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Gross Anatomy for Anesthesia > Upper Extremity > Flashcards

Upper Extremity Flashcards

1
Q

The Pectoral Girdle is consisted of what bones and what do they form?

A
  1. Scapulae
  2. clavicles
  3. manubrium of the sternum
  4. free part of the upper limb
    To form the superior appendicular skeleton
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2
Q

Superior appendicular skeleton only articulates with the?

A

Axial skeleton at the sternoclavicular joint for great mobility

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3
Q

Pectoral girdle is supported, stabilized and propelled by?

A

The axio-appendicular muscles, which attach to the ribs, sternum, and vertebrae of the axial skeleton

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4
Q

Clavicle connects?

A

connects upper limb to axial skeleton

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5
Q

The sternal (Medial) end of the clavicle articulates with the?

A

Sternal end articulates with the manubrium of the sternum at the sternoclavicular joint

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6
Q

The Acromial end of the clavicle articulates with the?

A

Acromial end articulates with the acromion of the scapula at the acromioclavicular joint

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7
Q

Describe the clavicle and its function.

A

Elongated S curvature which increases its resilience

Boundary for cervico-axillary canal providing protection to neurovascular bundle of the upper extremity

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8
Q

Scapula overlays what ribs?

A

Overlays the 2nd-7th ribs

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9
Q

Which border of the scapula is the thickest?

A

Lateral border is thickest

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10
Q

Glenoid cavity articulates with?

A

the head of the humerus at the glenohumeral joint

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11
Q

Describe the humerus

A

The largest bone in the upper limb

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12
Q

The radial groove of the Humerus is for

A

Radial groove for the radial nerve and profunda brachii artery

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13
Q

Describe the Ulna, its location, and function

A

Shaft is thick but tapers distally
Medial
Stabilizing bone of the forearm

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14
Q

Describe the Radius, its location, and function

A

Lateral to ulna and shorter
Shaft gradually enlarges as it passes distally
With pronation of forearm radius crosses ulna

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15
Q

List the Anterior Axio-Appendicular Muscles

A

Pectoralis Major
Pectoralis Minor
Subclavius
Serratus Anterior

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16
Q

Pectoralis Major muscle- Action and Innervation

A
  • Action: Adducts and medially rotates shoulder joint

- Innervation: Lateral and medial pectoral nerves

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17
Q

Pectoralis Minor muscle- Action and Innervation

A
  • Action: Stabilizes scapula inferiorly and anteriorly

- Innervation: Medial pectoral nerve

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18
Q

Subclavius muscle- Action and Innervation

A

Action: Anchors clavicle
Innervation: Subclavian nerve

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19
Q

Serratus Anterior muscle- Action and Innervation

A

Action: Holds scapula to thoracic wall
Innervation: Long thoracic nerve

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20
Q

List the Posterior Axio-Appendicular Muscles

A
  1. Trapezius
  2. Latissimus dorsi
  3. Levator Scapulae
  4. Rhomboid Minor and Rhomboid Major
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21
Q

Trapezius- Action and Innervation

A
  1. Action: Superior portion- elevates; inferior portion-depresses; middle portion retracts scapula
  2. Innervation: Spinal Accessory Nerve (CN XI)
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22
Q

Latissimus dorsi- Action and Innervation

A
  1. Action: Extends, adducts and medially rotates shoulder joint
  2. Innervation: Thoracodorsal nerve
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23
Q

Levator Scapulae- Action and Innervation

A

Action: Elevates scapula
Innervation: Dorsal scapular nerve

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24
Q

Rhomboid Minor Rhomboid Major- Action and Innervation

A

Action: Retracts scapula and fix scapula to thoracic wall
Innervation: Dorsal scapular nerve

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25
Q

List the Scapulohumeral Muscles

A
  1. Deltoid (3 parts)
  2. Supraspinatus*
  3. Infraspinatus*
  4. Teres Minor*
  5. Teres Major
  6. Subscapularis*
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26
Q

Deltoid (3 parts)-Action and Innervation

Acronym FLAME

A

Action: Flexes, laterally rotates, abducts shoulder joint, medically rotates and extends shoulder.
Innervation: Axillary nerve

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27
Q

Supraspinatus*- Action and Innervation

A

Action: Abduction of shoulder, rotator cuff muscle
Innervation: Suprascapular nerve

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28
Q

Infraspinatus*- Action and Innervation

A

Action-Laterally rotates shoulder joint, rotator cuff muscle

Innervation: Suprascapular nerve

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29
Q

Teres Minor*- Action and Innervation

A

Action: Laterally rotates shoulder cuff, rotator cuff muscle
Innervation: Axillary nerve

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30
Q

Teres Major- Action and Innervation

A

Action: Adducts and medially rotates shoulder joint
Innervation: Inferior subscapular nerve

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31
Q

Subscapularis*- Action and Innervation

A

Action-Medially rotates and adducts shoulder joint, rotator cuff muscle
Innervation: Superior and inferior subscapular nerves

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32
Q

List the Muscles of Arm: Anterior Compartment

A
  1. Biceps brachii
  2. Brachialis
  3. Coracobrachialis
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33
Q

