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BMS100 MSK Anatomy > Lecture 9 > Flashcards

Lecture 9 Flashcards

1
Q

Long thoracic, suprascapular, and dorsal scapular nerve all belong to which branches?

A

supraclavicular branches

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2
Q

Where are the supraclavicular branches largely located?

A

in the cervical region

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3
Q

Where are the infraclavicular branches primarily located?

A

axilla/armpit

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4
Q

What branches make up the infraclavicular branches?

A

Musculocutaneous (C5,6,7)
Axillary (C5/6)
Radial (C5 – T1)
Median (C5 – T1)
Ulnar (C8/T1)

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5
Q

What are the branches of the musculocutaneous nerve?

A

C5, 6, 7

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6
Q

What are the branches of the axillary nerve?

A

C5, 6

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7
Q

What are the branches of the radial nerve?

A

C5-T1

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8
Q

What are the branches of the median nerve?

A

C5-T1

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9
Q

What are the branches of the ulnar nerve?

A

C8/T1

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10
Q

Any injury to nerves will be felt __ to the site of injury.

A

distal

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11
Q

What is the origin of the musculocutaneous nerve?

A

terminal branch of lateral cord

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12
Q

What are the functions (motor and sensory) of the musculocutaneous nerve?

A

Motor to anterior arm:
- Coracobrachialis
- Biceps
- Brachialis

Sensory to :
- Skin of anterolateral forearm

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13
Q

Where is the most likely site of injury for musculocutaneous nerve?

A

in the coracobrachialis muscle belly

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14
Q

What is the pathway of the musculocutaneous nerve?

A
  • Terminal Branch of lateral cord within axilla
  • Travels through the coracobrachialis muscle belly
    *Most likely site of injury
  • Innervates muscles of the anterior compartment of the arm
  • Continues after passing the cubital fossa as the Lateral. Cutaneous N. of forearm
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15
Q

What is the name of the musculocutaneous nerve after is passes the cubital fossa?

A

lateral cutaneous nerve of the forearm

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16
Q

What is the origin of the axillary nerve?

A

terminal branch of posterior cord

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17
Q

What are the functions (motor and sensory) of the axillary nerve?

A

Motor to lateral shoulder:
- Deltoid
- Teres minor

Sensory to:
- Skin of lateral shoulder

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18
Q

What is the easiest way to assess nerve damage?

A

strength testing

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19
Q

What is the pathway of the axillary nerve?

A
  • heads posteriorly in axilla
  • Travels through the quadrangular axillary space
  • Wraps around posterior aspect of humeral neck
  • Relationship with the surgical neck of humerus
    *Most likely site of injury
  • Innervates deltoid and Teres minor
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20
Q

Where is the most likely site of injury for the axillary nerve?

A

surgical neck of humerus due to a fracture

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21
Q

If you injure the axillary nerve, what are the results?

A

abduction, external rotation, numbness and tingly on skin of lateral shoulder

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22
Q

What does long term nerve damage lead to?

A

atrophy

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23
Q

What can a long term axillary nerve injury cause?

A

deltoid atrophy

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24
Q

What is the origin of the radial nerve?

A

terminal branch of posterior cord

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25
Q

What are the functions (motor and sensory) of the radial nerve?

A

Motor To:
- Extensor muscles of posterior arm
- Extensor muscles of posterior forearm
- Brachioradialis
- Supinator muscle

Sensory to:
- Skin of posterior arm, forearm and hand
- Dorsal surface of digits 1, 2, 3 and lateral ½ of digit 4 (typically written as lateral 3.5 digits, dorsal surface)

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26
Q

What is the pathway of the radial nerve?

A
  • heads posteriorly in axilla
  • Travels posteriorly, inferior to the quadrangular axillary space
    wraps around posterior aspect of humeral shaft
  • Relationship with the radial groove of humerus
    *Most likely site of injury
  • Innervates extensors of arm and forearm and supinator
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27
Q

What is the most likely site of injury of the radial nerve?

A

radial groove (spiral groove) of humerus

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28
Q

T/F: The Radial nerve has a relationship with the cubital fossa by traveling through it.

A

True

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29
Q

What are the sensory branches in the posterior arm of the radial nerve?

