Term
| What are the joints of the upper limb? |
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Definition
| scapulothoracic, glenohumeral, fingers, wrist, elbow, and radioulnar |
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Term
| anterior compartment of the arm innervated by... |
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Definition
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Term
| Muscles of ant compartment of forearm innervated by.. |
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Definition
| Median C6-C8 and T1... 2 exceptions: flexor carpi ulnaris and medial half of flexor digitorum profundus |
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Term
| Intrinsic muscles of hand innervated by... |
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Definition
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Term
| Muscles of posterior compartment innervated by... |
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Definition
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Term
| Overall. what terminal nerves do all 5 upper limb nerves stem from in brachial plexus |
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Definition
MARMU
Musculcutaneous- C5-7
Axillary- C5-6
Radial- C5-8 and T1
Median- C5-8 and T1
Ulnar- C7-8 and T1 |
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Term
| Somatic sensory info form brachial plexus |
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Definition
musculocutaneous- anterolateral skin
median nerve-palmar surface, lateral 3.5 digits
ulnar nerve- palmar suface of medial 1.5 digits
radial nerve- skin on posterior surface of forearm and dorsolateral surface of hand |
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Term
| nerves of brachial plexus related to bone |
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Definition
axillary nerve- deltoid (passes around surgical neck of humerus)
radial nerve- extensor muscles goes around radial groove of humerus
ulnar nerve- posterior to medial epicondyle of humerus |
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Term
| what 3 components provide stability to the very unstable glenohumeral joint? |
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Definition
| cuff muscles, long head of biceps, extrascapular ligaments |
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Term
| dislocation of glenohumeral joint |
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Definition
ant. inferior most frequent- axillary and radial nerve may be injured.
post. dislocation seen more often in contact joints. |
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Term
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Definition
over handed sports and older people falling on shoulders.
intrascapular part of long head of biceps tendon becomes frayed.
supraspinitus tear- limb can not slowly adduct from 90 degree abduction, will just slowly drop. |
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Term
| muscles of scapular region |
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Definition
trapezius,
deltoid,
levator scapulae,
rhomboid major/minor,
supraspinatus,
infraspinatus,
teres major/minor
long head of triceps |
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Term
| Axilla anterior wall formed by... |
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Definition
| pec. major/minor and subclavius |
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Term
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Definition
| upper thoracic wall and serratus anterior |
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Term
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Definition
| intertubercular sulcus of humerus (where latissimus dorsi inserts!) |
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Term
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Definition
| subscapularis, teres major, latissimus dorsi, long head of triceps |
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Term
| Gateways in the posterior axillary wall |
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Definition
| quadrangular space, triangular interval, triangular space (slide 73 for picture and details.) |
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Term
| Axillary artery supplies... |
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Definition
| axilla walls and major blood supply yo distal parts of upper limb |
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Term
| 3 axillary artery branches |
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Definition
1st part- superior thoracic artery
2nd part- thoracoacromial and lateral thoracic
3rd part- subscapular, ant./post. circumflex humeral |
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Term
| parts of brachial plexus from medial to lateral (general) |
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Definition
| roots-->trunks-->divisions-->cords |
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Term
| where do roots of brachial plexus receive gray rami commnicantes? |
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Definition
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Term
| Clincial signs of problems related to lower cervical nerve problems (like brachial plexus) |
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Definition
| paresthesia and muscle twitching appear in upper limb |
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Term
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Definition
Often tested for sensation...
