Tri 2: Extremities MORE Exam 1 Questions
What is hidden by the deltoid?
Teres minor
What muscles are innervated by the axillary branch?
Teres minor Deltoid
What are the borders of the Triangular Space?
Teres minor Teres major Long head of triceps
What are the borders of the Quadrangular Space?
Teres minor Teres major Long head of triceps Humerus
What are the branch's of Part 2 axillary artery?
Thoracacromial trunk Lateral thoracic artery
What is produced by the compression the components of the brachial plexus, the subclavian artery, or the subclavian vein?
Thoracic outlet syndrome
What are the four walls of the axilla?
Three muscular One bony
____ contraction of the rotator cuff muscles help keep the humerus head in the glenoid cavity
Tonic
What is the act of the interosseous membrane?
Transmit force from the hand to the humerus
What fracture may have significant proximal and distal displacement due to unopposed muscle action?
Transverse fracture
What is the large flat muscle that attaches the pectoral girdle to the trunk?
Trapezius
What are the 4 posterior appendicular muscles?
Trapezius and Latissimus dorsi (superficial) Levator scapulae and Rhomboids (deep)
What are the muscles of the Posterior Compartment of the Brachial Muscles?
Triceps Anconeus
On the distal part of the humerus what articulates with the Ulna?
Trochlea
What does the massive proximal end of the ulna articulate with?
Trochlea of humerus Head of radius
What do the coronoid process and olecranon process form? And what does it articulate with?
Trochlear notch Trochlea of humerus
may result from metastatic involvement of proximal brachial nodes or as a consequence of its treatment
UE lymphedema
What is the stabilizing bone of the forearm?
Ulna
What are the BIG infraclavicular branches that come off the Medial cord? Little infraclavicular branches?
Ulnar and Medial Medial pectoral, medial brachial cutaneous, and medial antebrachial cutaneous
What infraclavicular branch follows the axillary artery into the arm to accompany the brachial artery- runs medial to the medial epicondyle and enters the ore arm between the ulnar and humeral heads of flexor carpi ulnaris?
Ulnar branch
A fracture of the humerus at the medial epicondyle can impact what nerve?
Ulnar nerve
What of the ulna is the attachment of the brachialis muscle?
Ulnar tuberosity
Thumb dermatome
C6
3rd digit dermatome
C7
middle brachial plexus trunk
C7
where does the deep brachial artery branch off the brachial artery?
1-3 cm
the triangle of auscultation covers the intercostal space between ribs _____ and ______
6, 7
Thoracoacromial trunk branches
Acromial Deltoid Pectoral Clavicular
the acromial end of the clavicle articulates with the acromion of the scapula at the __________ joint
Acromioclavicular
What does the lateral spine of the scapula flatten into?
Acromion
the acromial (lateral) end of the clavicle articulates with the __________ at the acromioclavicular joint
Acromion of the scapula
When should a scaphoid fracture x-ray be repeated?
After 2 weeks
What divisions of the Brachial Plexus form the posterior cord?
All posterior divisions
What isolates the anterior and posterior compartment in the forearm?
Antebrachial fascia Interosseous membrane Intermuscular septa
Anterior divisions in the brachial plexus innervate the muscles of the ____ compartment in the arm and the forearm
Anterior
the __________ wall of the axilla is formed by the Pectoralis major and minor and the clavicopectoral fascia
Anterior
As the trunks of the Brachial plexus pass lateral to the 1st rib each trunk splits into ___ and ____ divisions as they pass beneath the clavicle and enter the _____ canal
Anterior Posterior Cervicoaxillary
4 muscles that move the pectoral girdle
Anterior axioappendicular muscles
What are the three distinct groups of the shoulder muscles?
Anterior axioappendicular muscles Posterior axioappednicular muscles Scapulohumeral muscles
the roots of the brachial plexus pass laterally between the __________ and _________ scalene muscles with the ___________ artery
Anterior/middle subclavian
What are the axillary borders?
Apex (roof) Base (floor) Four walls
What is at risk with a scaphoid fracture?
