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Upper limb review
Upper limb review derived from BRS Anatomy
74
Anatomy
Post-Graduate
03/31/2008

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Cards

Term

The scapular noth is bridged by the superior transverse scaplar ligmanet and is converted into a foramen which permits passage of what?

Definition

Suprascapular nerve

Term

Supreglenoid and infraglenoid tuercles provide the origins for what?

Definition

The long heads of the biceps brachii and triceps brachii muscles respectively.

Term

 What does the lesser tubercle provide an insertion for?

Definition

Subscapularis muscle

Term

What does the intertubercular (bicipital) groove provide insertions for?

Definition

 

Pec major (lateral lip), teres major (medial lip) and latissimus dorsi (floor)
Term

 

What is the surgical neck of the humerus in contact with?

Definition

Axillary nerve and posterior humeral circumflex artery

Term

 

What runs through spiral groove?

Definition

Radial nerve, origin of lateral head of triceps above and medial head below

Term

What artery and nerve may be damaged in the event that the shaft of the humerus is injured?

Definition

Radial nerve and deep brachial artery

Term

Where do the extensor muscles of the forearm and the supinator muscle take origin?

Definition

Lateral epicondyle of the humerus

Term

Where to the flexor muscles of the forearm and pronator teres originate?

Definition

Medial epicondyle of the humerus

Term

What nerve might be damaged during fracture of the medial epicondyle?

Definition

Ulnar nerve

Term

What nerve may be injured in supracondylar fractures?

Definition

Median nerve

Term

What is Colle's fracture?

Definition

A fracture of the distal end of the radius characterized by displacement of the hand dorsally and radially.

Term

What does the capitulum of the humerus articulate with?

Definition

The head of the radius

Term

What is a clinical concern associated with a fracture of the scaphoid?

Definition

Fracture of the scapoid occurs often during  fall onto the outstretched hand and may lead to damage to the radial artery and avascular necrosis of the bone.

Term

 

What is Boxer's fracture?

Definition

It is a fracture typicall seen in the necks of the second and third metacarpals in experienced boxers and in the 5th metacarpal in unskilled boxers.

Term

What is the nerve and aterial supply of the elbow joint?

Definition

Receives innervation from the musculocutanious, median, radial and ulnar nerves. Receives its blood supply from the anastamosis between the brachial artery and recurrent branches of the radial and ulnar arteries.

Term

Describe the lymphatic drainage of the upper limb.

Definition

There are dorsal and palmar plexuses

Medial group of lymphatic vessels accompany the basilic vein and drain into the lateral axillary lymph nodes which go into the central axillary and then the apical lymph nodes

Lateral group of lymphatic follow the cephalic vein and drain into the lateral axillary nodes into the dltopectoral node which then drains into the apical nodes.

Term

 

What does the axillary sheath enclose?

Definition

 

The axillary vessels and the brachial plexus

Term

What is the blood supploy of the mammaxry gland?

Definition

Medial mammary branches of the anterior perforating branches of the internal thoracic artery, the lateral mamary branches of the lateral thoracic artery, the pectoral branches of the thracoacromialtrunk, the lateral cutaneous branhces of the posterior intercostal arteries.

Term

 

What is the nerve supply of the mamary gland?

Definition

Anterior and lateral cutaneous branches of the 2nd to 6th intercostal nerves

Term

 

What is the lymphatic drainage of the mammary gland?

Definition

Drain primarily into the pectoral (anterior) nodes which then go into the parasternal (internal thoracic) nodes which lie along the internal thoracic artery.

Some also drains into the apical nodes and may connect to lymphatics draining thje oppoosite breast and to lymphatics draining the anterior abdominal wall.

Term

 

What is the nerve supply and action of the pec major?

Definition

NS: Lateral and medial pectoral nerves

Action: Fexles, adducts and medially rotates arms

Term

 

What is the nerve supply of the pec minor?

Definition

NS: Medial (and lateral) pectoral nerves

Action: Depresses scapula, elevates ribs

Term

 

What is the nerve supply and action of the subclavius?
Definition

NS: Nerve to subclavius

Action: Depresses lateral part of the clavicle

Term

 

What is the nerve supply and action of the serratus anterior?
Definition

NS: Long thoracic (nerve to serratus anterior)

Action: Rotates scapula upward, abudcuts scapula with arm and elvates it above the horizontal and also protracts scapula (paralysis leads to winging of the scapula).

Term

 

What are the boundaries of the quadrangular space and what are its contents?
Definition

Bounded superiorly by the teres minor and subscapularis muscles, inferiorly by the teres major, medially by the lon head of the triceps and laterally by the surgical neck of the humerus.

It transmits the axillary nerve the posterior circumflex humeral artery.

Term

 

What are the boundaries and contents of the upper triangular space?

