Comprehensive Anatomy Test #3 (Upper Limb, Skull/Face, Neck, Nose/Oral Cavity/Mouth, Eye/Ear, and Brain/CN)

pectoral girdle

the upper limb is connected to the axial skeleton via this

medial (sternal) end

end of the clavicle that is triangular

lateral (acromial end)

end of the clavicle that is flattened

cervico-axillary canal

bony boundary for the passageway into the upper limb

2nd-7th ribs

ribs that the scapula lay over

ulna

arm bone that does NOT articulate with the carpals

ulna

arm bone that works in the elbow

radius

arm bone that rotates to pronate/supinate

scaphoid, lunate, triquetrum, pisiform

proximal carpals (lateral to medial)

trapezium, trapezoid, capitate, hamate

distal carpals (lateral to medial)

T2

superior angle of the scapula lies at

T3

medial end of scapular spine is at

T7

inferior angle of scapula is at

T3-T7

medial border of scapula runs along this range of ribs

FOOSH or direct fall on the shoulder

clavicle fracture most common mechanism

drop

in a clavicle fracture, the shoulder will ____ because the trapezius cannot lift the lateral fragment to compensate for the sternocleidomastoid pulling the medial fragment superior

clavicle fracture

SCM pulls medial fragment superior in the mechanism of this injury 

clavicle fractures

trapezius can’t lift the lateral fragment causing the shoulder drop in to this clavicle

clavicle fractures

greenstick fracture is this type of fracture, most commonly found in children

rare

scapular fractures are

scapular fractures

fractures don’t usually require surgery due to support of multiple muscles that hold scapula in place

scapular fracture 

results from severe trauma like a pedestrian vs car

scapular fractures

patients will almost always have rib fractures and pulmonary contusions 

humeral fractures

commonly occur at the surgical neck of the humerus 

FOOSH

radial and ulnar fractures mechanism of injury

Colles fracture; dinner fork

distal 2 cm transverse fracture of radius with dorsal displacement and will have this type of_____ deformity

Colles fracture

dorsal displacement of radius (distal 2 cm transverse fracture)

Smith fracture

volar displacement of radius (distal 2 cm transverse fracture) 

Smith fracture

volar displacement of radius

Scaphoid fracture

may result in avascular necrosis

scaphoid fracture

commonly misdiagnosed as a sprained wrist (doesn't show on X ray)

scaphoid fracture

million dollar break, results in snuffbox tenderness

Scaphoid fracture

commonly occurs when the patient falls on the palm with the thumb abducted

results in snuffbox tenderness

radial artery

artery affected in Scaphoid fracture

pectoral fascia

invests pectoralis major muscle, continuous with the abdominal fascia; joins the axillary fascia in the armpit

clavipectoral fascia

deep to the pectoral fascia; encloses subclavius and pectoralis minor

brachial fascia 

covers the arm and extends to the antebrachial fascia of the forearm 

cephalic and basilic veins

primary superficial veins of the upper limb

cephalic vein

lateral superficial vein

clavipectoral triangle

point at which the cephalic vein dives to join the axillary vein

cephalic vein

vein that ascends lateral to biceps brachii, inferior to deltoid

median cephalic and basilic vein

alternative venous drainage to the medial cubital vein in about 30% of people

basilic vein

medial superficial vein is termed

brachial

the basilic vein dives deep in the ____ region

median cubital vein

vein that connects the cephalic and basilic veins

ulnar, radial, and brachial

primary deep veins of the upper limb

deep veins

veins that go through the antecubital fossa separately

brachial vein

the ulnar and radial veins fuse into this vein

deep veins 

ulnar, radial, brachial veins

lymphatic 

drainage that passed through cubital lymph nodes and humeral axillary lymph nodes

cervical plexus

shoulder cutaneous innervation is from this plexus

C6

thumb dermatome

C7

middle finger dermatome

C8

pinky finger dermatome

the pectoralis major

this muscle of the pectoral and scapular region has two heads 

clavicular and sternocostal

pectoralis major two heads 

anterior

pectoralis major, pectoralis minor, subclavius, serratus anterior

_______ axio-appendicular muscles move the pectoral girdle; what are their names

posterior; superficial, deep, scapulohumeral

______ axio-appendicular muscles attach the appendicular skeleton to the axial skeleton; name the three groups

trapezius, latissimus dorsi

superficial posterior axio-appendicular muscles

levator scapulae, rhomboids

deep posterior axio-appendicular muscles

deltoid, teres major, rotator cuff

scapulohumeral muscles

supraspinatus, infraspinatus, teres minor, subscapularis

rotator cuff muscles

triangle of auscultation

small gap in musculature allowing great access to lung sounds

latissimius dorsi, scapula, trapezius

borders of the triangle of auscultation; have patient protract to increase size

axillary nerve

the __________ wraps posteriorly around the surgical neck of the humerus and is commonly injured because of fractures and IM shots

axillary nerve

the ______ is injured if symptoms pertain to the deltoid or skin on the outside of the arm

pectoralis major and minor, fascia

axilla anterior wall is comprised of these muscles

scapula, subscapularis, teres major, and latissimus dorsi

axilla posterior wall muscles

thoracic wall (ribs 1-4 and intercostals)

axilla medial wall

humerus

axilla lateral wall contains this singular bone

cervico-axillary canal

the apex of the axilla is also known as the

1st rib, clavicle, superior edge of scapula

boundaries of the cervico-axillary canal/apex of the axilla

teres major

landmark at which the axillary artery turns into the brachial artery

1st rib

landmark at which the subclavian artery turns into the axillary artery

C5-C8 and T1 spinal nerves

roots of the brachial plexus

superior (C5, C6), middle (C7), inferior (C8, T1)

trunks of the brachial plexus

anterior and posterior

each trunk of the brachial plexus divides into _____ and _____ divisions

anterior division (of brachial plexus)

this part of the brachial plexus supplies the anterior upper limb (flexors)

posterior division (of brachial plexus)

this part of the brachial plexus supplies the posterior upper limb (extensors)

lateral cord

anterior divisions of superior and middle trunks form the _____

medial cord

anterior division of the inferior trunk forms which cord _________

posterior cord

posterior divisions from all 3 trunks form which cord

cephalic vein

excessive enlargement of the axillary lymph node may obstruct _______ flow of this superficial vein

long thoracic and thoracodorsal

2 veins at risk in an axillary lymph node dissection

increase

brachial plexus injuries usually result from excessive ____ in angle between neck and shoulder

biceps brachii, brachialis, coracobrachialis

3 flexors of the arm

musculocutaneous nerve

the flexors of the arm are supplied by

triceps brachii

extensor of the arm

radial nerve

the extensor of the arm (triceps brachii) is supplied by

anconeus

supplemental muscle to triceps brachii

brachial artery

main arterial supply to the arm

cubital fossa

landmark at which the brachial artery ends

radial and ulnar

the brachial artery splits into the ________ arteries

median bicipital groove

palpations of the brachial artery are felt in the _______; also a great place to feel pulse of babies and take BP

median

the brachial artery accompanies the _______ nerve

brachial artery (dividing to radial and ulnar arteries), deep veins, biceps brachii tendon, median nerve, radial nerve, superficial veins

cubital fossa contents

line connecting medial and lateral epicondyles

superior boundary of cubital fossa

pronator teres

medial boundary of cubital fossa

brachioradialis

lateral boundary of cubital fossa

flexors and pronators

anterior muscles of forearm actions