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year 2 - t3 theme 2 > Nerve and blood supply to the upper limb > Flashcards

Nerve and blood supply to the upper limb Flashcards

1
Q

Main arterial supply to the upper limb

A
  • Subclavian artery supplies the upper limb
  • Right –> from brachiocephalic trunk
  • Left –> from arch of the aorta
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2
Q

What does the subclavian artery pass through

A
  • Passes through scalene triangle (over first rib)
  • Divided into 3 parts by scalenus anterior:
    1. Medial to muscle
    2. Behind muscle
    3. Lateral to muscle
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3
Q

Anatomical course - Aortic arch –> digital arteries

A

Aortic arch –> brachiocephalic trunk –> right common carotid + right subclavian –> right subclavian –> right axillary –> right brachial –> right radial + ulnar –> digital arteries

Aortic arch –> left subclavian –> left axillary –> left brachial –> left radial + left ulnar –> digital arteries

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4
Q

What does the dorsal scapular artery supply (from 2nd or 3rd part)

A
  • Contributes to scapular anastomosis
  • Supplies the levator scapulae, rhomboids and trapezius
  • Dorsal scapular artery arises from the subclavian
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5
Q

What does thyrocervical trunk supply

A
  • Thyrocervical trunk(to thyroid, cervical, scapular)

- Contributes to scapular anastomosis

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6
Q

Where does the subclavian artery end

A
  • Ends as it crosses outer border of first rib

- Becomes axillary artery

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7
Q

What does the axillary artery divide into

A

Divided into three parts by pec minor:
1st Medial to muscle
2nd Behind muscle
3rd Lateral to muscle

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8
Q

What are the first and second parts of the axillary artery associated with

A
  • Brachial plexus
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9
Q

Where does the axillary artery end

A
  • Ends at lower border of teres major
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10
Q

What does the axillary artery become

A
  • Becomes brachial artery
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11
Q

What can fractures to the surgical neck of humans cause trauma to

A
  • Ant/post circumflex humeral
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12
Q

Features of the brachial artery

A
  • Superficial throughout arm
  • Large branch - profunda brachii artery
  • Contributes to anastomosis around elbow
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13
Q

What does the brachial artery supply

A
  • Supplies flexors
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14
Q

What does the brachial artery divide into

A
  • Divides in cubital fossa to form the radial artery + ulnar artery
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15
Q

What does the profunda brachii artery accompany

A
  • Accompanies radial nerve in spiral groove
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16
Q

What is the quadrangular space

A

It is an intermuscular space through which the axillary nerve and posterior circumflex humeral vessels pass through backwards to encircle the surgical neck of the humerus.

It is bounded above by subscapularis and teres minor and below by teres major.

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17
Q

What is a fracture to the humerus likely to damage

A
  • Trauma to profounda brachii artery
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18
Q

Features of the radial artery

A
  • Lateral side of forearm
  • Smaller of the two terminal branches
  • Covered by brachioradialis muscle
  • Forms deep palmer arch
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19
Q

Path of the radial artery in the hand

A
  • At wrist, winds around to dorsum of hand through anatomical snuff box
  • Pierces first dorsal interosseous muscle
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20
Q

Features of ulnar artery

A
  • Medial side of forearm
  • Covered by flexor carpi ulnaris muscle
  • Deep branch - common interosseous artery
  • Forms superficial palmar arch
21
Q

Features of venous return from the hands

A
  • Considerably variable
  • Drains into axillary into subclavian vein

Deep veins - paired veins + venae comitantes

Superficial veins - cephalic(lateral forearm), basilic(medial forearm)
From dorsal venous arch

22
Q

What do the cephalic and basilic veins drain into

A
  • Axillary vein
23
Q

Features of lymphatic drainage in the upper limb

A
  • Relatively few lymph nodes in upper limb

- Lymph drains to axillary nodes

24
Q

Lymph nodes in the upper limbs

A
  • Deltopectoral node (cephalic vein)
  • Axillary nodes (axillary vein)
  • Cubital nodes (basilic vein)
25
Q

Features of the brachial plexus

A
  • Nerve supply to the upper limb
  • Carries motor, sensory and sympathetic axons
  • Produces mixed nerves (i.e. contains axons from multiple spinal nerves) - important to supply large muscle groups
26
Q

What is the brachial plexus divided into

A
  • Roots, trunks, division and cords

= mixed nerves

27
Q

Brachial plexus roots

A
  • Roots are ventral parimary rami of C5-T1

- Motor axons within each root innervate a different functional group of muscles (myotomes)

28
Q

C5 root innervation

A
  • Shoulder abduction and adduction
29
Q

C6/7 root innervation

A
  • Elbow flexion and extension
30
Q

C7/8 root innervation

A
  • Wrist flexion and extension
31
Q

C8/T1 root innervation

A
  • Movement of the digits
32
Q

What do brachial plexus roots form

A
  • Roots form trunks
  • C5 + C6 –> Superior
  • C7 –> Middle
  • C8 + T1 –> Inferior
33
Q

What do brachial plexus trunks pass through

A
  • Scalene triangle
34
Q

What does each brachial plexus trunk divide into

A
  • Each trunk divides into anterior and posterior divisions
  • Anterior: Axons to flexor compartments (forms lateral and medial cords)
  • Posterior: Axons to extensor compartments (forms posterior cord)
35
Q

Location of cords of brachial plexus

A
  • Under pectoralis minor
36
Q

What are the cords of the brachial plexus named in relation to

A
  • Cords named in relation to axillary artery

- Lateral, posterior, medial

37
Q

What does the lateral cord terminate as

A

Terminates as: Musculocutaneous nerve

- Lateral part of median nerve

38
Q

Divisions of the musculocutaneous nerve

A

Motor - anterior arm

Sensory - Lateral forearm

39
Q

What does the medial cord terminate as

A
  • Medial part of median nerve

- Ulnar nerve

40
Q

Divisions of the median nerve

A

Motor - anterior forearm and lateral hand

Sensory - Lateral palm hand, d1, 2, 3 + half d4

41
Q

Divisions of the ulnar nerve

A

Motor - medial side anterior forearm and hand

Sensory - medial hand + half d4 + d5

42
Q

What does the posterior cord terminate as

A
  • Radial nerve

- Axillary nerve

43
Q

Divisions of the radial nerve

A
  • Deep branch (motor)
  • Superficial branch (sensory)
    Motor - posterior arm and posterior forearm
    Sensory - posterior arm and posterior forearm + lateral dorsum hand
44
Q

Branches of the axillary nerve

A

Motor - deltoid and teres minor

Sensory - badge area of arm

45
Q

What are upper limb dermatomes

A

‘An individual area of skin innervated by a single spinal nerve.’

  • Established during development
  • Lots of overlap/variation
46
Q

What does altered sensation in the region of a dermatome indicate

A
  • Indicates damage to specific spinal nerve of spinal cord segment (i.e. proximal nerve injury)
47
Q

Why does the cutaneous innervation map look different to the dermatome map

A
  • Terminal branches contain axons from multiple spinal nerve
  • Altered sensation in one of these areas indicates damage to a more distal nerve segment (i.e distal nerve injury)
48
Q

What is the expansion of the tendon of biceps

A
  • An expansion of the tendon of biceps, the bicipital aponeurosis, crosses medially over the superficial flexors of the forearm and attaches to the posterior border of the ulna via the deep fascia
  • As biceps crosses both the shoulder joint and the elbow joint, it exerts its flexor action on both joints

year 2 - t3 theme 2 (17 decks)

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