What are the terminal branches of the brachial plexus?
Median, ulnar, musculocutaneous, radial, and axillary nerves.
What is the role of the articular disc in the sternoclavicular joint?
It helps to absorb force/shocks from the upper extremity and supports the joint anteriorly and posteriorly.
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p.10
Brachial Plexus Structure and Function

What are the terminal branches of the brachial plexus?

Median, ulnar, musculocutaneous, radial, and axillary nerves.

p.3
Joints of the Pectoral Girdle

What is the role of the articular disc in the sternoclavicular joint?

It helps to absorb force/shocks from the upper extremity and supports the joint anteriorly and posteriorly.

p.10
Blood Supply and Nerve Distribution

What are lymph nodes and their function?

Specialized immune system structures containing lymphoid follicles and lymphocytes, placed to increase antigen-immune cell interactions.

p.10
Brachial Plexus Structure and Function

What is the brachial plexus and its function?

The major nerve network supplying the upper limb, beginning in the neck and ending in the axilla.

p.11
Clinical Correlations of Upper Extremity Injuries

What causes 'upper plexus' injuries and what condition can result?

Increases in the neck/shoulder angle or a compressive force like a heavy backpack; Erb-Duchenne palsy (waiter's tip position) can result.

p.3
Joints of the Pectoral Girdle

What limits the elevation of the clavicle?

The costoclavicular ligament, which anchors the clavicle to the 1st rib.

p.6
Muscles of the Upper Extremity

Which muscles are referred to as intrinsic shoulder muscles?

The scapulohumeral muscles, including the deltoid, teres major, and the muscles of the rotator cuff (supraspinatus, infraspinatus, teres minor, and subscapularis).

p.11
Brachial Plexus Structure and Function

Which four branches of the brachial plexus are supraclavicular?

Dorsal scapular, long thoracic, suprascapular, and nerve to subclavius.

p.1
Upper Extremity Anatomy Overview

What has been sacrificed for the mobility of the upper extremity?

Stability.

p.3
Clinical Correlations of Upper Extremity Injuries

What happens to the medial part of the clavicle in a fracture?

It is drawn superiorly by the SCM (sternocleidomastoid) muscle.

p.2
Joints of the Pectoral Girdle

What joints are formed by the sternal and acromial ends of the clavicle?

The sternal end forms the sternoclavicular joint, and the acromial end forms the acromioclavicular joint.

p.2
Anatomical Landmarks of the Shoulder

What is the significance of the trapezoid line on the clavicle?

For attachment of the trapezoid ligament.

p.2
Anatomical Landmarks of the Shoulder

What is the impression for the costoclavicular ligament on the clavicle?

A roughened portion medially for attachment of the costoclavicular ligament.

p.1
Scapulohumeral Rhythm

What must proximal joints do for maximal efficiency of the hand?

Place the hand in the proper position for grasping and manipulating.

p.2
Upper Extremity Anatomy Overview

What are the three main functions of the clavicle?

1) Forms a strut to keep the arm and scapula away from the body during movements, 2) Provides protection for neurovascular structures passing from the thorax to the upper limb, 3) Transmits shocks from the limb to the axial skeleton.

p.6
Muscles of the Upper Extremity

What actions do the posterior fibers of the deltoid muscle assist with?

Extending the arm and laterally rotating the arm.

p.10
Blood Supply and Nerve Distribution

Where do lymphatic vessels empty on the left side of the body?

Into the thoracic duct.

p.2
Anatomical Landmarks of the Shoulder

What structure runs over the scapular notch?

The transverse ligament of the scapula.

p.5
Muscles of the Upper Extremity

What are the four anterior muscles that act to move the pectoral girdle?

Pectoralis major, pectoralis minor, subclavius, and serratus anterior.

p.2
Anatomical Landmarks of the Shoulder

What is the function of the conoid tubercle on the clavicle?

