Upper Limbs

Question 1

Structural joints

Answer 1

• Fibrous joints: bones united by fibrous CT
• Cartilaginous joints: bones united by hyaline cartilage (synchondroses) or fibrocartilage (symphyses)
• Synovial - connected by a fibrous joint capsule lined with a synovial membrane

Question 2

Functional joints

Answer 2

• synarthrosis: immovable
• amphiarthrosis: slightly movable
• diarthrosis: bone articulation permitting free motion in a joint

Question 3

Joints

Answer 3

• plane - short gliding movements
• hinge - angular movements
• pivot - rotational movements

Question 4

More joints

Answer 4

• condyloid and saddle - flexion, extension, abduction, adduction
• ball and socket - all directions of movement -

Question 5

Least -> Most mobile

Most -> Least mobile

Answer 5

Uniaxial, Biaxial, Multiaxial

Multiaxial, Biaxial, Uniaxial

Question 6

Ossification

Answer 6

bone-tissue formation begins in the embryo, proceeds through childhood and adolescence as the skeleton grows, slows down as an adult

Question 7

Bone development 8 weeks prior

Answer 7

the skeleton of the human embryo consists
only of hyaline cartilage and some membranes of mesenchyme, membrane bones form from mesenchyme -> intramembranous ossification
endochondral ossification - process which all other bones inferior to the basicranial, except for the clavicles, initially develop as hyaline cartilage which is replaced

Question 8

Growth of Endochondral Bones

Answer 8

• Bones lengthen entirely by growth of the epiphyseal plates.
• Cartilage is replaced with bone as quickly as it grows.
• Epiphyseal plates maintain constant thickness.
• The entire bone lengthens

Question 9

AAAM: Pectoralis major vs. minor

Answer 9

Major - prime mover of arm flexion; adduction, and medial rotation of humerus.
– Medial and Lateral Pectoral Nerves
Minor - stabilizes the scapula by drawing it anteriorly and inferiorly against the thoracic wall, attaches to the coracoid process, Medial Pectoral Nerve

Question 10

AAAM: Serratus Anterior and Subclavian

Answer 10

Serratus anterior - protracts and rotates the scapula, Long Thoracic Nerve
Subclavian - helps stabilize and depress the pectoral girdle, Nerve to Subclavius/ Subclavian Nerve
*All Innervated by Branches of the Brachial Plexus

Question 11

Anterior arm compartment: Biceps brachii

Answer 11

O: short head: coracoid process of scapula; long head: supraglenoid tubercle of scapula
I: tuberosity of radius
A: supinates and flexes the forearm;
flexes arm
I: Musculocutaneous nerve

Question 12

Anterior arm compartment: Coracobrachialis

Answer 12

O: coracoid process of scapula
I: medial surface of humerus
A: helps flex and adduct the arm
I: Musculocutaneous nerve

Question 13

Anterior arm compartment: Brachialis

Answer 13

O: distal half of humerus
I: coronoid process and tuberosity of ulna
A: flexes forearm in all positions
I: Musculocutaneous nerve

Question 14

Posterior arm compartment: Triceps brachii

Answer 14

O: long head: infraglenoid tubercle of
scapula; lateral head: posterior surface
of humerus superior to the radial
groove; medial head: P surface of humerus inferior to the radial groove
I: olecranon of ulna
A: chief forearm extensor; long head
extends the arm
I: Radial nerve

Question 15

Ulna

Answer 15

• stabilizing bone of the forearm
• has an olecranon process for articulation with the humerus, a coronoid process at its proximal end, and a styloid process at its distal end, The ulna articulates with the trochlea of the humerus

Question 16

Radius

Answer 16

• lateral and shorter bone
• has a head and a radial tuberosity at its proximal end, and styloid process at its distal end, the radius articulates with
  the capitulum

Question 17

Proximal and distal radioulnar joint

Answer 17

PRJ - pivot joint allows rotation of the head of the radius on the ulna during pronation and supination
DRJ - pivot joint allows rotation of the radius about the ulna during pronation and
supination

Question 18

Forearm compartments

Answer 18

A & P, separated by an intermuscular
septum and an interosseous membrane
running between the radius and ulna, AFP muscles arise from medial epicondyle of the humerus, superficial to deep, PES muscles arise from the lateral epicondyle of the humerus, 2 groups superficial to deep

