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Upper Limb
Test 1
96
Anatomy
Graduate
09/01/2007

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Cards

Term
what 4 structures are found in the cubital fossa?
Definition
-Brachial A.
-Median N.
-Radial N.
-Biceps tendon
Term
Which muscles make up the rotator cuff muscles?
Definition
1. subscapularis-medial rotator
2. supraspinatus-elevat arm 15 degrees
3. infraspinatus-lateral rotator
4. teres minor-lateral rotator
Term
what is the thenar eminence?
Definition
-fleshy mound of muscles under palmer aspect of thumb
-allows thumb to move freely
Term
what are the dermatomes of the upper extremity?
Definition
C5-upper lateral region of arm
C6-palmer pad of thumb
C7-pad of index finger
C8-pad of little finger
T1-armpit
Term
what are the myotomes of the upper extremity?
Definition
C5-Abduction of arms at glenohumoral joint
C6-Flexion of forearm at elbow
C7-Flexion of fingers
T1-Adduction and Abduction of index, middle and ring fingers.
Term
What are some somatosensory tests that can be performed on the upper extremity?
Definition
C6-Tap on tendon of Bicep in cubital fossa
C7-Tap on tendon of Triceps posterior to elbow
Term
Deltoid
Definition
I: deltoid tuberosity (on humerus)
O: inferior spine of scapula and lateral acromion and lateral 1/3 of clavicle
N: Axillary N.
F: Abduction of arm past 15 degrees
Term
Levator Scapulae
Definition
I: superior angle of scapula
O: transverse processes of C1-4
N: ventral rami
F: elevates scapula
Term
Rhomboid Minor and Major
Definition
Minor I: medial border at spine of scapula
O: spinous processes of C7-T1
Major I: medial border of scapula under minor
O: spinous process of T2-5
Both N: Dorsal Scapular N.
Both F: Elevate Scapula
Term
Supraspinatus
Definition
I: Superior facet of greater tubercle (Humerus)
O: Medial 2/3 of suprapinous fossa (scapula above spine, deep)
N: Suprascapular nerve
F: Abduction of arm initial 15 degrees
Term
Infraspinatous
Definition
I: Middle facet of Greater Tubercle (posterior humerus)
O: Medial 2/3 of infraspinous fossa (scapula below spine, deep)
N: Suprascapular N.
F: lateral rotation of arm
Term
Teres Minor
Definition
I: Inferior facet on posterior surface of greater tubercle (humerus)
O: Posterior lateral scapula
N: Axillary N.
F: Lateral rotation of arm
Term
Teres Major
Definition
I: Medial lip of intertubercular sulcus (anterior humerus)
O: Inferior angle of scapula
N: Inferior subscapular nerve
F: Medial rotation and Extension of arm
Term
What turns the suprascapular notch into a foramen?
and what structure runs throught the foramen?
Definition
-superior transverse scapular ligament

-suprascapular nerve

*suprascapular vein and artery usually run superior to the foramen rather than thru it
Term
What makes up the border of the quadrangular space?
Definition
-Inferior margin of Teres Minor
-Surgical neck of Humerus
-Superior margin of Teres Major
-Lateral margin of Long head of Triceps Brachii
Term
What 3 structures pass thru the quadrangular space?

What can hypertrophy or fibrosis of the muscles here do?
Definition
1. Axillary nerve
2. Posterior humoral circumflex artery
3. " " " vein

-impinge on axillary nerve = teres minor atrophy or...deltoid weakness
Term
What makes up the borders of the triangular space?
Definition
-Medial margin of Long head of Triceps Brachii
-Superior margin of Teres Major
-Inferior margin of Teres Minor
Term
What structures run throught the triangular space?
Definition
-scapular circumflex artery and vein
Term
What makes up the triangular interval and what structures run through it?
Definition
1. Lateral margin of long head of Triceps Brachii
2. shaft of Humerus
3. Inferior margin of Teres Major

*Profunda Brachii A. and Radial N.
Term
Where does the suprascapular nerve come from and what does it innervate?
Definition
-comes from upper trunk (C5-6 fibers)
-Innervates supra- and infra- spinatous

