Lecture 18 Flashcards Preview

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Flashcards in Lecture 18 Deck (63):
1

What is the Flexor compartment of the arm?

Anterior comartment

2

What is the Extensor compartment of the arm?

Posterior Compartment

3

What are the anterior and posterior compartments of the arm divided by?

Medial and Lateral intermuscular septae

4

What are 2x features of the intermuscular septae of the humerus?

Septa attached to medial and lateral supracondylar ridges(lines) of humerus
Septa fade out in upper part of arm
Continuous with deep fascia

5

What 3x muscles make up the bulk of the front of the arm?

Coracobrachialis
Brachialis
Biceps Brachii
-all innervated by the musculocutaneous nerve

6

What is the relative position of musculocutaneous nerve to the 3x muscles it innervates on the bulked front of the arm?

Coracobrachialis -through
Brachialis -lies on
Biceps Brachii - underneath

7

What 2x muscles originate from the coracoid process and are partially attached to one another?

Coracobrachilais
Short head of biceps

8

Where does the Long head of biceps Brachii originate from?

Supraglenoid tubercle

9

Where does brachialis originate from?

front of humerus
-oppostie deltoid tuberosity

10

What does brachialis cover and attach to?

Brachialis covers anterior aspects of elbow joint
attches to coracoid process and tuberosity of the ulna

11

Where are the 2x insertions of Biceps Brachii?

Strong tendinous insertion into the tuberosity of the radius
Bicepital aponeuorosis into the deep fascia onto the anterio-medial aspect of the forearm

12

What is the pathway of the ulna nerve?

Behind medial intermuscular septum in lower 1/3 of arm
accompanies superior ulnar collateral artery
Behing medial epicondyle of humerus
Enters Forearm between 2x head of flexor carpi ulnaris

13

What is the relationship between the median nerve and ulnar nerve and the arm?

Neither the median nerve or ulna nerve have any branches into the arm

14

What are the vena comitantes reinforced by?

Basilic vein
-which pierces deep fascia half way up the arm

15

Where does the basilic vein pierce the deep fascia?

Half way up the arm

16

What is the pathway of the cephalic vein?

Lies in subcutaneous tissue
Travels up anterolateral aspect of arm
Into the groove between the anterior fibres of deltoid and pectoralis major (deltopectoral groove)
joins axillary vein (via piercing clavipectoral fascia)

17

What 7 muscles run from the pectoral girdle --> arm?

1. Deltoid
2. Teres Major
3. Coracobrachilais
Rotator Cuff Muscles
4. Supraspinatis
5. Infraspinatis
6. Teres Minor
7. Subscapularis

18

What 2x muscles bypass the arm and run from the Pectoral girdle --> to the forearm?

Biceps Brachii
Triceps Brachii

19

What 2x muscles run from the Arm --> forearm?

Brachilais
Triceps - Lateral and Medial Head

20

Deltoid

Large powerful Lateral muscle
Delta = traingle
3x muscle fibres (Anterior, Posterior and Middle fibres)
Origin: anatomical Horseshoe (distal end of clavicle, acromium and spine)
Insertion: 1/2 way down humerus, on lateral deltoid tuberosity
-roughened area
Axillary Nerve

21

What are the Key features about the anterior fibres of deltoid?

Unipennate
=strong (non parallel arangement of fibres increasing/impacting on strength)
Primary: Flex shoulder + internally rotates arm

22

What are the Key features about the Posterior fibres of deltoid?

Unipennate
=strong
Primary: Extend shoulder Externally rotates arm
-almost complete antagonist to anterior fibres

23

What are the Key features about the middle fibres of deltoid?

Multipennate (very strong)
Abducts arm

24

How does the position of the limb affect the deltoid?

Position of the limb, affect whether with the middle fibres, the anterior and posterior fibres either help or not help with ABD abduction
-Alone: Middle fibres will ABDuct, and pass imaginary line/15 degree buffer zone with subscapularis firing
-stationary(behind imaginary line): posterior and anterior fibres with ABDuct
-already Abducted arm = Anterior and posterior fibres shorten and assist with abduction

25

Teres Major

O: inferior angle of scapula
I: Medial lip of inter tubercular groove
-twisting around Teres Major = Insertion of Lat Dorsi
Teres Major + Lat Dorsi= Posterior fold of axilla
-Internal Rotation + Extends shoulder
Teres Major inferior border= boundary between Axillary and Brachial structures
Lower Subscapular nerve

26

What is the does the Inferior border of Teres major form?

Boundary between Axillary structures and Brachial structures

27

Triceps Brachii

3x Heads Lateral, Long + Medial(under)
Long head: Infraglenoid Tubercle --> b/w teres major(front) and teres minor (behind)
-below glenoid of scapula. Extra capsular
-Shunt muscle (weak)
Lateral + Medial head =arise from back of humerus
Lateral and long head contribute to supernation and pronation)
Medial head does most of work (Like Brachialis)
All merge to form strong tendinous insertion of Olecranon of Ulna (posterior)
Extensors of Elbow
-Assisted by Anconeous (extensor of forearm (and triceps))
Radial Nerve
Profunda Brachii artery

28

What is the Nerve supply for the extensor compartment of the shoulder?

Radial Nerve

29

Where is Quadrangular space located?

Lateral Side
Teres Major inferiory
Teres minor Superiorly
Humerus Laterally

30

Where is Triangular space located?

Medial side
Teres Minor and Major above and below respectively

31

What passes through the Quadrangular space?

axillary nerve
posterior humeral circumflex

32

What passes through the Triangular space?

