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MED221A/B Lectures > MSK 05 - The axilla and brachial plexus > Flashcards

MSK 05 - The axilla and brachial plexus Flashcards

1
Q

what makes up the three borders of the apex of the axilla

A

clavicle

superior border of scapula

1st rib

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2
Q

what are the two muscles denoted on the 1st rib/medial boder of the apex of the axilla

A

ant and mid scalene muscles

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3
Q

how do the venous drainage, arterial supply and nerves run in relation to the scalene muscles

A

venous drainage runs out infront of the ant scalene muscle

arterial and nerve supply runs between the ant and mid scalene muscles

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4
Q

where is the axilla in terms of what structures does it sit between

A

between chest wall and free limb

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5
Q

what two walls join together to form the lateral wall of the axilla

A

anterior and posterior

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6
Q

what makes up the base of the axilla

A

the axillary fascia

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7
Q

what muscle(s) denote the medial wall of the axilla

A

serratus anterior

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8
Q

what anatomy(s) denote the lateral wall of the axilla

A

floor of the intertubercular groove

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9
Q

what muscle(s) and anatomy denote the posterior wall of the axilla (4)

A

latissimus dorsi

teres major

subscapularis

superior border of scapula

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10
Q

in the axial view what muscle(s) denote the anterior wall of the axilla (2)

A

pectoralis major

short head of biceps and coracobrachialis

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11
Q

in the sagittal view what anatomy and muscle(s) denote the anterior wall of the axilla (5)

A

subclavius

pectoralis minor and major

clavicle

costocoracoid ligament and membrane

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12
Q

what landmark denotes the change from axillary to subclavian and vice versa

A

the medial border of the 1st rib infront of the ant scalene muscle

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13
Q

what landmark denotes the change from axillary to brachial and vice versa

A

after passing below teres major

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14
Q

what spinal levels contribute to the brachial plexus for everyone

what are levels that some people have and others dont

A

C5-T1 for everyone

some have C4 and T2

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15
Q

describe the passage of anatomy from spinal cord to the anterior rami (4parts to it)

A

spinal cord -> posterior/dorsal and anterior/ventral rootlets -> posterior/dorsal (sensory) and anterior/ventral roots (motor) -> spinal nerve (mixed sensory and motor) -> intervertebral foramen -> posterior rami (back), rami communicans (ANS sympathetic chain), or anterior rami (root of plexus)

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16
Q

at what point along the spinal cord to the anterior rami defines the change from CNS to PNS

A

at the intervertebral foramen

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17
Q

what is the progression of roots to terminal branches and how many of each are there

A

5 roots -> 3 trunks -> 6 divisions -> 3 cords -> 7 terminal branches

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18
Q

from the roots to the terminal branches describe them in relation to the clavicle

A

supraclavicular = roots and trunks

clavicle level = divisions

infraclavicular (axilla level) = cords and terminal branches

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19
Q

what roots make up the superior trunk

A

C5 and C6

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20
Q

what roots make up the middle trunk

A

C7

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21
Q

what roots make up the inferior trunk

A

C8 and T1

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22
Q

what roots does the long thoracic nerve come off

A

C5 and C6 and C7

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23
Q

what smaller nerve comes off C5 and C6

A

long thoracic nerve

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24
Q

what trunk does the C5 and C6 roots produce

A

superior

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25
Q

what trunk does the C7 roots produce

A

middle

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26
Q

what trunk does the C8 and T1 roots produce

A

inferior

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27
Q

of the 3 cords which come off the anterior divisions and which come off the posterior divisions

A

lateral and medial cords - anterior divisions

posterior cord = posterior division

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28
Q

what is the smaller nerve that comes off the lateral cord

A

lateral pectoral nerve

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29
Q

what are the 3 smaller nerves that comes off the posterior cord

from closest to terminal branches to closer to divisions side

A

lower subscapular nerve, thoracodorsal nerve, upper subscapular nerve

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30
Q

what are the 3 smaller nerves that comes off the medial cord

from closest to terminal branches to closer to divisions side

A

medial cutaneous nerve of arm, medial cutaneous nerve of forearm, medial pectoral nerve