Avascular necrosis
__________ is a truncated pyramidal space located medial and inferior to the glenohumeral joint and superior to the axillary fascia located at the junction of the arm and thorax
Axilla
What are the BIG infraclavicular branches that come off the Posterior cord? Little infraclavicular branches?
Axillary and Radial Upper/Lower subscapular and Thorascodorsal
What is an extension of the subclavian artery as it passes the lateral border of the 1st rib?
Axillary artery
What infraclavicular branch passes through the quadrangular space with posterior circumflex humeral artery, sends a cutaneous branch and branch to teres minor, then passes posterior to surgical neck and supplies deltoid m?
Axillary branch
__________ forms the floor of the axillary
Axillary fascia
What are the contents of the Quadrangular Space?
Axillary nerve Posterior circumflex humeral vessels
A fracture of the humerus at the surgical neck can impact what nerve and what artery?
Axillary nerve posterior circumflex humeral artery
What are the contents of the axilla?
Axillary sheath Lymphatics
What is formed by the skin, subcutaneous tissue and fascia extending from the upper extremity to the thorax?
Base of axilla
the __________ vein begins on the ulnar side of the venous plexus and course on the medial aspect of the foramen and arm piercing the brachial fascia to join the brachial vein and form the axillary vein
Basilic
What has no direct attachment to humerus?
Biceps brachii
What is the strongest forearm flexor with forearm at 90 degrees and supinated and is the strongest forearm supinator with forearm at 90 degrees?
Biceps brachii
What does the axillary artery change into at the inferior border of the teres major?
Brachial artery
the _________ enshealthes the arm and attaches inferiorly to the epicondyle and olecranon
Brachial fascia
What is formed by the union of the anterior rami of C5-8 and T1?
Brachial plexus
Proximally to the axillary vein lays anteromedial to the artery and is formed by the union of the _____ and the _____ at the inferior border of the teres major
Brachial vein Basilic vein
What is the workhorse of the Anteiror compartment, located deep to biceps brachii and is a pure flexor?
Brachialis
Deltoid dermatome
C5
What gives a root to the Phrenic nerve?
C5
superior brachial plexus trunk
C5 and C6
5th digit dermatome
C8
inferior brachial plexus trunk
C8 and T1
What is the largest carpal bone?
Capitate
On the distal part of the humerus what articulates with the radius?
Capitulum
The thin proximal head of the radius articulates with what?
Capitulum of the humerus Radial notch of ulna
__________ forms on the radial side of venous plexus and courses proximally on the lateral arm crossing the arm to the delta-pectoral groove
Cephalic vein
arises from the seventh cervical vertebra
Cervical rib
- isolated fracture of the radial styloid - compression of the scaphoid bone of hand against the styloid process of distal radius
Chauffeurs fracture (Hutchison's)
What comes off the subscapular artery?
Circumflex scapula artery Thoracodorsal artery
What are the contents of the Triangular Space?
Circumflex scapular vessels
What connects the UE appendicular skeleton to axial skeleton?
Clavicle
What is the most commonly fractured bone?
Clavicle
The compression in TOS may be positional (caused by movement of the ____ and ____ ____ with arm movement) or static (caused by abnormalities of enlargement of various ____ surrounding the arteries, veins, and brachial plexus)
Clavicle Shoulder girdle Muscle
__________ descends from the clavicle to surround the subclavius muscle and pectoralis minor
Clavipectoral fascia
What are the different radius fractures?
Colle's Smith's Chauffeur's (Hutchison's)
What radial fracture is usually from forced dorsiflexion (hyperextension) of the hand, usually an associated ulnar styloid avulsion fractures, and "dinner fork" deformity from dorsal displacement of the fragments?
Colle's fracture
What are the Anterior compartment of the Brachial Muscles?
Coracobrachialis Biceps brachii (long and short head) Brachialis
What is a stout beak-like process superior to the glenoid fossa?
Coracoid process
What is a triangular space with a roof and floor?
Cubital fossa
What are the Scapulohumeral muscles?
Deltoid Teres major Rotator cuff (Supraspinatus, Infraspinatus, teres minor, Subscapularis)
What is the attachment of the inferior part of the middle trapezius?
Deltoid tubercle
What is located on the shaft of the humerus?
