Anatomy Exam 2 Upper extemities Flashcards
Define Axilla
The area between the chest wall and the proximal upper arm
Define the course of the left subclavian artery
Arises from the aortic arch and is continuous with the Axillary artery
Course of the Right Subclavian artery
Arises from the brachiocephalic trunk and is continuous with the R axillary artery
Brachial artery bifurcates into ?
Radial and Ulnar
Define vena comitantes
Vins which lie beside and aretery, usually found in pairs. The arterial pulsations aid in venous return
Superficial veins of the arm
- Cephalic
- Basilic
- Median Cubital
Deep veins of the arm
- Axillary
- Subclavian
- Brachial
- Vena Comitantes
Course of the cephalic vein
Lateral aspect of the arm. Drains into the Axillary vein (at the shoulder)
Course of the Basilic Vein
Medial aspect of the arm. Drains into the brachial vain (midshaft of the humerus)
the Course of Median Cubital vein
Communication between the cephalic and basilica veins
Course of the axillary vein
Begins at the inferior border of the teres major and drains into the subclavian vein
course of the Subclavian vein
Arises from the Axillary vein. Drains into the brachiocephalic vein
Course of the Brachial Vein
Arises from the radial and ulnar veins (venae comitantes). Drains into the Axillary Vein
Course of the venae comitantes
Deep Radial and Ulnar veins which drain into the Brachial Vein.
Axillary nerve site of vulnerability
Neck of the humerus
Radial nerve site of vulnerability
Midshaft of the humerus
Ulnar nerve site of vulnerability
Medial epicondyle
Proximal Attachments of the Deltoid muscle
- Clavicle
- Acromion
- Spine of scapula
Distal attachments of the Deltoid
- Deltoid tuberosity
Action of the deltoid muscle
- Primary abductor of the arm at the shoulder joint
- Flexion and extension of the arm
Nerve supply of the deltoid muscle
Axillary nerve (C5-C6)
Course of the axillary nerve
- Travels through the quadrangular space
- Accompanies posterior circumflex humeral artery and vein
Function of the axillary nerve
Motor innervation to deltoid and teres minor (rotator cuff muscle), sensory innervation to shoulder joint and skin overlying deltoid
Implications of damage to the axillary nerve
weak arm and shoulder abduction, impaired sensations, shoulder contour loss
Base of the Axilla
- Axillary fascia
- Skin of the armpit
Apex of the Axilla
- Clavicle
- 1st Rib
- Superior part of the scapula
Anterior wall of the Axilla
- Clavipectoral fascia
- Pectoralis major and minor
Posterior wall of the axilla
- Triceps (long head)
- Teres major
- Subscapularis
- Latissimus dorsi
Medial wall of the axilla
- Serratus anterior
- Intercostal
- Upper rib cage
Lateral wall of the axilla
Humerus (intertubercular sulcus)
Contents of the axilla
- Axillary artery and vein
- Axillary lymph nodes
- Portions of the brachial plexus
- Biceps and corachobrachialis muscles
- Fascia
Roots of the brachial plexus
C5, C6, C7, C8 and T1
Trunks of the brachial plexus
- Superior
- Middle
- Inferior
Divisions of the brachial plexus
- Anterior
- Posterior
Cords of the Brachial plexus
- Lateral
- Lateral Pectoral
- Posterior
- A, B and C
- Medial
- Medial Pectoral
- Medial Cutaneous (Brachial)
- Medial Cutaneous (antibrachial)
Branches of the Brachial Plexus
- Musculocutaneous
- Median
- Lateral head
- Median head
- Axillary
- Radial
- Ulnar
Name the axillary lymph nodes
- Apical (subclavian)
- Central
- Lateral (brachial)
- Posterior (subclavian)
- Anterior (Pectoral)
Drainage of the Central axillary lymphnodes
Receive lymph from other groups
Drainage of the ]Anterior (subclavian) lymph nodes
Drain breast and anterior trunk
Drainage of the posterior (subclavian) lymph nodes
Drain upper back, neck and shoulder
Drainage of the lateral (brachial) lymph nodes
Receive most of the upper limb drainage
Muscles of the anterior compartment of the arm
- Biceps brachii
- Coracobrachialis
- Brachialis
Vessels of the anterior compartment of the arm
- Brachial artery and its venae comitantes
Nerves of the anterior compartment of the arm
- Medians
- Ulnar
- Musculocutaneous
Lateral boundary of the cubital fossa
Brachioradialis
Medial boundary of the cubital fossa
Pronator teres
Proximal boundary of the cubital fossa
Imaginary line between the humeral epicondyles
Floor of the cubital fossa
Supinator muscle and brachialis muscle
Roof of the cubital fossa
Deep fascia, aponeurosis of biceps
Contents of the cubital fossa
- Median Nerve
- Brachial Nerve
- Biceps Tendon
- Radial Nerve
Superficial muscle group of the forearm
- Pronator teres
- flexor carpi radialis
- Palmaris longus
- Flexor carpi ulnaris
- Flexor digitorum superficialis
Proximal attachment of the superficial muscle group of the anterior forearm
Medial epicondyle
Innervation of the superficial muscle group of the anterior forearm
- All innervated by the median nerve
- **except the flexor carpi ulnaris (ulnar nerve)
Action of the superficial muscle group of the anterior forearm
Weak flexors of the elbow joint and movements of the wrist and hand
Deep muscles of the anterior forearm
- Flexor digitorum profundus
- Flexor policic longus
- Pronator Quadratus
Innervation of the deep muscle group of the anterior forearm
