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Anatomy for resit cause your stupid > MSK Upper Limb > Flashcards

MSK Upper Limb Flashcards

(259 cards)

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1
Q

What is the axilla a passageway for?

A

Vessels

Nerves

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2
Q

Anterior border of the axilla

A

Pectoralis major

Pectoralis minor

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3
Q

Posterior border of the axilla

A

Teres major
Scapularis
Latissmus dorsi

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4
Q

Medial wall of axilla

A

Thoracic wall

Serratus anterior

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5
Q

Lateral wall of axilla

A

Intertubercular sulcus of the humerus

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6
Q

What is the axillary artery a continuation of?

A

Subclavian artery

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7
Q

When does the axillary artery begin?

A

Lateral border of the 1st rib

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8
Q

When does the brachial artery?

A

Beyond the margin of the teres major

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9
Q

Nerve roots of the brachial plexus

A

C5-T1

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10
Q

What does the brachial plexus innervate?

A

The upper limb

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11
Q

Order of the brachial plexus

A 
Roots
Trunks
Divisions
Cords
Branches
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12
Q

What are the trunks of the brachial plexus?

A

Superior
Middle
Inferior

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13
Q

What are the divisions of the brachial plexus?

A

Anterior

Posterior

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14
Q

What are the cords of the brachial plexus?

A

Lateral
Posterior
Medial

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15
Q

Branches of the brachial plexus

A 
Musculocutaneous 
Axillary 
Medial
Radial
Ulnar
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16
Q

What does injury to the superior trunk cause?

A

Erb’s palsy

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17
Q

What does injury to the lower trunk cause?

A

Klumpke’s palsy

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18
Q

The cords of the brachial plexus are named in relation to what?

A

The axillary artery in the axilla

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19
Q

What are in close relation to the brachial plexus?

A

Anterior and posterior scalenes

Subclavian artery

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20
Q

What end of the dorsal venous arch does the cephalic vein make up?

A

Lateral end

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21
Q

What end of the dorsal venous arch does the basilic vein make up?

A

Medial end

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22
Q

What are superficial veins of the upper limb used for?

A

IV injections for transfusion

Blood testing

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23
Q

What is the median cubital vein?

A

Large communicating vein which shunts blood from the basilic vein to the cephalic vein

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24
Q

What is a dermatome?

