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MGA > Pectoral Region and Axilla > Flashcards

Pectoral Region and Axilla Flashcards

1
Q

origin of pectoralis major?

A

clavicular head: medial 1/2 of clavicle sternoclavicular head: sternum, costal cartilatges, aponeurosis of external abdominal obluique

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2
Q

insertion of pectoralis major?

A

lateral lip of intertubercular sulcus

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3
Q

action of pectoralis major?

A

flexes, adducts and medially rotates arm

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4
Q

innervation of pectoralis major?

A

medial and lateral pectoral nerve

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5
Q

specific function of clavicular head of pectoralis major?

A

flexes an all the way extended arm

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6
Q

specific function of sternocostal head of pectoralis major?

A

extends a flexed arm

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7
Q

origin of pectoralis minor?

A

ribs 3-5 near costal cartilages

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8
Q

insertion of pectoralis minor?

A

coracoid process of scapula

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9
Q

action of pectoralis minor?

A

stabilizes scapula by pulling it inferior and anterior

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10
Q

innervation of pectoralis minor?

A

medial pectoral nerve (C8, T1)

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11
Q

origin of subclavius?

A

rib 1 near costal cartilage

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12
Q

insertion of subclavius

A

middle 1/3 of clavicle

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13
Q

action of subclavius?

A

anchors and depresses clavicle

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14
Q

innervation of subclavius?

A

nerve to subclavius (C5,C6)

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15
Q

where is the clavipectoral fascia?

A

deep to pectoralis major, invests to pectoralis minor and subclavius

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16
Q

origin of serratus anterior?

A

ribs 1-8 or 9

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17
Q

insertion of serratus anterior?

A

medial border of scapula (anterior surface)

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18
Q

action of serratus anterior?

A

protracts scapula, upward rotation of glenoid, helps keep medial border and inferior angle opposed to thoracic wall (holds scapula to thoracic wall)

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19
Q

innervation of serratus anterior?

A

long thoracic nerve (is on the superficial surface of the muscle)

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20
Q

what could happen if the long thoracic nerve is damaged?

A

the serratus anterior could be paralyzed, causing winging of the scapula (protrusion of scapula away from the thoracic wall) (ask patient to push on a wall with outstretched arm)

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21
Q

what makes up the anterior wall of the axilla?

A

pectoralis major, pectoralis minor, subclavius, clavipectoral fascia

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22
Q

what makes up the lateral wall of the axilla?

A

intertubercular sulcus

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23
Q

what makes up the posterior wall of the axilla?

A

subscapularis, teres major, teres minor, latissimus dorsi, long head of triceps

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24
Q

what makes up the floor of the axilla

A

skin of the armpit

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25
Q

what makes the medial wall of the axilla?

A

upper thoracic wall, serratus anterior

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26
Q

what makes the inlet of the axilla?

A

lateral margin of rib 1, clavicle, superior margin of scapula to coracoid process

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27
Q

what goes through the inlet of the axilla

A

axillary sheath surrounding arteries, veins, nerves, lymphatics

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28
Q

what is the first division of the axillary artery?

A

from the lateral border of the first rib to the medial border of the pectoralis minor

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29
Q

what is the second division of the axillary artery?

A

from the medial border of the pectoralis minor to the lateral border of the pectoralis minor

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30
Q

what is the 3rd division of the axillary artery?

A

lateral border of pectoralis minor to the lateral border of the latissimus dorsi

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31
Q

what are the 4 branches of the thoracoacromial artery?

A

pectoral, deltoid, acromial, clavicular

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32
Q
A
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33
Q

trace the flow of blood back to the heart from the upper arm

A

brachial vein, basilic vein, axillary vein, subclavian vein

or the cephalic vein to the subclavian vein

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34
Q

3 common sites for swollen lymph nodes?

A

cervical, axilla, inguinal

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35
Q
A
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36
Q

trace the flow of lymph from the base of the axilla?

A

humeral, pectoral and subscapular nodes all drain the the central node, which drains to the apical node, to the infraclavicular node, to the subclavian lymphatic trunk to the right lymphatic duct

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37
Q

what is in the triangular space?

