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UPPER LIMB Flashcards

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1
Q

What is the anatomical name and bones of the shoulder?

A

shoulder: neck/trunk –> arm

Anatomical name: shoulder
Bones: pectoral girdle = clavicle + scapula

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2
Q

What is the anatomical name and bones of the arm?

A

Anatomical name: brachium
Bones: humerus

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3
Q

What is the anatomical name and bones of the Forearm?

A

Anatomical name: antebrachium
Bones: radius(lateral) + ulna(medial)

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4
Q

what is the anatomical name of the hand and three regions of the hand?

A

Anatomical name: manus
two regions: wrist, palm/dorsum and fingers

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5
Q

what is the anatomical name and bones of the wrist?

A

anatomical name: carpus
bones: carpal bones

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6
Q

What is the anatomical name and bones of the palm/dorsum?

A

Anatomical name: hand proper
bones: metacarpals

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7
Q

What is the anatomical name and bones of the fingers?

A

anatomical name: digits
bones:
phalanges (plural)
phalanx (singular)

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8
Q

what bones make up the shoulder region?

A
  • clavicle bone
  • scapula
  • humerus
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9
Q

clavicle bone

A

bone in shoulder region
- most frequently broken bone in body
- transmits energy from appendicular to axial when falling

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10
Q

scapula bone

A
  • shaped like a shovel
  • sight for UL mm attachment
  • articulates with humerus at glenoid fossa
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11
Q

humerus bone

A
  • glenoid fossa articulates with head of humerus = glenohumeral joint
  • sight for UL mm attachment
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12
Q

what are the movements of the shoulder?

A

all at glenohumeral jt

  • flexion (move anterior)
  • extension (move posterior)

-ABduction (away from midline)
- ADDuction (toward midline)

  • Rotation at the glenohumeral joint (medial + lateral shoulder)
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13
Q

sternoclavicular joint

A

(sternum –> clavicle)
- synovial, saddle joint
- joint capsule = tight ligaments = very stable

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14
Q

acromioclavicular joint

A

(acromial process of scapula –> acromial end of clavicle)
- synovial, plane/gliding joint
- x3 ligaments that stabilize/support joint

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15
Q

what three ligaments stabilize/support the acromioclavicular joint?

A
  1. acromioclavicular ligaments
    • form jt capsule + hold in synovial fluid
  2. coracoacromial ligament
    • coracoid –> acromion
    • provide stability
  3. coracoclavicular ligament
    • coracoid process –> clavicle
      - provides MOST stability to acromioclavicular joint
      - if rupture = shoulder separation injury (diff than shoulder dislocation)
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16
Q

scapulothoracic joint/ movements of this jt

A
  • “joint” as scapula moves along post thoracic wall
  • elevation(hands above head) /depression of scapula(shrug)
  • ABduction (hug/ move scapula away from midline)
  • ADDuction (arms out/retraction/protraction)
  • rotation of scapula (up/down) because glenohumeral jt can only move up to 90 deg (rotation to do Ymca)
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17
Q

glenohumeral jt

A

true shoulder joint
- synovial jt, ball in socket jt = great range of mobility = multi axial jt
- glenoid fossa –> head of humerus
- glenoid fossa = shallow = only 1/3 of humerus sits in glenoid fossa

inc mobility = DEC stability

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18
Q

what is the ligament of the glenohumeral jt

A
  1. glenoid labrum: cartilage that deepens the articulation
    - bursa around jt = dec friction
    - most stability comes from the rotator cuff mm
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19
Q

what mm are apart of the axiohumeral mm group?

A

axial skeleton –> humerus
1. Pectoralis Major m.
2. Latissimus Dorsi m.

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20
Q

pectoralis major m

A
  • 2 heads
    SAME:
  • b attachment: intertubercular sulcus
  • inn: medial + lateral pectoral nn

sternal head:
a: sternum
b: intertubercular sulcus
axn: medial rotation + flexion + arm ADDuction

clavicular head:
a: clavicle
b: intertubercular sulcus
axn: extension of arm + ADDuction of arm

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21
Q

Latissimus Dorsi m.

