Plexus brachialis Flashcards
How’s plexus brachialis formed by?
ventral/anterior branches of:
- 4 lower cervical spinal nerves (C5 – C8) and
- the first thoracic spinal nerve (T1).
Where does plexus brachialis locate in ?
The spatium interscalenum between m. scalenus anterior et medialis (costa prima). It takes place behind and above a. subclavia.
How is plexus brachialis divided?
Has 3 large truncus:
- Truncus superior formed by ventral branches of C5 and C6 spinal nerves. n. suprascapularis and n. subclavius
- Truncus medius formed by ventral branch of C7 spinal nerve.
- Truncus inferior formed by ventral branches of C8 and T1 spinal nerves.
–> all truncus join and form fasciculus posterior (fibers from C5 – T1) = Divisiones posteriores
–> Divisiones anteriores of truncus superior et medius join and form fasciculus lateralis (fibers C5 – C7)
–> Division anterior of truncus inferior form fasciculus medialis (fibers C8 – T1)
> > These 3 fasciculi enter apertura superior cavi axillaris (bordered by: clavicula, margo superior scapulae,
costa prima).
Topographically plexus brachialis is divided into pars supraclavicularis et pars infraclaviuclaris.
Pars supraclavicularis plexus brachialis
Placed in trigonum colli laterale (bordered by: m. sternocleidomastioideus, m.trapezius, clavicula) and it can be palpate in fossa supraclavicularis major.
7 brances arise from pars supraclavicularis.
- > innervate:
m. pectoralis major et minor (n. pectorales lateralis et medialis)
m. subclavius (n. subclavius)
m. serratus anterior (n. thoracicus longus)
m. latissimus dorsi (N. thoracodorsalis)
m. levator scapulae (n. dorsalis scapulae)
m. rhomboideus minor et major (n.dorsalis scapulae)
m. supraspinatus (n. suprascapularis)
m. infraspinatus (n. suprascapularis)
m. subscapularis (motor neurons of nn.subscapulares)
m. teres major (motor neurons of nn.subscapulares, also N. thoracodorsalis)
art. humeri (n. suprascapularis/subscapulares sensory)
Pars infraclavicularis plexus brachialis
Placed into the axilla. Formed by 3 fasciculus that surrounds a. axillaris:
- fasciculus lateralis
- N. musculocutaneous
- N. medianus - fasciculus medialis
- N. cutaneus brachii medialis
- N. cutaneous antebrachii medialis
- N. ulnaris - fasciculus posterior
- N. radialis
- N. axillaris
Innervate:
m. coracobrachialis (N. musculocutaneus)
m. biceps brachii (N. musculocutaneus)
m. brachialis (N. musculocutaneus)
m. triceps brachii (N. radialis rami musculares)
m. anconeus (N. radialis rami musculares)
the skin on the posterior region of brachii (N. radialis–> n. cutaneous brachia posterior)
the skin to thenar/ art.cubiti (N. cutaneous antebrachii lateralis, r. superficialis n. radialis, r. dorsalis n. ulnaris, n. cutaneous antebrachii medialis)
art. cubiti (rr. articulares n. ulnaris & medianus)
1st and 2nd mm. lumbricales (nn. digitales
palmares communes rr. musculares from n. medianus)
m. abductor pollicis brevis (nn. digitales
palmares communes rr. musculares from n. medianus)
m. opponens pollicis (nn. digitales
palmares communes rr. musculares from n. medianus)
m. flexor pollicis brevis (caput
superficiale) (nn. digitales
palmares communes rr. musculares from n. medianus)
m. pronator teres (N. medianus gives off rr. musculares)
m. palmaris longus (N. medianus gives off rr. musculares)
m. flexor digitorum superficialis (N. medianus gives off rr. musculares)
m. flexor digitorum profundus (radial side, N. interosseus antebrachii anterior from n. medianus)
m. pronator quadratus (N. interosseus antebrachii anterior from n. medianus)
the skin on the medial surface of antebrachii (N. cutaneous antebrachii medialis)
the skin on the medial surface of brachium (N. cutaneus brachii medialis)
mm. interossei palmares et dorsales (ramus profundus n. ulnaris)
III and IV mm. lumbricales (ramus profundus n. ulnaris)
M. adductor pollicis (ramus profundus n. ulnaris)
m. flexor pollicis brevis (ramus profundus n. ulnaris)
m. flexor carpi ulnaris (rr. musculares n. ulnaris)
m. flexor digitorum profundus (pars ulnaris, rr. musculares n. ulnaris)
antebrachii lateral, posterior 1st and 2nd layer muscles (ramus profundus n. radialis )
