BLOOD SUPPLY TO THE UPPERLIMBS

Question 1

What are the five main vessels that deliver arterial supply to the upper limb?

Answer 1

• Subclavian artery
• Axillary artery
• Brachial artery
• Radial artery
• Ulnar artery

Question 2

From where does the subclavian artery arise on the right side?

Answer 2

Brachiocephalic trunk

Question 3

From where does the subclavian artery arise on the left side?

Answer 3

Arch of aorta

Question 4

How is the subclavian artery divided based on its position relative to the anterior scalene muscle?

Answer 4

• First part – origin to medial border of anterior scalene
• Second part – posterior to anterior scalene
• Third part – lateral border of anterior scalene to lateral border of first rib

Question 5

What does the subclavian artery become at the lateral border of the first rib?

Answer 5

Axillary artery

Question 6

What are the three parts of the axillary artery based on its position relative to the pectoralis minor muscle?

Answer 6

• First part – proximal to pectoralis minor
• Second part – posterior to pectoralis minor
• Third part – distal to pectoralis minor

Question 7

What is an axillary artery aneurysm?

Answer 7

A dilation of the vessel to more than twice its original size

Question 8

What are the potential complications of an axillary artery aneurysm?

Answer 8

Vascular compromise of the upper limb, compression of the brachial plexus, neurological symptoms such as paraesthesia and muscle weakness

Question 9

What is the primary function of the brachial artery?

Answer 9

Main supply of blood for the arm

Question 10

What branches from the brachial artery immediately distal to the teres major?

Answer 10

Profunda brachii (deep artery)

Question 11

What does the brachial artery bifurcate into?

Answer 11

• Radial artery
• Ulnar artery

Question 12

What condition can result from complete occlusion of the brachial artery?

Answer 12

Volkmann’s ischaemic contracture

Question 13

What does the radial artery primarily supply?

Answer 13

Posterolateral aspect of the forearm

Question 14

What does the ulnar artery primarily supply?

Answer 14

Anteromedial aspect of the forearm

Question 15

What are the two arterial arches formed by the radial and ulnar arteries in the hand?

Answer 15

• Superficial palmar arch
• Deep palmar arch

Question 16

What is the function of arterial anastomoses in the upper limb?

Answer 16

Provide alternative blood supply when the primary arterial pathway is obstructed

Question 17

What arteries anastomose around the shoulder joint?

Answer 17

• Posterior Circumflex Humeral Artery
• Anterior Circumflex Humeral Artery

Question 18

What are the major superficial veins of the upper limb?

Answer 18

• Basilic vein
• Cephalic vein

Question 19

Where does the basilic vein originate?

Answer 19

Dorsal venous network of the hand

Question 20

What is the median cubital vein’s significance?

Answer 20

Common site for venepuncture

Question 21

What are the two systems of the venous drainage of the upper limb?

Answer 21

• Superficial system
• Deep system

Question 22

What do the deep venous system veins accompany?

Answer 22

Major arteries

Question 23

What is the function of the lymphatic system in the upper limb?

Answer 23

Drain tissue fluid, plasma proteins, and cellular debris back into the bloodstream

Question 24

What do superficial lymphatic vessels in the upper limb follow?

Answer 24

Major superficial veins

Question 25

What is the location of the majority of upper extremity lymph nodes?

Answer 25

Axilla

Question 26

What type of lymphatic vessels drain lymph from joint capsules and muscles?

Answer 26

Deep lymphatic vessels

Question 27

What is the primary function of the axillary lymph nodes?

Answer 27

They function to drain lymph from joint capsules, periosteum, tendons and muscles.

Question 28

How are the upper extremity lymph nodes anatomically divided?

Answer 28

They can be divided into 5 groups: * Pectoral (anterior) * Subscapular (posterior) * Humeral (lateral) * Central * Apical

Question 29

Where are the pectoral lymph nodes located and what do they drain?

Answer 29

Located in the medial wall of the axilla, they receive lymph primarily from the anterior thoracic wall, including most of the breast.

Question 30

What is the location and function of the subscapular lymph nodes?

Answer 30

Located along the posterior axillary fold, they receive lymph from the posterior thoracic wall and scapular region.

Question 31

What is the location and drainage function of the humeral lymph nodes?

Answer 31

Located in the lateral wall of the axilla, they receive most of the lymph drained from the upper limb.

Question 32

What do the central lymph nodes receive lymph from?

Answer 32

They receive lymph via efferent vessels from the pectoral, subscapular, and humeral axillary lymph node groups.

Question 33

Where are the apical lymph nodes located and what do they drain?

Answer 33

Located at the apex of the axilla, they receive lymph from all axillary lymph node groups and from lymphatic vessels accompanying the cephalic vein.

Question 34

What is the path of efferent vessels from the apical axillary nodes?

Answer 34

They travel through the cervico-axillary canal to form the subclavian lymphatic trunk.

Question 35

What does axillary lymphadenopathy refer to?

Answer 35

It refers to the enlargement of the axillary lymph nodes.

Question 36

What are common causes of axillary lymphadenopathy?

Answer 36

Common causes include: * Infection of the upper limb * Infections of the pectoral region and breast * Metastasis of breast cancers

Question 37

What is the clinical relevance of axillary lymph node dissection?

Answer 37

It is vital for staging breast cancers but can result in lymphoedema and damage to the long thoracic or thoracodorsal nerves.

Question 38

What is the Thenar Space and what does it contain?

Answer 38

Located in the thumb region, it contains: * Flexor pollicis longus tendon * Flexor digitorum profundus and superficialis tendons for the index finger * First lumbrical * Radial bursa * Palmar digital vessels of the thumb and lateral side of the index finger

Question 39

What is located in the Mid-Palmar Space?

Answer 39

It contains: * Flexor tendons of the third to fifth fingers * Second to fourth lumbricals * Superficial palmar arch * Digital nerves and vessels of the medial three and a half fingers * Ulnar bursa

Question 40

What structures are found in the Hypothenar Space?

Answer 40

It contains the hypothenar muscles.

Question 41

What is the Interdigital Subfascial Space and what does it contain?

Answer 41

Found between the dorsal hand fascia and skin and the palmar fascia, it contains the metacarpophalangeal joint and the extensor tendon.

Question 42

What does the Parona Space contain?

Answer 42

It contains: * Digital flexor tendons * Pronator quadratus * Flexor carpi ulnaris

Question 43

What is the definition of pronation?

Answer 43

Pronation refers to the movement of the forearm and hand that turns the palm downward or backward.

Question 44

Which muscles are involved in pronation?

Answer 44

The muscles involved are: * Pronator teres * Pronator quadratus

Question 45

What clinical conditions are associated with pronation?

Answer 45

Conditions include: * Anterior interosseous nerve syndrome * Erb’s palsy

Question 46

What is the definition of supination?

Answer 46

Supination is the opposite movement, where the forearm and hand turn the palm upward or forward.

Question 47

Which muscles are involved in supination?

Answer 47

The muscles involved are: * Supinator * Biceps brachii * Brachioradialis

Question 48

What clinical conditions are associated with supination?

Answer 48

Conditions include: * Musculocutaneous nerve palsy * Monteggia fracture * Galeazzi fracture