Lecture 5: Vessels and nerves of the upper limb Flashcards

1
Q

What vessel does the subclavian artery branch from on the right side?

A

brachiocephalic trunk

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2
Q

What vessel does the subclavian artery branch from on the left side?

A

arch of aorta

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3
Q

What boundary does the subclavian artery pass to become the axillary artery?

A

lateral boarder of the first rib

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4
Q

What artery does the subclavian artery become once it’s passed the lateral boarder of the first rib?

A

axillary artery

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5
Q

What boundary does the axillary artery pass to become the brachial artery?

A

inferior boarder of teres major

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6
Q

What artery does the axillary artery become once it’s passed the inferior boarder of teres major?

A

brachial artery

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7
Q

What two arteries does the brachial artery bifurcate into?

A

radial and ulnar

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8
Q

What is the function of the numerous anastomoses between the radial and ulnar arteries?

A

to provide a back-up route for perfusion, to ensure perfusion to the hand is maintained in the event that one of these arteries is injured

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9
Q

What region of the body do the ulnar and radial arteries supply?

A

forearm and arm

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10
Q

What arteries branches off the axillary artery and wraps around the surgical neck of the humerus?

A

anterior and posterior circumflex humeral arteries

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11
Q

Describe the course of the anterior and posterior circumflex humeral arteries:

A

branches off the axillary artery and wraps around the surgical neck of the humerus with the axillary nerve

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12
Q

True or false: the brachial artery runs through the cubital fossa

A

true

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13
Q

Does the brachial artery run more medially or laterally down the arm?

A

medially

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14
Q

What artery branches from the brachial artery and wraps around the posterior region of the humerus?

A

profunda brachii

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15
Q

Which artery does the profunda brachii branch off?

A

brachial artery

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16
Q

What compartment of the arm does the profunda brachii artery supply?

A

posterior compartment

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17
Q

What site does the profunda brachii wrap around on the humerus?

A

the radial groove (with the radial nerve!)

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18
Q

At what anatomical point does the brachial artery bifurcate into ulnar and radial arteries?

A

just below the cubital fossa

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19
Q

What is the name of the extra arteries that run between the brachial, ulnar, profunda brachii and radial arteries, providing a back up route for circulation?

A

collateral arteries

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20
Q

Does the common interosseous artery branch from the ulnar or radial artery?

A

ulnar

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21
Q

Describe the course of the interosseous artery:

A

it branches off the ulnar artery shortly after the brachial artery bifurcates and travels deep towards the interosseous membrane

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22
Q

What two vessels arise from the common interosseous artery?

A

anterior and posterior interosseous artery

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23
Q

Describe the course of the posterior interosseous artery:

A

it runs through a hole in the interosseous membrane and courses along the posterior surface, supplying the posterior compartment

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24
Q

What side of the interosseous membrane does the anterior interosseous artery course?

A

anterior surface

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25
Q

Where are the radial and ulnar arteries closest to our skin?

A

the wrist

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26
Q

What are the anastomoses between the ulnar and radial arteries at the wrist called?

A

superficial and deep palmar arches

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27
Q

Which artery mainly supplies the deep palmar arch?

A

radial artery

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28
Q

Which artery mainly supplies the superficial palmar arch?

A

ulnar artery

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29
Q

What arteries branch off the palmar arches?

A

metacarpal arteries

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30
Q

What arteries branch off the metacarpal arteries?

A

two digital arteries

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31
Q

Describe the course of the digital arteries?

A

two run down each finger (not thumb) one on the lateral aspect and one on the medial aspect

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32
Q

A fracture to the clavicle can damage which artery?

A

subclavian artery

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33
Q

A fracture to the surgical neck of the humerus can damage which arteries?

A

anterior and superior circumflex humeral arteries

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34
Q

A mid humeral shaft fracture can damage which artery?

A

profunda brachii

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35
Q

A supracondylar fracture can damage which artery?

A

brachial artery

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36
Q

True or false: forearm vessels are less likely to be damaged during a fracture as they are found further from bones

A

True

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37
Q

What are the two types of veins found in the upper limb?

A

deep and superficial

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38
Q

True or false: corresponding deep veins and arteries have the same name

A

True

39
Q

Are deep or superficial veins used in venepuncture?

A

superficial

40
Q

Which type of veins drain directly into the heart (deep or superficial)?

A

Deep

41
Q

What vessels do superficial veins drain into before being drained into the heart?

A

deep veins

42
Q

What superficial vein comes from the anatomical snuff box, up the lateral edge of the forearm and drains into the axillary vein?

A

Cephalic vein

43
Q

What vein does the cephalic vein drain into?

A

axillary vein

44
Q

Describe the course of the cephalic vein:

A

comes from the anatomical snuff box, up the lateral edge of the forearm, then more medially before draining into the axillary vein

45
Q

How many brachial veins are found in the average person?

A

two

46
Q

What is the name of the vein that runs deep around the humerus and merges with the brachial veins to form the axillary vein?