skin of the posterior surface of antebrachii (n. cutaneous antebrachii posterior n. radialis)
M. deltoideus
M. teres minor
Art. humeri (N. axillaris together with n. suprascapularis/subscapulares sensory)
the skin of the upper arm at the lateral region (n. cutaneous brachii lateralis n. axillaris)
Arteriae membri superioris
a. subclavia
- Arises at the left side from arcus aortae and at the right side from truncus brachiocephalicus
- Continues as a. axillaris behind clavicula
- Extends to cavitas axillaris and becomes a. brachialis
- At fossa cubiti a. brachialis divides into the terminal branches: a. radialis and a. ulnaris
- On the palmar side of the wrist the terminal branches of a. radialis and a. ulnaris from arcus palmaris superficialis et profundus
- These palmar arches supply the hand and the fingers with oxygenated blood
Supply:
m. supraspinatus (a. suprascapularis)
m. infraspinatus (a. suprascapularis branch from a.subclavia)
the upper portion of m. trapezius (r. superficialis a. transversa colli)
mm. superficialis pars posterior colli (r. superficialis a. transversa colli)
mm. rhomboidei (r. profundus or a. dorsalis scapulae from a. transversa colli)
mm. superficialis dorsi (r. profundus or a. dorsalis scapulae from a. transversa colli)
m. subclavius (r. clavicularis of a.thoracoacromialis)
rete acromiale (r. acromialis of a.thoracoacromialis)
m. deltoideus (r. deltoideus of a.thoracoacromialis, a. circumflexa humeri posterior)
m. pectoralis major et minor (rr. pectorals of a.thoracoacromialis)
m. serratus anterior (a. thoracica lateralis, a. thoracodorsalis)
m. pectoralis major et minor (a. thoracica lateralis)
–> skin above them (a. thoracica lateralis)
glandula mammaria (rr. mammarii lateralis of a.thoracica lateralis)
m. subscapularis (a. thoracodorsalis)
m. latissimus dorsi (a. thoracodorsalis)
art. humeri (a. circumflexa humeri posterior)
mm. anterior brachii superficialis (rr. musculares a. brachialis)
mm. posterior brachii (rr. musculares a. profunda brachii from a. brachialis)
mm. antebrachii anterior et lateralis (rr. musculares of a. radials both and of a. ulnaris anterior
mm. profundi antebrachii anterior (rr. musculares a. interossea anterior of ulnaris)
mm. digiti minimi and overlying skin (r. palmaris profundus a. ulnaris)
Lymph vessels of the upper extremity
Lymp vessels of the upper extremity are arranged in 2 networks: deep and superficial.
Supeficial lymph vessels collect the lymph from the skin and subcutaneous tissue. There are 3 groups of
superficial lymp vessels: lateral, medial and anterior. Lymph vessels are divided into 2 groups according to their location and lymph flow direction:
1- Lateral superficial lymph vessels collect the lymph from lateral side of the wrist (1-3 fingers) and
drain it to axillary lymph nodes.
2- Medial superficial lymph vessels collect the lymph from medial side of the wrist (4-5 fingers),
medial side of antebrachii and drain it to the cubital lymph nodes
3- Anterior superficial lymph vessels collect the lymph from the wrist, ventral side of antebrachii and
drain it to the cubital lymph nodes
The deep lymph vessels accompany the deep blood vessels. They collect the lymph from the muscles, tendons,
joints and bones and drain it to the deep lymph nodes.
The lymph nodes of the upper extremity
The lymph nodes of the upper extremity are divided into 2 groups: superficial and deep lymph nodes.
The superficial lymph nodes:
- Nodi lymphoidei supratrochleares
o Placed in fossa cubiti above epicondylus medialis humeri
o Number are from 1 to 2
o Afferent lymph vessels collect the lymph from wrist and medial side of antebrachii
o Efferent lymph vessels accompany v. basilica and deep blood vessels
- Nodi lymphoideideltopectorales
o Number are from 1 to 2
o Lie in sulcus deltoideopectoralis near v. cephalica near clavicula
o Afferent lymph vessels collect lymph from lateral side of antebrachii
The deep lymph nodes:
- Nodi lymphoidei antebrachii
o Lie in upper third of antebrachii along a. ulnaris
- Nodi lymohoidei cubitales profundi
o Placed in fossa cubiti near blood vessels
- Nodi lymphoidei brachiales
o Situated in the middle part of upper arm along a. brachialis
Nodi lymphoidei axillares
high in number (30-45).
