Lecture 8 Flashcards by Elise Ponchard

How many somites form a limb bud?

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When do the elbow and knee joints form during development?

12 weeks

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Where is the clavicle most likely to fracture and why?

Between the lateral 1/3 and the medial 1/3 (mid shaft)

Weakest point

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Which muscles pull the clavicle parts on top of each other when it’s fractured?

Deltoid pulls down
SCM pulls up
Pectoral muscles pull across

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Which part of the humerus makes contact with the ulna?

The trochlea

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Which part of the humerus makes contact with the radius?

The capitulum

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Which part of the humerus does the ulna sit in full extension?

The olecranon process.

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Which part of the humerus does the ulna sit in full flexion?

The coronoid process.

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Which part of the humerus does the radius sit in full flexion?

The radial fossa

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Where is the humerus most likely to fracture?

Surgical neck

Mid shaft

Supracondylar

Medial epicondyle

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What structures are endangered by a surgical neck humerus fracture?

Axially nerve

Posterior circumflex artery

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What structures are endangered by a mids haft humerus fracture?

Posterior side of radial artery

Deep brachial artery (profunda)

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What structures are endangered by a supracondylar humerus fracture?

Median nerve

Brachial artery

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What structures are endangered by a medial epicondyle humerus fracture?

Ulnar nerve

Avulsion of epicondyle

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What are the segments of the upper and lower limb buds?

Upper C1-T1

Lower L2-S2

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What are the superficial and deep muscles of the upper limb from the spine?

Superficial:
Trapezius
Latissimus dorsi

Deep:
Levator scapulae
Rhomboid minor
Rhomboid major

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What is the:
Origin?
Insertion?
Movements?
Nerve supply?

Of the trapezius

Origin: occipital protrudence
Insertion: spine of scapula? Spinous processes? Nuchal ligament?
Movements: elevation (superior fibres), depression (inferior fibres), protraction/rotation (both)
Nerve supply: cranial nerve 11?

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What is the:
Origin?
Insertion?
Movements?
Nerve supply?

Of the Latissimus dorsi?

Origin: thoracolumbar fascia
Insertion: inter tubercular groove of humerus (bicipital groove)
Movements: internal rotation, outward rotation, adduction
Nerve supply:

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What is the:
Origin?
Insertion?
Movements?
Nerve supply?

Of the levator scapulae?

Origin: transverse processes or cervical spine
Insertion: superior angle of scapula
Movements:
Nerve supply:

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What is the:
Origin?
Insertion?
Movements?
Nerve supply?

Of the rhomboid minor and major

Origin: spinous processes of thoracic spine
Insertion: medial border of scapula
Movements: retraction of scapula (moving inwards)
Nerve supply:

Separated by the spine of the scapula
Minor above major

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What are the pectoral muscles?

Pectoralis major
Pectoralis minor
Subclavius
Serratus anterior

What is the:
Origin?
Insertion?
Movements?
Nerve supply?

Of pectoralis major?

Origin: wide, sternum, median part of clavicle
Insertion: lateral lip of intertubercular groove of humerus
Movements: internal rotation, abduction

What is the:
Origin?
Insertion?
Movements?
Nerve supply?

Of pectoralis minor?

Origin: ribs
Insertion: coracoid process
Movements: protraction upwards and outwards (lifts rib cage)

What movements occur at the subclavius?

Depression of the clavicle.

``` What is the: Origin? Insertion? Movements? Nerve supply? ``` Of the serratus anterior

Origin: lateral edge of ribs Insertion: medial border of scapula Movements: accessory respiratory? Nerve supply: lies on superficial side

What is the deltopectoral groove?

In between the superior border of pectoral major and inferior border of deltoid. Contains cephalic vein on lateral side of arm. Important in shoulder separation surgery.

How does winging of the scapula occur?

Due to paralysis of the serratus anterior

What are the intrinsic shoulder muscles?

