Anatomy of the Upper Limb Bones
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Questions and Answers

What structure is directly responsible for the arm's medial rotation during flexion?

  • Pectoralis minor
  • Subclavius
  • Pectoralis major (correct)
  • Serratus anterior
  • Which artery does NOT supply blood to the breast?

  • Internal thoracic artery
  • Brachial artery (correct)
  • Thoracoacromial artery
  • Lateral thoracic artery
  • What is the innervation of the serratus anterior muscle?

  • Medial pectoral nerve
  • Medial nerve
  • Lateral pectoral nerve
  • Long thoracic nerve (correct)
  • Which of the following lymph nodes would primarily drain the upper lateral quadrant of the breast?

    <p>Apical axillary lymph nodes (D)</p> Signup and view all the answers

    What is the primary action of the pectoralis minor muscle?

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

    Where does the subclavius muscle insert?

    <p>Subclavian groove on clavicle (C)</p> Signup and view all the answers

    The axillary region is primarily surrounded by which muscles?

    <p>Pectoralis major and teres major (D)</p> Signup and view all the answers

    Which nerve roots contribute to the innervation of pectoral major muscle?

    <p>C5 - C7 (C)</p> Signup and view all the answers

    What is the characteristic feature of the clavicle's medial end?

    <p>Round and forms the sternoclavicular joint (C)</p> Signup and view all the answers

    Which artery is primarily transmitted through the nutrient foramen at the lateral end of the clavicle?

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

    What is the primary function of the suprascapular notch?

    <p>Passage for the suprascapular nerve (B)</p> Signup and view all the answers

    Which part of the humerus is commonly associated with dislocation?

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

    Which nerve is affected leading to a 'wrist drop' due to a humeral fracture?

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

    What does the retromammary space in the breast provide?

    <p>Loose areolar tissue allowing mobility (A)</p> Signup and view all the answers

    What is the significance of the medial epicondyle of the humerus?

    <p>More projected than the lateral epicondyle (D)</p> Signup and view all the answers

    Which rib corresponds with the superior angle of the scapula?

    <p>2nd rib (B)</p> Signup and view all the answers

    Which of the following nerves is associated with the dorsal scapular nerve?

    <p>C5 (B)</p> Signup and view all the answers

    Which trunk of the brachial plexus contains the C7 contribution?

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

    What is the primary muscle affected in Erb's paralysis?

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

    Which cord of the brachial plexus is formed by the anterior divisions of the lower trunk?

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

    During excessive abduction, which paralysis is likely to occur?

    <p>Klumpke's paralysis (B)</p> Signup and view all the answers

    What is the arrangement of the brachial plexus from its roots to the branches?

    <p>Roots &gt; Trunks &gt; Divisions &gt; Cords &gt; Branches (A)</p> Signup and view all the answers

    Which nerve is NOT a branch from the posterior cord of the brachial plexus?

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

    What is the primary deformity associated with Klumpke's paralysis?

    <p>Extension of the MPJ and flexion of the IPJ (A)</p> Signup and view all the answers

    Flashcards

    Clavicle

    A long bone in the shoulder, shaped like an 'S' and connecting the shoulder blade to the breastbone.

    Scapula

    A triangular bone in the back, connecting to the humerus.

    Humerus

    The upper arm bone connecting the shoulder to the elbow.

    Humerus Head

    The rounded top of the humerus that fits into the shoulder socket.

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    Bicipital Groove

    The groove on the humerus for the biceps tendon.

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    Deltoid Tuberosity

    The prominent bump on the humerus where the deltoid muscle attaches.

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    Trochlea

    The large, pulley-like structure on the lower end of the humerus.

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    Capitulum

    A small, rounded prominence on the lower end of the humerus.

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    Pectoralis Major

    The largest muscle in the pectoral region, responsible for flexing the arm at the shoulder and rotating it medially.

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    Pectoralis Minor

    A smaller muscle situated beneath the Pectoralis Major, assisting in drawing the scapula forward and downward.

