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UKCD Upper Limb
learning objectives for the upper limb
Question | Answer |
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Name the two major superficial veins of the upper limb. | The cephalic and basilic vv. |
Both these superficial veins originate distally at what structure? | They originate at the dorsal venous network (arch) of the hand. |
These superficial veins communicate again in the cubital fossa via what structure? | The median cubital v. |
Name the muscles that arise from the vertebral column and connect the upper limb tothe trunk. | The trapezius, levator scapulae, rhomboideus major and minor and the latissimus dorsi. |
Which of these muscles is not innervated by a branch off the brachial plexus? | The trapezius (CN XI - spinal accessory n.). |
Name the muscles arising from the thoracic wall that connect the upper limb to thetrunk. | The pectoralis major and minor, serratus anterior, subclavius, and the sternocleidomastoid. |
Which of these muscles connecting the thoracic wall to the upper limb is located deepest? | The serratus anterior. |
For what two nerves is the pectoralis minor a landmark? | The medial and lateral pectoral nn. |
Why is the nomenclature of these nerves reversed with regard to the anatomicallocation? | Their nomenclature is NOT related to their relationship to the pectoralis minor but rather to the cord from which they arise off the brachial plexus. |
Name the muscles of the scapular region. | The subscapularis, supraspinatus, infraspinatus, teres minor and teres major. |
Which of the muscles of the scapular region is not a rotator cuff muscle? | The teres major is not a rotator cuff muscle. |
What is the function of the rotator cuff? | They apply the head of the humerus to the shallow glenoid cavity of the glenohumeral joint. |
Which aspect of the shoulder joint is not reinforced by these muscles and what is the clinical significance of this? | The inferior aspect. Shoulder dislocation occurs inferiorly and then pops up anteriorly. |
What structures pass through the quadrangular space? | The axillary nerve and the posterior circumflex artery. |
What structures pass through the triangular space? | The radial nerve and the profunda (deep) brachial artery. |
Which muscles form the various walls of the axilla; medial, anterior, and posterior. | Medial: serratus anterior and intercostal mm.; anterior: pectoralis major, minor and the subclavius; posterior: subscapularis, teres major and latissimus dorsi. |
At what anatomical landmark does the subclavian artery become the axillary artery? | The lateral edge of the first rib. |
What anatomical structure serves as a landmark to define the three divisions of the axillary artery? | The pectoralis minor m. |
Name the branches off each of the three parts of the axillary artery. | First part: superior thoracic a.; second part: thoracoacromial a. and lateral thoracic a.; third part: subscapular a., anterior and posterior circumflex humeral aa. |
At what anatomical landmark does the axillary artery become the brachial artery? | The lower border of the teres major m. |
The arm consists of two distinct compartments. Name them. | The flexor (anterior) compartment and the extensor (posterior) compartment. |
What two fascial structures define these two compartments? | The lateral and medial intermuscular septae. |
What type of action does Coracobrachialis, biceps brachii and brachialis perform? What are they innervated by? | are flexors and are innervated by the musculocutaneous n.; What type of action does the triceps brachii perform? What is it innervated by? |
In the flexor compartment of the arm which muscles cross the elbow joint? | The biceps brachii and the brachialis. |
How does this attachment affect the action of these muscles? | In addition to flexing the elbow, the biceps is a powerful supinator. |
How does the brachial artery terminate? | The radial and ulnar aa. |
Where does this termination occur with relation to the cubital fossa? | The bifurcation occurs deep to the bicipital aponeurosis but superficial to the tendon of the biceps brachii. |
Name the two muscles that form the lateral and medial boundaries of the cubital fossa. | Lateral = brachioradialis; medial = pronator teres. |
Which of the three major nerves found passing from the arm into the forearm is not found within the cubital fossa? | The ulnar n. |
Which muscles are found in the superficial group within the flexor compartment? | Lateral to medial: Pronator teres, Flexor Carpi Radialis, Palmaris longus, Flexor Digitorum Superficialis and Flexor Carpi Ulnaris. |
Of these five muscles which is not innervated by the median nerve? | The flexor carpi ulnaris is innervated by the ulnar n. |
Name the muscles of the deep group of the flexor compartment. | Lateral to medial: Flexor Pollicis Longus, Flexor Digitorum Profundus and Pronator Quadratus. |
What is the innervation of each of these muscles in this compartment? | Flexor pollicis longus and pronator quadratus = anterior interosseus br. of median n.; the digitorum profundus has a dual innervation: medial portion = ulnar n., lateral portion = anterior interosseous br. of median n. |
Which muscle is located most medial? | Flexor digitorum profundus. |
Name the muscles in the superficial group of the extensor compartment. | Brachioradialis, extensor carpi radialis longus, extensor carpi radialis brevis, extensor digitorum, extensor digiti minimi, and extensor carpi ulnaris. |
What is the innervation of the Brachioradialis and extensor carpi radialis longus? | radial n.; |
What is the innervation of the extensor carpi radialis brevis, extensor digitorum, extensor digiti minimi, and extensor carpi ulnaris? | posterior interosseus (deep) br. of the radial n. |
Name the muscles of the deep group of the extensor compartment. | Anconeus, supinator, abductor pollicis longus, extensor pollicis brevis, extensor pollicis longus, extensor indicis. |
What is the innervation of the anconeus? | radial n. |
What innervates all of the extensor compartment but the anconeus? | all the others innervated by the posterior interosseous (deep) br. of the radial n. |
Which vessel passes into the extensor compartment to supply the muscles? | The posterior interosseous artery. |
What other artery pierces the interosseous membrane to assist in supplying thesemuscles. | The anterior interosseous artery. |
The dorsal carpal arch arises from which artery on the dorsal surface? | The anterior interosseous artery which has fused with the posterior interosseous artery just before this. |
This artery passes through what anatomical region at the base of the thumb and then passes to the palmar surface to contribute to the formation of which arterial arch? | The anatomical snuff box; forms the deep palmer arch. |
What structure forms the roof of the carpal tunnel? | The flexor retinaculum. |
Which nerve is irritated in carpal tunnel syndrome? | The median nerve. |
Which nerve(s) supply the thenar muscles? List the three muscles in this group | The (recurrent br.) of the median nerve. Abductor pollicis brevis, flexor pollicis brevis, and opponens pollicis. |
Which nerve(s) supply the hypothenar muscles? List the muscle sin this group. | The (deep br.) of the ulnar nerve. Abductor digiti minimi, flexor digiti minimi, and opponens digiti minimi. |
Which artery is responsible for forming the majority of the superficial palmar arch? | The superficial palmar arch arises from the ulnar artery. |
Which artery is responsible for forming the majority of the deep palmar arch? | The deep palmar arch arises from the radial artery. |
All Superficial flexor compartment of forearm except flexor carpi ulnaris is innervated by? | median nerve, FCU innervated by the ulnar nerve |
The Flexor digitorum profundus is innervated by? | BOTH the ulnar and median nn. |
All intrinsic muscles of the hand except the lateral two (1 & 2) lumbricals are innervated by? | the ulnar nerve. Theses two are innervated by the median n. |