L9 Flashcards

1
Q

What is the origin of the subclavian artery?

A
  • RHS Brachiocephalic artery

- LHS origin arch of the aorta

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2
Q

What is the course of the subclavian artery?

A

→ (P) to sternoclavicular joint → (P) to scalenus anterior muscle → over lung apex on suprapleural membrane → over 1st rib → Axillary artery

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3
Q

What are the three parts of the subclavian artery?

A
  • Medial
  • Behind
  • Lateral in relation to scalenus anterior
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4
Q

What are the branches of the subclavian artery?

A
  • Vertebral
  • Internal thoracic
  • Thyrocervical trunk in the root of the neck (M) to Scalenus anterior.
  • Costo-cervical trunk
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5
Q

Where do the highest intercostal and deep cervical arteries arise
from?

A

From behind scalenus anterior

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6
Q

What is the origin of the axillary artery?

A

From subclavian artery at outer border of 1st rib

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7
Q

What is the end of the axillary artery?

A

Lower border of teres major - brachial artery

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8
Q

What are the three parts of the axillary artery?

A
  • Pectoralis minor 1st: (S) thoracic artery
  • 2nd: Thoracoacromial & (L) thoracic artery
  • 3rd: (A) & (P) circumflex humeral and subscapular artery
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9
Q

Scapular anastomosis of the axillary artery

A

1st part of subclavian artery to brs. 3rd part of axillary artery

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10
Q

What is the origin of the brachial artery?

A

From axillary artery at lower border of teres major

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11
Q

What are the branches of the brachial artery?

A
  • Profunda brachii artery
  • Superior / inferior ulna
  • Collaterals nutrient artery of humerus muscular and articularc branches
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12
Q

What is the course of the brachial artery?

A

Lower border of teres major - ventral surface of the arm - the cubital fossa. Then divides into its terminal branches: the radial and ulnar arteries of the forearm.

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13
Q

What is the origin of radial artery?

A

Terminal branch of brachial artery at apex of cubital fossa

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14
Q

What is the course of radial artery?

A

Anterior forearm → deep to brachioradialis close to radial forearm muscles → lower forearm on anterior radius → (L) aspect of wrist → floor of anatomical snuffbox → 1st web space → 2 heads of 1ST dorsal interosseous → 2 heads adductor policis

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15
Q

Where is the radial artery palpated?

A

At lower forearm on anterior radius

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16
Q

Where does the radial artery end?

A

At the deep palmar arch artery

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17
Q

What are the branches of the radial artery?

A
  • Radial recurrent artery.
  • Palmar carpal branch.
  • Dorsal carpal branch.
  • Muscular branches.
  • Superficial palmar branch.
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18
Q

What is the origin of the ulna artery?

A

Terminal branch of the brachial artery in cubital fossa along with radial A3

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19
Q

What is the course of the ulna artery?

A

Deep to CFO muscles → then deep to flexor carpi ulnaris with ulnar nerve on medial side → anterior forearm → lying on FDP → crosses anterior to wrist between flexor digitorum profundus and flexor carpi ulnaris tendons → lateral side of pisiform

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20
Q

What does the ulnar artery end as?

A

As superficial palmar arch artery

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21
Q

What are the branches of the ulnar artery?

A
  • Common interosseous artery
  • Anterior interosseous artery
  • Posterior interosseous artery
22
Q

Describe the anterior interosseous artery

A
  • Lies on interosseous membrane between flexor digitorum profundus and flexor pollicis longus → perforating branches supply deep extensors gives nutrient branches to radius / ulna at upper border of pronator quadratus → posterior
    compartment
23
Q

Describe the posterior interosseous artery

A
  • Smaller vessel from ulnar artery /common interosseous artery
    between oblique cord and interosseous membrane → with
    posterior interosseous nerve / supplies deep extensors ends at
    back of wrist → dorsal carpal anastamosis
24
Q

Give details of scapular arterial anastomosis

A

Between branches of the 1st part of the subclavian artery with 3rd part of axillary artery

25
Q

Give details of arterial anastomosis at the elbow joint

A

Recurrent branches of radial, ulnar and interosseous artery passing up anteriorly and posteriorly to elbow → anastomose with descending branches of posterior brachial artery and superior and inferior ulnar collateral branches of brachial artery.

26
Q

Give details of arterial anastomosis at the wrist joint

A

Dorsal and palmar carpal branches of radial and ulnar arteries above the wrist joint freely anastomose.

27
Q

Give details of arterial anastomosis at the deep and superficial palmar

A

Radial and ulna arteries giving their deep and

superficial arch arteries eventually unite with one another

28
Q

Give the organisation of venous drainage

A

Organised into deep and superficial systems.

29
Q

Give the perforating vessels of the venous drainage.

A
Pass venous blood to deep veins which accompany arteries. Important perforators at the mid medial biceps (basilic vein) and in
cubital fossa (median cubital vein)
30
Q

Give the venous drainage of the arm

A

Similarly named vessels to arteries in the drain proximally to axillary vein.

31
Q

Give the venous drainage of the forearm

A

Distal to the elbow main

arteries have venae commitantes a dual set of veins in close proximity.

32
Q

Give clinical importance of venous drainage

A

Superficial veins of the
upper limb are very important sites for IV access for drug delivery and fluid and blood replacement. NB cephalic vein and pacing wires

33
Q

Why are artery and veins proximal to eachother?

A

To pump venous blood back to heart

34
Q

What is the function of superficial lymph vessels?

A

To drain the skin

35
Q

Give details of superficial lymphatic drainage.

A
  • Medial vessels drain with basilic vein to epitrochlear and axillary nodes.
  • Lateral vessels drain with cephalic vein to infraclavicular and
    axillary nodes
36
Q

Give details of deep lymphatic drainage

A

They drain with

arteries to lateral axillary nodes

37
Q

Where do epitrochlear nodes lie?

A

At medial elbow

38
Q

What are the 5 groups of axillary nodes?

A
  • Pectoral
  • Lateral
  • Central
  • Apical
  • Infraclavicular
39
Q

What do pectoral nodes drain?

A

Lateral and anterior chest wall, breast ad anterior abdominal wall

40
Q

Where do lateral axillary nodes receive efferents from?

A

From upper limb

41
Q

What does the subscapular node drain?

A

The back of the trunk

42
Q

Where is the central axillary node situated?

A

Around axillary vessels

43
Q

Give details of the apical axillary node.

A

Receive from other groups, blockage →

lymphoedema

44
Q

Where are the infraclavicular nodes present?

A

They lie around end of cephalic vein → apical group

45
Q

Cephalic vein details

A

Pierces the clavipectoral fascia at upper end of the deltopectoral groove to enter axillary vein

46
Q

Where is the radial artery pulse?

A

Lateral to the tendon of flexor carpi radialis

47
Q

What is the course of the basilic vein

A

Pierces the fascia in the medial mid arm to jon the venae commitantes which together, at the inferior border of teres major, become the axillary vein

48
Q

Where is the brachia; artery pulse?

A

In the cubital fossa, lateral to the median nerve

49
Q

What should be performed before taking an arterial sample?

A

An Allen test

50
Q

What are the steps in the Allen test?

A
  • Patient clenches fist
  • Use finger to obstruct blow flow at ulnar and radial arteries
  • Release the ulnar artery - if hand flushes - good blood flow, if not bad blood flow
51
Q

What is the radial artery used for?

A

Radial cannulation