UPPER LIMB Flashcards
(244 cards)
1
Q
commonly fractured bone that forms the pectoral girdile with the scapula, which conencts the upper limb to the sternum, by articualting with the sternum at the stenoclavicular joint and with the acromion at the acromioclavicular joint
A
Clavicle
2
Q
First bine to begin ossification during fetal development but is the last one to complete ossification
A
Clavicle
- The only long bone to be ossified intramembranously
3
Q
Most common fracture site of the clavicle
A
Middle third
- upward displacement of the proximal fragment by the SCM and downward displacement of the distal fragment by the delotid muscle and gavity
4
Q
triangular shaped process that continues laterally as the acromion
A
Spine of the scapula
- Divides into:
- upper supraspinous fossae
- lower infraspinous fossae
- Provides origin of the deltoid and an insertion for the trapezius
5
Q
Lateral end of the spine and articulates with the clavicle
A
Acromion
- Provides an origin for the deltoid and an insertion for the trapezius
6
Q
Provides the origin of the coracobrachialis and biceps brachii, the insertion of the pectoralis minor and the attachment site for the coracoclavicular, coracohumeral and coracoacromial ligaments and costocoracoid membrane
A
Coracoid process
7
Q
________- is bridged by the superior transverse scapular ligament and converted into a foramen that transmits the suprascapular nerve
A
Scapular notch
8
Q
Calcification of the superior transverse scapular ligament may trap or compress the _________ nerve as it passes through the scapular notch under the superior transverse scapular ligament
A
Suprascapular nerve
9
Q
Glenoid cavity is deepened by the _______for the head of the humerus
A
Glenoid labrum
10
Q
Provide origins for the tendons of the long heads of the biceps brachii and triceps brachii muscles, respectively
A
Supraglenoid and infraglenoid tubercles
11
Q
The head of the humerus articulates with the scapula at the _________
A
glenohumeral joint
12
Q
Is an indentation distal to the head and provides an attachment for the fibrous joint capsule
A
Anatomic neck
13
Q
Lies just lateral and distal to the anatomic neck and provides attachment for the supraspinatus, infraspinatus, and teres minor muscles
A
Greater tubercle
14
Q
fracture of the _______ accompanies posterior dislocation of the shoulder joint, and the bone fragment has the insertion of the subscapularis tendon
A
Lesser tuberosity
15
Q
Fracture of the _______- may injure the axilalry nerve and the posterior humeral circumflex artery as they pass through the quadrangular space
A
Surgical neck
16
Q
Lies on the anterior medial side of the humerus just distal to the anatomic neck and provides insertion for the subscapularis muscle
A
Lesser tubercle
17
Q
Lies between the greater and lesser tubercles, lodges the tendon of the long head of the biceps brachii muscle, and is bridged by the transverse humeral ligament
A
Intertubercular groove (bicipital)
18
Q
Narrow area distal to the tubercles that is a common site of fracture
A
Surgical neck
19
Q
Is a rough triangular elevation on the lateral aspect of the midshaft that marks the insertion of the deltoid muscle
A
Deltoid tuberosity
20
Q
Contains the radial nerve, separating the origin of the lateral head of the triceps above and the origin of the medial head below
A
Spiral groove
21
Q
Fracture of the _________ may injure the radial nerve and deep brachial artery in the spiral groove
A
Shaft
22
Q
Fracture of the distal end of the humerus; it is common in children and occurs when the child falls on the outstretched hand with the elbow partially flexed and may injure the median nerve
A
Supracondylar fracture
23
Q
Fracture of the _________ may damage the ulnar nerve. This nerve may be compressed in a groove behind cuasing numbness
A
medial epicondyle
24
Q
spool shaped medial articular surface and articulare with the trocheal notch of the ulna
A
trochlea
25
The alteral articular surface, globualr in shape, and articulates with the head of the radius
Capitulum
26
Is a posterior depression above the trocheal of the humerus that houses the **olecranon of the ulna** on full extension of the forearm
Olecranon fossa
27
In an anterior depression above the trocheal of the humerus that accomodates the coronoid process of the ulna on flexion of the elbow
Coronoid fossa
28
Is an anterior depression above the capitulum that is occupied by the head of the radius during full flexion of the elbow joint
Radial fossa
29
The lateral epicondyle projects from the capitulum and provides the origin of the ________ and _______ muscles of the forearm
supinator and extensor
30
The medial epicondyle projects from the trochlea and has a groove on the back for the ________ and \_\_\_\_\_\_\_\_\_
Ulnar nerve
Superior ulnar collateral artery
31
Provides attachment sites for the ulnar collarteral ligament, the pronator teres, and the common tendon of the forearm flexor muscles
Medial epicondyle
32
Radius is ______ than ulna
shorter
33
radius is situated\_\_\_\_\_\_to the ulna
Lateral
34
The head of the radius (proximal end) articulates with the \_\_\_\_\_\_\_\_of the humerus and the _____ of the ulna and is surrounded by the annular ligament
Capitulum
Radial notch
35
The distal end of the humerus articualres with the proximal row of carpal bones including the\_\_\_\_\_\_\_\_\_\_\_\_
scaphoidm lunate and triquetral bones but excluding the pisiform bone
36
Is an obling prominence just distal to the neck and provides an attachment site for the **biceps brachii tendon**
Radial tuberosity
37
