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UE Attachments
Anatomy
| Question | Answer |
|---|---|
| Pectoralis Major | Sternum; Clavicle to Humerus Intertubercular Groove; gr tubercle of intertub sulcus |
| Pectoralis Minor | Anterior Ribs to Coracoid Process |
| Serratus Anterior | Ribs to Scapula Medial Border |
| Trapezius | External Occipital Protuberance; Thoracic Spinous Processes to Clavicle; Acromion Process; Scapular Spine |
| Rhomboid Major | Thoracic Spinous Processes to Scapula Medial Border |
| Rhomboid Minor | Cervical Spinous Processes to Scapula Medial Border |
| Levator Scapulae | Cervical Transverse Processes to Superior Medial Scapula |
| Latissimus dorsi | Thoracic/Lumbar Vertebrae; Ribs; Iliac Crest to Humerus Intertubercular (biceps) Groove (ant side of humerus) |
| Deltoid | Clavicle; Scapular Spine; Acromion Process to Humerus Deltoid Tuberosity |
| Subscapularis | Scapula Medial Border; subscapular fossa to Anterior Proximal Lesser Tubercle of Humerus |
| Teres Minor | Superior lateral Scapula to Post Proximal (inf facet) Gr Tubercle of Humerus |
| Infraspinatus | Scapula Medial Border; infraspinous fossa to Post Proximal (middle facet) Gr Tubercle of Humerus |
| Supraspinatus | Scapula Medial Border; supraspinous fossa to Proximal Surface/ (sup facet) Gr Tubercle of Humerus |
| Teres Major | Posterior Inferior Angle Scapula to Medial Proximal Humerus; lesser tubercle of humerus |
| Biceps brachii (long head) | Glenoid Cavity (supraglenoid tub of scap) to Radial Tuberosity/ bicipital aponeurosis |
| Biceps Brachii (short head) | Coracoid Process to Radial Tuberosity/ bicipital aponeurosis |
| Coracobrachialis | Coracoid Process to middle medial shaft of humerus |
| Brachialis | Anterior Distal Humerus to Ulna Coronoid Process and Tuberosity |
| Triceps Brachii (long head) | Scapula/Glenoid Cavity (infraglenoid tub) to Ulna Olecranon Process |
| Triceps Brachii (Lateral Head) | Posterior Proximal Humerus to Ulna Olecranon Process |
| Triceps Brachii (Medial Head) | Posterior Shaft of Humerus to Ulna Olecranon Process |
| Pronator Teres | Medial Epicondyle of Humerus; Coronoid Process of Ulna to Lateral Shaft of Radius |
| Flexor Carpi Radialis | Medial Epicondyle of Humerus to Base of Metacarpals 2-3 |
| Palmaris Longus | Medial Epicondyle of Humerus to Base of Carpals/ palmar aponeurosis & distal flexor retinaculum |
| Flexor Carpi Ulnaris | Medial Epicondyle of Humerus; olecranon, posterior ulna to Pisiform, Hamate, Metacarpal 5 |
| Flexor digitorum superficialis | Medial Epicondyle of Humerus; coronoid; superior ant radius to middle phalanges of 2-5 |
| Flexor Digitorum Profundus | Proximal 3/4 of medial/ ant ulna & interosseous membrane to Distal Phalanges 2-5 |
| Flexor pollicis longus | Ant radius & interosseous membrane to distal phalanx of 1 |
| Pronator quadratus | Distal 1/4 of ant ulna to Distal 1/4 of ant radius |
| Brachioradialis | Proximal lateral supraepicondylar ridge of Humerus to Lateral distal radius; styloid process |
| Extensor carpi radialis longus | Lateral supraepicondylar ridge of Humerus to Base of Metacarpal 2 |
| Extensor carpi radialis brevis | Lateral Epicondyle of Humerus to Base of Metacarpal 3 |
| Extensor Carpi Ulnaris | Lateral Epicondyle of Humerus; Posterior Shaft of Ulna to Base of Metacarpal 5 |
| Extensor Digitorum | Lateral Epicondyle of Humerus to Dorsal Surfaces of (distal & middle) Phalanges 2-5 |
| Extensor digiti minimi | Lateral Epicondyle of Humerus to extensor expansion of digit 5 |
| Extensor indicis | Posterior ulna & interosseous membrane to extensor hood of digit 2 |
| Extensor pollicis longus | Posterior surface of middle of ulna and interosseous membrane to Distal phalanx of thumb |