Biceps brachii- Action and Innervation

A

Action: Supinates forearm and flexes elbow joint
Innervation: Musculocutaneous nerve

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34
Q

Brachialis- Action and Innervation

A

Action: Flexes elbow

Innervation: Musculocutaneous nerve

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35
Q

Coracobrachialis- Action and Innervation

A

Action: Flex and adduct shoulder joint
Innervation: Musculocutaneous nerve

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36
Q

Muscles of Arm: Posterior Compartment

A

Triceps brachii

Anconeus

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37
Q

Triceps brachii- Action and Innervation

A

Action: Extends elbow joint
Innervation: Radial nerve

38
Q

Anconeus- Action and Innervation

A

Action: Assists triceps
Innervation: Radial nerve

39
Q

Superficial Muscles of Forearm: Anterior Compartment

A

Pronator Teres
Flexor Carpi Radialis
Palmaris Longus
Flexor carpi ulnaris

40
Q

Pronator Teres- Action and Innervation

A

Action- Pronates and flexes forearm

Innervation- Median nerve

41
Q

Flexor Carpi Radialis- Action and Innervation

A

Action: Flexes and abducts hand at wrist
Innervation: Median nerve

42
Q

Palmaris Longus- Action and Innervation

A

Action: Flexes hand at wrist
Innervation: Median nerve

43
Q

Flexor carpi ulnaris- Action and Innervation

A

Action: Flexes and adducts hand at wrist
Innervation: Ulnar nerve

44
Q

Intermediate Muscles of Forearm: Anterior Compartment

A

Flexor digitorum superficialis

45
Q

Flexor digitorum superficialis- Action and Innervation

A

Action: Flexes wrist joint; flexes proximal phalanges at metacarpophalangeal joints
Innervation: Median nerve

46
Q

Deep Muscles of Forearm: Anterior Compartment

A

Flexor digitorum profundus
Flexor pollicis longus
Pronator quadratus

47
Q

Flexor digitorum profundus- Action and Innervation

A

Action: Flexes wrist joint, flexes distal interphalangeal joints (2nd-5th)
Innervation: Median nerve (lateral part); Ulnar nerve (medial part)

48
Q

Flexor pollicis longus- Action and Innervation

A

Action: Flexes wrist; flexes thumb
Innervation: Median nerve

49
Q

Pronator quadratus- Action and Innervation

A

Action: Pronates forearm
Innervation: Median nerve

50
Q

Superficial Muscles of the Forearm: Posterior Compartment

A 
Brachioradialis
Extensor carpi radialis longus
Extensor carpi radialis brevis
Extensor digitorum
Extensor digiti minimi
Extensor carpi ulnaris
51
Q

Supinator- Action and Innervation

A

Action-Supinates forearm

Innervation: Radial nerve

52
Q

Abductor pollicis longus- Action and Innervation

A

Action: Extends wrist; abducts and extends the thumb
Innervation: Radial nerve

53
Q

Extensor pollicis longus- Action and Innervation

A

Action: Extends wrist; extends thumb
Innervation: Radial nerve

54
Q

Extensor pollicis brevis- Action and Innervation

A

Action: Extends wrist; extends thumb
Innervation: Radial nerve

55
Q

Extensor indicis- Action and Innervation

A

Extends wrist joint; extends 2nd finger

Innervation: Radial nerve

56
Q

Innervation of the Hand

A

Median Nerve
Ulnar Nerve
Radial Nerve

57
Q

Median Nerve action:

A

Abducts thumb
Opposes thumb
Flexes thumb
Flexes metacarpophalangeal joints of the 2nd-4th fingers

58
Q

Ulnar Nerve action

A

Adducts thumb
Abducts 5th finger
Flexes 5th finger
Opposes 5th finger towards thumb

59
Q

Radial Nerve action

A

Extends fingers and thumb

60
Q

Innervation of the Upper Extremity:Brachial Plexus

A

Roots: anterior rami of C5-T1; pass between anterior and middle scalene muscles

Trunks: named in relation to each other

Divisions: anterior divisions supply the anterior (flexor) compartments of the upper limb. Posterior division supply the posterior (extensor) compartments of the upper limb.

Cords: named for their position in relation to the axillary artery

Branches: terminal nerves of the brachial plexus: Musculocutaneous, Axillary, Radial, Median, Ulnar

61
Q

Roots Trunks: inferior part of the neck, lateral border of the scalenes

Trunks Divisions: cervico-axillary canal
posterior to the clavicle/1st rib

Divisions Cords: pectoral minor muscle

Cords Terminal Branches: axilla

A

Roots Trunks: inferior part of the neck, lateral border of the scalenes

Trunks Divisions: cervico-axillary canal
posterior to the clavicle/1st rib

Divisions Cords: pectoral minor muscle

Cords Terminal Branches: axilla

62
Q

Dorsal Scapular Nerve (C5) innervates

A

Rhomboid major/minor; levator scapulae muscles

63
Q

Long Thoracic Nerve (C5-C7) innervates

A

Serratus anterior muscle

64
Q

Suprascapular Nerve (Superior trunk/ C5-C6) innervates

A

Supraspinatus and infraspinatus muscles

65
Q

Nerve to Subclavius (Superior trunk/ C5) innervates

A

Subclavius muscle

66
Q

Dorsal Scapular Nerve (C5) innervates

A

Rhomboid major/minor; levator scapulae muscles

67
Q

Suprascapular Nerve (Superior trunk/ C5-C6)

