Upper Limb Forum

Front 1

Sternoclavicular joint

Back 1

-It is a double synovial PLANE (GLIDING) JOINT and united by fibrous capsule
-It is reinforced by anterior and posterior sternoclavicular, intercalvicular and costoclavicular ligaments
-Allows elevation and depression,protraction and retraction, and circumduction of the shoulder

Front 2

Acromioclavicular joint

Back 2

-Is a synovial PLANE joint that allows a gliding movement when scapula rotates and is reinforced by CORACOCLAVICULAR LIGAMENT, which consist of conoid and trapezoid ligaments

Front 3

Glenohumeral joint (shoulder)

Back 3

-Is a synovial BALL-AND-SOCKET joint between glenoid cavity of scapula and head of humerus. Both articular surfaces are covered with hyaline cartilage
-Is surrounded by FIBROUS CAPSULE that is attached superiorly to glenoid cavity and inferiorly to anatomic neck of humerus. The capsule is reinforced by ROTATOR CUFF, GLENOHUMERAL LIGAMENTS and CORACOHUMERAL LIGAMENTS.
-Has a cavity that is deepened by fibrocartilaginous GLENOID LABRUM, communicates with subscapular bursa, allows abduction, adduction, flexion, extension, circumduction and rotation
-Innervated by axillary. lateral pectoral and suprascapular nerves.
-May be subject to inferior or anterior DISLOCATION, which stretches fibrous capsule, avulses glenoid labrum and can injure axillary nerve

Front 4

Elbow joint

Back 4

-Forms a synovial HINGE joint, consists of HUMERORADIAL and HUMEROULNAR joints, allows flexion and extension, innervated by musclulocutaneous, median, radial and ulnar nerves

Front 5

Proximal radioulnar joint

Back 5

- forms a synovial PIVOT joint in which the head of the raius articulates with the radial notch of the ulna and allows PRONATION AND SUPINATION

Front 6

Distal radioulnar joint

Back 6

-Forms a synovial PIVOT joint between head of the ulna and ulnar notch of the radius and allows PRONATION AND SUPINATION

Front 7

Radiocarpal (wrist) joint

Back 7

-Is a synovial CONDYLAR joint formed superiorly by radius and inferiorly by proximal row of carpal bones(mostly scaphoid and lunate), EXCEPT pisiform.
-Allows flexion, extension, abduction, adduction and circumduction

Front 8

Intercarpal joints

Back 8

-Joints between individual carpal bones
-Plane synovial joints

Front 9

Carpometacarpal joints

Back 9

-Form synovial SADDLE joint between carpal bone (trapezium) and first metacarpal bone, allowing flexion, extension, abduction, adduction and circumduction
-Also form PLANE synovial joints between carpal bones and medial four metacarpal bones, allowing simple gliding movement

Front 10

Intermetacarpal joint

Back 10

- articulation between adjacent sides of proximal ends of metacarpals 2-5
- synovial PLANE joint, limited motion

Front 11

Metacarpophalangeal joint

Back 11

-CONDYLOID joint, supported by palmar and two collateral ligaments, allows flexion, extension, abduction and adduction, circumduction

Front 12

Interphalangeal joint

Back 12

-HINGE joint, supported by palmar ligament and two collateral ligaments, allow flexion and extension.

Front 13

Identify rotator cuff muscles, what is their primary function?

Back 13

SItS - subscapularis, supraspinatus, infraspinatus and teres minor
Primary function is to keep head of humerus in the glenoid fossa and stabilizing shoulder joint

Front 14

Describe muscular and fascial borders of axilla

Back 14

MEDIAL WALL - upper ribs and their intercostal muscles and serratus anterior
LATERAL WALL - humerus
POSTERIOR WALL- subscapularis, teres major, latissimus dorsi
ANTERIOR WALL- pectoralis major and minor
BASE- axillary fascia
APEX- interval between clavicle, scapula and first rib

Front 15

Describe contents of axilla

Back 15

axillary vasculaturs, branches of brachial plexus, lymph nodes and areolar tissue