| Extensor pollicis brevis | Posterior surface of radius & interosseous membrane to Proximal phalanx of thumb |
| Abductor pollicis longus | Posterior surface of radius & ulna & interosseous membrane to First metacarpal |
| Supinator | Lateral Epicondyle of Humerus; radial notch & crest of Ulna to Proximal 1/3 of Radius |
| Abductor digiti minimi | Pisiform to Medial proximal digit 5 |
| Flexor digiti minimi brevis | Hamate & flexor retinaculum to medial border of metacarpal 5 |
| Opponens digiti minimi | Hamate & flexor retinaculum to medial border of metacarpal 5 |
| Adductor pollicis | MCP 2-3, capitate; ant MCP 3 to Medial proximal thumb |
| Lumbricals 1-2 | lateral 2 tendons of FDP to extensor hoods of 2-5 |
| Lumbricals 3-4 | Medial 3 tendons of FDP to extensor hoods of 2-5 |
| Palmar interossei | Palmar surface of MCPs 2, 4, & 5 to extensor hoods & proximal phalanges of 2, 4, & 5 |
| Dorsal interossei | Adj sides of 2 MCPs to extensor hoods & proximal 2-4 |
| Types of synovial joints | Hinge, Pivot, Condylar, Planar (gliding) joint, Ball and socket joint |
| Synovial joints: lined by: | hyaline cartilage |
| Synovial joints: Enclosed by: | joint capsule containing synovial fluid |
| Hinge joint: movement | Flexion and extension only (e.g., elbow) |
| Pivot joint: movement | Rotation only (e.g., atlanto-axial joint) |
| Condylar joint: movement | Movement around two axes (flex/exten, abduct/adduct) (e.g., wrist) |
| Saddle joint can be considered a special type of _____ joint | condylar joint (e.g., thumb) |
| Planar (gliding) joint: movement | Limited movement around multiple axes (e.g., joints between tarsals) |
| Ball and socket joint: movement | Movement around multiple axes (e.g., hip joint) |
| Function of rotator cuff muscles | Stabilize glenoid joint; action of a single mx may act to adduct/ abduct or medially/laterally rotate GH joint |
| Rotator cuff disorders = | Impingement or tendinopathy (including avascular necrosis) |
| Mx most commonly involved in rotator cuff disorders | Supraspinatus |
| Supraspinatus involvement in rotator cuff disorders (MOA) | Constriction by acromion process and clavicle |
| Rotator cuff disorders: after initial trauma: | trauma is more likely to reoccur |
| Non-synovial (e.g. solid) joints | Lack a joint capsule; elements linked via fibrous conn tissue or cartilage; very little movement at these joints |
| Examples of non-synovial joints | Sutures (btw cranial bones); Syndesmoses (inteross membrane); Symphyses (pubic symphysis, intervert discs) |
| Muscles acting across a particular joint result in: | movement at that joint |
| Soft tissue structures in the joint help to: | increase congruence of the bony components of a joint & decrease stress (=force/area) at a joint |
| Movements of the shoulder | Retraction/ protraction; Abduction/ adduction; Flexion/ extension; Medial/ lateral rotation; Circumduction |
| Movements of the Elbow/ Forearm | Flexion/ extension; Pronation/ supination |
| Movements of the Wrist | Flexion/ extension; Abduction (radial deviation) / adduction (ulnar deviation) |
| Movements of the MP joints | Flexion/ extension; Abduction/ adduction |
| Movements of the IP joints | Flexion/ extension |
| Components of upper arm | Ant compartmt; Post compartmt; Deep fascia; Intermuscular septa |
| Components of forearm | Ant compartmt; Post compartmt; Deep fascia; Inteross membrane; Intermuscular septa |
| Superficial veins of arm | Cephalic; Basilic; Median cubital vein |
| Superficial veins of arm: variable anatomy | Median cubital may be replaced by median antebrachial vein |
| Arm lymphatics follow: | venous system |
| Superficial lymphatic drainage along cephalic vein: | deltopectoral and axillary nodes |
| Superficial drainage along basilic vein: | cubital and axillary nodes |
| Deep drainage along axillary vein: | axillary nodes |