- Nodi lymphoidei pectorals
o From 4 to 5
o Lie along the lower border of m. pectoralis minor near a. thoracica lateralis
o Afferent lymph vessels collect the lymph from anterior side of chest, upper part of anterior
abdominal wall, glandulae mammaria.
o Efferent lymph vessels flow into nodi lymphatici centrales and nodi lymphatici subclaviculares - Nodi lymphoidei subscapularis
o From 6 to 7
o Placed along dorsal wall of cavum axillare near a. subscapuralis
o Afferent lymph vessels collect the lymph from the dorsal wall of chest, the upper part of dorsal
abdominal wall, glandulae mammaria
o Efferent lymph vessel flow into nodi lymphoidei centrales - Nodi lymphoidei laterales s. nodi lymphoidei humerales
o From 4 to 6
o Placed near v. axillaris
o Afferent lymph vessels collect the lmph from upper extremity
o Efferent lymph vessels flow into nodi lymphoidei centrales, nodi lymphoidei subclaviculares and
nodi lymphoidei cervicales profundi - Nodi lymphoidei centrales
o From 3 to 4
o Placed in corpus adiposum axillare of the base of the cavum axillare
o Afferent lymph vessels drain the lymph from all lymph nodes of cavum axillare
o Efferent lymph vessels flow into nodi lymphoidei subclaviculares - Nodi lymphoidei infraclaviculares
o From 6 to 12
o Placed above m. pectoralis minor
o Collect afferent lymph vessels that accompanied v. cephalica, the afferent lymph vessels from
glandulae mammaria and other lymph nodes from cavum axillare - Nodi lymhoidei apicales
o Placed at the top of apex cavi axillaris behind clavicula near v. axillaris
o Collect the afferent lymph vessels from other lymph nodes of cavum axillare
o Efferent lymph vessels form truncus subclavius, which flow into ductus lymphaticus dexter or
ductus thoracicus
v. mediana antebrachii
o Ascendes in the middle of the anterior aspect of the antebrachii between v. basilica and v.
cephalica
o In fossa cubiti it flows into v. mediana cubiti
o Sometimes it divides into 2 veins, which join v. cephaliva or v. basilica
v. basilica
o Begins from rete venosum dorsale manus at the ulnar side
o At first passes on the dorsal side of the antebrachii
o On the proximal third of the antebrachii it reaches the anterior side of antebrachii
o In the region of upper arm it lodges in sulcus bicipitalis medialis
o In the middle region it passes together with n. cutaneous antebrachii medialis through fascia
brachii and flows to v. brachialis
- accompanied by efferent lymph vessels coming from nodi lymphoidei supratrochleares and nodi lymphoidei deltopectorales near clavicle
v. cephalica
o Formed on the radial side of rete venosum dorsale manus
o Reachs art. radiocarpalis
o Continues to the anterior side of antebrachii and passes along the radial border till fossa cubiti
o Forms a slanting anasthomose v. mediana cubiti
o Joins to vv. brachiales
o Flows into v. basilica
o In the region of upper arm lodges into sulcus bicipitalis lateralis
o Continues along sulcus deltoideopectoralis
o Reches trigonum clavicopectorale, where it penetrates fascia clavicopectoralis
o Flows into v. axillaris
o In the region of antebrachii it receives unconstant v. cephalica accessoria
o The latter arises from rete venosum dorsale manus
o Form the dorsal side of antebrachii
o Flows into v. cephalica distally from art. cubiti
vv. superficiales s. vv. subcutaneae
Form rete venosum dorsale manus on the dorsal surface of the wrist, the latter being formed by networks of
vv. digitales dorsaes and the vein continuations of vv. metacarpales dorsales.
v. cephalica
v. basilica
v. mediana antebrachii
N. musculocutaneous
(C5 – C7)
Passes sidelong, penetrates m.coracobrachialis. Passes between m. biceps brachii and m. brachialis.
> Nerve is placed into sulcus bicipitalis lateralis
> runs laterally from distal tendon of m. biceps brachii above
epicondylus lateralis
> penetrates fascia brachii
> passes downwards to the anterior antebrachii region as n.cutaneous antebrachii lateralis.
> N. musculocutaneus gives off rr. musculares (= plur. =“rami”, sing.
= “ramus”, muscular branches), supply:
o m. coracobrachialis
o m. biceps brachii
o m. brachialis
> N. cutaneous antebrachii lateralis innervate the skin on the lateral region of forearm till thenar and art. cubiti
> Skin branches can join
o r. superficialis n. radialis
o r. dorsalis n. ulnaris
o n. cutaneous antebrachii medialis
N. medianus
A mixed nerve and it is formed by joining of radix lateralis C6
– C7 and radix medialis C8 – T1.
> Nerve is placed in axilla in front of a. axillaris
> Passes together with vasa brachialia along sulcus bicipitalis medialis
> In fossa cubiti n. medianus is below aponeurosis of m. biceps brachii, where it penetrates m. pronator teres
> Lodges between m. flexor digitorum superficialis et profundus and reaches sulcus medianus antebrachii
> Enters through canalis carpi and divides into nn. digitales palmares communes
N. medianus branches
- rr. musculares
-to the anterior group of
forearm muscles:
o m. pronator teres: flexio et pronatio antebrachii
o m. flexor carpi radialis: flexio et abductio manus
o m. palmaris longus: flexio manus
o m. flexor digitorum superficialis: flexio phanalx mediae et proximalis, flexio manus - N. interosseus antebrachii anterior
- to the mm. profundi antebrachii
o m. flexor digitorum profundus (radial side): flexio phalanx distalis, mediae et proximalia, flexio manus
o m. pronator quadratus: pronatio antebrachii et manus - rr. articulares
- arise from n. medianus that innervates art. cubiti and art. radiocarpalis - nn. digitales palmares communes
- Placed beneath aponeurosis palmaris at the level of 1st, 2nd, 3rd spatium intermetacarpales.
