Upper Extremetiy Learning Objectives Flashcards
(191 cards)
1
Q
What are the bony landmarks the Latissimus dorsi attach to?
A
From the lower thoracic spinous processes, thoracolumbar fascia & iliac crest to the floor of the intertubercular sulcus of the humerus
2
Q
What are the bony landmarks the Levator scapulae attach to?
A
From the transverse process of C1-C4 to the superior angle & superomedial border of the scapula
3
Q
What are the bony landmarks the Rhomboids attach to?
A
Major: from spinous process T2-T5 to medial border of scapula
Minor: from ligamentum nuchae & spinous process to the most medial end of spine of scapula
4
Q
What are the bony landmarks the Trapezius attach to?
A
From the superior nuchal line, external occipital protuberance, ligamentum nuchae & cervical & thoracic spinous processes to the clavicle, acromion & scapular spine
5
Q
What are the actions of the Latissimus dorsi?
A
adduction extension & medial rotation of the humerus
6
Q
What are the actions of the Levator scapulae?
A
elevation & downward rotation of the scapulae
7
Q
What are the actions of the Rhomboids?
A
scapular retraction, elevation (upper) & downward rotation
8
Q
What are the actions of the Trapezius?
A
scapular elevation (upper), depression (lower), retraction (middle) & upward rotation (upper & lower)
9
Q
Distinguish between the extrinsic and intrinsic back muscles
A
Extrinsic back muscles are responsible for limb movement and respiration, while the intrinsic back muscles are responsible for
the deep vertebral column movement and stabilization
10
Q
List the intermediate extrinsic back muscles
A
Serratus posterior superior
Serratus posterior inferior
11
Q
List the superficial intrinsic back muscles
A
Splenius Capitis
Splenius Cervicis
12
Q
List the intermediate intrinsic back muscles
A
Erector Spinalis
Erector Longissimus
Erector Ilicostalis
13
Q
List the deep intrinsic (transversospinales) muscles of the back
A
Semispinalis
Multifidus
Rotatores
14
Q
What are the bony landmarks the deltoid attach to?
A
From the clavicle, acromion, and spine of scapula to the deltoid tuberosity of the humerus
15
Q
What are the bony landmarks the Supraspinatus attach to?
A
From the medial 2/3 of the supraspinatus fossa to the superior facet of the greater tubercle of the humerus & to shoulder joint capsule
16
Q
What are the bony landmarks the infraspinatus attach to?
A
From the medial 2/3 of the infraspinatus fossa to the middle facet of the greater tubercle of the humerus & to shoulder joint capsule
17
Q
What are the bony landmarks the Teres minor attach to?
A
From the upper 2/3 of the dorsal surface of the lateral border of the scapula to the inferior facet of the greater tubercle of the humerus & to shoulder joint capsule
18
Q
What are the bony landmarks the Subscapularis attach to?
A
From the subscapular fossa to the lesser tubercle of the humerus
19
Q
What are the bony landmarks the Teres major attach to?
A
From the dorsal surface of the inferior angle scapula & lower 1/3 of the lateral border of the scapula to the medial lip of the intertubercular sulcus of the humerus
20
Q
What are the actions of the Deltoid?
A
flexion & medial rotation (anterior), abduction (middle), extension & lateral rotation, horizontal extension (posterior) of humerus
21
Q
What are the actions of the Supraspinatus?
A
initiates lateral abduction of humerus & laterally rotates humerus; stabilizes glenohumeral joint (reinforces superior aspect of joint capsule)
22
Q
What are the actions of the Infraspinatus?
A
lateral rotation of the humerus; stabilizes the glenohumeral joint
23
Q
What are the actions of the Teres minor?
A
lateral rotation of the humerus; stabilizes the glenohumeral joint
24
Q
What are the actions of the Subscapularis?
A
medial rotation of the humerus; stabilizes the glenohumeral joint
25
What are the actions of the Teres major?
humeral adduction, medial rotation & extension
26
Describe the location and contents of the quadrangular space neurovascular tract
Location- exists between the humerus, long head of triceps, Teres minor & Teres major
Contents- axillary nerve, posterior circumflex humeral artery & accompanying vein
27
Describe the location and contents of the medial border of the scapula neurovascular tract
Location- parallel to the spine
Contents- dorsal scapular artery & nerve
28
Describe the location and contents of the scapular notch neurovascular tract
Location- inferior to the superior transverse scapular ligament, medial to the coracoid process, lateral to the superior angle of the scapula
Contents- suprascapular artery & suprascapular nerve
29
Describe a shoulder separation and relate anatomical structures
Tearing of the acromioclavicular ligament and maybe even the coracoclavicular ligament.