A

a: lower thoracic + lumbar spinous processes
b: intertubercular sulcus
axn: medial rotation + powerful extensor + ADDuctor of arm/shoulder
inn: thoracodorsal n

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22
Q

what muscles make up the axioscapular mm group?

A

axial skeleton –> scapula

  1. pectoralis minor m
  2. trapezius m
  3. levator scapulae m
  4. serratus anterior m
  5. Rhomboids (major + minor) m
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23
Q

pectoralis minor m

A

just deep to pec major m
a: ribs
b: coracoid process of scapula
inn: medial + lateral pectoral nn
ax: elevation of rib cage + stabilization + depression of scapula

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24
Q

trapezius m

A

a: external occipital protuberance, nuchal ligament, spinous process C7- T12
b: spine of scapula, acromion process of scapula + clavicle
inn: accessory CN XI
3 parts

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25
Descending Fibers of Trapezius m
** upper part ** a: external occipital protuberance b: acromion process of scapula + clavicle axns: elevation of scapula, upper rotation of scapula
26
Transverse Fibers of Trapezius m
** middle part ** a: nuchal ligament + spinous processes b: acromion process of scapula + clavicle axn: retract scapula
27
Ascending Fibers of Trapezius m.
** lower part ** a: lower spinous processes b: medial spine of scapula axns: depression of scapula + upward rotation
28
Levator Scapulae m
a: clavicle vertebra b: superior/medial boarder of scapula axn: elevation of scapula + some inf rotation of glenoid inn: dorsal scapular n
29
serratus anterior m
a: anterior aspect of ribs b: medial boarder of scapula axns: pull scapula to posterior thoracic wall + protract + rotate glenoid fossa superiorly inn: long thoracic n
30
winged scapula
damage to long thoracic n = impair serratus anterior m - can happen during lateral mastectomy
31
rhomboids m (major + minor)
a: spinous process (upper thoracic) b: medial border of scapula axn: ADDuct scapula inn: dorsal scapular n.
32
what muscles are apart of the scapulohumeral mm group
- scapula --> humerus - mm will manipulate 1. deltoid m 2. teres major m 3. rotator cuff mm
33
what muscles are apart of the rotator cuff mm group?
- give strength to shoulder joing - unique to have mm as 1* fxn = stabilization of jt 1. infraspinatus m. 2. teres minor m. 3. supraspinatus m. 4. subscapularis m.
34
deltoid m.
- x 3 heads named like inverted delta all work together to ABduct shoulder/arm SAME: inn: axillary n b: deltoid tuberosity clavicular head: a: clavicle b: deltoid tuberosity axn: flexing arm + slight medial rotation acromial head: a: acromion process of scapula' b: deltoid tuberosity axn: ABduction of arm spinal head: a: spine of the scapula b: deltoid tuberosity axn: extension of arm + slight lateral rotation
35
teres major m
a: inferior angle of scapula b: intratubular sulcus axn: medial rotation + ADDuction + some extension of arm
36
infraspinatus m
a: infraspinous fossa of scapula b: greater tubercle of humerus inn: suprascapular n axn: lateral rotation + ADDuction of arm
37
teres minor m
a: lateral half of scapula b: greater tubercle of humerus inn: axillary n axn: lateral rotation of shoulder + stabilization of arm
38
supraspinatus m.
a: supraspinous fossa of scapula b: greater tubercule of humerus inn: suprascapular n axn: ABduction of arm
39
subscapularis m
a: subscapular fossa b: lesser tubercule of humerus inn: lower + upper subscapular n. axn: medial rotation + ADDuction of arm
40
what are the boundaries of the axilla?
posterior: - subscapularis m. - teres major m + latissimus dorsi m. medial: - serratus anterior m. anterior: - pectoralis major m. - pectoralis minor m.