- All these 3 nerves gives of motor
fibers rr. musculares
–> innervate:
» 1st and 2nd mm. lumbricales (flexio phalangis proximalis, extensio phalanx mediae et distalis)
» m. abductor pollicis brevis (abductio pollicis)
» m. opponens pollicis (oppositio pollicis)
» m. flexor pollicis brevis (caput
superficiale, flexio pollicis) - nn. digitales palmares communes:
- divides into 7 nn. digitales palmares proprii
1st nn. digitales palmares communes gives of 3 nn. digitales palmares proprii
- medial and
- lateral side of pollicis
- radial side of indicis.
2nd nn. digitales palmares communes divides into 2 nn. digitales palmares proprii
- ulnar side of indicis
- radial side of middle finger
3rd nn. digitales palmares communes divides into 2 nn. digitales palmares proprii
- ulnar side of third finger
- radial side of ring finger.
> > nn. digitales palmares proprii wing from palmar side of the fingers to dorsal side
supply the skin on the:
o palmar side of pollicis, index finger and middle finger
o radial side of ring finger
o dorsal surface of phalangis distalis et media (for these fingers)
a. radialis branches
1) a. recurrens radialis
- Arises at fossa cubiti laterally from a. radialis
- Runs along sulcus cubitalis anterior lateralis
- Forms anastomosis with a. collateralis radialis from a. profunda bachii
> Both take part in the formation of rete articulare cubiti
2) rr. musculares
Supply mm. antebrachii anterior et lateralis
3) r. palmaris superficialis
Arises from a. radialis at the level of processus styloideus radii
On the palmar side of the wrist it gives blood supply to thenar muscles group and the skin over them
- Makes anastomosis with with terminal branch of a. ulnaris
x Form arcus palmari superficialis
4) r. carpalis palmaris
- Arises from a. radialis at the lower part of antebrachii
- Forms anastomosus with r. carpalis palmaris from a. ulnaris
- Branches from rete carpi palmare
5) r. carpalis dorsalis
- Arise from a. radialis at the dorsal side of the wrist in the “snuff box”
- Gives off 3 branches aa. digitales dorsales
x Supply the dorsal side of index finger from radial side and the pollicis
6) a. metacarpals dorsalis prima
- arises from a.radialis at the dorsal side of the wrist in the snuff box
- gives off 3 branches: aa. digitalis dorsal that supply the dorsal side of the index finger from radial side and the thumb
7) a. princeps pollicis
- Arise from a. radialis at the palmar side of the wrist
- Gives off 3 branches aa. digitales palmares
x Supply the palmar side of the thumb
and the radial side of the index finger
Anastomosis
- N. cutaneus brachii medialis to the
skin branches of the 2nd n. intercostalis. - with a. subscapularis from a. axillaris
- to a. suprascapularis from a. subclavia’’
- with a. circumflexa humeri posterior & -“- anterior
- a. collaterals radialis from a. profunda brachii (brachialis) with a. recurrens radialis from a. radialis
- a. collaterals medialis from a. brachialis to a. interossea recurrens from a. interossea
posterior
–> both aa. Collaterialis and their anastomoses form rete articulare cubiti - a. collateralis ulnaris inferior from a. brachialis to ramus anterior from a. recurrens ulnaris
- a. radialis with r. palmaris profundus from a. ulnaris
- r. palmaris superficialis with terminal branch of a. ulnaris = arcus palmari superficialis
- r. anterior of a. recurrens ulnaris with a. collateralis ulnaris inferior from a. brachialis
- r. posterior of a. recurrens ulnaris with a. collateralis ulnaris superior from a. brachialis
- a. interossea posterior with a. collateralis media from a. profunda brachii –> Terminates in rete carpale dorsale
- r. palmaris profundus with terminal part of a. radialis to form arcus palmaris profundus
- v. thoracoepigastrica between v. cava superior et inferior
Spatium interscalenum
m. scalenus anterior
m. scalenus medius
costa prima
behind it arteria subclavia –> a. transversa colli
nerves of plexus brachialis
Fasciculus posterior
n. radialis / axillaris
nn. subscapularis and n. thoracodorsalis
N. radialis (also branches)
In cavitas axillaris behind a. axillaris
> In brachial region it passes in Canalis humeromuscularis s. canalis n. radialis
- in canalis n. radialis gives off motor branches rr. musculares to:
- m. triceps brachii: (extensio antebrachii, caput longum – extensio et adductio brachii)
- m. anconeus (extensio antebrachii)
- Gives also n. cutaneous brachii posterior –> Supply the skin on the posterior region of brachii
