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149 Cards in this Set
- Front
- Back
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What are the two ends of the clavicle, and what do they articulate with? |
* Sternal end, articulates with sternum, to form the steroclavicular joint.
* Acromial end, articulates with acromion process of the scapula, to form the acromioclavicular joint. |
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Does the clavicle undergo intermembranous ossification, or endochondral ossification?
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Intermembranous ossification. It is the first bone to start to ossify in the body.
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Anterior scapula
Name the four unlabeled parts, and the part that has been scratched out. |
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Posterior scapula.
Name the 3 unlabeled parts, and the part that has been scratched out. |
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What is transmitted through the suprascapular foramen?
What lies above the suprascapular ligament? |
* Suprascapular nerve
* Suprascapular vessels |
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What is the area between the greater and lesser tubercles on the proximal head of the humerus called? (Note: it has two names)
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Intertubercular sulcus, or bicipital groove.
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What are the two necks of the humerus?
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* Anatomical neck - separates head from the rest of the upper end.
* Surgical neck. |
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What is the course of the cephalic vein?
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Begins at lateral end of the dorsal venous arch, runs upwards within superficial fascia, and pierces the deep fascia. Drains into axillary vein in the deltopectoral groove.
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What is the course of the basilic vein?
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Medial end of the dorsal venous arch, runs upwards in the superficial fascia. In the middle of the arm, it pierces the deep fascia, and at the lower border of teres major it becomes the axillary vein.
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What is the course of the median cubital vein?
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It shunts blood from cephalic to basilic vein, in the superficial fascia of the cubital fossa.
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What are the 4 boundaries of the axillary space?
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* Anterior wall - pectoral region
* Posterior wall - scapular region * Medial wall - upper 4 ribs and upper part of serratus anterior muscle * Lateral wall - intertubercular sulcus of the humerus |
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What are the contents of the axilla?
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1. Axillary artery + branches
2. Axillary vein + tributaries 3. Infraclavicular part of brachial plexus 4. Lymph nodes 5. Long thoracic nerve |
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What is the innervation and function of the pectoralis major muscle?
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* Lateral and medial pectoral nerves.
* Flexion, adduction, and medial rotation of arm. |
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What is the innervation and function of the pectoralis minor muscle?
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* Medial pectoral nerve.
* Pulls tip of shoulder down * Protracts scapula. |
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What is the innervation and function of the serratus anterior muscle?
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* Long thoracic nerve
* Protraction and rotation of scapula * Keeps medial border and inferior angle of scapula opposed to thoracic wall. |
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What happens if the long thoracic nerve is injured?
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Paralysis of the serratus anterior muscle, causing a winged scapula. The inferior angle of the medial border of the scapula is excessively prominent. The patient can't do pushing actions, and can't raise his/her arm above head.
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What is the course of the axillary artery?
What are the three parts of the axillary artery? |
* Continuation of subclavian artery.
* At lateral border of the first rib, it becomes the axillary artery. * At the lower border of teres major, it becomes the brachial artery. 1. First part is above pectoralis minor, and has 1 branch - superior thoracic artery. 2. Second part is behind pectoralis minor, and has 2 branches - thoracoacromial and lateral thoracic arteries. 3. Third part is below pectoralis minor, and has 3 branches - subscapular artery, anterior and posterior circumflex humeral arteries. |
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What do the anterior and posterior circumflex humeral arteries supply?
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They form an arterial circle around surgical neck of humerus, and supply the head of the humerus and shoulder joint.
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What is the large branch of the subscapular artery (which is a branch of the 3rd part of the axillary artery)?
What does it anastomose with? |
* Circumflex scapular artery.
* Anastomoses with the suprascapular artery in the infraspinatous fossa. |
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What is the origin of the suprascapular artery?
Which muscles does it supply? |
* Branch of thyrocervical trunk, which is a branch of the subclavian artery.
* Supplies muscles attached on the posterior aspect of the scapula. |
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What is the course of the axillary vein?
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* Continuation of the basilic vein.