For attachment of the conoid ligament, part of the coracoclavicular ligament.

p.2
Anatomical Landmarks of the Shoulder

What is the purpose of the subclavian groove on the clavicle?

For attachment of the subclavius muscle.

p.1
Brachial Plexus Structure and Function

What is essential for understanding proper physical examinations of the upper extremity?

Understanding the brachial plexus and the distribution of C5-T1 nerve fibers.

p.5
Clinical Correlations of Upper Extremity Injuries

What causes a winged scapula?

Paralysis of the serratus anterior muscle or injury to the long thoracic nerve.

p.4
Joints of the Pectoral Girdle

What is the function of the subacromial (subdeltoid) bursa?

To protect the supraspinatus tendon from wear against the inferior surface of the acromion.

p.7
Muscles of the Upper Extremity

What are the muscles of the rotator cuff?

Supraspinatus, infraspinatus, teres minor, and subscapularis.

p.7
Muscles of the Upper Extremity

Which rotator cuff muscle is a medial rotator of the arm?

Subscapularis.

p.9
Blood Supply and Nerve Distribution

How is the axillary vein formed?

By the merging of two brachial veins and the basilic vein.

p.7
Clinical Correlations of Upper Extremity Injuries

What are the symptoms of axillary nerve injury?

Deltoid atrophy, a hollow just inferior to the acromion, and lateral, proximal anesthesia.

p.6
Muscles of the Upper Extremity

How does the deltoid muscle contribute to the stability of the humeral head?

It holds the humeral head in place, preventing inferior slipping from the glenoid cavity.

p.1
Upper Extremity Anatomy Overview

How is the upper extremity generally discussed in anatomy?

From proximal to distal, broken down by regions: shoulder, axilla, brachium, cubital fossa/elbow, antebrachium, and wrist/hand.

p.3
Clinical Correlations of Upper Extremity Injuries

Where do clavicular fractures usually occur?

At the junction of the middle and lateral thirds of the bone.

p.3
Joints of the Pectoral Girdle

What is the function of the sternoclavicular joints?

They are the only points of attachment for the upper limbs to the trunk and function as a ball-and-socket joint.

p.5
Muscles of the Upper Extremity

What are the two heads of the pectoralis major muscle and their functions?

Clavicular head (flexes the humerus and is a powerful horizontal adductor) and sternocostal head (extends the humerus from a flexed position).

p.5
Muscles of the Upper Extremity

What is the function of the pectoralis minor muscle?

Draws the scapula anteriorly and inferiorly against the thoracic wall.

p.8
Axilla Anatomy and Function

What forms the superior boundary (apex) of the axilla?

The cervicoaxillary canal, found between the 1st rib, superior edge of the scapula, and the clavicle.

p.8
Axilla Anatomy and Function

What forms the lateral wall of the axilla?

The intertubercular groove of the humerus.

p.4
Joints of the Pectoral Girdle

Which ligaments strengthen the joint capsule of the shoulder anteriorly?

The superior, middle, and inferior glenohumeral ligaments.

p.9
Axilla Anatomy and Function

How many branches does each part of the axillary artery have?

The first part has 1 branch, the second part has 2 branches, and the third part has 3 branches.

p.9
Blood Supply and Nerve Distribution

What are the branches of the subscapular artery and what do they supply?

The subscapular artery bifurcates into the thoracodorsal artery, which supplies the latissimus dorsi muscle, and the circumflex scapular artery, which supplies blood to posterior scapular muscles and participates in scapular anastomoses.

p.7
Anatomical Landmarks of the Shoulder

What structures lie deep in the triangular interval?

Radial nerve and profunda brachii artery.

p.7
Axilla Anatomy and Function

What is the axilla?

A pyramid-shaped, fat-filled space inferior to the glenohumeral joint and between the lateral thoracic wall and the upper extremity.

p.6
Muscles of the Upper Extremity

What are the functions of the teres major muscle?

Adducting and medially rotating the arm, and stabilizing the humeral head.

p.2
Muscles of the Upper Extremity

What are the main functions of the axioappendicular muscles?

