation of the median nerve?
Radial 3 1/2 digits | Test: tip of index finger and base of thenar muscles
78
What muscles does the unlar nerve supply in the hand?
Small intrinsics of hand except LOAF | Test: abductor digiti minimi
79
What is the cutaneous sensation of the ulnar nerve?
Ulnar 1 1/2 digits | Test: dorsum and volar aspects of little finger
80
What muscles does the radial nerve supply?
Extensors of forearm | Test: extensor digitorum communis and extensor indicis
81
What is the cutaneous sensation fo the radial nerve?
Variable portion of the dorsum of the hand | Test: dorsum of 1st webspace
82
What pathological sign will be seen with a radial nerve problem?
Wrist drop
83
Where does the ulnar nerve run in the cubital tunnel?
Passes posterior to the medial epicondyle | Enters an arch formed by the two heads of the flexor carpi ulnaris muscles, and underneath the arcuate ligament
84
What are the boundaries of the carpal tunnel?
Carpal bones which form the dorsal, medial and alteral constraints Flexor retinaculum carpal ligament

MSK (34 decks)

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