Glossary of Upper limb forum

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Sternoclavicular joint
-It is a double synovial PLANE (GLIDING) JOINT and united by fibrous capsule
-It is reinforced by anterior and posterior sternoclavicular, intercalvicular and costoclavicular ligaments
-Allows elevation and depression,protraction and retraction, and circumduction of the shoulder
Acromioclavicular joint
-Is a synovial PLANE joint that allows a gliding movement when scapula rotates and is reinforced by CORACOCLAVICULAR LIGAMENT, which consist of conoid and trapezoid ligaments
Glenohumeral joint (shoulder)
-Is a synovial BALL-AND-SOCKET joint between glenoid cavity of scapula and head of humerus. Both articular surfaces are covered with hyaline cartilage
-Is surrounded by FIBROUS CAPSULE that is attached superiorly to glenoid cavity and inferiorly to anatomic neck of humerus. The capsule is reinforced by ROTATOR CUFF, GLENOHUMERAL LIGAMENTS and CORACOHUMERAL LIGAMENTS.
-Has a cavity that is deepened by fibrocartilaginous GLENOID LABRUM, communicates with subscapular bursa, allows abduction, adduction, flexion, extension, circumduction and rotation
-Innervated by axillary. lateral pectoral and suprascapular nerves.
-May be subject to inferior or anterior DISLOCATION, which stretches fibrous capsule, avulses glenoid labrum and can injure axillary nerve
Elbow joint
-Forms a synovial HINGE joint, consists of HUMERORADIAL and HUMEROULNAR joints, allows flexion and extension, innervated by musclulocutaneous, median, radial and ulnar nerves
Proximal radioulnar joint
- forms a synovial PIVOT joint in which the head of the raius articulates with the radial notch of the ulna and allows PRONATION AND SUPINATION
Distal radioulnar joint
-Forms a synovial PIVOT joint between head of the ulna and ulnar notch of the radius and allows PRONATION AND SUPINATION
Radiocarpal (wrist) joint
-Is a synovial CONDYLAR joint formed superiorly by radius and inferiorly by proximal row of carpal bones(mostly scaphoid and lunate), EXCEPT pisiform.
-Allows flexion, extension, abduction, adduction and circumduction
Intercarpal joints
-Joints between individual carpal bones
-Plane synovial joints
Carpometacarpal joints
-Form synovial SADDLE joint between carpal bone (trapezium) and first metacarpal bone, allowing flexion, extension, abduction, adduction and circumduction
-Also form PLANE synovial joints between carpal bones and medial four metacarpal bones, allowing simple gliding movement
Intermetacarpal joint
- articulation between adjacent sides of proximal ends of metacarpals 2-5
- synovial PLANE joint, limited motion
Metacarpophalangeal joint
-CONDYLOID joint, supported by palmar and two collateral ligaments, allows flexion, extension, abduction and adduction, circumduction
Interphalangeal joint
-HINGE joint, supported by palmar ligament and two collateral ligaments, allow flexion and extension.
Identify rotator cuff muscles, what is their primary function?
SItS - subscapularis, supraspinatus, infraspinatus and teres minor
Primary function is to keep head of humerus in the glenoid fossa and stabilizing shoulder joint
Describe muscular and fascial borders of axilla
MEDIAL WALL - upper ribs and their intercostal muscles and serratus anterior
LATERAL WALL - humerus
POSTERIOR WALL- subscapularis, teres major, latissimus dorsi
ANTERIOR WALL- pectoralis major and minor
BASE- axillary fascia
APEX- interval between clavicle, scapula and first rib
Describe contents of axilla
axillary vasculaturs, branches of brachial plexus, lymph nodes and areolar tissue
Identify structures that pierce costocoracoid membrane
-Is a part of clavipectoral fascia that covers deltopectoral triangle and interval between subclavius and pectoralis minor
Which muscles provide flexion at glenohumeral joint
DELTOID (anterior part)
PECTORALIS MAJOR (clavicular part)
Which muscles provide flexion at elbow joint
Which muscles provide flexion at wrist joint
Which muscles provide flexion at metacarpophalangeal joints of fingers 2-5
Whats is the primary flexor of proximal interphalangeal joint
Flexor digitorum superficialis
What is the primary flexor of distal interphalangeal joint
Flexor digitorum profundus
Name muscles of the anterior compartment of the arm which are supplied by musculocutaneous nerve
Biceps brachii
Name muscles of the posterior compartment of the arm which are supplied by radial nerve
Name muscles of posterior compartment of forearm which are supplied by radial nerve
