Upper Extremity: Overview Flashcards
1
Q
Layers of the skin
A
- Skin
- Superficial fascia
- Deep fascia
2
Q
Deep fascia of upper limb
A
- Pectoral fascia
- Axillary fascia
- Clavipectoral fascia
- Deltoid fascia
- Brachial fascia
- Antebrachial fascia
3
Q
Deep fascia of upper limb function
A
- Can attach to bone
- Covers muscle
- Form intermuscular septa
4
Q
Arterial supply/venous drainage
A
- Deep to the deep fascia
- Arteries and deep veins have the same name
- Veins are next to artery (vena comitans)
- Often duplicated (venae comitantes)
5
Q
Arteries of upper limb
A
- Subclavian
- Axillary
- Brachial
- Radial
- Ulnar
6
Q
Superficial veins of upper limb
A
- External to deep fascia: drain superficial structures
- Arise from dorsal venous network (hand)
7
Q
Superficial veins of upper limb names
A
- Cephalic vein
- Basilic vein
- Median cubital vein
8
Q
Cephalic vein
A
- Lateral side of forearm/arm
- Leltopectoral groove
- Pierces clavipectoral fascia in the deltopectoral triangle
- Drains into the axillary vein
9
Q
Basilic vein
A
- Medial side of forearm/lower arm
- Pierces brachial fascia around mid-arm
- Joins brachial vein to form axillary vein
10
Q
Median cubital vein
A
- Connects cephalic and basilic veins
11
Q
Superficial lymph drainage of upper limb
A
- Most drain into lateral (humeral) axillary lymph nodes directly
- Medial side of hand/forearm drains into the cubital lymph nodes
- Lateral side can drain into deltopectoral and apical nodes bypassing humeral axillary nodes
12
Q
Deep lymph drainage of upper limb
A
- Drain into lateral (humeral) axillary lymph nodes
13
Q
Scapular region lymph drainage
A
- Posterior (subscapular) axillary lymph nodes
14
Q
Pectoral region lymph drainage
A
- Anterior (pectoral) axillary lymph nodes
15
Q
C4 dermatome
A
- Base of neck, superior shoulder
16
Q
C5 dermatome
A
- Upper lateral arm
17
Q
C6 dermatome
A
- Planar thumb pad (lateral forearm)
18
Q
C7 dermatome
A
- Middle finger pad (some sources say index also)
19
Q
C8 dermatome
A
- Little finger pad (medial forearm)
20
Q
T1 dermatome
A
- Medial elbow
- Upper forearm
- Lower arm
21
Q
T2 dermatome
A
- Upper arm
- Axilla
22
Q
C5 myotome
A
- Arm abduction
23
Q
C6 myotome
A
- Elbow flexion
- Wrist extension
- *C6 biker chicks**
24
Q
C7 myotome
A
- Elbow extension
- Wrist flexion
- Finger extension
25
C8 myotome
- Finger flexion
26
T1 myotome
- Finger abduction/adduction
27
C4 myotome
- Major contributor to motor innervation of the diaphragm
28
C5,6 tendon reflex
- Biceps reflex
| - Brachioradialis reflex
29
C7 tendon reflex
- Triceps reflex
30
Major nerves of the upper extremity
- Radian nerve
- Ulnar nerve
- Median
31
Peripheral nerve cutaneous innervation
- Axillary nerve
- Radial nerve
- Musculocutaneous nerve
- Ulnar nerve
- Median nerve
32
Pectoral region muscles
- Connect the pectoral girdle and humerus to the axial skeleton
- Primarily function in moving the pectoral girdle and humerus
33
Anterior axio-appendicular muscles
- Pectoralis major
- Pectoralis minor
- Subclavius
- Serratus anterior
34
Deltopectoral groove
- Between pectoralis major and deltoid
- Cepahlic vein
- Deltoid branch of thoracoacromial artery
35
Pectoral fascia
- Covers anterior and posterior of pectoralis major
| - Becomes axillary fascia (floor of axilla)
36
Clavipectoral fascia
- Deep to pectoral fascia
- Attaches to clavicle and envelopes subclavius and pectoralis minor muscles
- Pierced by cephalic vein, thoracoacromial artery, pectoral nerves
- Costocoracoid ligament
- Suspensory ligament of axilla below pec minor
37
Costocoracoid ligament
- Thickening between coracoid and 1st costochondral junction
38
Suspensory ligament of axilla below pec minor
- Connects to and supports axillary fascia
39
Pectoralis major
