Upper limbs Flashcards

Question

Identify the tendons, nerves, vessels in this cross section of the hand

Answer 1

the ulnar and radial bursa are able to communicate this can lead to horse-shoe tenosynovitis - v-like spread of infection

Answer 2

Extensor digitorum (attaches to extensor attachment of medial 4 digits) Extensor indicis (additional to forefinger) Extensor digiti minimi (extensor attachment of 5^th)

Answer 3

**extensor pollicis longus dorsal III** **extensor pollicis brevis dorsal I** **abductor pollicis longus dorsal I**

Answer 4

dorsiflexion - moving hand up to the sky palmarflexion - moving hand down to the ground radial deviation - moving had toward the left ulnar deviation - moving hand towards the right

Answer 5

Cutaneous - anterior and posterior ⅓ of hand * **Flexor carpi ulnaris** – flexes and adducts the hand at the wrist. * **Flexor digitorum profundus (medial half)** – flexes the ring and little fingers at the distal interphalangeal joint * Hypothenar muscles (flexor digiti minimi brevis, abductor digiti minimi, opponens digiti minimi) * Medial two lumbricals * Adductor pollicis brevis * Palmar and dorsal interossei of the hand

Answer 6

most of posterior forearm = extensors and supinators triceps brachii, brachialis, anconeus, extensor carpi radialis longus/brevis, extensor carpi ulnaris, extensor Digitorum , extensor digiti minimi, extensor indicis, supinator cutaneous supply to dorsal hand and fingers, lateral upper arm, posterior forearm

Answer 7

Extrinsic muscles originate from the torso and attach to the clavice, scapula or humerus ; also located in the back so maybe called superficial back muscles trapezius - elevate the scapula and rotate it during abduction of the arm latissiumus dorsi ; arises from spinous processes T7-12 and converges into a tendon that attaches to the intertubercular sulcus of the humerus ; acts to extend addict and medially rotate the upper limb 3 deep muscles: levator scapulae - being in in transverse processes of C1-4 and attaches to medial border of scapula ; acts to elevate scapula rhomboids - major and minor; originate from spinous processes of C7-T1 and attach to medial border of scapula; act to retract and rotate the scapula

Answer 8

as it descends the upper arm, it travels medially ; brachial artery located laterally Passes posterior to the elbow via the ulnar tunnel Travels lateral to ulnar bone in forearm enters hand via ulnar canal (between pisiform and hook of hamate)

Answer 9

originates from post chord found next to axillary artery passes through radial groove Enters forearm anterior to lateral epicondyle and passes through the cubital fossa teminates at deep/superficial branches (does not enter hand)

Answer 10

Lateral to the brachial artery as it passes anterior to the humerus passes over the brachial artery at the cubital fossa and becomes situated medially as it passes over the forearm (still anterior) enters the hand via the carpal tunnel

Answer 11

Radial - wrist drop median - oppose thumbs, ask patients to dorm ring and try to break the ring ulnar - pull paper from finger, ask patient to spread fingers and you try to press fingers together

Answer 12

A - long head of triceps B - lateral head of triceps C - medial head of triceps D - radial nerve and deep brachial artery

Answer 13

palpate the head of the humerus, the coracoid process, and the acromion.

Answer 14

Three short muscles in the base of the thumb ; allow fine movements of thumb (intrinsic muscles) all 3 innervated by median nerve opposes policis - largest and lies under the other two ; allows opposition of thumb by medically rotating and flexing the metacarpal on the trapezium abductior pollicis brevis - anterior to the OP and next to the FCB ; abducts the thumb flexor pollicis brevis - the most anterior ; flexes the metacarpophalangeal joint of the thumb

Answer 15

Produce the hypothenar eminence - muscular protrusion on the medial side of the palm, below the little finger Innervated by ulnar nerve opponents digiti minimi - deepest of the 3 muscles; rotates the metacarpal of the little finger towards the palm = opposition abductor digiti minimi - most superficial ; abduction of the little finger flexor digiti minimi - lateral the ADM; flexes the MCP joint of little finger