May cause damage from the acromion process moving inferior
30
Describe shoulder dislocation and relate anatomical structures
Separation of the glenohumeral joint.
May cause damage from blocking axilla contents
31
Describe the location and contents of the subacromial space
Location- subacromial, subdeltoid & subtendinous of Subscapularis
Contents- lined by synovial membrane with synovial fluid
32
Predict what neurovascular structures would be injured based on bone fracture located at the medial border of the scapula
The dorsal scapular artery and the dorsal scapular nerve because they run parallel to the medial border of the scapula
33
Describe the location and function of the bursae of the scapular region
The scapular bursae consist of the subacromial bursae, subdeltoid bursae & subtendinous bursae of the Subscapularis.
All function to cushion and reduce friction between bone, tendon & muscle
34
Which dermatome covers the back of the head and cheek?
C2
35
Which dermatome covers the back of neck and upper trap?
C3
36
Which dermatome covers the back of shoulder swoops up to the lower neck?
C4
37
Which dermatome is at the very top of the back and the lateral part of the brachial part of the arm?
C5
38
Which dermatome is at the very top of the back and the lateral part of the forearm and thumb?
C6
39
Which dermatome covers the middle fingers?
C7
40
Which dermatome covers the pinky and ring fingers?
C8
41
Which dermatome covers the medial part of the forearm?
T1
42
Which dermatome covers the medial part of the arm and the upper back?
T2
43
Which group of dermatomes covers the back from the scapula to the iliac crest?
T3-T12
44
List all of the major arteries of the shoulder blade from proximal to distal
Thyrocervical trunk
R subclavin
Suprascapular
Dorsal scapular
Circumflex scapular
Thoracodorsal
Subscapular
Axillary
45
What are the bony landmarks the pectoralis major attach to?
From clavicle, costal cartilages, sternum & aponeurosis of the external oblique to the lateral lip of the intertubercular sulcus of the humerus
46
What are the bony landmarks the Pectoralis minor attach to?
From outer surface of ribs 3-5 to the coracoid process
47
What are the actions of the Pectoralis minor?
anterior tilt of scapula; assists with depression of the shoulder & forced inspiration
48
What are the actions of the Pectoralis major?
humeral adduction, flexion & medial rotation (sternocostal portion assists with extension of the flexed arm)
49
What are the joints of the pectoral (shoulder) girdle and their synovial classification?
Sternoclavicular- (saddle or seller)
Acromioclavicular- (plane or gliding)
Glenohumeral- (ball & socket)
Scapulothoracic- (pseudo-joint for full glenohumeral function)
50
What are the functions and attachments of the Coracoclavicular ligament?
Function- stabilizes acromioclavicular joint limiting medial displacement, protraction & elevation
Trapezoid
Attachments- from coracoid process to trapezoid line of clavicle
Conoid
Attachments- from coracoid process to conoid tubercle of clavicle
51
What are the functions and attachments of the Acromioclavicular ligament?
Function- stabilizes acromioclavicular joint
Attachments- from superior aspect of acromial end of the clavicle to adjacent acromion
52
What are the functions and attachments of the Coracoacromial ligament?
Functions- prevents the superior displacement of the humeral head by forming the coracoacromial arch
Attachments- from lateral border of coracoid process to acromion adjacent to clavicular articulation
53
What are the functions and attachments of the Coracohumeral ligament?
Functions- reinforces superoanterior aspects of joint capsule
Attachments- from base of coracoid process to anterior aspect greater tubercle
54
What are the functions and attachments of the Costoclavicular ligament?
Function- stabilizes sternoclavicular joint, limiting elevation of the clavicle
Attachments- from superior aspect of cartilage of first rib to undersurface of the clavicle
55
What are the functions and attachments of the Superior transverse scapular ligament?