A

Post. Cutaneous Nerve of Forearm

Lower lateral cutaneous nerve of arm

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30
Q

Which branch of the radial nerve innervates the muscles in the posterior compartment of the forearm?

A

deep branch (motor)

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31
Q

Which branch of the radial nerve contributes to the cutaneous innervation of the dorsal hand & fingers?

A

superficial branch (sensory)

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32
Q

If the radial nerve is injured which functions are affected?

A

Loss of elbow extension, loss of wrist extension, loss of finger extension, weakness in supination

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33
Q

What nerve is associated with “wrist drop”?

A

radial nerve

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34
Q

What is the origin of the median nerve?

A

terminal branch of lateral and medial cords

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35
Q

What are the functions (sensory and motor) of the median nerve?

A

Motor to Muscles of the anterior forearm and hand:
- Flexors of wrist
- Pronators of forearm
- Flexors of Digits 1, 2, 3
- Lumbricals 1 and 2
- Thenar muscles

Sensory to:
- Palmer surface of digits 1, 2, 3 and lateral ½ of digit 4
(typically written as lateral 3.5 digits, palmer surface)

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36
Q

What is the pathway of the median nerve?

A
  • heads inferiorly from axilla, travelling down antero-medial arm (within layers of muscle)
  • crosses anterior elbow within cubital fossa
    *likely site of injury
  • travels down anterior forearm
    enters hand via carpal tunnel
    *likely site of injury
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37
Q

What are the likely sites of injury of the median nerve?

A
  • cubital fossa
  • carpal tunnel
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38
Q

If there is damage of median nerve in the cubital fossa, what occurs?

A

loss of wrist flexion, digit flexion, pronation, thumb movement, sensory loss in hand

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39
Q

What is carpal tunnel syndrome?

A

compression of the median nerve as it passes through the carpal tunnel

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40
Q

How does carpal tunnel arise?

A
  • typing
  • mechanics
  • pregnancy
  • obesity
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41
Q

Where is the primary area of impact when there is compression at the wrist?

A

function of the hand –> thenar muscles
- weakness in thumb movement, and numbness & tingling of 3.5 digits

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42
Q

As the median nerve compression (carpal tunnel) progresses, where can sensory changes radiate to?

A

forearm & axilla

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43
Q

Which muscles show atrophy quicker if it is not innervated?

A

smaller muscles

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44
Q

Ape hand deformity is a lesion at which nerve?

A

median nerve

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45
Q

What is the origin of the ulnar nerve?

A

terminal branch of medial cord

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46
Q

What are the functions (sensory and motor) of the ulnar nerve?

A

Motor to medial forearm and hand:
- Medial ½ of flexor digitorum profundus,
- Flexor carpi ulnaris
- Hand intrinsics: Lumbricals 3&4, Hypothenar group, Palmer and Dorsal Interossei

Sensory to:
- Palmer and Dorsal surface of medial ½ of digit 4, And all if digit 5 (typically written as medial 1.5 digits)

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47
Q

What is the pathway of the ulnar nerve?

A
  • heads inferiorly from axilla, travelling down antero-medial arm (protected by muscle)
  • passes posterior to medial epicondyle,
    *Most likely site of injury
  • travels down medial forearm
  • enters hand external to carpal tunnel
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48
Q

What is the most likely site of injury of the ulnar nerve?

A

medial epicondyle (funny bone)

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49
Q

If the ulnar nerve is damaged, where will you see

A

loss of hand function specific to 2, 3, 4, 5, atrophy

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50
Q

What would the fracture of the medial epicondyle of the humerus cause?

A

ulnar claw hand

51
Q

What are nerves?

A

WHITE matter pathways that provide a route for motor and sensory signals to travel between PNS and CNS

52
Q

Spinal nerves are __ and will carry signals to and from target/receptors on the same side of the body.

A

ipsilateral

53
Q

posterior/dorsal root carries __/__ information into CNS.

A

sensory/afferent

54
Q

Ventral/anterior root carriers __/__ information out of CNS

A

motor/efferent

55
Q

Ventral & dorsal roots come together to form a spinal nerve in the __ __.