Located on the distal end of the radius and is approximately 1cm distal to that of the ulna and provides **insertion** of the **bracioradialis muscle**
Styloid process
38
The styloid process can be palpated in the proximal part of the anatomic snuffbox between the __________ and \_\_\_\_\_\_\_\_
Extensor pollicis longus and brevis tendons
39
distal radius fracture in whic the distal fragment is displaced posteriorly , producing a characteristic bump described as **dinner fork deformity**
Colle's fracture
40
Reverse Colle's fracture is also called as \_\_\_
Smith's fracture
The distal fragment is displaced anteriorly
41
Olecranon is the curved projection on the back of the elbow that provides an attachment site for the **triceps tendon**
Olecranon
42
located below the trochlear notch and provides an **attachment site for the brachialis**
Coronoid process
43
Is a roughened prominence distal to the coronoid process that provides an attachment site for the brachialis
Ulnar tuberosity
44
Carpal bones
* 2 rows of 4
* lateral to medial
* Scared lovers try positions that they cant handle
45
occurs after a fall on the outstretched handm shows deep tenderness in the anatomical snuffbox and damages the **radial artery** and cause avascular necrosis of the bone
Fracture of the scaphoid
46
Fracture of the hamate may injure the \_\_\_\_\_\_
Ulnar nerve and artery
47
Is a fractue of the base of the metacarpal of the thumb
Bennet's fracture
48
Fracture of the necks of the 2nd and 3rd metacarpals
Boxer's fracture
* May involve the fifth metacarpal in unskilled boxer
49
entrapment of the ulnar nerve. which causes pain, numbness, and tingiling in the ring and little fingers, followed by loss of sensation and motor weakness
Guyon canal syndrome
50
The Guyon's canal (ulnar canal) is formed by \_\_\_\_
pisiform, hook of hamate, and pisohamate ligament
deep to the palamris brevis and palmar carpal ligament
51
Miniature long bones consisting of bases (proximal), shafts and heads
Metacarpals
52
is a synovial plane joint that allows a gliding movement when the scapula rotates and is reinforced by the **coracoclavicular ligament**, which cosnsists of the conoid and trapezoid ligaments
Acromioclavicular joint
53
Is a double synovial plane (gliding joint) and united by the fiborus capsule
Is reinforced by the anterior and posterior sternoclavicular, interclavicular, and costoclavicular ligaments
Sternoclavicular joint
54
Synovial ball and socket joint between the glenoid cavity of the scapula and the head of the humerus
Shoulder (Glenohumeral) joint
* surrounder by the **fibrous capsule** that is attached superiorly to the margin of the glenoid cavity and inferiorly to the **anatomic neck** of the humerus
* The capsule is reinforced by the
* rotator cuff
* glenohumeral ligaments
* coracohumeral ligaments
55
The glenohumeral joint is innervated by the \_\_\_\_, \_\_\_\_. amd \_\_\_\_\_\_
Axillary, suprascapular and lateral pectoral nerves
56
Dislocation of the shoulder joint occurs usually in the ________ direction
Anteroinferior
57
The rotator cuff is formed by the tendons of \_\_\_\_\_\_\_\_\_\_\_\_
Suprapinatus
Infraspinatus
Teres minor
subscapualris
58
A ruputre of the rotator cuff, most frequently attrition of the ___________ can cause dengenrative tendonitis
supraspinatus
59
Ligaments of the shoulder joints
* Glenohumeral ligaments
* Transverse humeral ligament
* Coracohumeral ligament
* Coracoacromial ligament
* Coracoclavicular ligament
60
Extend from the supraglenoid tubercle to the upper part of the lesser tubercle of the humerus
Superior glenohumeral ligament
61
Exten from the supraglenoid tubercle to the lower anatomic neck of the humerus
Middle glenohumeral ligament
62
Extend from the supraglenoid tubercle to the lesser tubercle of the humerus
Inferior glenohumeral ligament
63
Extend between the greater and lesser tubercles and holds the tendon of the long head of the biceps in the intertubercular groove
Transverse humeral ligament
64
Lies between the coracoacromial arch and the supraspinatus muscle, usually communicated with the subdeltoid bursa, and protects the supraspinatus tendon against friction with the acromions
Subacromial bursa
65
Lies between the deltoid muscle and the shoulder joint capule
Subdeltoid bursa
66
Lies between the subscapularis tendon and the neck of the scapula
Subscapular bursa
67
The elbow joint is innervated by the ____ , \_\_\_\_,\_\_\_\_, and \_\_\_\_\_
Musculocutaneous
Median
Radial
ulnar
68
is a fibrous band that forms nearly 4/5 of the circle around the head of the radius; the **radial notch** forms the remainder
Annular ligament
69
Extends from the lateral epicondyle to the anterior and posterior margins of the radial notch of the ulna and the annular ligament of the radius
Radial Collateral ligament
70
triangular, and is composed of anterior, posterior, and oblique bands
Ulnar collateral ligament
71
The proximal radioulnar joint allows \_\_\_\_\_\_\_\_and \_\_\_\_\_\_\_\_\_
Proantion and supination
72
The distal radioulnar joint allows _______ and \_\_\_\_\_\_\_
Pronation and supination
73
Is a synovial condylar joint formed superiorly by the radius and the articular disk and inferiorly by the proximal row of carpal bones (Scaphoid, lunate, and rarely triquetru,)
Radiocarpal joint
74
Forms a synovial plane joint between the proximal and distal rows of carpal bones and allows gliding and sliding movements
Midcarpal joints
75
Form synovial saddle (sellar) joints between the carpal bone (trapzium) and the first metacarpal bone, allowing flexion and extension, abdution and adduction and circumduction.