Function- closes off the suprascapular notch
Attachments- from the base of the coracoid process to the medial edge of the scapular notch
56
What are the attachments of the Glenoid capsule ligament?
Attachments- from the circumference of gleniod cavity to anatomical neck of the humerus
57
What are the functions and attachments of the Glenohumeral ligament? (3 ligaments: superior, middle & inferior)
Function- stabilizes glenohumeral articulation
Attachments- from upper part of medial margain of gleniod cavity to lesser tubercle & anatomical neck
58
What are the innervations of the Latissimus dorsi?
(C6-C8) thoracodorsal nerve
59
What are the innervations of the Levator scapulae?
(C4-C5) dorsal scapular nerve (sensory: direct branches of C3-C4)
60
What are the innervations of the Rhomboids?
(C4-C5) dorsal scapular nerve (sensory: direct branches of C3-C4)
61
What are the innervations of the Trapezius?
accessory nerve (CN XI; motor) & C3-C4 (sensory)
62
What are the innervations of the Deltoid?
(C5-C6) axillary nerve
63
What are the innervations of the Supraspinatus?
(C4-C6) suprascapular nerve
64
What are the innervations of the Infraspinatus?
(C5-C6) suprascapular nerve
65
What are the innervations of the Teres minor?
(C5-C6) axillary nerve
66
What are the innervations of the Subscapularis?
(C5-C6) upper & lower Subscapular nerves
67
What are the innervations of the Teres major?
(C5-C6) lower subscapular nerve
68
What are the innervations of the Pectoralis minor?
(C5-T1) medial & lateral pectoral nerves
69
What are the innervations of the Pectoralis major?
(clavicular head C5-C7) (sternocostal head C8-T1) lateral & medial pectoral nerves
70
What are the bony landmarks the anconeous attach to?
From lateral epicondyle of humerus to lateral surface of the olecranon process
71
What are the bony landmarks the biceps brachii attach to?
From coracoid process (short head) & supraglenoid tubercle (long head) of the scapula to the radial tuberosity & deep antebrachial fascia (through the bicipital aponeurosis
72
What are the bony landmarks the brachialis attach to?
From the distal anterior shaft of the humerus & lateral & medial intermuscular septa to the coronoid process & ulnar tuberosity
73
What are the bony landmarks the coracobrachialis attach to?
From the coracoid process to the proximal medial shaft of the humerus
74
What are the bony landmarks the triceps brachii attach to?
From the infraglenoid tubercle of the scapula (long head) & proximal posterolateral (lateral head) & distal posteromedial (medial shaft of the humerus to the olecranon process of the ulna
75
Why are the actions of the anconeous?
Extension of the elbow
76
What are the actions of the biceps brachii?
Flexion of shoulder & elbow & supination of the forearm
77
What are the actions of the brachialis?
Flexion of the elbow
78
What are the actions of the coracobrachialis?
Flexion & adduction of the shoulder
79
What are the actions of the triceps brachii?
Extension of the shoulder (long head) & extension of the elbow (long, lateral & medial heads)
80
What are the innervations of the anconeous?
(C7-8) radial nerve
81
What are the innervations of the biceps brachii?
(C5-6) musculocutaneous nerve
82
What are the innervations of the brachialis?
(C6-7) musculocutaneous nerve & small branch from radial nerve
83
What are the innervations of the coracobrachialis?
(C6-7) musculocutaneous nerve
84
What are the innervations of the triceps brachii?
(C6-T1) radial nerve
85
What are the boundaries of the axilla? (apex, base, anterior, posterior, medial, lateral)
Apex: 1st rib, clavicle
Base: skin of armpit
Anterior: pectoralis major muscle
Posterior: scapula, subscapularis
Medial: thoracic wall, Serratus anterior muscle
Lateral: humerus
86
What are the contents of the axilla?
3 cords of the brachial plexus, axillary vein, artery, and lymph nodes
87
What are the spinal cord segments for the dorsal scapular nerve?
(C4-5)
88
What are the spinal cord segments for the suprascapular nerve?
(C4-5)
89
What are the spinal cord segments for the long thoracic nerve?
(C5-7)
90
What are the spinal cord segments for the subclavian nerve?
(C5-6)
91
What are the spinal cord segments for the lateral pectoral nerve?