- 2 heads
| - Forms anterior axillary fold
40
Pectoralis major proximal attachment
- Medial ½ clavicle
- Anterior sternum
- Upper 6 costal cartilages
- Aponeurosis of external oblique muscle
41
Pectoralis major distal attachment
- Lateral lip of intertubercular sulcus
42
Pectoralis major innervation
- Lateral (C5-7) and medial pectoral nerves (C8-T1)
43
Pectoralis major function
- Adduction
- Medial rotation
- Flexion
44
Pectoralis minor
- Deep to pec major
- Important landmark (axillary artery, brachial plexus)
- Subcoracoid space
45
Pectoralis minor proximal attachment
- Ribs 3-5
46
Pectoralis minor distal attachment
- Coracoid process
47
Pectoralis minor innervation
- Medial pectoral nerve (C8-T1)
48
Pectoralis minor function
- Stabilize scapula
- Pulls against thoracic wall (lateral angle moves inferiorly)
- Accessory muscle of respiration
49
Subclavius proximal attachment
- 1st rib/costal cartilage jxn
50
Subclavius distal attachment
- Inferior, middle 1/3 of clavicle
51
Subclavius innervation
- Nerve to subclavius (C5)
52
Subclavius function
- Stabilize SC joint
| - Depress clavicle
53
Serratus anterior
- Serrated appearance
| - Boxer’s muscle
54
Serratus anterior proximal attachment
- Lateral aspect of ribs 1-8(9)
55
Serratus anterior distal attachment
- Distal attachment: anterior surface of medial scapular border
56
Serratus anterior innervation
- Long thoracic nerve (C5,6,7)
57
Serratus anterior function
- Scapular protraction and rotation
| - Stabilizes against thorax
58
Long thoracic nerve
- Branch of the brachial plexus
- Has a superficial location
- Injured in: mastectomy, knife injury, chest tube
59
Long thoracic nerve injury
- Causes weakness or paralysis of serratus anterior
| - Results in winging of the scapula, and difficulty with arm elevation (abduction)
60
Trapezius
- Named based on shape
| - 3 divisions based on muscle fiber direction
61
Divisions of trapezius
- Superior (descending): elevation, rotation
- Middle: retraction
- Inferior (ascending): depression, rotation
62
Trapezius proximal attachment
- Medial 1/3 of superior nuchal line
- EOP (external occipital protuberance)
- Nuchal ligament
- SPs of C7-T12
63
Trapezius distal attachment
- Lateral 1/3 of clavicle
- Acromion
- Scapular spine
64
Trapezius innervation
- Spinal accessory nerve (motor)
| - C3,4 spinal nerves (pain and proprioception)
65
Weakness or CN XI injury
- Shoulder drooping
- Weakness in shrugging
- Impaired abduction
66
Latissimus dorsi
- Expansive muscle
| - Forms posterior axillary fold
67
Latissimus dorsi proximal attachment
- SPs of T7-L5
- Thoracolumbar fascia
- Iliac crest
- Ribs 10 to 12 (inferior 3 or 4 ribs)
- Scapula (inferior angle)
68
Latissimus dorsi distal attachment
- Humerus (floor of intertubercular sulcus)
69
Latissimus dorsi innervation
- Thoracodorsal nerve (C6-8)
70
Latissimus dorsi function
- Extends
- Adducts
- Medial rotation of humerus
- Pull-up type motions
71
Levator scapulae proximal attachment
- Posterior tubercles of C1-4 TPs
72
Levator scapulae distal attachment
- Medial border of scapula (above scapular spine base)
73
Levator scapulae innervation
- Dorsal scapular nerve (C4,5): motor
| - C3,4: proprioception
74
Rhomboid major/minor
- 2 muscles: rhombus shaped
75
Rhomboid major proximal attachment
- T2-5 SPs
76
Rhomboid minor proximal attachment
- Nuchal ligament
| - C7 and T1 SPs
77
Rhomboid major distal attachment
- Medial border of scapula
| - Spine to inferior angle of scapula
78
Rhomboid minor distal attachment
- Medial border of scapula
| - Base of scapular spine
79
Rhomboid major/minor innervation
- Dorsal scapular nerve (C4,5): motor
| - C3,4: proprioception
80
Rhomboid major/minor function
- Retract and rotate scapula
| - Fix against thoracic wall
