Lecture 10

Question 1

Explain the relationship between the Radial nerve and the deep brachial artery in radial (spiral groove)?

Answer 1

They travel with each other with the deep brachial artery being more lateral than the radial nerve

Question 2

Explain the relationship between the Brachial artery and the median nerve?

Answer 2

They run together for the length of the humerus and diverge at the same level that the brachial artery splits into the ulnar artery and radial artery

The median nerve diverges from the brachial artery when it runs between the 2 heads of the pronator teres (ulnar head and Humeral head)

Question 3

Explain the relationship between the Brachial artery and the bicipital aponeurosis?

Answer 3

the brachial artery splits into the radial and ulnar arteries after it passes beneath the bicipital aponeurosis

Question 4

Explain the relationship between the Superior ulnar collateral artery and the medial epicondyle?

Answer 4

The superior ulnar collateral artery runs posterior to the medial epicondyle where it anastamoses and becomes the posterior ulnar recurrent artery

Question 5

Explain the relationship between the Inferior ulnar collateral artery and the medial epicondyle?

Answer 5

The inferior ulnar collateral artery runs anterior to the medial epicondyle where it anastamoses and becomes the anterior ulnar recurrent artery

Question 6

Explain the relationship between the Radial collateral artery and the lateral epicondyle?

Answer 6

The radial collateral artery runs anterior to the lateral epicondyle where it anastamoses and becomes the radial recurrent artery

Question 7

Explain the relationship between the Median cubital vein and the bicipital aponeurosis?

Answer 7

The median cubital vein runs superficial to the bicipital aponeurosis (common place to draw blood)

Question 8

Explain the relationship between the Ulnar nerve and the medial epicondyle?

Answer 8

The ulnar nerve passes around superficially to the medial epicondyle (this exposed position makes injury more likely)

Question 9

Explain the relationship between the Musculocutaneous nerve and the coracobrachialis muscle?

Answer 9

The coracobrachialis muscle is pierced by the musculocutaneous nerve (in the upper half or third of the brachium)

Question 10

Explain the relationship between the Musculocutaneous nerve and the biceps and brachialis muscles?

Answer 10

The musculocutaneous nerve innervates the biceps and corcacobrachialis muscles

Question 11

Explain the relationship between the Lateral cutaneous nerve of the forearm and the bicipital tendon?

Answer 11

The lateral cutaneous nerve is the distal continuation of the musculocutaneous nerve.

The musculocutaneous nerve becomes the lateral cutaneous nerve at the level (just before the elbow) of the bicipital tendon, where it pierces the deep fascia then continues medially into the forearm as the lateral cutaneous nerve.

Question 12

State the 2 fascial septae in the arm

Answer 12

Medial intermuscular septum

Lateral intermuscular septum

Question 13

What are the attachments for the Medial intermuscular septum and the Lateral intermuscular septum

Answer 13

They both Form from the subcutaneous sheath to the humerus

Question 14

Describe the muscles, general function(s), innervation, nerves passing through, and vascularization of the anterior compartments of the arm.

Answer 14

Muscles: biceps brachii, coracobrachialis, and brachialis

Function: forearm flexors ; biceps also flexes the shoulder and supinates the forearm

Innervation: Musculocutaneous nerve, C5-6

Nerves passing through: median and ulnar nerves

Vascularization: brachial artery ; basilic vein and venae comitantes

Question 15

Describe the muscles, general function(s), innervation, nerves passing through, and vascularization of the posterior compartments of the arm.

Answer 15

Muscles: Triceps (long, lateral, and medial heads)

Function: forearm extensors, synergists in forearm supination, and the long head can extend the shoulder (brachium)

Innervation: Radial nerve ; C7

Nerves passing through: median and ulnar(through the proximal part of the anterior compartment) nerves

Vascularization: deep brachial artery

Question 16

Describe the Biceps brachii muscle with regard to general morphology, attachments, action and innervation

Answer 16

General morphology: 2 joint muscle that crosses the glenohumoral and elbow joints ; affected by passive and active insufficiency ; the tendon for the long head passes through the bicipital groove between the greater and lesser tubercles of the humerus

Proximal Attachments: short head = tip of coracoid process ; long head = supraglenoid tubercle of scapula

Distal Attachments: tuberosity of the radius
Action: flexion and extension of the forearm ; assists in forearm supination

Innervation: musculocutaneous nerve ; C5-6

Question 17

Describe the coracobrachialis muscle with regard to general morphology, attachments, action and innervation

Answer 17

General morphology: single-joint muscle over glenohumeral joint ; pierced by musculocutaneous nerve

Proximal Attachments: tip of coracoid

Distal Attachments: middle 1/3rd of the medial border of the humerus

Action: weakly flexes the arm and adducts arm

Innervation: Musculocutaneous nerve ; C6-7

Question 18

Describe the brachialis muscle with regard to general morphology, attachments, action and innervation