(C5-7)
92
What are the spinal cord segments for the lower subscapular nerve?
(C5-6)
93
What are the spinal cord segments for the thoracodorsal nerve?
(C6-8)
94
What are the spinal cord segments for the upper subscapular nerve?
(C5-6)
95
What are the spinal cord segments for the medial pectoral nerve?
(C8-T1)
96
What are the spinal cord segments for the medial cutaneous nerve of the arm?
(C8-T1)
97
What are the spinal cord segments of the medial cutaneous nerve of the forearm?
(C8-T1)
98
What are the spinal cord segments of the radial nerve?
(C5-T1)
99
What are the spinal cord segments of the axillary nerve?
(C5-6)
100
What are the spinal cord segments of the musculocutaneous nerve?
(C5-C7)
101
What are the spinal cord segments of the median nerve?
(C5-T1)
102
What are the spinal cord segments of the ulnar nerve?
(C7-T1)
103
What are the functions of the motor, sensory, and sympathetic axons in the peripheral nerves of the brachial plexus?
Motor- innervation of skeletal muscle
Sensory- impulses from skin or proprioceptive organs in the muscle (any cutaneous nerves and dorsal scapular nerve)
Sympathetic (pre/post)- innervation of smooth muscle of blood vessel wall
104
What is the naming convention for the spinal nerves as they exit the vertebral column?
Cervical- named based on the inferior vertebrae
All other- named based on the superior vertebrae
105
Describe the location and contents of the triangular space
Location- between the long head of the triceps, the Teres minor, and Teres major
Contents- circumflex scapular artery
106
Describe the location and contents of the triceps hiatus
Location- between the humerus, long head of the triceps and the Teres major
Contents- profunda brachii artery, radial nerve
107
What divides the anterior and posterior compartments of the arm?
The medial and lateral intermuscular septum
108
What are the muscles and actions of the anterior compartment of the arm?
Muscles- biceps brachii, coracobrachialis, brachialis
Actions- shoulder flexion, supination and elbow flexion
109
What are the muscles and actions of the posterior compartment of the arm?
Muscles- triceps brachii, anconeous
Actions- shoulder extension, and elbow extension
110
What is the neurovasculature of the anterior compartment of the arm?
Musculocutaneous nerve, brachial artery
111
What is the neurovasculature of the posterior compartment of the arm?
Radial nerve, profunda brachii artery
112
What neurovasculature structures would be injured based on a bone fracture at the surgical neck of the humerus?
Anterior and posterior circumflex humeral arteries
113
What dermatome is associated with the deltoid tuberosity?
C5
114
What dermatome is associated with the thumb?
C6
115
What dermatome is associated with the index finger?
C7
116
What dermatome is associated with the pinky finger?
C8
117
What dermatome is associated with the elbow?
T1
118
What neurovascular structures would be injured based on a bone fracture at the radial groove of the humerus?
Radial nerve and profunda brachii artery
119
What are the bony landmarks the flexor carpi radialis attach to to?
From the medial epicondyle (common flexor origin) of the humerus to the palmar aspect of the base of the 2nd metacarpal
120
What are the bony landmarks the flexor carpi ulnaris attach to?
From the medial epicondyle (common flexor origin) of the humerus & proximal ulnar shaft to the pisiform
121
What are the bony landmarks the flexor digitorum profundus attach to?
From the anterior proximal 2/3 of the ulna & interosseous membrane to the base of the distal phalanges of digits 2-5
122
What are the bony landmarks the flexor digitorum superficialis attach to?
From the medial epicondyle (common flexor origin) of the humerus to the sides of the middle phalanges of digits 2-5
123
What are the bony landmarks the flexor pollicis longus attach to?
From the anterior surface of the radius & interosseous membrane to the base of the distal phalanx of the thumb
124
What are the bony landmarks the palmaris longus attach to?
From the medial epicondyle of the humerus (common flexor origin) to the palmar aponeurosis
125
What are the bony landmarks the pronator quadratus attach to?
From the anterior surface of the distal ulnar to the anterior surface of the distal radius
126
What are the bony landmarks the pronator teres attach to?
From the medial epicondyle & ulnar coronoid process to the lateral aspect of the radius
127
What are the bony landmarks the supinatior attach to?
