ANAT 315 > Upper Limbs > Flashcards

Upper Limbs Flashcards

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1
Q

What is the classification and movement of the acromioclavicular joint?

A

Classification: synovial plane/gliding

Movement: not a lot of movement (due to strong ligaments) but some rotation of the acromion about the lateral end of the clavicle

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2
Q

What is the classification and movement of the sternoclavicular joint?

A

Classification: synovial saddle (biaxial)

Movement: protraction-retraction, and elevation-depression of the clavicle (+ minimal rotation)

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3
Q

What is the function of the scapulothoracic ‘joint’?

A

Allows scapular protraction/retraction, elevation/depression and upward/downward rotation

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4
Q

Most motion at the scapulothoracic ‘joint’ is actually produced via the ________ and less so at the _______ joint

A

Sternoclavicular

Acromioclavicular

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5
Q

What is the function and motor innervation of the subclavius muscle?

A

Function: depresses clavicle, stabilizes sternoclavicular joint

Innervation: subclavian nerve (C5-C6)

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6
Q

What is the function and motor innervation of pectoralis minor?

A

Function: depresses, protracts and rotates scapula inferiorly

Innervation: medial pectoral nerve (C8-T1)

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7
Q

What is the function and motor innervation of serratus anterior?

A

Function: primary protractor of scapula, holds scapula against thoracic wall; assists upward rotation with trapezius

Innervation: long thoracic nerve (C5-C7)

Note: long thoracic nerve is vulnerable to injury

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8
Q

What muscle is known as the ‘’boxer’s muscle’’?

A

Serratus anterior

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9
Q

Weakness or paralysis of serratus anterior leads to weakness in scapular _____ (movement)

A

Protraction

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10
Q

What percentage of all fractures (namely elderly/osteoporotic patients) are proximal humerus fractures?

A

4-5%

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11
Q

Fractures at the proximal humerus are accompanied by injuries of the blood vessels that supply _____ (part of humerus) with an associated risk of ____ due to disrupted blood supply to the bone.

A

Humeral head

Avascular necrosis

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12
Q

What is the type and motion of the glenohumeral joint?

A

Type: multiaxial - ball and socket joint (moves in 3 planes)

Motion: allows combined movements (e.g., circumduction + flexion/extension, abduction/adduction and lateral/medial rotation)

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13
Q

What are the passive and active stabilizers of the glenohumeral joint?

A

Passive: glenoid labrum, coracohumeral ligament (CH) and glenohumeral ligaments (GH, 3 bands = superior, middle and inferior)

Active: rotator cuff muscles (Supraspinatus, infraspinatus, teres minor and subscapularis)

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14
Q

Motor innervation and function of supraspinatus?

A

Innervation: suprascapular nerve (C5-C6)

Function: abduction (esp. early)

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15
Q

Motor innervation and function of teres minor?

A

Innervation: axillary nerve (C5-C6)

Function: adduction (weak)

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16
Q

Motor innervation and function of infraspinatus?

A

Innervation: suprascapular nerve (C5-C6)

Function: lateral rotation

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17
Q

Motor innervation and function for subscapularis?

A

Innervation: superior and inferior subscapular nerves (both C5-C6)

Function: medial rotation and adduction (weak)

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18
Q

Glenohumeral joint contributes to approximately __ degrees of shoulder abduction.

The scapulothoracic joint (and movement from the sternoclavicular joint) contributes to around __ degrees

A

120

60

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19
Q

Motor innervation and function for deltoid?

A

Innervation: axillary nerve (C5-C6)

Function: flexion, abduction and extension

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20
Q

Motor innervation and function of teres major?

A

Innervation: lower subscapular nerve (C5-C6)

Function: adduction, medial rotation + extension (when shoulder is flexed)

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21
Q

Motor innervation and function of coracobrachialis?

A

Innervation: musculocutaneous nerve (C5-C7)

Function: flexion, adduction + medial rotation (weak)

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22
Q

What is the motor innervation and function of the pectoralis major?

A

Innervation: medial (C8-T1) and lateral (C5-C7) pectoral nerves

Function: adduction and medial rotation

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23
Q

What composes the superior (apex) border of the axilla?