A

intervertebral foramen

56
Q

What is dermatome?

A

specific area on the skin innervated by a specific spinal root

57
Q

What are the 2 test we can do to isolate injury of spinal nerves?

A

dermatome & myotome

58
Q

What is myotome?

A

specific group of muscles innervated by a particular spinal root

59
Q

What is the myotome and function of the nerve root C5?

A

myotome: deltoid muscle
function: abduction of arm at the shoulder

60
Q

What is the myotome and function of the nerve root C6?

A

myotome: biceps
function: flexion of arm at the elbow

61
Q

What is the myotome and function of the nerve root C7?

A

myotome: triceps
function: extension of the arm at the elbow

62
Q

What is the myotome and function of the nerve root C8?

A

myotome: small muscles of the hand
function: finger flexion

63
Q

What is the myotome and function of the the nerve root T1?

A

myotome: small muscles of hand
function: finger abduction

64
Q

What is the dermatome and myotome of C5?

A

Dermatome = sensation of skin of anterior/lateral arm (skin over deltoid)

Myotome = muscle strength of deltoid (arm abduction)

65
Q

What is the dermatome and myotome of C6?

A

Dermatome = sensation of anterior skin of thumb

Myotome = muscle strength of biceps (elbow flexion)

66
Q

What is the dermatome and myotome of C7?

A

Dermatome = sensation of anterior skin of digits 2 and 3

Myotome = muscle strength of triceps (elbow extension)

67
Q

What is the dermatome and myotome of C8?

A

Dermatome = sensation of skin of digits 4 and 5

Myotome = muscle strength of finger flexors

68
Q

What is the dermatome and myotome of T1?

A

Dermatome = sensation of skin of antero/medial elbow

Myotome = muscle strength of finger abductors

69
Q

Why is the reflex arc the simplest of all neural responses?

A
  • automatic
  • predictable
  • acquired
70
Q

What are the branches of the arch of aorta?

A
  • left subclavian artery
  • left common carotid artery
  • brachiocephalic artery
71
Q

What are the branches of the brachiocephalic arterty?

A
  • right subclavian artery
  • right common carotid artery
72
Q

The subclavian artery goes under the __

A

clavicle

73
Q

What is the only source of the blood supply to the upper limb?

A

subclavian artery

74
Q

What is the pathway and names of the subclavian artery down the arm?

A

Subclavian –> under clavicle –> passes axilla –> Axillary artery –> goes to brachial –> brachial artery

75
Q

Which artery supplies the supraspinatus muscle?

A

Suprascapular artery

76
Q

What is the pathway of the suprascapular artery?

A

goes posteriorly and enters the supraspinous fossa –> passes to infraspinous fossa –> supraspinatus and infraspinatus

77
Q

Where does the suprascapular artery originate from?

A

subclavian artery

78
Q

What does the dorsal scapular artery supply?

A

levator scapuale, rhomboid major & minor

79
Q

Axillary artery is the continuation of the ?

A

subclavian artery

80
Q

Where does the axillary artery start?

A

lateral margin of rib 1

81
Q

When does the axillary artery become the brachial artery?

A

when it reaches the inferior border of pectoralis major (anterior) or teres major (posterior)

82
Q

What is the division of the axillary artery based on?

A

course of pectoralis minor

83
Q

What is the branch of the 1st part of the axillary artery?

A

superior thoracic artery

84
Q

What are the branches of the 2nd part of the axillary artery?

A

thoraco-acromial artery
lateral thoracic artery

85
Q

What are the branches of the 3rd part of the axillary artery?

A

subscapaular
anterior circumflex humeral artery
posterior circumflex humeral artery

86
Q

What does the thoraco-acromial branch supply?

A

pectoral and deltoid regions

87
Q

What does the lateral thoracic artery supply?

A

lateral thoracic wall (serratus anterior)

88
Q

What does the subscapaular artery supply?

A

muscles of the scpaular region

89
Q

What does the anterior and posterior circumflex humeral arteries supply?

A

muscles attached to proximal end of humerus

90
Q

What are the main branches of the brachial artery?

A

deep brachial (profonda brachii) and muscular branches (2-5)

91
Q

Where does the deep brachial (profonda brachii) artery travel and supply?

