Upper Limb Flashcards
1
Q
Articulation of Clavicle
A
- medially with sternum
- laterally with acromion process
- forms pectoral girdle
2
Q
Function of clavicle
A
- connects axial skeleton to UL
- allowing weight to be transferred from the upper limb to the axial skeleton
- protect neurovascular structures as they travel between the trunk and the upper limb.
3
Q
What joints does the clavicle form?
A
- sternoclavicular joint
- acromioclavicular joint - keep movements of the scapula separated from the trunk when the arm is moved in various ways.
4
Q
Impression for costoclavicular ligament
A
clavicle
attachment of costaclavicular ligament which connects clavicle to first rib
5
Q
Subclavian groove
A
clavicle
-attachment for subclavius muscle
6
Q
conoid tubercle
A
- attachment for conoid ligament - involved in coracoclavicular ligament
- The conoid ligament of the coracoclavicular ligament runs from the inferior surface of the clavicle, the conoid tubercle to the superior aspect of the coracoid process of the scapula
7
Q
trapezoid line
A
clavicle
- attachment site for trapezoid ligament
lateral part of coracoclavicular ligament
- runs from the inferior aspect of the clavicle to the coracoid process of the scapula.
8
Q
intertubercular sulcus
A
- humerus
- bicipital groove
- because this is where you will find the proximal tendon of the long head of the biceps brachii muscle as it courses distally towards its muscular belly in the arm
9
Q
anterior divisons of the surface of humerus
A
anteromedial, anterolateral
- anterior border runs from crest of greater tubercle
10
Q
deltoid tuberosity
A
humerus
- lateral midshaft
- point of insertion or distal attachment for the deltoid muscle.
11
Q
fossae
A
humerus
radial fossa which is located laterally
- medial side, coronoid fossa.
12
Q
medial epicondyle
A
humerus
attachment for several of the anterior or flexor muscles of the forearm
13
Q
lateral epicondyle
A
humerus
attachment to the posterior muscles or extensor muscles of the forearm
14
Q
radial groove
A
humerus
- posterior
- radial nerve runs through
- same for ulnar groove on distal end
15
Q
subscapular fossa
A
scapula
gives origin to the subscapularis muscles which extends laterally to the humerus
16
Q
scapulothoracic joint
A
physiological joint as opposed to a true anatomical joint due to the fact that there is no bony articulation here.
17
Q
coracoid process
A
- scapula
- attachment site for several muscles such as the short head of the biceps brachii, pectoralis minor, and coracobrachialis muscles.
18
Q
supraspinous and infraspinous fossa
A
scapula, posterior
- provide attachments for muscle of the rotator cuff which are the supraspinatus and infraspinatus muscles respectively
19
Q
supraglenoid tubercle
A
- scapula
- proximal attachment point or origin of the long head of the biceps brachii muscle
20
Q
infraglenoid tubercle
A
- scapula
provides attachment for the long head of the triceps brachii muscle
21
Q
coracoclavicular ligament
A
more medial is known as the conoid ligament which originates from the knuckle of the coracoid process
- trapezoid ligament which runs from the trapezoid edge of the coracoid process
- One primary function of this ligament is to hold the acromial end of the clavicle in place preventing it dislocating from the acromioclavicular joint.
22
Q
coracoacromial ligament
A
extends from the coracoid process to the acromion of the scapula
forms what is known as the coracoacromial arch
23
Q
Acromioclavicular joint
A
- synovial joint
- connects the acromion of the scapula with the clavicle at its lateral end
- This joint is stabilized by two sets of ligaments – the coracoacromial ligament and the coracoclavicular ligaments
- functions to allow anterior and posterior movement of the acromion during the protraction and retraction of the scapula, rotation during adduction and abduction of the shoulder, and the tilting of the acromion during adduction and abduction of the arm.
24
Q
glenohumeral ligaments, Flood’s ligament
A
- superior - supraglenoid tubercle of the scapula to the medial ridge of the intertubercular groove of the humerus
middle - originating inferior to the superior glenohumeral ligament and inserting on the lesser tubercle of the humerus
inferior - originates mostly along the inferior edge of the glenoid margin and attaches onto the neck of the humerus
- all the ligaments blend with the capsule and are not clearly distinguishable.
- function to reinforce the articular capsule of the glenohumeral joint
25
Glenohumeral joint
- ball-and-socket-type synovial joint
- flexion and extension, abduction and adduction, medial and lateral rotation, and circumduction
26
Glenoid Labrum
glenohumeral joint
- fibrocartilaginous ring attaching around the outer margin of the glenoid fossa
- This helps to deepen the glenoid fossa giving the socket part of the joint a bit more of a functional socket shape.