41
what are the contents of the axilla?
- brachial plexus nn. - axillary a./v. - lymphatics - fat
42
what are some differences between the breast and the mammary gland?
mammary gland = - glandular lobule - produces milk during pregnancy within breast - sex accessory organ in female breast= - modified sweat gland - packed full of fat, mammary glands, and are suspended by suspensory ligaments
43
what is the pathway for milk in the breast?
1. mammary gland produce milk (15-20 in breast) 2. Lactiferous duct (common spot for carcinoma to develop) 3. lactiferous sinus (storage spot for milk) 4. Nipple/ out areola = pigmented skin around nipple - sweat and oil glands surround nipple to reduce chaffing during breast feeding
44
Milk let down reflex
- driven by oxytocin - initiated by suckling - milk comes from mammary glands mostly but some is released from lactiferous sinuses
45
is the breast compartmentalized?
No - Suspensory ligaments that hold/ support breasts are made of superficial fascia - can lead to easy spread of carcinoma
46
where does breast cancer typically start?
- superior lateral quadrant of breast - close to axilla = close to mammary lymph nodes = can metastasize easy = sample lymph nodes from lateral to medial to check for breast cancer - can also spread to opposite breast via parasternal lymph nodes
46
Mastectomy vrs radical mastectomy
mastectomy = removal of breast tissue from sup--> ant radical mastectomy = take even more tissue ** can damage the long thoracic = the serratus anterior m. = winged scapula **
47
is the brachial plexus PANS or SANS?
sympathetic ONLY (SANS) **NO PANS IN UL** erector pili m, blood vessels, sweat glands
48
are ventral/anterior rami motor and/or sensory?
BOTH sensory and motor sensory to skin motor to skeletal mm
49
what is the anatomy of the brachial plexus?
1. Ventral Rami (C5/T1) 2. Trunks a: upper: C5-C6 b: middle: cont of C7 c: lower: C8-T1 3. Divisions a: anterior: inn ant. mm b: posterior: inn post mm 4. Cords (named for relation to axillary a) a: posterior cord b: medial cord c: lateral cord 5. Terminal Branches
50
what are the terminal branches of the brachial plexus?
1. Musculocutaneous n. 2. Axillary n. 3. Radial n. 4. Median n. 5. Ulnar n. MARMU other branches: 6. Dorsal Scapular n. 7. Long thoracic n. 8. Suprascapular n. 9. Lateral Pectoral n. 10. Medial pectoral n. 11. Thoracodorsal n. 12. Lower Subscapular n.
51
where does Musculocutaneous n. come from and what does it innervate?
C5/C6 --> Upper/Sup trunk --> anterior division --> lateral cord --> Musculocutaneous n. inn: anterior arm mm
52
where does median n come from and what does it innervate?
**made lateral + medial cord** C5/C6 --> Upper/Sup trunk --> anterior division --> lateral cord --> lateral root of median n. --> median n. C8/T1 --> Lower/inf trunk --> anterior division --> medial cord --> medial root of median n. --> median n. inn: thumb + hand intrinsic m
52
where does axillary n come from and what does it innervate?
C7 --> middle trunk --> posterior division --> posterior cord --> axillary n. inn: shoulder mm (deltoid m + teres minor m)
52
where does radial n come from and what does it innervate?
C7 --> middle trunk --> posterior division --> posterior cord --> radial n. inn: post arm + post forearm mm
53
where does ulnar n come from and what does it innervate?
C8/T1 --> Lower/inf trunk --> anterior division --> medial cord --> ulnar n.
54
where does dorsal scapular n come from and what does it innervate?
C5 --> dorsal scapular n. inn: Rhomboids m. + levator scapulae m.
55
where does long thoracic n come from and what does it innervate?
C5 +C6+ C7 --> long thoracic n. inn: serratus anterior m
56