SUPERFICIAL - brachioradialis, extensor carpi radialis longus, extensor carpi radialis brevis, extensor carpi ulnaris, extensor digitorum, extensor digiti minimi
DEEP - supinator, abductor pollicis longus, extensor pollicis longus, extensor pollicis brevis, extensor indicis
Name muscles of anterior compartment of forearm innervated by median nerve
SUPERFICIAL - pronator teres, flexor carpi radialis, palmaris longus
MIDDLE - flexor digitorum superficialis
DEEP flexor digitorum profundus, flexor pollicis longus,pronator quadratus
Which ONE muscle of the anterior compartment of the forearm innervated by ulnar nerve
Which muscle of the anterior compartment of forearm innervated by both median and ulnar nerve
Flexor digitorum profundus
Name thenar muscles and their innervation
Muscles - abductor pollcis brevis, opponens pollicis and flexor pollicis brevis
ALL innervated by MEDIAN NERVE, except flexor pollicis brevis which is innervated by both MEDIAN AND ULNAR NERVES
Which muscle innervates ADDUCTOR POLLICIS muscle
Ulnar nerve
Name hypothenar muscles and their innervation
Abductor digiti minimi, opponens digiti minimi. flexor digiti minimi
ALL innervated by ULNAR NERVE
What innervates INTEROSSEI muscles
Ulnar nerve
What innervates two medial lumbricals
What innervates two lateal lumbricals
Describe upper brachial plexus injury
Occurs during fall on shoulder or during difficult delivery, causes arm to be medially rotated, and forearm pronated, called waiters tip hand or ERB DUSCHENNE PARALYSIS
Describe lower brachial plexus injury
Caused during excessive ABduction of the arm or by stab or bullet wounds, causing a CLAW HAND.
Describe results of axillary nerve damage
Caused by fracture of surgical neck of humerus or inferior dislocation of humerus. It results in weakness of lateral rotation and abduction of arm (supraspinatus can abduct arm but not to horizontal level)
Describe results of radial nerve injury
Caused by the fracture of the midshaft of the humerus. Results in loss of function in extensors of forearm, hand, metacarpals, and phalanges. It also results in loss of wrist extension, leading to WRIST DROP, and produces weakness in ABduction and ADDuction of the hand
Describe results of injury to musculocutaneous nerve
Results in weakness of supination - BICEPS and forearm flexion - BRACHIALIS AND BICEPS
Describe results of injury to MEDIAN NERVE
May be caused by supracondylar fracture of the humerus or compression of carpal tunnel.It results in loss of pronation, opposition of the thumb, flexion of lateral two interphalangeal joints and impairment of medial two interphalangeal joints. It also produces characteristic flattening of thenar compartment called APE HAND
Describe results of injury to ULNAR NERVE
Caused by fracture of medial epicondyle and results in CLAW HAND, in which ring and little fingers are hyperextended at metacarpophlangeal joints and flexed in interphalangeal joints.It results in loss of abduction and adduction of fingers and flexion of MP joints, because of paralysis of paralysis of palmar and dorsal interossei's and medial two lumbricals.It also produces a wasted hypothenar eminence and palm and also leads to loss of adduction of thumb because of paralysis of ADDUCTOR POLLICIS
Describe borders of cubital fossa and name important structures inside
-Is a v shaped interval on anterior side of elbow that is bounded laterally by BRACHIORADIALIS and medially by PRONATOR TERES.
-Has an upper limit that is an imaginary line connecting epicondyles with a floor formed by brachialis and supinator musles
-Has a lower end where brachial artery divides into radial and ulnar with a fascial roof strengthened by bicipital aponeurosis
Name two branches of subclavian artery and describe
SUPRASCAPULAR- branch of thyrocervical trunk, passes ABOVE superior transverse scapular ligament(nerve goes UNDER ligament), anastomoses with DORSAL SCAPULAR and CIRCUMFLEX SCAPULAR to form collateral circulation around scapula, supplies supraspinatus, infraspinatus and shoulder and AC joints.
DORSAL SCAPULAR- accompanies dorsal scapular nerve, supplies levator scapulae, major and minor rhomboids, serratus anterior
Describe axillary artery
Central structure of AXILLA
from the outer border of first rib to inferior border of teres major where it becomes BRACHIAL ARTERY, bordered on medial side by axillary vein, divided into three parts by pectoralis minor
Supreme thoracic artery
supplies intercostal muscles
Thoracoacromial artery - name branches, what does it go through?