Front 16

Identify structures that pierce costocoracoid membrane

Back 16

-Is a part of clavipectoral fascia that covers deltopectoral triangle and interval between subclavius and pectoralis minor
-Pierced by CEPHALIC VEIN, THORACOACROMIAL ARTERY, LATERAL PECTORAL NERVE

Front 17

Which muscles provide flexion at glenohumeral joint

Back 17

BICEPS
CHORACOBRACHIALIS
DELTOID (anterior part)
PECTORALIS MAJOR (clavicular part)

Front 18

Which muscles provide flexion at elbow joint

Back 18

BRACHIALIS
BICEPS
BRACHIORADIALIS
PRONATOR TERES

Front 19

Which muscles provide flexion at wrist joint

Back 19

FLEXOR CARPI RADIALIS
FLEXOR CARPI ULNARIS
PALMARIS LONGUS
ABDUCTOR POLLICIS LONGUS

Front 20

Which muscles provide flexion at metacarpophalangeal joints of fingers 2-5

Back 20

LUMBRICALS
INTEROSSEI

Front 21

Whats is the primary flexor of proximal interphalangeal joint

Back 21

Flexor digitorum superficialis

Front 22

What is the primary flexor of distal interphalangeal joint

Back 22

Flexor digitorum profundus

Front 23

Name muscles of the anterior compartment of the arm which are supplied by musculocutaneous nerve

Back 23

Biceps brachii
Coracobrachialis
Brachialis

Front 24

Name muscles of the posterior compartment of the arm which are supplied by radial nerve

Back 24

Triceps
Anconeus

Front 25

Name muscles of posterior compartment of forearm which are supplied by radial nerve

Back 25

SUPERFICIAL - brachioradialis, extensor carpi radialis longus, extensor carpi radialis brevis, extensor carpi ulnaris, extensor digitorum, extensor digiti minimi
DEEP - supinator, abductor pollicis longus, extensor pollicis longus, extensor pollicis brevis, extensor indicis

Front 26

Name muscles of anterior compartment of forearm innervated by median nerve

Back 26

SUPERFICIAL - pronator teres, flexor carpi radialis, palmaris longus
MIDDLE - flexor digitorum superficialis
DEEP flexor digitorum profundus, flexor pollicis longus,pronator quadratus

Front 27

Which ONE muscle of the anterior compartment of the forearm innervated by ulnar nerve

Back 27

FLEXOR CARPI ULNARIS

Front 28

Which muscle of the anterior compartment of forearm innervated by both median and ulnar nerve

Back 28

Flexor digitorum profundus

Front 29

Name thenar muscles and their innervation

Back 29

Muscles - abductor pollcis brevis, opponens pollicis and flexor pollicis brevis
ALL innervated by MEDIAN NERVE, except flexor pollicis brevis which is innervated by both MEDIAN AND ULNAR NERVES

Front 30

Which muscle innervates ADDUCTOR POLLICIS muscle

Back 30

Ulnar nerve

Front 31

Name hypothenar muscles and their innervation

Back 31

Abductor digiti minimi, opponens digiti minimi. flexor digiti minimi
ALL innervated by ULNAR NERVE

Front 32

What innervates INTEROSSEI muscles

Back 32

Ulnar nerve

Front 33

What innervates two medial lumbricals

Back 33

ULNAR NERVE

Front 34

What innervates two lateal lumbricals

Back 34

MEDIAN NERVE

Front 35

Describe upper brachial plexus injury

Back 35

Occurs during fall on shoulder or during difficult delivery, causes arm to be medially rotated, and forearm pronated, called waiters tip hand or ERB DUSCHENNE PARALYSIS

Front 36

Describe lower brachial plexus injury

Back 36

Caused during excessive ABduction of the arm or by stab or bullet wounds, causing a CLAW HAND.