Deltoid tuberosity Radial (spiral) groove
What does the triquetrum articulate with?
Disc of the radioulnar joint
What end of the ulna tapers to the head and styloid process?
Distal
What forms the lips (crests) of the humerus?
Distal extensions of tubercles
What is the division of the axillary artery?
Divided into three parts by Pectoralis minor
(C5 root) pierces the middle scalene and passes inferiorly to the Rhomboids
Dorsal scapular nerve
What are the branches that come off the rami of the Brachial plexus?
Dorsal scapular nerve Long thoracic nerve
What are the four supraclavicular branches?
Dorsal scapular nerve (root) Long thoracic nerve (root) Nerve to subclavius (trunk) Suprascapular nerve (division)
Veins begin in the __________ of the hand
Dorsal venous plexus
What is the joint that articulates the humerus with the radius and ulna?
Elbow joint
__________ is a sheet of fibrous tissue that envelopes the body beneath the skin and/or encloses muscles and groups of muscles
Fascia
The ___ of the axilla is somewhat mobile depending on the position of the upper extremity
Floor
What Cubital Fossa boundary is brachialis and supinator?
Floor
The olecranon fossa accommodates olecranon of the ulna, for what ROM?
Full extension
What is the joint that articulates the humerus with the scapula?
Glenohumeral joint
What is the shallow, concave oval fossa for articulation of the humoral head?
Glenoid cavity
What is at the junction of the neck and shaft of the humerus?
Greater and lesser tubercles
What is formed by lateral extensions of the acromion?
Greater scapular notch
What carpal bone has an anteriorly directed hook?
Hamate
What fracture of the carpal bones is associated with injury to the distal ulnar nerve and artery?
Hamate fracture
What is the largest bone of the upper extremity?
Humerus
What divisions of the Brachial plexus form the medial cord?
Inferior anterior division of inferior trunk
The interosseous membrane runs between the transverse space between the radius and ulna, what way do the fibers run?
Inferno-medially from the radius to the ulna
What is the oblique cord proximal to neurovascular hiatus?
Interosseous membrane
What is for the tendon of the long head of biceps?
Intertubercular groove
What Cubital Fossa boundary is an extensor tendon from the lateral epicondyle, brachioradialis?
Lateral
the __________ wall of the axilla is formed by the interbercular groove of humerus
Lateral
What are the cords of the brachial plexus?
Lateral Medial Posterior
What infraclavicular branches come together to form the median nerve?
Lateral and medial
What infraclavicular branch pierces the clavipectoral fascia superior to Pectoralis minor- enters the Clavicular head of pectoralis major?
Lateral pectoral
What are the branches that come off the cords of the Brachial Plexus?
Lateral pectoral nerve Medial pectoral nerve Medial brachial cutaneous nerve Medial antebrachial cutaneous nerve Lower subscapular nerve Upper scapular nerve Thoracodorsal nerve
What muscle is innervated by the Thoracodorsal nerve?
Latissimus dorsi
What muscle raises the trunk to the arm (pull ups) and weakness significantly impairs climbing?
Latissimus dorsi
What is the location of the base of the axilla?
Level of 4th rib
What part of the biceps brachii passes through the intertubecular sulcus under the transverse humeral ligament?
Long head
What does the lateral thoracic artery run with?
Long thoracic nerve
__________ injury can result in winging and inability to raise the arm past horizontal due to inability to rotate glenoid
Long thoracic nerve
from C5,6,7 passes inferiorly on to the surface of the Serratus Anterior
Long thoracic nerve
What infraclavicular branch passes directly to subscapularis with a branch to teres major?
Lower scapular nerve
What carpal bone is moon shaped?
Lunate
the ulnar nerve runs with...
MBC and MABC nerves
Who has more robust and curvaceous clavicles?
Manual laborers
the sternal end of the clavicle articulates with the __________ at the sternoclavicular joint
Manubrium
At the proximal end of the humerus the spherical head allows what?
Maximum ROM
What Cubital Fossa boundary is a common flexor forearm tendon and pronator teres?