From the lateral epicondyle of the humerus, radial collateral ligament & superior crest of the ulna to the lateral surface of the proximal radius
128
What are the actions of the flexor carpi radialis?
Flexes & abducts hand at the wrist (radial deviation) & may assist in pronation of forearm & flexion of the elbow
129
What are the actions of the flexor carpi ulnaris?
Flexes & adducts hand at the wrist (ulnar deviation) & assists in flexion of the elbow
130
What are the actions of the flexor digitorum profundus?
Flexion of the 2-5 (metacarpophalangel & distal interphalangeal & proximal interphalangeal), & flexion of hand at wrist
131
What are the actions of the flexor digitorum superficialis?
Flexion of digits 2-5 (metacarpophalangeal & proximal interphalangeal), & hand at wrist
132
What are the actions of the flexor pollicis longus?
Flexes thumb (metacarpophalangeal & interphalangeal)
133
What are the actions of the palmaris longus?
Flexes hand at wrist & tenses palmar fascia
134
What are the actions of the pronator quadratus?
Pronates the forearm
135
What are the actions of the pronator teres?
Pronates & flexes the forearm
136
What are the actions of the supinator?
Supinates the forearm
137
What are the innervations of the flexor carpi radialis?
(C6-8) median nerve
138
What are the innervations of the flexor carpi ulnaris?
(C7-T1) ulnar nerve
139
What are the innervations of the flexor digitorum profundus?
(C7-T1) median (anterior interosseous nerve; 2nd & 3rd digits) & ulnar (4th & 5th digits) nerves
140
What are the innervations of the flexor digitorum superficialis?
(C7-T1) median nerve
141
What are the innervations of the flexor pollicis longus?
(C7-T1) median nerve (anterior interosseous nerve)
142
What are the innervations of the palmaris longus?
(C7-8) median nerve
143
What are the innervations of the pronator quadratus?
(C8-T1) median nerve (anterior interosseous nerve)
144
What are the innervations of the pronator teres?
(C6-7) median nerve
145
What are the innervations of the supinator?
(C5-6) radial nerve
146
What are the 3 joints of the elbow and their classifications?
Elbow-
1. Humeroulnar (ginglymus or hinge)
2. Humeroradial (plane or gliding)
3. Proximal radio-ulnar (pivot or trochoid)
147
What are the functions and attachments of the ulnar collateral ligament?
Functions- resists excessive cubital valgus
Attachments- from medial epicondyle to medial margain of coronoid process & olecranon process
148
What are the functions and attachments of the radial collateral ligament?
Function- resists excessive cubital varus
Attachments- from lateral epicondyle to anular ligament
149
What are the functions and attachments of the anular ligament?
Function- stabilizes proximal radioulnar joint
Attachments- from the anterior margain of radial notch to the posterior margain of radial notch surrounding head of humerus
150
What are the attachments of the interosseous membrane?
From interosseous border of radius to interosseous border of ulnar
151
What are the 7 bursae of the elbow?
Subcutaneous bursa of medial epicondyle
Subcutaneous bursa of lateral epicondyle
Bursa of anconeus
Bursa at origin of extensor carpi radialis brevis
Olecranon bursae
1. Subtendinous
2. Intratendious
3. Subcutaneous
152
Describe radial head subluxation and relate anatomical structures
Head of the radius being pulled distally from the anular ligament.
153
Describe olecranon bursitis and relate anatomical structures
Inflammation of the bursae of the olecranon (subtendinous, intratendinous, subcutaneous)
154
What are the actions and neurovasculature of the anterior forearm?
Actions- flexion and pronation
Neurovasculature- median nerve, ulnar nerve, ulnar artery (anterior interosseous)
155
What are the muscles of the superficial anterior compartment of the forearm?
Pronator teres
Flexor carpi radialis
Palmaris longus
Flexor carpi ulnaris
156
What are the muscles of the intermediate anterior compartment of the forearm?
Flexor digitorum superficialis
157
What are the muscles of the deep anterior compartment of the forearm?
Flexor digitorum profundus
Flexor pollicis longus
Pronator quadratus
158
What neurovascular structures would be injured based on bone fracture located at the medial epicondyle of the humerus?
Median nerve, brachial artery
159
What are the bony landmarks the abductor pollicis longus attach to?
