Upper Extremity Flashcards by Johannah Crumpton

_______ is a continuation of the spine of the scapula

Acromion (posterior)

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______ connects the coracoid process to the clavicle.

Coraclavicular ligament

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_____ connects the acromion to the clavicle

Acromioclavicular ligament

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______ connects it to itself, Coracoid and Acromion. Helps to stabilize

Coracoacromial ligament- would need a fracture of the scapula in order to stress this ligament

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Type I shoulder joint separation

Stretch and damage AC joint but nothing is ruptured

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Type II

AC joint is ruptured and stress CC

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Type III shoulder separation

AC and CC are both ruptured

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In what type of shoulder separation is the clavicle raised up and lump in their neck?

Type III

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______ articulates the humerus to the radius

Capitulum

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______ is where the humerus and ulnar articulate

Trochlea

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______ is a common place to fracture the humerus because it narrows and it is outside the joint capsule

Surgical neck of the humerus

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_______ is significantly larger in people who work manual labor jobs. Why?

Deltoid tuberosity, because it is a site for muscle attachment.

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Lateral epidcondyle and ridge is where Extensors or flexors attach?

Extensors

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Medial epidcondyle and ridge is where Extensors or flexors attach?

Flexors

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_______ is the point of the elbow. What bone is it on?

Olecranon process, Ulna

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What is weird about the Ulna?

The “head” is distal (closer to the wrist)

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What inserts at the Ulnar Tubersoity?

Brachiliasis muscle

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What inserts at the Radial tuberosity?

Biceps Brachi

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What three ligaments are responsible for the elbow?

Radial collateral, Ulnar collateral and annular

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What ligament does Tommy John’s Sx repair?

Ulnar collateral

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Nursemaid’s elbow is displacement of what ligament? What bone is displaced?

Annular ligament, radial head

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____ is the boat shaped carpal bone

Scaphoid

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_____ is stickying out of the carpal bones (palmar side)

Pisiform

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______ (hand bone) is on the thumb side

Trapezium

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Rank the joints in the hand from most moveable to least moveable.

1. Radiocarpal joint (most "flexible") 2. Intercarpal joint (middle) 3. Carpometacarpal joint (Least)

The _____ only has a proximal and distal phalanges

Thumb (digit 1)

Digits 2-5 has ____, ____ and _____.

Proximal, middle and distal phalanges

What are the 3 joints in the phalanges called?

MCP- Metacarpophalangeal joint PIP- Proximal interphalangeal joint DIP- distal interphalangeal joint

The flexor retinaculum connects what 3 carpal bones?

Pisiform, hamate and trapezium

______ is the top of the carpal tunnel

Flexor retinaculum

Hyperextension injury tears what ligament in the hand?

Palmar plates

_______ takes the most of the weight when you fall on your hand

Scaphoid bone

Colle fractures is a fracture of what bone?

fracture of the distal radius

_______ is responsible for holding the scapula to the body wall

Serratus Anterior

_____ starts abbduction of the arm

Supraspinatus

____ and ___ rotate the humerus

Infraspinatus and Teres Minor

_____ internally rotates the arm

Subscapularis

4 Rotator Cuff muscles

1. Supraspinatus 2. Infraspinatus 3. Subscapularis 4. Teres Minor

______ is testing the supraspinatus

Drop arm test

Scratch back from above (Externally rotate the arm)

Infraspinatus muscle

Scratch back from below (internally rotate the arm)

Subscapularis muscle

______ are lubricating sacs that help prevent friction

Bursae

Pectoralis major attaches to ____

Intertubulcar sulcus of the humerus

Anterior compartment of the arm is responsible for ____

Flexing the arm at the elbow

Deep to the biceps brachii is the ______

Brachialis

_______ shares most of its functions with the Pectoralis major

Coracobrachialis

_______ is responsible for flexion and supination of the forearm

Biceps Brachii

_______ is small, posterior arm muscles, mostly responsible for stablization. Some extension of the forearm

Anconeus

_____ on the anterior side

flexors

____ on the posterior side

extensors

_____ muscle move the wrist and entire hand

Carpi

____ muscles move the digits

Digitorum

_____ muscles move the thumb

Pollicis

____ muscles specifically move the index finger- 2nd digit

Indicis

_____ muscles specifically move the little finger- 5th digit

Digiti minimi

______ acts like a flexor even though it is on the posterior side

Brachioradialis

_____ and ____ both extend the 5th digit

Extensor Digitorum and Extensor Digiti Minimi

_____ wraps around the radius

Supinator

crank your thumb backwards

is extension

Flexion of the thumb in....

folding it in over your palm

_____ is important because it has a big, long tendon that can be used as an autograph for surgery

Palmaris longus

The _____ is responsible for the flexion of the DIP joint

Flexor Digitorum Profundus

What is tennis elbow?

