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Principles of Human Anatomy > Upper Limb > Flashcards

Upper Limb Flashcards

1
Q

Where is the only bony articulation b/w the upper limb and axial skeleton?

A

Where the medial end of the clavicle attaches with the sternum

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2
Q

Clavicle

A

attaches upper limb to axial skeleton via STERNOCLAVICULAR JOINT (joints to manubrium)
- enables the upper limb to be suspended away from axial skeleton

Structure:

  1. Sternal end (medial) has sternal facet which articulates with manubrium
  2. Conoid Tubercule: where conoid ligament attaches to the clavicle
  3. Trapezoid Line: where the trapezoid ligament attaches
  4. Acromial End: articulates with acromion process of scapular via acromial facet
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3
Q

Scapula

A

Flat, triangular bone lying posterior to the ribs

Attaches to the clavicle at the acromio and coracoclavicular joints

Structure:

  1. Acromion
  2. Coracoid process
  3. Glenoid Cavity (where humerus articulates)
  4. Supraspinous fossa
  5. Subscapular Fossa
  6. Spine of Scapula
  7. Coracoclavicular ligament

Straight edges = borders (superior, lateral, medial)
Corners = angles (superior, lateral, inferior)

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4
Q

Carpal, Metacarpals and Phalanges

A

8 carpal bones arranged in 2 rows
- proximal row articulates with the base of radius via the LUNATE and SCAPHOID

distal row articulates with metacarpals

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5
Q

Humerus

A

articulates with the socket of glenohumeral joint
articulates distally with radius and ulna at elbow joint complex

Structure:

  1. Greater Tubercule
  2. Less Tubercule
  3. Anatomical neck (region b/w head and shaft)
  4. Surgical Neck
  5. Intertubercular Groove
  6. Deltoid Tuberosity
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6
Q

Elbow Joint Complex

A

Made of:

HUMERO-ULNAR JOINT and HUMERO-RADIAL JOINT
and the RADIO-ULNAR joint

Distal articular surface of the humerus is a condyle, specialised to articulate with radius head

Structure:
Anterior View:
1. Radial Fossa
2. Coronoid Fossa
3. Lateral epicondyle
4. Capitulum (lateral part of anterior articular surface) 
5. Trochlea (medial part of ant. art. surface0
6. Medial epicondyle

Posterior:
1. Olecranon Fossa

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7
Q

Radius and Ulna

A 
Radius = thumb side/lateral
Ulna = medial/pinky side

Structure Anteriorly:
1. Head of radius - articulates with capitulum at radiohumeral joint and medially with notch of ulna at the proximal radio-ulna joint

  1. Radial Tuberosity
  2. Styloid process of Radius
  3. Cronoid Process
  4. Tuberosity of Ulna
  5. Styloid process of Ulna

Posteriorly:

  1. Olecranon
  2. Interosseous membrane
  3. Dorsal tubercule of radius
  4. Ulnar notch (notch in the base of the radius that articulates with the ulna
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8
Q

Scaphoid Fracture

A

the most common upper limb fracture when falling onto the hand

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9
Q

Sternoclavicular Joint

A

Manubrium and clavicle articulate

Joint = surrounded by a capsule stabilised by the:

  • ant. and post. sternoclavicular ligaments
  • interclavicular ligament
  • costoclavicular ligament

Articular Disc sits within this joint and is where movement of clavicle occurs

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10
Q

Acromioclavicular and Coracoclavicular Joints

A

Acriomioclavicular: where acromion of scapula articulates with clavicle

  • some movement
  • joint capsule stabilised by ACRIOMIOCLAVICULAR LIGAMENT

Coracoclavicular Joint: where coracoid process of scapular articulates with clavicle

  • coracoclavicular ligament attaches clavicle –> scapula
    • made up of trapezoid and coroid ligaments
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11
Q

Shoulder Joint/Gleno-Humeral Joint

A

head of humerus articulates with glenoid cavity of scapula

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12
Q

Elbow Joint

A

Hinge Joint b/w TROCHLEAR NOTCH of ulna and TROCHLEA of humerus b/w head of radius and capitulum of humerus

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13
Q

Radioulnar Joints

A

Join at 3 points:

  1. Proximal Radio-ulnar Joint - part of elbow joint
  2. Interosseous Membrane - holds 2 bones together
  3. Distal Radio-ulnar joint - holes 2 bones together at rist
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14
Q

Wrist Joint

A

b/w base of radius and lunate, scaphoid and triquestral bones

  • head of ulna is involved, but it is covered by a thick, articular disc
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15
Q

Joints of the Hand

A

Intercarpal Joints
Carpometacarpal
Metacarpophalangeal (MCP)
Interphalangeal (IP)