27
Joint capsule
glenohumeral joint
- surrounding it
- made from an outer fibrous layer and an inner synovial membrane
- The inner synovial membrane secrete synovial fluid which fills the joint capsule lubricating it
28
coracohumeral ligament
- glenohumeral joint
- posterior aspect of the coracoid process of scapula to the humerus
- flares out into an anterior and posterior band attaching to the lesser tubercle and the greater tubercle, respectively
- important in preventing inferior displacement of the humerus
29
Rotator cuff
- creates a compressive force around the humeral head
- ensuring stability against the glenoid cavity in every position
- helping to center it
- medial and lateral rotation of the arm of the shoulder joint
- supraspinatus, the infraspinatus, the teres minor, and the subscapularis
30
Supraspinatus
- rotator cuff
- superior aspect
- originates from the supraspinous fossa of the scapula and inserts on the greater tubercle of the humerus
- crosses the superior aspect of the shoulder joint where its tendon blends with the joint capsule
31
Function and Innervation of Supraspinatus
- this muscle initiates abduction of the arm at the shoulder joint, then the deltoid takes over
- As a rotator cuff muscle, it also stabilizes the shoulder joint
- innervated by the suprascapular nerve which arises from the superior trunk of the brachial plexus.
32
Infraspinatus
- rotator cuff
- posterior to supraspinatus
- originates from the infraspinous fossa of the scapula and also inserts on the greater tubercle of the humerus
- This tendon crosses the shoulder joint posteriorly, strengthening it from that aspect.
33
Function and Innervation of Infraspinatus
- Contraction of this muscle causes lateral rotation of the arm at the shoulder joint and it also stabilizes the shoulder joint
- This muscle is innervated by the suprascapular nerve
34
teres minor
rotator cuff
- originates from the lateral border of the scapula and also inserts on the greater tubercle of the humerus.
35
subscapularis
- rotator cuff
- originating from the subscapular fossa and inserting onto the lesser tubercle of the humerus
36
Function and Innervation of Subscapularis
- Contraction of the subscapularis results in medial rotation of the arm at the shoulder joint and it also stabilizes the shoulder joint
- innervated by the upper and lower subscapular nerves, which are branches of the posterior cord of the brachial plexus.
37
Function and Innervation of Teres Minor
muscle is responsible for lateral rotation of the arm at the shoulder joint and it also stabilizes the shoulder joint
- teres minor is innervated by the axillary nerve.
38
teres major
- originates from the inferior angle of the scapula and inserts on the medial lip of the intertubercular groove of the humerus
- contribute to the stability of the shoulder joint
39
Function and Innervation of Teres Major
- This muscle is responsible for medial rotation of the arm at the shoulder joint and extension of the arm at the shoulder joint.
- innervated by the subscapular nerve
40
long head of triceps brachii muscle
- originates from the infraglenoid tubercle of scapula
- travels distally to blend with the other two heads of the triceps brachii and insert on the olecranon process of the ulna
- The long head is the only head to cross the shoulder joint
- stability of shoulder joint
41
long head of biceps brachii
- originates from the supraglenoid tubercle of the scapula.
- continues to travel within the joint capsule over the humeral head and into the intertubercular groove on the humerus
- merges with the short head of the biceps brachii and inserts into the radial tuberosity as well as the deep forearm (antebrachial) fascia via the bicipital aponeurosis.
42
Bursae
small sac-like structures normally found between joints and ligaments or tendons
43
Subacromial bursa
- largest bursa associated with the glenohumeral joint
- lies deep to the coracoacromial ligament and the acromion process, which is how it gets its name
- Inferior to it, we find the joint capsule and the supraspinatus muscle tendon
- Therefore, the subacromial bursa creates padding between these structures
Laterally, the subacromial bursa extends to lie deep to the deltoid muscle, so it also has a portion called the subdeltoid bursa
44
Function of subacromial bursa
help to reduce friction, protect the joint capsule, and prevent wear of the supraspinatus tendon, in particular, during abduction.
45
subtendinous bursa of the subscapularis
- sits beneath the tendon of the subscapularis muscle to reduce friction and prevent wear of the subscapularis tendon
Unlike the subacromial bursa, the subtendinous bursa of the subscapularis normally does have an opening which connects it to the glenohumeral joint
- This means that any infection arising in it will likely pass into the joint, too.