Branch of circumflex scapula artery

33

Where is Triangular Interval located?

below teres major
between long and lateral heads of biceps brachii

34

What is the pathway of the Radial nerve and Profunda brachii?

infront of teres major --> pass to back of arm
Revealed from behind Triangular Interval
--> Back of humerus. Lying on origin of Medial head of triceps (in radial/spiral groove)

35

What is the pathway of the Ulna nerve?

supplies no structures in the arm
Medial side of posterior compartment with Superior Ulnar collateral artery(branch off brachial artery arising just below profunda)

36

What is the Superior Ulnar Collateral Artery?

branch off brachial artery, arising just below Profunda

37

Biceps Brachii

2x heads (long and short)
Long head = Supraglenoid tubercle = Intracapsular (inside shoulder joint = stabilises shoulder joint = Poppii muscle
Short head = coracoid (with Coracobrachialis)
Common insertion = Radial tuberosity + Bicepiteal Aponeurosis
-Primarily Supinator (feel) + Elbow Flexor
Musculocutaneous nerve

38

What 2x Anterior Arm muscles attach to the coracoid?

Short head of Biceps Brachii
+ Coracobrachilais

39

Brachialis

O: Anterior Distal Humerus (including intermuscular septa)
I: Tuberosity of the Ulna
-Pushes up Biceps Brachii when you flex elbow
Main elbow Flexor- cannot do anything else
Musculocutaneous nerve

40

Coracobrachialis

Musculocutaneous nerve landmark
O: Coracoid (with Short head biceps brachii)
I: Medial side of Humerus
ADDuction fo shoulder (+ flexion of shoulder)

41

What is bigger, a Trichanter or a tubercle?

Tubercle = big trichanter

42

What do the greater and lesser tubercles of the Humerus form?

Bicepital /Intertubercular groove
Anterior surface of humerus
-Where long head of biceps Brachii runs down

43

What muscles insert to the lateral lip of biceptial groove of the humerus?

Insertion of Pec Major

44

What muscles insert to the floor and medial lip of biceptial groove of the humerus?

Latissimus Dorsi (comes from posteriorly)
-forms Floor of biceptial groove
-posterior fold of axilla

45

What muscles insert to the medial lip of biceptial groove of the humerus?

Teres Major
(and Lat dorsi)

46

What tendon runs down the Bicepital groove?

Tendon of long head of Biceps Brachii

47

What does "Lady lies between 2x majors" mean?

Lady = Lat Dorsi
2x majors= Pec Major + Teres Major
-order of Intertubercular groove
-Lateral --> Medial

48

Where is the true formation of Arm compartments?

After insertion of Deltoid Tuberosity and Coracobrachialis
Established by Intermsucular septa (Medial and Lateral)
-Dont start forming until after D and C insertions
Intermuscular septa = continuous with Periosteum/Deep brachial fascia
-Divides into Anterior Flexor compart. and Posterior Extensor compart.
-Allows for more realestate for muscle to attach to
(e.g. Brachilais = more SA = more Pull on arm

49

What is the Anterior Flexor compartment of the arm's innervation?

Musculocutaneous nerve

50

What is the Posterior Extensor compartment of the arm's innervation?

Radial Nerve
-Only Triceps BRachii

51

What are important features of the Hands?

Dextress =fine motor controls
+ Power = strong grip
Large Movement
Cannot have big bulky muscles on a dextress structure
-therefore the forearm contains the strong power muscles of wrist and hand
-Tendons LONG and OFFSITE
Muscles have to be quite long, shorten 1/3 during contraction
-therefore to have Alot of movement your 1/3 needs to be really big
-Operation offsite/Remote control

52

What occurs at the distal part of the humerus?

Establishment of compartments that belong to Forearm
Forearm muscles originate from the arm (sides of elbow/epicondyles), (as anterior and posterior compartment are occupying realestate)
Then their tendons cross the wrist

53

What are the articular surfaces of the elbow?

Condyles
-curved articular surfaces of the elbow
+ their Epicondyles where most of the forearm muscles originate from

54

Where do most of the Forearm muscles originate from?

Epicondyles of the condyles of the humerus
-(Forearm muscles originate from the arm (sides of elbow/epicondyles), (as anterior and posterior compartment are occupying realestate)
Then their tendons cross the wrist)

55

What do the forearm muscles act upon?

arm and wrist
-cross 2x joints
-originate above elbow joint (on epicondyles of humerus)
-insert below wrist joint, after crossing wrist joint

56

Which muscle is attached to the intermuscular septa?

Brachialis

57

What are Biceps Brachialis and Brachialis innervated b?

Musculocutaneous nerve
-as Anterior flexor compartment

58

What are extensor Carpi radialis and Brachioradialis innervated by?

Radial Nerve

59

What are the 3x Anterior compartments muscles of the arm?

Biceps Brachii (2x heads)
Brachialis
Coracobrachialis

60

What is the Poppi muscle?

Long head of Biceps Femoris Ruptured
-main stabilise shoulder joint
- Not sesmoid bone
-does have synovial membrane + another tendon ontop
-but Rupturing due to bone movement around it
=Poppi muscle (distinctive buldge)

61

Olecranon

Posterior Ulna boney Prominence
-Insertion of Triceps Brachii
-allows Extension of Elbow

62

Radial Groove of Humerus

Between Lateral and Medial heads of Triceps Brachii

63

Anconeus

O: Posterior Lateral Epicondyle
I: Posterior Ulna (distal to olecranon)
Forearm extensor Muscle
-aids Extension of triceps brachii