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16
Q

Movements

A

Scapula: mainly PROTRACTION/RETRACTION (ant/post), rotation when shoulder joint abducts

Glenohumeral Joint:

  • flexion/extension
  • circumduction
  • rotation

Elbow Joint Proper:
- flexion and extenion

Proximal Radio-ulnar Joint:
- pronation/supination

Wrist:

  • Flexion/extension
  • abduction/adduction
  • circumduction

Carpometacarpal Joints:
Thumb can do: flexion/extension, abduction/adduction and circumduction
- other: only gliding movements

Metacarpophalangeal:

  • flexion/extension
  • abduction/adduction
  • circumduction

IP:
- flexion/extension

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17
Q

Glenohumeral Joint

A

shoulder joint b/w head of humerus and glenoid fossa of scapula

SCAPULO-HUMERAL RHYTHM: all movement at shoulder joint will move scapula

18
Q

Pectoralis Major Muscle

A

Connects Thorax –> Humerus and produces powerful upper limb movements

  • abduction/adduction
  • flexion/extension

Attaches:

  • proximally along clavicle, sternum, costal cartilages
  • distally along lateral lip of intertubercular sulcus
19
Q

Latissimus Dorsii Muscle

A

connects thorax –> posterior humerus

Attaches:

  • proximally to SPINOUS PROCESSES of lower thoracic vertebrae
  • thocolumbar fascia
  • iliac crest
  • inferior ribs

How does the muscle work when arm is by side?

  • distal attachment is twisted around itself to attach –> humerus
    • -> inf. part attaches superiorly, and vice versa
    • —-> creates tension in different parts of muscle in different positions so muscle can produce movement in many positions
20
Q

Pectoralis Minor

A

Connects scapula to thorax to hold it in place during movement

Deep to pectoralis major

Attaches:

  • to thorax via ribs close to the costal carilages
  • to scapula at the coracoid process
21
Q

Serrator anterior muscle

A

deep to pectoralis minor

Attaches:

  • anteriorly to ribs
  • posteriorly to scapula along anterior surface of medial border
22
Q

What is “winging”

A

When nerve damage means that serratus anterior is not maintaining the relationship b/w the thoracic wall and scapula

23
Q

Deltoid Muscle

A

Divided into 3 parts to allow for flex/ext, abd/add at glenohumeral joint

  1. Anterior part
  2. Middle Part
  3. Posterior Part

Attaches:

  • proximally at clavicle, acromion and spine of clavicle
  • distally at the deltoid tuberosity of humerus
24
Q

Rotator Cuff Muscles

A

allow for fine movements

Role: to limit movement at shoulder joint to confer stability
- keeps the large humeral head centred at small glenoid fossa