Answer 18

General morphology: single joint muscle over the elbow joint

Proximal Attachments: distal 1/2 of the anterior surface of the humerus and intermuscular septum

Distal Attachments: tuberosity of the coronoid process

Action: main flexor of the forearm (NOT the biceps)

Innervation: Musculocutaneous nerve ; C5-6

Question 19

Describe the triceps (and it’s heads) with regard to general morphology, attachments, action and innervation

Answer 19

General morphology: lateral and medial heads = single joint over elbow joint ; long head = 2 joint muscle over elbow and shoulder joints

Proximal Attachments: long head = infraglenoid tubercle of scapula ; lateral head = posterior surface of the humerus above the radial groove ; medial head = from posterior surface of the humerus below the radial groove

Distal Attachments: olecranon process (all 3 heads)

Action: forearm extension and the long head assists with arm extension

Innervation: radial nerve ; C6-8

Question 20

The the main nerve branch that the Superior lateral cutaneous nerve of the arm originates from

Answer 20

from the axillary nerve

Question 21

The the main nerve branch that the Medial brachial cutaneous nerve
originates from

Answer 21

Direct branch from the medial cord

Question 22

The the main nerve branch that the Medial antebrachial cutaneous nerve
originates from

Answer 22

Direct branch from the medial cord

Question 23

The the main nerve branch that the Lateral antebrachial cutaneous nerve originates from

Answer 23

termination of the musculocutaneous nerve

Question 24

The the main nerve branch that the Posterior cutaneous nerve of the arm
originates from

Answer 24

from the radial nerve

Question 25

The the main nerve branch that the Posterior cutaneous nerve of the forearm
originates from

Answer 25

from the radial nerve

Question 26

Describe the course through the arm, areas supplied, and branches of the median nerve

Answer 26

travels with the brachial artery (lateral to it in the upper half of the brachium and medial to it in the lower half of the brachium) and crosses over the cubital fossa superficially

Areas supplied: flexor muscles on the radial side of the forearm and does NOT supply any arm muscles

Branches: none

Question 27

Describe the course through the arm, areas supplied, and branches of the Musculocutaneous nerve

Answer 27

pierces coracobrachialis in upper 1/2 or 1/3rd of the brachium and pierces the fascia lateral to the biceps tendon

Areas supplied: muscles of the anterior brachia compartment

Branches: continues as the lateral cutaneous nerve

Question 28

Describe the course through the arm, areas supplied, and branches of the radial nerve

Answer 28

a terminal branch of the posterior cord of the brachial plexus

Areas supplied: extensor muscles in posterior compartment of the brachium as well as extensor muscles of the wrist and hand (all extensor muscles of the upper extremity

Also supplies the brachioradialis muscle

Branches: lateral antebrachial cutaneous nerve

Question 29

Describe the course through the arm, areas supplied, and branches of the ulnar nerve

Answer 29

runs with the superior ulnar collateral artery (pierces medial intermuscular septum, enters posterior compartment of the brachium, passes around (superficialy) the medial epicondyle, and passes into the forearm between the 2 heads of the flexor carpi ulnaris muscle

Areas supplied: flexor muscles on the ulnar side of the arm

Branches: none

Question 30

State the branches of the brachial artery and then describe it’s course through the arm

Answer 30

Branches: deep brachial artery (main branch) and the superior/inferior ulnar collateral arteries

Course: begins at the inferior border of the teres major and then deep brachial artery and the ulnar collateral arteries (inferior and superior)

Question 31

State the origin and anastomoses of the brachial artery

Answer 31

Origin: direct continuation of the axillary artery

Anastomoses: between the brachial artery and the ulnar artery (superior ulnar collateral - posterior ulnar recurrent ; inferior ulnar collateral - anterior ulnar recurrent)

Question 32

What are venae comitantes and how many of them usually occur “per artery”?

Answer 32

venae comitantes: veins that parallel arteries

usually 2 per artery

Question 33

For the Cephalic vein, state the route (including the fascia level it inhabits) and what vessels it connects

Answer 33

ascends in superficial fascia along the medial aspect of the forearm and arm

empties into axillary vein

Question 34

For the basilic vein, state the route (including the fascia level it inhabits) it takes

Answer 34

ascends in superficial fascia along the lateral aspect of the forearm and arm to the middle of the arm where it pierces the deep fascia and forms the axillary vein by joining venae comitantes

Question 35

For the median cubital vein, state the route (including the fascia level it inhabits) and what it drains blood from.

Answer 35

connects cephalic and cubital vein by extending diagonally across the bicipital aponeurosis ;

receives blood from the median antebrachial vein and the palmar hand

Question 36

What are the contents of the cubital fossa?

Answer 36

biceps tendon

brachial artery,

median nerve

(TAN lateral to medial as in tendon, artery, nerve)

Question 37

describe the boundaries (roof and floor) of the cubital fossa

Answer 37

Roof: skin, superficial/deep fascia, and the bicipital aponeurosis

Floor: Supinator and brachialis muscles