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MSK > Clinical anatomy of the upper limb > Flashcards

Clinical anatomy of the upper limb Flashcards

1
Q

What is involved in the shoulder girdle?

A 
Clavicle
Scapula
Steroclavicular joint
Acromioclavicular joint
Glenohumeral joint
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2
Q

What are common pathologies of the shoulder?

A 
OA
Impingement
Rotator cuff tears 
Adhesive capsulitis
Instability - atraumatic, traumatic, dislocations
Biceps tendonitis
Labral tears
ACJ dislocation
Humeral neck and shaft fracture
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3
Q

What are common elbow pathologies?

A

OA
Lateral and medial epicondylitis
Cubital tunnel syndrome
Supracondylar, olecranon, radial head/neck and forearm fractrure

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4
Q

What are common wrist pathologies?

A

OA
Carpal tunnel syndrome
Distal radius, scaphoid and carpal fractures and dislocations

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5
Q

What are common hand pathologies?

A 
OA
RA
Duptryen's contracture
Trigger finger
Finger injuries: tendons, fractures
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6
Q

What determines the different grades of ACJ dislocations?

A

Amount of soft tissue damage - if coracoclavicular ligaments rupture the clavicle will displace superiorly

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7
Q

What is the origin of the trapezius?

A

Spinous process T1-T12

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8
Q

What is the insertion of the trapezius?

A

Occipit and spine of scapula

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9
Q

What is the innervation of the trapezius?

A

Spinal accessory nerve

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10
Q

What is the action of the trapezius?

A

Elevates and depresses scapula

Retracts scapula

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11
Q

What movements are the first to go and last to come back in adhesive capsulitis (frozen shoulder)?

A

External rotation first to go

Internal rotation last to come back

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12
Q

What is the function of the labrum?

A

Increases capture of the humeral head and so increases stability

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13
Q

What is the insertion of the supraspinatous?

A

Greater tuberosity of humerus

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14
Q

What is the origin of the supraspinatous?

A

Supraspinatous fossa

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15
Q

What is the innervation of the supraspinatous?

A

Suprascapular nerve (C5/6)

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16
Q

What is the function of the supraspinatous?

A

Abducts arm

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17
Q

What is the origin of the infraspinatous?

A

Infraspinatous fossa

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18
Q

What is the insertion of the infraspinatous?

A

Greater tuberosity of humerus

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19
Q

What is the innervation of the infraspinatous?

A

Suprascapualr nerve (C5/6)

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20
Q

What is the function of the infraspinatous?

A

External rotation of arm

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21
Q

What is the origin of the teres minor?

A

Dorsal surface of lateral border of scapula

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22
Q

What is the insertion of the teres minor?

A

Greater tuberosity of humerus

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23
Q

What is the innervation of the teres minor?

A

Axillary nerve (C5/6)

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24
Q

What is the function of the teres minor?

A

External rotation of the arm

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25
Q

What is the origin of the subscapularis?

A

Anterior surface of the scapula

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26
Q

What is the insertion of the subscapularis?

A

Lesser tuberosity of humerus

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27
Q

What is the innervation of the subscapularis?

A

Upper and lower subscapular nerve (C5/6)

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28
Q

What is the fuction of the subscapularis?

A

Internal rotation of arm

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29
Q

What pathologies can occur with the rotator cuff muscles?

A

Tears

Impingement

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30
Q

What is the gold standard investigation for rotator cuff pathologies?

A

USS

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31
Q

What is the origin of the deltoid?

A

Clavicle
Acromion
Spine of scapula

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32
Q

What is the insertion of the deltoid?

A

Deltoid tuberosity on lateral aspect of humerus

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33
Q

What is the innervation of the deltoid?

A

Axillary nerve (C5/6)

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34
Q

What is the function of the deltoid?

A

Abduction of arm

35
Q

How can the motor function of the deltoid be tested?

A

Make an arc

36
Q

What is the origin of the biceps brachii?

A

Short head: coracoid process

Long head: labrum/ glenoid

37
Q

What is the insertion of the biceps brachii?

A

Tuberosity of radius

38
Q

What is the innervation of the biceps brachii?

A

Musculocutaneous nerve (C5/6)

39
Q

What is the function of the biceps brachii?

A

Main function: supination

Secondary function: flexion (chief flexor of elbow is brachialis)

40
Q

What pathology can occur with the biceps brachii?

A

Tendonitis at insertion point

41
Q

What is a SLAP tear?

A

Tear of labrum where biceps tendon anchors to the labrum

42
Q

What is a bankart tear?

A

A tear in the inferior, anterior labrum

43
Q

What is the extensor mechanism of the elbow?

A

Triceps muscle and tendon that inserts onto the olecranon

44
Q

In what age group are supracondylar fractures common?