upper lateral region of arm-C5
palmar pad of thumb- C6
pad of the index finger- C7
pad of the little finger- C8
skin on medial aspect of elbow- T1 |
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Term
| Joint Movement myotomes, that if cannot be done then there is a lesion at the corresponding nerve |
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Definition
abduction of arm- C5
flexion of forearm- C6
extension of arm at elbow- C7
flexion of fingers- C8
abduction/ adduction of index, middle and ring fingers- T1 |
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Term
| Dorsal and palmar interosseous muscles |
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Definition
| abduct and adduct index, middle and ring fingers. |
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Term
| If following tendon reflexes do not work, then lesions at corresponding nerves |
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Definition
biceps tendon- C6
triceps tendon- C7
diaphragm innervation- C3,4,5 (breathing problems). |
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Term
| Flexor digitorum profundus |
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Definition
| flexes fingers, innervated by ulnar nerve (C7-C8) |
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Term
| Nerves related to bone (nerves to worry about upon fracture of any of these bones) |
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Definition
axillary nerve- surgical neck of humerus
radial nerve- passes around posterior surface of humerus in radial groove
ulnar nerve- passes posteriorly to medial epicondyle (elbow) |
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Term
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Definition
| articulates with manubrium, anterior view: wider end. |
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Term
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Definition
| articulates with acromion. Anterior view: skinny end. |
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Term
| ligaments of sternoclavicular joint |
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Definition
-ant and posterior sternoclavicular joints
-interclavicular
-costoclavicular
- MOVEMENT limited but can move anteroposterior in a vertical plane and some rotation |
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Term
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Definition
Sternoclavicular- synovial
Acromioclavicular- synovial
Coracoclavicular |
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Term
| coracoclavicular ligament |
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Definition
| stabilizes joint bw coracoid process and clavicle. |
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Term
| What gives the glenohumeral joint stability? |
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Definition
| cuff muscles, long head of biceps and extrascapular ligaments |
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Term
| Bursa of the glenohumeral joint |
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Definition
subacromial and subscapularis
-in older peole, they become inflammed and pinched, resist use, and develop 'frozen shoulder' |
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Term
| ligaments of the glenohumeral joint |
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Definition
Glenohumeral ligamentS
coracohumeral ligament
transverse humeral ligament (holds tendon of ling head of biceps brachii in intertubercular sulcus) |
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Term
| Fxn of coracoacromial ligament with resect to glenohumeral joint |
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Definition
| restricts superior movement |
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Term
| Fxn of roatator cuff muscles with resect to glenohumeral joint |
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Definition
| surround post, superior and anterior parts |
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Term
| Fxn of long head of biceps with resect to glenohumeral joint |
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Definition
| restricts superior movement |
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Term
| Anterior and Posterior vascular supply to glenohumeral joint |
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Definition
| suprascapular arteries (come through suprascapular notch) |
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Term
| Innervation of the glenohumeral joint |
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Definition
| posterior cord of brachial plexus, and suprascapular, axillary and lateral pectoral nerves. |
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Term
| What does the axillary nerve innervate? |
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Definition
| deltoid, teres minor and long head of the triceps brachii |
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Term
| What does the radial nerve innervate? |
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Definition
| extensors of forearm and hand. (long head of triceps) |
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Term
| what are the 3 ways the deltoid can contract? |
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Definition
| flexion, abduction and hyperextension |
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Term
| 4 gateways to the posterior scapular region for nerves and blood vessels in scapular region? |
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Definition
| Suprascapular foramen, quadrangular space, triangular space, triangular interval |
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Term
| what passes through the suprascapular foramen? |
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Definition
| suprascapular nerve, artery and vein. |
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Term
| What passes through the quadrangular space in the axilla? what are its boundaries? |
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Definition
-axillary nerve, vein and artery
-posterior circumflex humeral artery and vein
IMAGE: slide 61 |
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Term
| What passes through the triangular space? |
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Definition
| Circumflex scapular artery and vein |
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Term
| What passes though the triangular interval? |
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Definition
-suprascapular artery and nerve -radial nerve -profunda brachii nerve
-suprascapular artery and nerve |
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Term
| What artery and nerve surrounds that surgical neck of the humerus that come through the quadrangular space? |
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Definition
| posterior circumflex humeral artery and axillary nerve |
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Term
| What artery and nerve surrounds that surgical neck of the humerus that come through the quadrangular space? |
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Definition
| posterior circumflex humeral artery and axillary nerve |
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Term
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Definition
| From superior trunk of brahcial plexus. innervates supraspinatus and infraspinatus |
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Term
| Blood supply of supraspinatus and infraspinatus |
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Definition
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Term
| Blood supply of glenohumeral joint |
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Definition
| Posterior circumflex artery from axillary joint |
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Term
| origin of circumflex scapular artery |
