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Year 2 > Axillary and Brachial plexus > Flashcards

Axillary and Brachial plexus Flashcards

1
Q

What is the axilla?

A

Region under the armpit which is an important anatomical point for structures that control the upper limb.

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2
Q

What does the axilla contain?

A

Axillary artery
Axillary vein
Axillary lymph nodes
Brachial plexus

Muscles:
Biceps brachii
Coracobrachialis muscle

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3
Q

What are the relations to the apex of the axilla?

A

Border of 1st rib, clavicle, coracoid process and superior border of scapula.

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4
Q

What are the relations to the anterior of the axilla?

A

Pectoralis major and pectoralis minor muscles and subclavius muscle.

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5
Q

What are the relations to the medial border of the axilla?

A

Ribs, intercostal muscles and serratus anterior.

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6
Q

What are the relations to the lateral border of the axilla?

A

Intertubular groove of humerus.

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7
Q

What are the relations to the posterior border of the axilla?

A

Lattisimus dorsi, teres major and subcapsularis muscle.

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8
Q

What are the axillary lymph nodes?

A

Drain the breast and upper limb and consist of 5 groups:

Apical/infraclavicular
Anterior/pectoral
Central
Lateral
Posterior/subcapsular

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9
Q

What axillary lymph node is most clinically relevant?

A

Axillary lymph node drains into the
R: Subclavian duct
L: Thoracic duct

Cancers of the breast which spread here can metastasise easily.

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10
Q

What is the direction of drainage in the axillary lymph nodes?

A

They drain into the central lymph node or apical lymph node. Central drains into the apical lymph node.

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11
Q

What is the brachial plexus?

A

Group of nerves innervating the upper limb which arise from C5,C6, C7, C8 and T1. It is located between the anterior and posterior scalene muscles.

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12
Q

Which nerve comes off C5?

A

Dorsal scapulae nerve which innervates the rhombdoid major, rhombdoid minor and levator scapulae.

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13
Q

Which nerve arises from C5, C6 and C7?

A

Long thoracic nerve which innervates the serratus anterior

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14
Q

What are the components of the brachial plexus?

A

C5 and C6 form the upper trunk
C7 forms the middle trunk
C8 and T1 forms the lower trunk

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15
Q

Which nerves arise from the upper trunk?

A

Suprascapular nerve
Subclavius nerve

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16
Q

What is the supracapsular nerve?

A

Innervates the supraspinatous muscle and infraspinatous muscle and shoulder joint.

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17
Q

What is the subclavius nerve?

A

Innervates the subclavius muscle to depress the clavicle.

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18
Q

What are the cords of the brachial plexus?

A

Lateral cord

Posterior cord

Medial cord

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19
Q

What is the lateral cord?

A

Formed of the anterior divisions of the upper and middle trunk (C5-C7)

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20
Q

What is the posterior cord?

A

Formed of the posterior divisions of all 3 trunks. (C5-T1)

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21
Q

What is the medial cord?

A

Formed of the anterior division of the lower trunk. (C8-T1)

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22
Q

Which nerve comes off the lateral cord?

A

Lateral pectoralis nerve supplying the pectoralis major muscle.

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23
Q

What forms the musculocutaneous nerve?

A

Lateral cord
-> Anterior division of upper and middle trunk (C5-C7)

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24
Q

What is the function of the musculocutaneous nerve?

A

Sensation of the lateral forearm

Innervation of elbow flexor muscles: Coracobrachialis, brachialis and biceps brachii

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25
Q

Which nerve comes off the posterior cord?

A

Upper Subscapular nerve
Thoracodorsal nerve
Lower subscapular nerve

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26
Q

What is the upper subcapsular nerve?

A

Innervates subcapsularis muscle for internal rotation at shoulder joint

Works with lower subcapsular nerve to innervate the teres major.

-> Branch of posterior cord

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27
Q

What is the thoracodorsal nerve?

A

Innervates the lattisimus dorsifor medial rotation, extension and adduction of shoulder.

-> Branch of posterior cord

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28
Q

What is the lower subcapsular nerve?

A

Innervates the teres major and subscapularis along with the upper subcapsular nerve.
-> Branch of posterior cord

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29
Q

What forms the axillary nerve?

A

Posterior cord
-> posterior division of all 3 trunks (C5-T1)

30
Q

What is the function of the axillary nerve?

A

Motor function is innervation of deltoid muscle and teres minor

Cutaneous sensation to lateral and posterior surface of deltoid muscle

31
Q

What forms the radial nerve?

A

Posterior cord
-> posterior division of all 3 trunks (C5-T1)

32
Q

What is the cutaneous function of the radial nerve?

A

Dorsum of hand from thumb, parts of digit 2 and 3

Sensation to the posterior and lateral forearm

33
Q

What is the motor function of the radial nerve?

A

Tricep muscle, extensor muscles of forearm and superficial cutaneous branch to the thumb and index finger.

34
Q

What forms the median nerve?

