Neurovascular Supply to the Upper Limb Flashcards
Where does the subclavian artery become the axillary artery?
After the 1st rib
Where does axillary artery end?
Inferior border of the teres major
What comes off the brachial artery?
Circumflex of the humerus going around humeral neck
Profunda brachii (deep artery of the arm going posteriorly)
collateral vessels going to elbow (radial inferior and superior ulnar)
What is the role of collateral vessels?
No matter what the position of the elbow and joint, you will still get blood flow to the forearm
Which compartment are the radial and ulna arteries in?
Both anterior
What runs between the radial and ulna arteries?
Anterior interosseous artery
Which arteries arise to which palmar arch?
Ulna artery arises to superficial palmar arch
Radial artery arises to deep palmar arch
What comes off the palmar arches?
Palmar arches anastomose and become digital branches
Where is the branchial pulse felt?
Mid shaft of the humerus or more easily in cubital fossa?
Where do the deep veins run?
In the muscular compartments and have same name as arteries
Where do the superficial veins run?
In superficial fascia
Where does your basilic vein run?
Down medial line of upper arm
Where does your cephalic vein run
Between pectoralis major and minor
Where do the basilic and cephalic veins join?
In cubital fossa by median cubital vein
What is the brachial plexus?
major network of nerves which provides sensory and motor innervation to the upper limb.
What spinal roots make up the brachial plexus?
C5-T1
What is the pathway of the brachial plexus?
see diagram…
What are the subdivisons of the brachial plexus?
Reach to drink cold beer
Roots trunk divisons cords branches
What are the names of the 3 trunks and where do they stem from?
Superior - C5 & C6
Middle - C7
Inferior - C8 & T1
What are the 3 cords?
Lateral, posterior, medial
What are the 5 branches and what are there roots?
Musculacutaneous - C5 and C7 Axillary - C5-C6 Median - C5-T1 Radial - C5-T1 Ulnar - C8-T1
What muscles does the musculocutaneous nerve supply?
Biceps brachialis
Brachialis
Coracobrachialis
What do the sensory fibres of the musculocutaneous arm inervate?
Sensory fibres innervate the skin of the lateral forearm
Why is damage to the musculocutaeous rare?
Very short pathway, especially to brachilais so not much chance that it will be damaged
Which compartment does the musculocutaneous nerve supply?
BBC - in anterior compartment
Where does the axillary nerve run
underneath shoulder to get posteriorly to deltoid and teres minor
What does the axillary nerve innervate?
motor innervation to deltoid and teres minor
What is the sensory innervation of the axillary nerve?
sensory innervation to the skin over the deltoid muscle.
When is axillary nerve damaged?
in shoulder dislocation or fracture of humeral neck.
What does damage to axillary nerve result in?
Resulting in a loss of shoulder abduction beyond 15 degrees, and a sensory loss on the lateral aspect of the proximal part of the arm
Where does the median nerve run?
The median nerve runs medial to biceps brachii with the brachial artery, and runs anteriorly at the cubital fossa to enter the forearm, the through carpal tunnel to reach hand
What does the media nerve supply?
majority of the flexor compartment of forearm
and muscles of the thumb
none of upper arm
What is the sensory innervation of the median nerve?
Sensory fibres innervate the skin over lateral palm, digits 1-3.5
Where does the radial nerve run?
posterior compartment of the arm and runs in the radial groove deep to triceps brachii
What does the radial nerve innervate?
all of the muscles on the posterior aspect of the arm and forearm
What is the sensory innervation of the radial nerve?
Sensory fibres innervate the skin over posterior arm to wrist, dorsal hand
Base of digits 1-3 & thumb
Where does the ulnar nerve run?
runs medially in the arm and passes posterior to the medial epicondyle of the humerus.
What does the ulnar nerve innervate?
Flexor carpi ulnaris and the ulnar half of flexor digitorum profundus in the forearm. In the hand the ulnar nerve innervates most of the intrinsic muscles of the hand.
What is the sensory innervation of the ulnar nerve?
innervate the skin over medial dorsal and plantar hand,
Digits 3.5 - 5
What is a symptom of ulnar nerve damage?
Clawing of the hands
What will a break in the superior trunk of the plexus affect?
affecting musculocutaneous axillary and some of median nerve
What condition can a break in the superior trunk cause?
Erb’s Palsy
What are the symptoms of Erb’s Palsy?
Adducted shoulder
Medially rotated arm
Extended elbow
excessive angle between the shoulder and neck
What is a condition of a break in the inferior plexus?
Klumpke Palsy
What are the symptoms of Klumpke Palsy?
Avulsion of the lower roots affects the small muscles within the hand, and a claw hand results.
What does the suprascapular nerve stem from?
Superior trunk, C5,6
What does the long thoracic nerve stem from?
C5,6,7
What does the thoracodorsal nerve stem from?
Posterior cord, C678
What does the long thoracic nerve supply/
Serratous anterior - keeps scapula in place otherwise get winged scapula
What does the suprascapular nerve supply?
Supraspinatus and infraspinatus