Also form plane joints between the carpal bones and the medial four metacarpal bones, allowing a simple glinding movement
Carpometacarpal
76
Are condyloid joints that allow flexion and extension, and abduction and adduction
Metacarpophalangeal joints
77
Are hinge joints that allow flexion and extension
Interphalangeal joints
78
Arises from the cervical plexus (c3, c4) and innercates the skin over the upper pectoral, deltoid and outer trapezius areas
Supraclavicular
79
Arises from the medial cord of the brachial pelxus and innervates the medial side of the arm
Medial Brachial cutaneous nerve
80
Arises form the medial cord of the brachial plexus and innervates the medial side of the forearm
Medial Antebrachial cutaneous nerve
81
Arises from the axillary nerbe and innervates the lateral side of the arm
Lateral brachial cutaneous nerves
82
Arises from the musculocutaneous nerve and innervates the lateral side of the forearm
Lateral antebrachial curaneous nerves
83
Arise form the radial nerve and innervate the posterior sides of the arm and forearm
Posterior Brachial and antebrachial cutaneous nerves
84
Is the lateral cutaneous branch of the second intercostal nerve emerging from the second intercostal space and may communicate with the medial brachial cutaneous nerve
Intercostal nerve
85
Cutaneous nerves of the upper limb
86
Begins as a radial continuation of the dorsal venous network, runs on the lateral side, and is often connected with the basilic vein by the median cubital vein in front of the elbow
Cephalic vein
* Pierces the costocoracoid membrane of the clavipectoral fascia and ends in the axillary vein
87
Arises from the dorsan venous arch of the hand and accompanies the medial antebrachial curaneous nerve along the ulnar border of the forearm and passes anterior to the medial epicondyle
Basilic vein
* Pierces the deep fascia of the arm and joins the brachial venins to form the axillary vein at the lower borser of the teres major muscle
88
Connects the cephalic vein to the basilic vein over the cubital fossa. Lies superficial to the bicipital aponeurosis, and thus separates it from the brachial artery.
Median cubital vein
89
Arises in the palmar venous network, ascends on the front of the forearm, and terminated in the median cubital or the basilic vein
Median antebrachial vein
90
is a network of veins formed by the dorsal metacarpal veins that receive dorsal digital veins and continues proximally as the cephalic vein and the basilic vein
Dorsal venous networks
91
accompanies the basilic vein; passes through the cubital or supratrochlear nodes; and ascends to enter the lateral **axillary nodes**, which drain first into the **Central axillary nodes** and then into the **apical axillary nodes**
Medial group of lymphatic vessels
92
Accompanies the cephalic vein and drains into the **lateral axilalry nodes**, and also into the **deltopectoral** (infraclavicular) node, which then drain into the **apical nodes**
Lateral Group of lymphatic vessels
93
Extends between the coracoid process, clavicle and the thoracic wall and envelops the subclavius and pectoris minor muscles
Clavipectoral fascia
* Components:
* costocoracoid ligament
* thickening between the coracoid process and the first rib
* Costocoracoid membrane
* between the subclavius and pectoralis minor
* pierced by the cephalic vein, thoracoacromial artery and the lateral pectoral nerve
* Suspensory ligament of the axilla
* inferior extension of the fascia
94
continuous anteriorly with the pectoral and clavipectoral fascia, laterally with the brachial fascia, and posteromedially with the fascia over the latissimus dorsi
Axillary fascia
95
tubular fascial prolongation of the prevertebral layer of the deep cervical fascia into the axilla, enclosing the axillary vessels and the branchial plexus
Axillary sheath
96
Boundaries of the axilla
* Medial wall:
* upper ribs and their intercostal muscles
* serratus anterior muscle
* Later wall:
* intertubercular groove of the humerus
* Posterior wall:
* subscapularis, teres, major, and latissimus dorsi muscles
* Anterior wall
* pectoralis major and pectoralis minor muscles and clavipectoral fascia
* Base
* axilalry fascia, and skin
* Apex:
* interval between the clavicle, 1st rib, and upper border of the scapula
97
Brachial plexus
98
Formed by the union of the brachial veins and the basilic vein
Axilalry vien
99
superolateral externsion of the mammary gland
Axillary tail of Spence
100
Axillary lymphnodes
101
The breasy extends from the \_\_\_\_\_\_\_\_\_\_ribs
2nd to 6th
102
The mammary glands lie in the \_\_\_\_\_\_\_\_\_\_
Superficial fascia
103
strong fibrous processes that run from the dermis of the skin to the deep layer of the superficial fascia through the breast
Suspensory ligaments of (of Cooper)
104
The nipple usually lies at the level of the _____ intercostal space
4th
105
The breast receives blood from \_\_\_\_\_\_\_\_\_
* **Medial mammary** of the anterior perforating branches of the internal thoracic artery