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31
Q

what cords give off the musculocutaneous nerve

A

lateral

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32
Q

what cords give off the axillary nerve

A

posterior

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33
Q

what cords give off the radial nerve

A

posterior

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34
Q

what cords give off the median nerve

A

medial and lateral

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35
Q

what cords give off the ulnar nerve

A

medial

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36
Q

what are the cords named in relation to

A

the axillary artery

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37
Q

where does the smaller lateral pectoral nerve come off in the brachial plexus

A

lateral cord

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38
Q

where does the smaller medial pectoral nerve come off in the brachial plexus

A

medial cord

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39
Q

where does the smaller musculocutaneous nerves of the arm and forearm come off in the brachial plexus

A

medial cord

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40
Q

where does the smaller thoracodorsal nerve come off in the brachial plexus

A

posterior cord

41
Q

where does the smaller upper and lower subscapular nerves come off in the brachial plexus

A

posterior cord

42
Q

what trunks make up the lateral cord

A

anterior superior and middle trunks

43
Q

what trunks make up the medial cord

A

anterior inferior trunk

44
Q

where does the smaller suprasapular nerve come off in the brachial plexus

A

superior trunk

45
Q

where does the smaller subclavicular nerve come off in the brachial plexus

A

superior trunk

46
Q

what are the 3 arm muscles innervated by the musculocutaneous nerve

A

coracobrachialis

biceps brachii

brachialis

47
Q

which arm compartment does the musculocutaneous nerve innervate

A

anterior compartment

48
Q

once the musculocutaneous nerve has fulfilled its motor supply what sensory component of the cutaneous component is it named

A

lateral cutaneous nerve of forearm

49
Q

which areas of skin does the lateral cutaneous nerve of forearm supply

A

skin on lateral side of anterior and posterior forearm

50
Q

what muscles in the arm does the median nerve innervate

A

nothing in the arm

51
Q

what 7 muscles in the forearm does the median nerve innervate

A

pronator teres

flexor carpi radialis

palmaris longus

flexor digitorium superficialis

flexor digitorium profundus (radial side)

flexor pollicis longus

pronator quadratus

52
Q

what 5 muscles in the hand does the median nerve innervate

A

thenar muscles x3

1st and 2nd lumbricals

53
Q

what compartments does the median nerve innervate in the forearm

A

about 75% of the lateral side, anterior compartment

54
Q

what side does the median nerve innervate in the hand

A

around 25% of the lateral side

55
Q

what is the median nerves cutaneous distribution on the anterior side

A

first 3 digits and half of 4th digit of the anterior hand and the finger tips of digits 1-3 and half of 4 on the posterior side of the hand

56
Q

what is the ulnar nerves cutaneous distribution on the anterior side

A

5th digit and half of 4th digit both anteriorly and posteriorly on the hand

57
Q

what 2 muscles in the forearm does the ulnar nerve innervate

A

flexor carpi ulnaris

flexor digitorum profundus (ulnar side)

58
Q

what 4 muscles in the hand does the ulnar nerve innervate

A

3 hypothenar muscles

palmaris brevis

all dorsal and palmar interossei

3rd and 4th lumbricals

59
Q

what compartments does the ulnar nerve innervate in the forearm

A

about 25% of the medial side, anterior compartment

60
Q

what compartments does the ulnar nerve innervate in the hand

A

about 75% of the medial side of the hand

61
Q

what 2 muscles does the axillary nerve innervate

A

teres minor

deltoid

62
Q

what is the cutaneous distribution of the superior lateral cutaneous nerve of arm

A

oblique stripe running down posterior of humeral neck area

63
Q

once the axillary nerve has fulfilled its motor supply what sensory component of the cutaneous component is it named

