neurovasculature of the upper limb Flashcards

1
Q

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

A

Subclavian artery

Axillary artery

Brachial artery

Radial artery

Ulnar artery

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2
Q

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

A

Left-arch of aorta

Right-brachiocephalic trunk

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3
Q

When does the subclavian artery become the axilla

A

lateral border of the first rib

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4
Q

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

A

Anterior and posterior circumflex humeral arteries

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5
Q

When does the axilla become the brachial artery?

A

Lower border of the teres major muscle,

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6
Q

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

A

Profunda brachii

Travels with radial nerve- Through radial groove of humerous

Supplies structures in posterior aspect of the arm

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7
Q

Where will you find the brachial pulse?

A

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

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8
Q

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

A

At the cubital fossa underneath bicipital aponeurosis

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9
Q

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

A

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

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10
Q

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

A

Deep and superficial palmer arch

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11
Q

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

A

Ulnar- deep

Radial- superficial

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12
Q

Where are the radial and ulnar pulses located?

A

Radial- Lateral to tendon of felxor carpi radialis

Ulnar- Lateral to tendon of flexor carpi ulnaris

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13
Q

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

A

Radial pulse is easier

Ulnar pulse runs deeper and lies under pisiform bone

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14
Q

Where else can you palpate the radial pulse?

A

Anatomical snuff box

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15
Q

What are collateral arteries? Name the 4 in the arm

A

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
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16
Q

Name the superficial veins?

Which is more medial and which is more lateral?

Where are they located?

A

Basilic- Medial

cephalic - Lateral

Median antecubital- connects across anterior of cubital fossa

Located in the superficial fascia

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17
Q

Name the deep veins

Which compartment are they located in?

A

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)

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18
Q

What is the brachial plexus? What is its function?

A

Network of nerves

Supplies sensory and motor innervation to the upper limb

19
Q

Draw and label the brachial plexus

A
20
Q

Where can the brachial plexus be palpated?

A

superior border of clavicle

21
Q

What are the fibers for the brachial plexus?

A

C5-T1

22
Q

What are the anterior branches of the brachial plexus?

A

Musculocutaneous

Median

Ulnar

23
Q

What are the posterior branches of the brachial plexus?

A

Axillary and radial

24
Q

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

A

Flexor compartment of the arm

  • Biceps brachialis
  • Brachialis
  • Coracobrachialis

Sensory to- lateral formarm

25
Q

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

A

Lateral forarm

26
Q

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

A

Motor- Deltoid and teres minor

Sensory- skin over deltoid mucles

27
Q

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

A

Shoulder dislocation

Fracture to the humeral neck

Consequnce- Loss of shoulder abduction beyond 15 degrees

Sesnory loss over deltoids

28
Q

Name the nerve roots for the median nerve

Motor innervation?

Sensory innervation?

A

C5-T1

Anterior forarm (flexor) compartment

Passes through carpal tunnel and supplyes thenar mucles

Sensory- lateral palm digits 1,2,3.5

29
Q

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

A

Paralysis of most didgit fexors and muscles moving thumb

Long term- thenar wasting

30
Q

What happens when a high median nerve injury occurs?

What could cause a high median nerve injury?

A

Hand of benadiction

occurs when a patient is asked to make a fist

thumb and digits 1-2 stay straight

Elbow dislocation, forarm fracture

31
Q

Radial nerve motor and sensory innovation- also root fibers

A

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

32
Q

Ulnar nerve

Nerve roots?

Sensory?

Motor?

A

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

33
Q

Consequnce of Musculocutaneous nerve damage

A

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

34
Q

Consequnce of ulnar nerve damage. What can cause it?

A

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)

35
Q

Consequence of radial nerve injury

A

wrist drop

No extension of wrist and digits

Unapposed action of strong flexor mucles FDS and FDP

36
Q

Cause and consequence of superior brachial plexus injury?

A

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

37
Q

Apparence of somone with superior brachial plexus injury

A
  • Adducted shoulder
  • Medially rotated arm
  • Extended elbow
38
Q

Cause and consequnce of inferior brachial plexus injury

A

C8-T1

Klumpke Palsy

Consequnce- paralysis of small muscles of the hand

claw hand

Upper limbed excessively pulled anteriorly

39
Q

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

A
  • C5, C6, C7
  • Serratus anterior

Winged scapula

40
Q

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

A

C6, C7, C8

Latissimus dorsi

41
Q

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

A

–C5, C6

–Supraspinatus, infraspinatus

Mucsle wasting- indent in scapula

42
Q

How can Klumpke palsey lead to Horners syndrom?

A

When T1 is affected

43
Q

What is Horners syndrom and what are the symptoms?

A

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

44
Q
A