* **Lateral mammary** fro the lateral thoracic artery
* **Pectoral** branches of the thoracoacromial trunk
106
The lymphatic drainage of the breast drains primarity to the\_\_\_\_\_\_\_
axillary ndoes (75%) more specifically to the pectoral (anterior) nodes
107
The lymphatic drainage of the breast follows the perforating vessels through the pectoralis major msucle and the thoracic wall to enter the \_\_\_\_\_\_\_\_\_\_
Parasternal (internal thoracic) nodes
108
Pectoralis major
O: Medial half of the claviclee; manubrium and body of sternum; upper six costal cartialge
I: lateral lip of intertubercular groove of humerus
N: lateral and medial pectoral
A: flexes, adducts, and medially rotates the arm
109
Pectoralis minor
O: 3rd, 4th, and 5th ribs
I: coracoid process of the scapula
N: medial (and lateral) pectoral
A: depresses scapula; elevates ribs
110
Subclavius
O: junction of 1st rib and costal cartialge
I: inferior surface of clavicle
N: Nerve to subclavius
A: depresses lateral part of clavicle
111
Serratus anterior
O: upper 8th ribs
I: Medial border of scapula
N: long thoracic
AL Rotates scapula upward; abducts sacapula with arm and elevates it above the horizonal
112
Deltoid
O: lateral 3rd of clavicle, acromion, and spine of scapula
I: deltoid tuberosity of humerus
N: Axillary
A: Abducts, adductsm flexes, extends and rotates arm medially and laterally
113
Supraspinatus
O: supraspinous fossa of scapula
I: superior facet of greater tubercle of humerus
N: Suprascapular
A: abducts arm
114
Infraspinatus
O: infraspinous fossa
I: middle facet of greater tubercle of humerus
N: Suprascapular
A: rotates arm laterally
115
Subscapularis
O: Subscapular fossa
I: lesser tubercle of humerus
N: upper and lower subscapular
A: Adducts and rotates arm medially
116
Teres major
O: dorsal surface of inferior angle of scapula
I: medial lip of intertubercular groove of humerus
N: Lower subscapular
Action: adducts and roates arms medially
117
Teres minor
O: Upper portion of lateral border of scapula
I: lower facet of greater tubercle of humerus
N: Axillary
A: rotates arm laterally
118
Latissimus dorsi
O: spines of T7-T12 thoracolumbar fascia, iliac crest, ribs 9-12
I: floor of the bicipital groove of humerus
N: thoracodorsal
A: adducts, extends and rotates arm medially
119
Transmits the axilalry nerve and the psoterior humeral circumflex artery
Quadrangular space
* bounded
* superiorly: tere minor and subscapularis msucles
* inferiorly by the teres major muscle
* medially: long head of the triceps
* Laterally : surgical neck of the humerus
120
COntains circumflex scapular vessels
Triangular space(Upper)
* Bounded
* superiorly: teres minor muscle
* inferiorly: teres major
* laterally: long head of the triceps
121
Contains the radial nerve and the profunda brachii (deep brachial artery)
Triangular space (Lower)
* Bounded
* superiorly: teres major
* medially: long head of the triceps
* laterally: medial head of the triceps
122
The site at which breathing sounds are heard most
Triangle of ausculation
* Bounded by
* Upper border of the latissimus dorsi muscle
* lateral border of the trapezius
* medial border of the scapula
* floor is formed by the rhomboid major uscle
123
Consist of medial and lateral intermuscular septa, which divides the arm into anterior and posterior compartment
Brachial intermuscular septa
124
Is V-shaped interval on the anterior aspect of the elbow that is bounded **laterally by the bracioradialis muscle** a, **medially by the pronator teres**, and s**uperiorly by an imaginary horizontal lines** connecting the epicondyles.
Cubital fossa
125
The cubital fossa contains
From lateral to medial
(Ron beats Bad Man)
* Radial nerve
* Biceps tendon
* Brachial artery
* median nerve
126
Originates from the medial border of the biceps tendon, lied on the brachial artery and the median nerve, and blends with the deep fascia of the forearm
Bicipital aponeurosis
127
Dense connective tissue sheet between the radius and the ulna
Interosseous membrane
128
Coracobrachialis
O: coracoid process
I: Middle 3rd of medial surface of humerus
N: musculocutaneous
A: Flexes adnadducts arm
129
Biceps brachii
O: long head, supraglenoid tubercle: short head, coracoid process
I: radial tuberosity of radius
N: Musculocuataneous
A: flexes arm and forearm, supinates forearm
130
Brachialis
O: lower anterior surface of humerus
I: Coronoid process of ulna and ulnar tuberosity
N: musculocutaneous
A: flexes forearm
131
Triceps
O: long head, infraglenoid tubercle; lateral head, superior to radial groove of humerus; medial head, inferior to radial groove
I: Posterior surface of the olecranon process of ulna
N: radial
A: extends forearm
132
Aconeus
O: lateral epicondyle of humerus
I: olecranon and upper posterior surface of ulna
N: radial
A: extends forearm
133
formed laterally by the axis of the arm and forearm when the elbow is extended, because the medial edge of the trochlea projects more inferiorly than its lateral edge.