46
Anterior Muscles of the arm and shoulder
- coracobrachialis
- brachialis
- biceps brachii
47
Posterior muscles of the arm and shoulder
triceps brachii
anconeus
48
short head of biceps brachii
origin: coracoid process of scapula
- two heads merge on radial tuberosity of radius
49
Brachialis
- origin: from the distal half of the anterior surfaces of the humerus and also the medial and lateral intermuscular septum
- insertion or distal attachment on the ulna specifically onto its coronoid process and ulnar tuberosity.
50
Coracobrachialis
- proximal attachment point or origin at the coracoid process of the scapula
- extends distally along the humeral shaft to then insert along the anteromedial surface of the humerus.
51
Medial and Lateral head of Triceps Brachii
- medial head which is the smallest of the three arising from the posterior surface of the humerus distal to the radial groove, and medial intermuscular septum
- lateral head has its proximal attachment on the posterior surface of the humerus; however, this time proximal to the radial groove and the lateral intermuscular septum
- The three heads of the triceps brachii fuse into then a flat common tendon which crosses the elbow before inserting into the olecranon process of the ulna.
52
Anconeus
small triangular-shaped muscle which is often blended with the lateral border of the triceps brachii tendon, and it too attaches to the proximal end of the ulna.
- origin: lateral epicondyle of humerus
53
Deltoid
- three subdivisions
- anteriorly - clavicular part of the deltoid which is attached to the lateral third of the clavicle
- posteriorly - acromial part that originates from the acromion of the scapula
- posteriorly - the scapular spinal part - its origin along then the spine of the scapula.
- three parts converge towards their insertion point which is the deltoid tuberosity found on the lateral surface of the shaft of the humerus.
54
Innervation and function of Deltoid Muscle
- responsible for several movements of the shoulder joint
- Each part of the deltoid performs a different function
- The clavicular part flexes the arm at the shoulder joint, the acromial part is the main abductor of the arm, and the spinal part extends the arm at the shoulder joint
- innervated by the axillary nerve.
55
Triangular Space
- The superior border of the space is formed by the inferior border of teres minor
- the inferior border is defined by the superior border of teres major
- the lateral border is formed by the medial border of the long head of the triceps brachii muscle
- The triangular space transmits the circumflex scapular vessels.
56
Quadrangular space
- The superior border of the space is formed by the inferior border of teres minor
- the inferior border is defined by the superior border of teres major
- The lateral border is formed by the surgical neck of the humerus
- the medial border is defined by the lateral border of the long head of the triceps brachii muscle
- The quadrangular space transmits the axillary nerve and the posterior circumflex humeral artery.
57
Triangular interval
- the superior border of this space is formed by the inferior border of the teres major
- the lateral border is formed by the surgical neck of the humerus
- the medial border is defined by the lateral border of the long head of the triceps brachii muscle
- The triangular interval transmits the profunda brachii artery and the radial nerve.
58
Pectoralis Major
- pectoral region
- it’s made up of three parts which are named based on their origin
- clavicular part which originates from the medial half of the clavicle
- sternocostal part which originates from the sternum and the second to sixth costal cartilages,
- abdominal part which originates from the anterior layer of the rectus sheath
- These three parts come together to insert at the crest of the greater tubercle of the humerus.
59
Function and Innervation of Pectoralis Major
- Contraction of this muscle causes flexion, adduction and medial rotation of the arm at the shoulder joint
- The innervation of pectoralis major is supplied by two nerves – the medial pectoral nerve and the lateral pectoral nerve – which are direct branches of the brachial plexus.
60
61
Function and Innervation of Coracobrachialis
- This muscle is responsible for flexion of the arm at the shoulder joint, and as for innervation, coracobrachialis is innervated by the musculocutaneous nerve,
62
Function and Innervation of Biceps Brachii
- flexion of the arm at the shoulder joint, and like coracobrachialis, the biceps brachii is innervated by the musculocutaneous nerve.
63
Latissimus Dorsi
- The latissimus dorsi is a muscle of the back
- originates from the spinous processes of T7 to T12, the iliac crest, the thoracolumbar fascia, and the ninth to twelfth ribs
- The fibers of this muscle then converge to insert at the intertubercular sulcus of the humerus.
64
Functions and Innervations of Latissimus Dorsi
- responsible for medial rotation, adduction and extension of the arm at the shoulder joint
- one of the swimming muscles of the human body
- This muscle is innervated by the thoracodorsal nerve, which is a branch of the brachial plexus.
