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147 Cards in this Set

  • Front
  • Back
5 Basic Segments of Appendicular Skeleton
Pectoral Girdle
Arm (Brachium)
Forearm
Wrist
Hand
The Pectoral Girdle Includes
Clavicle
Scapula
The movement and existence of the clavicle and scapula provide:
1.) position of shoulder join (increases ROM)
2.) stability for arm movement
3.) Attachment sites for muslce that serve to move upper extremity
The Clavicle serves to:
- keep the upper limb away from the thorax (max mobility)
- transmits shock to axial skeleton (dissipates shock)
Where is the pectoral girdle only connected to?
axial skeleton- where the clavicle meets the sternum (specifically the MANUBRIUM)
where the clavicle meets the sternum (specifically the MANUBRIUM) is known as?
STERNOCLAVICULAR JOINT
What does the scapular spine and its acromium process and the coracoid process protect?
GLENOHUMERAL JOINT superiorly and anteriorly
Does the scapula have a direc ligamental or bony connection to the thorax?
NO, but it does have a strong skeletal muscle support
The strong skeletal musle support place protectively around the pectoral girdle are attached to the:
ribs, sternum, and vertebrae
The Long bone of the arm is called the:
HUMERUS
Where does the humeral head of the brachium articulate w/ the scapula
GLENOHUMERAL JOINT
The distal end of the humerus has 3 articulating surfaces, what are they?
Anteriorly: the CAPITULUM, and the TROCHLEA

Posteriorly: OLECRANON PROCESS OF THE ULNA
The capitulum articulates with?
head of the radius
The trochlea articulates with
trochlear notch
The olecranon process of the ulna articulates into
the olecranon fossa
The forearm (antebrachium) includes
2 long bones: the ulna and the radius
In the Ulna,the olecranon process articulates with the
olecranon fossa of the humerus posteriorly
In the Ulna, the coronoid process articulates anteriorly
around the trochlea of the humerus
lateral to the coracoid process is the
radial notch for the radioulnar joint articulation
In the Ulna, distally it is
narrower, rounded head and styloid process, posterior medially
In the Radius, disc-like head articulates in the radial notch of the ulna rotates in
pronation- supination
In the Radius,the head articulates with the
capitulum of the humerus in flexion-extension
In the Radius, the ulnar notch medially
radius moves around and anterior to the ulna in pronation with the head of the ulna, while reversing motion in supination
The wrist is also known as
the carpus
what does the wrist contain
8 carpal bones arranged in 2 rows
what does the scaphoid articulate with
radius to form the only true synovial joint between the forearm and wrist
the carpus is posteriorly
convex
the carpus is anteriorly
concave
what does the hand include?
- metacarpus and the phalanges
what does the metacarpus do?
connects the carpus to the phalange (ie. metacarpo-phalangeal joints)
Numbered 1-5 in anatomical position is
lateral to medial
In the phalanges (digits), each digit has
3 phalanxes except digit 1 (thumb or pollix), which only has 2
What are the characteristics of the Upper Extremity
- fractures
- cutaneous nerves
- superficial veins
- lymphatic drainage
- deep fascia
- pec muscles
- axilla
- brachial plexus
what are most fractures caused by
a fall on a pronated and outstretched arm

they include the clavicle, surgical neck of the humerus radius and the scaphoid bones
Simple fracture
bone does not break through skin
compound or open fracture
bone is exposed to outside
partial fracture
bone is partially broken
complete fracture
bone is split into 2
colles' fracture
fracture at the distal end of the radius
what are the cutaneous nerves?
- cervical plexus
- brachial plexus
what does the cervical plexus consist of
the ventral rami of he upper cervical nerves C1-C5
what does the cervical plexus provide innervation to
shoulder
what does the cevical plexus consist of
the ventral rami of lower cervical nerves and 1st thoracic (C5-C8, T1)
what does the cervical plexus innervate
upper limb
the primary superficial drainage is from the following veins:
cephalic vein
basilic vein
median cubital vein
where does the cephalic vein start
on the supeficial fascia of the lateral border of the wrist and passes antero-laterally up the arm
what does the cephalic vein join after passing between the pectoralis major and deltoid muslce
axillary vein
what does the cephalic vein drain
the superficial portion of the hand and forearm on the radial side and then continues up the lateral side of the arm
where does the basilic vein run
in the superficial fascia on teh medial side of the forearm and distal arm

