Axilla and Arm Flashcards

1
Q

Which arteries anastomose in the upper arm?

A

-Anterior circumflex humeral artery and Posterior circumflex humeral artery

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2
Q

Which arteries anastomose in the posterior shoulder?

A
  1. Dorsal scapular
  2. Suprascapular
  3. Circumflex scapular
  4. Thoracodorsal
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3
Q

What two branches come off the Thyrocervical trunk?

A

Thyrocervical trunk comes off the subclavian artery and produces:

  1. Transverse cervical artery
  • Superficial branch
  • Dorsal scapular artery
  1. Suprascapular
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4
Q

What artery supplies the posterior shoulder from the axillary artery?

A

Subscapular artery

  • Circumflex scapular
  • Thoracodorsal artery
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5
Q

What forms the anterior axillary fold?

A

pectoralis major

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6
Q

What forms the posterior axillary fold?

A

latissimus dorsi and teres major

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7
Q

What is inside the axillary sheath?

A

THICK fascia containing:

  1. Axillary artery
  2. Axillary vein
  3. Distal portion of Brachial plexus
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8
Q

Where does the subclavian artery become the axillary artery?

A

lateral border of 1st rib

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9
Q

Where does the axillary artery become the brachial artery?

A

inferior border of Teres major

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10
Q

What divides the three portions of the axillary artery?

A

First part - proximal to pectoralis minor Second part - deep to pec minor Third part - distal to pec minor

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11
Q

What comes off the first portion of the axillary artery?

A

Superior thoracic artery

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12
Q

What does the superior thoracic artery supply?

A

1st and 2nd intercostal spaces

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13
Q

What are the two branches off of the second part of the axillary artery?

A
  1. Thoracoacromial artery
  2. Lateral thoracic artery
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14
Q

What does the thoracoacromial artery supply?

A
  • Pectoral muscles
  • Deltoid
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15
Q

What does the Lateral thoracic artery supply?

A
  • Serratus anterior
  • pectoral muscles

*courses with the long thoracic nerve*

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16
Q

What are the 3 branches of the third part of the axillary artery?

A
  1. Subscapular artery 2. Anterior circumflex humeral artery 3. Posterior circumflex humeral artery
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17
Q

What are the branches of the subscapular artery?

A
  1. Circumflex scapular artery 2. Thoracodorsal artery
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18
Q

What does the circumflex scapular artery supply?

A

scapular region

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19
Q

What does the thoracodorsal artery supply?

A

Latissimus dorsi

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20
Q

What do the anterior and posterior circumflex humeral arteries supply?

A

shoulder and arm

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21
Q

What does the posterior circumflex humeral artery travel through the quadrangular space with?

A

Axillary nerve and posterior circumflex humeral vein

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22
Q

What are the borders of the quadrangular space?

A

-Teres minor (superior) -Teres major (inferior) -Long head of triceps -Humerus

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23
Q

The union of brachial veins and basilic vein form what?

A

Axillary vein

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24
Q

Where do the brachial veins join the basilic vein?

A

inferior border of teres major

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25
Q

Where are the roots of the brachial plexus?

A

neck

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26
Q

Where are the trunks of the brachial plexus?

A

neck

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27
Q

Where are the divisions of the brachial plexus?

A

deep to clavicle

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28
Q

What spinal levels comprise the superior trunk?

A

C5 and C6

29
Q

What spinal levels comprise the middle trunk

A

C7

30
Q

What spinal levels comprise the inferior trunk?

A

C8 and T1

31
Q

Anterior divisions give rise to which compartments of the arm, forearm and hand?

A

-Anterior compartments of the arm and forearm and palmar surface of hand

32
Q

Posterior divisions give rise to what?

A

posterior compartments of the arm and forearm and the dorsal hand

33
Q

What does the dorsal scapular nerve (C5) innervate?

A
  1. Levator scapulae 2. Rhomboid Major 3. Rhomboid Minor
34
Q

What muscle does the long thoracic nerve (C5, C6, C7) innervate?

A

Serratus anterior

35
Q

What causes a winged scapula?

A

lesion of the long thoracic nerve

36
Q

What does the suprascapular nerve (C5, C6) innervate?

A

-supraspinatus -infraspinatus

37
Q

Describe “army over navy”

A

suprascapular nerve goes under the superior transverse scapular ligament, and the suprascapular artery goes over the ligament

38
Q

What does the Lateral cord give rise to?

