Upper Limb 1 Flashcards Preview

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Flashcards in Upper Limb 1 Deck (61):
1

What forms the anterior, posterior, medial and lateral walls of the axilla?

Anterior:
-Pectoralis Major and minor

Posterior wall
-Teres Major and Latissimus dorsi

Medial wall
-Thoracic wall and serratus anterior

Lateral wall
-Intratubercular sulcus of the humerus

2

The axillary artery is the continuation of which artery?

Subclavian artery

3

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

Lateral border of the 1st rib

4

The axillary artery continues beyond the axilla as which vessel?

Brachial artery

5

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

Inferior border of the teres major

6

When may compression of the axillary artery be necessary?

Profuse bleeding occurs due to severe injury to the upper limb

7

What spinal nerve roots form the brachial plexus?

C5
C6
C7
C8
T1

8

Which nerve roots form the upper trunk, middle trunk and lower trunk of the brachial plexus?

Upper
-C5 and C6

Middle
-C7

Lower
-C8 and T1

9

What is Erb's point and what is the clinical relevance of it?

Point of unison of C5 and C6 forming the upper trunk of the brachial plexus.

Injury commonly sustained at this point during birth or from a fall onto the shoulder.

Causes Erb's palsy resulting in characteristic waiter's tip appearance of the upper limb -> medialy rotated with wrist flexed

10

What muscles are effected by Erb's palsy?

What nerves supply them?

Musculocutaneous nerve:
-Biceps brachii
-Brachialis
-Coracobrachialis

Radial nerve
-Brachioradialis

Axillary nerve
-Deltoid

11

Injury to the lower trunk of the brachial plexus causes what?

(what is the cause of this injury, what is effected, what is it called)

Klumpke's palsy

Muscles effected:
-Intrinsic muscles of the hand
-Ulnar flexors of the wrist and fingers

Cause of injury is undue abduction of the arm
-Trying to grab a branch while falling

12

What forms the medial, posterior and lateral cords of the brachial plexus?

Lateral cord
-Upper trunk and middle trunk

Posterior cord
-Upper, middle and lower trunks

Medial cord
-lower trunk

13

Musculocutaneous nerve comes from which brachial plexus cord?

Lateral cord once the branch for the median nerve is given off

14

What cords form the median nerve?

Lateral and medial cords give off fibres forming the median nerve

15

What nerves come from the posterior cord of the brachial plexus?

Axillary and radial nerve
Thoracodorsal nerve
Upper and lower subscapular nerve

16

What cord does the ulnar nerve come from?

Medial cord once fibres are given off for the median nerve

17

What are the branches of the lateral cord of the brachial plexus?

Lateral pectoral
Lateral root of median nerve
Musculocutaneous nerve

18

What are the branches of the medial cord of the brachial plexus?

Medial pectoral
Ulnar nerve
Medial root of median nerve
Medial cutaneous nerve of the arm
Medial cutaneous nerve of the forearm

19

What two veins arise at the dorsal venous arch and where on this arch?

Cephalic vein at lateral end
Basilic vein at medial end

20

The median cubital vein is a large communicating vein which shunts blood from where to where?

cephalic vein -> basilic vein

21

Where do lymphatic vessels from the upper limb drain?

Axillary nodes

22

Name the 5 distinct groups of axillary lymph nodes

Anterior or pectoral group
Posterior or subscapular group
Apical group
Central group
Lateral group

23

Infection in the little finger will drain to lymph nodes where?

Axilla

24

A boil in the scapular region will drain to lymph nodes where?

Axilla

25

The medial and lateral portions of the breast drain lymph where?

Medial -> internal thoracic
Lateral -> axilla

26

Infection around the umbilicus (e.g. infected tattoo) would drain lymph where?

Above umbilicus -> axilla
Below umbilicus -> superficial inguinal

27

The entire upper limb and pectoral girdle articulate at one small joint only, which is this?

Sternoclavicular

28

Which part of the clavicle is weakest and commonly breaks?

Junction of middle and lateral thirds

29

What type of synovial joint are the acromioclavicular (AC) and sternoclavicular (SC) joints?

