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GSSE Anatomy > Upper limb > Flashcards

Upper limb Flashcards

1
Q

What does the quadrangular space contain?

A

Posterior circumflex humeral artery and nerve, axillary nerve

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2
Q

What does the triangular interval contain?

A

Radial nerve, profunda brachii artery

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3
Q

Suprascapular notch

A

suprascapular nerve passes through

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4
Q

Traingular space

A

circumflex scapular artery

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5
Q

Pectoralis major- origin and insertion

A

Clavicular head originates from the medial half of the anterior surface of the clavicle and inserts on the lateral lip of the bicipital groove
Sternocostal head arises from the lateral part of the anterior surface of the manubrium and sternum and from the aponeurosis of external oblique. Insert deep to clavicular head fibres on lateral lip of bicipital groove

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6
Q

Pectoralis major action and innervation

A

Medial and lateral pectoral nerves (only muscle to be supplied by all 5 segments of brachial plexus)
Action: medial rotator of the arm and in combination with muscles of posterior axillary fold, powerful adductor.

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7
Q

Pectoralis minor origin and insertion

A

Origin: ribs 3-5 underneath pec major, variations common
Insertion: medial border and upper surface of the coracoid process of the scapula

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8
Q

Pectoralis minor innervation and action

A

Innervation: both pectoral nerves
Action: assists serrates anterior in protraction of the scapula. Contraction assists gravity with restoring scapula to original position

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9
Q

Subclavius origin and insertion

A

Origin: costochondral junction of first rib
Insertion: subclavian groove on the inferior surface of the clavicle

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10
Q

Subclavius innervation and action

A

Nerve to subclavius from the superior trunk of the brachial plexus. Assists in stabilising the clavicle in movements of the pectoral girdle

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11
Q

Suspensory ligament of the axilla

A

Made up by leaves of the clavipectoral fascia after enclosing pec minor, they fuse and form this ligament. It attaches to the floor of the axilla and its tension maintains the axillary hollow.

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12
Q

What pierces the clavipectoral fascia in the infraclavicular fossa?

A

Inwards: lymphatics from infraclavicular nodes to the apical nodes of the axilla, cephalic vein.
Outwards: thoracoacromial vessels and lateral pectoral nerve

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13
Q

What attaches to the greater tuberosity of the humerus?

A

SIT
Supraspinatus
Infraspinatus
Teres Minor

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14
Q

What attaches to the lesser trochanter of the humerus?

A

Subscapularis

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15
Q

Which nerve runs posterior to the axillary artery in the axilla?

A

Radial nerve

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16
Q

Which nerve goes THROUGH the coracobrachialis muscle?

A

The musculocutaneous nerve

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17
Q

Which artery does the common interosseous artery arise from?

A

The ulnar artery

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18
Q

Where does the annular ligament arise and insert?

A

The radial notch of the proximal radius

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19
Q

What is the course of the radial artery?

A

From its origin at the brachial artery, the radial artery passes medial to the biceps tendon, across the supinator and over the insertion of pronator teres. It then continues over the radial origin of flexor digitorum superficialis, the origin of flexor pollicis longus, and the insertion of pronator quadratus.

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20
Q

Which muscles are supplied by the posterior interosseous nerve?

A 
Most of the muscles in the posterior compartment of the arm EXCEPT:
Supinator
Brachioradialis
Extensor carpi radialis longus
Last's states PIN supplies ECRB
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21
Q

What are the borders of the quadrangular space?

A

Superior–teres minor

  • Inferior–teres major
  • Medial–long head of triceps
  • Lateral–humerus
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22
Q

What nerve root are you testing when you ask a patient to abduct their fingers?

A

T1 (ulnar nerve)

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23
Q

What is a possible site of entrapment of the PIN?

A

The arcade of Frohse- the most superior part of the superficial part of the supinator muscle

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24
Q

What are possible sites of entrapment of the ulna nerve?

A

The arcade of Struther’s, between the two heads of FCU, between Osborne’s ligament and the MCL.
Other’s: medial head of triceps, the medial epicondyle and the medial intermuscular septum

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25
Q

What are the contents of the antecubital fossa from lateral to medial?

A

Tendon of biceps brachii, brachial artery, median nerve

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26
Q

What are the borders of the antecubital fossa?

A

Superior border = an imaginary line between the epicondyles of the humerus

Lateral border = the medial border of the brachioradialis muscle

Medial border = the lateral border of the pronator teres muscle

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27
Q

Which nerve is at risk in a deltopectoral approach to the elbow?

A

The musculocutaneous nerve

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28
Q

What is in the first extensor compartment of the wrist?