where does suprascapular n come from and what does it inn?
C5/C6 --> Upper/Sup trunk --> suprascapular n. inn: supraspinatus m + infraspinatus m
57
where does lateral pectoral n come from and what does it inn?
C5/C6 --> Upp/sup trunk --> ant div --> lateral cord --> lateral pectoral n. inn: pectoralis major + minor mm.
58
where does upper subscapular n come from and what does it inn?
C7 --> middle trunk --> post div --> post cord --> upper subscapular n. inn: subscapularis m
59
what does medial pectoral n come from and what does it innervate?
C8/T1 --> lower/inf trunk --> ant div --> medial cord --> medial pectoral n.
60
where does thoracodorsal n come form and what does it innervate?
C7 --> middle trunk --> post div --> post cord --> thoracodorsal n. inn: latissmus dorsi m
61
where does lower subscapular n come from and what does it innervate?
C7 --> middle trunk --> post div --> post cord --> lower subscapular n. inn: subscapularis m. + teres major m
62
what does peripheral innervation mean? what is an example?
inn by a named nerve off the brachial plexus motor: whole mm or entire mm group sensory: patch of skin (cutaneous) ex: musculocutaneous n
63
what does injury musculocutaneous n (peripheral n) look like?
motor: paralysis to mm of anterior arm = paralysis of the elbow flexion of arm sensory: anesthesia to patch of skin inn by musculocutaneous n
64
what is segmented innervation? what is an example
innervation of a spinal cord segment motor: myotome (portion of a mm) sensory: dermatome (strip of skin) example: C5 ventral rami n.
65
what does injury to a C5 ventral rami look like? (segmented n)
motor: paresis to mm of ant arm sensory: anesthesia to dermatome (strip of skin)
66
What is the blood flow of the upper limb on the left side?
1. aortic arch a 2. L subclavian a 3. Axillary a 4. Brachial a 5a. Radial a 5b. Ulnar a 6.a. deep 6b. sup palmar palmar arch a arch a 7a+b. metacarpal aa 8a+b. digital aa
67
what arteries come off of axillary a and where do they go?
1. subscapular a 2. lateral thoracic a 3. thoracoacromial trunk a
67
What is the blood flow of the upper limb on the right side?
1. aortic arch a 2. brachiocephalic trunk a 3. Right subclavian a 4. Axillary a 5. Brachial a 6a. Radial a 6b. Ulnar a 7.a. deep 7b. sup palmar palmar arch a arch a 8a+b. metacarpal aa 9a+b. digital aa
68
what does subscapular a supply?
1. latissimus dorsi m 2. posterior shoulder 3. lateral thoracic wall m.
68
what does lateral thoracic a supply?
1. lateral thoracic wall m. 2. serratus anterior m.
69
what does thoracoacromial trunk a?
1. shoulder jt 2. pectoral mm 3. breast
70
what nerve does brachial a run with?
median n.
71
what artery comes off of brachial a?
profunda brachii a (deep brachial a)
72
what does radial a supply?
extensors of wrist + digits
73
what does ulnar a supply?
flexors of wrist + digits
74
what aa come off of subclavian a?
1. vertebral a 2. thyrocervical trunk a 3. internal thoracic a
75
what does internal thoracic a supply?
breast + anterior thoracic wall
76
deep veins are named for?
- the arteries they run w/ - they make venae comitantes
77
what are superficial veins named for?
- they have their own unique names - all begin at the dorsum of the hand = dorsal venous network
78
what is the venous return of the upper limb? **double check
1. dorsal venous arch v 2. basilic v (medial arm + forearm) 3. median cubital v 4. cephalic v (lateral arm + forearm) 5. deep brachial v (join w basilic v to form axillary v)
79
what articulations are found in the elbow joint?
1. btwn humerus + ulna 2. btwn humerus + radius 3. btwn radius + ulna (3 articulations(bones) in 1 jt capsule) - 1+2 are true elbow jt
80
what is the true elbow jt? what are the actions of it?