A

Clavicle, superior scapula and first rib (root of neck)

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24
Q

What composes the inferior border of the axilla

A

Axillary skin, fascia of pectoralis major, teres major, and latissimus dorsi

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25
What composes the **anterior** wall of the axilla?
Pectoralis major & minor
26
What composes the **posterior** wall of the axilla?
Subscapularis muscle, teres major & latissimus dorsi
27
What composes the **medial** wall of the axilla?
Serratus anterior
28
What composes the **lateral** wall of the axilla?
Humerus (intertubercular groove)
29
What does the axillary fascial sheath contain?
Axillary artery, vein and brachial plexus
30
When does axillary artery become brachial artery?
After passing beyond the inferior border of **teres major**
31
What is/are the **branch(es)** of the **first part** of the axillary artery? What **muscle(s)** does it supply or branches it has?
Superior thoracic artery -pecs -subclavius -serratus anterior
32
What is/are the **branch(es)** of the **second part** of the axillary artery? What **muscle(s)** does it supply or branches it has?
1) Thoracoacromial trunk -clavicular -acromial -deltoid -pectoral (Name of **branches** not muscle) 2) lateral thoracic artery -serratus anterior
33
What is/are the **branch(es)** of the **third part** of the axillary artery? What **muscle(s)** does it supply or branches it has?
1) subscapular artery (largest branch of axillary artery) - circumflex scapular artery -thoracodorsal artery 2) Anterior humeral circumflex arteries 3) Posterior humeral circumflex arteries
34
What are the 3 scapular **anastomoses**?
1. Suprascapular & circumflex scapular 2. Dorsal scapular & circumflex scapular 3. Dorsal scapular & thoracodorsal
35
What is the humeral arterial **anastomosis**?
A/P circumflex humeral arteries
36
Paired deep brachial veins join basilic vein to form the ______
Axillary vein
37
What are the axillary lymph nodes?
Humeral, subscapular, pectoral, central and apical
38
What is the venous angle? (Drainage of axillary lymph nodes)
Convergence of the internal jugular vein & subclavian vein
39
What are the 2 supraclavicular branches from the roots?
1) long thoracic nerve (roots C5-C7) —> innervates serratus anterior 2) Dorsal scapular nerve (Root C5) —> innervated levator scapular w/ C3/C4 and rhomboids
40
What are the supraclavicular branches from **superior trunk**?
Suprascapular nerve (*C4), C5-C6) —> innervates supraspinatus and infraspinatus (C4 is outside of brachial plexus) Nerve to subclavius (C5-C6) —> innervates subclavius
41
Suprascapular nerve and artery travel together but _____ goes under the transverse scapular ligament and _____ goes over the ligament
Nerve Artery
42
What are the infraclavicular branches from **cords** (for medial and lateral)?
Lateral pectoral nerve (C5-C7) —> pectoralis major (clavicular part) Medial pectoral nerve (C8-T1) —> pectoralis minor and pectoralis major (sternocostal part) Note: lateral pectoral nerve comes from lateral cord and medial from medial cord
43
What are the infraclavicular branches coming from the **posterior cord**?
Thoracodorsal nerve (C6–C8) —> latissimus dorsi Superior subscapular nerve (C5-C6) —> subscapularis Inferior subscapular nerve (C5-C6) —> subscapularis and teres major
44
Musculocutaneous nerve (C5-C7) leads to..
Motor to anterior compartment of arm Sensory to lateral anterior forearm
45
Median nerve (C6-T1) leads to…
Motor and sensory to **lateral** aspect of anterior compartments of forearm and hand (lat. palm area)
46
Ulnar nerve (C8-T1) leads to..
Moto and sensory to **medial** aspects of anterior compartments of forearm and hand (med.palm area)
47
What nerve passes through the quadrangular space and what does it innervate?
Axillary nerve (C5-C6). Motor to deltoid and teres minor muscles. Sensory to inferior deltoid region and shoulder joint
48
What nerve passes through triangular interval and what does it innervate?
Radial nerve (C5-T1) Motor to posterior compartments of arm and forearm Sensory to same, and to dorsum of hand
49
What passes through the quadrangular space?
Axillary nerve and posterior humeral circumflex artery
50
What passes through the triangular interval?
Radial nerve and deep brachial artery
51
What passes through triangular space?
Circumflex scapular artery
52
What are the 2 additional sensory-only nerves that emerge from the *medial* cord?
Medial brachial cutaneous nerve Medial antebrachial cutaneous nerve
53
Median nerve (C6-T1) injury will lead to loss of sensation in… Injury to C6 root….
Palm of hand and lateral digit tips Includes loss of sensation overlapping musculocutaneous n, (C5-C6-C7), median n. (C6-T1 (esp, thumb area), axillary n. (C5-C6) and radial n. (C5-T1)