* At lateral border of the first rib, it becomes the subclavian vein. * It receives the cephalic vein in its upper part. |
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Which rami form the brachial plexus?
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Ventral rami of C5-T1
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What is the structure of the brachial plexus?
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Roots -> trunks -> divisions -> cords -> terminal nerves
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Draw the brachial plexus, and all nerve branches.
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Brachial plexus
1. Median nerve 2. Musculocutaneous nerve 3. Ulnar nerve 4. Lacteral pectoral nerve 5. Medial pectoral nerve 6. Radial nerve 7. Axillary nerve 8. Lower subscapular nerve 9. Upper subscapular nerve 10. Thoracodorsal nerve 11. Suprascapular nerve 12. Long thoracic nerve |
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What muscles does the axillary nerve supply?
What space does it pass through? |
* Innervates the deltoid and teres minor muscle.
* Passes through quadrangular space. |
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Which part of the brachial plexus does the thoracodorsal nerve branch off of?
What muscle does it innervate? |
* Posterior cord of the brachial plexus.
* Innervates the latissimus dorsi. |
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What do the upper and lower subscapular nerves innervate?
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* They both supply the subscapularis muscle.
* Lower subscapular nerve also innervates the teres major. |
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What part of the brachial plexus does the suprascapular nerve branch off of?
What is the course of the nerve? Which muscles does it innervate? |
* Branches off the upper trunk of the brachial plexus.
* Passes through suprascapular foramen, and enters the supraspinous fossa, then the infraspinous fossa. * Innervates the supraspinatus and infraspinatus muscles. |
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What are the dermatomes of the upper limb?
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What causes Erb's palsy?
What is the consequence? |
Injury to superior part of brachial plexus (C5,6) caused by excessive angle between neck and shoulder.
* Limbs hang by side in medial rotation. |
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What causes Klumpke's palsy?
What is the consequence? |
* Happens when the limb is suddenly pulled superiorly.
* Injures the inferior trunk of the plexus (C8, T1). * Short muscles of hand affected, resulting in clawhand. |
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What are two ligaments related to the clavicle, in the shoulder area?
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Acromioclavicular ligament
Coracoclavicular ligament |
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What runs in the spiral groove of the humerus?
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* Radial nerve
* Profunda brachii artery |
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What are the four unlabeled structures on the anterior side of the distal humerus?
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* Coronoid fossa
* Radial fossa * Capitulum * Trochlea |
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What direction does shoulder dislocation commonly occur in?
What important "thing" is at risk of injury if dislocation occurs? |
The genlohumoral joint capsule is least supported inferiorly where dislocation commonly occurs. This may damage the axillary nerve.
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What ligaments surround the glenohumeral joint?
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* Superior, middle, and inferior glenohumeral ligaments
* Coracohumeral ligament |
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What are two important bursae in the shoulder?
Which structures does each reduce friction between? |
* Subacromial bursa - between acromion process and tendon of supraspinatus muscle.
* Subdeltoid bursa - between deltoid muscle, and tendon of infraspinatus muscle. |
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What are the four unlabeled structures on the posterior distal humerus?
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* Medial epicondyle
* Trochlea * Lateral epicondyle * Olecranon fossa |
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Name the three unlabeled parts of the proximal radius.
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* Head
* Neck * Radial tuberosity |
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What are the five unlabeled parts of the proximal ulna?
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* Radial notch
* Trochlear notch * Coronoid process * Ulnar tuberosity * Olecranon |
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Name the 3 ligaments of the elbow joint.
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* Ulnar collateral ligament.
* Radial collateral ligement. * Anular ligament - surrounds the head of the radius, anchoring it to the ulna. |
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Anterior arm compartment:
Name the muscles of the anterior arm compartment, the main artery that supplies the compartment, and the nerve that innervates the muscles. |
* Biceps brachii
* Brachialis * Coracobrachialis * Supplied by the brachial artery. * Innervated by the musculocutaneous nerve. |
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Posterior arm compartment:
Name the muscles of the posterior arm compartment, the main artery that supplies the compartment, and the nerve that innervates the muscles. |
* Triceps brachii
* Anconeus * Supplied by the profunda brachii artery. * Innervated by the radial nerve. |
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Name the muscles that comprise the rotator cuff.