Lateral Epicondylitis

What is golfer's elbow?

Medial Epicondylitis

The ______ usually communicate with the common flexor sheath versus the rest of the digits are independent tendon sheaths.

Synovial sheath of the 5th digit

_____ is not part of the thenar eminence

Adductor Pollicis

______ attach to the tendons in the hand and help extend the phalanges

Lumbricals

The Lumbricals are ____ until they reach the MCP and then they go _____

palmar, dorsal

_____ are found with the tendon sheath to help reduce friction

synovial fluid

What nerve roots are the major contributors to the upper limbs?

C5-T1

The more promixal the muscles, what nerves are it more likely to be innervated by?

Superior nerves

The more distal the muscle, what nerves are it more likely to be innervated by?

Inferior nerves

C5 Dermatome

Lateral shoulder

C6 Dermatome

First digit (Thumb)

C7 Dermatome

3rd Digit

C8 Dermatome

5th Digit- pinky

T1 Dermatome

Medial elbow

The "roots" in the brachial plexus are actually what?

Anterior Rami

C5 and C6 form to become what trunk?

Superior Trunk

C7 is what trunk of the brachial plexus?

Middle

C8 and T1 fuse to become what trunk?

Inferior Trunk

Superior and Middle anterior divisions form ____

Lateral cord

Inferior anterior forms what ?

Medial cord

The superior posterior, middle posterior and inferior posterior all fuse to become ____

Posterior cord- extensor muscles

Lateral cord innverates _____

Musculocutaneous nerve

Medial cords innverates _____

ulnar nerve

______ and _____ form the median nerve.

Lateral and Medial Cord

Posterior cord innervates all the _______. Name the 2 nerves

Extensors, Axillary and Radial nerve

______ innervates all the muscles of the anterior compartment of the arm.

Musculocutaneous nerve

_______ carries sensory information form the lateral forearm.

Musculocutaneous nerve

A _______ nerve lesion presents with weakness/inability to flex the forearm at the elbow and altered sensation over lateral forearm

Musculocutaneous

What nerve does this represent? WITH weakness/inabiilty to flex the forearm

Musculocutaneous

What happened here?

Biceps Tendon Rupture

Axillary nerve innervates ______

Deltoid (mainly the Deltoid) and teres minor

The _____ innervates all the muscles of the posterior compartment of the arm.

Radial nerve

In the forearm the radial nerves divides into: (Name and what kind?)

1. Superficial Radial- Sensory 2. Deep Radial- Motor 3. Posterior Interosseous- Motor

The area in red represents what what nerve?

Radial nerve

The area in grey represents what nerve?

Axillary nerve

An ______ lesion will present with weakness/inability to flex/extend/abduct the arm at the shoulder and altered sensation over the shoulder.

Axillary Nerve

The ______ carries sensory information from the posterior arm and posterior forearm

radial nerve

A ______ nerve lesion presents with weakness or inability to extend the forearm at the elbow, extend the hand at the carpus and extend the fingers. Also altered sensation over the posterior arm, forearm and hand.

proximal radial

A______ nerve lesion presents with intact elbow movement but weakness/inability when extending the wrist and fingers. Also altered sensation over the posterior forearm and hand.

More distal radial

Axillary nerve damage can cause atrophy to what muscle?

Deltoid muscle

The _______ innervates nearly all of the muscles in the anterior forearm and a few of the muscles of the hand

Median Nerve

The ______ innervates 1 & ½ muscles in the forearm and nearly all of the muscles of the hand

ulnar nerve

What muscles in the hand does the Median Nerve Innervate?

-Abductor pollicis brevis -Opponens pollicis -Flexor pollicis brevis -1st and 2nd lumbricals

Name the 2 branches of the median nerve

-Anterior interosseous nerve -Recurrent branch of the median nerve (muscles of thenar eminence)

The ______ carries sensory info from the palmar aspect of digits 1-3 & the radial ½ of the 4th digit

median nerve

What nerve doest this correlate with? Sensory or Motor?