Question 19

Superficial layer: fingers

Answer 19

Superficial layer: arise from the medial
epicondyle of humerus; innervated by the
median nerve, FCU - ulnar nerve
- Index - Pronator teres: pronates forearm
- Middle - Flexor carpi radialis: flexes and abducts hand
- Ring - Palmaris longus: flexes hand
- Pinkie - Flexor carpi ulnaris: flexes and adducts hand

Question 20

Intermediate layer: flexors

Answer 20

• Flexor digitorum superficialis
• O: medial epicondyle of humerus and
  superior half of radius
• I: middle phalanges
• F: flexes middle phalanges 2-5 at proximal interphalangeal joints and flexes the proximal phalanges at the metacarpophalangeal joints
• I: median nerve

Question 21

Deep layer: flexors

Answer 21

Flexor digitorum profundus
- I: distal phalanges
- F: flexes distal phalanges 2-5 at distal interphalangeal joints
- I: medial side: ulnar nerve; lateral side; median nerve

Question 22

Deep layer: flexors part 2

Answer 22

Flexor pollicis longus
- F: flexes phalanges of 1st digit
- Pronator quadratus
- F: pronates forearm

Question 23

Flexor retinaculum

Answer 23

is a ligament that runs from the hamate and pisiform bones medially to the scaphoid and trapezium bones of the wrist laterally, 9 tendons from 3 muscles

Question 24

P: extensors, abductors or adductors of the hand

Answer 24

extensor carpi radialis longus, extensor carpi radialis brevis, extensor carpi ulnaris

Question 25

P: digital extensors

Answer 25

extensor digitorum, extensor indicis, extensor digiti minima

Question 26

P: thumb extensors or abductors

Answer 26

abductor pollicis longus, extensor pollicis brevis, extensor pollicis longus, radial nerve, lateral epicondyle of humerus

Question 27

P: superficial layer

Answer 27

Extensor carpi ulnaris: extends and adducts hand at wrist - Extensor digitorum: extends digits 2-5 at metacarpophalangeal joints - Extensor carpi radialis brevis: extends and abducts hand at wrist - Extensor carpi radialis longus: extends and abducts hand at wrist - Brachioradialis: flexes forearm

Question 28

P: Deep layer

Answer 28

Supinator: supinates the forearm by rotating the radius - Extensor indicis: extends 2nd finger - Abductor pollicis longus: abducts and extends the thumb - Extensor pollicis longus: extends the thumb - Extensor pollicis brevis: extends the thumb

Question 29

Hand muscles

Answer 29

Extrinsic hand muscles have tendons that reach the hand but originate in the forearm. Intrinsic hand muscles originate and terminate in the hand

Question 30

Intrinsic muscles and blood supply

Answer 30

- thenar (for the thumb muscles) - hypothenar (for the 5th digit) - short muscles of the hand (lumbricals and interossei) radial and ulnar arteries; innervation: median and ulnar nerves

Question 31

Short muscles

Answer 31

lumbricals and interossei lumbricals - flex MCP joints, extends IP joints, 1&2: MN, 3&4: UN Interossei arise from sides of metacarpals to insert on bases of proximal phalanges: dorsal abducts: 2-4 digits palmar adducts: 2,4,5 UN

Question 32

Axilla and sheath

Answer 32

pyramid space inferior to glenohumeral joint, superior to skin and axillary fascia, passageway for nerves and vessels: axillary artery & vein, nerves of the cords and branches of the brachial plexus, lymphatic vessels, and axillary lymph nodes axillary sheath – a sleeve-like continuation of the cervical prevertebral fascia

Question 33

Arm arteries

Answer 33

The brachial artery begins at the inferior border of teres major and ends in the cubital fossa: deep artery of the arm (profunda brachii artery) (to the posterior arm compartment), ulnar collateral arteries (anastomoses)

Question 34

Forearm arteries

Answer 34

Radial artery - muscles of anterior and posterior compartments, deep palmar arch Ulnar artery - muscles of the medial side of the forearm (flexors and pronators) and forms the superficial palmar arch

Question 35

Upper limb superficial veins

Answer 35

Cephalic vein: preaxial compartment continues deep at the deltopectoral triangle to drain into the axillary vein. Basilic vein: postaxial compartment; dives deep in arm to join the deep veins. Median cubital vein: link between the cephalic and basilic veins; crosses the cubital fossa