The Appendicular Skeleton

Front 1

5 Basic Segments of Appendicular Skeleton

Back 1

Pectoral Girdle
Arm (Brachium)
Forearm
Wrist
Hand

Front 2

The Pectoral Girdle Includes

Back 2

Clavicle
Scapula

Front 3

The movement and existence of the clavicle and scapula provide:

Back 3

1.) position of shoulder join (increases ROM)
2.) stability for arm movement
3.) Attachment sites for muslce that serve to move upper extremity

Front 4

The Clavicle serves to:

Back 4

- keep the upper limb away from the thorax (max mobility)
- transmits shock to axial skeleton (dissipates shock)

Front 5

Where is the pectoral girdle only connected to?

Back 5

axial skeleton- where the clavicle meets the sternum (specifically the MANUBRIUM)

Front 6

where the clavicle meets the sternum (specifically the MANUBRIUM) is known as?

Back 6

STERNOCLAVICULAR JOINT

Front 7

What does the scapular spine and its acromium process and the coracoid process protect?

Back 7

GLENOHUMERAL JOINT superiorly and anteriorly

Front 8

Does the scapula have a direc ligamental or bony connection to the thorax?

Back 8

NO, but it does have a strong skeletal muscle support

Front 9

The strong skeletal musle support place protectively around the pectoral girdle are attached to the:

Back 9

ribs, sternum, and vertebrae

Front 10

The Long bone of the arm is called the:

Back 10

HUMERUS

Front 11

Where does the humeral head of the brachium articulate w/ the scapula

Back 11

GLENOHUMERAL JOINT

Front 12

The distal end of the humerus has 3 articulating surfaces, what are they?

Back 12

Anteriorly: the CAPITULUM, and the TROCHLEA

Posteriorly: OLECRANON PROCESS OF THE ULNA

Front 13

The capitulum articulates with?

Back 13

head of the radius

Front 14

The trochlea articulates with

Back 14

trochlear notch

Front 15

The olecranon process of the ulna articulates into

Back 15

the olecranon fossa

Front 16

The forearm (antebrachium) includes

Back 16

2 long bones: the ulna and the radius

Front 17

In the Ulna,the olecranon process articulates with the

Back 17

olecranon fossa of the humerus posteriorly

Front 18

In the Ulna, the coronoid process articulates anteriorly

Back 18

around the trochlea of the humerus

Front 19

lateral to the coracoid process is the

Back 19

radial notch for the radioulnar joint articulation

Front 20

In the Ulna, distally it is

Back 20

narrower, rounded head and styloid process, posterior medially

Front 21

In the Radius, disc-like head articulates in the radial notch of the ulna rotates in

Back 21

pronation- supination

Front 22

In the Radius,the head articulates with the

Back 22

capitulum of the humerus in flexion-extension

Front 23

In the Radius, the ulnar notch medially

Back 23

radius moves around and anterior to the ulna in pronation with the head of the ulna, while reversing motion in supination

Front 24

The wrist is also known as

Back 24

the carpus

Front 25

what does the wrist contain

Back 25

8 carpal bones arranged in 2 rows

Front 26

what does the scaphoid articulate with

Back 26

radius to form the only true synovial joint between the forearm and wrist

Front 27

the carpus is posteriorly

Back 27

convex

Front 28

the carpus is anteriorly

Back 28

concave

Front 29

what does the hand include?

Back 29

- metacarpus and the phalanges

Front 30

what does the metacarpus do?

Back 30

connects the carpus to the phalange (ie. metacarpo-phalangeal joints)

Front 31

Numbered 1-5 in anatomical position is

Back 31

lateral to medial

Front 32

In the phalanges (digits), each digit has

Back 32

3 phalanxes except digit 1 (thumb or pollix), which only has 2

Front 33

What are the characteristics of the Upper Extremity

Back 33

- fractures
- cutaneous nerves
- superficial veins
- lymphatic drainage
- deep fascia
- pec muscles
- axilla
- brachial plexus

Front 34

what are most fractures caused by

Back 34

a fall on a pronated and outstretched arm

they include the clavicle, surgical neck of the humerus radius and the scaphoid bones

Front 35

Simple fracture

Back 35

bone does not break through skin

Front 36

compound or open fracture

Back 36

bone is exposed to outside

Front 37

partial fracture

Back 37

bone is partially broken

Front 38

complete fracture

Back 38

bone is split into 2

Front 39

colles' fracture

Back 39

fracture at the distal end of the radius

Front 40

what are the cutaneous nerves?