Front 37

Describe results of axillary nerve damage

Back 37

Caused by fracture of surgical neck of humerus or inferior dislocation of humerus. It results in weakness of lateral rotation and abduction of arm (supraspinatus can abduct arm but not to horizontal level)

Front 38

Describe results of radial nerve injury

Back 38

Caused by the fracture of the midshaft of the humerus. Results in loss of function in extensors of forearm, hand, metacarpals, and phalanges. It also results in loss of wrist extension, leading to WRIST DROP, and produces weakness in ABduction and ADDuction of the hand

Front 39

Describe results of injury to musculocutaneous nerve

Back 39

Results in weakness of supination - BICEPS and forearm flexion - BRACHIALIS AND BICEPS

Front 40

Describe results of injury to MEDIAN NERVE

Back 40

May be caused by supracondylar fracture of the humerus or compression of carpal tunnel.It results in loss of pronation, opposition of the thumb, flexion of lateral two interphalangeal joints and impairment of medial two interphalangeal joints. It also produces characteristic flattening of thenar compartment called APE HAND

Front 41

Describe results of injury to ULNAR NERVE

Back 41

Caused by fracture of medial epicondyle and results in CLAW HAND, in which ring and little fingers are hyperextended at metacarpophlangeal joints and flexed in interphalangeal joints.It results in loss of abduction and adduction of fingers and flexion of MP joints, because of paralysis of paralysis of palmar and dorsal interossei's and medial two lumbricals.It also produces a wasted hypothenar eminence and palm and also leads to loss of adduction of thumb because of paralysis of ADDUCTOR POLLICIS

Front 42

Describe borders of cubital fossa and name important structures inside

Back 42

-Is a v shaped interval on anterior side of elbow that is bounded laterally by BRACHIORADIALIS and medially by PRONATOR TERES.
-Has an upper limit that is an imaginary line connecting epicondyles with a floor formed by brachialis and supinator musles
-Has a lower end where brachial artery divides into radial and ulnar with a fascial roof strengthened by bicipital aponeurosis
-Contains from lateral to medial - RADIAL NERVE, BICEPS TENDON, BRACHIAL ARTERY and MEDIAN NERVE
# RON BEATS BAD MEN

Front 43

Name two branches of subclavian artery and describe

Back 43

SUPRASCAPULAR- branch of thyrocervical trunk, passes ABOVE superior transverse scapular ligament(nerve goes UNDER ligament), anastomoses with DORSAL SCAPULAR and CIRCUMFLEX SCAPULAR to form collateral circulation around scapula, supplies supraspinatus, infraspinatus and shoulder and AC joints.
DORSAL SCAPULAR- accompanies dorsal scapular nerve, supplies levator scapulae, major and minor rhomboids, serratus anterior

Front 44

Describe axillary artery

Back 44

Central structure of AXILLA
from the outer border of first rib to inferior border of teres major where it becomes BRACHIAL ARTERY, bordered on medial side by axillary vein, divided into three parts by pectoralis minor

Front 45

Supreme thoracic artery

Back 45

supplies intercostal muscles

Front 46

Thoracoacromial artery - name branches, what does it go through?

Back 46

Short trunk from first or second part of axillary artery, has PECTORAL, CLAVICULAR, DELTOID and ACROMIAL branches.
-Pierces costocoracoid membrane (clavipectoral fascia)

Front 47

Lateral thoracic artery- where does it run, what does it supply

Back 47

-Runs along lateral border of pectoralis minor
-Supplies pectoralis major, pectoralis minor, serratus anterior and axillary lymph nodes

Front 48

Subscapular artery-divides into two - what are they? what do they supply?

Back 48

Largest branch of axillary artery, arises as lower border of subscapularis and descends along axillary border of scapula. Divides into thoracodorsal and circumflex scapular
THORACODORSAL- runs with thoracodorsal nerve, supplies lat dorsi amd lateral thoracic wall
CIRCUMFLEX SCAPULAR - passes in triangular space(teres minor, teres major, long head of triceps), anastomoses with dorsal scapular and suprascapular

Front 49

Which arteries form scapula anastomosis?

