Upper limb 1 Flashcards by Sandy 27

What is the axilla?

pyramidal space below the shoulder joint

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Function of axilla

passageway for vessels and nerves going to and from the upper limb

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Anterior wall of axilla

pec major & pec minor

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Posterior wall of axilla

teres major & subscapularis

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Medial wall of axilla

serratus anterior & thoracic wall

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Lateral wall of axilla

intertubercular groove of humerus

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The axillary artery is the continuation of which artery?

subclavian

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at what anatomical point does the axillary artery start?

lateral border of 1st rib

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Axillary artery continues beyond the axilla as which vessel?

brachial

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At what anatomical point does the axillary artery become the brachial artery?

distal to inferior border of teres major

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When may compression of axillary artery be necessary?

profuse bleeding due to severe injury of upper limb

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What forms the brachial plexus?

ventral rami of C5-T1

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major branches of brachial plexus

Musculocutaneous

Axillary

Median

Radial

Ulnar

(My Aunt Makes Ridiculous Umbrellas)

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Which nerves roots form upper trunk?

C5 & C6

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Erb’s point and clinical relevance

Union of C5 &C6

Can be injured at birth (shoulder dystocia) or fall on shoulders (hyperextension)

Can paralyse arm muscles -> waiter’s tip

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Waiters tip position

Erb’s palsy

Medially rotated & wrist flexed

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Which group of muscles affected in erb’s palsy?

Those innervated by the musculocutaneous nerve and the axillary nerve (and some of the radial nerve)

Musculocutaneous nerve: (BBC) Biceps Brachialis Coracobrachialis

Axillary nerve: Deltoid, teres minor,

Suprascapular nerve (C5-C6): Infraspinatus and supraspinatus

Radial nerve (partially): Wrist extensors

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Roots of lower trunk of brachial plexus

C8 & T1

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Klumpke’s palsy

Paralysis of: Intrinsic muscles of hand

Ulnar flexors of wrist and fingers

Causes claw hand

Lower trunk affected

Affects C8-T1

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Cause of klumpke’s palsy

Undue abduction of arm

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How are the cords of the brachial plexus named?

In relation to axillary artery

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Brachial plexus nerves and their cords

Lateral cord -> muscluocutanous & median

Posterior cord -> axillary &radial

Medial cord -> ulnar & median

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Where do the cephalic and basilic veins arise?

Cephalic -> lateral end of dorsal venous arch

Basilic - medial end of dorsal venous arch

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What is the median cubital vein?

Large communicating vein shunting blood from cephalic to basilic vein

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Dermatome

area of skin supplied by one spinal segment

Where do all upper limb lymphatic vessels drain?

Axillary LN

5 distinct axillary LN groups

Pectoral (anteiror) Subscapular (posteiror) Apical Central Lateral

Why can infected umbilicus spread to axillary and superficial inguinal LN?

Inguinal watershed region Boudry at which lymph can spread up and below

Pectoral girdle

Connects upper limb to axial skeleton involves only the scapula and clavicle

Upper limb and pectoral girdle articulating point

Acromioclavicular (AC) joint

Clavicle break

Inbetween the medial and lateral 1/3rds

AC joint is a type of

Synovial plane

Sternoclavicular joint is a type of

Synovial saddle

Movement of shoulder joint involves what?

Acromioclavicular (AC) Sternoclavicular (SC) Gelnohumeral Scapulothoracic

Scapula-humeral rhythm

Beyond 90 degrees of abduction... For every 3 degrees of abduction: 2^o -\> glenohumeral 1^o -\> scapula-thoracic

Elevation of scapula is caused by

Levetor scapulae Trapezius Rhomboids

Depression of scapula is caused by

Lower trapezius Serratus anterior

protraction of scapula is caused by

Serratus anterior Pec major and minor

Retraction of scapula is caused by

Middle fibres of trapezius Rhomboids

Lateral rotation of scapula is casued by

trapezius (superior and inferior) serratus anterior

medial rotation of scapula is caused by

Rhomboids pec major levator scapulae gravity

Glenohumeral joint type and what each part is

synovial ball and sockek ball= humeral head socket= glenoid cavity

Rim of cartilage around glenoid cavity

glenoid labrum

Glenoid labrum function

Insertion for structures Deepens socket increases stability Prevents discloations

Glenohumeral ligament strengthens what aspect of the joint

Anterior aspect of joint

Coracohumeral ligament strengthens what aspect of the joint

Superior aspect of joint capsule

Coraco-acromial arch is made up of

Acromion coracoid process coracoacromial ligament

function of coraco-acromial arch

Prevents displacement of humeral head

What part of shoulder joint is weakest and why?

