Anato block II: Axilla & Brachial plexus

Question 1

By what is the axilla composed

Answer 1

imaginary space
anterior wall of axilla:
-pectoralis major
-pectoralis minor

medial wall of axilla:
-serratus anterior
-4th rib

posterior wall of axilla:
-humerus
-teres major
-latissimus dorsi
-subscapularis
-scapula

intertubercular sulcus (lateral wall of axilla)

Question 2

What does the axillary artery supply?

Answer 2

Supplies the wall of the axilla and the related regions and continues as the mayor blood supply

Question 3

What are the axillary artery margins?

Answer 3

from clavicle to inferior border of teres major

Question 4

The first part of the axillary artery starts and ends where?

Answer 4

from clavicle to superior border of pectoralis minor

Question 5

The second part of the axillary artery starts and ends where?

Answer 5

under pectoralis minor

Question 6

The third part of the axillary artery starts and ends where?

Answer 6

from inferior border of pectoralis minor to teres major

Question 7

What are the 6 direct ramifications of the axillary artery?

Answer 7

1. superior/supreme thoracic artery
2. Thoracoacromial artery
3. Lateral thoracic artery
4. Subscapular artery
5. Anterior circumflex humeral artery
6. Posterior circumflex humeral artery

Question 8

How many ramifications does the thoracoacromial artery have?

Answer 8

4

Question 9

What are the ramifications of the subscapular artery?

Answer 9

Circumflex scapular branch artery
Thoracodorsal artery

Question 10

Which arteries come from the brachial artery? (direct ramifications

Answer 10

1. Profunda brachii artery
2. Humeral nutrient artery
3. Superior ulnar collateral artery
4. Inferior ulnar collateral artery

Question 11

What are the ramifications of the profunda brachii artery?

Answer 11

Radial collateral artery and middle collateral artery

Question 12

The brachial artery divides into?

Answer 12

Radial artery and ulnar artery

Question 13

What irrigates the deep part of the arm?

Answer 13

Common interosseous artery

Question 14

What are the ramifications of the common interosseous artery?

Answer 14

Posterior interosseous artery and anterior interosseous artery

Question 15

What are the veins of the arm?

Answer 15

1. Axillary vein
2. Basilic vein penetrating deep fascia
3. Cephalic vein

Question 16

Which vein drains in the axillary vein?

Answer 16

Basilic vein

Question 17

What anastomoses with the cephalic and basilic vein?

Answer 17

median cubital vein

Question 18

How do veins drain?

Answer 18

With muscle contraction and valve does not allow to return

Question 19

What is the deltopectoral triangle?

Answer 19

allows cephalic vein to enter and drain on the axillary vein

Question 20

Which is the first lymph node?

Answer 20

cubital lymph nodes

Question 21

Mention the lymphatic drainage of the upper limb and the order

Answer 21

Digits: lymphatic vessels
hand: lymphatic plexus of palm
1st lymph node: cubital lymph nodes
-subscapular lymph nodes (posterior)
-pectoral axillary lymph nodes (anterior)
-humeral axillary lymph nodes (lateral)
-central axillary lymph nodes
-deltopectoral lymph nodes
-apical axillary lymph nodes

Question 22

What is the brachial plexus?

Answer 22

It is a somatic plexus of nerves formed by
the anterior rami of C5 to T1.

Question 23

Where does the brachial plexus originate ?

Answer 23

Originates in the neck, passes laterally and
inferiorly over the first rib and enters the
axilla

Question 24

Explain the brachial plexus

Answer 24

Question 25

What are some brachial plexus injuries?

Answer 25

Waiter’s tip position
Erb-duchenne palsy
Klumpke paralysis

Question 26

Explain waiter’s tip or erb-duchenne palsy

Answer 26

-Injury to the superior trunk of the plexus

-limb hangs by the side in medial rotation

-Paralysis of the muscles of the shoulder and arm supplied by the C5 and C6 spinal nerves occurs [deltoid, biceps, brachialis]

-Usual clinical appearance is an upper limb with an adducted shoulder, medially rotated arm, and extended elbow

-Lateral aspect of the forearm also experiences loss of sensation

Question 27

identify

Answer 27

Erb-duchenne palsy

Question 28

Explain klumpke paralysis

Answer 28

– Injuries to inferior parts of the brachial plexus

– May occur when the upper limb is suddenly pulled superiorly

– Normally injure the inferior trunk of the brachial plexus (C8 and T1) and may avulse the roots of the spinal nerves from the
spinal cord. The short muscles of the hand are affected, and a claw hand results