Carrying angle
134
Pronator teres
O: medial epicondyle and coronoid process of ulna
I: Middle of lateral side of radius
N: Median
A: pronates and flexes forearm
135
flexor carpi radialis
O: medial epicondyle of humerus
I: Bases of second and 3rd metacarpals
N: median
A: Flexes forearm, flexes and abducts hand
136
Palmaris longus
O: medial epicondyle of humerus
I: Flexor retianculum, palmar aponeurosis
N: median
A: Flexes forearm; flexes and adducts hand
137
Flexor carpi ulnaris
O: medial epicondyle (humeral head); medial olecranon, and posterior border of ulna (ulnar head)
I: pisiform, hook of hamate and bse of fifth metacarpal
N: ulnar
A: flexes forearm; flexes and adducts hand
138
Flexor digitorum superficialis
O: medial epicondyle, coronoid process, oblique line of radius
I: middle phalanges of finger
N: Median
A: Flexes proximal interphalangeal joints, flexes hand and forearm
139
Flexor digitorum profundus
O: anteromedial surface of ulna, interosseus membrane
I: Bases of distal phalanges of fingers
N: ulnar and median
A: Flexes distal interphalangeal joints and hand
140
Flexor pollicis longus
O: anterior surface of radius, interosseus membrane, and coronoid process
I: base of distal phalanx of thumb
N: median
A: Flexes thumb
141
Pronator quadratus
O: anterior surface of distal ulna
I: anterior surface of distal radius
N: median
A: pronates forearm
142
Brachioradialis
O: Lateral supracondylar ridge of humerus
I: Base of radial styloid process
N: radial
A: flexes forearm
143
Extensor carpi radialis longus
O: Lateral supracondylar ridge of humerus
I: Dorsum of base of second metacarpal
N: Radial
A: extends and abducts hand
144
Extensor carpi radialis brevis
O: lateral epicondyle of humerus
I: posterior base of third metacarpal
N: radial
A: extends and abducts hands
145
Extensor digitorum
O: lateral epicondyle of humerus
I: Extensor expansion, base of middle and digital phalanges
N:radial
A: Extends fingers and hand
146
Extensor digiti minimi
O: common extensor tendon and interosseus membrane
I: Extensor expansion, base of middle and distal phalanges
N: radial
A: extends little finger
147
Externsor carpi ulnaris
O: lateral epicondyle and posterior surface of ulna
I: base of fifth metacarpal
N: radial
A: extendis and adducts hand
148
Supinator
O: Lateral epicondyle, radial collateral, and annular ligaments, supinator fossa and crest of ulna
I: Lateral side of upper part of radius
N: radial
A: supinates forearm
149
Abductor pollicis longus
O: interosseus membrane, middle third of posterior surfaces of radius and ulna
I: Lateral surface of base of first metacarpal
N: radial
A: Abducts thumb and hand
150
Extensor pollicis longus
O: Interosseous membrane and middle third of posterior surface of ulna
I: base of distal phalanx of thum
N: radial
A: Extend proximal phalax of thumb and abduct hand
151
Extensor pollicis brevis
O: interosseous membane and posterior surface of middle third of radius
I: base of proximal phalanx
N: radial
A: extends proximal phalanx of thumb and abducts hand
152
Extensor indicis
O: posterior surface of ulna and interosseus membrane
I: Extensor expansion of index finger
N: radial
A: Extends index finger
153
Occur at the proximal and distal radioulnar joints
Pronation and supination
Supination being stonger
154
Abductor pollicis brevis
O: Flexor retinaculum, scaphoid, and trapezium
I: lateral side of base of proximal phalanx of thumb
N: Median
A: Abducts thumb
155
Flexor pollicis brevis
O: flexor retinalculi, and trapezium
I: Base of proximal phalanx of thumb
N: median
A: flexes thumb
156
Opponens pollicis
O: flexor retinaculum and trapezium
I: Lateral side of first metacarpal
N: median
A: opposes thumb to to other digits
157
Adductor pollicis
O: capitate and base of 2nd and 3rd metacarpals; palmar surface of 3rd metacarpal
I: Medial side of base of proximal phalanx of the thumb
N: ulnar
A: adducts thumb
158
Palmaris brevis
O: medial side of flexor retinaculum, palmar aponeurosis
I: skin of medial side of palm
N: ulnar
A: wrinkles skin on medial side of palm
159
Abductor digiti minimi
O: Pisiform and tendon of flexor carpi ulnaris
I:medial side of base of proximal phalanx of little finger
N: ulnar
A: abducts the little finger
160
Flexor digiti minimi brevis
O: flexor retinaculum and hook of hamate
I: medial side of base of proximal phalanx of little finger
N: ulnar
A: Flexes proximal phalanx of little finger
161
Opponens digiti minimi
O: flexor retinaculim and hook of hamate
I: medial side of fifth metacarpal
N: ulnar
A: Opposes little finger
162
Lumbricals
O: lateral side of tendons of flexor digitorum profundus
I: lateral side of extensor expansion
N: median (2 lateral) and ulnar (2 medial)
A: Flex metacarpophalangeal joints and extend interphalangeal joints
163
Dorsal interossei
O: adjacent sides of metacarpal bones
I: Lateral sides of bases of proximal phalanges; extensor expansion
N: ulnar
A: Abduct fingers; flex metacarpophalangeal joints; extend interphalangeal joints
164
Palmar interossei (3)
O: medial side of second metacarpal; lateral sides of 4th and 5th metacarpals
I: Bases of proximal phalanges in same sides as their origins;e extensor expansion
N: Ulnar
A: adduct finger; flex metacarpophalangeal jointsl extend interphalangeal joints
165
Thickening of the antebrachial fascia on the back of the wrist,
Externsor retinaculum
166
Triangular fibrous layer overlying the tendons in the palm and is consunuous with the palmaris longus, the thena and hypothenar fasciae, the flexor retinaculum and the palmar carpal ligament
Palmar aponeurosis
167
progressive thickening, shortening and fibrosis of the palmar fascia
Dupuytren's contracture
168
ischemic muscular contracture(flexion deformity) of the fingers and sometimes of the wrist
Volkmann contracture
169
thickening of deep antebrachial fascia at the wrist, covering the tendons of the flexor muscles, median nerve, and ulnar artery and nerve,e xcept palmar branches of the median and ulnar nerves
Palmar carpal ligament
170
Forms the carpal (osteofascial) tunnel on the anterior aspect of the wrist