``` Deltoid Teres major Teres minor Supraspinatus Infraspinatus Subscapularis ```

``` What is the: Origin? Insertion? Movements? Nerve supply? ``` Of the deltoid

Origin: spine of scapula? Insertion: deltoid tuberosity on humerus Movements: abduction, flexion, extension Nerve supply:

``` What is the: Origin? Insertion? Movements? Nerve supply? ``` Of the teres major

Origin: lateral border of scapula Insertion: medial lip of intertubercular groove Movements: adduction, rotation Nerve supply:

What are the rotator cuff muscles?

SITS Supraspinatus Infraspinatus Teres minor Subscapularis

``` What is the: Origin? Insertion? Movements? Nerve supply? ``` Of the supraspinatus?

Origin: Insertion: Movements: Nerve supply:

``` What is the: Origin? Insertion? Movements? Nerve supply? ``` Of the infraspinatus

Origin: supraspinatus fossa of scapula Insertion: greater tubercle of humerus Movements: adduction Nerve supply:

``` What is the: Origin? Insertion? Movements? Nerve supply? ``` Of the teres minor

Origin: Insertion: Movements: adduction Nerve supply:

``` What is the: Origin? Insertion? Movements? Nerve supply? ``` Of the subscapularis

Origin: anterior side of scapula Insertion: Movements: adduction Nerve supply:

What are the roles of the rotator cuff muscles?

Stabilise shoulder Act as dynamic ligaments Fixators - fix head of humerus in glenoid fossa

What rotator cuff injuries can occur?

``` Impingement or supraspinatus Frozen shoulder (adhesive capsulitis) - calcification of bursa, bursa can be subaeromid or subdeltoid ```

What biceps injuries can occur?

Tendinitis - long head of biceps at bicipital groove undergoes a lot of tension. Dislocation Rupture of long head of biceps - Popeye syndrome, tendon breaks, must be surgically reattached

What are the muscles of the anterior compartment of the arm?

Biceps Coracobrachialis Brachialis

``` What is the: Origin? Insertion? Movements? Nerve supply? ``` Of the biceps

Origin: LH supraglenoid tubercle, SH coracoid process. Insertion: both heads converge past elbow to bicipital aponeurosis and radial tuberosity. Movements: supination of forearm, flexion, extension. Nerve supply: musculocutaneous nerve

``` What is the: Origin? Insertion? Movements? Nerve supply? ``` Of the coracobrachialis

Origin: coracoid process Insertion: medial side of humerus shaft Movements: flexion Nerve supply: musculocutaneous nerve

``` What is the: Origin? Insertion? Movements? Nerve supply? ``` Of the brachialis

Origin: humerus shaft Insertion: ulnar tuberosity Movements: flexor of the elbow joint Nerve supply: musculocutaneous nerve

What are the muscles of the posterior compartment of the arm?

Triceps Anconeus

``` What is the: Origin? Insertion? Movements? Nerve supply? ``` Of the anconeus

Origin: supracondylar ridge/shaft of humerus Insertion: ulnar Movements: assists triceps during extension Nerve supply: radial nerve

``` What is the: Origin? Insertion? Movements? Nerve supply? ``` Of the triceps

Origin: medial and later head - shaft of humerus, long head - scapula. Insertion: heads converge to olecranon process of ulnar. Movements: extension. Nerve supply: radial nerve - passes between medial and lateral heads.

What are the posterior apertures?

Suprascapular notch Quadrangular space Triangular space Triangular interval

Which structures pass through he suprascular notch?

The suprascapular nerve - can get pinched by ligament. Formed by the transverse scapular ligament and suprascapular notch.

Which structures pass through the quadrangular space?

The axillary nerve and posterior humerus circumflex artery.

Which structures pass through the triangular space?

The circumflex scapula artery.

Which structures pass through the triangular interval?

The radial nerve and deep brachial artery (profunda). Fracture of midshift = extensor muscles are compromised.