Podcast
Questions and Answers
What structure is directly responsible for the arm's medial rotation during flexion?
What structure is directly responsible for the arm's medial rotation during flexion?
Which artery does NOT supply blood to the breast?
Which artery does NOT supply blood to the breast?
What is the innervation of the serratus anterior muscle?
What is the innervation of the serratus anterior muscle?
Which of the following lymph nodes would primarily drain the upper lateral quadrant of the breast?
Which of the following lymph nodes would primarily drain the upper lateral quadrant of the breast?
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What is the primary action of the pectoralis minor muscle?
What is the primary action of the pectoralis minor muscle?
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Where does the subclavius muscle insert?
Where does the subclavius muscle insert?
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The axillary region is primarily surrounded by which muscles?
The axillary region is primarily surrounded by which muscles?
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Which nerve roots contribute to the innervation of pectoral major muscle?
Which nerve roots contribute to the innervation of pectoral major muscle?
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What is the characteristic feature of the clavicle's medial end?
What is the characteristic feature of the clavicle's medial end?
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Which artery is primarily transmitted through the nutrient foramen at the lateral end of the clavicle?
Which artery is primarily transmitted through the nutrient foramen at the lateral end of the clavicle?
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What is the primary function of the suprascapular notch?
What is the primary function of the suprascapular notch?
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Which part of the humerus is commonly associated with dislocation?
Which part of the humerus is commonly associated with dislocation?
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Which nerve is affected leading to a 'wrist drop' due to a humeral fracture?
Which nerve is affected leading to a 'wrist drop' due to a humeral fracture?
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What does the retromammary space in the breast provide?
What does the retromammary space in the breast provide?
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What is the significance of the medial epicondyle of the humerus?
What is the significance of the medial epicondyle of the humerus?
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Which rib corresponds with the superior angle of the scapula?
Which rib corresponds with the superior angle of the scapula?
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Which of the following nerves is associated with the dorsal scapular nerve?
Which of the following nerves is associated with the dorsal scapular nerve?
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Which trunk of the brachial plexus contains the C7 contribution?
Which trunk of the brachial plexus contains the C7 contribution?
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What is the primary muscle affected in Erb's paralysis?
What is the primary muscle affected in Erb's paralysis?
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Which cord of the brachial plexus is formed by the anterior divisions of the lower trunk?
Which cord of the brachial plexus is formed by the anterior divisions of the lower trunk?
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During excessive abduction, which paralysis is likely to occur?
During excessive abduction, which paralysis is likely to occur?
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What is the arrangement of the brachial plexus from its roots to the branches?
What is the arrangement of the brachial plexus from its roots to the branches?
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Which nerve is NOT a branch from the posterior cord of the brachial plexus?
Which nerve is NOT a branch from the posterior cord of the brachial plexus?
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What is the primary deformity associated with Klumpke's paralysis?
What is the primary deformity associated with Klumpke's paralysis?
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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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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.