54
Injury to musculocutaneous nerve (C5-C7)…
Impairs elbow flexion (biceps brachii and brachialis) and to a lesser extent, shoulder flexion (biceps brachii, coracobrachialis)
55
Injury to C5 root leads to…
Impaired elbow flexion, shoulder flexion, shoulder abduction and lateral rotation
56
What type of joint is the elbow joint? What are its articulations?
Synovial — hinge joint Articulations: -humeroradial -humeroulnar -radioulnar
57
Coronoid and radial limit… (Distal humerus fossae)
Flexion
58
Olecranon limits.. (Distal humerus fossae)
Extension
59
What is radial head subluxation? What is its treatment?
Radial head slips out of annular ligament (common in children) Reduction (pop back in)
60
The humerus divides the brachium into which 2 **musculofascial** compartments?
1) anterior = flexion -> musculocutaneous n. (C5-C7) 2) posterior = extension -> radial n. (C5-T1)
61
What is the function and innervation of **biceps brachii**?
Function: elbow flexion, accessory flexor of glenohumeral joint and supination Innervation: musculocutaneous nerve (C5-C7)
62
Bicipital aponeurosis covers/protects contents of the…
Cubital fossa
63
What is the function and innervation of **coracobrachialis**?
Function: glenohumeral flexion, weak adduction and some medial rotation -stabilizes humeral head (resists downward dislocation of head of humerus) Innervation: musculocutaneous nerve (C5-C7)
64
What is the function and motor innervation of **brachialis**?
Function: elbow flexion (works with biceps brachii) Innervation: musculocutaneous nerve (C5-C7)
65
What is the function and innervation of **triceps brachii**?
Function: elbow extension -adduction and extension of glenohumeral head (for long head of triceps only) Motor innervation: radial nerve (C5-T1)
66
What is the function and innervation of **anconeus**?
Function: assists in elbow extension and stabilizes capsule and prevents pinching it during elbow extension Innervation: radial nerve (C5-T1)
67
_____ artery travels with the radial nerve in the radial groove
Deep brachial
68
Which vein is superficial? Basilic vein or brachial?
Basilic
69
…. And …. Join to form axillary vein
Brachial veins and basilic vein
70
What is the function and innervation of **brachioradialis**?
Function: elbow flexor Innervation: radial nerve (C5-T1)
71
What are the contents of the **cubital fossa**?
Tendon (biceps brachii) Artery (brachial) Nerve (median)
72
What is the most fractured bone in the forearm? (Especially for children and young adults)
The distal radius
73
What type of joint is the proximal radioulnar joint?
synovial, pivot
74
What type of joint is middle radioulnar joint?
Solid, fibrous joint, syndesmosis
75
What type of joint is distal radioulnar joint?
Synovial, pivot
76
What is the most commonly fractured carpal bone?
Scaphoid (High risk of avascular necrosis)
77
What is a common mechanism of injury for a **distal radius fracture**? (Common way this injury occurs)
Falling on an outstretched hand (FOOSH)
78
Distal radius fractures are commonly associated with ulnar fractures, either at the _____ (upper/same/lower) level or at the ______ (part of ulna).
Same Ulnar styloid
79
True or false? The ulna rotates around the radius.
False, The radius rotates around the ulna
80
What type of joints are **intercarpal joints**?
Synovial, plane/gliding
81
The wrist joint articulates between the … (3).
Distal radius Triangular fibrocartilage complex (TFCC) Proximal row of carpals
82
The **wrist joint** (radiocarpal joint) is what type of joint?
Synovial, condyloid joint
83
Distal radius with scaphoid and lunate have ___ (direct/indirect/no) articulations. Triangular fibrocartilage complex (TFCC) with triquetrum has ___ (direct/indirect/no) articulation. Pisiform and the wrist joint has ____ (direct/indirect/no) articulation.
Direct Indirect No
84
The wrist moves farther in ___ (radial/ulnar) deviation.
Ulnar
85
The **radial collateral ligament** limits _____ (motion).
Ulnar deviation (adduction)
86
The **ulnar collateral ligament** limits ___ (motion)
Radial deviation (abduction)
87
Why can the wrist move farther in ulnar deviation than radial deviation?
There is a gap between the ulna and carpal bones that is larger than the gap between radius and carpal bones. Therefore, ulna has more space to move.
88
What type of joints is the metacarpophalangeal (MCP) joint?
Condyloid (Allows for abduction/adduction. Flexion/extension)
89
What type of joint is the **carpometacarpal (CMC) joint I**?
Saddle (biaxial) (Allows for abduction/adduction, flexion/extension, opposition)
90
What type of joint is the **interphalangeal (IP)** joint?
Hinge (Allows for flexion/extension)
91
What type of joint is the **carpometacarpal (CMC) joint (II-V)**?
Condyloid (Limited movement)