  1. Subscapularis
    - attaches on anterior surface in subscapular fossa
  2. Supraspinatus:
    - attaches posteriorly abvoe spine of scapular in supraspinous fossa
  3. Infraspinatus
    - posteriorly below spine of scapular in infraspinous fossa
  4. Terers Mino
    - runs along lateral border of scapula
25
Where is the shoulder joint most likely to dislocate?
Shoulder joint = limited the most SUPERIORLY as there is a skeletal arch formed by the coracoid process, acromio- and coracoacromial ligaments. ---> useful in preventing shoulder from popping out Most likely to get an ANTERIOR or INFERIOR shoulder dislocation as scapula is medial and skeletal arch = superior.
26
Shoulder Joint Stabilisation
1. Glenoid Labrum (rim of fibrocartilage deepening socket of glenoid cavity) 2. Tendon of Long Head Brachii - helps stabilise by running through the joint and is held in the bicipital groove by the transverse humeral ligament
27
Ligaments of Shoulder Joint Capsule
INTRACAPUSLAR LIGAMENTS form joint capsule: 1. Superior, middle and inferior glenohumeral ligaments 2. Coracohumeral ligaments 3. Transverse humeral ligament Redundant capsule: slack part of capsule that allows upper limb to fully abduct over head Fibrous Membrane: wraps around joint capsule to hold it tog
28
Anterior Arm Muscles
BICEPS BRACHII Attaches Proximally: - long head's tendon runs through intertubercular groove to stabilise shoulder joint - short head attaches to coracoid process of scapula Distally: - radial tuberosity - bicipital aponeurosis Crosses shoulder and elbow joint - --> increases stability at shoulder - --> contributes to flex/supination at elbow 2. BRACHIALIS Deep to Biceps brachii - doesn't cross shoulder joint Attaches: - from humerus --> ulnar tuberosity and coracoid process of ulna Ulna = main bone for flexion of elbow, so brachialis contributes significantly to flexion 3. CORACOBRACHIALIS - deepest Attaches: - from coracoid process of scapula to humerus helps with: - flexion and adduction at shoulder joint (anteromedial)
29
Posterior Arm Muscles
1. TRICEPS BRACHII Attaches: - long head to scapula just below glenoid cavity - lateral and medial heads to posterior surface of humerus - distally to olecranon of ulna and through some forearm fascia Function: - maintain shoulder stability - main elbow extensor
30
Brachioradialis Muscle
Acts at elbow joint = a weak elbow flexor - belly lies in anterior of forearm, but is INNERVATED by the same nerve as posterior forearm muscles - acts MAXIMALLY during MID-PRONATION of forearm (eg: bringing a glass to your mouth)
31
What movements are the Biceps brachii, brachialis, coracobrachialis, brachoradialis and triceps brachii involved in?
Bb: supination and flexion of elbow, shoulder stability Brachialis: flexion of elbow Coracobrachialis: shoulder flexion, adduction and stability Triceps brachii: forearm extension, shoulder stability Brachoradialis: weak elbow flexor, flexion in mid-pronation
32
Elbow Flexion and Extension
Hinge joint formed by trochlear notch of ulna articulating with trochlea of humerus - head of radius moves on capitulum of humerus
33
Pronation and Supination - Elbow
Head of radius rotates with CAPITULUM of humerus Muscles: 1. SUPINATOR: attaches: - proximally to lateral epicondyle of humerus and to ulna - distally to radius 2. PRONATOR TERES: - more distal attaches: - from coronoid process and medial epicondyle of humerus --> lateral surface of radius 3. PRONATOR QUDRATUS attaches: - b/w anterior radius and anterior ulna at distal forearm
34
Elbow Joint Ligaments and Capsule
1. RADIAL/LATERAL COLLATERAL LIGAMENT - on lateral part of capsule 2. ANNULAR LIGAMENT: wraps around head of radius to allow head to rotate on capitulum while preventing lateral deviation 3. ULNA/MEDIAL COLLATERAL LIGAMENT - on medial part 4. Synovial membrane: helps radial head glide smoothly during pronation/supination
35
Muscles of Anterior Forearm
Medial epicondyle: common flexor tendon where most forearm flexors attach Superficial: 1. Pronator teres (flex wrist) 2. Flexor Carpi Radialis (abducts) 3. Flexor carpi ulnaris (adducts) 4. Plamaris longus (flex) Intermediate: 5. Flexor digitorum superficialis Deep: 6. Pronator quadratus 7. Flexor digitorum profundus (FDP) 8. Flexor pollicis longus (FPL)
36
Muscles of Posterior Forearm
Lateral epicondyle = common extensor origin ``` Superficial: 1. Brachioradialis 2. Extensor carpi radialis longus 3. Extensor carpi radialis brevis 4. Extensor digitorum 5. Extensor digiti minimi Extensor ulnaris ``` Deep: 6. Abductor pollicus longus 7. Extensor pollicus brevis 8. Extensor pollicus longus 9. Extensor indicus
37
Carpal Tunnel
A restricted space beneath the FLEXOR RETINACULUM (deep band of fascia the tendons of anterior forearm go under to get to hand to prevent flexor tendons from BOWSTRINGING) Flexor tendons and median nerve = most susceptible to compression injury
38
Intrinsic Hand Muscles
1. Thenar (thumb/radial side) 2. Adductor (deep to thenar, contains adductor pollicus) 3. Hypothenar (medial/ulnar side) 4. Central 5 Interosseus
39
Arteries of Upper Limb
1. subclavian (from either left or right) --> 2. Axillary --> 3. Brachial --> 4. Radial and Ulnar --> 5. Interconnecting arches to supply hand
40
Veins of Upper Limb
Dorsal venous network of hand drains to 2 superficial veins: 1. Cephalic vein (lateral) 2. Basilic vein (medial) both drain via AXILLARY VEIN to subclavian vein in neck Deep veins: follow arteries as venae comitantes
41
Brachial Plexus
5 roots which emerge from anterior rami of C5, 6, 7, 8 and T1 1. Each root splits --> pos. and ant. for superior, middle and inferior trunks 2. Each division then joins back tog to form 3 cords (lat. post, medial) 3. Each cord branches into one of 5 terminal branches (musculocutaneous, axillary, radial and medial)
42
Why do nerves branch?
allows different muscles to contract together and be innvervated from different nerves, but the same spinal root --> can send the right axon to the correct muscle to enable coordinated muscle contractions.

Principles of Human Anatomy (8 decks)

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