A

superior lateral cutaneous nerve of arm

64
Q

What are the 5 muscles of the arm that are innervated by the radial nerve

A

Lateral head of triceps

Long head of triceps

Medial head of triceps

Anconeus

Brachiaoradialis

65
Q

What are the 10 muscles of the forearm that are innervated by the radial nerve

A

Extensor carpi radialus longus

Extensor carpi radialus breves

Supinator

Extensor digitorum

Extensor carpi ulnaris

Extensor pollicis longus

Extensor indicis

Abductor pollicis longus

Extensor pollicis brevis

66
Q

What compartment of the arm does the radial nerve innervate

A

Posterior

67
Q

What compartment of the forearm does the radial nerve innervate

A

Posterior

68
Q

What part of the hand does the radial nerve innervate

A

Radial nerve does not innervate anything in the hand

69
Q

What part of the arm and forearm and hand does the radial nerve’s cutaneous distribution supply

A

Middle stripe of posterior arm and forearm

Back of hand excluding the 5th and half of 4th digit and the fingertips of the1st to half of 4th digit

70
Q

What do lymph nodes produce

A

White blood cells

71
Q

What is lymph

A

Fluid lost from capillaries is never fully recovered and this excess tissue fluid is collected by lymph system and returns it to the nervous system

72
Q

What vein along the Axilla facilitates mild lymph drainage

A

Cephalon vein

73
Q

Most of the lymph from the free limb is collected in which node

A

Humeral/brachial node

74
Q

What are the 3 distal lymph nodes in the axilla

A

Humeral/brachial node

Subscapular nodes

Pectoral nodes

75
Q

Most of the lymph from the breast drains into which node

A

Pectoral node

76
Q

What aren sentinel nodes

A

Biopsy made in these nodes to check that cancer isn’t spreading eg pectoral node

77
Q

What do the Humeral/brachial nodes, subscapular nodes and pectoral nodes drain into

A

Central nodes

78
Q

What does the central node feed into

A

Apical nodes

79
Q

the axillary artery is divided into three sections based on what borders of which muscle

how many arterial branches come off each section

A

divided by superior border of pec min and inferior border of pec min

section 1 (closest to subclavian) = 1 branch
section 2 = 2 branch
section 3 (closest to brachial artery) = 1 branch

80
Q

what is the artery that branches off from the first section (closest to the subclavian) of the axillary artery

A

supreme/superior thoracic artery

81
Q

what are the two artery branches that come off the middle section (section 2) of the axillary artery

A

thoracoacromial artery (more proximal)

thoracic artery (more distal)

82
Q

what is the arterial branch coming off section 3 of the axillary artery

A

subscapular artery

83
Q

which part of the body does the superior thoracic artery supply

A

upper medial wall of the axilla

84
Q

which part of the body does the pectoral branch of the thoracoacromial artery supply

A

anterior wall of axilla

85
Q

which part of the body does the subscapular artery supply

A

posterior wall of the axilla

86
Q

which part of the body does the lateral thoracic artery supply

A

lower medial wall of the axilla

87
Q

what artery supplies the upper medial wall of the axilla

A

superior thoracic artery

88
Q

what artery supplies the anterior wall of the axilla

A

pectoral branch of thoracoacromial artery

89
Q

what artery supplies the posterior wall of the axilla

A

subscapula artery

90
Q

what artery supplies the lower medial wall of the axilla

A

lateral thoracic artery

91
Q

what are the two branches that come off the thyrocervical trunk (branches off the subclavian artery)

A

dorsal scapular artery (more superior)

suprascapular artery (more inferior of the two)

92
Q

what do the dorsal scapular artery and suprascapular artery anastomose with

A

circumflex humerus artery

93
Q

what artery supplies the base of the axilla

A

thoracodorsal artery from the subscapular artery

94
Q

what does the thoracodorsal artery stem off and what does it supply

A

stems off subscapular artery

supplies the base of the axilla

95
Q

what does the circumflex scapular artery stem off and what does it supply

A

stems off subscapular artery

supplies the back of the scapula

96
Q

what are the two small branches that come off the axillary artery that wrap around the humerus

A

anterior and posterior circumflex humeral arteries

97
Q

what does the circumflex humeral arteries supply

A

lateral wall of the axilla

98
Q

which arteries supply the lateral wall of the axilla

A

anterior and posterior circumflex humeral arteries

99
Q
A

MED221A/B Lectures (23 decks)

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