Nerve and blood supply to upper limb Flashcards

1
Q

Subclavian artery origins

A

Left SCA
- Arch of aorta

Right SCA
- Brachiocephalic trunk

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2
Q

Subclavian artery is divided by what muscle?

A

Scalenus anterior

- It passes through the scalene triangle

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3
Q

Scalene triangle

  • Borders
  • Structures that pass through it
A

Borders:

  • Lateral, scalene medius muscle
  • Medial, scalene anterior
  • Inferior, first rib

Structures that enter through

  • Subclavian artery
  • Brachial plexus (trunk)
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4
Q

Subclavian artery division

A

In relation to the scalene anterior

  • First part= medial
  • Second part= behind
  • Third part= Lateral
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5
Q

First SCA division

A

Gives rise to
- Vertebral artery

  • Thyrocervical trunk —> thyroid, cervical, supra-scapular (scapular anastomosis)
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6
Q

Dorsal scapular artery

A

Branch of SCA

  • 2nd or 3rd division
  • Contributes to scapular anastomosis/
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7
Q

Termination of the SCA

A

Terminates as axillary artery after crossing outer border of first rib.

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8
Q

Axillary artery division

A

In relation to the pectoralis minor muscle

  • First= medial
  • Second= behind
  • Third= lateral

First and second part associated with brachial plexus

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9
Q

Axillary artery termination

A

Terminates at the lower border of teres major to become the brachial artery.

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10
Q

Third division of axillary artery branches

A

Subcapular
- Part of scapular anastomosis

Anterior+ Posterior circumflex humeral artery
- To the surgical neck and shaft of the humerus

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11
Q

Fracture of humeral surgical neck

A

Can lead to trauma of the ant/post circumflex humeral artery.

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12
Q

Brachial artery

  • Supplies
  • Branch
  • Division
A

Located superficially
- Supplies flexors of the arm (bicep, brachialis etc)

Branch

  • Profunda brachii–> supplies extensors (triceps), anastomosis around elbow.
  • Runs along radial groove

Division- at cubital fossa.

  • Radial
  • Ulnar
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13
Q

Fracture to humerus

A

Can cause trauma to profunda brachii artery

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14
Q

Radial artery

  • Covered by..
  • Enters through…
  • Pierces what muscle?
  • Terminates at
A

Lateral in forearm, smaller than ulnar

Covered by brachioradialis muscle.

Enters through anatomical snuff box to the dorsal hand

Pierces through first dorsal interosseous muscle

Forms deep Palmer arch

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15
Q

Deep palmer arch

A

Arterial network that anastomoses with the ulnar artery

  • It is formed from the radial artery
  • Located below flexor tendons

Surface anatomy
- On an extended thumb, it is located on a line drawn from the distal border of the thumb across the palm.

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16
Q

Ulnar artery

  • Covered by..
  • Deep branch
  • Terminates at
A

Medial of forearm, larger than radial.

Covered by flexor carpi ulnaris muscle.

Branch- common interosseous artery
- Supplies muscle in the forearm

Terminates at superficial palmar arch

17
Q

Superficial palmar arch

A

Terminal arterial network of the ulnar artery
- Located above flexor tendons

Gives rise to palmar digit arteries

Surface anatomy
- One finger breath distal from deep palmar branch.

18
Q

Deep veins

A

Vanae comintantes
- Paired veins

Drain into axillary vein ultimately

19
Q

Superficial arm veins

A

Drains from dorsal venous arch
- Cephalic (lateral). Runs within deltopectoral groove.

  • Basilic (medial)
  • Joined by median cubital vein (where blood is common taken from)

Ultimately drain to axillary veins

20
Q

Lymph nodes

A

Axillary nodes
- Into axillary vein

Cubital nodes
- Into basilic vein

Deltopectoral node
- Into cephalic vein

21
Q

Brachial plexus

A

Mixed nerves to the upper limbs

  • Motor, sensory and sympathetic fibres
  • Axons from multiple spinal nerves

Divisons

  • Roots
  • Trunks
  • Divisions
  • Cords
  • Terminals
22
Q

Brachial plexus roots

A

C5-T1 ventral primary rami

23
Q

Dorsal scapular nerve

A

Originates from C5 of brachial plexus nerve root.

Supplies

  • Rhomboids
  • Levator scapulae
24
Q

Long thoracic nerve

A

Roots C5-7 of brachial plexus

- Supplies serratus anterior

25
Motor innervations of brachial plexus roots | C5-T1
C5- Shoulder C6- Flexors in arm C7- Extensors in arm C7/8- Flexor and extensor of forearm T1- Arm intrinsics
26
Brachial plexus trunks
Passes trough scalene triangle Divided into - Superior (C5-6) - Middle (C7) - Inferior (C8-T1) Superior trunk--> suprascapular nerve
27
Suprascapular nerve
Arises from the superior trunk of the brachial plexus Supplies - Supraspinatus - Infraspinatus
28
Divisons of the brachial plexus
Divide from the trunk- anterior and posterior Anterior division, from middle and superior trunk - Forms Lateral cord Anterior division, from inferior trunk - Forms medial cord Posterior divisions from all trunks - Forms posterior cord Anterior divisions - Supply flexor muscles Posterior divisions - supply extensors
29
Cords of the brachial plexus
Described in relation to the axillary artery - Lateral (anterior divisions of superior and middle trunk) - Posterior (posterior divisions of all trunks) - Medial (anterior division of inferior trunk) Located under pectoralis minor muscle.
30
Lateral cord terminates as...
Musculocutaneous nerve Median nerve (w/ median cord)
31
Musculocutaneous nerve
Terminal branch of the lateral cord. (C5-6) Innervates - Motor supply: Coracobrachialis (which it pierces), biceps brachii, brachialis. - Sensory: lateral forearm, via lateral cutaneous nerve of the forearm (at the elbow)
32
Medial cord
Composed of the anterior division of the inferior trunk. Terminates as - Ulnar nerve - Median nerve (w/ lateral cord)
33
Medial nerve
From medial and lateral cord - C8-T, C5-C7. Innervates - Motor to: Anterior forearm and hand EXCEPT flexor carpi ulnaris. - Sensory to: Lateral palm of hand, digits 1-3, half of 4
34
Ulnar nerve
Terminal branch of the medial cord - C8-T1 - Transverses through cubital tunnel (funny bone) Innervates - Motor to: medial anterior forearm and hand, including flexor carpi ulnaris - Sensory to: Medial hand, digits half 4 and 5.
35
Posterior cord termination
Radial nerve Axillary nerve Posterior cord - Posterior divisions of all trunks
36
Radial nerve
Terminal branch of the posterior cord. (C5-6, C7, C8-T1) - Runs along spiral groove of humerus ``` Innervates - Motor (deep branch) to: Posterior arm, forearm (Extensors) Triceps Supinator Brachioradialis ``` - Sensory (superficial branch) to: Posterior arm, forearm, lateral dorsum hand.
37
Axillary nerve
Terminal branch of posterior cord. - Enters quadrangular space Innervates - Motor to: Deltoid, teres minor - Sensory to: badge area of the arm.