A

Children

45
Q

What are the main ligaments in the elbow?

A

Medial collateral
Lateral collateral
Annular ligaments wraps around the radial head

46
Q

What is the common insertion of the extensor muscles of the forearm?

A

Lateral epicondyle

47
Q

What is the common insertion of the flexor muscles of the forearm?

A

Medial epicondyle

48
Q

What occurs with the radius when the arm is in pronation?

A

Radial head rotates against the capitellum of the distal humerus - it crosses the ulna

49
Q

What side of the arm is the radius?

A

Thumb side - will articulate with the lunate and scaphoid

50
Q

What side of the arm is the ulna?

A

Pinky side - will articulate with the pisiform/ triquetrum

51
Q

What is a colles fracture?

A

Distal radial fracture - extraarticular fracture which is dorsally displaces

52
Q

What areas of bone are susceptible to AVN?

A

Those with a retrograde blood supply - femoral head, talus and scaphoid

53
Q

How can you feel the anatomical snuffbox?

A

Ulnar deviation of hand

54
Q

What ligaments form the anatomical snuffbox?

A

Tendons of extensor pollicus longus and abductor pollicus longus

55
Q

What are the thenar muscles of the hand?

A

Opponens pollicus, flexor pollicis brevis, abductor pollicis brevis

56
Q

What innervates the thenar muscles?

A

Recurrent medial nerve

57
Q

What are the hypothenar muscles of the hand?

A

Abductor digiti minimi

Flexor digiti minimi brevis

58
Q

What innervates the hypothenar muscles?

A

Ulnar nerve

59
Q

What is the function of the interossei muscles?

A

Move fingers, flex MCPJs and IPJs

60
Q

What innervates the interossei muscles?

A

Ulnar nerve

61
Q

What is the function of the dorsal interossei’s?

A

DAB - abduct at MCPJs

62
Q

What is the function of the palmar interossei’s?

A

PAD - adduct at MCPJs

63
Q

What is the function of the lumbrical muscles?

A

Link extensor and flexor tendons

64
Q

What is the innervation of the lumbricals?

A

Lateral: median nerve
Medial: ulnar nerve

65
Q

What is the function of the FDS?

A

Flexes fingers at PIPJs

66
Q

What innervates the FDS?

A

Median nerve (C7/8 T1)

67
Q

What is the function of the FDP?

A

Flexes fingers at the DIPJs

68
Q

What is the innervation of the FDP?

A

Median nerve laterally

Ulnar nerve medially

69
Q

What are the A2 and A4 ligaments needed for?

A

Critical to prevent bowstringing - most important

70
Q

What are the A1, A3 and A5 ligaments needed for?

A

Overlie the MP, PIP and DIP joints

71
Q

What pathology is A1 trigger involved in?

A

Trigger finger

72
Q

What is the function of the cruciate pulleys?

A

Funcion to prevent sheath collapse and expansion during digitial motion - 3 total at the level of the joints

73
Q

What is the palmar fascia?

A

Separates the palmar muscle bellies and flexor tendons from the skin

74
Q

What pathology can occur with the palmar fascia?

A

Hypertrophy and fibrosis

Metaplasia in palmar fascia turns it into fibroblasts in dupuytren’s disease

75
Q

What are the 3 peripheral nerves of the hand?

A

Median
Ulnar
Radial

76
Q

What muscles does the median nerve supply?

A 
Flexors of forearm 
LOAF muscles (lumbircals, opponens pollicus, abductor pollicus brevis and flexor pollicus brevis)
77
Q

What is the cutaneous sensation of the median nerve?

A

Radial 3 1/2 digits

Test: tip of index finger and base of thenar muscles

78
Q

What muscles does the unlar nerve supply in the hand?

A

Small intrinsics of hand except LOAF

Test: abductor digiti minimi

79
Q

What is the cutaneous sensation of the ulnar nerve?

A

Ulnar 1 1/2 digits

Test: dorsum and volar aspects of little finger

80
Q

What muscles does the radial nerve supply?

A

Extensors of forearm

Test: extensor digitorum communis and extensor indicis

81
Q

What is the cutaneous sensation fo the radial nerve?

A

Variable portion of the dorsum of the hand

Test: dorsum of 1st webspace

82
Q

What pathological sign will be seen with a radial nerve problem?

A

Wrist drop

83
Q

Where does the ulnar nerve run in the cubital tunnel?

A

Passes posterior to the medial epicondyle

Enters an arch formed by the two heads of the flexor carpi ulnaris muscles, and underneath the arcuate ligament

84
Q

What are the boundaries of the carpal tunnel?

A

Carpal bones which form the dorsal, medial and alteral constraints
Flexor retinaculum carpal ligament

MSK (34 decks)

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