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Definition
| axillary artery-->subscapular--> circumflex scapular |
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Term
| What does thyrocervical trunk supply? |
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Definition
| First branch off subclavian. |
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Term
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Definition
| Pec major, subclavius, pec minor |
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Term
| Pec minor origin and insertion |
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Definition
O: coracoid process
I: inserts on the ribs |
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Term
| Pec minor origin and insertion |
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Definition
O: coracoid process
I: inserts on the ribs |
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Term
| Pec minor origin and insertion |
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Definition
O: coracoid process
I: inserts on the ribs |
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Term
| Pec minor origin and insertion |
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Definition
O: coracoid process
I: inserts on the ribs |
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Term
| Pec minor origin and insertion |
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Definition
O: coracoid process
I: inserts on the ribs |
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Term
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Definition
| upper thoracic wall and serratus anterior |
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Term
| What does the long thoracic nerve innervate? |
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Definition
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Term
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Definition
| intertubercular process of humerus |
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Term
| Axilla posterior wall muscles |
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Definition
| Subscapularis, teres major, latissimus dorsi, long head of triceps |
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Term
| Floor of axillaWhat passes throughthe floor of the axilla |
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Definition
| biceps brachii and coracobrachialis |
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Term
| What does the axillary artery supply? what are it's branches? |
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Definition
-supplies walls of axilla, major blood supply of distal parts of upper limb
-Branches
-First part: superior thoracic artery
-Second part: thoracoacromial and lateral thoracic
- Third part:subscapular, ant. and post. circumflex humeral |
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Term
| Flow from subclavian to radial and ulnar arteries |
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Definition
| subclavian--> axillary at clavicle (damage to clavicle could be axillary--> 1st, 2nd, and 3rd parts of axillary --> brachial artery--> radial and ulnar (at elbow) |
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Term
| Where is the superior cervical sympathetic ganglia located on sympathetic chain? |
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Definition
| around C4 on either side of the vert. column. |
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Term
| What does the dorsal scapular branch of the brachial plexus innervate? |
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Definition
| From C5, innervates rhomboid major and minor |
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Term
| What does the long thoracic nerve off brachial plexus innervate? |
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Definition
| Stems form C5-7, innervates serratus anterior. |
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Term
| What does the suprascapular nerve off brachial plexus innervate? |
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Definition
From superior trunk (gets to posterior through suprascapular notch (C5-6)
Innervates supraspinatus and infraspinatus |
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Term
| What does the subclavius innervate? |
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Definition
From C5&6
Innervates subclavius muscle |
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Term
| What are the branches of the lateral cord and their innervations? |
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Definition
-lateral pectoral nerve- pec. minor and pec. major
-musculocutaneous terminal branch- coracobrachialis, biceps brachii, brachialis. |
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Term
| Branches of the medial cords and their innervations. |
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Definition
medial pectoral nerve- pec minor
medial cutaneous of arm- upper part of medial surface of arm and floor of axilla
medial cutaneous of forearm- skin over: biceps brachii, ant. surface of forearm, and medial surface of forearm to the wrist
ulnar-(term. branch) intrinsic muscles of hand except 3 thenar and 2 lateral lumbrical muscles, also: flexor carpi ulnaris and medial half of flexor digitorum profundus
medial nerve (term. branch)- most muscles in ant. compartment of forearm EXCEPT flexor carpi ulnaris and medial flexor digitorum profundus ALSO innervates 3 thenar muscles ad two lateral lumbericals. |
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Term
| branches of the posterior cord of brachial plexus and their innervations. |
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Definition
upper subscapular- subscapularis
thoracodorsal- latissimus dorsi (crutch walking)
Lower subscapular- subscapularis and teres major
axillary- (term. branch) deltoid and teres minor
radial- (terminal branch) all muscles in post compartment of arm and forearm including skin, and extensors of the hand. |
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Term
|
Definition
injury to superior parts of brachial plexus (C5-6)
-excessive increase in angle bw neck and shoulder
-paralysis of deltoid, biceps, brachialis and brachioradialis
- common in carrying a backpack |
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Term
|
Definition
injuries of inferior part of brachial plexus
- excessive pulling of upper limb superiorly |
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Term
| long thoracic nerve injury |
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Definition
'winged scapula'
-issues with lat. dorsi and serratus anterior
-seen when a pt pushes against a wall |
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Term
|
Definition
waiter's tip position
from falling on shoulder |
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Term
|
Definition
wrist drops
-from improper deltoid injection or tight cast
-thumb will not work correctly, hard to pick things up. |
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Term
|
Definition
numb palm and fingers
-cannot pronate and flex fingers
-if beneath flexor retinaclum then is carpal tunnel syndrome. |
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Term
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Definition
(clawhand)
-cannot abduct or adduct fingers
-atrophy of interosseus membrane |
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Term
| what are the 3 articulations at the elbow? |
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Definition
ulna with trochlea of humerus (process into fossa)
radius with capitulum
radius and ulna together |
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Term
| Branches of brachial artery |
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Definition
In arm:
1. profunda brachial artery
2. radial collateral
3. middle collateral
ELBOW
At forearm:
-becomes radial and ulnar arteries.
