MSK1 - Upper Limb Flashcards
(83 cards)
What forms the walls of the axilla?
Anterior: pec major and minor
Posterior: subscapularis
Medial: thoracic wall and serratus anterior
Lateral: intertubercular sulcus of humerus
Inferior: teres major and latissimus dorsi
The axillary artery is a continuation of which vessel? Which vessel does it become? And what are the anatomical borders for these?
Continuation of subclavian from lateral border of first rib
Becomes brachial at inferior border of teres major
What forms the brachial plexus? Which roots form each trunk?
Ventral rami of C5-T1
Upper/superior trunk: C5-6
Middle trunk: C7
Lower/inferior trunk: C8-T1
Damaging one of the trunks would result in what palsies? How do they appear on examination?
Upper: Erb’s palsy - medially rotated arm with flexed wrist
Lower: Klumpke’s palsy - claw hand
What are common reasons for damage to each trunk?
Upper: Hyperextension of head from shoulder e.g. fall, birth injury
Lower: undue abduction of the arm
Which nerves come from each CORD of the brachial plexus?
Lateral: lateral pectoral, lateral root of median, musculocutaneous
Posterior: thoracodorsal, axillary, radial, upper and lower subscapular nerve
Medial: medial pectoral, medial root of median, ulnar, medial cutaneous nerve of arm, and medial cutaneous of forearm
Describe the venous drainage of the upper limb?
Dorsal venous network in hand goes into cephalic (lateral) and basilic (medial) veins.
These veins communicate (cephalic to basilic) via the median cubital vein.
Describe the dermatome distribution of the upper limb
C6: thumb and lateral border of arm
C7: lateral palm and 2nd/3rd fingers
C8: 4th/5th fingers, medial palm and medial border of arm
C5/T1 down centre of anterior arm
Describe the lymphatic drainage of the upper limb
Axillary nodes
- anterior/pectoral group
- posterior/subscapular group
- apical group
- central group
- lateral group
Label the scapula

Acromion
Coracoid Process
Glenoid cavity
Spine
Supraspinous and infraspinous fossa
Subscapular fossa
Medial and lateral border
Inferior and superior angle
Supra and infraglenoid tubercles
What type of joints are the AC and SC joints?
AC: plane synovial
SC: saddle synovial
What is the scapulo-humeral rhythm?
Beyond the first 30 degrees of arm abduction, every further 3 degrees of movement is from 2 at the glenohumeral and 1 at the scapulo-thoracic
What muscles are responsible for each movement of the scapula?
Elevation: upper trapezius, rhomboids, levator scapulae
Depression: lower trapezius, pec minor, lower serratus anterior
Protraction: serratus anterior
Retraction: middle trapezius and rhomboids
Lateral rotation (elevates glenoid cavity): upper trapezius Medial rotation (depresses glenoid): gravity, levator scapulae, rhomboids and pec minor
What name is given to the cartilage surrounding the glenoid cavity and what purpose does it serve?
Glenoid labrum - deepens the socket for stability
Which ligaments surround the glenohumeral joint?
Coracohumeral
Coracoacromial
Glenohumeral ligaments
Which part of the shoulder joint is weakest and why?
Inferior - no muscle or ligaments
What are the two important bursae around the glenohumeral joint? Which communicates with the joint cavit?
The subacromial and subscapular bursae
- subscapular communicates
What are the muscles of the rotator cuff?
Subscapularis
Supraspinatus
Infraspinatus
Teres minor
What is the most important function of the rotator cuff?
Stability of the joint
What is the nerve supply to the deltoids? What injury may damage it?
Axillary nerve
- surgical neck of humerus fracture can damage
Where would you test for loss of sensation to see if axillary nerve injury had occurred?
Lateral shoulder
What is the action of the pec major?
Adducts and medially rotates humerus
Which vein is located in the deltopectoral triangle, and what is its clinical significance?
Subclavian vein
- used for central lines
What is the nerve supply of the serratus anterior? What clinical sign is seen when it is injured?
Long thoracic - C5-7
- winged scapula if damaged