Back 49

Dorsal scapular, subscapular, and suprascapular

Front 50

Anterior humeral circumflex

Back 50

Pass anteriorly around surgical neck of humerus
anastomoses with posterior circumflex humeral

Front 51

Posterior humeral circumflex

Back 51

Runs with axillary nerve through quadrangular space (teres minor, teres major, triceps, humerus)

Front 52

Describe brachial artery and name branches

Back 52

Extends from inferior part of teres major to bifurcation in cubital fossa.
Lies on triceps, then on brachialis muscles medial to coracobrachialis and biceps and accompanied by basilic vein in the middle of the arm
Lies in the center of the arm medial to biceps, lateral to median nerve, deep to bicipital aponeurosis. Place for putting stethoscope for BP measurement. Terminated at cubital fossa when bifurcates into radial and ulnar
Branches - profunda, superior ulnar collateral, inferior
ulnar collateral

Front 53

Describe radial artery and name branches

Back 53

Descends from cubital fossa under brachioradialis with superficial radial nerve on the lateral side, on supinator and flexor pollicis longus.
Runs through anatomic snuffbox, divides into PRINCEPS POLLICIS AND DEEP PALMAR ARCH
Branches - radial recurrent (between brachioradialis and brachialis), palmar carpal, superficial palmar, dorsal carpal, princeps pollicis(two proper digital arteris for the thumb), radialis indicis and deep palmar arch

Front 54

Describe ulnar arteries and name branches

Back 54

LARGER MEDIAL BRANCH of the brachial artery in cubital fossa, lies between flexor digitorum superficialis and profundus
Contributes to superficial palmar arch, gives rise to three common palmar digital arteries each of which bifurcates into proper palmar digital arteries which run distally to supply adjacent sides of fingers

Front 55

What does carpal tunnel contain

Back 55

1.MEDIAN NERVE
2.FLEXOR POLLICIS LONGUS
3.FLEXOR DIGITORUM PROFUNDUS
4.FLEXOR DIGITORUM SUPERFICIALIS

Front 56

Describe lymphatic drainage of upper limb

Back 56

Lymph vessels from radial side of hand drain into axillary nodes, whereas some lymph nodes from ulnar side can drain into cubital and then into axillary nodes
Breast drains primarily into AXILLARY nodes (75%), more specifically to pectoral nodes. Also drains to apical nodes, opposite breast, abd wall.

Front 57

Distal muscles are innervated by..

Back 57

antomically LOWER spinal cord segments

Front 58

Which nerve provides cutaneous innervation to skin overlying acromion

Back 58

Branches of nerves from cervical plexus

Front 59

Metastases from medial quadrants of breast are difficult to ascertain because drainage of this areas pass to which nodes?

Back 59

Parasternal

Front 60

Which artery accompanies radial nerve as it courses posterior to humerus

Back 60

Deep brachial

Front 61

Describe generally brachial plexus

Back 61

-Formed by VENTRAL RAMI of C5-T1
-Enclosed with axillary artery and vein in AXILLARY SHEATH which is formed by prolongation of prevertebral fascia

Front 62

Injury of which nerve would complete abolish ability to pronate hand

Back 62

Median

Front 63

What are cord levels for ulnar nerve

Back 63

C7-T1

Front 64

Where does ulnar nerve course

Back 64

Arises from medial cord of brachial plexus, runs down medial aspect of arm, descends between FLEXOR CARPI ULNARIS and FLEXOR DIGITORUM PROFUNDUS
Enters hand superficial to FLEXOR RETINACULUM and lateral to PISIFORM BONE

Front 65

What muscle is the major flexor of forearm

Back 65

BRACHIALIS

Front 66

Radial nerve is a branch of ..

Back 66

Posterior cord of brachial plexus

Front 67

Where does the radial nerve course?

Back 67

on the back of the humerus;

Front 68

Which muscle is injured when you try to catch something heavy?

Back 68

Supraspinatus

Front 69

Flexibility of the hand is gained by the presense of?

Back 69

Presense of mid carpal joint

Front 70

Which joint characteristic is responsible for unique range of motion of thumb

Back 70

saddle joint between trapezium and 1st metacarpal