*no cutaneous branches
Term
Where does the Axillary nerve come from and what does it innervate?
Definition
-Comes from the posterior branch of the brachial plexux (C5-6 fibers)
-goes thru the quadrangular space
-innervates deltoid and teres minor

*superior lateral cutaneous nerve- skin inferior to deltoid
Term
Pectoralis Major
Definition
I: Lateral lip of intertubercular sulcus of humerus
O: anterior medial 1/2 of clavicle and anterior surface of sternum
N: Medial and Lateral Pectoral nerves (C6-T1 fibers)
F: flexion, adduction, and medial rotation of arm

*extension of flexed arm
Term
What muscles does the suprascapular artery supply?
Definition
-Infraspinatus
-Supraspinatus

*runs superior to the suprascapular foramen
Term
Where can the scapular circumflex artery be found?
Definition
-leaves axilla through triangular space
-enters posterior scapular region
-forms anastomotic connections with other arteries in the region
Term
Subclavian
Definition
I: inferior middle 1/3 of clavicle
O: 1st rib
N: "Nerve to the Subclavius"
(upper trunk C5-6)
F: pulls shoulder down and clavicle medially

*deep to pec major
Term
Pectoralis Minor
Definition
I: Coracoid process of scapula
O: Anterior superior surface of ribs 3-5
N: Medial Pectoral N. (C8-T1)
F: Pulls tips of shoulder down and Protracts scapula

*deep to Pec Major
Term
Serratus Anterior
Definition
I: Costal surface of medial border of Scapula
O: Lateral surface of upper 8-9 ribs
N: Long Thoracic N. (C5-7 fibers)
F: Protraction and rotation of scapula-keeps medial border and inferior angle of scapula oppsed to thoracic wall
Term
What are the causes and symptoms of "winged scapula"?
Definition
-Caused by dammage to the Long Thoracic N.
which weakens serratus anterior

-scapula wings out when pushing forward on forearm and normal elevation is not possible
Term
Subscapularis
Definition
I: Lesser Tubercle of Humerus
O: Medial 2/3 of Subscapular Fossa
N: Upper and Lower Subscapular N. (Posterior cord C5-6)
F: Medial Rotation
Term
Biceps Brachii
Definition
I: Radial Tuberosity
O: Long Head-supraglenoid tubercle of scapula; Short Head-coracoid process (scapula)
N: Musculocutaneous Nerve (C5-C7 fibers)
F: Power Flexor of forearm at elbow
-supinator of forearm
-accessory flexor of arm
Term
Coracobrachialis
Definition
I: Medial midshaft of humerus
O: Coracoid Process of Scapula
N: Musculocutaneous N. (C8-T1)
F: Flexor of Arm
Term
What arteries branch off the axillary artery in the axilla?
Definition
1. superior thoracic
2. thorcoacromial trunk
3. lateral thoracic
4. subscapular
i.scapular circumflex
ii. thorcadorsal
5. brachial
i.ant./post.circumflex
Term
Brachialis
Definition
I: Tuberosity of Ulna
O: Anterior aspect of humerus (medial and lateral surfaces)
N: Musculocutaneous N. (C5-7) and small contribution to Radial N.
F: Powerful flexor of Forearm
Term
Triceps Brachii
Definition
I: Olecrenon
O: Long:infraglenoid tubercle of scapula
Med and Lat: posterior surface of humerus
N: Radial Nerve (C6-8)
F: Extension of Forearm

*long head can extend /adduct Arm
Term
What are the branches of the Brachial artery and where are they found
Definition
-Brachial artery: goes from medial superior arm to cubital fossa

-Profunda Brachii: larges branch, runs through triangular interval, supples posterior comparment on arm

-Radial and Ulnar collateral: start after cubital fossa
Term
which nerve leaves the axilla and passes through the coracobrachialis?
Definition
musculocutaneous nerve
Term
what are the motor and sensory components of the musculocutaneous nerve?
Definition
-Innervates all muscles in the anterior comparment of arm