Median nerve, sensory to the hand and motor to the thumb

______ is response for rolling the radius over? Innervation?

Pronator Teres, median nerve

_______ innervates the thenar eminence

Median nerve

Impingement at the carpal tunnel or damage to the ______ presents with: -weakness in thumb motion -diminished grip strength (thumb). -altered sensation over the palmar hand -altered sensation over palmar aspect of digits 1-3 - altered sensation over the lateral aspect of 4th digit

recurrent branch of the median nerve

______ presents with: -weakness in thumb motion -diminished grip strength (thumb). -altered sensation over the palmar hand --altered sensation over palmar aspect of digits 1-3 - altered sensation over the lateral aspect of 4th digit -weakness in motion of the 2nd digit -Inability to make a circle with the thumb and index fingers

median nerve proximal to the carpal tunnel or damage to the anterior interosseous nerve

________ presents with: -weakness in thumb motion -diminished grip strength (thumb). -altered sensation over the palmar hand --altered sensation over palmar aspect of digits 1-3 - altered sensation over the lateral aspect of 4th digit -weakness in motion of the 2nd digit -Inability to make a circle with the thumb and index fingers -weakness in wrist flexion and in grip strength from the forearm muscles. -When asked to make a fist “hand of benediction" is formed

proximal median nerve lesion

The ulnar nerve innervates two muscles of the anterior forearm:

Flexor carpi ulnaris ½ of Flexor digitorum profundus

The _______ innervates all muscles of the hand that are not innervated by the median nerve.

deep branch of the ulnar nerve

The ______ carries sensory information from the palmar and dorsal aspects of the 5th digit and the ulnar ½ of the 4th digit.

superficial branch of the ulnar nerve

What nerve?

Ulnar Nerve

ulnar nerve lesion at the wrist

_____ presents with: -atrophy of intrinsic muscles of the hand (except thenar eminence) -weakness in grip but particularly in abduction and adduction of the digits against resistance -altered sensation of 5th digit - altered sensation of the medial aspect of 4th digit -weakness in wrist flexion and in grip strength from the forearm muscles -when asked to make a fist, patient will often be described as having a “claw hand”

proximal ulnar nerve lesion

What does this indicate? Name?

proximal ulnar nerve lesion, "Claw Hand"

On the palm, the _______ send sensory branches to the palmar aspect of each finger.

median and ulnar nerves

Common palmar digital nerves give off ______

proper palmar digital nerves

_______ innerves the thenar eminence

Recurrent branch of the median nerve

The Dorsal Scapular Nerve comes off of _____

C5, C6 and C7 proximally give off what nerve?

Long thoracic nerve

The Superior branch has 2 proximal branches, named....

1. Suprascapular nerve 2. Nerve to subclavius

_______ is a proximal branch off the lateral cord

Lateral pectoral nerve

_______ is a proximal branch off the medial cord

Medial Pectoral nerve

the ____ and _____ nerve tend to form a loop

Lateral pectoral and medial pectoral nerves

Name the 3 proximal branches off the Posterior cord

1. Subscapular Nerve 2. Thoracodorsal Nerve 3. Subscapular Nerve

The ______ from the radial nerve do not quite make it to the end of the fingers.

dorsal digital nerves

The ______ nerves also give off a dorsal branch to the fingertips and nail bed areas

proper palmar digital

Name 6 nerves that originate from cords:

1.Subscapular nerve 2. Thoracodorsal nerve 3. Lateral pectoral nerve 4. Medial pectoral nerve 5. Medial cutaneous nerve of arm 6. Medial cutaneous nerve of forearm

______ internal rotation of the arm

subscapularis muscle

_______ is responsible for arm adduction

Teres major muscle

A _______ presents with weakness/inability to internally rotate the arm. It may present with the arm persistently rotated externally.

subscapular nerve lesion

__________ innervates Latissimus dorsi muscle

thoracodorsal nerve

______ Adduct and extend arm at the shoulder

Latissimus dorsi muscle

A ______ will present with weakness/inability to “row” one’s arm back from a flexed or abducted position at the shoulder

thoracodorsal nerve lesion

______ innervates the Pectoralis major and minor

medial pectoral nerve

______ adduct and flex arm at shoulder

Pectoralis major

_____ stabilize scapula by pulling coracoid process inferiorly and anteriorly

Pectoralis minor

_____ innervates just the Pectoralis Major

lateral pectoral nerve

______ present with weakness/ inability to push away from a wall or move the shoulder from an abducted to flexed position

Pectoral nerve lesions

_______ Loss of radial and axillary nerve function.

Posterior cord damage

______ Loss of musculocutaneous and weakness of median nerve

Lateral cord damage

________ Loss of ulnar nerve and weakness of median nerve. Loss of sensation from medial arm and forearm

Medial cord damage

Nerves from the roots and trunks include what 4 nerves.