Medial
the __________ wall of the axilla is formed by the lateral thoracic wall (4th and 5th ribs) and serratus anterior
Medial
What epicondyle of the humerus is for flexor attachment? Extensor attachment?
Medial (flexor) Lateral (extensor)
What are the borders of the scapula?
Medial (vertebral) Lateral (axillary) Superior
What are the parts of the supracondylar ridge of the humerus?
Medial and lateral
the __________extends the medial and lateral surface of the humerus and separates the arm into the anterior (flexor) and posterior (extensor) compartments
Medial and lateral inter muscular septa
What infraclavicular branch runs with axillary an brachial arteries then runs inferiorly with the basilic vein?
Medial antebrachial cutaneous nerve
What infraclavicular branch runs parallel and abuts axillary and brachial veins to the medial aspect of arm?
Medial brachial cutaneous nerve
What infraclavicular branch pierces pectoralis minor and enters Pectoralis major?
Medial pectoral nerve
the ___________ vein crosses the antebrachial fossa to communicate between the cephalic and basilic veins
Median cubital
A fracture of the humerus at the distal end can impact what nerve?
Median nerve
What infraclavicular branch forms from the medial and lateral branches on anterior surface of axillary artery (encircles the axillary artery)- accompanies the brachial artery into the forearm, enters the forearm between the deep and superficial head of the pronator teres?
Median nerve
What are the contents of the Cubital Fossa Medial to Lateral?
Median nerve Terminal brachial artery Biceps tendon Deep radial nerve
What runs posterior-medial to the Coracobrachialis?
Median nerve and brachial artery
The sympathetic fibers from the ___ and ___ cervical ganglia join the roots of the Brachial Plexus as they pass between the scalenes
Middle Inferior
What part of the radius is the most common fracture site?
Middle third
What are the BIG infraclavicular branches that come off the Lateral cord? Little infraclavicular branches?
Musculocutaneous and Lateral Lateral pectoral
What is the innervation for all of the Anterior Compartment of brachial Muscles?
Musculocutaneous nerve
What pierces the Coracobrachialis?
Musculocutaneous nerve
What infraclavicular branch pierces coracobrachialis m and then emerges between the biceps m and brachialis, becomes the lateral cutaneous nerve to the forearm- runs parallel to the cephalic vein in the forearm?
Musculocutensous branch
What are the contents of the axillary sheath?
Nerve Artery Vein
passes directly to the inferior surface of clavicle gives branch to sternoclavicular joint
Nerve to Subclavius
What are the branches that come off the trunks/divisions of the Brachial Plexus?
Nerve to Subclavius Suprascapular nerve
What are the subtypes of Thoracic Outlet Syndrome (TOS)?
Neurogenic Arterial Venous
What is the main concern with humerus fractures?
Neurovascular status
What enters at the distal end of the Coracobrachialis?
Nutrient artery of humerus
On the ulna what serves as a short stout lever arm for extension?
Olecranon
What is the axillary artery part is superior to the Pectoralis minor?
Part 1
What axillary artery part is deep to pectoralis minor?
Part 2
What axillary artery part is inferior to pectoralis minor?
Part 3
__________invests the pectoralis major muscle and is continuous with abdominal wall fascia and leaves the lateral border of the pectoralis to become axillary fascia
Pectoral fascia
What muscle is described? -large fan shaped muscle on the superior thorax -forms the anterior wall and inferior border of the axilla -forms the inferior border of the delta pectoral groove that contains the cephalic vein -lies anterior to the clavicopectoral fascia
Pectoralis major
What muscle is innervated by the Lateral pectoral?
Pectoralis major
What muscles are innervated by the Medial Pectoral nerve?
Pectoralis major Pectoralis minor
What are the Anterior Axioappendicular muscles?
Pectoralis major and minor Subclavius Serratus anterior
What muscles is described? -forms the anterior wall of the axilla deep to Pectoralis major
Pectoralis minor
3rd segment of the axillary artery branches to form a _______ collateral circulation system with the ___ subclavian branches
Peri-scapular Distal
What carpal bone is pea like on the palmar surface?