Short trunk from first or second part of axillary artery, has PECTORAL, CLAVICULAR, DELTOID and ACROMIAL branches.
-Pierces costocoracoid membrane (clavipectoral fascia)
Lateral thoracic artery- where does it run, what does it supply
-Runs along lateral border of pectoralis minor
-Supplies pectoralis major, pectoralis minor, serratus anterior and axillary lymph nodes
Subscapular artery-divides into two - what are they? what do they supply?
Largest branch of axillary artery, arises as lower border of subscapularis and descends along axillary border of scapula. Divides into thoracodorsal and circumflex scapular
THORACODORSAL- runs with thoracodorsal nerve, supplies lat dorsi amd lateral thoracic wall
CIRCUMFLEX SCAPULAR - passes in triangular space(teres minor, teres major, long head of triceps), anastomoses with dorsal scapular and suprascapular
Which arteries form scapula anastomosis?
Dorsal scapular, subscapular, and suprascapular
Anterior humeral circumflex
Pass anteriorly around surgical neck of humerus
anastomoses with posterior circumflex humeral
Posterior humeral circumflex
Runs with axillary nerve through quadrangular space (teres minor, teres major, triceps, humerus)
Describe brachial artery and name branches
Extends from inferior part of teres major to bifurcation in cubital fossa.
Lies on triceps, then on brachialis muscles medial to coracobrachialis and biceps and accompanied by basilic vein in the middle of the arm
Lies in the center of the arm medial to biceps, lateral to median nerve, deep to bicipital aponeurosis. Place for putting stethoscope for BP measurement. Terminated at cubital fossa when bifurcates into radial and ulnar
Branches - profunda, superior ulnar collateral, inferior
ulnar collateral
Describe radial artery and name branches
Descends from cubital fossa under brachioradialis with superficial radial nerve on the lateral side, on supinator and flexor pollicis longus.
Runs through anatomic snuffbox, divides into PRINCEPS POLLICIS AND DEEP PALMAR ARCH
Branches - radial recurrent (between brachioradialis and brachialis), palmar carpal, superficial palmar, dorsal carpal, princeps pollicis(two proper digital arteris for the thumb), radialis indicis and deep palmar arch
Describe ulnar arteries and name branches
LARGER MEDIAL BRANCH of the brachial artery in cubital fossa, lies between flexor digitorum superficialis and profundus
Contributes to superficial palmar arch, gives rise to three common palmar digital arteries each of which bifurcates into proper palmar digital arteries which run distally to supply adjacent sides of fingers
What does carpal tunnel contain
Describe lymphatic drainage of upper limb
Lymph vessels from radial side of hand drain into axillary nodes, whereas some lymph nodes from ulnar side can drain into cubital and then into axillary nodes
Breast drains primarily into AXILLARY nodes (75%), more specifically to pectoral nodes. Also drains to apical nodes, opposite breast, abd wall.
Distal muscles are innervated by..
antomically LOWER spinal cord segments
Which nerve provides cutaneous innervation to skin overlying acromion
Branches of nerves from cervical plexus
Metastases from medial quadrants of breast are difficult to ascertain because drainage of this areas pass to which nodes?
Which artery accompanies radial nerve as it courses posterior to humerus
Deep brachial
Describe generally brachial plexus
-Formed by VENTRAL RAMI of C5-T1
-Enclosed with axillary artery and vein in AXILLARY SHEATH which is formed by prolongation of prevertebral fascia
Injury of which nerve would complete abolish ability to pronate hand
What are cord levels for ulnar nerve
Where does ulnar nerve course
Arises from medial cord of brachial plexus, runs down medial aspect of arm, descends between FLEXOR CARPI ULNARIS and FLEXOR DIGITORUM PROFUNDUS
Enters hand superficial to FLEXOR RETINACULUM and lateral to PISIFORM BONE
What muscle is the major flexor of forearm
Radial nerve is a branch of ..
Posterior cord of brachial plexus
Where does the radial nerve course?
on the back of the humerus;
Which muscle is injured when you try to catch something heavy?
Flexibility of the hand is gained by the presense of?
Presense of mid carpal joint
Which joint characteristic is responsible for unique range of motion of thumb
saddle joint between trapezium and 1st metacarpal

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