A

An area of skin supplied by one spinal segment

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25
What lymph nodes are the upper limbs drained by?
Axillary nodes
26
5 groups of axillary nodes
``` Anterior/pectoral group Posterior/subscapular group Apical group Central group Lateral/humeral group (Axillary) ```
27
Another name for the shoulder girdle
Pectoral girdle
28
Function of the shoulder girdle
A set of bones that connect the upper limb to the axial skeleton on each side
29
What type of cartilage is the glenoid labrum?
Fibroelastic cartilage
30
Where is the clavicle commonly fractured?
Middle 1/3rd
31
What type of joint is the acromioclavicular joint?
Synovial plane joint
32
What type of joint is the sternoclavicular joint?
Synovial saddle joint
33
What type of joint does the sternoclavicular joint ACT as?
Synovial ball and socket joint
34
What ratio do the scapula and humerus move in?
1:2 ratio
35
What is the scapulo-humeral rhythm?
Beyond approx. 30 degrees, for every 3 degrees of abduction, 2 degrees occur at the shoulder joint and 1 degree at the scapulothoracic joint
36
What is the scapulo-thoracic joint?
The movement of the scapula on the thoracic wall
37
What elevates the scapula?
Levator scapulae Serratus anterior Rhomboids Superior fibres of the trapezius
38
What depresses the scapula?
Pectoralis major Pectoralis minor Lattissimus dorsi Inferior fibres of the trapezius
39
What retracts the scapula?
Middle fibres of the trapezius Rhomboids Lattisimus dorsi
40
What causes lateral (upward) rotation of the glenoid cavity?
Trapezius (upper and lower fibres) | Serratus anterior
41
What causes medial (downward) rotation of the glenoid cavity?
Gravity Levator scapulae Rhomboids Pectoralis major
42
Another name for the shoulder joint
Gleno-humeral joint
43
What type of joint is the shoulder joint?
Synovial ball and socket joint
44
What is the ball and what is the socket of the shoulder joint?
Ball - head of humerus | Socket - Glenoid cavity
45
Function of the glenoid labrum
Deepens the glenoid cavity and effectively increases the surface of the shoulder joint
46
Ligaments of the shoulder joint
``` Transverse humeral ligament Glenohumeral ligament Coracoacromial ligament Coracoclavicular ligament Coracohumeral ligament ```
47
What does the coracoacromial ligament strengthen?
The superior aspect
48
What does the coracohumeral ligament strengthen?
Superior aspect
49
Function of the coracoclavicular ligament?
Maintains alignment of the clavicle
50
What is the weak area of the shoulder and why?
The glenohumeral ligament | Not supported by any muscles
51
What does the glenohumeral ligament strengthen?
The anterior aspect
52
What makes up the coracoacromial arch?
Acromion Coracoid process Coracoacromial ligament
53
Function of the coracoacromial arch
To prevent upward displacement of the humeral head
54
Two bursae of the shoulder
Subacromial (subdeltoid) bursae | Subscapular bursae
55
What shoulder bursae communicates with the shoulder cavity?
Subscapular bursae
56
What shoulder bursae is injured in a rotator cuff tear?
Subacromial bursae
57
What is the subacromial/deltoid bursae related to?
Supraspinatus tendon
58
What are the rotator cuff muscles?
Subscapularis Supraspinatus Infraspinatus Teres minor
59
Action of the anterior fibres of the deltoid
Flexion of shoulder | Internal rotation of shoulder
60
Action of the middle fibres of the deltoid
Abduction of the shoulder
61
Action of the posterior fibres of the deltoid
Extension at shoulder joint | External rotation of shoulder joint
62
Innervation of the deltoid
Axillary nerve
63
How can the axillary nerve be damaged?
Fracture of the surgical neck of the humerus
64
How can you test for axillary nerve function?
Deltoid | Test for sensation on lateral side of proximal forearm
65
Actions of pectoralis major on the shoulder
Adduction Internal rotation Flexion
66
Borders of the deltopectoral triangle
Deltoid Clavicle Pec major
67
What is found in the deltopectoral triangle and what is it used for?
Cephalic vein | Used for central lines
68
Actions of serratus anterior
Protraction of scapulae | Stabilises scapulae during limb movements and keeps it pulled against the thoracic cage
69
What innervates the serratus anterior?
Long thoracic nerve
70
Damage to the long thoracic nerve causes what?
Winging of scapulae
71
Pathology of winging of scapulae
Medial border of scapulae moves laterally and posteriorly away from thoracic wall
72
What procedure can result in winging of the scapulae?
Radical mastectomies
73
What do superior fibres of the trapezius do?
Elevate scapulae
74
What do middle fibres of the trapezius do?
Retract scapulae
75
What do inferior fibres of the trapezius do?
Depress the scapulae
76
Innervation of trapezius
Accessory nerve
77
Roots of accessory nerve
CN XI
78
Action of teres major on shoulder
Adduction Extension Medial rotation
79
Action of lattisimus dorsi on the shoulder