Pisiform
Posterior divisions in the brachial plexus innervate muscles of the ___ compartment of the arm and forearm
Posterior
the __________ wall of the axilla is formed mainly by the scapula and subscapularis on the anterior surface, inferiorly by teres major and Latissimus dorsi
Posterior
Which styloid process is larger and extends more distally?
Radial
What infraclavicular branch passes around humerus at radial groove with profunda brachii a. To the lateral humerus inferior to deltoid insertion and runs between the brachioradialis and brachial proximal to the elbow it divides into the deep and superficial branches?
Radial branch
A fracture of the humerus at the radial groove can impact what nerve?
Radial nerve
What innervated the Posterior compartment muscles?
Radial nerve
What are the contents of the Triangular Interval?
Radial nerve Deep brachia vessels (profunda brachii)
What on the radius is where the biceps brachii tendon inserts?
Radial tuberosity
What do the scaphoid and lunate articulate with?
Radius
What is the floor of the triangle of auscultation formed form?
Rhomboid major
What is located deep to trapezius?
Rhomboid major and minor
What Cubital Fossa boundary is skin, Median cubital vein, fat, fascia, and Bicipital aponeurosis?
Roof
What is often injured in throwing athletes and others through neglect?
Rotator cuff
What muscles suffer wear and tear to the tendons, especially the Supraspinatus?
Rotator cuff
Small branches arise from all roots to supply the ______ and ________ muscles
Scalene/longus coli
What carpal bone is the largest proximally?
Scaphoid
What fracture is difficult to visualize radiographically in the acute setting?
Scaphoid
What carpal bones articulates with the distal radius?
Scaphoid and lunate
What is the most common carpal bone fracture that is associated from a fall on an open palm and occurs across the waist?
Scaphoid fracture
What is the triangular shaped flat bone?
Scapula
__________ invests each muscle originating from the surface of the scapula (Supra/Infraspinatus and subscapularis) creating a tough fascia compartment
Scapular fascia
What divides the supra- and infra- spinous fossa on the posterior surface?
Scapular spine
6 muscles that act on the glenohumeral joint
Scapulohumeral muscles
What separates the anatomical neck from the head of the humerus?
Subcapital groove
What muscle is described? -found on the inferior surface of the clavicle to 1st rib
Subclavius
What are the branches of Part 3 axillary artery?
Subscapular artery Anterior humeral circumflex Posterior humeral circumflex
What fossa in the on the anterior surface of the scapula?
Subscapular fossa
What muscle is innervated by the upper scapular nerve?
Subscapularis
What muscles are innervated by the lower subscapular nerve?
Subscapularis Teres major
What muscles function in antagonist and synergistic groups to position the scapuloclavicular joint?
Superficial and deep
What Cubital Fossa boundary is a line from the medial to the lateral epicondyles?
Superior
What are the angles of the scapula?
Superior Lateral Inferior
What are the boundaries of the Cubital Fossa?
Superior Medial Lateral Floor Roof
What infraclavicular branch passes directly to subscapularis?
Upper scapular nerve
the __________ serves as a passage way for neurovascular structures from the trunk to the upper extremity
axilla
The brachial artery: - a continuation of the __________ artery -begins at the lower border of __________ -ends in the __________ -splits into the __________ and ___________ arteries opposite the neck of the radius -runs in the __________, anterior to triceps and brachialis, medial to humerus -enters cubital fossa (with median nerve) __________to the medial supracondylar ridge
axillary teres major cubital fossa radial, ulnar bicipital groove anterior
the posterior circumflex humeral artery runs with the...
axillary nerve
the __________ vein forms at the elbow by the confluence of the radial and ulnar veins and is joined by the basilic vein to form the axillary vein
brachial
the median nerve runs with the...
brachial artery
which lymph node comes from 3 nodes?
central
CALL (go through clavipectoral fascia)
cephalic vein pectoral branch of thoracoacromial artery lateral pectoral nerve lymphatics
axilla apex is bounded by:
clavicle 1st rib scapula
The cephalic vein will pierce the __________ fascia to join the axillary vein
clavipectoral
The __________ accommodates the coronoid process of the ulna for full flexion
coronoid fossa
the radial nerve runs with...