-sensory innervation to skin on the lateral surface of the forearm
Term
The median nerve is immediately lateral to what artery in the cubital fossa?
Definition
Brachial artery
Term
What nerve passes posterior to the medial epicondyle into the forearm anteriorly?
Definition
Ulnar nerve
Term
Where can the radial nerve be found?
Definition
-originates from posterior cord
-enters arm by crossing inferior margin of teres major
-posterior to brachial artery with profundus brachii
-through triangular interval to posterior compartment of arm
-medial->lateral in Radial groove on bone
-enters forearm anterior compartment
Term
When the humerus bone is broken, which nerve would be in most danger of damage?
Definition
Radial Nerve

-test posterior cutaneous arm or look for wrist drop
Term
Carpel tunnel syndrome is compression of what nerve?
Definition
Median nerve
Term
kyphosis
Definition
Abnormal rearward curvature of the spine, resulting in protuberance of the upper back; hunchback.
Term
lordosis
Definition
an abnormal forward curvature of the spine in the lumbar region, resulting in a swaybacked posture.
Term
scoliosis
Definition
an abnormal lateral curvature of the spine.
Term
osteoporosis
Definition
a disorder in which the bones become increasingly porous, brittle, and subject to fracture, owing to loss of calcium and other mineral components, sometimes resulting in pain, decreased height, and skeletal deformities: common in older persons, primarily postmenopausal women, but also associated with long-term steroid therapy and certain endocrine disorders.
Term
auscultation
Definition
the act of listening, either directly or through a stethoscope or other instrument, to sounds within the body as a method of diagnosis.
Term
radiculopathies
Definition
Disease of the spinal nerve roots
Term
what is nerve and blood supply of the anterior compartment of the arm
Definition
-brachial artery
-musculocutaneous nerve
Term
where does the blood and nerve supply of the posterior compartment of the arm come from?
Definition
-Radial nerve
-Profunda brachii
Term
What ligament reinforces the head of the radius laterally?
and what kind of damage is associated with this ligament
Definition
-anular ligament
-pulled elbow- head of radius of child is not yet fully developed and can be pulled out of the anular ligament
-ligament can be popped back in by supination
Term
what is dangerous about a supracondylar fraction?
Definition
contraction of the triceps pulls humorus posteriory "bowstringing" the brachial artery causing ischemia to the anterior compartment of the arm
Term
what nerve can be found under the brachioradialis?
Definition
radial nerve
-superficial radial nerve continues into forarm under the brachioradialis
-deep radial nerve passes b/t 2 heads of the supinator muscles to access the posterior compartment of the forearm
Term
what are the 2 pronator muscles and what are the 2 supinator muscles?
Definition
Supination
1. Biceps Brachii
2. Supinator

Pronation
1. Pronator Teres
2. Pronator Quadratus
Term
What 3 muscles insert on the greater tubercle?
Definition
Supraspinatus-abduct 15 degrees
Infraspinatus-lateral rotator
Teres Minor-lateral rotator
Term
what 3 muscles insert on the Coracoid process?
Definition
1. Short head of biceps brachii
2. Coracobrachialis
3. Pectoralis minor
Term
what artery does the common interossseous artery branch from?
Definition
Ulnar artery
Term
Where is the lesion if one cannot initiate abduction?
Definition
Suprascapular Nerve
Term
What lymphnodes are responsible for the lateral 1/2 of the breast?
Definition
Pectoral axillary nodes
Term
What lymph nodes are responsible for draining the medial 1/2 of the breast?
Definition
Parasternal Nodes
Term
Which nerve supplies the dorsum of the hand?
Definition
Superficial Radial Nerve
Term
what makes up the borders of the cubital fossa?
Definition
Top: Lateral and Medial Epicondyle
Lateral: Brachioradialis
Medial: Pronator Teres
Floor: Supinator and Brachialis
Term
what artery will you see if you peel away the pronator teres?
Definition
Inferior Ulnar Collateral as it joins with the Anterior Ulnar Recurrent
Term
What innervates the majority of the anterior forearm?

what are the exceptions?
Definition
-Median Nerve

-Flexor Carpi Ulnaris and medial 1/2 of the Flexor Digitorum is innervated by the Ulnar Nerve
Term
What are the 4 superficial muscles of the anterior forearm (laterally to medially)?