92
What is **golfer’s elbow**?
Medial epicondylitis (Condition that causes pain where the tendons of forearm muscles attach to bony bump on inside of elbow)
93
Rotation of the radius occurs at the ______ and ______ joints.
Humeroradial Radioulnar
94
The ____ (proximal/middle/distal) radius crosses over the ulna when rotating.
Distal
95
When is the **brachioradialis** muscle **best (strongest)** at **flexing the elbow**?
When forearm is halfway between pronation and supination (Neutral)
96
Is brachioradialis a posterior or anterior forearm muscle?
Posterior (bc of its radial n. Innervation)
97
_____ and ____ (2 muscles) act together on the anterior and posterior aspects of the wrist to produce abduction (radial deviation).
Flexor carpi radialis Extensor carpi radialis (longus and brevis)
98
The superficial radial nerves is ____ (motor/sensory/both)
Sensory only.
99
After traveling through **cubital fossa** with median nerve, the **brachial artery** splits into ____ and ___ arteries, which supply the structures of the forearm before anastomosing in the hand.
Radial Ulnar
100
The **posterior interosseous** artery supplies…
Muscles of the **deep posterior** compartment (forearm)
101
The **radial** artery supplies…
**Antero-** and **postero-lateral** muscles (in forearm)
102
The **ulnar** artery supplies…
**Antero-** and **postero-medial** muscles (forearm)
103
The **anterior interosseous** artery supplies…
**Deep** muscles of **anterior** compartment (forearm)
104
True or false? The radial artery travels anterior to the thumb.
False, it travels posterior to the thumb.
105
Posterior and anterior interosseous arteries both branch off of ______.
Common interosseous artery
106
The anatomical snuff box occurs between which tendons?
Extensor pollicis longus and brevis
107
What are the contents of the **anatomical snuffbox** (radial fossa)?
**Radial artery** (travels deep in snuffbox) **Superficial radial nerve** (travels superficial in snuffbox)
108
Palmar aponeurosis is in the ______ (superficial/deep) layer of palm
Superficial
109
What does the **flexor retinaculum** prevent?
Bowing of the tendons of the digital flexors originating in the forearm
110
The **flexor retinaculum** is a ligamentous band stretching from the ____ and ___ (medial) to the _____ and _____ (lateral), creating the **carpal tunnel**.
Pisiform Hook of hamate Trapezium Scaphoid
111
What are the **contents** of the **carpal tunnel** (10)?
Tendons of **Flexor Digitorum Superficialis** (4x), **Flexor digitorum profundus** (4x) and **Flexor Pollicis Longus (FPL)** (1x). -Median n.
112
What is Carpal Tunnel Syndrome (CTS)?
Chronic pressure on the **median nerve** deep to the flexor retinaculum, resulting in numbness and muscle weakness (intrinsic hand muscles)
113
**Guyon’s (ulnar) canal** is _____ (superficial/deep) to flexor retinaculum.
Superficial
114
The **ulnar canal** is formed by the ______ ligament over the ulnar nerve and artery.
Palmar carpal (Stretching from the flexor carpi ulnaris tendon to the flexor retinaculum)
115
Palmaris longus tendon is ____ (superficial/deep) to flexor retinaculum
Superficial
116
Tendons of digital flexors and extensors are surrounded by ____ sheaths to reduce friction and ____ sheaths to keep tendons from bowing.
Synovial Fibrous
117
The **extensor retinaculum** (in the dorsum of the hand) continuous with the **palmar carpal ligament** _____ (anteriorly/posteriorly/medially/laterally).
Anteriorly
118
**Superficial branch of ulnar nerve** provides sensory to… and motor to…
Palmar medial 1.5 digits Palmar brevis
119
Nerves on the dorsum hand are _____ (sensory/motor) only.
Sensory
120
The three arterial arches (____, _____, and ____) ‘branch out’ to provide blood to the metacarpals and digits, forming extensive anastomoses.
Superficial palmar arch Deep palmar arch Dorsal carpal arch (from radial arteries)
121
**Glenohumeral ligaments** reinforce the joint capsule _____ (where).
Anteriorly/inferiorly
122
**Coracohumeral ligaments** reinforce the joint capsule _____ (where) + stabilizes the long head of biceps brachii.
Superiorly
123
Most posterior intercostal arteries branch directly off the ________, except for the first two, which come from ________.
Thoracic aorta Superior intercostal artery
124
What is the largest branch of the axillary artery?
Subscapular artery
125
What comes off of the subscapular artery?
Circumflex scapular artery Thoracodorsal artery
126
**Cephalic** vein drains into the _____ vein after piercing the ______ fascia.
Axillary Clavipectoral
127
What nerve provides motor innervation to all posterior muscles **except** *anconeus, brachioradialis and extensor carpi radialis B/L*?
Deep branch of radial nerve
ANAT 315
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