Back 40

- cervical plexus
- brachial plexus

Front 41

what does the cervical plexus consist of

Back 41

the ventral rami of he upper cervical nerves C1-C5

Front 42

what does the cervical plexus provide innervation to

Back 42

shoulder

Front 43

what does the cevical plexus consist of

Back 43

the ventral rami of lower cervical nerves and 1st thoracic (C5-C8, T1)

Front 44

what does the cervical plexus innervate

Back 44

upper limb

Front 45

the primary superficial drainage is from the following veins:

Back 45

cephalic vein
basilic vein
median cubital vein

Front 46

where does the cephalic vein start

Back 46

on the supeficial fascia of the lateral border of the wrist and passes antero-laterally up the arm

Front 47

what does the cephalic vein join after passing between the pectoralis major and deltoid muslce

Back 47

axillary vein

Front 48

what does the cephalic vein drain

Back 48

the superficial portion of the hand and forearm on the radial side and then continues up the lateral side of the arm

Front 49

where does the basilic vein run

Back 49

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

Front 50

the median cubital vein ascends from where?

Back 50

cephalic vein on teh lateral side

Front 51

what does the median cubital vein connect with on the medial side

Back 51

it connects with the basilic vein

Front 52

what does the median cubital vein allow

Back 52

communication between basilic and cephalic veins at the anterior elbow (in cubital fossa)

Front 53

if the median cubital veins is very large, much of the cephalic blood drains into the _____

Back 53

basilic vein

Front 54

where is the frequent site for blood draws (venipuncture) and IV (intra-venous) therapy

Back 54

Median Cubital Vein

Front 55

Fascia

Back 55

fibrous CT of varying thickness that covers the muscle and attaches to the skin

Front 56

Superficial Fascia

Back 56

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)

Front 57

Deep Fascia

Back 57

is an inward extension of the superficial fascia.

Front 58

what does the deep fascia lack

Back 58

adiose tissue

Front 59

what does the deep fascia blend with

Back 59

epimysium of muscle

Front 60

what does the deep fascia surround

Back 60

adjacent muscles, compartmentalizing and binding them into functional groups

Front 61

what type of fascia is in the brachial fascia

Back 61

deep fascia that encloses the extremity extending to the humeral epicondlyes and the olecranon of the ulna

Front 62

the deep fascia in the arm splits int 2 fascial compartments:

Back 62

anterior flexor
posterior extensor

Front 63

the deep fascia at the wrist thickens posteriorly in a transverse and called the

Back 63

extensor retinaculum

Front 64

the anterior thickening of the deep fascia of the wrist is called

Back 64

flexor retinaculum

Front 65

the flexor retinaculum covers the anterior cavity formed by carpus, forming a

Back 65

"tunnel" (ie. carpal tunnel)

Front 66

what passes through the carpal tunnel

Back 66

flexor tendons and the median nerve

Front 67

what is the deep fascia of the hand known as

Back 67

palmer fascia

Front 68

the palmar fascia is continuous with the

Back 68

retinacula

Front 69

the central part of the palmer fascia is called the

Back 69

palmer aponeurosis

Front 70

approximately how many muscle are there that act on the pectoral girdle and move the shoulder joint

Back 70

16

Front 71

4 muscles that move the pectoral girdle and attach to the thoracic wall

Back 71

pec major
pec minor
subclavius
serratis anterior

Front 72

what does the pectoralis major attach to

Back 72

clavicle, sternum, and costal cartilages (ribs 2-6) to the lateral, proximal humerus (greater tubercle)

Front 73

what is the action of the pectoralis major

Back 73

flexes
adducts
medially rotates the humerus
draws the scapula anterior and infriorly (via clavicular attachment)

Front 74

in pectoralis major, the clavicular head can aid the arm in

Back 74

flexion

Front 75

in pec major, the sterno-costal head can aid the arm in

Back 75

extension

Front 76

what is the pec major innervated by

Back 76

lateral and medial pectoral nerves

Front 77

where does the pec minor originate

Back 77

sternal ends of the 3rd, 4th, and 5th ribs

Front 78

where does te pec minor insert on

Back 78

coracoid procss of the scapula

Front 79

what is the action of the pec minor

Back 79

depreses the scapula and can elevate the ribs of scapula if it is stabilized

Front 80

where does the subclavius originate

Back 80

at the 1st rib and attaches at the subclavian groove of the clavicle.

