Anatomy of Shoulder and Upper Limb Muscles

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Questions and Answers

What is the primary action of the supraspinatus muscle during shoulder abduction?

  • Starts abduction up to 15 degrees (correct)
  • Adducts the arm
  • Extends the arm
  • Rotates the arm laterally

Which nerve supplies the infraspinatus muscle?

  • Radial nerve
  • Subscapular nerve
  • Axillary nerve
  • Suprascapular nerve (correct)

What is the insertion point for the teres minor muscle?

  • Greater tubercle below the infraspinatus (correct)
  • Top of the greater tubercle of the humerus
  • Deltoid tuberosity
  • Lesser tubercle of the humerus

Which muscle is responsible for adducting the arm and rotating it laterally?

<p>Infraspinatus (D)</p> Signup and view all the answers

What are the muscles connecting the upper limb with the vertebral column?

<p>Trapezius and latissimus dorsi (A)</p> Signup and view all the answers

Which part of the deltoid muscle is responsible for flexing the arm?

<p>Anterior part (C)</p> Signup and view all the answers

What is the nerve supply for the deltoid muscle?

<p>Axillary nerve (A)</p> Signup and view all the answers

What is the primary function of the trapezius muscle?

<p>To help in shoulder elevation (A)</p> Signup and view all the answers

Which head of the flexor digitorum superficialis originates from the medial epicondyle?

<p>Humero-ulnar head (C)</p> Signup and view all the answers

What is the primary action of the flexor carpi ulnaris?

<p>Flexion and adduction of the wrist joint (D)</p> Signup and view all the answers

Which nerve supplies the flexor digitorum superficialis?

<p>Median nerve (B)</p> Signup and view all the answers

Where do the tendons of the flexor digitorum superficialis insert?

<p>Margins of the middle phalanx (B)</p> Signup and view all the answers

Which muscle assists in flexion of the wrist joint along with the flexor carpi radialis?

<p>Flexor carpi ulnaris (D)</p> Signup and view all the answers

Which structure do the tendons of the flexor digitorum superficialis pass deep to?

<p>Flexor retinaculum (B)</p> Signup and view all the answers

What is the origin of the ulnar head of the flexor carpi ulnaris?

<p>Olecranon process (A)</p> Signup and view all the answers

Which of the following muscles lies deeper than the flexor carpi radialis?

<p>Flexor digitorum superficialis (A)</p> Signup and view all the answers

Which muscle does the radial nerve lie on in the cubital fossa?

<p>Supinator (B)</p> Signup and view all the answers

What does the radial nerve give off as it descends in the forearm?

<p>Posterior interosseous nerve (A)</p> Signup and view all the answers

Which of the following muscles is NOT supplied by the radial nerve?

<p>Pronator teres (C)</p> Signup and view all the answers

To which part of the hand does the radial nerve primarily supply sensation?

<p>Back of the lateral 2/3 of the hand (C)</p> Signup and view all the answers

What structure does the radial nerve wind around in the lower part of the forearm?

<p>Brachioradialis tendon (B)</p> Signup and view all the answers

Which branch of the radial nerve provides motor function?

<p>Posterior interosseous nerve (D)</p> Signup and view all the answers

What does the radial nerve supply in the upper arm?

<p>Long head of triceps (D)</p> Signup and view all the answers

Which muscle is located lateral to the radial nerve in the forearm?

<p>Flexor pollicis longus (B)</p> Signup and view all the answers

What is the primary action of the flexor pollicis longus muscle?

<p>Flexion of all joints of the thumb (C)</p> Signup and view all the answers

Which nerve supplies the flexor digitorum profundus for the medial four fingers?

<p>Ulnar nerve (D)</p> Signup and view all the answers

Which muscle is primarily responsible for pronating the forearm?

<p>Pronator quadratus (C)</p> Signup and view all the answers

The flexor digitorum profundus acts on which joints?