- Leaves canalis n. radialis through lower opening, lodges in sulcus cubitalis anterior lateralis where it divides into 2 braches: ramus superficialis
- Passes along sulcus radialis antebrachii downwards
- Runs beneath the tendon of m. brachioradialis
- Reach the dorsal surface of the wrist, divides into - > > 5 nn. digitales dorsales, supply the skin on:
- The dorsal surface of the wrist at radial side over
phalanx proximalis pollicis et indicis
- Radial side of phalanx proximalis of middle finger - et ramus profundus
- Passes through m. supinator
- With rr. musculares innervate posterior and lateral muscle groups of antebrachii
* Lateral muscle group
o M. brachioradialis
o M. extensor carpi radialis longus
o M. extensor carpi radialis brevis
* Posterior muscle group 1st layer
o M. extensor digitorum
o M. extensor digiti minimi
o M. extensor carpi ulnaris
* Posterior muscle group 2nd layer
o M. abductor pollicis longus
o M. extensor pollicis brevis
o M. extensor pollicis longus
o M. extensor indicis
o M. supinator - > > Gives off n. cutaneous antebrachii posterior
- Innervate skin of the posterior surface of antebrachii - > > > Terminal end n. interosseus antebrachii posterior passes along the dorsal side
of membrana interossea antebrachii, innervate
o Mm. profundi antebrachii posterior
o Gives off rr. articulares to articulation of the wrist at radial side
retinaculum musculorum extensorum
6 canals, 9 muscles
- m. abductor pollicis longus & m. extensor pollicis brevis
- m. extensor carpi radialis longus & brevis
- m. extensor pollicis longus
- m. extensor digitorum & indices
- m. extensor digiti minimi
- m. extensor carpi ulnaris
sulcus deltoipectoralis
b. m. deltoideus / m. pectoralis major
Nodi lymphoideideltopectorales lie there near v. cephalica near clavicula
trigonum clavipectorale
clavicula, m. pectoralis minor, sternum
- v. cephalica
- a. axillaris to
1) a. thoracica superior - Branches out at 1st and 2nd spatium intercostale
2) a. thoracoacromialis
- Short trunk that wings around upper border of m. pectoralis minor medially
- Penetrates fascia clavicopectoralis
Divides into 4 branches:
x r. acromialis, from rete acromiale
x r. clavicularis, supplies m. subclavius
x r. deltoideus, passes to m. deltoideus
x rr. pectorals, run to m. pectoralis major et minor and supply them
trigonum pectorale
m. pectoralis minor
a. axillaris –> a. thoracica lateralis
- arise at the lateral border of m. pectoralis minor
- passes along external side of m. serratus anterior below fascia pectoralis
- supplies m. serratus anterior, m. pectoralis major et minor and skin above them
- rr. mammarii lateralis supplies glandula mammaria
glandula mammaria
nodi lymphoidei pectoralis / infraclavicularis / subscapularis
supplied by rr. mammarii lateralis a. thoracica lateralis
The anatomical snuff box
Snuff box is limited by tendons of m. abductor pollicis longus et m. extensor pollicis brevis from
the one side. From the other side limited by tendon of m. extensor pollicis longus.
a. radialis
- -> r. carpalis dorsalis
- -> a. metacarpals dorsalis prima
- arises from a.radialis at the dorsal side of the wrist in the snuff box
- gives off 3 branches: aa. digitalis dorsal that supply the dorsal side of the index finger from radial side and the thumb
trigonum subpectorale
m. pectoralis minor: lower border
m. pectoralis major; upper border
m. deltoideus: anterior border
a. axillaris:
- -> a. subscapularis: short/largests
- -> a. circumflexa humeri anterior
- -> a. cirrcumflexa humeri posterior
1) a. subscapularis
- Largest branch of a. axiilaris, a short vessel
- At the level of lateral border of m. subscapularis gives off 2 branches
* 1. a. thoracodorsalis
o accompanied by n. thoracodorsalis
o extends to lateral border of scapula between m. serratus anterior, m. subscaularis and m. latissimus dorsi
–> supplies these muscles
* 2. a. circumflexa scapulae o passes through foramen trilaterum o extends to fossa infraspinata o forms anastomosis to a. suprascapularis from a. subclavia o forms rete dorsalis scapulae
2) a. circumflexa humeri anterior
- A small branch in front of collum chirurgicum humeri
- Extends behind m. coracobrachialis and m. biceps brachii
- Lodges along sulcus intertubercularis to art. humeri
- Forms anastomosis with a. circumflexa humeri posterior
3) a. circumflexa humeri posterior
- a. circumflexa humeri posterior passes through foramen quadrilaterum with n. axillaris
- Supplies art. humeri and m. deltoideus
- Anastomosis with a. circumflexa humeri anterior
fascia brachii
v. basilica passing together with –> n. cutaneous antebrachii medianus (and flows too v. brachialis)
