part 3 axilla and arm Flashcards
Compartment syndrome
swelling within a fascial enclosed muscle compartment in limbs causes: limb trauma, intracompartment hemorrhage, limb compression , pressure increase compromise capillary blood flow and tissue perfusion –> neuromuscular damage if not treated
Flexor compartment
BBC
Biceps brachii
Brachilais
Coracobrachialis
Biceps brachii movement
- Flex elbow joint
2. Powerful supinator when arm is flexed as its tendon is attached to radial tuberosity
Biceps brachii long head and short head origin and insertion
innervation
long head: labrum (supraglenoid tubercle of scapula)
short head: coracoid process
both insert to radial tuberosity
innervated by musculocutaneous nerve (C5-6)
Bicipital aponeurosis
from where, function
fans out from the medial side of the bicep brachii tendon
Function: wrap brachial artery and median nerve, protect them from venepuncture from median cubital vein
Extensor compartment of humerus (muscles origin and insertion, innervation)
Triceps Brachii
long head: infraglenoid tubercle of scapula
lateral head: posterior humerus
Medial head (deep): posterior humerus inferior to the radial groove
All insert into olecranon of ulna –> extension of elbow joint
Innervation: C 6,7,8
Disease related to humeus
Midshaft fracture: damage radial nerve because the nerve lies close to the posterior bone surface
Anterior and posterior axillary fold
Anterior: Pec Major muscle inferior
Posterior: Latissmus dorsi + Teres major
Axilla region
muscles
medial: serratus anterior, upper thoracic wall
Lateral wall, intertubercular sulcus of the humerus
Anterior wall: lateral part of pec major, pec minor , subclavius
Posterior wall: subscapularis, teres major, latissimus dorsi, proximal part of long head of tricep
Posterior triangle
Sternocleidomastoid trapezius clavicle
feel pulse
4 parts of brachial plexus
root (C5-T1)
trunk (upper middle lower)
division (anterior posterior)
cord (lateral, posterior, medial)
Supracondylar fracture
damage brachial artery, blood out pressure –> compress on median nerve (not due to proximity)
Saturday Night paralysis
compression on the radial nerve
Humerus Surgical neck fracure
axillary nerve injury –> deltoid paralysis and atrophy
Midshaft fracture
radial nerve
Radial nerve damaged in which two condition
Saturday paralysis
Midshaft fracture of humerus
Where to applu Axillary nerve block/ brachial plexus nerve block?
axillary sheath (thick connective tissue) contains brachial plexus, subclavian artery and vein
Triangular space
circumflex scapular artery goes to the back of scapular (from subscapular artery from 3rd part of axillary artery)
Stretching of the axillary region damage ___
upper plexus C5,C6
Erb’s palsy
Compression of axillary region
lower plexus injury C8, T1 (Klumpke palsy)
Symptom of upper plexus injury
Waiter’s tip sign
Adduct and medially rotated shoulder
extended and pronated forearm
damaged deltoid (axillary nerve C5,6), BBC (Musculocutaneous C5,6,7), supinator (radial nerve), brachioradialis (Radial), infraspinatus (suprascapular n) teres minor (Axillary nerve)
Sapular muscles : supraspinatus, infraspinatus, rhomboids, levator scapulae, teres minor
are innerved by ?
C5,6
Pec M and Latissimus dorsi are big marble innervated by
common: C6,7,8.
5+ T1 for Pec major as well
Radial nerve goes with which artery?
Profunda brachii a. (a branch from the brachial artery) can be seen in triangular interval where they are getting near to the posterior humerus
What happens to brachial artery upon reaching the elbow joint
splits into radial and ulnar artery
Describe scapular anstomoses
dorsal scapular artery (medial scapular border) + suprascapular artery (both from subclavian artery high up) + circumflex scapular artery (from subscapular artery anterior)
Dorsal scapular artery also anastomose with subscapular artery anteriorly.
Occlusion/ligation of axillary artery below the ? artery –> no blood to upper limb
Subscapular artery
because it is where circumflex scapular artery branches out, which form anastomoses around the scapular with dorsal and supra- scapular artery coming out directly from subclavian artery
Lymphatic drainage of axillary region
axillary lymph nodes drain into subclavian vein
Name all superficial veins of upper limb and where do they drain into?
Cephalic vein (lateral) Basilic vein (medial) Median cubital vein (connect cephalic and basilic) All drains into axillary vein which is a deep vein.
Deep veins are in pairs beside the arteries, this arrangement is known as ___. WHY? Any exception?
vena comitantes
artery pulsate helps promote blood flow in the nearby veins
(except axillary vein which is a single vein)