<p>Interphalangeal and metacarpophalangeal joints (B)</p> Signup and view all the answers

What is the origin point of the flexor pollicis longus muscle?

<p>Upper 2/3 of the anterior surface of the radius (B)</p> Signup and view all the answers

Which muscle originates from the anterior surface of the lower 1/3 of the ulna?

<p>Pronator quadratus (A)</p> Signup and view all the answers

What is the nerve supply for the flexor pollicis longus?

<p>Median nerve (C)</p> Signup and view all the answers

Which muscle binds the radius to the ulna?

<p>Pronator quadratus (C)</p> Signup and view all the answers

What is the action of the extensor pollicis longus?

<p>Extension of all joints of the thumb (D)</p> Signup and view all the answers

Which structure forms the floor of the anatomical snuff-box?

<p>Scaphoid (C)</p> Signup and view all the answers

Which nerve supplies the extensor indicis?

<p>Radial nerve (B)</p> Signup and view all the answers

What do the boundaries of the anatomical snuff-box include laterally?

<p>Tendon of abductor pollicis longus (B)</p> Signup and view all the answers

Which two tendons are responsible for the extension of the thumb?

<p>Extensor pollicis longus and extensor pollicis brevis (B)</p> Signup and view all the answers

What structure crosses the floor of the anatomical snuff-box?

<p>Radial artery (A)</p> Signup and view all the answers

Which structure is deep within the carpal tunnel?

<p>Tendon of flexor pollicis longus (A)</p> Signup and view all the answers

Which bone does the flexor retinaculum laterally attach to?

<p>Trapezium (A)</p> Signup and view all the answers

What happens to the thenar eminence in the case of nerve lesions above the elbow?

<p>It is hyperextended and flattened. (D)</p> Signup and view all the answers

Which muscles are primarily affected by lesions above the elbow?

<p>Pronators and flexors of the digits. (C)</p> Signup and view all the answers

What sensory loss is expected with a lesion just above the wrist?

<p>Loss of sensation in the lateral 31/2 fingers. (B)</p> Signup and view all the answers

What is the deformity called when the thumb is hyperextended due to muscle paralysis?

<p>Ape hand. (C)</p> Signup and view all the answers

Which of the following muscles is NOT affected by a lesion above the elbow?

<p>Brachialis. (B)</p> Signup and view all the answers

Where does the ulnar nerve arise from in the brachial plexus?

<p>Medial cord. (B)</p> Signup and view all the answers

What is the impact of a lesion above the elbow on the palmaris longus muscle?

<p>Weak flexion of the wrist. (B)</p> Signup and view all the answers

Which area experiences cutaneous supply loss due to a lesion above the elbow?

<p>Skin of the lateral 31/2 fingers. (C)</p> Signup and view all the answers

Flashcards

Supraspinatus

A muscle involved in abduction and rotation of the arm, aiding head of humerus stability in the glenoid cavity.

Infraspinatus

A rotator cuff muscle that aids in steadying the head of the humerus and rotation.

Teres Minor

A muscle responsible for adduction and lateral rotation of the arm, contributing to head of humerus stability.

Muscles connecting the upper limb with the vertebral column

The group of muscles responsible for connecting the upper limb with the vertebral column, playing a role in movement and stability of the shoulder and arm.

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Muscles connecting the upper limb with the ribs

The group of muscles connecting the upper limb with the ribs, contributing to movement and stability of the chest and arm.

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Deltoid

A powerful muscle responsible for flexion, extension, and abduction of the arm.

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Anterior Deltoid

The part of the deltoid muscle that flexes the arm and rotates it medially.

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Posterior Deltoid

The part of the deltoid muscle that extends the arm and rotates it laterally.

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Flexor Digitorum Superficialis: What does it do?

A muscle that flexes the middle finger joints and assists in wrist flexion.

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Flexor Digitorum Superficialis: Origin?