n. musculocutaneous penetrates it
fossa infraspinata
- a. subclavia –> a. suprascapularis
o Arises from truncus thyrocervicalis
o Extends to venter inferior m. omohyoidei and n. suprascapularis to incisura scapulae
o Passes above lig. transversum scapulae superius
o Supply the muscles in fossa supraspinata and fossa infraspinata
o At collum scapulae there is anastomosis with a. subscapularis from a. axillaris
- a. circumflexa scapulae (from a. subscapularis from a. axillaris)
o passes through foramen trilaterum
o extends to fossa infraspinata
o forms anastomosis to a. suprascapularis from a. subclavia
o forms rete dorsalis scapulae
Spatium interscalenum
m. scalenus anterior
m. scalenus medius
costa prima
arteria subclavia
nerves of plexus brachialis
a. subclavia –> a. transversa colli
cavum axillare
apertura superior: clavicula, margo superior scapulae, costa prima
apertura inferior: A m. pectoralis major, P m. latissiimus dorsi, M m. serratus anterior, L m. coracobrachialis
Lateral wall: m. coracobrachialis & humerus
Medial wall: m. serrates anterior
Anterior wall; m. pectoralis minor & major
Posterior wall: m. teres minor & major, m. subscapularis, m. triceps brachii caput longum, m. latissiimus dorsi
- n. axillaris enters it
- a. axillaris enters and passes through and then continues as a. brachialis
a. subclavia
- -> a. brachialis
- 2 vv. brachialis flow into one v. axillaris
The lymph nodes in cavum axillare are high in number (30-45). Nodi lymphoidei axillares are divided into
following groups:
Nodi lymphoidei pectorals / subscapularis / laterales s. humerales / centrales / infraclaviculares / apicales
Foramen trilaterum
m, teres minor
/major,
m. triceps brachii caput longum
a. circumflexa scapulae
o extends to fossa infraspinata
o forms anastomosis to a. suprascapularis from a. subclavia
o forms rete dorsalis scapulae
Foramen quadrilaterum
Humerus, m, teres minor/major, m. triceps brachii caput longum
n. axillaris
a. circumflexa humeri posterior
- Supplies art. humeri and m. deltoideus
- Anastomosis with a. circumflexa humeri anterior
VENA CIRCUMFLEXA HUMERI POSTERIOR
Sulcus bicipitalis medialis
a. brachialis
a. collaterals ulnaris superior (branch from a. brachialis)
n. ulnaris
n. medianus
vasa brachilia
v. basilica
fossa cubiti
lateral border: m. brachioradialis
medial: m. pronator teres
base: m. brachialis
Sulcus cubitalis anterior lateralis:
- n.radialis —> rr. superficialis & profundus
- a. collateralis radialis from a. brachialis
- a. recurrens radialis from a. radialis
Sulcus cubitalis anterior medialis:
- a. collateralis ulnaris inferior from a. brachialis
- r. anterior from a. recurrens ulnaris from a. ulnaris
Sulcus cubitalis posterior medialis:
- n. ulnaris
- a. collateralis ulnaris superior from a.brachialis
- r. posterior from a. recurrens ulnaris from a. ulnaris
sulcus cubitalis posterior lateralis:
- a. interossea recurrens from a. interossea posterior from a. interossea communis from a. ulnaris
- a. collateralis medialis from a. profunda brachii from a. brachialis
- nodi lymphoidei supratrochleares/cubitales profundi (2)
- a. brachialis
- > a. radialis -> a. recurrens radialis
- > a. ulnaris
- v. cephalica forms anastomose with v. mediana cubiti
- v. mediana antebrachii flows into v. mediana cubiti
- n. medianus (below aponeurosis of m. biceps brachii)
- n.radialis —> rr. superficialis & profundus,
sulcus bicipitalis lateralis
continuation of sulcus deltoideopectoralis
n. musculocutaneous
v. cephalica
canalis n. radialis
s. canalis humeromuscularis
sulcus n. radialis
a. profunda brachii divides into a. collaterals radialis and medialis
M. subscapularis
a. subscapularis
–> a./ n. thoracodorsalis (supplied by the artery)
–> a. circumflexa scapulae
(also some supply from a. suprascapularis and a. thoracica lateralis)
n. axillaris passes along
nn. subscapulares and its motor neurone innervate it
(on posterior wall of cavum axillare)
M. serratus anterior
Supplied by a. thoracica lateralis (below fascia pectoralis)
Innervated by N. thoracicus longus (elevatie brachii)
a. thoracodorsalis from a. subscapularis trigononum subpectorale from a. axillaris (also some supply + a. thoracica superior from a. axillaris in trigononum clavipectorale)
M. biceps brachii
innervation: rr. muscular from n. musculocutaneous goes below and in the lateral sulcus
n. medianus and a. brachialis (supply) below its aponeurosis
extends behind a. circumflexa humeri anterior (from trigononum subpectorale a. axillaris) = supply
sulcus medianus antebrachii