Definition

Superiorly: teres minor

Inferiorly: teres major

Laterally: long head of triceps

Contents: Circumflex scapular artery and vein

Term

 

What are the boundaries and contents of the lower triangular space?


Definition

Superiorly: tres major

Medially: long head of triceps

Laterally: medial head of triceps

Contains: radial nerve and deep brachial artery

Term

 

What is the nerve supply of the and action of the deltoid muscle?

Definition

NS: axillary

Action: Adducts, abucts arm, flexes, extends and rotates arm medially laterally

Term

 

What is the nerve supply and action of the supraspinatus?

Definition

NS: suprascapular N

Action: Abducts arm

Term

What is the nerve supply and action of the infraspinatus?


Definition

NS: Suprascapular N

Action: Rotates arm laterally

Term

What is the nerve supply and action of the subscapularis?

Definition

Upper and lower subscapular N

Adducts and rotates arm medially

Term

 

What is the nerve supply and action of the teres major?

Definition

Lower subscapular nerve

Adducts and rotates arm medially

Term

 

What is the action and nerve of the supply of the teres minor?

Definition

Axillary nerve

Rotates arm laterally

Term

What is the nerve supply and action of the latissimus dorsi?

Definition

Thracodorsal N

Adducts, extends and rotates arm medially

Term

What is the nerve supply and action of triceps?

Definition

Radial N

Extends forearm

Term

What is Dupuyutren's Contracture?

Definition

 

Thickening, shortening and fibrosis of the palmar fascia especially the palmar aponeurosis. Leads to inability to fully extend fingers.

Term

 

What is Volkmann's contracture?

Definition

 

An ischemic muscular contracture (flexion deformity) of fingers and sometimes the wrist resulting from ischemic necrosis of the forearm flexor muscles resulting form pressure injury or a tight cast. The muscles are replaced by fibrous tissue.

Term

 

What is the Carpal tunnel?

Definition

It is formed anteriorly by the flexor retinaculum and posteriorly by the carpal bones. It transmits the median nerve and the tenons of the flexor pollicis longus, flexor digitorum profundus and flexor digitorum superficialis muscles.  

Term

 

What is Carpal tunnel syndrome?

Definition

 

It is caused by compression of the median nerve due to the reduced size of the osseofibrous carpal tunnel, resulting from inflammation of the flexor retinaculum, arthritic changes in the carpal bones, or inflammation or thickening of the synovial sheaths of the flexor tendons.

Term

What are the upper roots of the Brachial plexus?

Definition

 

C5 and C6

Term

What are the middle roots of the Brachial plexus?


Definition

 

C7

Term

What are the lower roots of the Brachial plexus?

Definition

C8 and T1

Term

Where do the trunks of Brachial plexus lie?

Definition

Posterior triangle of neck

Term

What forms the lateral cord of the Brachial plexus?

Definition

 

The anterior divisions of the upper and middle trunks (C5-C7) join to form the lateral cord

Term

What forms the medial cord of the Brachial plexus?

Definition

It is a continuation of the lower trunk (C8-T1)

Term

What forms the posterior cord of the Brachial plexus?

Definition

It is formed by the merger of the posterior divisions of all the trunks of the Brachial plexus (C5-T1)

Term
  

What branches does the upper trunk of the Brachial plexus give?

Definition

Suprascapular N (C5, C6)

Nerve to subclavius (C5)

Term

What are the branches from the lateral chord of the Brachial plexus?

Definition

Lateral pectoral nerve (C5-C7)

Lateral root of median nerve (C5-T1)

Musculocutaneous nerve (C5-C7)

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Term

What are the branches from the middle chord of the Brachial plexus?

Definition

Medial pectoral nerve (C8-T1)

Medial root of the median nerve (C5-T1)

Medial cutaneous nerve of forearm (C8-T1)

Ulnar nerve (C7-T1)

Medial cutaneous nerve of forearm (C8-T1)

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Term

What are the branches of the posterior cord of the Brachial plexus?

Definition

Upper subscapular (C5-C6)

Lower subscapular (C5-C6)

Nerve to latissimus dorsi (thoracodorsal N) (C7-C8)

Axillary (C5-C6)

Radial nerve (C5-T1)

Term

 

Which nerve is responsible for wrist drop?

Definition

Radial nerve

Dr. Cuma = Drop wrist - radial, Claw hand- ulnar, median nerve – ape hand

Term

 

Fracture of the surgical neck of the humerus or inferior dislocation of humerus can result in what?

Definition

It can result in damage to the axillary nerve. It results in weakness of lateral rotation and abudcution of the arm (the supraspinatus can abduct the arm but not to a horizontal level)

Term

 

What does the musculocutaneous nerve supply?

