Upper Limb (from handbook)

Question 1

what are the movements of the scapula?

Answer 1

• protraction (extends upper limb)
• retraction (squares shoulders)
• elevation (shruggs shoulders)
• depression (lowers shoulders)
• rotation (tilts glenoid fossa cranially to aid elevation)

Question 2

what is the pectoral girdle?

Answer 2

connects your upper limbs to the bones along the axis of your body

Question 3

what are the large superficial muscles of the posterior pectoral girdle?

Answer 3

• trapezius

- latissimus dorsi

Question 4

what are the muscles of the anterior pectoral girdle?

Answer 4

• pectoralis major
• pectoralis minor
• serratus anterior

Question 5

what is the attachment of latissimus dorsi?

Answer 5

anterior aspect of proximal humerus

Question 6

what is the attachment of latissimus dorsi?

Answer 6

anterior aspect of proximal humerus

Question 7

what are the smaller deeper muscles of the posterior pectoral girdle?

Answer 7

• levator scapulae
• rhomboid major
• rhomboid minor

Question 8

what do the posterior pectoral girdle muscles attach?

Answer 8

scapula to vertebral column

- except latissimus dorsi (inserts onto humerus)

Question 9

what are the muscles of the posterior pectoral girdle innervated by?

Answer 9

branches of the brachial plexus

trapezius: spinal root of CN XI
latissimus dorsi: thoracodorsal nerve

Question 10

which muscles attach the scapula to the humerus?

Answer 10

• deltoid
• supraspinatus
• infraspinatus
• subscapularis
• teres minor
• teres major

Question 11

what do the scapulo-humeral muscles do and where do they lie?

Answer 11

• move and stabilise shoulder joint

- deep to posterior scapular muscles (except deltoid)

Question 12

what are the rotator cuff muscles and what do they do?

Answer 12

• supraspinatus
• infraspinatus
• subscapularis
• teres minor
• stabilise the shoulder joint

Question 13

what are the posterior arm muscles?

Answer 13

triceps brachii

• long head
• lateral head
• medial head

Question 14

what is the function of the anterior compartment of the arm?

Answer 14

• extends elbow

- (long head) extends shoulder joint

Question 15

what is the posterior compartment of the arm innervated by?

Answer 15

radial nerve

Question 16

what are the boundaries of the axilla?

Answer 16

anterior - pectoralis major & minor
posterior - subscapularis, teres major, latissimus dorsi
lateral - upper humerus
medial - serratus anterior, chest wall
apex - 1st rib, clavicle, scapula
base - skin, fascia

Question 17

what does the axilla contain?

Answer 17

• lymph nodes
• axillary artery
• axillary vein
• brachial plexus

Question 18

what is the axillary artery a continuation of and what does it continue as?

Answer 18

• subclavian

- brachial

Question 19

what are the roots of the brachial plexus and where are they found?

Answer 19

C5-T1

- neck

Question 20

what are the trunks of the brachial plexus and where are they found?

Answer 20

superior - C5&6
middle - C7
inferior - C8 & T1

• neck

Question 21

what are the divisions of the trunks of the brachial plexus and where are they found?

Answer 21

• anterior
• posterior
• under the clavicle

Question 22

what are the muscles of the anterior compartment of the arm?

Answer 22

• biceps brachii
• brachialis
• coracobrachialis

Question 23

what are the functions of the anterior compartment of the arm?

Answer 23

flexion

Question 24

what is the anterior compartment of the arm innervated by?

Answer 24

musculocutaneous nerve

Question 25

what are the borders of the cubital fossa?

Answer 25

lateral - brachioradialis medial - pronator teres superior (base) - imaginary line between medial and lateral epicondyles of humerus apex - 'points' towards forearm and hand

Question 26

what are the contents of the cubital fossa?

Answer 26

- tendon of biceps brachii - bicipital aponeurosis (from biceps tendon) - brachial artery - radial artery - ulnar artery - radial nerve - median nerve

Question 27

what are the terminal branches of the brachial artery?

Answer 27

- radial | - ulnar

Question 28

what are the superficial muscles of the anterior forearm?

Answer 28

lateral -> medial - pronator teres - flexor carpi radialis - palmaris longus - flexor carpi ulnaris

Question 29

where do the superficial muscles of the anterior forearm originate?

Answer 29

medial epicondyle of the | humerus

Question 30

what are the middle muscles of the anterior forearm?

Answer 30

flexor digitorum superficialis

Question 31

what are the deep muscles of the anterior forearm?

Answer 31

- Flexor digitorum profundus - Flexor pollicis longus - Pronator quadratus

Question 32

what is the action of the anterior forearm muscles?

Answer 32

- flexion except: pronator teres - pronator of proximal radioulnar joint pronator quadratus - pronator of distal radioulnar joint

Question 33

what are the anterior forearm muscles innervated by?

Answer 33

- median nerve except: flexor carpi ulnaris - ulnar nerve medial 1/2 flexor digitorum profundus - ulnar nerve

Question 34

what are the borders of the carpal tunnel?