Answer 16

4 , each associated with a finger ; they link the extensor tendons to the flexor tendons each initiate from a tendon of the flexor digitorum profundus and wrap around the fingers , ending posteriorly actions: flexion at MCP and extension at the interphalangeal joints of each finger

Answer 17

Located between the metacarpals ulnar innervated dorsal interossei - most superficial ; consists of 4 muscles ; abduct the fingers at the MCP joint palmar interossei - anteriorly located ; consist of 3 muscles ; addict the finger at the MCP joint

Answer 18

Both ulnar innervated Palmaris brevis ; wrinkles skin of hypothenar eminence , curving hand = stronger grip adductor pollicis - large triangular muscle with two heads - radial artery passes anteriorly through them; adductor of thumb

Answer 19

Originate from the scapula and attach to the Humeral head ; they pull the Humeral head into the glenoid fossa uses the acronym SITS Supraspinatus - abducts the arm the first 15 degrees , assist deltoid from 15-90 degrees Infraspinatus - laterally rotates the arm Teres minor - laterally rotates arm Subscapularis - medially rotates the arm

Answer 20

Ulnar claw is caused by ulnar nerve damage - hyperflexion at IP/ hyperextension at MCP of 4/5th digits; also wasting of hypothenar eminence seen at rest as well

Answer 21

In the axilla, its posterior to the axillary artery and anterior to the subscapularis muscle. It exits the axilla via the **quadrangular space.** The axillary nerve then passes medially to the **surgical neck of the humerus**

Answer 22

Long head - proximal to infraglenoid tubercule of glenoid cavity lateral head - attaches above the radial groove of the humerus medial head - attaches below the radial groove of humerus all 3 head join to form the tricep aponeuroisis which attaches to the olecranon of ulna

Answer 23

Due to repetitive use of superficial extensor muscles, and hence strain of the common extensor tendon Inflammation forms Pain is at lateral epicondyle and can extend down to posterior aspect of forearm

Answer 24

Lunate separates from capitate and radius Occurs when a great force is applied to a hyperextended wrist – e.g FOOSH.

Answer 25

* It has two heads – one originates from the medial epicondyle of the [humerus](https://teachmeanatomy.info/upper-limb/bones/the-humerus/), the other from the [radius](https://teachmeanatomy.info/upper-limb/bones/radius/). The muscle splits into four tendons at the wrist, which travel through the carpal tunnel, and attaches to the middle phalanges of the four fingers. * **Actions:** Flexes the metacarpophalangeal joints and proximal interphalangeal joints at the 4 fingers, and flexes at the wrist. * **Innervation:** Median nerve.

Answer 26

gap in the muscles in posterior scapular region; pathway for axillary nerve and the posterior humeral circumflex artery to pass from the axilla to the posterior arm and shoulder ; these can be compressed as a result of trauma, hypertrophy (athletes who complete overhead activities) = weakness of delts and teres minor

Answer 27

the supinator (floor of cubita fossa; radial nerve passes between its 2 heads; abductor pollicis longus (abducts thumb), extensor pollicis brevis(Extends at the metacarpophalangeal and carpometacarpal joints of the thumb.), extensor pollicis longus(Extends all joints of the thumb: carpometacarpal, metacarpophalangeal and interphalangeal.) and extensor indicis(Extends the index finger, allowing it to be independent of the other fingers).

Answer 28

Wrist drop is a sign of **radial nerve** injury that has occurred proximal to the elbow. There are two common characteristic sites of damage: * **Axilla** – injured via humeral dislocations or fractures of the proximal humerus. * **Radial groove of the humerus** – injured via a humeral shaft fracture.