To support, stabilize, and move the pectoral girdle.

p.11
Clinical Correlations of Upper Extremity Injuries

What are the principal symptoms of brachial plexus injuries?

Paralysis and anesthesia.

p.1
Joints of the Pectoral Girdle

What anatomical feature contributes to the great freedom of movement in the upper extremity?

The shallow, ball-and-socket glenohumeral joint and the conceptual scapulothoracic joint.

p.3
Joints of the Pectoral Girdle

What supports the sternoclavicular joints besides the articular disc?

The interclavicular ligament, which attaches the medial ends of the clavicles with the superior border of the manubrium of the sternum.

p.10
Brachial Plexus Structure and Function

How are the cords of the brachial plexus named?

By their relation to the axillary artery in the axilla: medial, lateral, and posterior.

p.5
Muscles of the Upper Extremity

What is the function of the serratus anterior muscle?

Protracts the scapula and rotates the scapula so that the glenoid tips superiorly when the inferior fibers are isolated.

p.5
Clinical Correlations of Upper Extremity Injuries

What happens to the scapula in a winged scapula condition?

The medial edge of the scapula protrudes posteriorly, appearing like a wing, especially when the patient leans forward against a wall.

p.4
Joints of the Pectoral Girdle

Which ligament strengthens the shoulder capsule superiorly?

The coracohumeral ligament.

p.4
Clinical Correlations of Upper Extremity Injuries

What is the common direction of glenohumeral joint dislocation?

Most dislocations are inferior, though they are referred to as 'anterior' or 'posterior' according to their relative position with the long head of the triceps on the infraglenoid tubercle.

p.9
Blood Supply and Nerve Distribution

What are the final two branches off the axillary artery and what do they encircle?

The anterior and posterior circumflex humeral arteries, which encircle the surgical neck of the humerus.

p.9
Blood Supply and Nerve Distribution

What is the continuation of the axillary vein at the lateral border of the first rib?

The subclavian vein.

p.7
Axilla Anatomy and Function

What is the function of the axilla?

To provide a passageway for neurovascular structures from the upper extremity to the neck and vice versa.

p.6
Muscles of the Upper Extremity

What is the primary action of the deltoid muscle when all parts work together?

Arm abduction.

p.6
Muscles of the Upper Extremity

What actions do the anterior fibers of the deltoid muscle assist with?

Flexing the arm and medially rotating the arm.

p.11
Brachial Plexus Structure and Function

From which cord does the lateral pectoral nerve emerge?

The lateral cord.

p.11
Brachial Plexus Structure and Function

Which nerves emerge from the posterior cord in the axilla?

The subscapular nerves (upper, middle, lower).

p.3
Clinical Correlations of Upper Extremity Injuries

What is a common cause of clavicular fractures?

Force on an outstretched arm or at the shoulder.

p.6
Muscles of the Upper Extremity

Which muscle initiates arm abduction up to 15 degrees?

The supraspinatus muscle.

p.2
Joints of the Pectoral Girdle

What is the only point of attachment of the pectoral girdle to the axial skeleton?

The sternoclavicular joint.

p.11
Brachial Plexus Structure and Function

Which nerves emerge from the medial cord in the axilla?

The medial pectoral nerve, medial cutaneous nerve of the arm, and medial cutaneous nerve of the forearm.

p.10
Clinical Correlations of Upper Extremity Injuries

What is the purpose of axillary lymph node dissection?

To evaluate the status of a malignancy, usually breast cancer.

p.1
Joints of the Pectoral Girdle

What movements take place at the scapulothoracic joint?

Elevation/depression, protraction/retraction, and superior/inferior rotation.

p.10
Brachial Plexus Structure and Function

What are the three trunks of the brachial plexus and their corresponding spinal nerves?

Superior (C5-6), middle (C7), and inferior (C8-T1).

p.5
Muscles of the Upper Extremity

What is the function of the subclavius muscle?