*where do they all originate?
Definition
PFPF
1. Pronator Teres
2. Flexor Carpi Radialis
3. Palmaris Longus
4. Flexor Carpi Ulnaris

*O: Medial Epicondyle of Humerus
Term
Pronator Teres
Definition
I: Roughening on Lateral surface, mid-shaft of Radius
O: Medial epicondyle, Medial surface of Coronoid Process
N: Median Nerve (C5-T1 fibers)
F: Pronation
Term
Flexor Carpi Radialis
Definition
I: Base of Metacarpals II and III
O: Medial Epicondyle of Humerus
N: Median Nerve (C5-T1 fibers)
F: Flexion of forearm
Term
The radial artery lies lateral to what muscles tendon? why is this important?
Definition
-Flexor Carpi Radialis

-Palpate the tendon, and laterally is where the Radial Pulse can be taken
Term
Palmaris Longus
Definition
I: Medial Epicondyle of the Humerus
O: Palmar Aponeurosis of the Hand
N: Median Nerve
F: Flex wrist joint
Term
Flexor Carpi Ulnaris
Definition
I: Pisiform bone, Hamate, and Metacarpal V
O: Medial Epicondyle of Humerus and Olecronon and posterior border of Ulna
N: Ulnar Nerve (C7-T1)
F: Flexion and Adduction of wrist
Term
What is the only muscle of the anterior forearm?
Definition
Flexor Digitorum Superficialis
Term
Flexor digitorum superficialis
Definition
I: 4 tendons at the palmer surface of middle phalanges of index, middle, ring, and little fingers (attach on either lateral side of phalanx)
O: Humero-ulner head-medial epicondyle of humerus and coronoid process
Radial head- oblique line of radius
N:Median Nerve
F:Flex proximal interphalangeal joints, and metacarpophalangeal joints of 4 fingers, and flex wrist
Term
What are the 3 deep muscles of the anterior forearm?
Definition
1.Flexor Digitorum Profundus
2.Flexor Pollicis Longus
3.Pronator Quadratus
Term
The anterior interosseous nerve is a branch off of what nerve? and what vessel does it run along w/?
Definition
-Median Nerve

-Anterior interosseous nerve
Term
Flexor digitorum Profundus
Definition
I: 4 tendons at the palmer surface of distal phalanges of index, middle, ring, and little fingers (attach to middle of phalanx)
O: Anterior medial surface of Ulna and Anterior medial half of interosseous membrane
N: Lateral 1/2: Median Nerve
Medial 1/2: Ulnar Nerve
F: Flex distal interphalanges joint, metacarpal phalange joint, and wrist
Term
Flexor Pollicis Longus
Definition
I: Palmar surface of base of Distal Phalynx of Thumb
O: Anterior surface of Radius and Radial half of interosseous membrane
N: Anterior Interosseous Nerve (median)
F: Flex thumb at ip and mp joints
Term
Pronator Quadratus
Definition
I: Distal anterior surface of the radius
O: Linear ridge on distal anterior surface of Ulna
N: Anterior Interosseous Nerve (median)
F: Pronation
Term
What are the 2 cutaneous branches of the Ulnar Nerve?
Definition
1. Palmar Branch-originates in the middle of the forearm and passes into the hand to supply skin on the medial side of the palm

2. Dorsal Branch-larger, originates from the ulnar in distal forarem and passes posteriorly deep to the tendo fo the flexor carpi ulnaris and innervates skin on the dorsomedial side of the back of the hand and most skin on the posterior sufaces of the medial 1 1/2 digits
Term
Where does the radial nerve branch off and what are the names of the 2 branches?
Definition
-Branching occures in the lateral border of the cubital fossa under the brachioradialis

1. Deep branch-mainly motor and passes b/t the 2 heads of the supinator to access and supply the muscles of the posterior compartment
2. Superficial branch-all sensory, passes doewn the anterolateral aspect of the forearm deep tot eh brachioradialis and in assoc. w/ the Radial Artery... eventually pass dorsolaterally thru the forearm to supply the skin on the dorsolateral surface of the hand
Term
What are the 7 muscles in the superficial layer of the posterior forearm?
Definition
1. Brachioradialis
2. Extensor Carpi Radialis Longus
3. Extensor Carpi Radialis Brevis
4. Extensor Digitorum
5. Extensor Digiti Minimi
6. Extensor Carpi Ulnaris
7. Anconeus