it actually begins distally as the ulnar vein

it then goes dee to run ontinuously to the axillary vein
the median cubital vein ascends from where?
cephalic vein on teh lateral side
what does the median cubital vein connect with on the medial side
it connects with the basilic vein
what does the median cubital vein allow
communication between basilic and cephalic veins at the anterior elbow (in cubital fossa)
if the median cubital veins is very large, much of the cephalic blood drains into the _____
basilic vein
where is the frequent site for blood draws (venipuncture) and IV (intra-venous) therapy
Median Cubital Vein
Fascia
fibrous CT of varying thickness that covers the muscle and attaches to the skin
Superficial Fascia
secures the skin to underlying structures

it can be thick (and laced w/ adipose tissue as in the abdominal wall)

or thin (back of hand)
Deep Fascia
is an inward extension of the superficial fascia.
what does the deep fascia lack
adiose tissue
what does the deep fascia blend with
epimysium of muscle
what does the deep fascia surround
adjacent muscles, compartmentalizing and binding them into functional groups
what type of fascia is in the brachial fascia
deep fascia that encloses the extremity extending to the humeral epicondlyes and the olecranon of the ulna
the deep fascia in the arm splits int 2 fascial compartments:
anterior flexor
posterior extensor
the deep fascia at the wrist thickens posteriorly in a transverse and called the
extensor retinaculum
the anterior thickening of the deep fascia of the wrist is called
flexor retinaculum
the flexor retinaculum covers the anterior cavity formed by carpus, forming a
"tunnel" (ie. carpal tunnel)
what passes through the carpal tunnel
flexor tendons and the median nerve
what is the deep fascia of the hand known as
palmer fascia
the palmar fascia is continuous with the
retinacula
the central part of the palmer fascia is called the
palmer aponeurosis
approximately how many muscle are there that act on the pectoral girdle and move the shoulder joint
16
4 muscles that move the pectoral girdle and attach to the thoracic wall
pec major
pec minor
subclavius
serratis anterior
what does the pectoralis major attach to
clavicle, sternum, and costal cartilages (ribs 2-6) to the lateral, proximal humerus (greater tubercle)
what is the action of the pectoralis major
flexes
adducts
medially rotates the humerus
draws the scapula anterior and infriorly (via clavicular attachment)
in pectoralis major, the clavicular head can aid the arm in
flexion
in pec major, the sterno-costal head can aid the arm in
extension
what is the pec major innervated by
lateral and medial pectoral nerves
where does the pec minor originate
sternal ends of the 3rd, 4th, and 5th ribs
where does te pec minor insert on
coracoid procss of the scapula
what is the action of the pec minor
depreses the scapula and can elevate the ribs of scapula if it is stabilized
where does the subclavius originate
at the 1st rib and attaches at the subclavian groove of the clavicle.
what is the action of the subclavius
draws the clavicle medially and inferiorly
where does the serratus anterior originate
at the upper 8 or 9 ribs
where does the serratus anterior attach
at the anterior vertebal (medial) border of the scapula
what is the action of the serratus anterior
it protracts the scapula against the thoracic wall

also rotates shoulder medially
with the serratus anterior, if the nerve supply is injured, what will you see
a winged scapula when arms are raised anteriorly.

there will be diminished abduction since th serratus works w/the trapezius to rotate the glenoid fossa superiorly
what type of fascia is in the brachial fascia
deep fascia that encloses the extremity extending to the humeral epicondlyes and the olecranon of the ulna
the deep fascia in the arm splits int 2 fascial compartments:
anterior flexor
posterior extensor
the deep fascia at the wrist thickens posteriorly in a transverse and called the
extensor retinaculum
the anterior thickening of the deep fascia of the wrist is called
flexor retinaculum
the flexor retinaculum covers the anterior cavity formed by carpus, forming a
"tunnel" (ie. carpal tunnel)
what passes through the carpal tunnel
flexor tendons and the median nerve
what is the deep fascia of the hand known as
palmer fascia
the palmar fascia is continuous with the
retinacula
the central part of the palmer fascia is called the
palmer aponeurosis
approximately how many muscle are there that act on the pectoral girdle and move the shoulder joint
16
4 muscles that move the pectoral girdle and attach to the thoracic wall
pec major
pec minor
subclavius
serratis anterior
what does the pectoralis major attach to
clavicle, sternum, and costal cartilages (ribs 2-6) to the lateral, proximal humerus (greater tubercle)
what is the action of the pectoralis major
flexes
adducts
medially rotates the humerus
draws the scapula anterior and infriorly (via clavicular attachment)
in pectoralis major, the clavicular head can aid the arm in
flexion
in pec major, the sterno-costal head can aid the arm in
extension
The Pectoralis minor originates at
sternal ends of 3rd, 4th, and 5th ribs
the pec minor inserts on
coracoid process of the scapula
the action of the pec minor is
depesses the scapula
elevates the ribs if scapula is stabilized
the subclavius originates
at the 1st rib an attaches at the subclavian groove of the clavicle.
the action of the subclavius is
it draws the clavicle medially and inferiorly
the serratus anterior originates
at the upper 8 or 9 ribs
where does the serratus anterior attach
anterior vertebral (medial) border of the scapula
wht is the action of the serratus anterior
protacts the scapula against the thoracic wall