Anchors and depresses the clavicle.

p.1
Blood Supply and Nerve Distribution

Where are superficial veins located in the upper extremity?

In the loose connective tissue layer, immediately deep to the skin.

p.8
Axilla Anatomy and Function

What structures are contained within the axillary sheath?

The axillary artery and vein, cords of the brachial plexus, and lymphatic vessels.

p.4
Joints of the Pectoral Girdle

Where does the joint capsule of the shoulder attach medially and laterally?

Medially to the margin of the glenoid and laterally to the anatomical neck of the humerus.

p.4
Scapulohumeral Rhythm

What is the scapulohumeral rhythm?

The ratio of movement in shoulder elevation, with 2 degrees at the glenohumeral joint for every 1 degree at the scapulothoracic joint.

p.9
Blood Supply and Nerve Distribution

What are the branches of the thoracoacromial trunk and where does it emerge from?

The thoracoacromial trunk has 4 branches: deltoid, clavicular, pectoral, and acromial. It emerges from the proximal second part of the axillary artery, medial to the pectoralis minor muscle.

p.7
Anatomical Landmarks of the Shoulder

What structure lies deep in the triangular space?

Circumflex scapular artery.

p.7
Clinical Correlations of Upper Extremity Injuries

Which rotator cuff muscle is most vulnerable to injury?

Supraspinatus.

p.6
Muscles of the Upper Extremity

What are the fiber groupings of the deltoid muscle?

The deltoid muscle has unipennate fibers (anteriorly and posteriorly) and multipennate fibers (middle part).

p.2
Upper Extremity Anatomy Overview

What bones make up the pectoral girdle?

The scapula and clavicle.

p.2
Anatomical Landmarks of the Shoulder

Name the three fossae of the scapula.

Supraspinous, infraspinous, and subscapular fossae.

p.1
Upper Extremity Anatomy Overview

What is the main difference between the upper and lower extremities in terms of function?

The upper extremity sacrifices stability for mobility, while the lower extremity sacrifices some mobility for stability.

p.5
Muscles of the Upper Extremity

What are the anterior axioappendicular muscles?

Pectoralis major, pectoralis minor, subclavius, and serratus anterior.

p.5
Muscles of the Upper Extremity

What movements do the pectoralis major muscle provide for the arm?

Powerful adduction and medial rotation.

p.8
Axilla Anatomy and Function

What are the six boundaries of the axilla?

Superior, inferior, medial, lateral, anterior, and posterior.

p.5
Brachial Plexus Structure and Function

What are the medial and lateral pectoral nerves named for?

Their sources in the brachial plexus, not their relative positions in the body.

p.8
Blood Supply and Nerve Distribution

What is the axillary artery and where does it begin?

The axillary artery is a continuation of the subclavian artery as it crosses the lateral border of the 1st rib.

p.9
Axilla Anatomy and Function

How is the axillary artery divided for descriptive purposes?

Into 3 parts.

p.7
Muscles of the Upper Extremity

Which rotator cuff muscle is responsible for abduction of the arm?

Supraspinatus.

p.9
Blood Supply and Nerve Distribution

What are the major contributors to the scapular anastomoses?

Suprascapular artery, dorsal scapular artery, posterior intercostal arteries, and circumflex scapular artery.

p.9
Axilla Anatomy and Function

Which lymph nodes receive all lymph flow from the axilla before transmitting it through the subclavian lymphatic trunk?

The apical nodes.

p.11
Brachial Plexus Structure and Function

Where are most of the branches of the brachial plexus found?

In the axilla or infraclavicular region.

p.10
Blood Supply and Nerve Distribution

What is the function of lymphatic vessels?

Clearing the filtrate from capillary beds and returning extravascular fluid to the venous circulation in the neck.

p.2
Upper Extremity Anatomy Overview

Describe the curvature of the clavicle.

The medial half is convex anteriorly, and the lateral half is concave anteriorly.

p.10
Clinical Correlations of Upper Extremity Injuries

What condition may result after lymph node dissection and what causes it?

