L2 - Nerve and blood supply to the upper limb

Question 1

Which artery supplies the upper limb?

Answer 1

Subclavian artery

Question 2

On the right hand side, the where does the subclavian artery branch off from?

Answer 2

Right brachiocephalic trunk

Question 3

On the left side, where does the subclavian artery branch off from?

Answer 3

Arch of aorta

Question 4

The subclavian artery passes through which structure over the 1st rib?

Answer 4

Scalene triangle

Question 5

Which structures make up the scalene triangle?

Answer 5

Scalenus anterior
Scalenus medius
1st rib

Question 6

How many parts does the scalenus anterior divide the subclavian artery into?

Answer 6

Three:

1. Medial to Scalenus anterior
2. Behind scalenus anterior
3. Lateral to scalenus anterior

Question 7

When does the subclavian artery become the axillary artery?

Answer 7

When it crosses the outer border of the 1st rib

Question 8

What are the important divisions of the lateral part of the axillary artery?

Answer 8

Subscapular artery
Anterior circumflex humeral artery
Posterior circumflex humeral artery

Question 9

What is significant about a trauma to the surgical neck of the humerus?

Answer 9

Could tear the anterior and posterior circumflex humeral arteries which wrap around the surgical neck

Question 10

What is a large branch of the brachial artery?

Answer 10

Profunda brachii artery

Question 11

Fracture to the shaft of the humerus might cause trauma to which artery?

Answer 11

Profunda brachii artery

Question 12

Which artery goes through the quadrangular space?

Answer 12

The posterior circumflex humeral artery

Question 13

Why is the spiral groove also called the radial groove of the humerus?

Answer 13

Because the radial nerve travels through this groove

Question 14

Which artery travels with the radial nerve in the spiral groove of the humerus?

Answer 14

The profunda brachii artery

Question 15

What does the brachial artery divide into in the cubital fossa?

Answer 15

The radial and ulnar arteries

Question 16

Which is the smaller of the two terminal branches of the brachial artery?

Answer 16

Radial artery

Question 17

The radial artery is covered by which muscle?

Answer 17

Brachioradialis muscle

Question 18

The brachioradialis muscle allows you to do which movement?

Answer 18

Beer drinking arm movement - bringing a glass to your mouth

Question 19

Where does the radial artery anastomose with the ulnar artery?

Answer 19

The deep palmar arch

Question 20

Which structure does the radial artery travel through?

Answer 20

The anatomical snuff box

Question 21

Which muscle covers the ulnar artery?

Answer 21

Flexor carpi ulnaris

Question 22

Which branch of the ulnar artery forms the superficial palmar arch?

Answer 22

Deep branch: Common interosseous artery

Question 23

Common interosseous artery divides into what arteries either side of the interosseous membrane?

Answer 23

Anterior and posterior interosseous arteries

Question 24

Where do you find the deep palmar arch?

Answer 24

Draw a line from the tip of extended thumb to the base of the little finger

Question 25

Where do you find the superficial palmar arch?

Answer 25

One finger's breadth distal to the deep palmar arch

Question 26

Which artery supplies the flexors of the arm?

Answer 26

Brachial artery

Question 27

Which artery supplies the extensors of the arm?

Answer 27

Profunda brachii artery

Question 28

Which nerve passes through the quadrangular space?

Answer 28

Axillary nerve

Question 29

The radial artery pierces through which muscle?

Answer 29

The first dorsal interosseous muscle

Question 30

Which vein to the veins in the upper limb drain into?

Answer 30

Axillary vein

Question 31

Which vein does the axillary vein drain into?

Answer 31

Subclavian vein

Question 32

The deep veins are what kind of veins?

Answer 32

Venae comitantes - they are paired with a deep artery and piggyback off it

Question 33

Name the superficial/ subcutaneous veins

Answer 33

Cephalic vein | Basilic vein

Question 34

Name the course of the cephalic vein

Answer 34

It runs up the lateral side of the forearm

Question 35

Name the course of the basilic vein

Answer 35

It runs up the medial side of the forearm

Question 36

The cephalic and basilic veins drain the ________ in the hand

Answer 36

Dorsal venous arch

Question 37

Which vein forms a bridge between the cephalic and basilica veins?

Answer 37

Median cubital vein

Question 38

The basilic and cephalic veins drain into which vein?

Answer 38

Axillary vein

Question 39

What do the basilic and cephalic veins pierce in order to drain into the axillary vein?

Answer 39

Fascia - axillary vein is deep

Question 40

Where does the lymph from the arm drain into?