*Origin at supraepicondylar ridge and lateral epicondyle of humerus
Term
What is the difference between separation and dislocation?
Definition
-Dislocation: a disarticulation of the humerus and the scapula

-Separation: a tearing of ligaments; it is characterized by stages decided by the number of tears in any or all of these various ligaments.
Term
Brachioradialis
Definition
I: Lateral surface of distal end of radius
O: Proximal part of lateral supraepicondylar ridge of humerus
N: Radial Nerve BEFORE division into superficial and deep branches
F: Accessory flexor of forearm when its in mid pronation
Term
Extensor Carpi Radialis Longus
Definition
I: Dorsal surface of base of metacarpal II
O: Distal part of lateral superaepicondlylar ridge
N:Radial Nerve BEFORE division into superficial and deep branches
F: Extends and abducts wrist
Term
Extensor Carpi Radialis Brevis
Definition
I: Dorsal surface of base of metacarpals II and III
O: Lateral epicondyle of humerus
N: Deep branch of Radial Nerve before penetrating supinator muscle
F:extends and abducts wrist
Term
Extensor digitorum
Definition
I: 4 tendons that insert via "extensor hoods" into the dorsal aspects of the bases of the middle and distal phalanges of the index, middle, ring, and little fingers
O: lateral epicondyle of humerus
N: Posterior interosseous nerve
F: Exntends the index, middle, ring, and little fingers and wrist
Term
Extensor Digiti Minimi
Definition
I: Dorsal hood of the little finger
O: Lateral epicondyle of humerus
N: Posterior Interosseous Nerve
F: Extends little finger
Term
Extensor Carpi Ulnaris
Definition
I: Tubercle on the base of the medial side of metacarpal V
O: Lateral epicondyle of humerus and posterior border of ulna
N: Posterior Interosseous Nerve
F: Extends and adducts wrist
Term
Anconeus
Definition
I: Olecranon and proximal posterior surface of ulna
O: Lateral epicondyle
N: Radial nerve (via branch to medial head of triceps brachii)
F: Abduction of the ulna in pronation; accessory extensor of elbow joint
Term
What are the 5 muscles of the deep posterior forearm?
Definition
1. Supinator
2. Abductor pollicis longus
3. Extensor pollicis brevis
4. Extensor pollicis longus
5. Extensor indicis

*all innervated by the posterior interosseous nerve
Term
Supinator
Definition
I: Lateral surface of radius superior to the anterior oblique line
O: Superficial-lateral epicondyle of humerus
Deep-supinator crest of ulna
N: Posterior interosseous nerve
F: Supination
Term
Abductor Pollicis Longus
Definition
I: lateral side of base of metacarpal I
O: Posterior surfaces of ulna and radius (distal to the attachements of supinator and anconeus), and intervening interossous membrane
N: Posterior Interosseous Nerve
F: Abducts carpometacarpal joint of thumb; accessory extensor of thumb
Term
Extensor Pollicis Brevis
Definition
I: Dorsal surace of base of proximal phalanx of the thumb
O: Posterior surface of radius (distal to abductor pollicis longus)
N: Posterior Interosseous Nerves
F: Extends MC and CM joints
Term
Extensor Pollicis Longus
Definition
I: Dorsal surface of distal phalanx of thumb
O: Posterior surface of ulna (distal to the abductor pollicis longus)
N: Posterior Interosseous Nerve
F: Extends IP joint of the thumb; can also extend CM and MC joints of thumb
Term
Extensor Indicis
Definition
I: Extensor Hood of index finger
O: Posterior surface of ulna (distal to the abductor pollicis longus)
N: Posterior Interosseous Nerve
F: Extends Index Finger
Term
What nerve terminates in the brachioradialis?
Definition
Musculocutaneous Nerve as the
LATERAL ANTIBRACHIAL CUTANEOUS NERVE
Term
The tendons of what muscles and what carpal bones make up the snuff box?
What can be found in the snuff box?
Definition
-Lateral border: Abductor Pollicis Longis
Extensor Pollicis Brevis
-Medial border: Extensor Pollicis Longis
-Floor: Scaphoid and Trapezium and Extensor Carpi Radialis Longus and Brevis

*Radial artery is found here
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