Extension Adduction Medial rotation
80
What flexes the shoulder?
Anterior fibres of deltoid Serratus anterior Pectoralis major
81
What extends the shoulder?
Posterior fibres of deltoid Lattisimus dorsi Teres major
82
What adducts the shoulder?
Lower pec major Latissimus dorsi Teres major Teres minor
83
What abducts the shoulder?
Middle fibres of the deltoid | Supraspinatus
84
What laterally/externally rotates the shoulder?
Teres minor Infraspinatus Posterior fibres of the deltoid Lower trapezius
85
What medially/internally rotates the shoulder?
Anterior fibres of deltoid Teres major Lattisimus dorsi Pectoralis major
86
What does the long head of the biceps brachii arise from?
Supraglenoid tubercle
87
What does the short head of the biceps brachii arise from?
The coracoid process
88
Where do the two heads of the biceps brachii tendon insert?
The tuberosity of the radius
89
Actions of the biceps brachii
Flexes shoulder Flexes elbow Supinator of radio-ulnar joint
90
Innervation of biceps brachii
Musculocutaneous nerve
91
Musculocutaneous nerve roots
C5-C7
92
Axillary nerve roots
C5 + C6
93
What cord is the musculocutaneous nerve from?
Lateral cord
94
What cord is the axillary nerve from?
Posterior cord
95
Muscles of the anterior arm
Biceps brachii Brachialis Coracobrachialis
96
Root values of the median nerve
C5-T1
97
Median nerve cord
Lateral and medial cords
98
Root values of the radial nerve
C5-T1
99
Radial nerve cord
Posterior cord
100
Ulnar nerve roots
C8-T1
101
Ulnar nerve cord
Medial cord
102
Attachments of the coracobrachialis
From the coracoid process | Inserted into the medial margin of the humerus at about its middle
103
Actions of coracobrachialis
Flexion of shoulder | Adduction of shoulder
104
Innervation of coracobrachialis
Musculocutaneous
105
Innervation of brachialis
Musculocutaneous
106
Attachments of brachialis
Arises from front of the distal 1/2 of the shaft of the humerus
107
Actions of brachialis
Flexion of elbow
108
What does the musculocutaneous nerve perforate?
Coracobrachialis
109
What does the musculocutaneous nerve descend between?
Brachialis and biceps brachii
110
What does the musculocutaneous nerve continue as?
Lateral cutaneous nerve of the forearm
111
What does the musculocutaneous nerve provide sensation to?
Lateral side of forearm
112
4 main nerves of the arm
Musculocutaneous Radial Ulnar Median
113
What is the brachial artery a direct continuation of?
The axillary artery
114
When does the brachial artery begin?
Lower border of teres major
115
When does the brachial artery end?
In the cubital fossa close to the neck of the radius
116
What does the brachial artery divide into?
Radial and ulnar arteries
117
What is a deep artery which is a branch of the brachial artery?
Profunda brachii artery
118
On specimens, what does the median nerve look like?
Very thick
119
Where does the median nerve arise?
The axilla
120
Where does the median nerve descend?
along lateral side of axillary artery and upper part of brachial artery Enters cubital fossa
121
Where does the ulnar nerve descend?
Along the medial side of the brachial artery (Artery lateral to nerve) Enters posterior compartment of arm due to medial intermuscular septum and runs along the medial head of the triceps
122
How can the radial nerve be injured?
Injury to the radial groove of the humerus
123
How can the axillary nerve be injured?
By damage to the surgical neck of the humerus
124
How can the ulnar nerve be injured?
Damage to the medial epicondyle
125
Contents of the cubital fossa
``` Brachial artery Median nerve Radial nerve Biceps brachii Pronator teres Supinator Biceps brachii Brachioradialis Cubital vein ```
126
What can the cubital vein be used for?
IV injections
127
Base of cubital fossa
Imaginary line between the two epicondyles
128
Median border of border of cubital fossa
Lateral border of pronator teres
129
Lateral border of cubital fossa
Medial border of brachioradialis
130
Innervation of the triceps brachii
Radial nerve
131
Heads of the triceps brachii
Long Medial Lateral
132
Where does the long head of the triceps brachii insert?
Infraglenoid tubercle
133
Where does the triceps tendon insert?
Olecranon process of ulna
134
Action of triceps brachii
Extension at elbow
135
Innervation of anconeus
Radial nerve
136
Action of anconeus
Extension of elbow
137
What accompanies the radial nerve in the radial groove?
Profunda brachii artery
138
Injury to the radial nerve causes what?
Wrist drop
139
Pathway of the radial nerve
Enters arm anterior to triceps Runs with the profunda femoris artery Curves around the midshaft region of the humerus in the radial groove
140
What type of joint is the elbow joint?
Synovial hinge
141
What muscles flex the elbow?
Biceps brachii Brachialis Brachioradialis
142
What muscles extend the elbow?
Triceps brachii | Anconeus
143
What is the function of the annular ligament?
Holds the head of the radius
144
What are the three ligaments on either side of the elbow?