Attached medially to the triquetrum, the pisiform, and the hook of the hamate and laterally to the tubercles of the scaphoid and trapezium
Flexor retinaculum
* serves as an origin for muscles of the thenar eminence
171
The flexor retinaculum is crossed superficially by
* ulnar nerve
* ulnar artery
* palmaris longus tendon
* palmar cutaneous branch of the median nerve
172
Formed anteriorly by the flexor retinaculum and posteriorly by the carpal bones
Carpal tunnel
173
The carpal tunnel transmits the \_\_\_\_\_\_
* Median nerve
* flexor pollicis longus
* flexor digitiorum profundus
* flexor digitorum superficialis muscles
174
lateral space that cintains the flexor pollicis longus tendon and the other flexor tendons of the index finger
Thenar space
175
Medial space that contains the flexor tendons of the medial three digits
Midpalmar space
176
Envelops or contains the tendons of both the flexor digitorum superficialis and profundus muscles
Common synovial flexor sheath (Ulnar Bursa)
177
Envelops the tendon of the flexor pollicis longus muscle
Synovial sheath for flexor pollicis longus (radial Bursa)
178
The flexor digitorum superficialis tendon splits into \_\_\_\_\_\_\_\_\_\_\_\_
Medial and lateral bands
and inserts on the base of the middle phalanx
179
Flexor digitorum profundus tendon inserts on the base of the
Distal phalanx as a single tendon
180
The expansion of the extensor tendon over the metacarpophalangeal joint and is referred to by clinicians as the\_\_\_\_\_\_
extensor hood
181
triangular interval bounded medially by the tendon of the extensor pollicis longus muscle and laterally by the tendons of the extensor pollicis brevis and abductor pollicis longus muscles
Anatomic snuffbox
* limited proximally by the styloif process of the radius
182
The anatomic snuffbox has a floor formed by the scaphoif and trapezium bones and crossed by the \_\_\_\_\_\_\_\_artery
radial
183
The brachial plexus is formed by the ventral primary rami of
C5-T1
184
Brachial plexus is enclosed with axillary artery and vein by the \_\_\_\_\_\_\_\_\_\_
axilalry sheath
(formed by a prolongation of the prevertebral fascia)
185
[Brachial Plexus]
Branches from the roots
* **Dorsal Scapular nerve (C5)**
* pierces the scalaneus medius muscle to reach the posterior cervical triangle and descends deep to the levator scapulae and the rhomboid minor and major muscles.
* Innervates the rhomboids and frequently the levator scapular muscles
* **Long thoracic Nerve (C5-C7)**
* Descends behind the brachial plexus and runs in the external surface of the serratus anterior muscle
186
[Brachial Plexus]
Branches From the Upper Trunk
* **Suprascapular nerve (c5-c6)**
* runs laterally across the posterior cervical triangle
* passes through the scapular notch under the superior transverse scapular ligament, whereas the suprascapular artery passes over the ligament. (artery over the ligament and under the nerve)
* Supraspinatus muscle and the shoulder joint, infraspinatus
* **Nerve to Subclavius (C5)**
* Descends in front of the bracial plexus and the subclavian artery and behind the clavicle to reach the subclavius
* Sternoclavicular joint
* Usually branches to the accessory phrenic nerve (c5)
187
[Brachial Plexus]
Branches from the Lateral cord
* **Lateral Epctoral nerve (C5-C7)**
* pectoralis major and minor by a nerve loop
* pierces the costocoracoid membrane of the clavipectoral fascia
* accompanied by the pectoral branch of the thoracoacromial artery
* **Musculocutaneous nerve (C5-C7)**
* pierces the coracobrachialis muscle, descends between the biceps bracii and brachialis muscles, and innervates these 3 muscles
188
[Brachial Plexus]
Branches from the Medial cord
* **Medial Pectornal nerve (C8-T1)**
* Passes forward between the axillary artery and vein and forms a loop in front of the axillary artery with the lateral pectoral nerve
* Enters and supplies the pectoralis minor muscle and reaches the overlying pectoralis major muscle
* **Medial Bracial Cutaneous nerve (C8-T1)**
* Runs along the medial side of the axillary nerve
* Medial side of the arm
* communicate with the intercostobrachial nerve
* **Medial Antebrachial Cutaneous nerve (C8-T1)**
* Runs between the axillary artery and vein and then runs medial to the brachial artery
* medial side of the forearm
* **Ulnar nerve (C7-T1)**
* Runs down the medial aspect of the arm but does not branch in the brachium
189
[Brachial Plexus]
Branches from the medial and lateral cords
median nerve (C5-T1)
* formed by the heads from both the medial and lateral cords
* Runs down the anteromedial aspect of the arm but does not branch in the brachium
190
[Brachial Plexus]
Branches from the Posterior cord
* **Upper subscapular nerve (C5-C6)**
* Innervates the upper portion of the subscapularis muscle
* **Thoracodorsal nerve (C7-C8)**
* Runs behind the axilalry artery and accompanies the thoracodorsal artery to enter the latissimus dorsi muscle
* **Lower subscapualr nerve (C5-C6)**
* Innervates the lower part of the subscapularis and teres major muscles
* Runs downward behind the subscapular vessels to the teres major muscle
* **Axilalry nerve (C5-C6)**
* Innervates the deltoid and teres minor muscles and give rise to the lateral brachial cutaneous nerve
* Passes posteriorly through the quadrangular space accompanied by the posterior circumflex humeral artery and winds around the surgical neck of the humerus
191
Injury to the posterior cord is caused by the pressure of the crosspiece of a crutch, resulting in paralysis of the arm called \_\_\_\_\_\_\_\_\_\_\_-
Crutch palsy
* It results in loss in function of the extensors of the arm, forearm, and hand and produces a wrist drop
192
Injury to the axillary nerve is caused by a fracture of the ___________ of the humerus or inferior dislocation of the humerus
surgical neck
* weakness of the lateral rotation and abduction of the arm (the supraspinatus can abduct the arm but not to a horizontal level
193
Pierces the coracobrachialis muscle and descends between the biceps and brachialis muscles