A

triceps long head (base)

teres major (bottom)

teres minor (top)

circumflex scapular artery through center

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38
Q

what is in the quadrangular space

A

teres minor (top)

teres major (bottom)

triceps long head (left)

humerus (right)

posterior circumflex humeral artery (center)

axillary nerve (center)

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39
Q

what is in the triangular interval

A

teres major (base)

triceps long head (left)

humerus (right)

profunda brachii (center)

radial nerve (center)

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40
Q

blood supply serratus anterior

A

lateral thoracic artery

41
Q

how to test the suprascapular nerve

A

abduction (supraspinatus), lateral rotation (infraspinatus) of arm

palpate muscles while testing against resistance

42
Q

what does superior subscapular nerve innervate?

A

subscapularis

43
Q

what does the middle subscapular nerve innervate?

A

latissimus dorsi

44
Q

what does the inferior subscapular nerve innervate?

A

subscapularis, teres major

45
Q

how to test subscapular nerve

A

medial rotation, adduction of arm

46
Q

where is the landmark of the subscapular nerves?

A

subscapular fossa

47
Q

landmark of suprascapular nerve

A

suprascapular notch

48
Q

landmark of long thoracic nerve

A

midaxillary line

49
Q

landmark for dorsal scapular nerve

A

medial border of scapula

50
Q

how to test medial pectoral nerve

A

flexion of adduction of arm while palpating muscle

51
Q

landmark for medial pectoral nerve

A

pierces pectoralis minor

52
Q

testing for lateral pectoral nerve

A

flexion or adduction of arm while palpating muscle

53
Q

what vessel supplies pec major

A

pectoral branch of thoracoacromial trunk

54
Q

what is the landmark for lateral pectoral nerve

A

passes medial pectoral nerve (along its superior border) to pectoralis minor

55
Q

what does the axillary nerve supply?

A

deltoid, teres minor, skin over deltoid

56
Q

testing for axillary nerve

A

abduction over 15 degrees, palpate muscle while testing actions against resistance

57
Q

blood supply deltoid and teres minor

A

posterior circumflex humeral artery

58
Q

landmark for the axillary nerve

A

surgical neck of humerus

59
Q

landmark for radial nerve

A

radial groove/midshaft humerus

60
Q

what does the radial nerve supply?

A

extensor muscles of arm and forearm, skin of posterior arm, forearm and much of dorsal hand

61
Q

how to test radial nerve

A

extension at elbow, wrist, MCP joints, against resistance

62
Q

skin area tested for radial nerve

A

dorsal surface of hand between 1st and 2nd metacarpals, posterior skin of arm and forearm

63
Q

what is the cause of wrist drop?

A

problem with radial nerve

64
Q

what damage could be caused by a mid shaft fracture

A

damage to radial nerve in the radial groove of the humerus, leading to wrist drop

65
Q

symptoms of wrist drop

A

paralysis of wrist and finger extendors in the posterior compartment, loss of cutaneous innervation over posterior forearm and dorsum of han = damage to radial nerve

66
Q

describe saturday night palsy

A

posterior cord of brachial plexus is compressed or injured in the axilla. results in wrist drop (radial nerve innervation), inability to abduct arm beyond 15 degrees (axillary nerve innervation) and possible weakened glenohumeral movements (subscapular nerve innervation) (subscapularis, teres major, lat dorsi)

67
Q

what cutaneous area does the musculocutaneous nerve innervate

A

lateral forearm

68
Q

cutaneous and motor tests for musculocutaneous nerve

A

lateral forearm, flexion at elbow

69
Q

landmark for musculocutaneous nerve

A

pierces coracobrachialis

70
Q

describe Erb’s palsy

A

damage to the superior roots of the brachial plexus C5 and C6 or the superior trunk due to excessive lateral flexion of the neck or difficulties during delivery (shoulder dystocia)

damage causes partial or complete paralysis of muscles supplied by the suprascapular nerve, musculocutaneous nerve, and axillary nerve.

