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MRCS A > ANATOMY - upper limb p3 > Flashcards

ANATOMY - upper limb p3 Flashcards

1
Q

what nn roots forms the brachial plexus?

A

anterior rami C5,6,7,8 + T1

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2
Q

how to remember the parts of the brachial plexus

A

read that damn cadaver book!
Roots
Trunks
Divisions
Cords
Branches

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3
Q

which mm do the brachial plexus roots pass between after forming from anterior rami

A

ant + medial scalene mm

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4
Q

what are the 3 trunks of the brachial plexus

A

superior - C5/6
middle - C7
inferior - C8/T1

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5
Q

into what region of the neck do the trunks of the brachial plexus traverse laterally towards

A

posterior triangle of the neck

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6
Q

where do the trunks of the brachial plexus become division

A

in post triangle of neck - divide into ant + post divisions - then leave into axilla to recombine to become the cords

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7
Q

how are the 3 cords of the brachial plexus named?

A

in relation to the axillary aa

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8
Q

lateral cord brachial plexus consists of

A

anterior division sup trunk
anterior division middle trunk

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9
Q

posterior cord of brachial plexus consists of

A

posterior divisions of sup, mid + inf trunks

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10
Q

medial cord of brachial plexus consists of

A

anterior division of inferior trunk

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11
Q

draw brachial plexus

A

plz

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12
Q

nn roots musculocutaneous nn

A

C5,6,7

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13
Q

motor inn musculocutaneous nn

A

biceps
brachialis
coracobrachialis

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14
Q

sensory inn musculocutaneous nn

A

lateral cutaneous branch to forearm - lateral 1/2 anterior forearm + small portion post forearm

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15
Q

which cord is the musculocutaneous nn the terminal branch of

A

lateral

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16
Q

anatomical course musculocutaneous nerve

A

emerges inferior border pec minor to leave the axilla
pierces coracobrachialis
passes into flexor compartment, superior to brachialis but deep to biceps
pierces deep fascia lateral to biceps –> lateral cutaneous branch

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17
Q

Sx musculocutaneous nn injury

A

weakness in flexion + supination

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18
Q

axillary nn roots

A

C5 + 6

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19
Q

motor inn axillary nn

A

teres minor
deltoid

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20
Q

sensory inn axillary nn

A

sup lateral cutaneous nn –> regimental badge area

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21
Q

which cord is the axillary nn a continuation of?

A

posterior cord

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22
Q

anatomical course axillary nn

A

starts in axilla, post to axillary aa + ant to subscapularis
exits axilla at the inferior border subscapularis via the quadrangular space
passes medially to surgical neck to branch into 3
1) post terminal branch - motor inn post deltoid, teres minor, regimental badge sensory
2) ant terminal branch 0 winds round neck humerus - ant deltoid
3) articular brach to glenohumeral joint

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23
Q

Sx injury axillary nn

A

can’t abduct arm past 15’
regimental badge area sensory loss

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24
Q

Erbs palsy is 2’ to

A

damage to C5/6 nn root
axillary, musculocutaneous, suprascapular + nn to subclavius