Which one does abduction of the arm? |
* Supraspinatus - does abduction of the arm to 15 degrees at shoulder joint.
* Infraspinatus * Teres minor * Subscapular |
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What is the innervation and function of supraspinatus muscle?
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* Suprascapular nerve
* Abduction of arm to 15 degrees at shoulder joint |
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What is the innervation and function of infraspinatus muscle?
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* Suprascapular nerve
* Lateral rotation of arm |
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What is the innervation and function of teres minor muscle?
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* Axillary nerve
* Lateral rotation of arm |
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What is the innervation and function of subscapularis muscle?
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* Subscapular nerve
* Medial rotation of arm |
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What is the innervation and function of teres major muscle?
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* Subscapular nerve
* Medial rotation, and extension of arm |
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What is the innervation and function of deltoid muscle?
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* Axillary nerve
* Main abductor of the arm |
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What are the boundaries of the triangular space?
What passes through it? |
Lateral - long head of triceps brachii
Superior - teres minor Inferior - teres major Contents are the circumflex scapular vessels. |
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What are the boundaries of the triangular interval?
What passes through it? |
Medial - long head of triceps brachii.
Lateral - shaft of humerus Superior - teres major Contents are radial nerve, and profunda brachii artery. |
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What is the innervation and function of coracobrachialis muscle?
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* Musculocutaneous nerve
* Flexion of arm |
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What is the innervation and function of brachialis muscle?
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* Musculocutaneous nerve
* Flexion of forearm |
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What is the innervation and function of biceps brachii muscle?
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* Musculocutaneous nerve
* Flexion of forearm, and forearm supination. |
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What is the innervation and function of triceps brachii muscle?
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* Radial nerve
* Extension of forearm |
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What are the boundaries of the cubital fossa?
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Lateral - brachioradialis muscle.
Medial - pronator teres muscle. Superior - imaginary line between the two epicondyles of the humerus. |
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What is the course of the brachial artery?
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At the lower border of teres major, the axillary artery becomes the brachial artery. It runs to the neck of the radius, where it divides into two terminal branches - radial and ulnar arteries.
The largest branch of the brachial artery is the profunda brachii artery, which supplies the back of the arm. |
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What is the course of the radial nerve?
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Branch of the posterior cord of the brachial plexus.
Passes through the triangular interval space, accompanied by the deep brachial artery. Runs along spiral groove of humerus. In lower part of arm, the nerve appears on front part of arm and divides into 2 terminal branches - superficial and deep branches. |
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What is the course of the musculocutaneous nerve?
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Branch of the lateral cord of brachial plexus.
Leaves axilla, and enters front of arm by piercing the coracobrachialis muscle. Runs downwards between biceps and brachialis muscles, and supplies these muscles as well as coracobrachialis. It continues as the lateral cutaneous nerve of the forearm. |
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What nerve is behind the medial epicondyle of the humerus?
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Ulnar nerve.
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What are the most important deep contents of the cubital fossa?
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* Brachial artery
* Median nerve |
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Where is the dorsal tubercle of Lister?
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Posterior surface of distal end of radius.
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Name the 5 unlabeled parts of the radius and ulna.
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What are the thickenings of the forearm fascia called?
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* Extensor retinaculum
* Flexor retinaculum |
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What passes through the carpal tunnel?
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* Median nerve
* Tendons of the finger flexor tendons. |
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Name the 2 structures that are unlabeled.
What is the space in the centre called? |
The space in the centre is called the carpal tunnel.
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What functions do the anterior forearm muscles perform?
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Flexor-pronator
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What functions do the posterior forearm muscles perform?
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Extensor-supinator
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Which epicondyle of the humerus does the common flexor tendon attach to?
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Medial epicondyle of the humerus.
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Which epicondyle of the humerus does the common extensor tendon attach to?
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Lateral epicondyle of the humerus.
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What are the layers of the anterior forearm compartment?