71
Q

what muscles could be weakened or paralyzed due to Erb’s Palsy (damage to C5, C6)

A

supraspinatus, infraspinatus

deltoid, teres minor

biceps, brachialis

pectoralis major (clavicular head)

supinator

72
Q

symptoms of erb’s palsy

A

waiter’s tip position, adducted and medially rotated arm, extended and pronated forearm, flexed hand

DUE TO LOSS OF ROTATOR CUFF INNERVATION, INCREASED RISK FOR SHOULDER DISLOCATION

73
Q

what does the median nerve supply

A

thenar muscles (abductor pollicis brevis,flexor pollicis brevis, opposens pollicis), lateral 2 lumbricals, muscles of forearm EXCEPT FLEXOR CARPI ULNARIS AND MEDIAL 1/2 OF FLEXOR DIGITORUM PROFUNDUS), skin of lateral 2/3 of hand

74
Q

how to test median nerve

A

pronation of forearm, opposition/flexion of thumb, flexion at wrist (look for ulnar deviation during hand flexion), flexion of fingers at PIP joints

75
Q

common lesion name for median nerve damage

A

hand of benediction

76
Q

cutaneous test for median nerve

A

tip of index finger

77
Q

landmark for median nerve

A

cubital fossa, carpal tunnel

78
Q

cutaneous innervation of median nerve

A

lateral 2/3 of anterior hand and fingertips of digits 1, 2, 3.5 on dorsum

79
Q

what causes median nerve palsy

A

compression or injury of median nerve at wrist (carpal tunnel syndrome) can cause sensory loss in regions supplied by palmar digital branches and paralysis of thenar muscles

80
Q

symptoms median nerve palsy

A

weakened or loss of thumb opposition and eventually wasting of the thenar eminence = APE HAND

dr cuMA

81
Q

what causes the hand of benediction

A

compression of median nerve at the cubital fossa or proximally, causes loss of innervation to all the muscles in the anterior forearm EXCEPT FOR FLEXOR CARPI ULNARIS AND THE MEDIAL 2 BELLIES OF THE FLEXOR DIGITORUM PROFUNDUS

82
Q

symptoms of hand of benediction

A

when asked to make a fist, only digits 4+5 flex, 1,2,3 cannot.

also sensory loss to lateral 2/3 of anterior hand and fingertips of digits 1,2,3

83
Q

what does the ulnar nerve innervate

A

flexor carpi ulnaris

medial half of flexor digitorum profundus

hypothenar musles (flexor digiti minimi brevis, opponens digiti minimi, abductor digiti minimi)

medial 2 lumbricals

interossei muscles

adductor pollicis

84
Q

cutaneous innervation of ulnar nerve

A

skin of medial 1/2 of hand (dorsal and anterior)

(dorsal branch = dorsal)

(palmar branch = palmar)

85
Q

how to test ulnar nerve

A

abduction and adduction of digits, flexion of wrist (look for radial deviation during hand flexion)

86
Q

what is the common lesion name for ulnar nerve damage

A

claw hand

dr CUma

87
Q

cutaneous test for ulnar nerve

A

tip of pinkie finger

88
Q

landmark for ulnar nerve

A

medial epicondyle (cubital tunnel)

hook of hamate/pisiform (guyon’s canal)

89
Q

what is guyon’s canal

A

fibro-osseous tunnel between palmar carpal ligament and flexor retinaculum

90
Q

what is guyon’s canal syndrome or cyclist’s palsy

A

compression of ulnar nerve at the WRIST at guyon’s canal, leading to paralysis of hypothenar muscles, 2 medial lumbricals, interossei, and adductor pollicis

91
Q

symptoms of guyon’s canal syndrome

A

inability to adduct the digits, abduct digits 2-5 and fine motor movement of fingers

92
Q

what causes claw hand

A

compression of the ulnar nerve at the elbow, leading to paralysis of the flexor carpi ulnaris, medial 2 bellies of flexor digitorum profundus, hand muscles,

93
Q

symptoms of claw hand or partial claw hand

A

difficulty making a fist, radial deviation during wrist flexion, partial claw hand where MCP joints are extended and the PIP/DIP joints are flexed for digits 4+5

94
Q

what is klumpke’s palsy

A

damage to C8 or T1 roots affect muscles innervated by median and ulnar nerves.

caused by pulling the arm during delivery, hanging by one arm, severe pulling of the arm from above

presents as FULL CLAW HAND

drCUM a

95
Q

what cutaneous innervation does the radial nerve supply

A

dorsal 1/2 of hand except fingertips of digits 1,2,3

also area where the abductor pollicis brevis and flexor pollicis brevis would be

96
Q

what cutaneous area does the medial cutaneous verve of the arm supply

A

medial area of upper arm

97
Q

what cutaneous area does the medial cutaneous nerve of the forearm supply

A

medial half of forearm (anterior)

98
Q

what is colley’s fracture and what can it do

A

fracture of distal radial head, damages median nerve

99
Q
A

MGA (27 decks)

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