Lymphedema, caused by the inability to clear lymph in the subcutaneous tissues normally.

p.10
Brachial Plexus Structure and Function

Which spinal nerves participate in the brachial plexus?

The anterior rami of the caudal 4 cervical spinal nerves (C5-C8) and the first thoracic spinal nerve (T1).

p.1
Muscles of the Upper Extremity

How are muscles in the upper extremity compartmentalized?

By deep fascial coverings, including the brachial and antebrachial fascia, septa, and an interosseous membrane.

p.3
Muscles of the Upper Extremity

What is the role of the rotator cuff muscles in the glenohumeral joint?

They are largely responsible for holding the humeral head in the joint.

p.5
Clinical Correlations of Upper Extremity Injuries

Why can't the arm abduct past the horizontal in a winged scapula condition?

Because the glenoid cannot rotate superiorly.

p.4
Joints of the Pectoral Girdle

What is the coracoacromial arch and its function?

An extrinsic structure consisting of the bony parts and the coracoacromial ligament, preventing the humeral head from becoming displaced superiorly.

p.9
Blood Supply and Nerve Distribution

What is the branch of the first part of the axillary artery and what does it supply?

The superior (or supreme) thoracic artery, which supplies the subclavius muscle, intercostal muscles, some of the serratus anterior, and pectoral muscles.

p.9
Blood Supply and Nerve Distribution

What is an anastomosis?

A communication between arteries.

p.9
Axilla Anatomy and Function

How are the lymph nodes of the axilla arranged?

In 5 distinct groups: humeral, subscapular, pectoral, central, and apical.

p.7
Axilla Anatomy and Function

What reflex indicates the vulnerability of the axilla?

The tickle reflex.

p.11
Brachial Plexus Structure and Function

How many side branches are usually described/studied in the brachial plexus?

11 side branches.

p.11
Brachial Plexus Structure and Function

What is another name for the middle subscapular nerve?

The thoracodorsal nerve.

p.10
Clinical Correlations of Upper Extremity Injuries

What is a common clinical procedure involving the subclavian vein?

Subclavian vein puncture for central catheter insertion.

p.11
Clinical Correlations of Upper Extremity Injuries

What causes 'lower plexus' injuries and what condition can result?

Trauma when the upper limb is suddenly pulled superiorly, stretching the axilla; Klumpke paralysis can result, affecting the short muscles of the hand and causing a 'claw hand'.

p.1
Joints of the Pectoral Girdle

How is sternoclavicular joint movement related to scapular movements?

Sternoclavicular joint movement is coupled to scapular movements.

p.3
Joints of the Pectoral Girdle

What type of joint is the acromioclavicular joint?

A plane-type synovial joint.

p.1
Blood Supply and Nerve Distribution

What artery supplies blood to the upper extremity?

The axillary artery.

p.8
Axilla Anatomy and Function

What structures form the anterior wall of the axilla?

The pectoralis major and minor muscles and the associated fascia (pectoral and clavipectoral).

p.4
Joints of the Pectoral Girdle

What is the function of the transverse humeral ligament?

To bridge over the intertubercular groove and hold the tendon of the long head of the biceps in place.

p.7
Muscles of the Upper Extremity

What is the principal function of the rotator cuff muscles?

To form a cuff around the humeral head and keep it in the glenoid cavity.

p.7
Anatomical Landmarks of the Shoulder

What structures pass through the quadrangular space?

Posterior circumflex humeral artery and axillary nerve.

p.7
Anatomical Landmarks of the Shoulder

What are the boundaries of the triangular interval?

Inferior border of teres major and lateral/long heads of the triceps brachii.

p.7
Axilla Anatomy and Function

What happens to the axilla when the upper limb is fully abducted?

The axilla virtually flattens, leaving its contents vulnerable to damage.

p.3
Joints of the Pectoral Girdle

What are the two ligaments that make up the coracoclavicular ligament?