Anterior osseous nerve except the medial part of the frlxor digitorum profundus (Ulnar nerve)
Arteries of the anterior forearm
- Ulnar artery
- Radial artery
Nerves of the anterior forearm
- Median nerve
- Radial Nerve
- Ulnar Nerve
Proximal row of the carpal bones
- Scaphoid
- Lunate
- Triquetrum
- Pisiform
Distal row of the carpal bones
- Trapezium
- Trapezoid
- Capitate
- Hamate
Flexor tendons of the hand
- Flexor pollicis longus
- Flexor dig profundus
- Flexor dig superficialis
Thenar muscles of the hand
- Abductor pollicis brevis
- Flexor pollicis brevis
- Opponens Pollicis
Hypothenar muscles of the hand
- Abductor digiti minini
- Flexor digiti minimi
- Opponens digiti minimi
Arterial supply of the hand
- superficial palmar arch (derived from the ulnar artery)
- Deep palmar arch (derived from the radial artery)
Venous drainage of the hand
Blood from fingers and palms drain into superficial veins on dorsum of hand, then entering the cephalic or basilic veins
Nerve supply of the hand
Ulnar and Median nerves
Muscles that attach the arm to the trunk
- Trapezius
- Levator scapulae
- Rhomboids
- Latissimus dorsi
Fibers of the trapezius and function
- Upper fibers = lateral flexion of the neck
- Middle fibers = scapular retraction
- Lowe fibers = scapular depression
- Upper and lower = scapular rotation (glenoid fossa turns superiorly allowing full abduction of the arm)
Innervation of the trapezius
- Accessory nerve (CN XII)
Levator scapulae, rhomboid major and minor function
- Scapular elevation
- assist scapular rotation during arm adduction
Levator scapulae innervation
- dorsal scapular nerve (C5 brachial plexus)
- C3 and C4 (Cervical plexus)
Rhomboids major and minor innervation
Dorsal scapular nerve (C5 brachial plexus)
Latissimus dorsi function
- Adducts, extends and extends arm
- assists in scapular rotation and retraction
Innervation of Latissimus dorsi
Thoracodorsal nerve
Arterial supply of latissimus dorsi
Thoracodorsal artery
Muscles of the rotator cuff
- Subscapularis
- Supraspinatus
- Infraspinatus
- Teres major
Function of the rotator cuff
Assist in joint stabilization and holds humeral head firmly to glenoid fossa
Proximal attachment of the subscapularis muscle
Costal surface of the scapula
Distal attachment of the subscapularis muscle
Lesser tubercule
Action of the subscapularis muscle
Medial rotation of the arm at the shoulder
Proximal attachment of the supraspinatus muscle
Supraspinatus fossa
Distal attachment of the supraspinatus muscle
Greater tubercle
Action of the supraspinatus mescle
Initiates abduction
Proximal attachment of the infraspinatus muscle
Infraspinatus fossa
Distal attachment of the Infraspinatus
Greater tubercle
Action of the infraspinatus muscle
Lateral rotation of the arm at the shoulder
Proximal attachment of the teres minor
Posterior scapulae surface
Distal attachment of the teres minor
Greater tubercle of the humerus
Action of the Teres minor
Lateral rotation of the arm
Proximal Attachment of the triceps brachii
- Infraglenoid tubercule (long head)
- Posterior shaft of humerus (lateral head)
- IM septa on shaft of humerus (medial head)
Distal attachment of the triceps brachii
Olecranon process
Action of the triceps brachii
- Extend the arm at the shoulder
- Long head crosses shoulder jount (aids in stability)
Superficial muscles of the posterior forearm and innervation
Innervated by posterior interosseouls branch of radial nerve - Extensor Radialis brevis - Extensor digitorum - Extensor digiti minimi - Extensor carpi ulnar Innervated by Radial Nerve - Brachioradials - Extensor carpi radialis longus
Function of Extensor carpi radialis brevis
Extensor and abductor of the hand
Function of Extensor digitorum
Four fingers, extensor of hand
Function of extensor digiti minimi
Fifth digit
Function of extensor carpi ulnar
Extensor and adductor of hand at the wrist
Deep muscles of the posterior forearm
- Extensor indicis
- Extensor pollicis longus
- Extensor pollicis brevis
- Abductor pollicis longus
Branches of the radial nerve
- Axillary nerve
- Posterior interosseous nerve
- Superficial Branch
- Digital branches
The musculocutaneous nerve turns into which nerve
Lateral cutaneous nerve of the forearm
Branches of the median nerve
- Anterior interosseous
- Recurrent branch (in the hand)
Muscles innervated by the musculocutaneous
- Biceps Brachii
- Coracobrachialis
- Brachialis
Muscles innervated by the median nerve
- Pronator teres
- Flexor carpi radialis
- Palmaris longus
- Flexor digitorum superficialis
Muscles innervated by the ulnar nerve
- Flexor carpi ulnaris
- Medial part of the flexor digitorum profundus
Muscles innervated by the anterior interosseous
- Lateral part of the flexor digitorum profundus
- Flexor policis longus
- Pronator quadratus
Muscles innervated by the Radial nerve
- Triceps Brachii
- Brachioradialis
- Extensor carpi radialis longus
Muscles innervated by the posterior interosseous nerve
- Extensor digitorum
- Extensor digiti minimi
- Extensor carpi ulnaris
- Abductor policis brevis
- Extensor policis brevis
- Extensor policis longus
- Extensor indices
Musces innervated by the deep branch of the radial nerve
- Extensor carpi radialis brevis