The flexor digitorum superficialis originates from two heads: one from the medial epicondyle and the other from the radius.

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Flexor Digitorum Superficialis: Insertion?

The flexor digitorum superficialis inserts into the middle phalanges of the middle four fingers.

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Flexor Digitorum Superficialis: Nerve supply?

The flexor digitorum superficialis is innervated by the median nerve.

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Flexor Carpi Ulnaris: What does it do?

A muscle that flexes and adducts the wrist joint.

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Flexor Carpi Ulnaris: Origin?

The flexor carpi ulnaris originates from two heads: one from the medial epicondyle and the other from the ulna.

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Flexor Carpi Ulnaris: Insertion?

The flexor carpi ulnaris inserts into the pisiform bone and the 5th metacarpal bone, connecting to the wrist and hand.

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Flexor Carpi Ulnaris: Nerve supply?

The flexor carpi ulnaris is innervated by the ulnar nerve.

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Deep Forearm Muscles

The deepest layer of forearm muscles, located in the anterior compartment. These muscles flex fingers, thumb, and pronate the forearm.

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Flexor Pollicis Longus

One of the deep forearm muscles, responsible for flexing all the joints of the thumb.

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Flexor Digitorum Profundus

A deep forearm muscle that flexes the fingers at all joints and helps flex the wrist.

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Pronator Quadratus

This deep forearm muscle helps to pronate the forearm by binding the radius to the ulna.

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Flexor Digitorum Profundus - Wrist

This deep muscle flexes the wrist and helps to flex the fingers.

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Flexor Digitorum Profundus - Fingertip

The deep forearm muscle that flexes the fingers at the fingertip

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Extensor Muscles of the Forearm

This muscle group is located at the back of the forearm and is responsible for extending the wrist, fingers, and thumb.

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Brachioradialis

The most lateral of the superficial extensor muscles, located on the back of the forearm.

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Extensor Retinaculum

A fibrous band that runs across the back of the wrist, holding the extensor tendons in place.

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Flexor Retinaculum

A fibrous band that runs across the front of the wrist, forming a tunnel (carpal tunnel) for the flexor tendons and the median nerve.

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Anatomical Snuff Box

A triangular space on the radial side of the wrist, formed by tendons of the thumb muscles.

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Extensor Pollicis Longus (EPL)

The muscle responsible for extending all the joints of the thumb.

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Extensor Pollicis Brevis (EPB)

The muscle responsible for extending the proximal phalanx (first bone) of the thumb.

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Extensor Indicis

The muscle that extends the index finger.

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Lateral Boundary of the Anatomical Snuff Box

The outermost part of the wrist region, containing the tendons of Abductor Pollicis Longus (APL) and Extensor Pollicis Brevis (EPB).

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Medial Boundary of the Anatomical Snuff Box

The innermost part of the wrist region, containing the tendon of Extensor Pollicis Longus (EPL).

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Radial Nerve - Path & Branches

A branch of the radial nerve that travels through the lateral intermuscular septum and supplies the posterior compartment of the arm and forearm.

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Radial Nerve - Hand innervation

This nerve supplies the back of the lateral 2/3 of the hand and the back of the lateral three and half fingers.

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Radial Nerve - Muscle Innervation

The radial nerve branches out to supply various muscles in the arm and forearm, including the triceps, anconeus, brachioradialis, extensor carpi radialis longus, and others.

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Radial Nerve - Sensory Branches

The radial nerve gives off branches to the skin of the back of the arm, lower part of the lateral side of the arm, and back of the forearm.

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Radial Nerve - Motor Functions

The radial nerve provides motor innervation to the posterior compartment of the forearm, controlling muscles responsible for wrist and finger extension.

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Posterior Interosseous Nerve

A branch of the radial nerve that supplies muscles involved in supination of the forearm.

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Radial Nerve - Summary

The main functions of the radial nerve are to control the muscles in the back of the arm and forearm, provide sensation to the back of the hand, and assist in extending the wrist and fingers.