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    Subclavius

    A small muscle that helps to depress the clavicle, located on the anterior surface of the thorax.

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    Serratus Anterior

    A large, expansive muscle that helps in protraction of the scapula, also involved in abducting the shoulder (98-180 degrees).

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    Deltopectoral Groove

    A triangular space containing important structures like the cephalic vein, deltoid branch of thoracoacromial artery, and deltopectoral lymph nodes, located between the deltoid and pectoralis major muscles.

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    Clavipectoral Fascia

    A thick layer of fascia that envelops the Pectoralis Minor and Subclavius muscles, attaching to the clavicle superiorly and connecting to the axillary region.

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    Axilla

    A pyramidal space in the arm, containing vital blood vessels, nerves, lymph nodes, and other structures, bordered by muscles and fascia.

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    Axillary Region

    A space or region in the upper limb where key blood vessels and nerves pass through, connecting the arm to the thorax.

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    What is the Brachial Plexus?

    The brachial plexus is a network of nerves that supplies the upper limb. It originates from the spinal nerves C5-T1 and branches out into multiple nerves that control the muscles, sensation, and movement of the arm, forearm, and hand.

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    How is the Brachial Plexus Organized?

    The brachial plexus is organized into five stages: roots, trunks, divisions, cords, and branches. Each stage represents a different level of nerve organization and helps you understand where a nerve comes from and what it supplies.

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    Which spinal nerves make up the Brachial Plexus?

    The brachial plexus is made up of the spinal nerves C5-T1, with minor contributions from C4 or T2 in some people. This tells you which spinal nerves are involved in the plexus.

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    Where is the Brachial Plexus Located?

    The brachial plexus starts in the neck, passes behind the clavicle, and into the axilla where it branches out to supply the upper limb. Understanding this pathway helps locate the plexus and nerve injuries.

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    How are the trunks of the Brachial Plexus formed?

    Each trunk of the brachial plexus is formed by the merging of two roots. The upper trunk is made of C5 and C6. The middle trunk is made of C7. The lower trunk is made of C8 and T1.

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    What is the Lateral Cord and what nerves arise from it?

    The lateral cord is formed by the anterior divisions of the upper and middle trunks. It gives rise to the lateral pectoral nerve, musculocutaneous nerve, and part of the median nerve.

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    What's the Medial Cord and what nerves arise from it?

    The medial cord is formed by Anterior division of lower trunk. It gives rise to the medial pectoral nerve, medial cutaneous nerve of the arm and forearm, and the ulnar nerve.

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    What is the Posterior Cord and what nerves arise from it?

    The posterior cord is formed by all the posterior divisions of the trunks. It gives rise to the upper subscapular nerve, lower subscapular nerve, thoracodorsal nerve, axillary nerve and radial nerve.

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    Study Notes

    Bones of the Upper Limb

    • Clavicle:

      • Roughly 13-15 cm long
      • Located on each side of the neck
      • The only long bone ossified by membrane ossification
      • Lies horizontally
      • Two ends: Medial (sternal) and lateral (acromial)
      • Two surfaces: superior (smooth) and inferior (rough)
      • Two parts: medial 2/3 are convex anteriorly and lateral 1/3 are concave anteriorly
      • Nutrient foramen at the lateral end of subclavian groove
      • Two ligaments: costoclavicular and coracoclavicular
      • Commonest site of fracture in the clavicle is in the middle portion
    • Scapula:

      • Flat, triangular bone positioned in the thorax
      • Three angles: superior, inferior, and lateral
      • Three borders: superior, medial (vertebral), and lateral (axillary)
      • Two surfaces: anterior (concave) and posterior (convex)
      • Processes: coracoid, acromion
      • Notches: supraspinatus and infraspinatus
      • Associated muscles: supraspinatus, infraspinatus, subscapularis
    • Humerus:

      • Located in the upper arm
      • Proximal end: head, anatomical neck, surgical neck, bicipital groove. The head is round and upward and backward
      • Shaft: deltoid tuberosity, radial groove
      • Distal end: medial and lateral epicondyles, trochlea, capitulum, radial fossa, coronoid fossa
      • Common fractures: involve surgical neck & midshaft

    Nerves and Arteries Liable to Damage in Fracture Humerus

    • Nerves:
      • Axillary nerve (flat shoulder)
      • Radial nerve (wrist drop)
      • Musculocutaneous nerve
      • Median nerve
      • Ulnar nerve
    • Arteries:
      • Brachial artery (with possible Ape Hand)

    Pectoral Region

    • Breast:

      • Modified sweat gland
      • Lies in 2nd to 6th intercostal nerves (anterior to the ribs)
      • Extends from 2nd to 6th ribs, and the midaxillary line to the sternum
    • Ms. Bed:

      • Major, SA, and form the main muscle that anchors the breast to the chest wall
      • Retromammary space: loose areolar tissue, provides mobility. Nipple at 4th intercostal, most sensitive
    • Areola:

      • Pigmented, Montgomery glands, and stroma
    • Parenchyma:

      • 15 to 20 lobes, separated by Cooper's ligaments
      • 15 to 20 lobules ducts, converge, opening through lactiferous sinusses
    • Breast cancer:

      • Commonest in females
      • 60% occur in the upper outer quadrant (ULQ)
      • Age 40-60 years old
      • Usually painless hard mass, fixed, retraction skin nipple (orange peel),

    L.D & Breast

    • Upper quadrants: Axillary lymph nodes.
    • Lower quadrants: Parasternal lymph nodes.
    • Medial quadrants: Abdominal lymph nodes.
    • Inferior quadrants: Abdominal lymph nodes.

    Subclavius

    • Origin: first rib
    • Insertion: subclavian groove of the clavicle
    • Nerve supply: nerve to subclavius
    • Action: depresses clavicle

    SA

    • Origin: upper 8 ribs
    • Insertion: scapula (medial border)
    • Nerve supply: long thoracic nerve
    • Action: protracts and elevate the scapula
    • Possible injuries/conditions: boxer's muscles, injuries

    Deltopectoral Groove

    • Description: groove between the deltoid and pectoralis major muscles
    • Clinical implications: contains cephalic vein, deltoid branch of the thoracoacromial artery, deltopectoral node

    Clavipectoral Fascia

    • Located deep to pectoralis major and minor muscles, superficial to subclavius
    • Attaches to clavicle and sternum
    • Continuous with suspensory ligaments of the axilla
    • Contains vessels and nerves from axilla

    Axilla

    • Structure: pyramid-shaped space bordered by muscles and ribs
    • Apex: formed by the clavicle, first rib and upper border of scapula
    • Base: formed by skin and fascia inferiorly.
    • Anterior wall: formed by pectoralis major and minor muscles
    • Posterior wall: formed by serratus anterior and subscapularis
    • Medial wall: formed by serratus anterior and ribs
    • Lateral wall: formed by intertubercular groove of humerus (superiorly), and cords of brachial plexus inferiorly
    • Contents: brachial plexus, axillary vessels and lymph nodes
    • Regions: cords, long thoracic nerve, branches, lymph nodes, superior and inferior
    • Clinically important: injuries and conditions

    Brachial Plexus

    • Roots: C5-T1, contributes to the upper, middle and lower trunks
    • Trunks: superior, middle, and inferior, subdivided into anterior and posterior divisions.
    • Divisions: Anterior and posterior subdivisions arise from the trunks
    • Cords: lateral, posterior, and medial, branches arises from the divisions
    • Branches: numerous, detailed and labelled

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    Related Documents

    Upper Limb Anatomy Notes (PDF)

    Description

    Explore the intricate details of the bones in the upper limb, focusing on the clavicle and scapula. This quiz covers essential anatomical features, measurements, and their functional aspects. Perfect for students of anatomy or healthcare professionals looking to refresh their knowledge.

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