What muscles are in each layer? |
Superficial layer:
* Flexor carpi radialis * Flexor carpi ulnaris * Pronator teres * Palmaris longus Intermediate layer: * Flexor digitorum superficialis Deep layer: * Flexor digitorum profundis * Pronator quadratus * Flexor pollicis longus |
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What is the innervation of the anterior forearm compartment?
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* All innervated by the median nerve, except the following which are innervated by the ulnar nerve:
- Flexor carpi ulnaris. - Medial half of flexor digitorum profundis. Note that the deep group (FDP, PQ, FPL) are innervated by the anterior interosseus nerve, a branch of the median nerve. |
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What is the innervation and function of the pronator teres muscle?
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* Median nerve
* Pronation |
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What is the innervation and function of the flexor carpi radialis muscle?
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* Median nerve
* Flexion of wrist joint |
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What is the innervation and function of the palmaris longus muscle?
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* Median nerve
* Flexion of wrist joint |
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What is the innervation and function of the flexor carpi ulnaris muscle?
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* Ulnar nerve
* Flexion of wrist joint |
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What is the innervation and function of the flexor digitorum superficialis muscle?
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* Median nerve
* Flexion of PIPs * Flexion of MCPs * Flexion of wrist |
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What is the innervation and function of the flexor digitorum profundis muscle?
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* Medial half - ulnar nerve
* Lateral half - anterior interosseous nerve * Flexion of DIPs (primary function) * Flexion of MCPs * Flexion of wrist |
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What is the innervation and function of the flexor pollicis longus muscle?
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* Anterior interosseous nerve
* Flexion of IP joint of thumb |
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What is the innervation and function of the pronator quadratus muscle?
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* Anterior interosseous nerve
* Pronation |
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What is the innervation of the posterior forearm compartment?
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* Radial nerve.
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All of the muscles in the posterior forearm compartment do extension or supination, except for one of them. Name the exception.
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* The brachioradialis muscle does flexion of the elbow joint.
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Name the unlabeled structure.
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Name all of the posterior forearm compartment muscles.
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There are 8 "extensor" muscles:
* Extensor pollicis longus * Extensor pollicis brevis * Extensor carpi radialis longus * Extensor carpi radialis brevis * Extensor digitorum * Extensor carpi ulnaris * Extensor digiti minimi * Extensor indicis There are 4 "other" muscles: * Supinator * Anconeus * Brachioradialis * Abductor pollicis longus |
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What is the innervation and function of the brachioradialis muscle?
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* Radial nerve
* Elbow flexion |
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What is the innervation and function of the extensor carpi radialis longus muscle?
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* Radial nerve
* Wrist extension |
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What is the innervation and function of the extensor carpi radialis brevis muscle?
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* Radial nerve
* Wrist extension |
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What is the innervation and function of the extensor digitorum muscle?
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* Radial nerve
* Extension of four medial fingers |
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What is the innervation and function of the extensor digiti minimi muscle?
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* Radial nerve
* Extension of the little finger |
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What is the innervation and function of the extensor carpi ulnaris muscle?
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* Radial nerve
* Wrist extension |
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What is the innervation and function of the anconeus muscle?
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* Radial nerve
* Elbow extension |
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What is the innervation and function of the supinator mucle?
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* Radial nerve
* Supination |
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What is the innervation and function of the abductor pollicis longus muscle?
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* Radial nerve
* Abduction of thumb |
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What is the innervation and function of the extensor pollicis brevis muscle?
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* Radial nerve
* Thumb extension |
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What is the innervation and function of the extensor pollicis longus muscle?
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* Radial nerve
* Thumb extension |
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What is the innervation and function of the extensor indicis muscle?
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* Radial nerve
* Index finger extension |
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What are the 13 unlabeled structures on the posterior forearm?
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Name the three structures in the deep part of the posterior forearm compartment.
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What forms the extensor hoods on the dorsal aspect of the digits (of the hand)?
What is their purpose? |
* Extensor tendons flatten and form them.
* They extend across two interphalangeal joints, and attach to distal phalanx. * When lumbrical and interossei muscles contract to flex MCP joints, the PIP and DIP joints are pulled into near complete extension. |
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What are the borders of the anatomical snuff box?