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Median Nerve: Lateral Division

The nerve that supplies the muscles of the thenar eminence (flexor pollicis brevis, abductor pollicis brevis, and opponens pollicis), the 1st lumbrical muscle, and the palmar surfaces of the index and middle fingers.

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Median Nerve: Medial Division

The nerve that supplies the 2nd lumbrical muscle and the palmar surfaces of the middle and ring fingers.

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Ape-hand

A condition characterized by paralysis of the thenar muscles, resulting in a flattened thenar eminence and inability to oppose the thumb.

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Median Nerve Function (Wrist)

The median nerve supplies the muscles involved in wrist flexion, thumb flexion, and opposition.

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Median Nerve Injury (Above Elbow)

Damage to the median nerve above the elbow causes paralysis of the pronators, flexor digitorum superficialis, part of flexor digitorum profundus, and the thenar muscles. This results in loss of pronation, flexion of middle phalanges, and thumb opposition.

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Median Nerve Injury (Above Wrist)

Damage to the median nerve just above the wrist causes paralysis of the thenar muscles, resulting in Ape-hand.

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Ulnar Nerve: Course

The ulnar nerve originates from the medial cord of the brachial plexus and descends along the medial side of the arm to the forearm.

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Ulnar Nerve: Relations in the Axilla

The ulnar nerve is located medial to the axillary artery in the axilla, with the medial cutaneous nerve of the forearm anterior to it and the axillary vein medial to it.

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Study Notes

Bones of the Upper Limb

  • The upper limb consists of the shoulder girdle and 3 segments: the arm, forearm, and hand
  • The shoulder girdle connects the limb to the trunk. It comprises two scapulae and two clavicles.

Clavicle

  • Functions: Acts as a prop to allow the arm to swing away from the trunk and transmits part of the limb's weight to the trunk.
  • Structure: Has a shaft and two ends, medial and lateral. The lateral third is flattened, and the medial two-thirds are cylindrical. It displays four surfaces.
  • Superior surface: Smooth and subcutaneous. The sternomastoid takes origin from its medial third.
  • Inferior surface: Rough medially for the costoclavicular ligament and laterally for the coracoclavicular ligament (conoid and trapezoid parts). A groove is present for the subclavius muscle.
  • Anterior surface: Medially convex and laterally concave with attachment sites for muscles.
  • Posterior surface: Has a reverse curvature of the anterior surface.
  • Medial (sternal) end: Quadrangular in shape, articulates with the manubrium sterni to create the sternoclavicular joint. The articular disc and interclavicular ligament are attached here. Sternohyoid muscle is attached to its posterior surface.
  • Lateral (acromial) end: Flattened, articulates with the acromion to form the acromioclavicular joint.
  • Ossification: It's a long bone whose shaft ossifies in membrane. Its two ends ossify in cartilage. The first bone to begin ossification (5th week of intrauterine) is the clavicle, which fuses with the shaft at 25 years of age.
  • Applied Anatomy: Its weakest point is where the two curves meet (medial 2/3 and lateral 1/3); this is where fractures commonly occur.

Scapula

  • Shape: Triangular
  • Borders: Upper, medial, and lateral
  • Angles: Superior, lateral, and inferior
  • Surfaces: Anterior (subscapular fossa) and posterior (supraspinous and infraspinous fossae).
  • Upper border: Suprascapular notch(foramen) for suprascapular nerve and vessel passage.
  • Medial border: Attachment sites for elevator scapulae, rhomboids, and serratus anterior.
  • Lateral border: Attachment sites for teres minor, teres major, and long head of triceps.
  • Anterior surface: subscapular fossa.
  • Posterior surface: The spine runs from the superior angle to the inferior angle, dividing the surface into the supraspinous and infraspinous fossae.
  • Applied Anatomy: The weakest point is at the lateral border, where fractures commonly occur.

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