A

The abductor pollicis longus and extensor pollicis brevis

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29
Q

What is in the second extensor compartment of the wrist?

A

The extensor carpi radialis longus and brevis

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30
Q

What is in the third extensor compartment of the wrist?

A

The extensor pollicis longus

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31
Q

What is in the fourth extensor compartment of the wrist?

A

Extensor digitorum and extensor indicis

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32
Q

What is in the fifth extensor compartment of the wrist?

A

Extensor digiti minimi

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33
Q

What is in the sixth extensor compartment of the wrist?

A

Extensor carpi ulnaris

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34
Q

What structure is the pisiform in?

A

The tendon of FCU

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35
Q

Which nerve is most at risk with the anterolateral port in elbow arthroscopy?

A

The radial nerve

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36
Q

What is the origin of the long head of triceps?

A

The infraglenoid tubercle

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37
Q

Where does the dorsal branch of the ulnar nerve branch?

A

5cm proximal to the extensor retinaculum

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38
Q

What is the course of the dorsal branch of the ulnar nerve?

A

Passes deep to flexor carpi ulnaris before passing dorsally to perforate the deep fascia and course along the medial side of the dorsum of the hand.

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39
Q

Which nerve is at risk during a lateral approach to the elbow?

A

The posterior interosseous nerve

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40
Q

How is the subclavian artery divided into 3 parts?

A

First- Origin to the medial border of scalenus anterior
Second- Behind scalenus anterior
Third- From scalenus anterior to the outer border of the first rib

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41
Q

Which arteries come off the first part of the subclavian artery? (three)

A

Vertebral
Internal thoracic
Thyrocervical trunk

42
Q

Which artery comes off the second part of the subclavian artery?

A

Costal cervical trunk

43
Q

Which artery comes off the third part of the subclavian artery?

A

Dorsal scapular artery

44
Q

What are the attachments of the carpal tunnel?

A

Pisiform, hamate, scaphoid, trapezium

45
Q

What does injury to the long thoracic nerve cause?

A

Winging of the scapula

46
Q

What is the intercostal brachial nerve a branch of?

A

Cutaneous branch of the second intercostal nerve. At risk during axillary lymph node clearance.

47
Q

How many cruciate pulleys are part of the flexor tendons?

A

There are three cruciate pulleys. C1 sits between pulleys A2 and A3. C2 lies between A3 and A4. C3 lies between A4 and A5.

48
Q

Which vein is found in the anatomical snuffbox?

A

The cephalic vein is found within the anatomical snuffbox alongside the radial artery. The basilic vein is found on the ulnar side of the wrist.

49
Q

Where does the radial nerve give off the posterior cutaneous nerve of the forearm?

A

In the spiral groove

50
Q

What is the sensory supply of the PIN?

A

Interosseous membrane, periosteum of radius and ulna and the wrist and carpal joints on the extensor surfaces

51
Q

Where does the brachial artery divide into the radial and ulnar arteries?

A

In the ACF second half

52
Q

What does the radial artery course under in the forearm?

A

Brachioradialis

53
Q

What does the radial artery pass over in the forearm?

A

Supinator, insertion of pronator teres, FDS, FPL and the insertion of PQ

54
Q

What does the radial artery go medial to?

A

The tendon of biceps brachii

55
Q

What does the radial artery course lateral to?

A

FCR

56
Q

How does the radial artery leave the forearm?

A

It passes between APL and EPB into the anatomical snuffbox

57
Q

Which arch does the radial artery form in the palm?

A

The deep palmar arch

58
Q

What is the course of the ulnar artery in the forearm?

A

Goes deep to pronator teres and the fibrous arch of FDS. Then it lies on FDP with the ulnar nerve ulnar to it

59
Q

What is the most important branch of the ulnar artery?

A

The common interosseous which branches into anterior and posterior interosseous. The anterior is important for supply of the bones

60
Q

Where does the ulnar artery go after the forearm?

A

It passes through Guyon’s canal and forms the superficial palmar arch

61
Q

What is the key structure of the proximal radioulnar joint?

A

The annular ligament

62
Q

What does the annular ligament attach to?

A

It attaches to the radial notch of the ulna. Forms a ring around the radius

63
Q

What is the relation of the annular ligament to the radius?

A

It encircles the radius- covering both the head and neck- leaving the radius free to move within it.

64
Q

Is the proximal radioulnar joint synovial cavity continuous with that of the elbow joint?

A

Yes and the joint capsule is continuous as well

65
Q

What are the attachments of the quadrate ligament?