A

basilic vein

47
Q

Describe the course of the basilic vein:

A

found on the medial side of the arm and runs deep around the humerus before merging with the brachial veins to form the axillary vein

48
Q

What is the name of the venous communication between the basilic and cephalic vein?

A

medial cubital vein

49
Q

True or false: the medial cubital vein is usually where blood samples are taken from

A

True

50
Q

What vessel branches down from the medial cubital vein?

A

median antebrachial vein

51
Q

Which cervical cord segments does the brachial plexus arise from

A

C5-8 and T1

52
Q

What are the five major terminal branches of the brachial plexus?

A

1) musculocutaneous

2) axillary

3) radial

4) median

5) ulnar

53
Q

Are the terminal branches of the brachial plexus somatic or autonomic?

A

somatic

54
Q

True or false: the terminal branches of the brachial plexus contains both sensory and motor fibres

A

True

55
Q

Where does the axillary nerve originate in the cervical spine?

A

C5 and C6

56
Q

Where does the radial nerve originate in the cervical spine?

A

C5-T1

57
Q

Where does the musculocutaneous nerve originate in the cervical spine?

A

C5-C7

58
Q

Where does the median nerve originate in the cervical spine?

A

C6-T1 (some argue C5 too)

59
Q

Where does the ulnar nerve originate in the cervical spine?

A

C8-T1

60
Q

What two muscles does the axillary nerve innervate?

A

1) deltoid

2) teres minor

61
Q

What skin does the axillary nerve innervate?

A

skin over the upper lateral arm

62
Q

Where does the axillary nerve wrap around?

A

surgical neck of humerus (posterior side)

63
Q

What muscle does the radial nerve innervate?

A

triceps brachii

64
Q

Where does the radial nerve wrap around?

A

radial groove of the humerus

65
Q

Describe the course of the radial nerve:

A

1) runs past radial groove of humerus

2) at the level of the elbow, it runs anteriorly to the lateral epicondyle

3) at this point superficial and deep branches from

66
Q

What does the superficial branch of the radial innervate?

A

some posterior muscles and sensory innervation to skin over the lateral posterior aspect of the arm and hand

67
Q

What nerve does the posterior interosseous nerve branch from?

A

deep radial nerve

68
Q

How does the posterior interosseous nerve enter the posterior compartment of the arm?

A

it enters via a hole in the interosseous membrane

69
Q

What two digits does the superficial radial nerve run all the way to?

A

thumb and index finger

70
Q

What group of muscles does the musculocutaneous nerve innervate?

A

muscles of the anterior compartment of the arm

71
Q

What muscle does the musculocutaneous nerve travel under?

A

coracobrachialis

72
Q

What muscles does the median nerve innervate?

A

most anterior forearm muscles excluding the flexor carpi ulnaris and the ulnar half of the flexor digitorum

73
Q

What nerve does the anterior interosseous nerve branch from?

A

median nerve

74
Q

What three muscles does the anterior interosseous nerve innervate?

A

1) pronator quadratus

2) flexor digitorum profundus (half of it)

3) flexor pollicis longus

75
Q

True or false: the median nerve travels through the carpel tunnel

A

True

76
Q

What nerve branches of the median nerve at the hand?

A

recurrent branch of the median nerve

77
Q

What muscle does the recurrent branch of the median nerve innervate?

A

thenar eminence

78
Q

What is the thenar eminence?

A

muscular pad on palmar surface of 1st metacarpal

79
Q

What regions of the hand does the median nerve innervate?

A

the palmar aspect of the thumb, index finger, middle finger and lateral half of the ring fingers as well as the finger tips on the dorsal side

80
Q

Describe the course of the ulnar nerve?

A

it travels straight down the arm, past the medial epicondyle and running down the lateral part of the anterior forearm

81
Q

What two muscles of the forearm does the ulnar nerve?

A

1) flexor carpi ulnaris

2) ulnar half of the flexor digitorum profundus

82
Q

Does the ulnar nerve travel through, over or under the carpel tunnel?

A

Over

83
Q

Which nerve innervates most muscles in the hand?

A

ulnar nerve

84
Q

What regions of the hand are innervated by the ulnar nerve?

A

the medial palm and the medial one and a half digits and on the dorsum, the medial two digits excluding the lateral half of the fourth digit

85
Q

What does a peripheral nerve map show?

A

regions of the skin supplied by major peripheral nerves

86
Q

What does a dermatome map show?

A

regions of skin supplied by a single spinal nerve

87
Q

What regions of the hand does the radial nerve innervate?

A

the anatomical snuff box and almost all of the lateral digits on the dorsal side

88
Q

What do myotome maps show?

A

the muscle mass innervated by a single spinal nerve

89
Q

What movement can be used to check the C5 spinal nerve?

A

shoulder abduction

90
Q

What movement can be used to check the C6 spinal nerve?

A

elbow flexion

91
Q

What movement can be used to check the C7 spinal nerve?

A

elbow extension

92
Q

What movements can be used to check the C8 spinal nerve?

A

finger flexion and thumb extension

93
Q

What movements can be used to check the T1 spinal nerve?

A

finger abduction and adduction