1. Dorsal Scapular 2. Long thoracic 3. Nerve to the subclavius 4. Suprascapular nerve

______ innervates Levator scapulae and Rhomboid major and major

dorsal scapular nerve

An _____ would present with weakness elevating and retracting the scapula, but a functional trapezius would mask the problem.

isolated dorsal scapular nerve lesion

______ innervates Serratus anterior muscle

long thoracic nerve

_______ protraction and rotation of scapula

Serratus anterior muscle

A _____will present with weakness/inability to protract the scapula. The scapula “wings” posteriorly when the person tries to push their body away from leaning against a wall or doing a push up.

long thoracic nerve lesion

nerve to subclavius innervates the ____

Subclavius muscle

______ innervates the Supraspinatus muscle and Infraspinatus muscle

suprascapular nerve

_______ initiate of arm abduction

Supraspinatus muscle

_____ lateral rotation of the arm

Infraspinatus muscle

A _______ will present with weakness/inability to initiate abduction of the arm at the shoulder and to externally rotate the arm at the shoulder

suprascapular nerve lesion

_______ caused by injury to the superior trunk or C5-C6 roots of the brachial plexus. It results in weak or nonfunctional: nerve to the subclavius, suprascapular, axillary and musculocutaneous nerves. The dorsal scapular, long thoracic nerves MAY be injured

Erb-Duchenne Palsy

The axillary region is bordered by what 4 structures?

Pectoral muscles- Anterior Subscapularis muscle- Posterior Humerus- Lateral Serratus Anterior Muscle- Medial

Erb-Duchenne Palsy will results in weak or nonfunctional: (What 4 nerves). The dorsal scapular, long thoracic nerves MAY be injured

1. nerve to the subclavius 2. suprascapular 3. axillary 4. musculocutaneous nerves

______ caused by injury to the inferior trunk of the brachial plexus. Nonfunctional ulnar nerve and sensory loss from the medial cutaneous nerves of the arm and forearm. Median & radial nerves will be less severely affected.

Klumpke's Paralysis

Klumpke's Paralysis caused by injury to the ________. Nonfunctional _____ nerve and sensory loss from the _____ nerves of the arm and forearm. Median & radial nerves will be less severely affected.

inferior trunk of the brachial plexus, ulnar, medial cutaneous

In Klumpke's Paralysis the claw hand appreance is due to what?

Proximal ulnar nerve damage

______ firmly attaches the scapula to the ribs

Serratus anterior

Persistent internally rotation of the arm. What is weak?

Weak infraspinous and supraspinous

Persistently extended elbows is during to damage to what nerve?

muslcocutaneous nerve

Describe the "Waiter's Tip" sign and what Palsy does it indicate?

Elbows extended with wrist permanently flexed, Erb- Duchenne Palsy

Name 2 causes of Erb-Duchenne Palsy

Traction of the neck during childbirth and falling on your neck

The ____ allows passage of neurovascular structures to axilla from the neck

Apex

_____ is the parent artery to the entire upper limb

Subclavian artery

Once subclavian artery crosses the first rib, it becomes the _____

axillary artery

____ supplies levator scapulae and rhomboid muscles.

Dorsal scapular artery

_____ supplies supraspinatus and infraspinatus muscles

Suprascapular artery

The axillary artery is divided into 3 segments

Supreme thoracic artery-Segment 1 Lateral thoracic artery- Segment 2 Thoracoacromial trunk- Segment 3

_______ supplies the anterior 1st and 2nd intercostal spaces. Where is it in relation in the chest cavity?

Supreme thoracic artery, Proximal to the pectoralis minor

______ supplies serratus anterior muscle and breast tissues.

Lateral thoracic artery

The thoracoacromial trunk supplies what 4 things

Clavicular branch Pectoral branch Acromial branch Deltoid branch

Segment 2 of the Axillary artery is called _____. Where is it in the chest cavity?

