Module 5: The Back and Axilla Flashcards
Parts of the sacrum
-sacral canal
-sacral foramina
-sacral cornua
-promontory
Sacral canal
-continuation of vertebral canal terminating at sacral hiatus
Sacral foramina
-located lateral to fused sacral bodies on both anterior and posterior surface
How many sacral foramina are there
-4
Sacral cornua
-2 bony processes that can be palpated by clinicians as an anatomical landmark
Promontory
-upper border articulates with L5 vertebral body
-it projects forwards, decreasing the anteroposterior diameter of pelvic brim
Why is promontory considered important in women
-to measure size of pelvis
The coccyx
-composed of 4 fused rudimentary coccygeal vertebrae, which articulate with sacrum superior at sacrococcygeal joint
What happens at coccyx when sitting
-small and variable amount of flexion and extension occurs at sacrococcygeal joint
What happens to vertebral foramina going further down column
-they get smaller
Accessory ligaments of the vertebral column
-ligamentum flavum
-anterior longitudinal ligament
-posterior longitudinal ligament
Function of accessory ligaments of vertebral column
-flexion and extension of back
Lumbar spinal stenosis
-narrowing of vertebral canal in lumbar region
-may be caused by extra bone and/or tissue growth in vertebral canal from calcification of ligamentum flavum
Lumbar spinal stenosis symptoms
-numbness and weakness in lower limb
-pain in lower back
-worse with weight bearing
-relieved when bending forward
Extrinsic muscles of the back
-latissimus dorsi
-trapezius
-rhomboid minor
-levator scapulae
-rhomboid major
Parts of the latissimus dorsi
-thoracolumbar fascia
-insertion point
Thoracolumbar fascia of latissimus dorsi
-made form multiple crosshatched layers of collagen, plays an important role in stabilization and load transfer
Insertion point of latissimus dorsi
-intertubucular sulcus (bicipital groove) of humerus
Latissimus dorsi strain
-can be caused by overuse
Who is at higher risk of latissimus dorsi strain
-those with poor posture
Latissimus dorsi strain symptoms
-lower back pain that radiates to scapula
-pain and discomfort with lateral flexion of back
-as well as with extension, adduction, or rotation of arm
Erector spinae muscles
-iliocostalis
-longissimus
-spinalis
Iliocostalis
-most lateral
Longissimus
-middle
Spinalis
-most medial
Divisions of the iliocostalis muscle
-cervicis
-thoracis
-lumborum
Where would pain be felt for an iliocostalis muscle strain
-along medial border of scapula and posterior thorx
-anterior thorax is strained muscle irritates underlying intercostal nerves
-can also be felt in the sacroiliac region
The axilla
-armpit
Axilla function
-passageway for major nerves and blood vessels to enter and leave upper limbs
Borders of axilla
-anterior wall
-posterior wall
-medial wall
-lateral wall
-apex
-base
Anterior wall of axilla
-pectoralis major
Posterior wall of axilla
-subscapularis
-latissimus dorsi
-teres major
Medial wall of axilla
-serratus anterior
Lateral wall of axilla
-intertubercular surface of humerus
Apex of axilla
-base of neck
Base of axilla
-skin of armpit
Contents of the axilla
-axillary lymph nodes
Axillary lymph nodes function
-drain the breast
The brachial plexus parts
-roots
-trunks
-divisions
-cords
-branches
Roots of the brachial plexus
-ventral rami of spinal nerves C5-T1
Trunks of the brachial plexus
-superior
-middle
-inferior
Divisions of the brachial plexus
-each trunk branches into 6 divisions
-3 anterior and 3 posterior
Cords of the brachial plexus
-after divisions enter the axilla, they combine together to form 3 cords
-named by position
-medial, lateral, and posterior
Branches of brachial plexus
-musculocutaneous
-radial
-axillary
-ulnar
-median
Musculocutanous nerve
-motor innervation of anterior compartment
-flexion
Radial nerve
-motor innervation of posterior compartment
-extension
Axillary nerve
-motor innervation to deltoid (abduction) and teres minor (lat rotation)
Ulnar nerve
-motor innervation of 2 muscles of anterior compartment of forearm and most intrinsic muscles of hand
Median nerve
-motor innervation of most of anterior compartment of forearm as well as 5 intrinsic muscles of hand
Arterial supply of the upper limb
-subclavian artery
-axillary artery
-brachial artery
-radial and ulnar artery
What is the clinical application of the radial pulse
-can check the pulse at the wrist
Axillary artery damage symptoms
-bruising caused by pooling of blood under skin
-swelling/redness
-elevated temperature
-weak pulse
Venous drainage of the upper limb
-radial vein
-ulnar vein
-cephalic vein
-basilic vein
-medial cubital vein
-brachial vein
-axillary vein
Radial vein
-drains blood from structures of palm and lateral aspect of forearm
Ulnar vein
-drains blood from deep structures of palm and medial aspect of forearm
Cephalic vein
-ascends on lateral anterior forearm and arm to drain into axillary vein
Basilic vein
-ascends on medial side of forearm and arm to become axillary vein
Medial cubital vein
-connects basilic and cephalic veins and is often site of venipuncture for drawing blood
Brachial vein
-receives blood from radial and ulnar veins and drains into axillary vein
Axillary vein
-continuation of basilic vein becomes subclavian vein as it crosses lateral border of first rib
