neurovasculature of the upper limb

Question 1

Name the branches of the arteries in the upper limb (in order)

Answer 1

Subclavian artery

Axillary artery

Brachial artery

Radial artery

Ulnar artery

Question 2

Where does the subclavian artery originate from in the left and right arm

Answer 2

Left-arch of aorta

Right-brachiocephalic trunk

Question 3

When does the subclavian artery become the axilla

Answer 3

lateral border of the first rib

Question 4

What is formed around the surgical neck of the humerous and is prone to damage during a fracture?

Answer 4

Anterior and posterior circumflex humeral arteries

Question 5

When does the axilla become the brachial artery?

Answer 5

Lower border of the teres major muscle,

Question 6

Name an important branch of the brachial artery. What does it travel with and through where? What does it supply?

Answer 6

Profunda brachii

Travels with radial nerve- Through radial groove of humerous

Supplies structures in posterior aspect of the arm

Question 7

Where will you find the brachial pulse?

Answer 7

Medial to the distal tendon of biceps brachii. In the cubital fossa

Question 8

When does the brachial artery form the Radial and Ulnar arteries?

Answer 8

At the cubital fossa underneath bicipital aponeurosis

Question 9

What does the ulnar artery give rise to? What does this supply?

Answer 9

Gives rise to the anterior and posterior interosseous arteries, which supply deeper structures in the forearm.

Question 10

What does the ulnar and radial artery produce in the hand?

Answer 10

Deep and superficial palmer arch

Question 11

Which artery- radial or ulnar contributes the most to each palmer arch?

Answer 11

Ulnar- deep

Radial- superficial

Question 12

Where are the radial and ulnar pulses located?

Answer 12

Radial- Lateral to tendon of felxor carpi radialis

Ulnar- Lateral to tendon of flexor carpi ulnaris

Question 13

Which pulse out of the ulnar and radial, is easier to palpate and why?

Answer 13

Radial pulse is easier

Ulnar pulse runs deeper and lies under pisiform bone

Question 14

Where else can you palpate the radial pulse?

Answer 14

Anatomical snuff box

Question 15

What are collateral arteries? Name the 4 in the arm

Answer 15

They are found around joints to allow continuouse supply of blood during movments at the joint.

1. Anterior and posterior circumflex arteries
2. superior ulnar collateral artery
3. Inferior ulnar collateral artery
4. Radial collateral artery

Question 16

Name the superficial veins?

Which is more medial and which is more lateral?

Where are they located?

Answer 16

Basilic- Medial

cephalic - Lateral

Median antecubital- connects across anterior of cubital fossa

Located in the superficial fascia

Question 17

Name the deep veins

Which compartment are they located in?

Answer 17

Deep veins take the name of accompanying arteries

Subclavian artery and vein

Axillary artery and vein

Brachial artery and vein

Radial artery and vein

Ulnar artery and vein

Located in the deep fascia (muscular compartments)

Question 18

What is the brachial plexus? What is its function?

Answer 18

Network of nerves

Supplies sensory and motor innervation to the upper limb

Question 19

Draw and label the brachial plexus

Answer 19

Question 20

Where can the brachial plexus be palpated?

Answer 20

superior border of clavicle

Question 21

What are the fibers for the brachial plexus?

Answer 21

C5-T1

Question 22

What are the anterior branches of the brachial plexus?

Answer 22

Musculocutaneous

Median

Ulnar

Question 23

What are the posterior branches of the brachial plexus?

Answer 23

Axillary and radial

Question 24

What does the musculocutaneous nerve supply? Name the muscles and location of sensory innervation.

Answer 24

Flexor compartment of the arm

• Biceps brachialis
• Brachialis
• Coracobrachialis

Sensory to- lateral formarm

Question 25

Where on the skin is the sensory innervation for Musculocutaneous nerve?

Answer 25

Lateral forarm

Question 26

Which muscles does the axillary nerve suppy? Where is the sensory innervation?

Answer 26

Motor- Deltoid and teres minor Sensory- skin over deltoid mucles

Question 27

How is the axillary nerve often injured? If injured what is the consequnece?

Answer 27

Shoulder dislocation Fracture to the humeral neck Consequnce- Loss of shoulder abduction beyond 15 degrees Sesnory loss over deltoids

Question 28

Name the nerve roots for the median nerve Motor innervation? Sensory innervation?

Answer 28

C5-T1 Anterior forarm (flexor) compartment Passes through carpal tunnel and supplyes thenar mucles Sensory- lateral palm digits 1,2,3.5

Question 29

What happens when the median nerve is damaged or compressed? (low median nerve injury)

Answer 29

Paralysis of most didgit fexors and muscles moving thumb Long term- thenar wasting

Question 30

What happens when a high median nerve injury occurs? What could cause a high median nerve injury?

Answer 30

Hand of benadiction occurs when a patient is asked to make a fist thumb and digits 1-2 stay straight Elbow dislocation, forarm fracture

Question 31

Radial nerve motor and sensory innovation- also root fibers

Answer 31

Motor to muscles in the posterior compartment of the forarm runs through radial groove Sensory- Skin over posterior arm- wrist Dorsal hand, base of digits 1-3 and thumb Nerve roots c5-T1

Question 32

Ulnar nerve Nerve roots? Sensory? Motor?

Answer 32

Roots- C8-T1 Motor- Most of the intrinsuc muscles of the hand Medial half of deep forarm muscles- Flexor carpi ulnaris and the ulnar half of flexor digitorum profundus in the forearm. Sensory- Medial and dorsal planter hand Digits 3.5-5

Question 33

Consequnce of Musculocutaneous nerve damage

Answer 33

Paralysis of coracobrachialis, biceps and brachialis(anterior muscle compartment)

Question 34

Consequnce of ulnar nerve damage. What can cause it?

Answer 34

Paralysis of intrinsic muscles of the hand (claw hand) Loss of sensation to little finger cause- frature of medial epicondyle of humerous (nerve runs lateral to it)

Question 35

Consequence of radial nerve injury

Answer 35

wrist drop No extension of wrist and digits Unapposed action of strong flexor mucles FDS and FDP

Question 36

Cause and consequence of superior brachial plexus injury?

Answer 36

C5-C6 Erb-Duchenne Palsy Loss of sensation lateral aspect of arm Paralysis of muscles of shoulder and arm supplied by these nerve roots (Deltoid, infraspinatus, biceps, brachialis) Cause- Extensive stretching of neonates head during birth Back packers

Question 37

Apparence of somone with superior brachial plexus injury

Answer 37

* Adducted shoulder * Medially rotated arm * Extended elbow

Question 38

Cause and consequnce of inferior brachial plexus injury

Answer 38

C8-T1 Klumpke Palsy Consequnce- paralysis of small muscles of the hand claw hand Upper limbed excessively pulled anteriorly

Question 39

Roots for long thoracic nerve. Which muscle does it innervate? Consequence of damage?

Answer 39

* C5, C6, C7 * Serratus anterior Winged scapula

Question 40

What are the nerve roots for Thoracodorsal nerve? Which muscle does it innervarte?

Answer 40

C6, C7, C8 Latissimus dorsi

Question 41

What are the nerve roots for Suprascapular? Which msucle does it innervate? Consequnce of damage?

Answer 41

–C5, C6 –Supraspinatus, infraspinatus Mucsle wasting- indent in scapula

Question 42

How can Klumpke palsey lead to Horners syndrom?

Answer 42

When T1 is affected

Question 43

What is Horners syndrom and what are the symptoms?

Answer 43

Syndrome of sympethetic nerve causes constriction of pupils and drooping eye lids