n. medianus b. m. flexor digitorum superficialis et profundus
sulcus ulnaris antebrachii
n. / a. / 2 vv. ulnaris
sulcus radialis antebrachii
a. radialis / 2 vv. radiales / r. superficialis n. radialis
collum scapulae
a. suprascapularis has anastomosis with a. subscapularis from a. axillaris
collum chirurgicum humeri
v. circumflexa humeri –> v. axillaris
n. axillaris
a. circumflexa humeri anterior
m. pectoralis minor
Innervated by n. pectoralis medialis PLUS n. pectoralis lateralis gives branch to it as well
behind it is a. axillaris and at the lateral border is its branch a. thoracica lateralis (trigononum pectorale)
a. thoracoacromialis short trunk that wings around upper border of m. pectoralis minor medially in trigononum clavipectorale from a. axillaris
- -> rr. pectorales and rr. deltoideus supply
above are nodi lymphoidei infraclaviculare
along the lower border: nodi lymphoidei pectoralis
Below fascia pectoralis
a. thoracica lateralis
m. pronator teres
Beneath is a. ulnaris (at the level of column radii)
Supply:
- a. collateralis inferior ulnaris (from a. brachialis)
- a. interossea communis (from a. ulnaris)
- r. anterior a. recurrens ulnaris
- a. ulnaris
- a. radialis
Penetrated by n.medianus and its rr.musculares innervate it
m. latissimus dorsi
N. thoracodorsalis passes along
anterior side –> Innervates it
only supplied by a. thoracodorsalis (branch in trigononum subpectorale from a. subscapularis in a. axillaris) from arteries we know so far
a. axillaris to a.brachialis at the lower edge
a. profunda brachii arise beneath the tendon
m. brachioradialis
ramus superficiali n. radialis runs beneath the tendon
innervated by ramus profundus n. radialis
supplied by a. recurrens radialis and a. collateralis radialis from a. brachialis
m. levator scapulae
innervated by n. dorsalis scapulae (anteriorly placed)
supplied by a. transversa colli –> r. superficial/ r. profundus = a. dorsalis scapulae
anteriorly m. scalenus anterior
n. subclavius
m. brachialis
innervated by rr. musculares of n. musculocutaneous
supplied by a. brachialis, a. collateralis ulnaris superior, a. recurrens radialis
- n. musculocutaneous passes between it and m. biceps brachii
- a. collaterals ulnaris inferior transverses anteriorly.
penetrates fascia clavicopectoralis
a. thoracoacromialis from a. axillaris in trigononum clavipectorale
n. pectoralis medialis / lateralis
v. cephalica (in trigononum clavipectorale)
penetrates m. scalenus medius
n. dorsalis scapulae
n. thoracicus longus
a. transversa colli
penetrates membrana interrossea
a. interossea communes ( ulnaris)
n. interossea antebrachii from r. profundus n. radialis
m. supinator
r. profundus n. radialis –> rr. musculares of it innervate it
Supply:
a. interosseous posterior (a. ulnaris) which gives off a. interossea recurrens that supplies it as well
a. recurrens radialis
N. dorsalis scapulae
C5
Penetrates m. scalenus medius –> reach anterior side of m. levator
scapulae.
Pass together with a. transversa colli.
Innervate m. levator scapulae and mm. rhomboideus minor et major.
Î Pull scapula medially and superiorly.
N. thoracicus longus
C5 – C7
Penetrates m. scalenus medius. Passes anteriorly along external
side of m. serratus anterior.
Innervate m. serratus anterior: Elevatio brachii
Where does N. dorsalis scapulae and N. thoracicus longus originate?
From ventral brances of spinal nerves C5 – C8 that
that form plexus brachialis.
N. suprascapularis
C5 – C6
Passes to fossa supraspinata through incisura scapulae below lig.
transversum scapulae superius.
Passes together with a. suprascapularis.
Innervate m. supraspinatus (abductio brachii), m. infraspinatus (rotatio externa brachii) and art. humeri
N. subclavius
Passes downwards along the anterior side of m. scalenus
anterior. Runs adjacent to m. subclavius.
Innervate m. subclavius (Elevatio costae prima and depressio clavicula)
Where does N. suprascapularis and N. subclavius arise from?
truncus superior plexus brachialis
Nn. Pectorals medialis et lateralis
C5 – T1
Lateralis et medialis terms are related to their origins from the lateral and medial fasciculus (not their topographical position)
N. pectoralis medialis arise from fasciculus medialis, descends, penetrates fascia clavicopectoralis. It also branches of to m.
pectoralis major pars sternocostalis.
Innervates m. pectoralis minor (Moves scapula downwards and medially)
N. pectoralis lateralis arise from fasciculus lateralis, penetrates fascia
clavicopectoralis, reaches m. pectoralis major from inner side. Gives
also branch to m. pectoralis minor.