Innervates all of the flexor muscles in the anterior compartment of the arm, such as the coracobrachialis, biceps, and brachialis muscles
Musculocutaneous nerve
194
The musculocutaneous nerve continue into the forearms as the \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
lateral cutaneous nerve
195
the median nerve give rise to the _________ in the cubital fossa
Anterior interosseus nerve
196
Runs down the anteromedial aspect of the arm, and at the elbow, it lies medial to the brachial artery on the brachialis muscle (has no muscular branches in the arm)
Median nerve (C5-T1)
* Innervates all of the anterior muscles of the forearm **except the flexor capi ulnaris and the ulnar half of the flexor digitorum profundus**
197
Median nerve gives off a muscular branch(recurrent branch) to the thenar musclesl and terminates bu dividing into three \_\_\_\_\_\_\_\_\_\_
Common palmar digital nerves
* which then divide into the palmar digital branches
* innervates also the lateral 2 lumbricals, the skin of the lateral side of the palm
198
Arises from the posterior cord and the alrgest branch of brachial plexus
Descends posteriorly between the long and medial heads of the triceps, after which it passes inferolaterally with the profunda brachii artery in the spiral groove on the back of the humerus between the medial and lateral heads if the triceps
Radial Nerve (C5-T1)
199
Branches of the radial nerve
* **Deep branch**
* Enters the supinator muscle, winds laterally around the radius in the substance of the muscle and supplies the extensor carpi radialis brevis and supinator muscles
* emerges from the supinator as the **posterior interosseus nerve** and continues with psoterior interosseus artery and innervates the extensor muscles of the forearm
* **Superficial branch**
* Descend in the forearm under cover of the brachioradialis muscle and then passes dorsally around the radius under the tendon of the brachioradialis
* Runs distally to the dorsum of the hand to innercate the skin of the radial side of the hand and the radial two and one half digits over the proximal phalanx. This nerve does not supply the skin of the distal phalanges
200
Arises from the medial cord of the brachial plexus, runs down the medial aspect of the arm. pierces the medial intermuscular septum at the middle of the arm and descends together with the superior ulnar collateral branch of the brachial artery
Ulnar nerve
* Descends behinf the medial epicondyle in a groove or tunnel
* Enters the forearm by passing between the 2 heads of the flexor carpi ulnaris and descends between and innervates the flexor carpi ulnaris and flexor digitorum profundus muscle
* Enters the hand superficial to the flexor retinaculum and lateral to the pisiform bonbe, where it is vulnerable to damage from cuts or stab wounds
201
The Ulnar nerve terminates by dividing into \_\_\_\_\_\_\_\_
* **Superficial nerve**
* innervates palmaris brevis and the skin over the palmar and dorsal surfaces of the medial one 1/3 of the hand, including hypothenar eminence
* terminates in the palm by dividing into 3 palmar digital branches
* **Deep branch**
* Arises at and travels through Guyon's canal and then passes between the pisiform and the hook of hamate, and then deep to the opponens digiti minimi
* Curves medial to the hook of the hamate, and then turns laterally to follow the course of the deep palmar arterial arch across the interossei, and then runs between 2 heads of the adductor pollicis
* Innervates the hypothenar muscles, the medial two lumbricals, all of the interossei, the adductor pollicis, and usually the deep head of the flexor pollicis brevis
202
Somatic Motor Nerves
Include radial, axillary, median, musculocutaneous, and ulnar nerves and ventral or dorsal primary rami and other nerves
Contain nerve fibers with cell bodies that are located in the dorsal root ganglia, anterior horn of the spinal cord, and sympathetic chain ganglia
203
Cutaenous nerves
Include medial brachial, medial, antebrachial, lateral and other cutaneous nerves
Contain nerve fibers with cell bodies that are lcoated in the Dorsa; root ganglia for GSA and GVA and Sympathetic chain ganglia for sympathrtic postganglionic GVE fibers
204
Injury during breech delivery or a violent displacement of the head from the shoulder such as might result from a fall from a motorcycle or horse
Erb-ducheene paralysis or erb paralysis
| (Upper trunk)
205
May be caused during a difficult breech delivery by a cervical rub or by abdnormal insertion or spasm of the anterior and middle scalene muscles
Klumpke's paralysis
206
branch of the thyrocervical trunk
passes over the superior transverse scapular ligament (whereas the suprascapular nerve passes under the ligament)
Suprascapular artery
* Anastomoses with the deep branch of the transverse cervical artery (dorsal scapular artery) and the circuflex artery around the scapula, providing a collateral circulation
* Supplies the
* Supraspinatus
* infraspinatus
* shoulder
* acromioclavicular joints
207
Arises from the subclavian artery but may be a deep brach of the transcverse cervical artery
Accompanies the dorsal scapular nerve
Dorsal scapular or Descending Scapular artery
* Supplies the
* levator scapular
* rhomboids
* serratus anterior muscles
208
Arterial anastomoses around scapular occur between this 3 groups of arterie
* suprascapular, descending sacpular and circumflex scapular
* Acromial and posterior humeral circumflex
* Descending scapular and posterior intercostal arteries
209
The central structure of the axilla
Axillary artery
210
The axillary artery is divided into 3 parts by the \_\_\_\_\_\_
Pectoralis minor
211
supplies the intercostal muscles in the 1st and 2nd anterior intercostal spaces and adjacent muscles
Superior or SUpreme thoracic artery
212
Short trunk from the first or second part of the axillary artery and has pectoral, clavicular, acromial, and deltoid branches
thoracoacromial artery
213
Runs along the lateral border of the pectoralis muscle
Supplies the pectoralis major, minor and serratus anterior and the axillary lymph nodes.