From proximal posterior radius, ulna, & interosseous membrane to the base of the 1st metacarpal & trapezium
160
What are the bony landmarks the brachioradialis attach to?
From the lateral supracondylar ridge of the humerus to the distal radius lateral to the styloid process
161
What are the bony landmarks the extensor carpi radialis brevis attach to?
From the lateral epicondyle of the humerus (common extensor origin) to the base of the 3rd metacarpal
162
What are the bony landmarks the extensor carpi radialis longus attach to?
From the lateral supracondylar ridge of the humerus to the base of the 2nd metacarpal
163
What are the bony landmarks the extensor carpi ulnaris attach to?
From the lateral epicondyle of the humerus (common extensor origin) to the base of the 5th metacarpal
164
What are the bony landmarks the extensor digitorum attach to?
From the lateral epicondyle of the humerus (common extensor origin) to the extensor expansions of digits 2-5
165
What are the bony landmarks the extensor digiti minimi attach to?
From the lateral epicondyle of the humerus (common extensor origin) to the digital expansion of the 5th digit
166
What are the bony landmarks the extensor indicis attach to?
From the posterior surface of the ulna & interosseous membrane to the digital expansion of the 2nd digit
167
What are the bony landmarks the extensor pollicis brevis attach to?
From the posterior radial surface & interosseous to the base of the 1st proximal phalanx
168
What are the bony landmarks the extensor pollicis longus attach to?
From the middle 1/3 of the posterior surface of the ulna & interosseous membrane to the base of the 1st distal phalanx
169
What are the actions of the abductor pollicis longus?
Abducts & extends the thumb at the carpometacarpal joint & abducts hand at wrist (radial deviation)
170
What are the actions of the brachioradialis?
Flexes the elbow
171
What are the actions of the extensor carpi radialis brevis?
Extends and abducts hand at wrist (radial deviation)
172
What are the actions of the extensor carpi radialis longus?
Extends and abducts hand at wrist (radial deviation) & assists in flexion of the elbow
173
What are the actions of the extensor carpi ulnaris?
Extends and adducts hand at wrist (ulnar deviation)
174
What are the actions of the extensor digitorum?
Extends phalanges (primarily at metacarpophalangeal, secondarily at interphalangeal) & hand at wrist
175
What are the actions of the extensor digiti minimi?
Extends the 5th digit (metacarpophalangeal & interphalangeal)
176
What are the actions of the extendor indicis?
Extends the 2nd digit (metacarpophalangeal & interphalangeal)
177
What are the actions of the extensor pollicis brevis?
Extends thumb (metacarpophalangeal) & extends & abducts CMC joint
178
What are the actions of the extensor pollicis longus?
Extends thumb (CMC & metacarpophalangeal & interphalangeal)
179
What are the innervations of the abductor pollicis longus?
(C6-8) radial nerve
180
What are the innervations of the brachioradialis?
(C5-6) radial nerve
181
What are the innervations of the extensor carpi radialis brevis?
(C6-8) radial nerve
182
What are the innervations of the extensor carpi radialis longus?
(C6-8) radial nerve
183
What are the innervations of the extensor carpi ulnaris?
(C6-8) radial nerve
184
What are the innervations of the extensor digitorum?
(C6-8) radial nerve
185
What are the innervations of the extensor digiti minimi?
(C7-8) radial nerve
186
What are the innervations of the extensor indicis?
(C7-8) radial nerve
187
What are the innervations of the extensor pollicis brevis?
(C6-8) radial nerve
188
What are the innervations of the extensor pollicis longus?
(C6-8) radial nerve
189
What are the actions and neurovasculature of the posterior forearm?
Actions- extension and supination
Neurovasculature- radial nerve, posterior interosseous nerve, radial artery, posterior interosseous artery, recurrent interosseous artery
190
What are the muscles of the superficial posterior compartment of the forearm?
Brachioradialis
Extensor carpi radialis longus
Extensor carpi radialis brevis
Extensor digitorum
Extensor digiti minimi
Extensor carpi ulnaris
191
What are the muscles of the deep posterior compartment of the forearm?
Supinator
Extensor indicis
Abductor pollicis longus
Extensor pollicis brevis
Extensor pollicis longus