A

Supraspinatus and infraspinatus muscles

68
Q

Nerve to Subclavius (Superior trunk/ C5)

A

Subclavius muscle

69
Q

Lateral Pectoral Nerve (C5-C7)

A

Pectoralis major muscle

70
Q

Medial Pectoral Nerve (C8-T1)

A

Pectoralis major and minor muscles

71
Q

Medial Brachial Cutaneous Nerve (C8-T1)

A

Sensory to the medial side of the arm

72
Q

Medial Antebrachial Cutaneous Nerve (C8-T1)

A

Sensory to the medial side of the forearm

73
Q

Superior Subscapular Nerve (C5-C6)

A

Subscapularis muscle

74
Q

Thoracodorsal Nerve (C7-C8)

A

Latissimus dorsi muscle

75
Q

Inferior Subscapular Nerve (C5-C6)

A

Subscapularis and teres major muscles

76
Q

Musculocutaneous Nerve:

A

pierces the coracobrachialis muscle, supplies innervation to brachialis and biceps brachii then continues as purely sensory nerve as the lateral cutaneous nerve of the forearm.

77
Q

Median Nerve follows:

A

follows the brachial artery, distal branch of the axillary artery.

Median Nerve: follows course of common interosseus artery (branch of ulnar artery)

78
Q

Ulnar Nerve course:

A

Courses behind the medial epicondyle of the humerus bone

Ulnar Nerve: joins up with ulnar artery along medial anterior aspect forearm

79
Q

Axillary Nerve course:

A

Enters posterior compartment through the quadrangular space formed by the teres minor, teres major, humerus and long head of the triceps brachii.

80
Q

Radial Nerve:

A

Enters posterior compartment through the triangular interval formed by the teres major, humerus, long head and lateral head of the triceps brachii.

Radial Nerve: joins up and follows the radial artery along lateral aspect forearm

Radial Nerve: Deep branch of the radial nerve becomes posterior interosseous nerve

81
Q

Injury Sensory Impairment

Motor Impairment of Ulnar nerve

A

Medial surface of hand/palm. Medial 1 ½ fingers.

Loss of flexion at 4th and 5th fingers, loss of thumb adduction, loss ability to oppose and abduct 5th fingerà “claw hand”

82
Q

Injury Sensory Impairment
Motor Impairment
of Long thoracic nerve

A

Paralysis of serratus anterior results in medial border of scapula to protrude away from bodyà “winged scapula”

83
Q

Injury Sensory Impairment

Motor Impairment of Musculocutaneous nerve

A

Lateral surface of forearm

Paralysis of coracobrachialis, biceps, brachialisà impaired flexion and supination of forearm

84
Q

Injury Sensory Impairment

Motor Impairment of Axillary nerve

A

Lateral surface of shoulder

Shoulder weakness, especially with abduction

85
Q

Injury Sensory Impairment

Motor Impairment Median nerve

A

Anterior thumb, palmer surface, anterior first 2 ½ fingers, posterior distal joint of first 2 ½ fingers

Loss of thumb opposition, decreased abduction of thumb, loss of flexion of proximal and distal interphalangeal jointsà “pope’s blessing” or “ape hand”

86
Q

Injury Sensory Impairment

Motor Impairment of Radial nerve

A

Posterior surface of forearm, posterior thumb and first 2 ½ fingers (not distal joint)

Paralysis of triceps, brachioradialis, supinator, extensors of the wrist and fingersà “wrist drop” (unopposed flexors)

87
Q

Subclavian artery axillary artery brachial artery four terminal branches

A

Ulnar artery
Radial Artery
Anterior interosseous artery
Posterior interosseous artery

88
Q

Where does the Axillary Artery begin and end?

A

Lateral margin of the 1st rib to the inferior border of the teres major muscle

89
Q

Where does the Brachial Artery begin and end

A

Inferior border of the teres major

muscle to the distal portion of the cubital fossa

90
Q

Ulnar and Radial arteries provide collateral blood supply to

A

hand (palmar arch)

91
Q

Anterior and Posterior Interosseous arteries provide blood supply to

A

anterior and posterior divisions of the interosseous membrane

92
Q

Note location of arteries in relation to nerves:
Radial artery radial nerve
Ulnar artery ulnar nerve
Anterior interosseous artery median nerve
Posterior interosseous artery posterior interosseous nerve (deep branch of the radial nerve)

A

Note location of arteries in relation to nerves:
Radial artery radial nerve
Ulnar artery ulnar nerve
Anterior interosseous artery median nerve
Posterior interosseous artery posterior interosseous nerve (deep branch of the radial nerve)

Gross Anatomy for Anesthesia (3 decks)

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