Lateral thoracic artery
(gives rise to the lateral mammary artery)
214
Largest brach of the axillary artery, arises at the lower border of the subscapularis muscle, and descenfs along the axillary border of the scapula
Subscapular
* Divides into
* Thoracodorsal
* latissimus dorsi and lateral thoracic wall
* Circumflex Scapular
* passes posteriorly tot he triangular space
* Ramifies in the infraspinous fossa and anastomoses with branches of the dorsal scapular and suprascapular arteries
215
Passes anteriorlu around the surgical neck of the humerus
Anastomoses with the posterior humeral circumflex artery
Anterior Humeral Circumflex artery
216
Runs posteriorly with the axillary nerve through the quadrangular space bounded but the teres minor and teres major muscles, the long head of the triceps brachii and the humerus
Anastomoses with the anterior humeral circumflex artery and an ascending branch of the profunda brachii artery and also sends a branch to the acromial rete
Posterior Humeral CIrcumflex artery
217
Lies in the center of the cubital fossa, medial to the biceps tendon, lateral to the median nerve, and deep to the bicipital aponeurosis.
Brachial artery
Terminates by dividing into the radial and ulnar arterues at the level of the radial neck, approximately 1 cm below the bend of the elbow
218
Descends posteriorly with the radial nerve and gives off an **ascending branch** which anastomoses with the descending branch of the posterior humeral circumflex artery
Profunda brachii (Deep Brachial artery)
219
The profunda brachii artery divides into \_\_\_\_\_\_\_\_
* Middle collateral artery
* anastomoses with the interosseus recurrent artery
* Radial collateral artery
220
Pierces the medial intermuscular septum and accompanies the ulnar nerve behind the septum and medial epicondyle
Anastomoses with the posterior ulnar recurrent branch of the ulnar artery
Superior ulnary artery
221
arises just above the elbow and descends in front of the medial epicondyle.
Anastomoses with the anterior ulnar recurrent branch of the ulnar artery
Inferior Ulnar collateral artery
222
Arises as the smaller lateral branch of the brachial artery in the cubital fossa and descends laterally under the cover of the brachioradialis muscle, with the superficial radial nerve on its lateral side, on the supinator and flexor poliicis longus muscles
Radial artery
* divides into princeps pollicis artery and the deep palmar artery
223
Arises from the radial artery just below its origin and ascends on the supinator and then between the brachioradialis and brachialis muscles
Anastomoses with the radial collateral branch of the profunda brachii artery
Radial recurrent artery
224
Joins the palmar carpal branch of the ulnar artery and forms the palmar carpal arch
Palmar carpal branch of the Radial artery
225
passes through the thenar muscles and anastomoses with the superficial branch of the ulnar artery to complete the superficial palmar arterial arch
Superficial palmar branch
226
Joins the dorsal carpal branch of the ulnar artery and the dorsal terminal branch of the anterior interosseus artery to form the **dorsal carpal rete**
dorsal carpal branch of the radial artery
227
Descends along the unlar border of the first metacarpal bone under the flexor pollicis longus tendon
Divides into two proper digital arteries
Princeps Pollicis Artery
228
formed by the main termination of the radial artery and usually is compelted by the deep palmar branch of the ulnar artery
Deep palmar arch
* gives rise to 3 palmar metacarpal arteries
229
the larger medial branch of the brachial artery
Ulnar artery
230
Anastomoses with the inferior ulnar collateral artery
Anterior ulnar recurrent artery
231
Anastomoses with the superior ulnar collateral artery
Posterior Ulnar recurrent artery
232
Arises from the lateral side of the ulnar artery and divides into the anterior and posterior interosseus areteries
Common interosseus
* Anterior Interosseuos
* betyween the flexor digitorum profundus and the flexor pollicis longus muscle
* Posterior interosseous
* Gives rise to the interosseous recurrent artery
233
the maintemriantion of the ulnar artery
Superficial palmar arterial arch
Gives rise to 3 common plamar digital arteries
234
formed at the lower border of the teres major muscle by the union of the brachial veins and the basilic vein
Continues as the subclavian vein at the inferior margin of the 1st rib
Axillary vein
235
The development of the limbs begins with the activation of mesenchymal cells in the \_\_\_\_\_\_\_\_\_\_\_
Lateral plate somatic mesoderm
236
Appendicular skeleton develops from mesenchyme derived from the somatic __________ in the limb buds
Mesoderm
237
Consists of **mesenchymal core** covered with ectoderm and capped by an **apical ectodermal ridge**
Limb buds
238
Limb buds arise in somatic mesoderm at week \_\_\_\_\_
4
239
Bones of limbs are derived from the \_\_\_\_\_\_\_\_\_\_
lateral plate somatic mesoderm
240
Develop exclusively from the myotomic portions of the somites and also from the ventral and dorsal condensations of somitic mesoderm
muscles
241
FIbroserous sac that encloses the heart and the roots of the great vessels and occupies the middle mediastinum
Pericardium
242
The pericardium receives blood supply from
* Pericardiphrenic
* bronchial
* esophageal arteries
243
Strong, dense, fibrous layer that blends with the adventitia of the root of the great vessels and the central tendon of the diaphragm
Fibrous pericardium
244
Consists of the parietal layer, which lines the inner surface of the fibrous pericardium, and the visceral layer, which forms the outer layer (epicardium) of the heart wall and the roots of the great vessels
Serous Pericardium