Answer 40

``` Cubital nodes (basilic vein) Deltopectoral node (cephalic vein) & ultimately these all drain into the axillary nodes (axillary vein) ```

Question 41

What is the brachial plexus?

Answer 41

It is the nerve supply to the upper limb | It carries motor, sensory and sympathetic axons

Question 42

Why is the brachial plexus important?

Answer 42

Because it contains mixed nerves - contains axons from multiple spinal nerves - which is needed to supply large muscle groups as they need innervation from more than one spinal nerve

Question 43

The brachial plexus is divided into:

Answer 43

Roots, trunks, divisions, cords & terminal branches

Question 44

What are the roots of the brachial plexus?

Answer 44

Ventral/ anterior primary rami of C5 - T1 spinal nerves

Question 45

Which nerves branch off the roots?

Answer 45

Dorsal scapular nerve | Long thoracic nerve

Question 46

Which muscles are supplied by the dorsal scapular nerve?

Answer 46

Rhomboids | Levator scapulae

Question 47

Which muscles are supplied by the long thoracic nerve?

Answer 47

Serratus anterior

Question 48

Which spinal nerve contribute to the dorsal scapular nerve?

Answer 48

C4 & C5

Question 49

Which spinal nerves contribute to the long thoracic nerve?

Answer 49

C5, C6 & C7

Question 50

What are myotomes?

Answer 50

Functional groups of muscles innervated by motor axons of the spinal nerves

Question 51

What is the function of the C5 myotome?

Answer 51

Shoulder abduction and adduction

Question 52

What is the function of the C6/C7 myotome?

Answer 52

Elbow flexion and extension

Question 53

What is the function of the C7/C8 myotome?

Answer 53

Wrist flexion and extension

Question 54

What is the function of the C8/T1 myotome?

Answer 54

Movement of the digits

Question 55

The roots of the brachial plexus form?

Answer 55

The trunks

Question 56

Which structure do the trunks pass through?

Answer 56

The scalene triangle

Question 57

Which nerve branches off the superior trunk?

Answer 57

Suprascapular nerve

Question 58

Each trunk divides into?

Answer 58

Anterior and posterior divisions

Question 59

The anterior divisions consist of axons to..?

Answer 59

Flexor compartments

Question 60

The posterior divisions consist of axons to..?

Answer 60

Extensor compartments

Question 61

The anterior divisions of the brachial plexus form the..?

Answer 61

Lateral and medial cords

Question 62

The posterior divisions of the brachial plexus form the..?

Answer 62

Posterior cord

Question 63

The cords of the brachial plexus sit under which structure?

Answer 63

The pectoralis minor

Question 64

The cords are named in relation to which structure?

Answer 64

The axillary artery

Question 65

Where does the lateral cord sit in relation to the axillary artery?

Answer 65

Lateral side of the axillary artery

Question 66

Where does the posterior cord sit in relation to the axillary artery?

Answer 66

Posterior to the axillary artery

Question 67

What are the terminal branches of the lateral cord?

Answer 67

Musculocutaneous nerve & | Lateral part of the median nerve

Question 68

What are the terminal branches of the median cord?

Answer 68

Medial part of the median nerve & | Ulnar nerve

Question 69

What are the terminal branches of the posterior cord?

Answer 69

Radial nerve | Axillary nerve

Question 70

The musculocutaneous nerve pierces through which muscle?

Answer 70

Coracobrachialis muscle

Question 71

The musculocutaneous nerve becomes the ______ which supplies the _____

Answer 71

Lateral cutaneous nerve to the forearm | supplies the skin of the forearm

Question 72

The musculocutaneous nerve gives off branches which supply the..?

Answer 72

Muscles of the upper arm

Question 73

Median nerve does NOT innervate

Answer 73

anything in the upper arm

Question 74

Median nerve innervates:

Answer 74

Flexor muscles of the forearm EXCEPT flexor carpi ulnaris & Intrinsic muscles of the hand

Question 75

The median nerve provides?

Answer 75

Motor innervation to the anterior forearm and lateral hand Sensory innervation to: skin of lateral palm of hand D1, D2, D3 & half D4 and skin from distal interphalangeal joints in D1, D2, D3 & half D4 on dorsum of hand

Question 76

The ulnar nerve innervates which muscle?

Answer 76

Flexor digitorum profundus

Question 77

Ulnar nerve provides:

Answer 77

Motor innervation to: medial side of the anterior forearm and hand Sensory innervation to: skin on the medial dorsum of hand and half of D4 and D5 on palm of hand

Question 78

The radial nerve innervates:

Answer 78

Extensor muscles

Question 79

Radial nerve provides:

Answer 79

Motor innervation to: the posterior/ extensor compartments of the arm and forearm Sensory innervation to: posterior arm and posterior forearm and skin of lateral dorsum of hand

Question 80

Axillary nerve provides:

Answer 80

Motor innervation to: deltoids & teres minor | Sensory innervation to: badge area of arm

Question 81

What are all the terminal branches of the brachial plexus?

Answer 81

``` Musculocutaneous nerve Median nerve Ulnar nerve Radial nerve Axillary nerve ```

Question 82

What is a dermatome?

Answer 82

"An individual area of skin innervated by a single spinal nerve"

Question 83

Cutaneous innervation by the terminal branches

Answer 83

looks different to a dermatome map

Question 84

Terminal branches contain

Answer 84

axons from multiple spinal nerves