| 3 bones of shoulder: | Clavicle, Scapula, Humerus |
| 3 Joints of shoulder | Sternoclavicular (SC); Acromioclavicular (AC); Glenohumeral (GH) |
| Ligament of SC joint: | Sternoclavicular ligament |
| Ligament of AC joint: | Acromioclavicular ligament |
| Ligaments anchoring the clavicle to the coracoid | Coracoclavicular ligament |
| Clavicular dislocation | Can occur at SC or AC joints |
| GHJ: joint congruence increased by: | Glenoid labrum |
| GHJ: friction at joint reduced by: | Bursa or synovial sheaths |
| GHJ dislocation: likelihood increased by: | Shallowness of GHJ |
| GHJ dislocation: can impinge on: | nerves of brachial plexus or axillary a. |
| Bursitis = | Inflammation of the bursal sacs |
| Lesion of the long thoracic n. nerve causes: | winged scapula |
| Axilla: Anterior wall = | Pectoralis major/minor |
| Axilla: Posterior wall = | Subscapularis, teres major, latissimus dorsi |
| Axilla: Medial wall = | Upper thoracic wall, serratus anterior |
| Axilla: Lateral wall = | Intertubercular sulcus of humerus |
| Axilla: Contents | Axillary a./v.; Brachial plexus |
| Axillary artery: continuous proximally with: | subclavian a. |
| Axillary artery: Name changes after passing: | clavicle and teres major m. |
| Axillary artery: continuous distally with: | brachial a. |
| Axillary a. gives off multiple branches to: | ant & post walls of axilla, & intrinsic shoulder mxs |
| Circumflex humeral arteries (ant & post): route | Wrap around surgical neck of humerus |
| Circumflex humeral arteries: potentially damaged in: | fracture or dislocation |
| Brachial artery: gives off: | deep a. of arm (profunda brachii) |
| Brachial a.: runs in: | radial groove |
| Brachial a.: susceptible to: | injury with humeral fractures |
| Brachial a.: splits in cubital fossa into: | radial and ulnar arteries |
| Brachial a.: used for: | BP measurements; hemorrhage control |
| Axillary vein: follows: | path & branches of axillary a. |
| Axillary vein: receives drainage from: | superficial veins |
| Brachial plexus = ventral rami of: | C5, C6, C7, C8, T1 |
| Brachial plexus: medial to lateral can be separated into: | Roots, Trunks, Divisions, Cords, Branches |
| Cords of brachial plexus: named for: | their position relative to axillary artery |
| Musculocutaneous nerve: Motor | muscles of anterior arm |
| Musculocutaneous nerve: Sensory | terminates as lateral cutaneous n. of forearm |
| Median nerve: Motor: | most muscles of theanterior forearm, some intrinsic muscles of the hand |
| Median nerve: Sensory: | some skin of hand |
| Carpal tunnel syndrome is associated with which nerve? | median nerve |
| Ulnar nerve: Motor: | 1-1/2 muscles in anterior forearm, most intrinsic muscles of hand |
| Ulnar nerve: Sensory: | some skin of hand |
| Radial nerve: Motor: | all muscles of posterior arm and forearm |
| Radial nerve: Sensory: | skin of posterior arm, forearm, and hand |
| Susceptible to damage with fractures of humerus (wrist drop) | radial nerve |
| Actions of elbow joint | Flexion/ extension (humerus- ulna); Pronation/ supination (ulna-radius) |
| Elbow joint: Ligaments | Collateral ligaments (Radial (lateral), Ulnar (medial)); Annular ligament of radius |
| Nursemaids elbow: MOA | Dislocation of proximal radius out of annular ligament (dislocates laterally) |
| Movement at a joint is determined by: | its bony components, anatomy of the fibrous capsule surrounding the joint, & the position of muscles relative to ctr of rotation of the joint |
| Clavicular fracture | Usually middle 1/3 of clavicle; SCM pulls medial clavicle superiorly; very common in children or young adults |
| GHJ: Bursa or synovial sheaths | Subtendinous bursa of subscapularis; Subacromial bursa; Synovial sheath around long head of biceps brachii |