Ulnar Collateral ligament Radial collateral ligament Annular ligament
145
What type of joints are the proximal and distal radio-ulnar joints?
Synovial pivot
146
How would one dislocate their radius from proximal radio-ulnar joint?
Pulled elbow or | Subluxation of radial head
147
What muscles supinate the radio-ulnar joints?
Biceps brachii | Supinator
148
What is the main supinator of the radio-ulnar joint?
Biceps brachii
149
What are the assisting muscles that cause supination of the radio-ulnar joint?
Extensor pollicus longus | Extensor carpi radialis longus
150
What muscles pronate the radio-ulnar joints?
``` Pronator teres Pronator quadratus Flexor carpi radialis Palmaris longus Brachioradialis ```
151
Innervation of the pronator teres
Median nerve
152
Innervation of flexor carpi radialis
Median nerve
153
Innervation of flexor carpi ulnaris
Ulnar nerve
154
Innervation of palmaris longus
Median nerve
155
Action of the pronator teres
Pronation
156
Actions of flexor carpi ulnaris
Flexion of wrist | Adduction of wrist
157
Actions of flexor carpi radialis
Flexion of wrist | Abduction of wrist
158
Action of the palmaris longus
Flexion of wrist
159
Which compartment does the Brachioradialis belong to?
Extensor compartment
160
Innervation of Brachioradialis
Radial nerve
161
Action of Brachioradialis
Flexion at elbow
162
What is the flexor digitorum superficialis superficial to?
Flexor digitorum profundus
163
Where does the FDS attach to?
middle/second phalanges of the 4 fingers
164
Actions of the Flexor digitorum superficialis
Flexion of wrist Flexion at metacarpalphalangeal joints Flexion at interphalangeal joints
165
What are the deep muscles of the forearm in contact with?
Bones and interosseous membranes
166
What are the deep muscles of the forearm?
Flexor digitorum profundus Flexor pollicus longus Pronator quadratus
167
Actions of flexor digitorum profundus
Flexes phalanges | Flexes wrist
168
Innervation of the flexor digitorum profundus
Medial (4th + 5th digits) = ulnar nerve | Lateral (2nd + 3rd digits) = median nerve
169
Innervation of the flexor pollicus longus
Median nerve
170
Action of the flexor pollicus longus
Flexion of thumb
171
Action of the pronator quadratus
Pronation
172
Innervation of pronator quadratus
Median nerve
173
Attachments of the pronator quadratus
Origin at ulna | Passes across to be inserted into radius
174
Where does the median nerve lie in relation to the brachial artery?
Superomedial to the artery
175
Where does the ulnar nerve enter the forearm?
By passing between the heads of the flexor carpi ulnaris muscle
176
Where does the ulnar nerve lie in relation to the ulnar artery?
Nerve lies medial to the artery
177
Where does the brachial artery divide?
At the neck of the radius
178
Where is the radial pulse felt?
Medial to the tendon of the flexor carpi radialis muscle
179
Bones forming the borders of the carpal tunnel
Scaphoid and trapezium on the lateral side | Pisiform and hamate on the medial side
180
What is the flexor retinaculum?
A strong fibrous band which converts the concavity of the palmar surface (carpal bones) into a channel - the carpal tunnel
181
Contents of the carpal tunnel
Median nerve 4 tendons of the FDS 4 tendons of the FDP 1 tendon of the FPL
182
What is carpal tunnel syndrome caused by?
Any lesion that significantly reduces the size of the carpal tunnel
183
Most sensitive structure of the carpal tunnel affected in carpal tunnel syndrome
Median nerve
184
What is the palmar fascia (aponeurosis) a continuation of?
Palmaris longus muscle
185
What make up the thenar eminence?
Abductor pollicus brevis Flexor pollicus brevis Oppenens pollicus
186
What innervates the thenar muscles?
Median nerve
187
What makes up the hypothenar eminence?
Abductor digiti minimi Flexor digiti minimi Oppenens digiti minimi
188
What innervates the hypothenar eminence?
Ulnar nerve
189
Action of abductor digiti minimi
Abduction of pinkie
190
Action of flexor digiti minimi
Flexes MCP of pinkie
191
Action of opponens digiti minimi
Flexes pinkie towards palm, producing oppositio
192
Two heads of the adductor policus
Transverse | Oblique
193
Innervation of adductor policus
Ulnar nerve
194
Where does each lumbrical originate from?
The tendon of the flexor digitorum profundus
195
Actions of lumbricals
Flex fingers at the MCP joint and SIMILTANEOUSLY | Extend the interphalangeal joints of digitis 2-5
196
Innervation of lumbricals
medial 2 lumbricals = ulnar nerve | Lateral 2 lumbricals = median nerve
197
What are the interossei bones present between?
The metacarpal bones
198
How many interossei do we have?
4 dorsal | 3 palmar
199
Innervation of interossei
Ulnar nerve
200
Action of dorsal interossei
DAB | Abduction
201
Action of palmar interossei
PAD | Adduction
202
What artery is the main contributor to the superficial palmar arch?
Ulnar artery
203
What artery is the main contributor to the deep palmar arch?
Radial artery
