Upper Limb

  1. Anatomical Snuffbox
    • Anterior: Abductor pollicis longus & Extensor Pollicis Brevis
    • Posterior: Extensor Pollicis Longus
    • Radial Artery courses thru the box & passes to the Dorsum of the Hand
    • Superifcial branch of the Radial Nerve crosses the tendon of box and enters the Hand
  2. Muscles action: Z-position
    • Flexion of the PP (proximal phalanges) @ MCP
    • Extension of MP & DP ( middle & distal phalanges) @ IPs ( PIP & DIP)
    • Muscles are:
    • Lumbricals - small hand
    • Dorsi Interossei
    • Extensor digitorum
  3. Fibrous Digital Sheath
    • is a strong CT structure that arches over the tendons flexing the digits
    • there are 5 digital sheaths
    • attach to the margins of the phalanges
    • each form tunnels for 1 FDS tendon & 1 FDP tendon (except Thumb)
    • function as Retinacula
  4. Synovial Sheath
    • are Loose CT bursae located wherever tendon are retained by retinacula
    • located btwn the tendons to the 5 digits & respective fibrous digital sheath
    • located deep to the flexor & extensor retinacula
  5. 9:2:1
    • content of the carpal canal
    • 9 : 4 FDS tendons + 4 FDP tendons + 1 tendon of Flexor Pollicis Longus
    • 2: Ulnar bursa (synovial sheath surround 8 tendons) + Radial Bursa ( synovial sheath surroud Flexor Pollicis Longus)
    • 1: Median nerve
  6. Flexor Retinaculum
    • tranverse fibrous structure anterior to the carpals
    • Lateral attachment: Scaphoid & Trapezium
    • Medial attachment: Pisoform, Triangular & Hook of Hamate
  7. Extensor Retinaculum
    • transverse fibrous structure located on posterior surface of the distal FA (forearm)
    • Lateral attachment: Radius
    • Medial attachment: Ulna & triangular
    • Deep aspect: septa is attached to ridges on posterior surface of the Radius & ulna - 6 compartments
    • 1st - abductor pollicis longus & extensor pollicis brevis
    • Radial nerve
    • 3rd - extensor pollicis longus
    • 2nd- extensor carpi radialis longus & extensor carpi radialis brevis
    • 4th- extensor digitorum & extensor indicis
    • 5th- extensor digiti minimi
    • 6th- extensor carpi ulnaris
  8. Extensor Expansions
    • expanded tendons of insertion of extensor digitorum
    • located on the posterior surfance of the PP & MP of digits 2-5
    • each tendon splits into 3 bands
    • 1- central band : attaches to the posterior surface of base of MP
    • 2- collateral bands: attach to the posterior surface of base of DP
    • provides aponeurotic / tendinous fusion of digital extensors, lumbricals, & interossei muscles
  9. Trangular space of the Shoulder
    • Superior: Teres Minor ( Subscapularis : anteriorly
    • Inferior: Teres major
    • Lateral: Long head of Tricep
    • C: Circumflex scapular artery
  10. Triangular Auscultation
    • Boundaries
    • Latissimus dorsi
    • Trapezius
    • Medial border of Scapula
    • Floor
    • Rhomboid major
    • Chest wall
  11. Triangular Interval
    • Superior: Tere major
    • Medial: Long head of Tricep
    • Lateral: Lateral head of Tricep
    • C: Radial Nerve Profunda brachial artery
  12. Quadragular Space of the Shoulder
    • Superior: Teres minor ( subscapularis anteriorly )
    • Lateral: Sugerical Neck of humerous
    • Inferior: Teres major
    • Medial: Long Head of Tricep
    • C: Axillary Nerve Posterior circumflex humeral artery
  13. Connecting UL to Vertebral column
    • Trapezius
    • Lat. Dorsi
    • Levator Scapulae
    • rhomboid major & minor
  14. Connecting Scapula to Arm
    • Deltoid
    • Supraspinatus
    • infraspinatus
    • teres major & minor
    • subscapularis
  15. Connecting thoracic wall to Arm/ Scapula
    • Pectoralis major & minor
    • Subclavius
    • Serratus Anterior
  16. Bones of the pectoral girdle
    • clavicle
    • scapula
    • proximal humerus
  17. Insertion of Trapezius is the origin of
    • Deltoid
    • LAS
    • lateral 1/3 clavicle
    • Acromion
    • Spine of Scapula
  18. When cancer invades the Retromammary space of & attaches to deep fascia?
    • breast become less movable
    • contraction of Pmajor breast will move superiorly
  19. Infiltration of cancer along the suspensory ligament/ Fascial Septae
    dimpling of the skin similar to appearance of an organe peel
  20. Conections of intercostal vein with the vertebral venous plexus in the Breast region provide
    route for spread of cancer cells from the breast to the vertebrae & then to the skull and brain
  21. Pervertebral Fascia
    covers the brachial plexus
  22. What is sigificant about lymphatic vessels of the breast
    these vessels will anatomose across the midline so if cancer develop in one breast it can develop in the other
  23. What helps stablizes the Acromioclavicular joint
    coraococlavicular ligament
  24. What are Intra-articular discs
    • fibrous capsule attached at their periphery to the joint capsule
    • separate two cavities
  25. The sternoclavicular Joint is stablized by
    • costoclavicular ligament -type of fibrous joint
    • it is the only attachment of the UL with the axial skeleton
  26. What are the branches of the radial artery in the hand? What is the nerve within the thenar compartment
    • princeps pollicis a-principal thumb a.
    • radialis idicis -lateral side of the index finger
    • descends btwn 1st dorsal interosseous muscle & oblique head of the adductor p. near the base of the 1st phalanx
    • supplies skin & subcut tissue of thumb
    • Superficial palmar branch-from the rad a. prox wrist, thru thenar eminence which it supplies
  27. What supplies muscles of the thenar compartment? vs the hypothenar compartment?
    • Recurrent branch of the median nerve -Thenar compartment
    • Ulna nerve -hypothenar muscles except Palamis brevis supplied by superifical ulnar n.
  28. What is vincula?
    special folds of CT of long flexor tendons in the phalangeal region supplied by blood vessels, which these tendons pass from the periosteum of the phalanges w/n
  29. Describe what are fascial spaces of the mid palmar compartment?
    • defined as any area btwn fascial layers of a compartment
    • may contain tissue fluid
    • spaces are posterior to the radial & ulnar bursa & adductor pollicis muscle
    • separated by oblique palmar septum - 3 MC to Palmar Ap
    • Lat palmar space lat to oblique septum
    • Med palmar space med to oblique septum
    • infection to spaces can ONLY move proximally
Card Set
Upper Limb
Arteries, Nerves and terms