Anatomy::Upperlimb Flashcards
Borders of the anatomical suffbox
Medial border(Dorsal): Tendon of extensor pollicis longus
Lateral border(Palmar): Tendon of abductor pollicis longus and extensor pollicis brevis
Contents:
base of metacarpal of the thumb
- Trapezius
- Scaphoid
Radial styloid
dorsal branch of radial artery
Dorsal branch of radial artery lies close to the cephalic vein - appropriate site for AV fistula for dialysis
Contents of Carpel Tunnel
Roof: Flexor retinaculum
floor and wall: by the carpal bones
Contents:
Flexor digitorum superficialis
Flexor digitorum profundus
Flexor pollicis longus
Flexor carpi radialis
Median nerve
Venous supply of the Upper limb
Basilic vein
- Dorsal venous network of the hand, ascends medially
At the border of teres major, it runs deep in the arm
Combines with brachial veins to form AXILLARY VEIN
Cephalic vein
Dorsal aspect of hand, ascend antero-lateral, passing anteriorly to the elbow
At the shoulder, travels between deltoid and pectoralis major and enters clavipectoral triangle
In the axiila, cephalic empties into the axillary
In the Elbow basilic and cephalic connects by the medial cubital vein
Boundaries of Axilla
Medial border: Serratus anterior and thoracic wall
Lateral border: Intertubercular sulcus
Anterior border: Pectoralis major and minor
Posterior border: Scapularis, teres major, latissimus dorsi
Median nerve innervation at the level of the wrist
LOAF MUSCLES
Latral 2 Lumbrical
Opponens pollicis
Abductor pollicis brevis
Flexor pollicis brevis
Weakness of thumb Lac over medial wrist
No sensation over the thenar eminensce - anaesthetized at the elbow
Muscles of the rotator cuff
- Subscapularis
- Supraspinatus
- Infraspinatus
- Teres minor
All muscles originates from the scapula
Supraspinatus, infraspinatus and Teres minor insert in to the greater tuberosity of the humerus
Subscapularis inserts to the lesser tuberosity.
Actions at the shoulder joint and the muscles involved
- Abduction- Suprapinatus(rotator cuff)
- Adduction - Pectoralis major, lat dorsi, teres major
- Internal rotation- Pectoralis major, Lat dorsi, Teres major, Subscapularis and ant. deltoid
- External rotation- Infraspinatus and Teres minor
- Circumduction- combo of above
BRACHIAL PLEXUS
3:1:0:3:5:5
3 branches from the roots
- Long thoracic nerve
- Nerve to sunclavius
- Dorsal sub scapular
1 from the Trunk
- Suprascapular
0 from the divisions
3 from the lateral cord
- Lateral pectoral nerve
- Musculocutaneous
- lateral root of median nerve
5 from medial cord
- Medial pectoral nerve
- medial cutaneous nerve of forearm
- medial cutanoeus nerve of the arm
- medial root of the median nerve
- Ulnar nerve
5 from posterior cord
- 2 subscapular (upper/lower)
- Thoracodorsal
- Axillary
- Radial
ROOTS- C5,C6, C7, C8 , T1
TRUNKS- Superior, middle, inferior
DIVISION
CORDS
Nerves coming off the roots-
1. Dorsal Scapular(C5)- Rhomboid minor and major
2. Long thoracic Nerve(C5/C6/C7)- Serratus anterior muscle
Superior Trunk-(Rotator cuff muscles)
1. Suprascapular- Supraspinatus and infraspinatus
2. Nerve to Subclavius- Subclavius muscle(first rib and Clavicle)
Lateral cord and medial cord(Anterior Compartments)
Posterior Cord(Posterior compartments
Terminal nerves
1. Musculocutaneous nerve: terminates as lat cutaneous nerve of forearm
Sensory: Lateral forearm
2, Axillary: Deltoid, Teres minor, long head of triceps brachii
Sensory: Deltoid area
3. Radial nerve: All the muscles of the posterior compartments of arm and forearm
4. Median nerve: All muscles of anterior compartment(except FCU, FDP)
Sensory: Lateral 3 1/2 Lat. wrist and hand
5. Ulnar nerve: Intrinsic muscles except thenar, Flexor carpi ulnaris, flexor digitorum profundus
Sensation- Medial 1 1/2, medial palm and wrist
Lateral Cord:
Medial Cord:
Ulnar nerve
(M Nerves)
1. Medial pectoral nerve
2. Medial cutaneous nerve to upper arm
3. Medial cutaneous nerve of the forearm
Posterior cord:(ULTRA)
1. Upper Subscapular nerve: Sub scapularis muscle(internal rotation of humerus)
2. Lower Subscapular nerve: Subscapularis and Teres major
3. Thoracodorsal nerve: Lat dorsi(Internal rotation
4. Radial Nerve
5. Axillary Nerve
Muscles of the Anterior compartment of the arm
Supplied by the Musculocutaneous nerve
‘‘BBC’’
1. Biceps Brachii(supination of the forearm, flexes at elbow and shoulder)
C6
2. Brachialis
(Flexion of elbow)
3. Coracobrachialis
(Flexion at shoulder, weak adduction)
Posterior Compartment of arm
Triceps brachii (C7)
Radial nerve
Extension of the arm
Anterior compartment of the forearm
Course of Radial artery
Passes under brachioradialis, reaching radius where pulsations are felt against radius winds laterally around radius and crosses the floor of the anatomical snuffbox to enter palm and between two heads of the first dorsal interosseous muscle
Borders and contents of Cubital Fossa
Borders:
Proximally: Line connecting the epicondyles of the humerus
Medially: Lateral border of pronator teres
Laterally: Medial border of brachioradialis
Roof: Bicipital aponeurosis, antebrachial and brachial fascia, subcut fat and skin
Floor: Brachialis and supinator
Muscle that divides axillary nerve into 3 parts
Pectoralis minor
Axillary artery
Divided into 3 parts
- First part: lateral first rib to the medial border of the pectoralis minor
GIves of Superior thoracic
- Second part: behind pectoralis minor
Gives off thoracoacromial and lateral thoracic
- Third part: lateral border of pectoralis minor to the inferior border of teres major
Gives off Subscapular and the ant. and post. circumflex humeral artery.
