Upper Limb- Joints and Musculature from Lectures

Question 1

What are the axes of the upper limb movement?

Answer 1

Prox/distal

Lateral/medial

Ant/Post

Sup/Inf

Question 2

What is a hinge joint?

Answer 2

Uniaxial with concave/vex restricted to FLEX/EXTEND

Question 3

What is a pivot joint?

Answer 3

Uniaxial, rounded surface articulating with a ring restricted to ROTATION

Question 4

What is a condyloid joint?

Answer 4

Biaxial; oval surface fitting in elliptical socket

FLEX/EXT and ADD/ABDUCT

Question 5

What is a saddle joint?

Answer 5

Biaxial; each has concave and convex surface

FLEX/EXT and ADD/ABDUCT

Question 6

What is a ball and socket joint?

Answer 6

Multiaxial; rounded ball-like surface articulates with concave “cup” socket

Question 7

What is a plane joint?

Answer 7

Multiaxial; gliding joint with flat articulating surface

Question 8

What are good examples of a hinge, B&S, plane, and saddle joints?

Answer 8

Hinge: Elbow

B&S: Glenohumoral

Plane: tarsal-phalange joint

Saddle: Thumb joint

Question 9

What are the ligaments of the AC joint?

Answer 9

Acromioclavicular lig, coracoclavicular lig, coracoacromial lig

Question 10

What are the ligaments of the rotator cuff?

Answer 10

Coracohumeral ligament, Superior/Inferior/Middle glenohumeral ligaments

Question 11

What are the articulating factors in 180* arm abduction?

Answer 11

Glenohumeral abduction and scapular movement (3:2 ratio)

Question 12

What are the ligaments of the elbow joint?

Answer 12

Radial collateral lig, anular lig, ulnar collateral ligaments (post,ant,transverse)

Question 13

What nerves innervate the anterior shoulder?

Answer 13

Medial and lateral pectoral; long thoracic; subclavian

Question 14

What nerves innervate the posterior shoulder?

Answer 14

• axillary
• upper/lower subscapular
• suprascapular

Question 15

What nerve innervates the anterior arm?

Answer 15

Musculocutaneous

Question 16

What nerve innervates the posterior arm?

Answer 16

Radial

Question 17

What nerve innervates the anterior forearm?

Answer 17

Medial/ulnar

Question 18

What nerve innervates the posterior forearm?

Answer 18

Radial

Question 19

What nerve innervates the anterior hand?

Answer 19

Median/ulnar

Question 20

What nerve innervates the subclavius? What compartment is this in?

Answer 20

N. To subclavius

-anterior shoulder

Question 21

What nerve innervates the serratus anterior?

Answer 21

Long thoracic

Question 22

What nerve innervates the deltoid muscle?

Answer 22

Axillary

Question 23

What are the rotator cuff muscles? What nerve innervates the rotator cuff muscles?

Answer 23

Supraspinatus- suprascapular n.

infraspinatus- suprascapular n.

teres minor- axillary n.

Subscapularis- upper/lower subscapular n.

Question 24

What nerve innervates the teres major?

Answer 24

Lower subscapular n.

Question 25

What muscles does the musculocutaneous n. supply?

Answer 25

Coracobrachialis, biceps brachii, brachialis (radial nerve can contribute to brachialis)

Question 26

What muscles does the radial nerve innervate?

Answer 26

Triceps, aconeus

Question 27

Forearm muscles nomenclature: what does “flexor” and “extensor” denote?

Answer 27

Flex: flexor compartment Exten: extensor compartment

Question 28

Forearm muscles nomenclature: what does carpi and digitorum denote?

Answer 28

Carpi- inserts at carples Digitorum- inserts at digits

Question 29

Forearm muscles nomenclature: what does “profundus”, “superficialis”, and “Opponens” denote?

Answer 29

Profundus= deep superficialis= superficial Opponens= action is opposition

Question 30

Forearm muscles nomenclature: what does “ulnaris” and “radialis” denote?

Answer 30

Ulnaris= ulnar side Radialis= radius side

Question 31

Forearm muscles nomenclature: what does brevis and longus denote?

Answer 31

Brevis= short head (usually intrinsic) Longus= long head

Question 32

Forearm muscles nomenclature: what does pollicis and minimi denote?

Answer 32

Pollicis= inserts at thumb Minimi= inserts at little finger

Question 33

In the forearm compartment, what muscles does the ulnar nerve innervate?

Answer 33

Flexor carpi ulnaris and 1/2 of the flexor digitorum pollicis (digits 4 & 5)

Question 34

What does the median nerve innervate in the forearm musculature?

Answer 34

All flexor-side muscles except flexor carpi ulnaris and flexor digitorum pollicis (digits 4 & 5)

Question 35

What does the median nerve innervate in the hand? Ulnar nerve?

Answer 35

Thenar muscles (not adductor pollicis) and first two lumbricals Everything else

Question 36

What is Erb-Duchenne Palsy?

Answer 36

C5-6 lesion at the root of the brachial plexus - paralysis of abductors and lateral rotators @ shoulder - paralysis of elbow flexors and forearm supinators

Question 37

What is the postural result of Erb-Duchenne Palsy?

Answer 37

Medially rotated arm, pronation at forearm,flexed wrist/fingers, sensory loss across lateral aspect of shoulder->hand

Question 38

What can cause Erb Palsy?

Answer 38

Could be caused at childbirth: shoulders forced inferiorly by mother’s vaginal canal can cause rip at upper roots/trunk of BP

Question 39

What is Klumpke Paralysis? Symptoms?

Answer 39

C8-T1 lesion; loss of ulnar and part of median nerve -loss of intrinsic hand muscles, partial loss of flexion at the hand, loss of all muscle control at ulnar nerve innervation sites

Question 40

What are the clinical/postural signs of Klumpke Paralysis?

Answer 40

Extension at wrist, muscle wasting along lateral aspect of forearm and intrinsic hand muscles, supinated arm, sensory loss to medial arm forearm and hand

Question 41

What can cause Klumpky Paralysis?

Answer 41

Sharp or extended upward “yanking” of the arm (like yanking a child by the arm up in the air)

Question 42

From proximal to distal, name the branching arteries from the subclavian artery.

Answer 42

Subclavian -> axillary -> brachial -> ulnar and radial

Question 43

What are the branches of the subclavian artery?

Answer 43

Dorsal scapular, thyrocervical trunk, suprascapular, axillary

Question 44

What are the branches of the axillary artery?

Answer 44

Superior thoracic; lateral thoracic, thoracoacromial trunk (clavicular, acromial, deltoid, pectoral branches); suprascapular (circumflex scapular and thoracodorsal); post/ant circumflex humeral; deep brachial (profundus brachial)

Question 45

What are the branches of the brachial artery?

Answer 45

Radial, middle, (superior/inferior) ulnar collateral; deep brachial; radial and (post/ant) ulnar recurrent

Question 46

What does the ulnar artery branch into?

Answer 46

Commmon interosseous artery (A/P interosseous)