A

Joining of the lateral cord and median cord (C5 -T1)

35
Q

What is the cutaneous function of the median nerve?

A

Sensation to ventral surface of hand of thumb, digit 2, 3 and 1/2 of digit 4

36
Q

What is the motor function of the median nerve?

A

Radial side of flexor digitorum profundus
Muscles of thenar eminence
Radial side flexors of hand and forearm

37
Q

What nerve comes off the median cord?

A

Medial pectoral nerve

Medial brachial cutaneous nerve

Medial antebrachial cutaneous nerve

38
Q

What is the medial pectoral nerve?

A

Innervates pectoralis major and pectoralis minor
-> Branch of median cord

39
Q

What is the medial brachial nerve?

A

Cutaneous innervation to the medial side of the arm
-> Branch of median cord

40
Q

What is the medial antebrachial cutaneous nerve?

A

Cutaneous innervation to the medial side of the forearm.
-> Branch of median cord

41
Q

What forms the ulnar nerve?

A

Median cord
-> Anterior division of lower trunk (C8 and T1)

42
Q

What is the cutaneous function of the ulnar nerve?

A

Hand dorsum digit 4 and 5
Hand ventral 1/2 of digit 4 and digit 5

43
Q

What is the motor function of the ulnar nerve?

A

Ulnar side of flexor digitorum profundus
Palmar and dorsal interosseus muscles
Provides innervation to majority of muscles of the hand such as Hypothenar eminence
->THENAR EMINENCE IS EXECEPTION

44
Q

What is a claw hand?

A

Flexed fingers of hand that are unable to straighten, commonly due to ulnar nerve lesion.
Partial claw hand: ulnar nerve
Complete claw hand: ulnar and median nerve lesion

45
Q

What is the consequence of a radial nerve lesion?

A

Weakness of extensor muscles of forearm

Loss of sensation in dorsum of hand web between thumb and digit 2

46
Q

What is the consequence of a ulnar nerve lesion?

A

Partial claw hand affecting digit 4 and 5 due to paralysis of intrinsic muscles of hand
Atrophy of hypothenar eminence

47
Q

What is the consequence of a median nerve lesion?

A

Atrophy of thenar eminence and flexor forearm muscles
Sensory loss in digit 2 and 3 and half of palm

48
Q
A
49
Q

What happens in upper brachial plexus injury?

A

Head and neck are moved away from the shoulder violently which damages C5 and C6, causing Erb’s palsy with arm and shoulder paralysis. The hand is rotated backwards.

-> can occur in childbirth

50
Q

What happens in lower brachial plexus injury?

A

Injury to C8 and T1 due to excessive abduction, typically during birth which affects lower myotomes and dermatomes with muscles of forearm and hand
-> Horner syndrome can occur due to T1 being affected

51
Q

What is Horner syndrome?

A

Lesion in the sympathetic nerve which results in:
Ptosis (drooping of eyelid), mioisis (constricted pupil) and anhydrosis (no sweating)

52
Q

What does C5 myotome innervate?

A

Deltoid muscle

53
Q

What does the C6 myotome innervate?

A

Biceps.

54
Q

What does the C7 myotome innervate?

A

Triceps

55
Q

What does the C8 myotome in nervate?

A

Hand muscled

56
Q

What does the T1 myotome innervate?

A

Finger muscles

57
Q

Which nerve root in the brachial plexus is important for shoulder abduction?

A

C5

58
Q

Which nerve root in the brachial plexus is important for shoulder adduction?

A

C6, C7, C8

59
Q

Which nerve root in the brachial plexus is important for elbow flexion?

A

C5 and C6

60
Q

Which nerve root in the brachial plexus is important for elbow extension

A

C7 and C8

61
Q

Which nerve root in the brachial plexus is important for forearm pronation?

A

C6 controls forearm pronation and supination.

62
Q

Which nerve root in the brachial plexus is important for wrist movements?

A

C6 and C7.

63
Q

Which myotome for wrist flexion?

A

C7

64
Q

Which myotome for wrist extension

A

C6

65
Q

Which nerve root in the brachial plexus is important for finger and thumb movement?

A

C8 control the flexion and extension of fingers and thumb

66
Q

Which nerve root in the brachial plexus is important for finger abduction?

A

T1 controls finger abduction.

67
Q

Where is the brachial plexus located?

A

Between the anterior and middle scalene muscle, close to the axiliary artery. The cords are named based on their relation to the auxiliary artery

68
Q

Loss of sensation over upper right lateral arm

A

Axillary nerve damage over regimental badge area.

69
Q

Winging of scapula

A

Damage to long thoracic nerve which innervates the serratus anterior.

70
Q

Innovation to lateral forearm

A

Musculouutaneous nerve.

71
Q

What is the role of the anterior divisions of the brachial plexus?

A

Innervates the flexor muscles.

72
Q

What is the role of the posterior division of the brachial plexus?

A

Innervates the extensor muscles.

Year 2 (247 decks)

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