Upper limb 1 Flashcards by Heo Mun Ho

Anterior wall
Posterior wall
Medial wall
Lateral wall

of axilla made up of what

Anterior wall - pec major and minor
Posterior wall - subscapularis
Medial wall - thoracic wall + serratus anterior
Lateral wall - intertubercular sulcus of humerus

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Apex (axillary inlet) of axilla located at

Lateral border of 1st rib

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Contents of axilla

Axillary artery 
Axillary vein
Brachial plexus
Axillary lymph nodes
Tendons of short head of biceps brachii &amp; coracobrachialis

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Axillary artery is a continuation of what artery + what does axillary continue as

Subclavian

Brachial

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What point does the subclavian become the axillary artery

Lateral border of 1st rib

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What point does the axillary become the brachial artery

Inferior border of teres major

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Brachial plexus is the ventral rami of

C5-T1

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Brachial plexus:

5 roots –> 3 … –> 6 … –> 3 … –> 5 …

3 trunks - superior, middle, inferior

6 divisions - each trunk divides into anterior + posterior division

3 cords - different divisions combine to form lateral, posterior + medial cord (see other flashcard)

5 major branches - given off by the 3 cords

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What nerve roots of the brachial plexus form the

superior trunk
middle trunk
inferior trunk

Superior - C5 + C6
Middle - C7
Inferior - C8 + T1

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What is erb’s point

Auscultation point for heart sounds + murmurs at the left sternal border 3rd intercostal space

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What is erb’s palsy + what is the characteristic clinical sign

Injury to upper trunk (C5-6) of brachial plexus –> characteristic ‘waiter’s tip’ sign where

shoulder is internally rotated
elbow extended + pronated
wrist flexed

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Causes of erb’s palsy

Usually due to large size or shoulder dystocia (shoulders too wide) in neonates so too big to fit through birth canal

In adults - high impact injuries

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What group of muscles are affected in erb’s palsy if it is the upper trunk of brachial plexus that is affected

C5 - elbow flexors (brachialis, biceps brachii, corachoradialis + brachioradialis)

C6 - wrist extensors (extensor carpi radialis longus (ECRL), extensor carpi radialis brevis (ECRB), extensor digitorum (ED), extensor digiti minimi (EDM), extensor carpi ulnaris (ECU), abductor pollicis longus (APL), extensor pollicis brevis (EPB), extensor pollicis longus (EPL), and extensor indicis (EI))

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What is klumpke’s palsy (RARE)

Injury to the inferior trunk of the brachial plexus

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What group of muscles are affected in klumpke’s palsy if it is the inferior trunk of brachial plexus that is affected

Intrinsic muscles of hand

Ulnar flexors of wrist + fingers

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The cords (lateral/posterior/medial) of the brachial artery are named in relation to what structure

Axillary artery in the axilla

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In the axilla and the proximal aspect of the upper limb, the three cords give rise to five major nerve branches - name these

Musculocutaneous
Axillary
Median
Radial
Ulnar

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The lateral cord of the brachial plexus is formed by the combination of which divisions (2)

The anterior division of the superior trunk

The anterior division of the middle trunk

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The posterior cord of the brachial plexus is formed by the combination of which divisions (3)

The posterior division of the superior trunk
The posterior division of the middle trunk
The posterior division of the inferior trunk

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The medial cord of the brachial plexus is formed by which division

The anterior division of the inferior trunk

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Main branches of

lateral cord
posterior cord
medial cord

Lateral - musculocutaneous nerve, lateral root of median nerve
Posterior - axillary nerve, radial nerve
Medial - ulnar nerve, medial root of median nerve

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Superficial veins of the upper limb

Dorsal venous arch
Cephalic vein
Basilic vein
Median cubital vein

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What vein joins the cephalic and basilic vein + this vein shunts blood from cephalic to basilic or basilic to cephalic

Median cubital - shunts blood from cephalic to basilic

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Dermatomes of upper limb

regimental badge patch area
thumb
middle finger
pinky
axilla

C5
C6
C7
C8
T1

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All lymphatics in the upper limb drain into which group of lymph nodes

Axillary

What 2 bones make up the pectoral girdle, connecting the upper limb to the axial skeleton

Scapula and clavicle

The upper limb and pectoral girdle articulate with the axial skeleton at one small joint - name this

Sternoclavicular

Clavicle has 2 ends - name them

Acromial end and sternal end

The conoid tubercle on the clavicle is the attachment point for what

Conoid ligament - which binds clavicle to coracoid process of scapula

Which part of the clavicle is the weakest

Junction between anterior 2/3 and outer 1/3, essentially the MIDDLE SHAFT (because thinnest)