What artery passes through it? |
* Laterally: extensor pollicis brevis and abductor pollicis longus.
* Medially: extensor pollicis longus The radial artery passes through the anatomical snuff box, deep to the extensor tendons of the thumb. |
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What is another name for medial epicondylitis?
What actions cause it? |
* Golf elbow
* Repeated forceful flexing of the wrist and fingers cause tiny ruptures of the common flexor origin. * Causes pain along medial epicondyle, made worse by flexing wrist. |
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* What is another name for lateral epicondylitis?
What actions cause it? |
* Tennis elbow
* Common extensor origin (lateral epicondyle) becomes painful and tender * Specific strain, overuse, direct impact. Sometimes no specific cause found. |
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* What is DeQuervain's syndrome caused by?
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* Inflammation of the sheath that surrounds abductor pollicis longus and extensor pollicis brevus.
* Repetitive up and down motion of the thumb. |
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What is the course of the median nerve in the forearm?
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* Leaves cubital fossa with the brachial artery, passes between two heads of pronator teres muscle. Passes through carpal tunnel to enter hand.
* Gives rise to the anterior interosseous nerve, which supplies deep muscles of anterior compartment of forearm. |
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Which peripheral nerve does cutaneous innervation of this area?
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* Median nerve
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Which peripheral nerve does cutaneous innervation of this area?
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* Radial nerve
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Which peripheral nerve does cutaneous innervation of this area?
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* Ulnar nerve
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What is the course of the ulnar nerve in the forearm?
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* Passes posterior to the medial epicondyle of humerus, enters forearm, giving branches to flexor carpi ulnaris and medial half of the flexor digitorum profundus. Runs on medial side of forearm, and wrist, passes superficial to the flexor retinaculum to enter hand.
* Divides into superficial and deep branch after passing superficial to flexor retinaculum. |
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What is the course of the radial nerve in the forearm?
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* Leaves posterior compartment of the arm, crosses anterior to lateral epicondyle of humerus. In cubital region, it divides into deep and superficial branches.
* Deep branch: pierces supinator muscle, and supplies muscles in posterior compartment of the forearm. After piercing supinator muscle, it becomes the posterior interosseus nerve. * Superficial branch: supplies skin on lateral half of the dorsum of hand and digits. |
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What is the course of the ulnar artery in the forearm?
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* It is a terminal branch of the brachial artery.
* Descends through anterior compartment of forearm. Passes distally over anterior aspect of the wrist to the palm and takes part in forming the palmar arterial arches. * In the proximal part of forearm, it gives rise to the common interosseous artery. |
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What are the branches of the common interosseous artery in the forearm?
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* Anterior interosseus artery.
* Posterior interosseous artery (which passes through the interosseuous membrane, and supplies deep part of posterior forearm compartment) |
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What is the course of the radial artery?
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* Supplies lateral side of forearm.
* Distal part of forearm, it passes through anatomical snuffbox, and passes through first interosseous space in the hand. It then enters the palm of hand, and takes part in forming deep palmar arch. |
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Name the proximal row of the carpal bones, from lateral to medial.
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* Scaphoid
* Lunate * Triquetrum * Pisiform |
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Name the distal row of the carpal bones, from lateral to medial.
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* Trapezium
* Trapezoid * Capitate * Hamate |
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How many tendons run through the carpal tunnel? Which muscles do these tendons belong to?
What nerve also runs through the carpal tunnel? |
* 9 tendons.
* 4 from FDS, 4 from FDP, 1 from FPL. * Median nerve also runs through the carpal tunnel. |
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What ligaments reinforce the wrist joint?
Note: there are 5. |
* palmar and dorsal radioulnar
* palmar ulnocarpal * lateral and medial collateral ligaments |
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What ligaments reinforce the MCP joints?
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* palmar, medial and lateral collateral ligaments.
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What ligaments reinforce the IP joints of the hand?
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* palmar and collateral ligaments.
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What is the triangular shaped condensation of fascia on the palmar side of the hand called?