A

moves posteriorly towards radial groove (accompanying radial nerve) supplying posterior arm compartment

92
Q

What does the muscular branches of the brachial artery supply?

A

anterior compartment muscles

93
Q

What does the brachial artery divide into?

A

ulnar and radial arteries

94
Q

T/F: Radial artery is larger than ulnar artery

A

False, smaller

95
Q

What does the ulnar artery lie under and what accompanies it?

A

under flexor carpi ulnaris accompanied by ulnar nerve

96
Q

What is the pathway of the ulnar artery?

A

lies under flexor carpi ulnaris and is accompanied by ulnar nerve on its way –> passes on medial side of wrist in front of flexor retinaculum lateral to pisiform –> hand and takes part in formation of palmar arterial arch

97
Q

What does the ulnar artery supply?

A

elbow
muscles of anterior compartment on medial side
deep muscles of anterior compartment of forearm
majority of muscles of posterior compartment of wrist joint

98
Q

Which side does the radial artery supply?

A

lateral side of forearm

99
Q

What is the pathway of the radial artery?

A

descends on the lateral side of the forearm under the cover of the brachioradialis muscle with the superficial branch of the radial nerve –> distal part of the forearm, it passes through the anatomical snuff box –> after passing through the first interosseous space in hand, enters the palm of the hand and takes part in forming the deep palmar arch

100
Q

What is the major source of blood supply for the dorsal surface of the hand?

A

radial artery

101
Q

What do the branches of the radial artery form at the level of the carpal bones?

A

dorsal arterial arch

102
Q

Some branches of the radial artery will joint with terminal branches of the ulnar artery for form which structure?

A

superficial and deep palmar arterial arch

103
Q

Palmar arches are protected by?

A

palmar aponeurosis

104
Q

What do the superficial veins run in (where are they located in the skin)?

A

superficial fascia

105
Q

What do the deep veins run with?

A

arteries

106
Q

What is the medial branch of the venous arch called?

A

basilic

107
Q

What is the lateral branch of the venous arch called?

A

cephalic

108
Q

What is the pathway of the basilic vein?

A

Basilic (basement) –> up on medial side within superficial fascia –> down in the arm pierces deep fascia and goes deep and enters axilla –> axillary vein

109
Q

What is the pathway of the cephalic vein?

A

Cephalic (lateral) –> travels lateral side within superficial fascia –> connected w/ basilic vein through median cubital vein (in cubital fossa) –> passes between deltoid and pec major –> drains into axillary vein

110
Q

From the axillary vein, what is the pathway to the right atrium?

A

Axillary –> subclavian –> internal jugular vein –> brachiocephalic –> right & left come together to form superior vena cava –> drains into right atrium

111
Q

What is the cubital fossa?

A

Triangular impression in front of elbow joint

112
Q

What is on the lateral and medial side of the cubital fossa?

A

brachioradialis on lateral side & pronator teres on medial side

113
Q

What tendon passes through the cubital fossa and divides it into medial and lateral?

A

tendon of biceps

114
Q

Which nerves pass through the cubital fossa?

A

radial and median

115
Q

What is the axilla? Where is it situated?

A

a four-sided pyramidal space situated between the upper part of the arm and the chest wall

116
Q

What is the axilla the transition region for?

A

between the root of the neck and the upper limb

117
Q

T/F: most of the structures that enter or leave the upper limb pass through the axilla

A

True

118
Q

What forms the anterior wall of the axilla?

A

pectoral region

119
Q

What forms the posterior wall of the axilla?

A

scapular region –> subscapularis mucscle, teres major, latissimus dorsi

120
Q

What forms the medial wall of the axilla?

A

the upper 4 ribs and the upper part of he serratus anterior muscle that attaches to these ribs

121
Q

What forms the lateral wall of the axilla?

A

narrow and is formed by the upper part of the humerus

122
Q

What are the contents of the axilla?

A

Axillary artery and its branches
Axillary vein and its tributaries
Infraclavicular part of the brachial plexus
Axillary Lymph nodes

123
Q
A

BMS100 MSK Anatomy (9 decks)

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