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25
Sx Erbs palsy
can't abduct/ext rotate shoulder (axillary nn) can't supinate forearm, flex shoulder --> Waiters tip - medially rotated w/ wrist flexed
26
median nn roots
C6-T1
27
motor inn median nn
flexors forearm thenar mm lateral 2 lumbricals flexion wrist+ digits pronation forearm flexion at MCPJ extension at IPJ
28
sensory inn median nn
palmar cutaneous branch - lateral palm digital cutaneous branch - lateral 3 1/2 palmar digits
29
which cords of the brachial plexus does the median nn arise from
medial and lateral cords
30
anatomical course median nn
descends initially LATERAL to brachial aa 1/2 way - crosses aa --> MEDIAL to brachial aa enters ant forearm via AC fossa travels down forearm betw FDP + FPS (gives off 2 branches - ant interossous - deep ant forearm mm + palmar cutaeneous - lat palmar skin) enters hand via carpal tunnel to terminate as: - recurrent branch - thenar mm palmar digital branch - palmar skin lat 3 1/2 digits + 2 lumbricals
31
cause median nn damage at elbow
usually 2' to supracondylar fracture
32
Sx median nn damage at elbow
constant forearm supination weak wrist flexion thenar eminence wasting hand of Benediction
33
cause median nn damage at wrist
2' laceration flexor retinaculum
34
Sx median nn damage at wrist
thenar + lat 2 lumbricals affected + hand benediction
35
radial nn root s
C5-T1
36
motor inn radial nn
triceps brachii posterior forearm mm
37
sensory inn radial nn
posterior forearm + arm posterolateral dorsal hand
38
which cord is the radial nn a continuation of
posterior cord
39
anatomical course radial nn
arises in axilla, posterior the axillary aa exits via traignular interval to supply lat + long head triceps descends in radial groove wraps around humerus laterally - supply med head triceps 3 cutaneous branches - lower lateral (lat arm inf to deltoid insertion), post cutaneous (post arm) - post cutaenous forearm (mid post forearm) enters forearm anterior to lateral epicondyle @ cubital fossa, then braches to derminate as: deep branch - post mm forearm superificial branch - sensation dorsal hand/fingers after it innervates the supinator, continues as the posterior interosseous nn
40
Sx of radial nn injury in axilla
wrist drop loss of sensation
41
Sx radial nn injury in radial groove
triceps weakened wrist drop superficial sensory branch affected
42
Sx radial nn injury in forearm
superficial branch if 2' to stabbing - lat 3 1/2 digits + dorsum sensory loss deep branch (2' fracture/dislocation) - no wrist drop as ECRL unaffected
43
ulnar nn roots
C8, T1
44
motor inn ulnar nn
mm hand except thenar + lat 2 lumbricals FCU + med ½ FDP
45
sensory inn ulnar nn
ant + post surface medial 1 ½ fingers
46
anatomical course ulnar nn
descends in plane between axillary aa (lat) + axillary vv (med) down med aspect of arm with brachial aa laterally mid point of the arm - penetrates the emdial fascial septum --> post arm compartment passes posterior to elbow --> ulnar tunnel (here articular branch to supply elbow joint) in forearm - pierces FCU, travels deep to mm alongside ulnar 3 main branches in forearm - mm branch - FCU + med ½ FDP, palmar cutaneous branch - med 1 ½ palm + dorsal cutaneous branch - dorsal surface med 1 ½ fingers travels superficial to flexor retinaculum + medial to ulnar aa --> hand via ulnar canal terminates into sup (palmaris brevis) + deep (hypothenar mm, med 2 lumbricals, palmar + dorsal interossei) branches
47
which mm is tested for with Froments
adductor pollicis
48
What is the ulnar paradox
different manifestation of a high ulnar nerve lesion (at the elbow) and a low ulnar nerve lesion (at the wrist). In a high lesion the clawing is paradoxically more mild than in a low lesion
49
minor branches from brachial plexus roots (2)
dorsal scapular nn long thoracic nn
50
minor branches from the brachial plexus trunks (2)
suprascapular nn nn to subclavius
51
minor branches from lateral cord brachial plexus (1)
lateral pectoral nn
52
minor branches from the medial cord brachial plexus (3)
medial pectoral nn medial cutaneous nn of arm medial cutaneous nn of forearm
53
minor branches from the posterior cord brachial plexus (3)
superior subscapular nn thoracodorsal nn inferior subscapular nn
54
what is Klumpe's palsy 2' to
injru to lower roots of brachial plexus C8-T1 assoc w/ dificult vaginal delivery
55
which nn are most commonly affected in Klumpe's palsy (2)
ulnar nn median nn
56
Sx Klumpe's palsy
clawed hand 2' to lumbricals paralysis
57
what are the 5 main vessels of the UL
SCA Axillary brachial Radial Ulnar
58
where does the SCA originate from on the R vs L
R - brachiocephalic trunk L - arch of aorta
59
which mm divides the SCA into 3 parts
anterior scalene
60
1st vs 2nd vs 3rd part SCA location
1st part = origin SCA --> med border ant scalene 2nd part = posterior to ant scalene 3rd part = lat border ant scalene to 1st rib
61
what does the SCA become once it enters the axilla ?
axillary aa
62
which mm is the axillary aa deep to
pec minor
63
what surrounds the axillary aa
axillary sheath
64
how is the axillary aa divided in 3?
via relation to pec minor 1) proximal to pec minor 2) post to pec minor 3) distal to pec minor
65
branches in 1st part axillary aa
PROXIMAL TO PEC MINOR superior thoracic aa
66
branches in 2nd part axillary aa
POST TO PEC MINOR thoraco-acromial aa lateral thoracic aa
67
branches in 3rd part axillary aa
subscapular aa ant = post circumflex aa
68
which mm's lower border does the axillary aa become the brachial aa
teres major
69
1st branch brachial aa
profunda brachii
70
which nn does the profunda brachii travel with
radial nn (hence supplies triceps)
71
where does the profunda brachii terminate
at an anastomotic network around the elbow
72
what does the radial aa supply
psterolat forearm elbow joint + carpals via anastomotic network thumb, index + palmar arches (after goes through snuffbox)
73
where can you palpate the radial aa in the arm
lateral to FCR tendon
74
between which mm head does the radial aa travel through the anatomical snuffbox
Abductor pollicis brevis
75
what does the ulnar aa supply
anteromed foreoarm anastomoses - elbow joint then ant + post interosseous aa superifical and deep palmar arches
76
where does the ulnar aa enter the hand
anterior to flexor retinaculum lateral to ulnar nn
77
where is the superficial palmar aa arch + what does it supply
anterior to flexor tendons of the hands deep to the palmar aponeurosis becomes digital aa to the 4 fingers
78
where is the deep palmar arch and what does it supply
deep to flexor tendons blood to digits + wrist joint
79
what are the 2 main superficial vv of the upper limb
cerphalic vv + basilic vv
80
what drains into the basilic vv
dorsal vv network
81
where does the basilic vv ascend on the upper limb
medial aspect
82
where does the basilic vv leave the arm
border teres major
83
where does the basilic vv drain into
+ brachial vv --> axillary vv
84
what drains into the cephalic vv
dorsal vv network
85
where does the cephalic vv ascend in the UL
anterolateral aspect of the upper limb, anteriorly at elbow
86
between what 2 muscles does the cephalic vv travel before entering the axillary at the clavicopectoral groove
deltoid pec minor
87
where does the cephalic vv drain into
axillary vv
88
what vv connects the basilic and cephalic vv at the elbow
medial cubital vv
89
where are the deep vv of the UL
under the deep fascia
90
which is the largest of the deep vv of the uL
brachial vv
91
what is vena comitantes
pulsations of the aa (e.g. brachial aa) assist w/ vv return
92
what connects the superficial and deep vv of the UL
perforating vv

MRCS A (36 decks)

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