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Gross Anatomy > Mod 2: Lecture 2 - Axilla and Brachial Plexus > Flashcards

Mod 2: Lecture 2 - Axilla and Brachial Plexus Flashcards

1
Q

Boundaries of Axilla

A
  • Anterior: pectoralis major and minor
  • Posterior: scapula, latissimus dorsi, teres major
  • Medial: ribs 1-4 and intercostal spaces
  • Lateral: intertubercular groove of the humerus
  • Base: skin and fascia of arm
  • Apex: convergence of clavicle, scapula, and rib 1
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2
Q

Contents of Axilla

A
  1. Axillary Artery
  2. Axillary Vein
  3. Lymphatics
  4. Brachial Plexus
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3
Q

Where does the axillary artery come from?

A
  • Aorta –> Brachial Trunk (BT)/ Brachiocephalic Artery –> Right Subclavian Artery + Right Common Carotid
  • —- Right Subclavian –> Right Axillary artery
  • Aorta —> Left Subclavian + Left Common Carotid
  • — Left Subclavian –> Left Axillary Artery
  • once the subclavian artery gets to the axilla, it changes names to the axillary artery
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4
Q

Axillary Artery Location

A
  • continuous with the subclavian artery
  • — same vessel, gets a new name
  • begins at the lateral border of the 1st rib and ends at the inferior border of the teres major
  • — at the inferior border of the teres major, the axillary artery is continuous with the brachial artery (same vessel, new name)
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5
Q

Part 1 of the axillary artery

A
  • parts are named in relation to the pectoralis minor muscle
  • located between the lateral border of the 1st rib and the medial border of the pectoralis minor
  • Branches - Axillary I: superior thoracic artery
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6
Q

Part 2 of the Axillary Artery

A
  • lies posterior to pectoralis minor
  • — deep to the muscle, underneath it
  • Branches - Axillary II:
  • — thoracoacromial trunk
  • — lateral thoracic arteries
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7
Q

Part 3 of the Axillary Artery

A
  • Part 3: extends from the lateral border of the pectoralis minor to the inferior border of the teres major
  • — emerges from underneath the pectoralis minor and goes to the lower limit of the axilla
  • Branches - Axillary III:
  • — subscapular artery
  • — anterior humeral circumflex
  • — posterior humeral circumflex
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8
Q

Axillary Vein

A
  • named from distal to proximal
  • — following the flow of blood back to the heart
  • — direction and naming is the opposite for veins and arteries
  • formed at the inferior border of the teres major muscle
  • — by the union of the brachial veins and the basilic vein
  • ends when it joins the subclavian vein
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9
Q

Lymph Nodes

A
  • part of the immune system
  • —body sends lymphatic fluid to the lymph nodes to decide if we need to develop to the pathogen
  • 5 main groups of axillary lymph nodes
  • — pectoral
  • — subscapular
  • — humeral
  • — central
  • — apical
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10
Q

Pectoral Lymph Nodes

A
  • anterior
  • mainly receive lymph from the anterior thoracic wall
  • including most of the breast
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11
Q

Subscapular Lymph Nodes

A
  • posterior

- receive lymph from the posterior aspect of the thoracic wall and scapular region

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12
Q

Humeral Lymph Nodes

A
  • receive nearly all the lymph from the upper limb
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13
Q

Central Group of Lymph Nodes

A
  • located along the 2nd part of the axillary artery

- receives lymph from the pectoral, subscapular, and humeral nodes

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14
Q

Apical Lymph Nodes

A
  • vessels from the central nodes pass to the apical nodes
  • located along the fist part of the axillary artery
  • drain into the supraclavicular nodes
  • — surpraclavicular nodes –> subclavian lymphatic trunk –> venous system
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15
Q

Spinal Nerve Plexuses

A
  • Cervical: C1 - C4
  • Brachial: C5 - T1
  • — in the axilla
  • Lumbar: L1 - L4
  • Sacral: L4 - S4
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16
Q

Brachial Plexus

A
  • Formed by the ventral rami of spinal nerves C5, C6, C7, C8, and T1
  • — those nerves are made of posterior roots (sensory) and anterior roots (motor)
  • — so the brachial plexus is mixed (both motor and sensory)
  • —- the rami all twist together to form one brachial plexus
  • Brachial Plexus breaks up into a bunch of nerves that travel throughout the arm
  • — innervation of entire upper extremity is derived from brachial plexus
  • — individual arm nerves are carrying fibers from several spinal cord levels because the brachial plexus is formed from many rami
17
Q

Brachial Plexus: Branching Pattern

A
  • Roots –> Trunks –> Divisions –> Cords –> Branches (Terminal)
  • “Randy Travis Drinks Cold Beer”
18
Q