Front 81

what is the action of the subclavius

Back 81

draws the clavicle medially and inferiorly

Front 82

where does the serratus anterior originate

Back 82

at the upper 8 or 9 ribs

Front 83

where does the serratus anterior attach

Back 83

at the anterior vertebal (medial) border of the scapula

Front 84

what is the action of the serratus anterior

Back 84

it protracts the scapula against the thoracic wall

also rotates shoulder medially

Front 85

with the serratus anterior, if the nerve supply is injured, what will you see

Back 85

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

Front 86

what type of fascia is in the brachial fascia

Back 86

deep fascia that encloses the extremity extending to the humeral epicondlyes and the olecranon of the ulna

Front 87

the deep fascia in the arm splits int 2 fascial compartments:

Back 87

anterior flexor
posterior extensor

Front 88

the deep fascia at the wrist thickens posteriorly in a transverse and called the

Back 88

extensor retinaculum

Front 89

the anterior thickening of the deep fascia of the wrist is called

Back 89

flexor retinaculum

Front 90

the flexor retinaculum covers the anterior cavity formed by carpus, forming a

Back 90

"tunnel" (ie. carpal tunnel)

Front 91

what passes through the carpal tunnel

Back 91

flexor tendons and the median nerve

Front 92

what is the deep fascia of the hand known as

Back 92

palmer fascia

Front 93

the palmar fascia is continuous with the

Back 93

retinacula

Front 94

the central part of the palmer fascia is called the

Back 94

palmer aponeurosis

Front 95

approximately how many muscle are there that act on the pectoral girdle and move the shoulder joint

Back 95

16

Front 96

4 muscles that move the pectoral girdle and attach to the thoracic wall

Back 96

pec major
pec minor
subclavius
serratis anterior

Front 97

what does the pectoralis major attach to

Back 97

clavicle, sternum, and costal cartilages (ribs 2-6) to the lateral, proximal humerus (greater tubercle)

Front 98

what is the action of the pectoralis major

Back 98

flexes
adducts
medially rotates the humerus
draws the scapula anterior and infriorly (via clavicular attachment)

Front 99

in pectoralis major, the clavicular head can aid the arm in

Back 99

flexion

Front 100

in pec major, the sterno-costal head can aid the arm in

Back 100

extension

Front 101

The Pectoralis minor originates at

Back 101

sternal ends of 3rd, 4th, and 5th ribs

Front 102

the pec minor inserts on

Back 102

coracoid process of the scapula

Front 103

the action of the pec minor is

Back 103

depesses the scapula
elevates the ribs if scapula is stabilized

Front 104

the subclavius originates

Back 104

at the 1st rib an attaches at the subclavian groove of the clavicle.

Front 105

the action of the subclavius is

Back 105

it draws the clavicle medially and inferiorly

Front 106

the serratus anterior originates

Back 106

at the upper 8 or 9 ribs

Front 107

where does the serratus anterior attach

Back 107

anterior vertebral (medial) border of the scapula

Front 108

wht is the action of the serratus anterior

Back 108

protacts the scapula against the thoracic wall

rotates shoulder medially

Front 109

in the serratus anterior, if nerve supply is injurd,you wll see a

Back 109

winged scapula when arms are raised anteriorly

Front 110

there will be diminished abduction since the serratus work with the ___

Back 110

trapezius to rotate the glenoid fossa superiorly.

Front 111

where is the axilla found

Back 111

junction between arm and thorax

pyramid shaped area that varies in shape depending on the position of the arm

Front 112

what travels in the axilla?

