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MSK 1 > Brachial Plexus and Pectoral > Flashcards

Brachial Plexus and Pectoral Flashcards

1
Q

3 main transition zones in upper limb

A

axilla- armpit

cubital fossa- depression anterior to elbow

carpal tunnel- flexor tendons and median nerve gateway to wrist

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2
Q

fn of clavicle

A

moveable strut allowing scapula to move

helps transmit shock from upper limb to axial skeleton

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3
Q

most common fracture

A

clavicle- usually through middle third of bone

shoulder falls lower than other side, pts hold and support arm

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4
Q

subclavian muscle

A

lays under clavicle, protects brachial plexus and other structures under clavicle

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5
Q

SC joint

A

synovial joint b/w clavicle and manubrium- only articulation b/w upper limb and axial skeleton

very strong articulation w/ rare dislocation, but have around 60 degree ROM

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6
Q

SC dislocaitons

A

can be an emergency, heart and trachea lie behind the joint

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7
Q

SC ligaments

A

anterior and posterior SC ligaments

interclavicular ligement along superior aspect of both joints

intra articular fiborcartilagenous disc acts as shock absorber (helps w/ FOOSH)

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8
Q

AC joint

A

synovial joint b/w acromion and clavicle, surrounded by loose fibrous capsule

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9
Q

AC ligaments

A

AC ligament- superior strength to capsue

coracoclavicular ligaments (trapezoid and conoid ligaments)- provides main strength

coracoacromial ligament- arch, bw/ coracoid and acromion processes

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10
Q

contrast 3 degrees of AC injuries

A

first- stretch or minor tear of AC ligament, still intact

second- subluxation, not totally separate

third- both AC and coracoclavicular ligaments torn, shoulder separation (essentially similar to broken clavicle)

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11
Q

insertion of pec major

A

lateral lip of intertubercular sulcus or bicipital groove

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12
Q

fn of pec major

A

internal rotation and adduction and flexor of arm

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13
Q

innervation of pec major

A

medial and lateral pec nerves

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14
Q

pec minor

A

inserts coracoid process

stabilizes scapula against thoracic wall

innervated by medial pec nerve

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15
Q

pec minor “bridge”

A

arches over axillary artery, axillary vein, brachial plexus

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16
Q

axillary artery progression

A

from subclavian as passes first rib, then 3 parts by pec minor as axillary, then brachial artery as passes lateral to teres major

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17
Q

2 key branches of axillary

A

subscapular- largest branch, anastamoses around scapula

anterior and posteriorr humeral circumflex- vascularize humerus and surrounding msucles

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18
Q

key role of suprascapular artery

A

can provide collateral circulation if axillary artery is thrombosed

19
Q

5 segments of brachial plexus

A 
roots
trunks
divisions
cords
 branches
20
Q

BP roots

A

formed by ventral rami of C5 thru T1

21
Q

formation of BP trunks

A

C5 and C6 form superior trunk

C7 is middle trunk

C8 and T1 form inferior trunk

22
Q

formation of BP divisions

A

each trunk forms anterior and posterior divisions

anterior forms nerves that innervate anterior compartments, posterior form posterior nerves

23
Q

formation of BP cords

A

anterior divisions of superior and middle trunk form lateral cord

anterior division of inferior trunk is medial cord

posterior of all three form posterior cord

24
Q

formation of BP terminal branches

A

lateral cord rise to musculocutaneous and lateral root of median nerve

posteriror cord gives rise to radial and axillary nerves

medial cord gives rise to ulnar nerve and medial root of median nerve

25
Q

innervation of 5 terminal branches of BP

A

musculocutaneous- flexors of arm

ulnar- intrinsic muscles of hand and some forearm flexors

axillary- deltoid and teres minor

radial- extensors of arm and forearm

median- most forearm flexors and thenar (thumb) muscles

26
Q

spinal nerve origins for each BP terminal branch

A

musculocutaneous- C5,6,7

axillary- C5,6

radial- C5,6,7,8, T1

median- C5,6,7,8 T1

ulnar- C8, T1 (sometimes C7)

27
Q

muscles that BP and subclavian must pass thru

A

anterior and middle scalene, prevertebral fascia surrounds these muscles

28
Q

axillary sheath

A

extension of prevertebral fascia extending laterally, surrounds BP and axillary artery

29
Q

names of BP cords depend on

A

location relative to axillary artery- ie lateral cord is lateral to axillary artery

30
Q

exception to BP innervation in upper limb

A

intercostobrachial nerve- lateral cutaneous sensory nerve, branch of T2 intercostal nerve

supplies region of skin along medial aspect of arm

not affected by BP nerve block

31
Q

components of BP below clavicle

A

cords and terminal branches, everything else is cranial

32
Q

sensory info from dermatomes to spinal cord enter..

A

via dorsal root, cell bodies in DRG

33
Q

site of dormancy of VZV

A

DRG of certain spinal nerves, reactivate along dermatomes, usually unilateral

34
Q

key dermatomes for MSK

A 
C5- tip of shoulder
C6- thumb
C7- middle finger
C8- little finger
T1- medial arm
35
Q

8 branches of BP

A 
long thoracic
dorsal scapular
suprascapular
upper subscapular
middle subscapular
lower subscapular
medial and lateral pectoral
medial cutaneous nerves (arm and forearm)
36
Q

long thoracic

A

from C5,7

serratus anterior

37
Q

dorsal scapular

A

C5, rhomboids and levator scapula

38
Q

suprascapular

A

C5,6

supra and infraspinatus

39
Q

upper subscapular

A

C5,6

subscapularis

40
Q

middle subscapular

A

C6,7,8

latissimus dorsi

41
Q

lower subscapular

A

C5,6

teres major and subscapularis

42
Q

medial and lateral pectoral

A

medial C8, T1
lateral C5,6,7

pectoral muscles

43
Q

medial cutaneous nerves of arm and forearm

A

C8, T1

sensation to medial arm and forearm

MSK 1 (10 decks)

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