rotates shoulder medially
in the serratus anterior, if nerve supply is injurd,you wll see a
winged scapula when arms are raised anteriorly
there will be diminished abduction since the serratus work with the ___
trapezius to rotate the glenoid fossa superiorly.
where is the axilla found
junction between arm and thorax

pyramid shaped area that varies in shape depending on the position of the arm
what travels in the axilla?
brachial artery and brachial plexus
what is the base of the axilla
armpit
what is the apex of the axilla deep to
the clavicle
what passes thrugh the apex of the axilla
nervs, arteries, lymphatics and vins (VAN + l)
In the Axilla:

Anterior wall =
pectoralis major (and minor)
In the Axilla:

Posterior wall =
scapula, subscapularis and latissimus dorsi
In the Axilla:

lateral wall =
biceps brachii and coracobrachialis
In the Axilla:

medial wall =
rib cage and serratus anterior
In the Axilla:

medial wall =
ribs 1-4
The axillary artery is a contiuation of
the subclavian artery fromthe lateral border of the 1st rib
where does the axillary artery pass through poteriorly
to the pectoralis minor where it becomes the brachial artery
what vein is media to the axillary artery
axillary vein
what is the axillary vein a continuation of
basili (and the cephalic veins drain into it)
what does the axillary vein become
subclavian vein
what is the most common site of metases from cancer of the breast
axillary lymph nodes
in the axillary lymph node, head injuries often lead to
lymphangitis (lateral axillary nodes swell)
In the Brachial Plexus:

which gives rise o most nerves of the uper limb
C5-C8 and T1 spinal nerve
In the neck, the spinal nerve form 3 trunks: what are they
Superior: C5-C6
Middle: C7
Inferior: C8-T1
what does each trunk of the brachial plexus divide into
anterior and posterior divisions behind the clavicle
what does the anterior division of the anterior branch of the spinal nerve trunks supply
anterior flexor parts of the upper extremity
In the Anterior Branch of the Spinal Nerve Trunks:

what does the anterior divisions of superior and middle trunks form
lateral cord (lateral to the axillar artery)
In the Anterior Branch of the Spinal Nerve Trunks:

the anterior division of the inferior turnk continues as the
medial cord (medial to the axillary artery)
In the Posterior Branch of the Spinal Nerve trunks:

the posterior division suppplies the
extensor parts of the upper extemity
In the Posterior Branch of the Spinal Nerve trunks:

what does the posterior division of all threeturnks form?
th posterior cord (cord posterior to the axillary artery)
The Median Nerve:

what gives rise to two roots of the median nerve?
the medial cord and lateral cord
what does the median nerve supply?
primary flexor muscles of the forearm

skin of part of the hand

5 muscles of the hand
The Median Nerve:

the _____ give rise to 2 roots of the median nerve
medial cord
what does the ulnar nerve supply?
2 flexor muscles of the forearm (flexor carpi ulnaris

part of the flexor digitorum profundus)

most small muscles of the hand and the skin on the anterior-medial side of the hand
what gives rise to the musculotcutaneous nerve?
lateral cord
what does the musculocutaneous nerve supply?
coracobrachialis
biceps brachii
brachialis muscles
skin of the lateral forearm (as the lateral antebrachial nerve)
The Axillary and Radial Nerves:

what gives rise to the axillary and radial nerves
posterior cord
what does the axillary nerve supply
deltoid and teres minor,
skin over the anterior/posterior deltoid,
shoulder joint
what is the largest branch of the brachial plexus?
radial nerve
what does the radial nerve supply?
extensor muscles of the upper limb
brachioradialis muscle
skin on posterior arm, forearm and posterior hand
joints of the wrist and hand
this sheath encloses the axillary artery, vein and brachial plexus cords
axillary sheath
what does the axillary sheath enclose?
axillary artery, vein and brachial plexus cords