The conoid ligament and the trapezoid ligament.

p.8
Axilla Anatomy and Function

What structures form the medial wall of the axilla?

The thoracic wall (ribs 1-4, intercostal muscles) and the overlying serratus anterior muscle.

p.4
Joints of the Pectoral Girdle

What is the function of the subscapular bursa?

To protect the subscapularis tendon from excessive wear.

p.4
Clinical Correlations of Upper Extremity Injuries

What happens during an AC joint dislocation?

The AC ligament is not as strong as the CC ligament, and a 'separation' occurs when the CC ligament is ruptured, causing the humeral head to fall away from the glenoid, the acromion to become more prominent, and the distal clavicle to appear elevated.

p.9
Blood Supply and Nerve Distribution

What does the lateral thoracic artery supply and where does it come from?

The lateral thoracic artery supplies the pectoral muscles, serratus anterior muscle, intercostal muscles, and the lateral aspect of the breast. It comes from the distal second part of the axillary artery, lateral to the pectoralis minor.

p.7
Anatomical Landmarks of the Shoulder

What are the boundaries of the triangular space?

Teres minor, teres major, and medial border of the long head of the triceps brachii.

p.7
Clinical Correlations of Upper Extremity Injuries

What can cause axillary nerve injury?

Humerus fractures at the surgical neck, dislocations of the humeral head, and incorrect crutch use.

p.8
Axilla Anatomy and Function

What forms the inferior boundary (base) of the axilla?

Skin, subcutaneous tissue, and axillary fascia from the arm to about the 4th rib.

p.8
Axilla Anatomy and Function

What structures form the posterior wall of the axilla?

The scapula/subscapularis muscle, and more inferiorly, the teres major and latissimus dorsi muscles.

p.4
Scapulohumeral Rhythm

What is the scapulothoracic joint?

A conceptual or 'physiologic' joint involving the movement of the anterior surface of the scapula gliding across the surface of the ribs.

p.4
Clinical Correlations of Upper Extremity Injuries

What causes glenoid labrum tears and what are the symptoms?

Caused by throwing or other overhead repeated, strenuous movements, usually in the anterosuperior aspect of the labrum. Symptoms include pain with the throwing motion, and abduction/lateral rotation may cause a popping or snapping.

p.7
Anatomical Landmarks of the Shoulder

What are the boundaries of the quadrangular space?

Superiorly: inferior border of teres minor; inferiorly: superior border of teres major; laterally: surgical neck of the humerus; medially: lateral border of the long head of the triceps brachii.

p.7
Clinical Correlations of Upper Extremity Injuries

What activities commonly lead to rotator cuff injuries?

Repetitive motion activities such as baseball, weightlifting, and swimming.

p.3
Joints of the Pectoral Girdle

What feature of the glenohumeral joint allows it the most freedom of movement of all the joints in the body?

The arrangement of the humeral head with a small area of articulation in the shallow glenoid cavity.

p.8
Blood Supply and Nerve Distribution

Where does the axillary artery end and what does it continue as?

It ends at the brachial artery, which continues off the axillary artery at the inferior border of the teres major muscle.

p.4
Joints of the Pectoral Girdle

What are the two deficits in the joint capsule of the shoulder for?

One for the passage of the tendon of the long head of the biceps brachii muscle and the other as a communication with the subscapular bursa.

p.9
Axilla Anatomy and Function

Which muscle provides cover for the second part of the axillary artery?

Pectoralis minor muscle.

p.7
Muscles of the Upper Extremity

Which rotator cuff muscles are lateral rotators of the arm?

Infraspinatus and teres minor.

p.9
Blood Supply and Nerve Distribution

What is the importance of collateral routes in blood flow?

They provide alternate pathways of blood flow if the normal blood flow is compromised.

p.7
Clinical Correlations of Upper Extremity Injuries

What can result from repetitive trauma to the rotator cuff?

Inflammation and tendinitis.

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