A

Neck of the radius to the upper part of the supinator fossa of the ulna

66
Q

What is the function of the quadrate ligament?

A

Prevents herniation of the synovial membrane between the anterior and posterior free edges of the annular ligament.

67
Q

What is the annular ligament continuous with?

A

the lateral collateral ligament of the elbow and the capsule of the elbow joint

68
Q

What is the key structure of the distal radioulnar joint?

A

Distal triangular fibrocartilage (articular disc)

69
Q

What is the key stabiliser of the distal radioulnar joint?

A

The Triangular fibrocartilage complex

70
Q

What are the attachments of the triangular fibrocartilage?

A

The ulnar notch of the radius and a small fossa at the base of the ulnar styloid.

71
Q

What are the characteristics of the DRUJ capsule?

A

Loose, pouches upwards behind PQ forming the sacciform recess
No connection with wrist joint

72
Q

Where does the axillary artery become the brachial artery?

A

At the inferior border of teres major?

73
Q

Where is the first part of the axillary artery?

A

Above pectoralis minor

74
Q

What is the branch of the first part of the axillary artery?

A

Superior thoracic artery- runs forward to supply both pec muscles

75
Q

Where is the second part of the axillary artery?

A

Behind pectoralis minor.

This is the part that is clasped by the 3 CORDS of the brachial plexus

76
Q

What are the branches off the second part of the axillary artery?

A

The thoracoacromial artery

The lateral thoracic artery (in females important blood supply to the breast)

77
Q

Where is the third part of the axillary artery?

A

Below pec minor

Clasped by the two heads of the median nerve

78
Q

What are the three branches of the third part of the axillary artery?

A

Subscapular artery
Anterior circumflex humeral artery
Posterior circumflex humeral artery

79
Q

Where are the trunks of the brachial plexus formed?

A

Between scalenus anterior and medius

80
Q

Where are the divisions of the brachial plexus formed?

A

Behind the clavicle

81
Q

Are the roots of the brachial plexus covered with prevertebral fascia?

A

Yeah

82
Q

What are the actions of serrratus anterior?

A

Whole muscle- scapula protraction
Lower 4 digitations assist trap in rotating scapula laterally and upwards. Thus it helps to raise the arm above the shoulder

83
Q

What is the nerve supply of the serratus anterior?

A

The long thoracic nerve- from C5,6,7 roots of the brachial

84
Q

Which bones ossify in membrane?

A

Flat skull bones, clavicles, mandible

85
Q

Is the ACJ capsule strong?

A

No, it is sleeve like and relatively weak

86
Q

What provides stability to the ACJ?

A 
Coracoclavicular ligament (2 parts conoid and trapezoid
Acromioclavicular ligaments
87
Q

What weird thing provides partial origin to the omohyoid muscle?

A

The transverse scapula ligament

88
Q

In the arm does the median nerve cross the brachial artery?

A

Yes from lateral to medial

89
Q

What is the lateral collateral ligament complex of the elbow comprised of?

A

The lateral collateral ligament complex consists of four ligaments. These include: the accessory collateral ligament, the lateral radial collateral ligament, the lateral ulnar collateral ligament, and the annular ligament.

90
Q

What are the secondary static stabilisers of the elbow?

A

radiocapitellar joint, common flexor and extensor origins, and the joint capsule

91
Q

What are the primary static stabilisers of the elbow?

A

ulnohumeral joint, medial collateral ligament and lateral collateral ligament complex

92
Q

Which muscle initiates arm abduction and then which muscle takes over?

A

Supraspinatus starts

Deltoid continues

93
Q

Which ligaments prevent superior dislocation of the clavicle?

A

Conoid and trapezoid These are the coracoclavicular ligaments

94
Q

Which nerve can give off fibres to the phrenic?

A

The nerve to subclavius

95
Q

What is a Klumpke palsy?

A

A palsy resulting from injury to the lower roots (C8 + T1) of the brachial plexus most commonly due to a hyperabduction traction injury

96
Q

How does a Klumpke palsy manifest?

A

Clinically, it can manifest with reduced sensation over the medial forearm, and clawing of the hand. There is loss of function of the intrinsic muscles of the hand, as well as thenar and hypothenar muscles.

97
Q

What is the main restraint to horizontal instability at the ACJ?

A

The acromioclavicular ligaments

98
Q

Which nerve root is primarily responsible for wrist extension?

A

C6

99
Q

Is the axillary vein encased by the axillary sheath?

A

No

100
Q

What is the axillary vein made up of?

A

It’s a continuation of the brachial vein and the basilic vein joins it. The cephalic vein joins at the terminal part

GSSE Anatomy (11 decks)

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