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anatomy - physio > Axilla and the brachial plexus > Flashcards

Axilla and the brachial plexus Flashcards

1
Q

what is the axilla?

A
  • an anatomical region (armpit) under the shoulder joint** where the arm connects to the shoulder **
  • it contains a lot of neurovascular structures including the brachial plexus, the axillary artery and vein and lymph nodes
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1
Q

what are the major contents of the axilla?

A
  • axillary artery
  • axillary vein
  • brachial plexus
  • nodes
  • adipose tissue
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2
Q

what is the anterior border of the axilla?

A
  • pectoralis major muscle
  • pectoralis minor muscle
  • subclavius muscle
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3
Q

what is the posterior border of the axilla?

A
  • subscapularis
  • teres major
  • latissimus dorsi
  • scapula
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4
Q

what is the medial border of the axilla?

A
  • ribs
  • serratus anterior
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5
Q

what is the lateral border of the axilla?

A

the humerus

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6
Q

where does the pectoralis major muscle originate and insert onto?

A
  • O: 3 places - sternal part of clavicle, the sternum and costal cartilages 1-7, and the rectus sheath
  • I: humerus - lateral to the bicipital groove (crista tuberculi majoris)
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7
Q

what are the main actions of the pectoralis major muscle?

A
  • arm adduction
  • arm internal rotation
  • arm flexion
  • elevates the rib cage during inspiration
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8
Q

what nerve supplies the pec major muscle?

A
  • pectoral nerves from the brachial plexus
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9
Q

what are the ‘3 portions’ of the pec major muscle?

A
  • clavicular
  • abdominal
  • sterno costal
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10
Q

where does the pectoralis minor originate and insert?

A
  • O: ribs 3-5
  • I: on the coracoid process of the scapula
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11
Q

what are the actions of the pectoralis minor muscle?

A

* depression - pulls the scapula anteriorly
* also involved in** elevation of the rib cage** during inspiration

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12
Q

where does the subclavious muscle originate and insert onto?

A
  • O: sternal end of rib 1 and costal cartilage
  • I: lower aspect of the clavicle
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12
Q

what nerve supplies the pectoralis minor muscle?

A

pectoral nerves from the brachial plexus

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13
Q

what is the main action of the subclavius muscle?

A
  • stabilisation of the clavicle during movements of the shoulder girdle
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14
Q

what nerve supplies the subclavius muscle?

A
  • subclavius nerve from the brachial plexus
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15
Q

where does the subscapularis originate and insert onto?

A
  • O: subscapular fossa of the scapula
  • I: lesser tubercle of the humerus
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16
Q

what is the main function / action of the subscapularis muscle?

A
  • medial rotation of the arm
17
Q

what nerve supplies the subscapularis muscle?

A

the subscapular nerves from the brachial plexus

18
Q

where does the latissimus dorsi originate and insert onto?

A
  • O: (4 parts) vertebral: spinous processes T7-T12, iliac part - posterior third of crest of ilium, **scapula part: inferior angle of scapula, costal part**: 0 10-12 ribs
  • I: intertubucular sulcus/ groove between pec major and teres major (lady between 2 majors)
19
Q

what nerve supplies the latissimus dorsi?

A
  • thoraco-dorsal nerve from the brachial plexus
20
Q

what are the main actions of the latissimus dorsi muscle?

A
  • arm adduction
  • elevation of the trunk - think of hands on bar
  • arm internal rotation
  • arm extension
  • depression of the scapula
21
Q

where does the** teres major** originate and insert onto?

A
  • O: lateral margin and inferior angle of the scapula
  • I: intertubular groove
22
Q

what is the origin and insertion of the serratus anterior?

A
  • O : ribs 1-2 (superior), ribs 2-4 (middle) and ribs 5-9 (inferior)
  • I: superior part - superior angle of scapula, middle part - medial margin of scapula, inferior part - lower angle of scapula
23
Q

what are the actions of the serratus anterior on the shoulder girdle?

A
  • keeps scapula close to throacic cage
  • superior part elevates the scapula
  • middle part depresses the scapula
  • inferior part depresses and rotates the scapula
24
Q

what are the actions of the serratus anterior on the thorax?

A
  • elevates the thoracic cage - for inspiration
24
Q

what nerve supplies the serratus anterior muscle?

A
  • long thoracic nerve from the brachial plexus
25
Q

what are the medial, middle and lateral branches of the axillary artery?

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A
  • medial - sup thoracic
  • middle - thoracoacromial and lateral thoracic
  • lateral - subscapular, anterior circumflex humeral artery and posterior circumflex humeral artery
26
Q

what is the brachial plexus?

A

network of nerves originating in the neck region, passes through the axilla where it then supplies many peripheral nerves to the upper limb

27
Q

what are the roots of the brachial plexus?

A

C5
C6
C7
C8
T1

28
Q

what do the roots of the branchial plexus unite to form?

A

trunks
* superior (C5 + C6)
* Middle (C7)
* Inferior (C8 + T1)

29
Q

as the trunks reach the posterior aspect of the middle third of the clavicle, what do they divide into?

A
  • each of the trunks divide into an anterior and posterior division - which gives rise to 6 divisions which then pass inferiorly behind the clavicle to enter the axilla
30
Q

instead of the divisions giving rise to branches, what do they do instead?

A

they merge to form cords - lateral cord (anterior div of superior and medial trunk), medial cord (anterior divisions from inferior trunk) and posterior cord (posterior divisions from all 3 trunks)

31
Q

what do the lateral and medial cords supply?

A

the anterior flexor compartment of the forearm

32
Q

what does the posterior cord supply?

A

innervates the muscles of posterior (extensor) compartment of the forearm

33
Q

what braches do the trunks of the brachial plexus give off?

A
  • long thoracic nerve (C5-C7)
  • dorsal scapular nerve (C5)
  • phrenic nerve (C5)
  • subclavius nerve (C5-C6)
34
Q

what nerves arise from the lateral cord?

remember: 2L 1M

A
  • Lateral pectoral nerve
  • Lateral root of the Median Nerve
  • Musculocutaneous nerve
35
Q

what nerves does the medial cord give off?

remember : 4M, 1U

A
  • Medial pectoral nerve
  • Medial cuteanous nerve of arm
  • Medial cuteanous nerve of forearm
  • Medial root of the median nerve
  • Ulnar nerve
36
Q

what nerves arise from the posterior cord of the branchial plexus?

remember STARS

A
  • Upper** S**ubscapular nerve
  • Thoracodorsal nerve
  • Axillary nerve
  • Radial nerve
  • Lower Scapular nerve
37
Q

what are the 5 groups of axillary lymph nodes?

A
  • anterior (pectoral)
  • posterior (subscapular)
  • lateral (humeral)
  • central
  • apical
38
Q

what is erbs palsy?

A
  • occurs when there is injury to the brachial plexus - specifically the upper brachial plexus
  • can happen due to hyperextension and or lateral extension of the neck or can happen at birth when baby coming out
39
Q

what are the clinical signs and symptoms of erb’s palsy?

A
  • waiters tip deformity - due to loss of lateral rotators of the shoulders, arm flexors and hand extensor muscles
  • the arm cannot be raised from the side - all power for flexion of the elbow and supination of the hand is lost
40
Q

what is klumpke’s palsy?

A
  • neuropathy of the lower brachial plexus that may have resulted from difficulted delivery of baby
41
Q

what is a classic symptom of klumpke’s palsy?

A
  • ‘claw hand’

anatomy - physio (17 decks)

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