Acromioclavicular -> plane
Sternoclavicular -> saddle

30

What is the scapulohumeral rhythm?

Consider abduction of the arm from the anatomical position.

Initially, all movement will be at the glenohumeral joint, but beyond about the first 30 degrees, for every 3 degrees of abduction, 2 degrees occurs at the shoulder joint and 1 degree at the scapulothoracic joint (2:1 ratio)

31

What muscles cause elevation of the scapula?

levator scapulae
Upper trapezius
Rhomboids

32

What muscles cause depression of the scapula?

Lower trapezius
Pectoralis major and minor

33

What muscles cause protraction of the scapula?

Serratus anterior
Pectoralis major and minor

34

What muscles cause retraction of the scapula?

Middle trapezius
Rhomboids

35

What muscles cause rotation depressing the glenoid cavity?

Inferior trapezius
Inferior part of serratus anterior

36

What is the glenoid labrum?

Rim of cartilage surrounding the socket of the glenoid cavity.

Doubles the glenoid depth and increases the surface area.
Acts as a "chock block" limiting glenohumeral translation

37

The coracohumeral ligament strengthens what aspect of the joint capsule

superior aspect

38

The coracoacromial arch is made up of what 3 structures?

Acromion
Coracoid process of the scapula
Coraco-acromial ligament

39

Which bursa communicates with the shoulder joint cavity?

Subscapula bursa

40

What is the role of the subacromial bursa?

Facilitates movement of the supraspinatus tendon under the coraco-acromial arch and of the deltoid over the joint capsule and the greater tubercle of the humerus

41

What movements of the glenohumeral joint are generated by the rotator cuff muscles?

Abduction, lateral and medial rotation

42

Where does the origin of the deltoid extend from?

Lateral spine of the scapula, across the acromion to the lateral 3rd of the clavicle

43

What do each of the fibres of the deltoid do?

Anterior fibres -> medially rotate and flexes at the shoulder joint

Middle fibres -> abduct at the shoulder joint

Posterior fibres -> extend and laterally rotate at the shoulder joint

44

What is the nerve supply to the deltoid?

Axillary nerve

45

Where could you test for loss of sensation in axillary nerve injury?

Shoulder badge region
Lateral side of proximal part of arm - C5 dermatome

Superior lateral cutaneous nerve of the arm

46

Where do the fibres of the pectoralis major originate?

Medial third of the clavicle, the sternum and ribs

47

What is the action of the pectoralis major on the shoulder joint?

Adduct and medially rotate the humerus at the glenohumeral joint

48

What is the deltopectoral triangle?

Why is it important?

Triangular space below the clavicle, between deltoid and pactoralis major muscle.

Subclavian vein is vound in this triangle for the insertion of central lines

49

What is the funtcion of the serratus anterior?

Protraction of the scapulae, but mainly serves to stabilise it during limb movements and to keep it pulled against the thoracic cage

50

What is the nerve supply to serratus anterior?

Long thoracic nerve

51

What clinical sign do you see when the long thoracic nerve is injured?

Winged scapula

52

What do all the different fibres of the trapezius do to the scapula?

Superior fibres -> elevate
Middle fibres -> retract
Inferior fibres -> depress

53

What is the nerve supply to the trapezius?

Accessory nerve

54

What is the action of teres major on the shoulder joint?

Adducts and medially rotates

55

What is the action of latissimus dorsi on the shoulder joint?

Extends, adducts and medially rotates shoulder joint

56

What muscles flex the shoulder?

Biceps bracii
Pectoralis major
Anterior deltoid
Coracobrachialis

57

What muscles extend the shoulder?

Posterior deltoid
Latissimus dorsi
Teres major

58

What muscles adduct the shoulder?

Pectoralis major
Latissimus dorsi
Teres major

59

What muscles abduct the shoulder?

Middle part of deltoid
Supraspinatus
Trapezius
Serratus anterior

60

What msucles cause medial or internal rotation of the shoulder?

Subscapularis
Lattisimus dorsi
Pectoralis major
Teres major

61

What muscles cause lateral or external rotation?

Teres minor and infraspinatus