- synovial hinge/uniaxial jt - has strong collateral ligaments - flex/extend arm
81
what are the 2 ligaments of the true elbow joint?
1. Ulnar collateral ligament 2. Radius collateral ligament
82
what is the function of ulnar collateral ligament
- resist ABduction of forearm - MCL of elbow
83
what is the function of the radius collateral ligament?
- resist ADDuction of forearm
84
carrying angle is bigger in men or women?
women because it helps with carrying things
85
what is tennis elbow?
lateral epicondylitis - over use of forearm extensors = inflammation at common tendon (lateral epicondyle)
86
what is golfer's elbow?
medial epicondylitis - overuse of forearm flexors = inc inflammation at common tendon(medial epicondyle)
87
what is the funny bone?
the ulnar bone = ulnar n funs posterior to medial epicondyle
88
what is the radioulnar joint?
- proximal + distal radioulnar jt - synovial/multiaxial jt - radius = only bone that moves
89
what are the movements of the radioulnar jt?
- pronation (palms down) - supination (palms up) anatomical position = supination = radius + ulna parallel
90
what are the 2 ligaments of the radioulnar jt?
1. Annular ligament (allow head of radius to spin during pronation + supination) 2. Interosseous membrane - physically holds radius + ulna together - transfer energy from carpals --> radius --> ulna --> upper limb
91
Which bone do the carpals articulate with at the wrist?
radius bone
92
which bone does the humerus articulate with at the elbow jt?
ulna bone
93
Brachialis m
a: anterior humerus b: coronoid process of ulna + ulnar tuberosity inn: musculotaneous n ax: primary elbow flexor
94
Coracobrachialis m
a: coracoid process of scapula b: medial humerus inn: musculocutaneous n ax: shoulder flexoin, ADDuct arm,
95
Biceps brachii m
long head: a: supraglenoid tubercle b: radial tuberosity short head: a: coracoid process b: radial tuberosity inn: musculocutaneous n. ax: PRIMARY supinator, flex @ elbow
96
What is the bicipital aponeurosis?
- CT from biceps --> deep fascia of forearm - covers median n/ brachial a - "grace of God tendon"
97
triceps brachii m
long head: a: infraglenoid tubercle b: olecranon process of ulna ax: arm extension + forearm extension (prim mvmnt) lateral head: a: posterior shaft of humerus b: olecranon process of ulna ax: forearm extension medial head: a: posterior shaft of humerus b: olecranon process of ulna ax: forearm extension ALL INN: radial n.
98
what is the radiocarpal jt? and what are the movements of it?
- wrist jt - btwn radius + carpals - synovial biaxial jt - flex/extend - ABduct (radial deviation) -ADDuct (ulnar deviation)
99
what bones are in the radiocarpal jt?
radius articulates w scaphoid + lunate bones scaphoid = most broken carpal bone
100
what is colle's fracture?
- distal fracture of the radius - happens when forearm is prone b/c interosseous mem cannot transfer force to ulna
101
what are the intercarpal jts?
- btwn carpal bones - all 8 carpal bones share 1 jt capsule - synovial planar/gliding jt
102
what are the two flexor retinaculum of the intercarpal jt?
- deep fascia 1. Superficial/proximal retinaculum: - palmar carpal lig - helps hold down ulnar n + ulnar a 2. Distal/Deep Retinaculum - transverse carpal lig - ties 2gether carpal bones + creates the carpal tunnel - creates an attachment pt for some hand intrinsic mm
103
what is and in the carpal tunnel?
- fiberosseous tunnel floor = row of carpal bones roof = transverse carpal lig contents: - x4 flexor digitorum profundus m. tendons - x4 flexor digitorum superficialis m tendons - x1 flexor pollicis longus m tendon - median n carpal tunnel = when inf occurs in carpal tunnel = median n gets pressed on
104

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