Answer 29

Cause - FOOSH most Common wrist fracture posterior angulation intra-articulation (fracture occurs within joint) = shortening of joint = muscle atrophy treatment - plaster

Answer 30

Symptoms - inability to lay hand flat and lift thumb, inability to straighten the thumb causes - wrist fracture or rheumatoid arthritis (inflammation of the tendon ) treatment - tendon graft, tendon transfer from one of the extensor tendons to the index

Answer 31

Some fractures can cause compression of the median nerve that pass through the carpal tunnel - this causes pain, numbness and parenthesis in the 3 and ½ digits (thumb, index, middle and half of ring) the procedure involves cutting through the flexor retinaculum

Answer 32

Absent in most people as not an essential muscle can be used as a graft for other damaged arm tendons

Answer 33

Paralysis of serrations anterior due to injury to the long thoracic nerve 9often in a knife fight where limbs are elevated) arm cannot be lifted above horizontal either

Answer 34

cutaneous branch - lateral forearm ; motor branch- coracobrachialis, brachialis, biceps brachii

Answer 35

medial chord

Answer 36

roots of C5/6/7

Answer 37

* **uperior** – inferior aspect of teres minor * **Inferior** – superior aspect of teres major * **Lateral** – surgical neck of [humerus](https://teachmeanatomy.info/upper-limb/bones/the-humerus/). * **Medial** – long head of triceps brachii * **Anterior** – subscapularis contents - axillary nerve and posterior circumflex humeral artery and vein. These structures can be **compressed** as a result of trauma, muscle hypertrophy or space occupying lesion; resulting in weakness of the deltoid and teres minor.

Answer 38

Trunks of brachial plexus, ***Scalenus anterior m; subclavian artery; 1st rib***

Answer 39

***Subclavian → axillary → brachial → radial***

Answer 40

Yes C5 and C6

Answer 41

inflammation of rotator cuff tendons as they pass through the subacromial space Symptoms- pain, weakness and reduced range of motion of shoulder caused by overuse from sport involving overhead motion, wear and tear with age, or the shape of your acromion being unaccommodating, bony growths on acromion due to age

Answer 42

common source of pain in athletes performing overhead sports such as tennis ; tendon of the supraspinatus degenerates from repeated use = inflammation; Patient will present with deltoid pain that is aggravated by abduction and flexion of arm; pain may radiate to lateral upper arm ; injection may be given but now practice is to avoid injections as can actually cause more inflammation to tendon; instead physical rehab exercises should be focused on instead - muscle needs lots of stimulation to heal

Answer 43

Acromioclavicular joint ; patient should be supine or seated; to identify the AC joint palpate the clavicle until it terminates at the shoulder at which you should feel a depression; needles is inserted above and in front but directed from the back

Answer 44

surgery to to treat shoulder impingement often done using arthroscopy (keyhole surgery); general anaesthetic given ; the aim is to make more space under the acromion by removing some bone and tissue; evidence emerging to show that surgery doesn’t help that much long term; NSAIDs, therapy and reposition of humerus and scapula via strengthening of serratous interior (involved in moving the lower scapula) are more effective

Answer 45

Acromioclavicular joint disease Glenohumeral joint disease - frozen shoulder or arthritis ; characterised by pain all over and restriction of all active and passive movements of shoulder Rotator cuff disorders - pain on abduction with thumb pointing down

Answer 46

Lumbricals Flexor digitorum profundis and superficialis also involved

Answer 47

Interossei, lumbricals and extensor digitorum

Answer 48

sign of benediction is cause by damage to the median nerve just above the condyles of the humerus - patients able to flex all fingers except for the index and middle(they will stay pointing as supplied by ulnar nerve) ; they will be unable to make a fist ; also wasting of anterior forearm and thenar eminence Ape hand - thumb usually in front of digits at rest ; damage to median nerve causes thumb to be in the same plane as the other fingers ; prominence at base of thumb too

Answer 49

caused by compression of the median nerve due to swelling of tissue inside carpal tunnel * an ache or pain in your fingers, hand or arm * numb hands * tingling or pins and needles * a weak thumb or difficulty gripping * atropy of thenar muscles * symptoms are intermittent and worsen at night causes - repetitive hand movements or prolonged hyperextension or hyperflexion Treatment - wrist splin to keep wrist straight and relieve pressure on median nerve ; steroid injection to reduce inflammation ; worst case scenario surgery ; avoid activities that put excessive strain on wrist such as playing instrument or using vibrating tools

Answer 50

Brachialis

Upper limbs Flashcards

(83 cards)