EXAM2_G10_G11_Pectoral_Axila Flashcards
What is the only bone articulation of the upper extremity with the Axillary skeleton?
Sternoclavicular joint
What is intramuscular septa?
What function clinically?
What is compartment syndrome?
Deep fascia that divide UE regions into facial compartments
Contain and direct spread of infection/hemorrhage in limb;
Accumulation can result in compartment syndrome
Deltoid fascia Biracial fascia Antebrachial fascia Palomar Fascia Dorsal Fascia Pectoral Fascia Axillary Fascia
What separates anterior and posterior compartments of the forearm?
Intermuscular septum (between radius and antebrachial fascia) and
Interosseous membrane between radius and ulna
Brachial Plexus:
What innervation? (CNS PNS SNS PSNS SOMATIC AUTONOMIC?)
What Rami?
What type of signals?
Somatic innervation (some autonomic-sns only) (anterior primary rami of C5-T1 spinal cord segments)
Cutaneous sensation
Motor innervation
Autonomic innervation of the brachial plexus? what type of autonomic motor innervation? (PSNS or SNS)
Where are the preganglionic neurons?
Where do they synapse?
Where are post ganglionic axons?
What do they innervate?
Sympathetic ONLY (no parasympathetic)
Preganglionic neurons (T1-T6)
Synapse in paravertebral (cervical) ganglia
-Postganglionic axons accompany somatic nerves of the brachial plexus to innervate:
-sweat/sebaceous glands
-arrector pili muscles
- vasculature
CRPS
What is it?
What causes it?
Complex regional pain syndrome (CRPS)
- dysfunction of SNS
- can be caused by UE injury
What makes up a dermatome?
All the peripheral nerves and fibers that take that single spinal cord segment.
IE: 5 peripheral nerves take C6 spinal nerve
Where are the superficial veins?
Travel in subcutaneous tissue
communicate w/ deep veins via perforating veins
Where is the venous drainage for the medial and lateral Upper extremity?
Where do they communicate?
WHAT VEIN IS NOT THERE?
cephalic - drains lateral UE into Axillary Vein
Basilic- drains medial UE -merges with brachial vein to form axillary vein
Communicate in Cubital fossa
NO THORACOACROMIAL VEIN!!!
What merges with brachial vein to form axillary vein?
What is most common arrangement in cubital fossa? where blood is most commonly drawn from?
basilica vein
median cubital vein
Where does lymph from deep veins and cubital lymph nodes drain?
Humeral (lateral) Axillary lymph nodes
drain into Central nodes and then drain into apical axillary lymph nodes then to supraclavicular nodes then into either the Right lymphatic duct or the Thoracic duct
Where does lymph drain from skin? (superficial)?
Cubital lymph nodes-
- rx lymph from vessels of basilic v.
- drain into humeral lateral axillary lymph nodes
Where do superficial lymph from cephalic vein drain? Where does that drain into?
Deltopectoral lymph nodes
drain into apical axillar lymph nodes
then supraclavicular>right lymphatic or thoracic duct
Where do superficial lymph from basilic vein drain?
cubital lymph nodes
drain humeral lateral axillary lymph nodes
Where is weakest point of clavicle?
middle/lateral 1/3 - most commonly broken bone
What forms the floor of the dectopectoral triangle? What vein goes through the dectopectoral groove?
Costocoracoid membrane forms the floor
Cephalic vein travels through the deltopectoral triangle
What ligament is superficial to the Flexor retinaculum? What travels between the two ligaments?
Palmar carpal ligament
- Superficial palmar branch of radial artery
- Ulnar artery and Ulnar nerve
- Tendon of palmaris longus is superficial to the flexor retinaculum also.
Flow of lymph from cubital all the way back
Cubital> Humeral > central > apical > supraclavicular > RLD or TD
What are the contents of the Deltopectoral groove and Triangle? 3 things
what forms the floor?
- Cephalic vein
- Thoracoacromial Artery
- Lateral Pectoral nerve
- Costocoracoid membrane (floor of triangle)
What are the boundaries of the Axilla? Apex (what called) (what 3 structures) base (what called) ant wall (what structure formed? what 4 structures) post wall (structure and 4 borders) med wall (2 borders) lat wall (1 border)
APEX: cervico-axillary canal- (1st rib, clavicle, scapula)
BASE: axillary fossa- (axillary fascia, subcutaneous skin)
ANT WALL: (Pec major/minor- anterior axilary fold. Subclavius, clavicle)
POST WALL: (scapula, subscapularis, Lat dorsi, Teres Major, posterior axilary fold)
MED WALL: Thoracic wall, serratus anterior
LAT WALL: intertubercular sulcus
What forms the anterior and posterior axillary folds
ant: pec major
post: teres major & Lat dorsi
3 branches of the Axillary artery
What is the next distal branch of the brachial artery? What does it turn into as it runs distally?
1- superior thoracic artery
2- Thoracoacromial artery (CADS)
2- Lateral thoracic artery (w/ long thoracic Nerve)= SALT
3- Subscapular (ct- Circumflex scapular & thoracodorsal)
3- PCHA
3- ACHA
Profunda brachii artery> radial collateral> Radial recurrent
Axillary Vein Landmark? When does it become subclavian vein? why important? What are the tributaries? Where does it arise from and morph into?
- Inferior border of teres MAJOR
- subclavian vein at lateral border of 1st rib (CENTRAL LINE)
- Tributaries- just like axillary arteries EXCEPT NO THORACOACROMIAL VEIN
- Arises from brachial veins and dumps into basillic veins then forms the Axillary vein.
Humeral (lateral) lymph nodes
Where located?
Where is lymph from ? Where is it NOT from?
Lateral wall of axilla- medial and posterior to axillary vein
- lymph from UE (except lymph from cephalic vein)
Pectoral (anterior) lymph nodes
Where at?
Where lymph from?
Along lateral thoracic vessels
- lymph from anterior thoracic wall/ Breast
Subscapular (posterior) lymph nodes?
location and where lymph from?
posterior axillary fold along subscapular vessels
lymph from posterior thoracic wall/ scapula
Central lymph nodes
Where and what lymph from?
Deep to pectoralis minor
Lymph from humeral, pectoral, and subscapular nodes
Apical lymph nodes
Where at?
Where lymph from?
Where does lymph drain into?
Apex of axilla
Lymph from central nodes and deltopectoral nodes
Drains into supraclavicular nodes
then drains either into Right lymphatic duct or the Thoracic duct