Answer 34

floor & sides - carpal bones | roof - flexor retinaculum

Question 35

what are the contents of the carpal tunnel?

Answer 35

- tendons of FDS. FDP, FPL | - median nerve

Question 36

which muscles of the anterior forearm are prime flexors of the wrist?

Answer 36

- flexor carpi radialis - flexor carpi ulnaris - palmaris longus

Question 37

which muscles of the anterior forearm flex the digits?

Answer 37

- Flexor digitorum superficialis - Flexor digitorum profundus - Flexor pollicis longus

Question 38

what are the 4 groups of intrinsic muscles of the hand (and the extra muscle)?

Answer 38

- thenar eminence - hypothenar eminence - lumbricals - interossei - adductor pollicis

Question 39

how many thenar eminence muscles are there and what are they innervated by?

Answer 39

3 | - median nerve

Question 40

how many hypothenar eminence muscles are there and what are they innervated by?

Answer 40

3 | - ulnar nerve

Question 41

how many lumbrical muscles in the hand are there and what are they innervated by?

Answer 41

4 digits 2 and 3 - median digits 4 and 5 - ulnar

Question 42

how many interossei muscles in the hand are there?

Answer 42

7

Question 43

what are the intrinsic muscles of the hand innervated by?

Answer 43

ulnar & median nerves

Question 44

what are the muscles of the thenar eminence and what is their insertion?

Answer 44

- flexor pollicis brevis - PP - abductor pollicis brevis - PP - oppnens pollicis - 1st metacarpal

Question 45

how is the adductor pollicis different from the muscles of the thenar eminence?

Answer 45

- lies deep in the palm (not thenar eminence) | - innervated by ulnar nerve

Question 46

what is the insertion of adductor pollicis?

Answer 46

- 3rd metacarpal | - proximal phalanx of thumb

Question 47

what are the muscles of the hypothenar eminence and what is their insertion?

Answer 47

- flexor digiti minimi - PP - abductor digiti minimi - PP - opponens digiti minimi - 5th metacarpal

Question 48

describe the passage of the lumbrical muscles of the hand

Answer 48

- arise from tendons of FDP - travel along lateral aspects of digits 2-5 - insert onto dorsal aspects

Question 49

what do the lumbricals do?

Answer 49

- flex MCP joints | - extend IP joints

Question 50

what are the subdivisions of the interossei muscles and how many are in each?

Answer 50

palmar - 3 | dorsal - 4

Question 51

what are the actions of the interossei muscles?

Answer 51

palmar - adduct dorsal - abduct (PAD-DAB) - extension of fingers at IP joints

Question 52

how would you test the dermatomes of the upper limb?

Answer 52

``` C5 - upper lateral arm C6 - thumb C7 - middle finger C8 - medial border of hand T1 - medial border of elbow ```

Question 53

what are the superficial muscles of the posterior compartment of the forearm?

Answer 53

lateral -> medial - Brachioradialis - Extensor carpi radialis longus - Extensor carpi radialis brevis - Extensor digitorum - Extensor digiti minimi - Extensor carpi ulnaris

Question 54

how are the posterior forearm muscles arranged?

Answer 54

- superficial layer | - deep layer

Question 55

what is the action of most of the posterior forearm muscles and what are the exceptions?

Answer 55

``` extensors of the wrist, digits or thumb except: - brachioradialis - supinator - abductor pollicis longus ```

Question 56

what are the posterior forearm muscles innervated by?

Answer 56

radial nerve

Question 57

what is the origin of the posterior forearm muscles?

Answer 57

lateral epicondyle of the humerus | common extensor origin

Question 58

what are the deep muscles of the posterior forearm?

Answer 58

lateral -> medial - Supinator - Abductor pollicis longus - Extensor pollicis brevis - Extensor pollicis longus - Extensor indicis

Question 59

what is the attachment of the deep posterior forearm muscles?

Answer 59

proximally to the forearm bones and the interosseous membrane (except supinator)

Question 60

which deep muscles of the posterior forearm are not extensors?

Answer 60

``` supinator: - supinates forearm and hand - attaches to humerus abductor pollicis longus - abducts thumb - inserts onto 1st metacarpal ```

Question 61

which superficial posterior forearm muscles are not extensors?

Answer 61

brachioradialis - lies on boundary between posterior and anterior compartments - weak flexor of elbow joint

Question 62

what is the anatomical snuffbox?

Answer 62

- triangular-shaped depression on the lateral aspect of the wrist, at the base of the thumb - seen when the thumb is extended.

Question 63

what are the boundaries of the anatomical snuffbox?

Answer 63

medial - tendon of EPL | lateral - tendons of EPB and APL

Question 64

why is the anatomical snuffbox a clinically important region?

Answer 64

- scaphoid lies in floor - radial artery - cephalic vein (cannulation)

Question 65

what are the areas of skin supplied by the peripheral nerves of the upper limb?

Answer 65

``` median: - palmar surface of the middle finger ulnar: - medial border of the hand radial: - lateral dorsum of the hand ```