upper limb part 1 - shoulder, brachial plexus
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Questions and Answers

Which bone is not part of the wrist joint?

  • Capitate (correct)
  • Scaphoid
  • Triquetrum
  • Lunate

    • Which artery is responsible for blood supply in the forearm?

  • Brachial artery
  • Subclavian artery
  • Cephalic artery
  • Radial artery (correct)

    • What is the primary function of the superficial veins in the upper limb?

  • Drain the joints
  • Transport lymph fluid
  • Drain muscles
  • Drain skin and fascia (correct)

    • Which lymphatic component is involved in the defense mechanism of the upper limb?

    <p>Cubital lymph nodes</p> Signup and view all the answers

    Which of the following joints includes both proximal and distal interphalangeal joints?

    <p>Digital joint</p> Signup and view all the answers

    Which of the following bones is not classified as a long bone in the upper limb?

    <p>Scapula</p> Signup and view all the answers

    Which joint is an example of a synovial joint in the upper limb?

    <p>Shoulder joint</p> Signup and view all the answers

    What is the primary function of the axillary nerve?

    <p>Innervates shoulder muscles</p> Signup and view all the answers

    Which of the following joints has the least mobility?

    <p>Sutures</p> Signup and view all the answers

    Which nerve is responsible for innervating the majority of muscles in the anterior compartment of the forearm?

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

    Which component is NOT a part of a synovial joint?

    <p>Fibrous tissue</p> Signup and view all the answers

    Which of the following statements about the brachial plexus is correct?

    <p>It includes major nerves like the ulnar and median nerves.</p> Signup and view all the answers

    Which classification of joints allows for the greatest range of movement?

    <p>Synovial joints</p> Signup and view all the answers

    What type of joint is the glenohumeral joint?

    <p>Ball-and-socket joint</p> Signup and view all the answers

    Which muscle primarily assists with shoulder abduction?

    <p>Supraspinatus</p> Signup and view all the answers

    Which of the following terms refers to a condition characterized by fibrosis and scarring in the shoulder joint?

    <p>Frozen shoulder</p> Signup and view all the answers

    What is the role of the glenoid labrum in the glenohumeral joint?

    <p>Stabilizes the humeral head</p> Signup and view all the answers

    Which nerve is typically affected in shoulder joint dislocation?

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

    What activity is most likely to lead to rotator cuff injuries?

    <p>Repetitive upper limb use above the horizontal line</p> Signup and view all the answers

    Which of the following ligaments is NOT associated with the glenohumeral joint?

    <p>Ulnar collateral ligament</p> Signup and view all the answers

    Which muscle is primarily involved in lateral rotation of the shoulder joint?

    <p>Infraspinatus</p> Signup and view all the answers

    What structure does the lateral end of the clavicle articulate with?

    <p>Acromion process of scapula</p> Signup and view all the answers

    Which of the following actions is primarily performed by the pectoralis major?

    <p>Adduction of humerus</p> Signup and view all the answers

    What is the nerve supply to the serratus anterior muscle?

    <p>Long thoracic nerve</p> Signup and view all the answers

    Which muscle helps medially rotate the arm and stabilize the head of the humerus in the glenoid cavity?

    <p>Subscapularis</p> Signup and view all the answers

    Which of the following muscles is responsible for abducting the arm along with the deltoid?

    <p>Supraspinatus</p> Signup and view all the answers

    What is the primary action of the trapezius middle part?

    <p>Retracts scapula</p> Signup and view all the answers

    The latissimus dorsi is involved in which action?

    <p>Adduction and extension of arm</p> Signup and view all the answers

    Which muscle originates from the supraspinous fossa of the scapula?

    <p>Supraspinatus</p> Signup and view all the answers

    What is the function of the rhomboid major muscle?

    <p>Retracts and rotates scapula inferiorly</p> Signup and view all the answers

    Which muscle primarily acts to depress the tip of the shoulder?

    <p>Pectoralis minor</p> Signup and view all the answers

    What is the primary action of the teres minor muscle?

    <p>Lateral rotation of arm</p> Signup and view all the answers

    What does the deltoid tuberosity of the humerus serve as an insertion point for?

    <p>Deltoid</p> Signup and view all the answers

    The long thoracic nerve innervates which muscle?

    <p>Serratus anterior</p> Signup and view all the answers

    Which muscle acts to laterally rotate the arm?

    <p>Infraspinatus</p> Signup and view all the answers

    Study Notes

    Upper Limb Bones

    • Most upper limb bones are long, except for the scapula and carpal bones.

    Brachial Plexus

    • Brachial plexus is the network of nerves that supply the upper limb.
    • Major nerves of the upper limb are branches of the brachial plexus, they are:
      • Axillary nerve
      • Radial nerve
      • Musculocutaneous nerve
      • Ulnar nerve
      • Median nerve
    • The brachial plexus is formed from the ventral rami of spinal nerves C5-T1.
    • The brachial plexus can be divided into five sections: roots, trunks, divisions, cords, and branches.