What does it attach to? |
* Palmar aponeurosis.
* Attaches to the palmaris longus muscle. If the palmaris longus not present, then it attaches to the flexor retinaculum. |
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What is Dupuytren's contracture?
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* Flexion contractur of the hand.
* Ring and little fingers are most affected. * Palmar fascia undergoes hyperplasia and contracture. |
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What are the intrinsic muscles of the hand?
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* Thenar, hypothenar, and centra muscles.
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Name the thenar muscles of the hand.
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* Abductor pollicis brevis.
* Flexor pollicis brevis. * Opponens pollicis. |
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Name the hypothenar muscles of the hand.
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* Abductor digiti minimi.
* Flexor digiti minimi brevis. * Opponens digiti minimi. * Palmaris brevis. |
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What muscle's tendons do the lumbricals muscles in the hand originate from?
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* They originate from the FDP tendons.
* Function is flexion of MCP joints, extension of the IP joints. |
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How many interossei muscles are there in the hand?
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* 4 dorsal interossei - abduction
* 4 palmar interossei - adduction |
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What are the central muscles of the hand?
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* Adductor pollicis.
* Dorsal and palmar interossei. * Lumbricals. |
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What is the innervation of the intrinsic muscles of the hand?
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* All innervated by the ulnar nerve, except the following which are innervated by the median nerve:
- thenar muscles. - 1st and 2nd lumbrical muscles. |
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What does the radial nerve innervate in the hand?
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* The only thing it innervates is the dorsolateral skin of the hand.
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Name the branches of the median nerve in the hand, and what they innervate.
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* Palmar branch, passes superficial to the flexor retinaculum, innervates the skin on the palm of the hand.
* Recurrent branch innervates the thenar muscles. * Palmar digital branches supply 1st and 2nd lumbricals, and the skin of the lateral 3 1/2 fingers of the hand. |
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Does ulnar nerve pass superficial or deep to the flexor retinaculum?
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* Superficial.
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What are the branches of the ulnar nerve in the hand?
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* Superficial branch.
* Deep branch. |
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What does the superficial branch of the ulnar nerve innervate?
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* Palmaris brevis muscle.
* Skin of medial 1 1/2 fingers. |
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What does the deep branch of the ulnar nerve innervate?
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* Abductor digiti minimi.
* Flexor digiti minimi brevis. * Opponens digiti minimi. * All interossei muscles. * Adductor pollicis * 3rd and 4th lumbrical muscles. |
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What are the branches of the ulnar artery in the hand?
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* Superficial branch is the main continuation. Forms the superficial palmar arch. Anastomoses with a branch of the radial artery. Supplies medial four fingers, except for the lateral side of index finger.
* Deep branch joins the radial artery to complete the deep palmar arch. This supplies the lateral side of the index finger and the thumb. |
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What muscle(s) attach to the lateral border of the scapula?
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* Teres minor
* Teres major |
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What muscle(s) attach to the coracoid process?
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* Short head of biceps brachii
* Coracobrachialis * Pectoralis minor |
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What muscle(s) attach to the supraspinous fossa?
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* Supraspinatus muscle
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What muscle(s) attach to the infraspinous fossa?
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* Infraspinatus muscle
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What muscle(s) attach to the supscapular fossa?
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* Subscapularis muscle.
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What muscle(s) attach to the supraglenoid tubercle?
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Long head of the biceps muscle.
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What muscle(s) attach to the infraglenoid tubercle?
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Long head of the triceps muscle.
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What muscle(s) attach to the lesser tubercle of the humerus?
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Subscapularis muscle
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What muscle(s) attach to the deltoid tuberosity of the humerus?
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Deltoid muscle
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What muscle(s) attach to the olecranon process?
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Triceps brachii tendon.
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What muscle(s) attach to the ulnar tuberosity?
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Brachialis muscle
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What muscle(s) attach to the radial tuberosity?
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Biceps brachii tendon
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what motion does brachialis do?
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flexion of arm
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What is the attachment of the flexor retinaculum? |
Trapezium and Pisiform
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