Blue Boxes 1: Axilla and Brachial Plexus

Question 1

Which scapular anastomosis artery can reverse the direction of blood flow to allow blood to reach the third part of the axillary artery if the axillary artery is blocked medial to it?

Answer 1

Subscapular

Question 2

What type of occlusion of the axillary artery does not allow sufficient time for adequate collateral circulation to develop?

Answer 2

Sudden Occlusion

Question 3

Where will a surgical ligation of the axillary artery cut off the blood supply to the arm because the collateral circulation is inadequate?

Answer 3

Between the origins of the subscapular artery and the profunda brachial artery

Question 4

Where can the axillary artery be palapated?

Answer 4

In the inferior part of the lateral wall of the axilla

Question 5

Where can the axillary artery be compressed to stop perfuse bleeding?

Answer 5

The third part of the artery against the humerus, or at is origin as the subclavian artery crosses the 1st rib

Question 6

What is an aneurysm?

Answer 6

Localized blood filled bulge in the wall of a blood vessel

Question 7

Aneurysm of what artery can cause brachial plexus pain?

Answer 7

axillary

Question 8

What is the relationship of the axillary vein to the axillary artery?

Answer 8

Anterior

Question 9

What is lymphangitis?

Answer 9

Inflammation of lymphatic vessels

Question 10

What is lymphangitis characterized by on the body surface?

Answer 10

The development of warm, red, tender streaks in the skin of the limb

Question 11

Infection in the upper limb causes an inflammation of what lymph nodes?

Answer 11

Axillary

Question 12

Excision of axillary lymph nodes is often necessary for what?

Answer 12

Staging and determinating the appropriate treatment of a cancer.

Question 13

Lymphatic drainage of the upper limb may be impeded after the removal of the axillary nodes, resulting in lymphedema, which is what?

Answer 13

Swelling as a result of accumulated lymph

Question 14

What two nerves are at risk during axillary node dissection?

Answer 14

Long thoracic nerve and the thoracodorsal nerve

Question 15

What do you call a brachial plexus that goes from C4 - C8?

Answer 15

Prefixed brachial plexus

Question 16

What do you call a brachial plexus that goes from C6 - T2

Answer 16

Postfixed brachial plexus

Question 17

What often happens to the inferior trunk in a postfixed brachial plexus?

Answer 17

It may be compressed by the 1st rib

Question 18

Injuries to the superior parts of the brachial plexus (C5 and C6) usually result from what?

Answer 18

Excessive increase in the angle between the neck and shoulder. EX a person is thrown off a motorcycle or a horse and lands on their shoulder

Question 19

Injury to the superior truck of the brachial plexus is apparent by what characteristic limb position?

Answer 19

Waiter’s tip position

Question 20

What is Erb-Duchenne palsy?

Answer 20

Injury to the superior part of the brachial plexus that results in paralysis of the muscles of the shoulder and arm supplied by the C5 and C6 spinal nerve

Question 21

What arm muscles are primarily innervated by C5 and C6?

Answer 21

Deltoid, Biceps, and Brachialis

Question 22

Back packer’s palsy?

Answer 22

superior brachial plexus injury that may produce muscles spasms and severe disability in hikers

Question 23

What is a neurologic disorder of unknown cause that is characterized by the sudden onset of severe pain, usually around the shoulder. Pain begins at night and is followed by muscle weakness and muscular atrophy.

Answer 23

Acute brachial plexus neuritis

Question 24

Compression of cords of the brachial plexus may result from what?

Answer 24

Prolonged hyperabduction of the arm

Question 25

Where are the cords usually compressed after prolonged hyperabduction of the arm?

Answer 25

Between the coracoid process of the scapula and the pectoralis minor tendon.

Question 26

What are common neurologic symptoms of cord compression?

Answer 26

Numbness, paresthesia (tingling), and erythema (redness of the skin caused by capillary dilation)

Question 27

Injuries to inferior parts of the brachial plexus (Klumpke paralysis) are cause by what?

Answer 27

Upper limb is suddenly pulled superiorly

EX when a person grasps something to break a fall, babys arm gets pulled during birth

Question 28

What is a common telltale sign of inferior brachial plexus injury?

Answer 28

Claw hand

Question 29

Why would surgeons use a brachial plexus block anesthetic?

Answer 29

To operate on the upper limb without using a general anesthetic