    Joints

    • Joints are unions between two or more bones.
    • There are three main types of joints:
      • Synovial Joints: Freely mobile, covered by capsule, examples are shoulder and knee joints.
      • Fibrous Joints: Less mobile, connected by fibrous tissue, examples are sutures.
      • Cartilaginous Joints: Bone ends are united by cartilage; primary cartilaginous joints are immovable; secondary allow less movement.

    Synovial Joint Components

    • Bones
    • Articular cartilage
    • Synovial cavity
    • Synovial fluid
    • Synovial membrane
    • Capsule

    Upper Limb Joints

    • Sternoclavicular joint
    • Acromioclavicular joint
    • Shoulder joint (Glenohumeral joint)
    • Elbow joint:
      • Humero-ulnar joint
      • Humeroradial joint
    • Wrist joint (Radiocarpal joint)
      • Radius, Scaphoid, Lunate, Triquetrum
    • Carpometacarpal joint
    • Metacarpophalangeal joint
    • Proximal and distal interphalangeal joint

    Upper Limb Blood Supply

    • Arteries:
      • Subclavian (neck)
      • Axillary (armpit)
      • Brachial (arm)
      • Radial (forearm)
      • Ulnar (forearm)
      • Superficial & Deep Palmar arches
    • Veins:
      • Superficial veins
        • Cephalic (arm-forearm)
        • Basilic (arm-forearm)
        • Median Cubital (elbow)
        • Superficial Palmar Venous Arch
        • Digital
        • Superficial veins drain skins and fascia.
      • Deep veins
        • Subclavian (neck)
        • Axillary (axilla)
        • Brachial (arm-elbow)
        • Radial (forearm)
        • Ulnar (forearm)
        • Deep Palmar Venous Arch
        • Deep veins drain muscles and bones.

    Lymphatic Drainage

    • Lymphatics are lymph vessels that carry a clear fluid called lymph.
    • Lymph plays a role in the immune defense mechanism.
    • Major lymph nodes of the upper limb: axillary, cubital.

    Clavicle

    • Transmits part of the weight of the upper limb to the axial skeleton.
    • The lateral or acromial end articulates with the acromion process of the scapula.
    • The medial or sternal end articulates with the manubrium sternum.

    Scapula

    • Anterior view - displays:
      • Spine
      • Coracoid process
      • Glenoid cavity
    • Posterior view - displays:
      • Infraspinous fossa
      • Supraspinous fossa

    Humerus

    • Anterior view - displays:
      • Deltoid tuberosity
      • Olecranon fossa
    • Posterior view - displays:
      • Radial groove
      • Coronoid fossa

    Muscles of the Upper Limb

    • Pectoral region
      • Pectoralis major:
        • Origin: Medial half of clavicle and anterior surface of sternum, first seven costal cartilages.
        • Insertion: Proximal part of humerus (lateral lip of intertubercular groove).
        • Action: Adduction, medial rotation, and flexion of the humerus at the shoulder joint.
        • Nerve supply Medial and lateral pectoral nerves.
      • Pectoralis minor:
        • Origin: Anterior surfaces of the third, fourth and fifth ribs, and deep fascia overlying the related intercostal spaces.
        • Insertion: Coracoid process.
        • Action: Depresses tip of shoulder; protracts scapula.
        • Nerve supply: Medial pectoral nerve
      • Serratus anterior:
        • Origin: External surfaces of lateral parts of 1st–8th ribs
        • Insertion: Medial border of scapula
        • Action: Protracts scapula and holds it against thoracic wall; rotates scapula.
        • Nerve supply: Long thoracic nerve (C5, C6, C7)

    Scapular Muscles

    • Intrinsic Shoulder Muscles (Move Humerus): Also known as Scapulohumeral Muscles
      • Rotator Cuff:
        • Subscapularis:
          • Origin: Subscapular fossa
          • Insertion: Lesser tubercle of humerus.
          • Action: Medially rotates arm, helps to hold head of humerus in glenoid cavity.
          • Nerve supply: Upper and lower subscapular nerves
        • Supraspinatus:
          • Origin: Supraspinous fossa of scapula.
          • Insertion: Greater tubercle of humerus.
          • Action: Abduction of arm, together with Deltoid.
          • Nerve supply: Suprascapular nerve.
        • Infraspinatus:
          • Origin: Infraspinous fossa of scapula.
          • Insertion: Greater Tubercle of humerus.
          • Action: Laterally rotates arm.
          • Nerve supply: Suprascapular nerve.
        • Teres Minor:
          • Origin: Middle part of lateral border of scapula -Insertion: Greater tubercle of humerus
          • Action: Adducts and laterally rotates arm.
          • Nerve supply: Axillary nerve.
      • Other Scapulohumeral Muscles:
        • Teres major
        • Deltoid
        • Latissimus Dorsi (partial)
        • Coracobrachialis
    • Extrinsic Shoulder Muscles (Move Scapula):
      • Rhomboids
      • Trapezius
      • Pectoralis Minor
      • Serratus anterior
      • Levator Scapulae

    Deltoid

    • Origin:
      • Lateral third of clavicle
      • Acromion
      • Spine of scapula
    • Insertion: Deltoid tuberosity of humerus
    • Action:
      • Clavicular (anterior) part: flexes and medially rotates arm.
      • Acromial (middle) part: abducts arm.
      • Spinal (posterior) part: extends and laterally rotates arm.
    • Nerve supply: Axillary nerve (C5, C6).