Lateral thoracic artery, covered by the pectoralis minor

______ innervates the serratus anterior

Long thoracic

Segment 3 of the axillary is named what? Where is it in the chest cavity?

Thoracoacromial trunk, distal to pectoralis minor

_____ supplies subscapularis and has two branches. Name them.

Subscapular artery 1. Circumflex scapular artery 2. Thoracodorsal artery

_____ supplies the infraspinatus muscle

Circumflex scapular artery

______ supplies latissimus dorsi muscle

Thoracodorsal artery

_____ and ______ supply the deltoid and anterior compartment of the arm

-Anterior humeral circumflex artery (tends to be smaller) -Posterior humeral circumflex artery (tends to be larger)

As the axillary artery crosses the teres major muscle it becomes the _____

Brachial artery

What artery when compressed against the humerus can you feel a pulse on the medial arm?

Brachial artery

Name the 3 branches of the brachial artery. What parts of the arm do they supply?

1. Deep brachial artery -supplies posterior compartment of arm 2. Superior ulnar collateral artery branches medially near middle arm. 3. Inferior ulnar collateral artery branches medially near elbow

In cubital fossa the brachial artery splits into _____ and ______.

radial and ulnar arteries

The radial artery gives off _____ near the elbow

Radial recurrent artery

the ______ has a very palpable pulse on anterior wrist near base of thenar eminence

Radial artery

The ______ has a pulse palpable just lateral to tendon of flexor carpi ulnaris muscle

ulnar artery

Name the 2 branches of the Ulnar artery

-Ulnar recurrent artery -Common interosseous artery

The common interosseous artery splits into: _____ which supplies deep structures of the anterior compartment of forearm. and ______ which supplies structures of the posterior compartment of the forearm and _____

Anterior interosseous artery Posterior interosseous artery Small recurrent interosseous branch

_______ supply the deep muscles in the forearm

Anterior and posterior interosseous arteries

The ulnar artery forms MOST of the ______ arch along with a variable contribution from the ______

superficial palmar arch, radial artery

_____ gives off several common _______ that then split into: _______ traveling on either side of the digit

Superficial palmar arch palmar digital arteries Proper palmar digital arteries

Most of the _____ passes posterior to wrist but dives anteriorly through the adductor pollicis muscle to form the ______ with some contribution from the _____

radial artery deep palmar arch ulnar artery

Deep palmar arch gives off: _______ that join with common palmar digital arteries

Palmar metacarpal arteries

Red blood cells, white blood cells, and platelets are produced in the marrow of long bones and enter circulation via ______

nutrient veins

Fluids can be administered into the long bones’ ______.

medulla

Define Anastomosis

The blood vessels interconnect

The ____ artery is commonly used as an autograph in heart surgery. Why?

Radial Artery. Due to anastomosis in the hand the Ulnar artery will find a way to keep the hand supplied with blood.

Name the 2 veins with no corresponding artery

Cephalic and basilic vein

Where does the cephalic vein empty?

Drains into the subclavian vein at the deltopectoral triangle

____ drains radial hand, posterior forearm and arm

Cephalic vein

_____ drains the ulnar hand and anterior forearm

Basilic vein

______ drains to the brachial vein at the elbow

Basilic vein

______ connects the cephalic and basilic vein

Medial cubital vein

Give one example of a neurovascular bundle

axillary artery’s close connection to cords of the brachial plexus, where vessels and nerves run alongside each other

The quadrangular space is bounded by:

long head of triceps teres minor teres major muscles humerus

The ____ is vulnerable during shoulder dislocation and humeral neck fracture

quadrangular space

The triangular interval bounded by: (3 things). When is it vulnerable?

long head of triceps lateral head of triceps teres major muscles During mid-shaft humeral fractures

The ulnar nerve/vessel bundle is vulnerable when....

trauma/fracture near the medial aspect of the distal forearm and carpus.

The proper palmar digital nerves/vessel bundle is vulnerable when...

laceration on the lateral palmar aspect of all digits

Fracture of humeral shaft will often involve:

Radial nerve and Deep brachial artery and vein

_____ is the result of blocking the flow of lymph results in edema, or swelling.

Lymphedema

Upper Extremity Flashcards

(218 cards)