Brachial Plexus: Branching Pattern

  1. Roots
  2. Trunks
A
    • from spinal nerves
      - — are the ventral rami
      - — so we start with 5 roots bc we have 5 ventral rami
  2. (+) = add nerves together
    - combination of roots
    - 3 trunks
    - — superior (C5 + C6)
    - — middle (C7)
    - — inferior (C8 + T1)
19
Q

Brachial Plexus: Branching Pattern

  1. Divisions
  2. Cords
A
  1. (-) = divide nerves apart
    - each trunk divides into anterior and posterior divisions
    - so there are 6 divisions
    - — 3 trunks, each splits in 2
  2. (+) = add nerves together
    - formed by combinations of divisions
    - 3 cords form from 6 divisions
    - Medial, Lateral, Posterior
    - — terms refer to the nerves position relative the axillary artery
    - —- Posterior: from the posterior divisions of the three trunks
    - — Lateral: from the anterior divisions of the superior and middle trunks
    - — Medial: from the anterior division of the inferior trunk
20
Q

Brachial Plexus: Branching Pattern

5. Terminal Branches

A
  1. (-) = divide nerves apart
    - two nerves from each cord, but two combine
    - —- 5 nerves total
    - Lateral Cord —> Musculocutaneous nerve + 1/2 of the Median Nerve
    - Posterior Cord —> Axillary Nerve and Radial Nerve
    - Medial Cord —> 1/2 of the Median Nerve + Ulnar Nerve
21
Q

Brachial Plexus in Relation to the Clavicle

A
  • Part is above the clavicle
  • — in the neck region
  • — supraclavicular part of the brachial plexus
  • Runs under the clavicle
  • Part is below the clavicle
  • — in the armpit
  • — infraclavicular part
22
Q

Supraclavicular Branches of the Brachial Plexus

A
  • additional branches
  • — come off of roots or trunks
  • Dorsal Scapular Nerve (C5)
  • Long Thoracic Nerve (C5-C7)
  • — goes down throughout the chest
  • Suprascapular Nerve (C5-6)
  • Nerve to the Subclavius (C5-6)
23
Q

Infraclavicular Branches of the Brachial Plexus

A
  • additional branches
  • — come off of cords
  • Lateral Cord –> lateral pectoral Nerve
  • Medial Cord –> medial pectoral, medial brachial cutaneous, medial antebrachial cutaneous
  • — the cutaneous nerves are the only sensory nerves in the brachial plexus
  • Posterior Cord –> upper subscapular, lower subscapular, thoracodorsal
24
Q

Nerves and Corresponding Muscles: Supraclavicular

  1. Long Thoracic Nerve
  2. Dorsal Scapular Nerve
  3. Suprascapular Nerve
  4. Nerve to the Subclavius
A
  1. serratus anterior muscle
  2. rhomboid major, rhomboid minor, levator scapularis
  3. supraspinatus, infraspinatus
  4. subclavius
25
Q

Terminal Branches and Corresponding Muscles

  1. Axillary
  2. Musculocutaneous
A
  1. deltoid and teres minor

2. biceps brachii, brachialis, coracobrachialis

26
Q

Median Nerve and Branches with Corresponding Muscles: Forearm

A
  • 6 1/2 muscles
  • – Pronator Teres
  • – Flexor Carpi Radialis
  • – Palmaris Longus
  • – Flexor Digitorum Superficialis
  • – Flexor Digitorum Profundus (1/2)
  • – Flexor Pollicis Longus
  • – Pronator Quadratus
27
Q

Nerves and Corresponding Muscles: Infraclavicular

  1. Lateral Pectoral
  2. Medial Pectoral
  3. Upper Subscapular
  4. Lower Subscapular
  5. Thoracodorsal
A
  1. pectoralis major
  2. pectoralis major and minor
  3. subscapularis
  4. subscapularis and teres major
  5. latissimus dorsi
    - NB: the medial brachial cutaneous and medial antebrachial cutaneous nerves are sensory only - no muscle innervation
28
Q

Median Nerve and Branches with Corresponding Muscles: Hand

A
  • intrinsic muscles
  • Lumbricals 1 and 2
  • Muscles of the Thenar Group
29
Q

Ulnar Nerve and Corresponding Muscles

A
  • Forearm (1 1/2 Muscles)
  • — Flexor Carpi Ulnaris
  • — Flexor Digitorum Profundus (1/2)
  • Hand: all remaining intrinsic hand muscles
  • — those not supplied by the median nerve
30
Q

Radial Nerve and Branches with Corresponding Muscles

A
  • all posterior compartment muscles of the arm and forearm

- no muscles in the hand

Gross Anatomy (14 decks)

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