    Axillary Nerve

    • Branch of posterior cord of the brachial plexus.
    • Supplies Deltoid and teres minor muscles.

    Trapezius

    • Origin:
      • Medial third of superior nuchal line
      • External occipital protuberance
      • Nuchal ligament
      • Spinous processes of C7–T12 vertebrae
    • Insertion:
      • Lateral third of clavicle
      • Acromion
      • Spine of scapula
    • Action:
      • Descending part elevates scapula.
      • Ascending part depresses scapula.
      • Middle part retracts scapula.
    • Nerve supply: Spinal accessory nerve.

    Muscle Summary Table

    • Muscles of the Scapula:

      • Move Scapula:

        MuscleProximal Attachments (Origin)Distal Attachments (Insertion)Nerve SupplyActionLevator scapulaeTransverse processes of C1–C4 vertebraePosterior surface of medial border of scapulaDorsal scapular nerveElevates the scapulaRhomboid minorLower end of ligamentum nuchae and spinous processes of C7 and T1 vertebraePosterior surface of medial border of scapulaDorsal scapular nerveElevates and retracts the scapulaRhomboid majorSpinous processes of TII-TV vertebraePosterior surface of medial border of scapula, root of the spine of the scapula, inferior angleDorsal scapular nerveRetract scapula and rotate its glenoid cavity inferiorly; fix scapula to thoracic wall

      • Move Humerus:

        MuscleProximal Attachments (Origin)Distal Attachments (Insertion)Nerve SupplyActionSubscapularisSubscapular fossaLesser tubercle of humerusUpper and lower subscapular nervesMedially rotates arm, helps to hold head of humerus in glenoid cavitySupraspinatusSupraspinous fossa of scapulaGreater tubercle of humerusSuprascapular nerveAbduction of arm, together with DeltoidInfraspinatusInfraspinous fossa of scapulaGreater Tubercle of humerusSuprascapular nerveLaterally rotates armTeres minorMiddle part of lateral border of scapulaGreater tubercle of humerusAxillary nerveAdducts and laterally rotates armTeres majorLateral border of scapula, inferior to Teres minorMedial lip of intertubercular sulcus of humerusLower subscapular nerveExtends, adducts, and medially rotates armCoracobrachialisCoracoid process of scapulaMedial surface of humerusMusculocutaneous nerveFlexes and adducts arm

    Glenohumeral Joint Anatomy

    • Ball-and-socket type of synovial joint.
    • Multiaxial, allowing a wide range of movement.
    • The large, round humeral head articulates with the shallow glenoid cavity of the scapula.
    • The glenoid cavity is deepened by a fibrocartilaginous collar called the glenoid labrum.
    • Glenohumeral ligaments stabilize the joint.

    Glenohumeral Joint Ligaments

    • Fibrous capsule
    • Glenohumeral ligaments:
      • Superior
      • Middle
      • Inferior
    • Glenoidal labrum (fibrocartilaginous rim)
    • Coracohumeral ligament
    • Transverse humeral ligament

    Glenohumeral Joint Movements

    • Flexion:
      • Pectoralis major, anterior fibers of deltoid, assisted by coracobrachialis and biceps brachii.
    • Extension:
      • Posterior fibers of deltoid and teres major
      • From full flexion, extension is by latissimus dorsi.
    • Abduction:
      • Supraspinatus, Deltoid
    • Adduction:
      • Anterior and posterior fibers of the deltoid, pectoralis major, teres major, latissimus dorsi, coracobrachialis and long head of triceps.
    • Medial Rotation:
      • Subscapularis, Pectoralis major; deltoid (clavicular part); latissimus dorsi; teres major.
    • Lateral Rotation:
      • Infraspinatus, Teres minor; deltoid (spinal part)

    Applied Anatomy

    • Dislocation of the shoulder joint:
      • Caused by laxity of ligaments and disproportionate articular surfaces.
      • Axillary nerve is commonly affected.
    • Rotator Cuff Injuries:
      • Occur during repetitive use of the upper limb above the horizontal line.
      • Characterized by inflammation or tears of the rotator cuff muscles, particularly the supraspinatus tendon.
      • Common cause of shoulder pain.
    • Frozen shoulder (adhesive capsulitis):
      • Result of adhesive fibrosis and scarring in the glenohumeral joint capsule.
      • Affects the rotator cuff, subacromial bursa, and deltoid.

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    MSK Upper Limb Part 1 PDF - Anatomy

    Description

    Test your knowledge on the bones, nerves, and joints of the upper limb. This quiz covers various aspects such as the brachial plexus and types of joints, enhancing your understanding of upper limb anatomy. Perfect for students and professionals in the medical and health sciences.

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