Back 112

brachial artery and brachial plexus

Front 113

what is the base of the axilla

Back 113

armpit

Front 114

what is the apex of the axilla deep to

Back 114

the clavicle

Front 115

what passes thrugh the apex of the axilla

Back 115

nervs, arteries, lymphatics and vins (VAN + l)

Front 116

In the Axilla:

Anterior wall =

Back 116

pectoralis major (and minor)

Front 117

In the Axilla:

Posterior wall =

Back 117

scapula, subscapularis and latissimus dorsi

Front 118

In the Axilla:

lateral wall =

Back 118

biceps brachii and coracobrachialis

Front 119

In the Axilla:

medial wall =

Back 119

rib cage and serratus anterior

Front 120

In the Axilla:

medial wall =

Back 120

ribs 1-4

Front 121

The axillary artery is a contiuation of

Back 121

the subclavian artery fromthe lateral border of the 1st rib

Front 122

where does the axillary artery pass through poteriorly

Back 122

to the pectoralis minor where it becomes the brachial artery

Front 123

what vein is media to the axillary artery

Back 123

axillary vein

Front 124

what is the axillary vein a continuation of

Back 124

basili (and the cephalic veins drain into it)

Front 125

what does the axillary vein become

Back 125

subclavian vein

Front 126

what is the most common site of metases from cancer of the breast

Back 126

axillary lymph nodes

Front 127

in the axillary lymph node, head injuries often lead to

Back 127

lymphangitis (lateral axillary nodes swell)

Front 128

In the Brachial Plexus:

which gives rise o most nerves of the uper limb

Back 128

C5-C8 and T1 spinal nerve

Front 129

In the neck, the spinal nerve form 3 trunks: what are they

Back 129

Superior: C5-C6
Middle: C7
Inferior: C8-T1

Front 130

what does each trunk of the brachial plexus divide into

Back 130

anterior and posterior divisions behind the clavicle

Front 131

what does the anterior division of the anterior branch of the spinal nerve trunks supply

Back 131

anterior flexor parts of the upper extremity

Front 132

In the Anterior Branch of the Spinal Nerve Trunks:

what does the anterior divisions of superior and middle trunks form

Back 132

lateral cord (lateral to the axillar artery)

Front 133

In the Anterior Branch of the Spinal Nerve Trunks:

the anterior division of the inferior turnk continues as the

Back 133

medial cord (medial to the axillary artery)

Front 134

In the Posterior Branch of the Spinal Nerve trunks:

the posterior division suppplies the

Back 134

extensor parts of the upper extemity

Front 135

In the Posterior Branch of the Spinal Nerve trunks:

what does the posterior division of all threeturnks form?

Back 135

th posterior cord (cord posterior to the axillary artery)

Front 136

The Median Nerve:

what gives rise to two roots of the median nerve?

Back 136

the medial cord and lateral cord

Front 137

what does the median nerve supply?

Back 137

primary flexor muscles of the forearm

skin of part of the hand

5 muscles of the hand

Front 138

The Median Nerve:

the _____ give rise to 2 roots of the median nerve

Back 138

medial cord

Front 139

what does the ulnar nerve supply?

Back 139

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

Front 140

what gives rise to the musculotcutaneous nerve?

Back 140

lateral cord

Front 141

what does the musculocutaneous nerve supply?

Back 141

coracobrachialis
biceps brachii
brachialis muscles
skin of the lateral forearm (as the lateral antebrachial nerve)

Front 142

The Axillary and Radial Nerves:

what gives rise to the axillary and radial nerves

Back 142

posterior cord

Front 143

what does the axillary nerve supply

Back 143

deltoid and teres minor,
skin over the anterior/posterior deltoid,
shoulder joint

Front 144

what is the largest branch of the brachial plexus?

Back 144

radial nerve

Front 145

what does the radial nerve supply?

Back 145

extensor muscles of the upper limb
brachioradialis muscle
skin on posterior arm, forearm and posterior hand
joints of the wrist and hand

Front 146

this sheath encloses the axillary artery, vein and brachial plexus cords

Back 146

axillary sheath

Front 147

what does the axillary sheath enclose?

Back 147

axillary artery, vein and brachial plexus cords