Upper Limb Flashcards
1
Q
Label all parts of the scapula
A
A = Acromion
B = Coracoid process
C = Infraspinatus fossa
D = Supraspinatus fossa
E = Medial border
F = Lateral border
G = Glenoid cavity (at lateral angle)
2
Q
The 4 rotator cuff muscles are
A
- Supraspinatus
- Infraspinatus
- Teres minor
- Subscapualris
SITS
3
Q
Painful arc degrees
A
60-120
4
Q
Axillary nerve injury presents how? What common injury type is this associated with?
A
Regimental badge area numbness & anterior shoulder dislocation
5
Q
From “top to bottom” the brachial nerves are….
A
(lateral pectoral at very top)
- Musculocutaneous
- Axillary
- Radial
- Median
- Ulnar
6
Q
External rotation of the shoulder is commonly lost in adhesive capsulitis. True/false?
A
True
7
Q
The musculocutaneous nerve supplies which arm compartment?
A
Anterior
8
Q
Radial nerve supplies which arm compartment?
A
Posterior
9
Q
Which nerve is particularly at risk in humeral shaft fractures?
A
Radial nerve (axillary is higher up; anterior shoulder dislocation)
10
Q
Radial nerve damage will present with which clinical sign?
A
Wrist drop
11
Q
The humero-ulnar joint is between which structures?
A
Trochlea and olecranon
12
Q
Which joint of the elbow enables pronation and supination?
A
Radio-capitellar joint
13
Q
The extensor origin of the elbow is which site?
A
Lateral epicondyle
14
Q
Lateral epicondylitis is AKA…
A
Tennis elbow
15
Q
Medial epicondylitis is AKA
A
Golfer’s elbow
16
Q
The common flexor origin of the forearm is where?
A
Medial epicondyle of elbow
17
Q
Supracondylar fractures of elbow present a risk of damage to which structures?
A
Median nerve & brachial artery
18
Q
Anterior forearm is all innervated by which nerve?
A
Median (EXCEPT FCU and ulnar half of FDP which are ulnar)
19
Q
The anatomical snuff box is commoly lost in which type of fracture?
A
Scaphoid
20
Q
Of the hand, which muscles are median nerve innervated?
A
The “LOAF” muscles:
- Lateral two lumbricals
- Opponens pollicis
- Abbductor pollicis brevis
- Flexor pollicis brevis
21
Q
PIP joint flexion and DIP hyperextension describes which type of deformtiy of the finger?
A
Boutonniere’s
22
Q
Describe “Swan necking” abnormality with anatomical terms
A
DIP in flexion, PIP in hyperextension
23
Q
Fromment’s test assess which nerve?
A
Ulnar nerve
24
Q
Label the wrist structures
A
A = Triquetrum
B = Hamate
C = Capitate
D = Trapezoid
E = Trapezium
F = Scaphoid
G = Lunate
H = Ulna
I = Radius
J = Pilsiform
K = 1st metacarpal
25
Median nerve function can be tested how? (2)
1) Testing opposition of thumb under resistance
2) Making an "OK" sign with first finger and thumb (uses FDL + FDP)
26
What's a test for painful arc syndrome?
Hawkins-Kennedy
27
What's the difference between Bankart & Hill-Sachs lesions?
Both result from anterior shoulder dislocation but Bankart only involves the labrum while Hill-Sachs involves the labrum AND the humeral head
28
Cubital Nerve Syndrome is caused by compression of which nerve?
Ulnar
29
Describe the EXTRINSIC muscles of the shoulder (4)
1) Deltoid
2) Trapezium
3) Pectoralis major
4) Latissimus dorsii
30
Which sign is associated with POSTERIOR shoulder dislocation on x-ray?
Light-bulb sign
31
32
Label the joints of the upper limb
A: AC joint
B: Glenohumeral joint
C: Humeroulnar joint
D: Radiohumeral joint
E: Proximal radioulnar joint
F: Radiocarpal joint
G: Distal radioulnar joint
H: Sternoclavicular joint
33
What is the major abductor of the arm - supraspinatus or deltoid?
Supraspinatus does the first 15 degrees, deltoid does the rest
34
How many degrees can the thumb rotate?
90
35
During supination / pronation of the forearm, which bone moves over which?
Radius moves over ulna
36
What kind of joint is the 1st MCP joint?
Saddle
37
What kind of joint if the 5th MCP joint (pinky)?
Condyloid
38
What is the trapezius innervated by? Where does it attach to? What movement does it allow?
Innervation = CN XI
Attached to C-spine
Allows scapular rotation
39
40
Which muscle allows the scapula to be elevated?
Rhomboids
41
Innervation of serratus anterior
Long thoracic nerve
42
Where do the SITS muscles attach to? (2)
Supraspinatus, Infraspinatus and Teres Minor all attach to the greater tuberosity of the humerus.
Subscapularis attaches to the lesser tuberosity.
43
The coracoid proces is present anteriorly/ posteriorly?
Posteriorly
44
Where does subscapularis attach to?
Coracoid process
45
Where does supraspinatus and infraspinatus attach to (not tuberosity)?
Acromion process
46
What are the anterior arm muscles? What are they innervated by? Major actions?
Muscles: biceps brachii, brachialis, coracobrachialis. ("BBC")
Innervation: Musculocutaneous nerve
Action: Flex arm and forearm. Brachaii is also a major supinator of the forearm.
47
What are the muscle(s) of the posterior compartment of the forearm? What is their innervation? What major action(s) do they perform?
