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Module 204: Musculoskeletal system > Nerve and blood supply to upper limb > Flashcards

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
Q

Motor innervations of brachial plexus roots

C5-T1

A

C5- Shoulder
C6- Flexors in arm
C7- Extensors in arm

C7/8- Flexor and extensor of forearm
T1- Arm intrinsics

26
Q

Brachial plexus trunks

A

Passes trough scalene triangle

Divided into

  • Superior (C5-6)
  • Middle (C7)
  • Inferior (C8-T1)

Superior trunk–> suprascapular nerve

27
Q

Suprascapular nerve

A

Arises from the superior trunk of the brachial plexus

Supplies

  • Supraspinatus
  • Infraspinatus
28
Q

Divisons of the brachial plexus

A

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
Q

Cords of the brachial plexus

A

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
Q

Lateral cord terminates as…

A

Musculocutaneous nerve

Median nerve (w/ median cord)

31
Q

Musculocutaneous nerve

A

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
Q

Medial cord

A

Composed of the anterior division of the inferior trunk.

Terminates as

  • Ulnar nerve
  • Median nerve (w/ lateral cord)
33
Q

Medial nerve

A

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
Q

Ulnar nerve

A

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
Q

Posterior cord termination

A

Radial nerve

Axillary nerve

Posterior cord
- Posterior divisions of all trunks

36
Q

Radial nerve

A

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
Q

Axillary nerve

A

Terminal branch of posterior cord.
- Enters quadrangular space

Innervates

  • Motor to: Deltoid, teres minor
  • Sensory to: badge area of the arm.

Module 204: Musculoskeletal system (22 decks)

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