204
What does the radial nerve supply on the hand?
Skin on the dorsal aspect of the hand
205
How does the median nerve enter the hand?
Through the carpal tunnel
206
Another name for the wrist joint
Radiocarpal joint
207
What type of joint is the wrist joint?
Synovial condyloid
208
Articular parts of the wrist joint
``` Proximal = radius Distal = proximal row of carpal bones ```
209
3 bones of the hand
Carpals Metacarpals Phalanges
210
Which carpal bone is most commonly fractured and what does this mean it is at risk of?
Scaphoid | Avascular necrosis
211
Blood supply to the scaphoid
Distal to proximal
212
What type of joint is the 1st CMC joint?
Synovial saddle
213
What type of joint is the 2nd-5th CMC joints?
Synovial condyloid
214
What type of joints are the MCP joints?
Synovial condyloid
215
What type of joints are the interphalangeal joints?
Synovial hinge
216
What innervates the posterior forearm muscles?
Radial nerve
217
Action of extensor carpi radialis longus and brevis
Extension of wrist | Abduction of wrist
218
Action of extensor carpi ulnaris
Extension of wrist | Adduction of wrist
219
Action of extensor digitorum
Extends medial 4 digits at MCP joint
220
Action of Brachioradialis
Flexion at elbow
221
Innervation of brachioradialis
Radial nerve
222
Innervation of supinator
Radial nerve
223
Action of extensor digiti minmi
Extends 5th finger at MCP joint
224
What does the supinator cover?
Shaft of radius completely EXCEPT on medial side
225
Action of supinator
Supination of radio-ulnar joints
226
What does the radial nerve divide into and where?
Superficial and deep branches | In the cubital fossa
227
What is the deep branch of the radial nerve also called?
Posterior intraosseous nerve
228
Features of the superficial branch of the radial nerve
Sensory | Is distributed on skin on dorsum of hand
229
What occurs on the dorsum of the hand from the extensor muscle tendons?
Synovial sheaths
230
What results in a "dinner fork deformity"?
Colles fracture of distal radius
231
What is the anatomical snuffbox?
A shallow depression on the lateral aspect of the wrist when the thumb is extended fully
232
What binds the anatomical snuffbox laterally?
Abductor pollicus longus | Extensor pollicus brevis
233
What binds the anatomical snuffbox laterally?
Extensor pollicus longus
234
What two carpal bones are in the anatomical snuffbox?
Scaphoid | Trapezium
235
What lies on the floor of the anatomical snuffbox?
Radial artery
236
What are the extensor compartment thumb muscles innervated by?
Radial nerve
237
When the 4 extensor digitorum tendons flatten, what do they form and what are these?
Form extensor expansions These are triangular tendinous aponeurosis that wraps around the dorsum and sides of the head of the metacarpal and base of the proximal phalanx
238
What muscles attach to the extensor expansion muscle?
Lumbricals Extensor indices Dorsal interossei Palmar interossei
239
When may compression of the axillary artery be necessary?
When profuse bleeding occurs due to severe injury to the upper limb
240
What is common in the infection of the upper limb?
Enlargement of axillary lymph nodes
241
What does erbs palsy result in?
Waiter's tip position
242
What is the presentation of waiters tip position?
Medially rotated with wrist flexed
243
What causes upper brachial plexus injury and give some examples?
Undue hyperextension of head from shoulder Fall on the shoulder Birth injury During anaesthesia
244
What causes klumpkes palsy?
Undue abduction of arm
245
What muscles are affected in klumpkes palsy?
Intrinsic muscles of hand | Ulnar flexors of wrists and fingers
246
Branches of the lateral cord of brachial plexus
Lateral pectoral Lateral root of medial nerve Musculocutaneous
247
Branches of the medial cord of brachial plexus
``` Medial pectoral Ulnar Medial cutaneous nerve of arm Medial cutaneous nerve of forearm Median ```
248
Branches of posterior cord of brachial plexus
Thoracodorsal nerve Axillary Radial Subscapular nerve
249
What makes up the coracoclavicular ligament?
Trapezoid ligament | Conoid ligament
250
What is the conoid tubercle an attachment for?
Conoid ligament
251
What are the attachments of the conoid ligament?
Binds the clavicle to the coracoid process of the scapula
252
Function of the shoulder joint ligaments
Strengthen and ease the movements at the shoulder joint
253
What are shoulder ligaments made from?
Thickening of joint capsule
254
What nodes would drain the infection of the pinkie?
Superficial inguinal nodes
255
What nodes would drain a boil in the scapular region?
Axillary
256
What nodes would drain the medial part of the breast close to the sternum?
Internal thoracic nodes
257
What nodes would drain the lateral part of the breast close to the axilla?
Axillary
258
Lymphatic drainage of above the umbilicus?
Axillary
259
Lymphatic drainage of below the umbilicus
Superficial inguinal

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