Muscle: Triceps brachii
Innervation: radial nerve
Actions: Extension of arm and forearm
48
What are the muscles of the anterior forearm compartment (superficial layer)?
- Palmaris Longus
- Flexor capri radialis
- Flexor capri ulnaris
- Pronator teres
(PFPF)
49
What are the muscles of the intermediate and deep layer of the anterior compartment of the forearm?
Middle layer: Flexor digitorum superficialis
Deep layer: Flexor digitorum profundus, flexor pollicis longus, pronator quadratus.
50
Describe the innervation of the anterior compartment of the forearm?
All median nerve except for flexor capri ulnaris and the medial half of flexor digitorum superficialis which are ulnar nerve.
51
Label the muscles of the anterior arm? What nerve supplies them?
A = Biceps brachaii
B = Brachialis
C = Coracobrachialis
All musculocutaneous nerve.
52
Label the muscles of the anterior forearm (superficial layer)
A = Pronator teres
B = Flexor capri radialis
C = Palmaris Longus
D= Flexor carpi ulnaris
53
Label this muscle of the anterior forearm (middle layer). What is its nerve innervation?
A = Flexor Digitorum Superficialis
Nerve: Median except for the medial half which is ulnar.
54
Label these muscles of the deep-layer of the anterior forearm. What is their innervation?
A: Flexor Pollicis Longus
B: Flexor Digitorum Profundus
C: Pronator Quadratus
All median nerve
55
What are the main functions of the anterior compartment of the forearm (actions)?
Flexion of the wrist and digits, pronation, abduction and adduction of the wrist.
56
Label the muscles of the posterior forarm (superficial layer). What nerve(s) innervate these muscles?
A: Brachioradialis
B: Anconeus
C: Extensor carpi radialis longus
D: Extensor digitorum
E: Extensor carpi radialis brevis
F: Extensor carpi ulnaris
G: Extensor digiti minimi
All radial nerve
("Big Chocolate Chips And Double DIp Cherries")
57
Label these muscles of the deep layer of the posterior forearm compartment? Which nerve are they innervated by?
A: Supinator
B: Abductor pollicus longus
C: Extensor pollicis longus
D: Extensor pollicis brevis
E: Extensor indicis
All radial nerve
("Syrup and Peanuts Preferably Included")
58
59
What are the thenar muscles? What is their nerve supply?
lOAF muscles (Opponens policis, Flexor pollicis brevis, Abductor pollicis brevis) - recurrent branch of the median nerve
60
What are the muscles of the hypothenar eminence? What is their nerve innervation?
Abductor digiti minimi, flexor digiti minimi brevis, opponens digiti minimi.
All innervated by the deep branch of the ulnar nerve
61
How many lumbricals are there? What is the innervation?
4 lumbricals, innervation:
Medial 2 = ulnar nerve
Lateral 2 = median nerve
62
What action do the DAB and PAD interossei take? What is their innervation?
DAB = abduction
PAD = adduction
(of digits)
Nerve = All ulnar nerve
63
The brachial plexus extends from which vertebral levels?
C5-T1
64
What structure do the cords of the brachial plexus travel around?
Brachial artery
65
Label the nerves of the brachial plexus
A: Musculocutaneous (C5)
B: Axillary (C6)
C: Radial (C7)
D: Median (C8)
E: Ulnar (T1)
66
Label the divisions/segments of the brachial plexus
A: Roots
B: Trunks
C: Divisions
D: Cords
E: Nerves
(Really Tired, Drink Coffee Now)
67
Label the accessory brachial plexus nerves
A: Lateral pectoral nerve
B: Suprascapular nerve
C: Dorsal scapular nerve (rhomboid muscles, levator scapulae)
D: Long thoracic nerve (serratus anterior)
68
Label the brachial plexus as shown
A: Radial nerve
B: Axillary nerve
C: Posterior cord
D: Coracobrachialis
E: Biceps Brachaii
F: Triceps brachaii
69
What are the contents of the carpal tunnel?
- Flexor digitorum superficialis (x4)
- Flexor digitorum profundus (x4)
- Flexor pollicis longus (x1)
- Median nerve
70
What are the signs of carpal tunnel?
Weakness in thenar muscles + numbness in digits 1-3 and lateral half of digit 4
71
The superficial palmar arch is mostly supplied by which artery?
Ulnar artery
72
The deep palmar arch is supplied mostly by which artery?
Radial artery
73
When does the subclavian artery become the axillary artery?
1st rib
74
What are the 3 scapular anastamoses?
1) Suprasapcular
2) Dorsal scapular
3) Circumflex
75
What are the static stablisers of the shoulder?
Capsule & labrum
76
Anterior shoulder dislocation is assoicated with what damage
Axillary neve (regimental badge injury)
77
How is adhesive capsulitis treated?
Injection of steroid into glenohumeral joint
78
What is a Monteggia fracture
GRIMUS:
Galeazzi - Radius Inferior.
Monteggia - Ulna Superior.
GRUsome MURder
Galeazzi Radius break with Ulnar Dislocation and Montegia Ulnar break with Radial Dislocation
79
What nerve innervates the TIPS of the first 3 digits + lateral half of the 4th
Median
80
Which nerve provides sensory innervation to the medial-half of 4th and entire 5th digit?
Ulnar
81
What nerve supplies sensory innervation to the thenar skin?
Radial
82
What nerve provides sensory innervation to the hypothenor eminence?
Ulnar
83
How would you test radial-nerve function?
Ask patient to extend/ flex wrist
84
How would you test the function of the median nerve (test)
Oppose pinky + thumb
85
How would you test for a functional ulnar nerve?
Ask patient to abduct all fingers