Inferior part Its not protected by any muscles or ligaments

Which shoulder bursa communicates with joint cavity?

Subscapular

Subacromial bursa function

Facilitate movement of supraspinous tendon and deltoid over joint capsule

Subacromial bursa injury

Dislocation of glenohumeral joint

4 rotator cuff muscles

Teres minor Subscapularis Supraspinatous Infraspinatous

Glenohumeral joint movements by rotator cuff muscles

Abduction External and internal rotation

Rotator cuff main function

Stability

Deltoid attachments

Lateral spine of scapula acromion lateral third of clavicle delotoid tuberosity of humerus

Anterior fibres of deltoid actions on glenohumeral joint

Flexion Medially rotation

Middle fibres of deltoid actions on glenohumeral joint

Abduction (its main function)

Posterior fibres of deltoid actions on glenohumeral joint

Extension Lateral rotation

Nerve supply to deltoid

Axillary nerve (posteior cord -\> C5/6)

Common injury trapping axillary nerve

Surgical neck of humerus fracture

Loss of sensation of axillary nerve

Regimental badge area Lateral arm

Origin of pec major fibres

Medial 1/3rd of clavicle sternum ribs

Pec major actions on glenohumeral joint

Flexion Adduction Internally rotation

Deltopectoral triangle

Space below clavicle & between: deltoid pec major cephalic vein

Nerve supply of serratus anterior

Long thoracic nerve C5, 6 & 7

Injury to long thoracic nerve and when this could happen

Winged scapula Radial mastecomy (surgery for breast cancer)

Superior fibres of trapezius actions on scapula

Elevation

Medial fibres of trapezius actions on scapula

Retraction

Inferior fibres of trapezius actions on scapula

Depression

Trapezius innervation

CN 11 -Accessory nerve

Teres major action on glenohumeral joint

Adduct Medial rotation

Lattisimus dorsi action on glenohumeral joint

Extension Adduction Medial rotation

what muslces cause Lateral or external rotation of glenohumeral joint

Teres minor infraspinatus

What muscles does the brachial plexus lie in between?

Middle and anterior **Scalene** muscles

What is the only bursa in the shoulder that communicates with the shoulder joint?

Suscapular bursa

What is the innervation of the pectroalis major

Medial pectroal nerve Lateral pectoral nerve

Klumpke's palsy affects the lower trunk, which is C8-T1. What is the risk if T1 being affected? (i.e. what syndrome is Klumpke's linked to)

Horner's syndrome Resulting in ptosis and miosis (constriction of pupil)

What are the 3 clinical tests for shoulder ligament injuries?

TOSSY classification 10kg test Piano key test

What type of bone is the scapula

Flat bone

What type of bone is the clacvicle

Long bone

What is the shape of the clavicle

**S shaped** Medial aspect -\> concave Lateral aspect -\> convex

Which lymph nodes is invloved in the following injuries... Infection of little finger Boil in scapular region Lateral part of th breat Infectoin around the umbilicus (along with the superficila inguinal)

AXILLAAAARRRYYYYYYY

What muscles attach to the greater tubercle of the humerus

Supraspinatus Infraspinatus Teres minor

What muscles attaches to the lesser trocanter of the humerus

Subscapularis

What is the only rotator cuff muscle that does not insert on the greater tubuercle of the huemrus

Subscapularis (inserts on the lesser tubercle)

What muscles attach to the intertubercular sulcus

Latissums dorsi Teres major Pec major

What muscles attach onto the medial epicondyle

Flexor carpi radialis Flexor carpi ulnaris FDS Palmaris longus

What muscels attach to the coaracoid process

Coracobrachialis Pec minor Short head of biceps brachii

What muscles attach to the supraglenoid and infragelnoid tubercle

Supraglenoid -\> long head of biceps Infraglenoid -\> long head of tricpes

What muscles attach to the acromion and clavicle

Deltoid Trapezius

Upper limb 1 Flashcards

(91 cards)