-runs to lateral side across anterior compartment |
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Term
Profundi brachial artery
-what it supplies and where it enters? |
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Definition
-posterior compartment
-enters with radial nerve |
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Term
musculosutaneous nerve
where does it enter?
what does it pass?
what does it innervate? |
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Definition
-enters arm by passing through the coracobrachialis
-bw biceps and brahcialis
-innervates biceps, and ant. compartment and skin of lateral surface of forearm (injury limits flexion and supination) |
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Term
median nerve.
where does it enter?
what does it pass?
what does it innervate? |
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Definition
- at inferior margin of teres major
-passes vertically down medial arm of ant. compartment WITH BRACHIAL ARTERY
-innervates pronator teres in arm, travels to forearm. |
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Term
ulnar nerve.
where does it enter?
what does it pass? |
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Definition
-enters with median and axillary artery
-passes posterior to medial epicondyle of humerus |
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|
Term
radial nerve.
where does it enter?
what does it pass?
what does it innervate? |
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Definition
-enters arm by crossing inferior margin of teres major muscle.
-passes medial to lateral in post. compartment
-innervates triceps, brachioradialis, extensor carpi radialis longus, brachialis on lateral side.
-also cutaneous innervation: inf. lateral and posterior of forearm. |
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Term
| Why is it hard to injure ulnar nerve and radial nerve? |
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Definition
| Lies bw biceps and brachialis |
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Term
| What ligaments reinforce the elbow joint and where? |
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Definition
-Anular and radial collateral ligament- reinforces lateral part.
-ulnar collateral ligament- reinforced medially |
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Term
| What is the vascular supply of the elbow joint? |
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Definition
-collateral and recurrent branches of brachial artery
-profunda brachii
-radial and ulnar arteries |
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Term
| What innervates the elbow joint? |
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Definition
| radial and musculocutaneous joints. |
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Term
| Where does a supracondylar fracture occur? And what other clinical manifestations can occur? |
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Definition
-above condyles of humerus
-ant. compartment of forearm can become ischemic
-reduces flexor muscles. |
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Term
| How does a 'pulled elbow' occur? How is it treated? |
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Definition
-being swung around by wrists (children)
-treated by supination and compression to relocate radial head. |
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Term
What is the cubital fossa?
What tendon attaches to it? Vasculature? Innervation? |
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Definition
-transition bw arm and forearm
-ant. to elbow
-biceps tendon, brachial artery and median nerve. |
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Term
| Best sites for venipuncture and their location |
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Definition
Median cubital vein- lies over cubital fossa
Cephalic vein- shown in forearn and arm, can be followed proximally where it empties into axillary vein
Basilic vein- shown in forearm and arm, divides to join brachial vein |
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Term
| Inappropriate sites for venipuncture |
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Definition
-arm on same side as mastectomy
-edematous areas
-hematomas
-arm in which blood is being transfused
-scarred areas
-arms with fistulas or vascular grafts
-sites above an IV cannula. |
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Term
| In general what does the anterior compartment do? posterior? |
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Definition
-flexes and pronates
-extends and supinates |
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|
Term
| What does the head of the ulna articulate with? |
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Definition
|
|
Term
| what carpals does the radius articulate with? |
|
Definition
|
|
Term
| What muscles are involved in supination and pronation? |
|
Definition
| biceps brachii, supinator, pronator teres, pronator quadratus, and anconeus |
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Term
| What are the affects of a medial nerve injury? |
|
Definition
-cannot flex joints of digits 1-3
-thenar muscle fxn lost
-when make a fist- fingers 2 and 3 stay extended |
|
|
Term
| what are the affects of an ulnar nerve injury? |
|
Definition
- Posterior to the medial epicondyle
-cubital tunnel syndrome. |
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|
Term
| How does the thumb have increased mobility? |
|
Definition
-No metacarpophalangeal joint between thumb and palmar ligament of index finger
-No saddle joint bw Metacarpal I and trapezium |
|
|
Term
|
Definition
tendons of extensors digitorum and pollicis longus pass to dorsal aspect of digits and expands to form hoods.
-many insertions here (lumbricals, interossei and abductor digiti minimi muscles)
-image: slide 209
-like when writing the upstroke of the t |
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