A

“LMM” -musculocutaneous -median

39
Q

What does the medial cord give rise to?

A

“MUM” -ulnar -median

40
Q

What does the posterior cord give rise to?

A

“PAR” -axillary -radial

41
Q

What does the musculocutaneous nerve innervate?

A

muscles of the anterior compartment of the arm

42
Q

What area does the musculocutaneous provide sensory for?

A

near the elbow (it terminates as the lateral cutaneous nerve of the forearm which innervates the skin of the lateral forearm)

43
Q

Median Nerve: motor

A
  1. anterior compartment of the forearm
  2. thenar
  3. lumbricals 2&3
44
Q

What provides sensation to the mid arm?

A

Medial cutaneous nerve of the forearm (C8, T1)?

45
Q

What provides sensory innervation to the anterior forearm and medial forearm?

A

Medial cutaneous nerve of the forearm (C8, T1)

46
Q

What does the lateral pectoral nerve (C5, C6, C7) innervate?

A

Pectoralis major

47
Q

What does the medial pectoral nerve innervate (C8, T1)?

A

Pectoralis major Pectoralis minor

48
Q

What does the ulnar nerve (C7, C8, T1) innervate?

A
  1. Flexor Carpi Ulnaris
  2. Flexor Digitorum Profundis (digits 4&5)
  3. Adductor pollicis (transverse and oblique heads)
  4. Hypothenar (Abductor digiti minimi, flexor digiti minimi brevis, opponens digiti minimi)
  5. lumbricals 4&5
  6. Interossei (dorsal and palmar)
49
Q

What structures are at risk with a break of the surgical neck of the humerus?

A

vessels in the quadrangular space:

  • Posterior circumflex humeral artery
  • Posterior circumflex humeral vein
  • Axillary nerve (C5, C6)
50
Q

What does the axillary nerve innervate?

A

Axillary nerve (C5, C6) -deltoid -teres minor

51
Q

What does the axillary nerve provide sensory innervation for?

A

skin on the lateral aspect of the shoulder

52
Q

What does the radial nerve travel with on the back of the humerus?

A

Radial nerve (C5, C6, C7, C8, T1) travels with the deep artery and vein of the arm in the radial groove

53
Q

Radial nerve: motor?

A

muscles of the posterior arm and forearm

54
Q

Radial nerve: sensory?

A

skin of posterior arm, forearm and hand

55
Q

What does the upper subscapular (C5, C6) nerve innervate?

A

subscapularis (superior part)

56
Q

What does the thoracodorsal nerve (C6, C7, C8) innervate?

A

latissimuss dorsi

57
Q

What does the lower subscapular nerve (C5, C6)

A
  1. Subscapularis (inferior part) 2. Teres major
58
Q

Injury to C5-C6 is called what?

A

Erb’s palsy “waiter’s tip position”

59
Q

What is affected in Erb’s palsy?

A

*ANTERIOR ARM MUSCLES Glenohumeral joint is:

  • adducted
  • medially rotated
  • extended elbow joint
  • C5, C6 dermatomes affected
60
Q

What muscles are affected in Erb’s Palsy (C5, C6)?

A
  • some rotator cuff muscles (Supraspinatus, infraspinatus, teres minor
  • Deltoid
  • Biceps brachii
  • Brachialis
61
Q

What nerve levels are affected in Klumpke’s Palsy?

A

C8 and T1

62
Q

What does Klumpke’s Palsy affect?

A

Intrinsic hand muscles (ulnar and median nerves)

*CLAW HAND*

63
Q

Where would someone with Klumpke’s palsy lose skin sensation?

A
  • C8 -medial part of arm and forearm and digits 4&5
  • T1 - Axilla, anteromedial portion of the arm and forearm to the wrist
64
Q

What are the actions of the anterior arm?

A
  1. Flex glenohumeral joint
  2. Flex elbow joint
  3. Supinate forearm
65
Q

What spinal levels/nerve are we assesing with the biceps reflex test?

A
  • Musculocutaneous nerve
  • C5-C6
66
Q

What are the actions of the posterior compartment of the arm?

A
  1. Extend the glenohumeral joint
  2. Extend elbow joint
67
Q

What spinal levels are being tested with the triceps reflex test?

A
  • Radial nerve (C7-C8)
68
Q

What is the primary supplier of blood to the posterior arm?

A

Deep artery of the arm