What type of joint is the acromioclavicular joint

Synovial plane

What type of joint is the sternoclavicular joint

Synovial saddle

Abduction of the arm from the anatomical position occurs at the glenohumeral (shoulder) joint for the first 30 degrees but beyond that, for every 3 degrees of abduction, 2 degrees occurs at ... joint and 1 degree at the ... joint

2 degrees at the glenohumeral joint | 1 degree at the scapulothoracic joint

What is the scapulothoracic joint

Not a true anatomical joint | It is just the movement on the scapula on the posterior thoracic wall

Name the 6 movements that occur at the scapula

``` Elevation Depression Protraction Retraction Lateral rotation Medial rotation ```

Name the muscles that -elevate (2) -depress (3) the scapula

Elevate - upper fibres of trapezius, levator scapulae Depress - pec major, lower fibres of trapezius, lattisimus dorsi, (gravity)

Name the muscles that -protract (2) -retract (3) the scapula

Protract - serratus anterior (MAINLY), pec minor Retract - middle fibres of trapezius, rhomboid major + minor

Name the muscles that -laterally (upward) rotate (2) -medially (downward) rotate (3) the scapula

Laterally rotate - trapezius, serratus anterior Medially rotate - levator scapulae, rhomboid major + minor

What are the 2 articular surfaces of the glenohumeral joint

Glenoid cavity of the scapula + Head of the humerus

What type of joint is the glenohumeral joint

Ball + socket

The rim of cartilage surrounding the glenoid cavity of the scapula is known as the + functions of this (2)

Glenoid labrum Function - deepens the glenoid cavity, shock absorption

Name the ligaments associated with the glenohumeral joint

Coracohumeral Coracoclavicular Glenohumeral Transverse humeral

Coracohumeral ligament strengthens which aspect of the joint capsule

The coraco-acromial arch is made up of what 3 things | + function

Acromion Coracoid process Coraco-acromial ligament Prevents superior displacement of the humeral head from the glenoid cavity

Which part of the glenohumeral joint is the weakest

Inferior part because it's not protected by muscles or ligaments

What are the 2 main bursa of the shoulder joint | + which of these communicates with the joint cavity

Subacromial bursa | Subscapular bursa - communicates with joint cavity

Function of the subacromial bursa

Decreases friction beneath the deltoid and allows smooth motion of the rotator cuff tendons

Common cause of subacromial bursitis

Repeated minor trauma such as repetitive overhead motions, e.g. swimming

Name the 4 rotator cuff muscles

Subscapularis Supraspinatus Infraspinatus Teres minor

Function of the rotator cuff muscles collectively

Resting tone of these muscles act to compress the humeral head into the glenoid cavity, so stabilising the GH joint

Function of deltoid - anterior fibres - middle fibres - posterior fibres

Anterior fibres - flex + medially rotate arm at GH joint Middle fibres - abduct arm at GH joint (MAJOR ABDUCTOR OF ARM) Posterior fibres - extend + laterally rotate arm at GH joint

Innervation of deltoid

Axillary nerve

Clinical sign seen when long thoracic nerve damaged

Winged scapula | -as long thoracic nerve innervates serrates anterior which holds scapula against ribs

Functions of trapezius - superior fibres - middle fibres - inferior fibres

Superior - elevate scapula Middle - retract scapula Inferior - depress scapula

Innervation of trapezius

CN XI

Actions of teres major (2)

Adduct + medially rotate arm at GH joint

Actions of latissimus dorsi on GH joint (3)

Extend Adduct Medially rotate

Muscles that flex GH joint (4)

Pec major Anterior fibres of deltoid Corachobrachialis Biceps brachii (WEAKLY ASSISTS)

Muscles that extend GH joint (2)

Posterior fibres of deltoid Latissimus dorsi (Teres major) (Teres minor)

Muscles that abduct at GH joint (4)

Supraspinatus - first 15 degrees Middles fibres of deltoid - next 15-90 degrees Trapezius + serratus anterior - past 90 degrees

Muscles that adduct at GH joint (3)

Pec major Latissimus dorsi Teres major

Muscles that internally/medially rotate at GH joint (5)

``` Subscapularis Pectoralis major Latissimus dorsi Teres major Anterior fibres of deltoid ```

Muscles that externally/laterally rotate at GH joint (2)

Infraspinatus | Teres minor

Actions of teres major (2)

Medial rotation + adduction of arm at GH

Function of coraco-acromial ligament

Prevent superior displacement of humeral head

Upper limb 1 Flashcards

(65 cards)