Definition

 

Biceps brachii, brahcialis, coracobrachialis. It continues as the lateral cutaneous nerve of the forearm

Term

What does the median nerve supply?

Definition

 

Pronator teres, flexor digitorum superficialis, palmaris longus, flexor carpi radialis, abductor pollicis brevis, opponens pollicis, flexor pollicis, 1st and 2nd lumbricals

It also does the lateral 3 and a half digits on the palmar surface of the hand in addition to the tips of those fingers on the dorsum of the hand

Term

What is anterior interosseous nerve a branch of and what does it supply?

Definition

 

It is a branch of the median nerve and it supplies the flexor digitorum profundus, flexor pollicis longus muscle and the pronator quadratus

Term

 

What does the ulnar nerve supply?

Definition

It supplies the flexor carpi ulnaris muscle, flexor digitorum profundus and the palmaris brevis muscle. It gives a deep branch that supplies the hypothenar muscles (abdudctor short flexor and opponens) as well as the adductor pollicis muscle and the deep head of the flexor pollicis brevis muscle.

 

 

It provides cutaneous sensation for the medial 1 and a half fingers as well as most of the palm and the dorsum on the corresponding side of the hand.

 

Term

 

What does the axillary nerve supply?

Definition

 

 

Teres minor and deltoid

 

Term

 

What does the radial nerve supply?

Definition

All 3 heads of triceps

Brachialis (proprioceptive fibers)

Aconues

Brachioradialis

Extensor carpi radialis longus

Extensor carpi radialis brevis

Supinator

 

 

Posterior interosseous branch innervates:

Extensor digitorum muscle

Extensor digiti mimimi

Extensor carpi ulnaris

 

Term

What is Erb-Duchenne palsy?

Definition

 

An injury to the upper trunk of the brachial plexus. It is caused by a birth injury during a breech delivery or a violent displacement of the head from the shoulder such as might result from a fall from a motorcycle or horse. It results in a loss of abduction, flexion and lateral rotation of the arm, producing a waiter’s tip hand, in which the arm tends to lie in medial rotation resulting from paralysis of lateral rotator muscles.

Term

 

What is Klumpke’s Palsy?

Definition

 

It is a lower trunk injury. It may be caused during a difficult breech delivery, by a cervical rib or by a abnormal insertion or spasm of the anterior and middle scalene muscles. The injury causes claw hand.

Term

What passes over the superior transverse scapular ligament?

Definition

The suprascapular artery. The nerve passes below (remember: the Army goes over the bridge and the Navy goes under)

Term

What are the parts of the axillary artery and what branches do they give?

Definition

1st part – Superior and medial to pec minor, gives the superior thoracic artery

2nd part – Behind the pec minor, gives the thoracoacromial and lateral thoracic arteries

3rd part – Lateral to and behind the pec minor, gives the subscapular, anterior and posterior circumflex humeral arteries

 

Remember: SALSAP

Term

What are the branches of the subclavian artery?

Definition

Vertebral artery

Internal thoracic artery

Thyrocervical trunk

Costocervical trunk

Dorsal scapular artery (occasionally)

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Term

 

What are the branches of the thyrocervical trunk?

Definition

Suprascapular artery

Inferior thyroid artery

Transverse cervical artery

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Term

What is the radial collateral artery a branch of and what does it anastamose with?

Definition

 

It is a branch of the deep brachial artery and it anastamoses with the radial recurrent artery.
Term

 

What are the branches of the common interosseous artery and what is it a branch of?

Definition

It is a branch of the ulnar artery and it gives the recurrent interosseous artery as well as the anterior and posterior interosseous arteries.

Term

 

How do the limbs begin to develop?

Definition

 

Limb development begins with the activation of mesenchymal cells in the lateral plate somatic mesoderm

Term

What does the appendicular skeleton develop from?

Definition

 

Develops from mesenchyme derived from the somatic mesoderm in the limb buds.

Term

 

What are limb buds?

Definition

They consist of a mesenchymal core covered with ectoderm and capped by an apical ectodermal ridge that induces limb growth and development. They arise in the somatic mesoderm at week 4. The upper limb buds arise first and then the lower limb buds soon follow.

Term

 

Describe the rotation of the upper and lower limb buds.

Definition

 

Upper limb buds rotate laterally through 90 degrees, whereas the lower limb buds rotate medially through almost 90 degrees.

Term

 

When does the upper limb begin to subdivide into the precursors of the arm, forearm and the hand? When do the digits begin to form?
Definition

 

The upper limb buds become elongated by week 5 and soon after they are subdivided into the precursors of the arm, forearm and the hand. The hand and foot are subdivided into digits by week 6 and individual fingers and toes are visible by week 8.
Term

 

What are the bones of the limbs derived from?

Definition

Lateral plate somatic mesoderm.

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