deep brachial artery
the __________ artery supplies the medial scapula
dorsal scapular
Heads of Pectoralis major can act independently - clavicular head alone acts to _____the humerus - when flexed, the sternocostal head __________ it from its flexed position
flex extends
most common site of sesamoid bones in the hand is the __________
flexor pollicis longus tendon
Where does the axillary artery become the brachial artery
inferior border of teres major
__________ artery anastomoses with the anterior ulnar recurrent artery
inferior ulnar collateral artery
the brachial artery runs with the...
median nerve
the deep brachial artery branches into the:
middle and radial collateral branches
__________ artery supplies the humerus at coracobrachialis
nutrient
superficial and deep veins communicate via:
perforating veins
the axillary nerve runs with...
posterior circumflex humeral artery
where does the recurrent interosseous artery branch from?
posterior interosseous artery
What is the purpose of the radial (spiral) groove of the humerus?
profunda brachii (deep brachial artery)
mid humeral fracture leads to damage of the:
profunda brachii and radial nerve
The __________ accommodates the head of the radius for full flexion
radial fossa
the deep brachial artery runs with...
radial nerve
___________ is the most common complication of humeral fractures
radial nerve entrapment
Where does the subclavian artery become the axillary artery?
rib 1
clavicles are thicker on the right side of the body in _____ handed individuals and thicker on the left side of the body in _____ handed individuals
right left
the axillary vein becomes the __________ at the inferior border of the 1st rib
subclavian vein
__________ artery anastomoses with the posterior ulnar recurrent artery
superior ulnar collateral
the __________ arteries supply the lateral/superior scapula
suprascapular & circumflex scapular
Which rotator cuff muscle is most commonly injured?
supraspinatus
rotator cuff muscles
supraspinatus infraspinatus teres minor subscapularis
the apex of the axilla is also known as the _________
thoracic outlet; cervicoaxillary canal
the triangle of auscultation is found between:
trapezius latissimus dorsi medial border of scapula
coracoclavicular ligament
trapezoid ligament and conoid ligament
superior trapezius by CN XI
upward rotation of lateral angle of scapula
serratus anterior test: pushing against the wall, weakness results in __________ of the scapula
winging
4 muscles which attach the upper limb to the skeleton of the trunk
Posterior axioappendicular muscles
What muscles serve to position and fix the base of the upper extremity (scapula and clavicle) so that the limb can function?
Posterior axioappendicular muscles
What forms the posterior inferior body of the axilla?
Teres major
What does the lateral thoracic artery supply?
Serratus anterior
What muscle is described? -located along lateral thorax, forms medial wall of axilla -attaches to whole length of medial scapula -most powerful muscle of pectoral girdle
Serratus anterior
ventral displacement of radius fragments; hyperflexion
Smith's fracture
What stage of rotator cuff injury is edema and hemorrhage, most commonly affecting persons younger than 25 years?
Stage 1
What stage of rotator cuff injury is fibrosis and tendinitis, most commonly affecting persons aged 25-40 years?
Stage 2
What stage of rotator cuff injury is tears of cuff, most commonly affecting persons older than 50 years old?
Stage 3
the sternal end of the clavicle articulates with the manubrium at the ____________ joint
Sternoclavicular
What joint is only holding the upper extremity to the axial skeleton?
Sternoclavicular joint
What are the borders of the Triangular Interval?
Teres major Long head of triceps Lateral head of triceps
What divisions of the brachial plexus form the lateral cord?
Superior and middle anterior divisions
What is the branch of the Part 1 axillary artery?
Superior thoracic artery
What supplies the first two intercostal spaces?
Superior thoracic artery
runs parallel to the suprascapular artery to the suprascapular notch (beneath suprascapular ligament) supplies the Supraspinatus m around the greater scapular notch to the Infraspinatus m
Suprascapular nerve
What is the division of the posterior surface of the scapula?
Supraspinous fossa Infraspinous fossa
What is the most common fracture site of the humerus?
Surgical neck
Where do proximal fractures of the humerus occur?
Surgical neck
The lower clavipectoral fascia forms the ____ _____ of the axillary which pulls the axillary fascia thought when the UE is abducted
Suspensory ligament