Innervates m. pectoralis major (Adductio brachii, rotatio interna brachii, flexio brachii (pars clacivularis)
Nn. Subscapulares
C5 – C7
Descend along anterior side of m. subscapularis.
Sensory neurons innervate art. humeri.
Motor neurons innervate m. subscapularis (adductio brachii, rotatio interna brachii) and m. teres major (adductio brachii, rotatio interna brachii, extensio brachii)
N. thoracodorsalis
C5 – C7
Placed between nn. Subscapularis. Descends along lateral border
of scapula together with a. subscapularis, then passes along
anterior side of m. latissimus dorsi.
Innervates m. latissimus dorsi (Adductio brachii, extensio brachii, rotatio interna brachii)
(Sobotta: innervates also m. teres major – adductio brachii, rotatio
interna brachii, extensio brachii)
Where does Nn. Subscapularis and N. thoracodorsalis arise from?
fasciculus posterior plexus brachialis.
Fasciculus medialis
- N. cutaneus brachii medialis
- Supply the skin on the medial surface of brachium and forms anastomosis (“connection of two”) to the
skin branches of the 2nd n. intercostalis. - N. cutaneous antebrachii medialis
- Supply the skin on the medial surface of antebrachii. - N. ulnaris (C7 – T1)
- A mixed nerve, placed in sulcus bicipitalis medialis where it is accompanied by a.brachialis and n.medianus.
> > Passes downwards and dorsally to sulcus cubitalis posterior medialis
- Found together with a. collateralis ulnaris superior
In antebrachii n. ulnaris is in sulcus ulnaris antebrachii
- Together with a. ulnaris and 2 vv. Ulnares.
- also n. pectoralis medialis:
- Penetrates fascia clavicopectoralis. It also branches of to m. pectoralis major pars sternocostalis.
- -> Innervates m. pectoralis minor (Moves scapula downwards and medially)
N. ulnaris branches
In the antebrachii n. ulnaris gives off the following branches:
1. rr. articulares n. ulnaris that together with rr. articulares n. medianus innervate art. cubiti
- rr. musculares innervate:
- m. flexor carpi ulnaris (flexio et adductio manus)
- m. flexor digitorum profundus (pars ulnaris)
( flexio phalanx distalis, mediae et proximalis, flexio manus)1. In distal third of antebrachii it gives off the branch r. dorsalis
- Supply the skin on the dorsal side of the wrist - Continues as r. palmaris through canalis carpi ulnaris, enters the wrist and divides into 2 branches
- > >
- Ramus superficialis
* Innervate the skin of the palmar side of the wrist at the ulnar side.
- Ramus superficialis
- > > > divides into 3 nn. digitales palmares proprii, innervate the skin on:
* the palmar surface of digiti minimi
* ulnar side of the ring finger - > >
- Ramus profundus
- Passes together with r. profundus a. ulnaris
Innervates the muscles:
- All mm. interossei palmares (adductio) et dorsales (abductio)
- 3rd and 4th mm. lumbricales (Flexio phalangis proximalis, Extensio phalanx mediae et distalis)
- M. adductor pollicis
- Deep head of m. flexor pollicis brevis
- Articulations on the ulnar side of the wrist
- Ramus profundus
- ramus dorsalis, which is a sensory branch, divides into
- > > > 5 nn. digitales dorsales that supply the skin on the dorsal surface of:
- digiti minimi
- ring finger on the ulnar side
- on the lateral side of ring finger supply
only over phalanx proximalis
- middle finger on the ulnar side of
phalanx proximalis
N. axillaris (also branches)
–> Passes along the anterior surface of m. subscapularis, enters cavum axillaris
–> Passes through foramen quadrilaterum
–> Wings around collum chirurgicum humeri
–> Branches out in m. deltoideus
> Innervate:
- M. deltoideus (Pars acromialis: abduction brachii, Pars clavicularis et Pars spinalis: adduction brachii, Pars clavicularis et Pars acromialis: flexio brachii, Pars acromialis et Pars spinalis: extension brachii, Pars clavicularis: rotation interna brachii, Pars spinalis: Rotatio externa brachii)
- M. teres minor (Rotatio externa, Extensio brachii)
- Art. humeri
Branches
- Gives off n. cutaneous brachii lateralis
- Supplies the skin of the upper arm at the lateral region
vv. profundae s. vv. comitantes
- The number of the deep veins are double.
- The deep veins in a double number accompany to arteries till the axilla.
- > At cavum axillare 2 vv. brachiales flow into one v. axillaris (It is located in a bundle of nerves and arteries in the axilla most superficially and medially)
- > Then it reaches to cervical region and continues as v. subclavia.
The tributaries of v. axillaris:
- v. circumflexa humeri anterior et posterior
- from collum chirurgicum region - v. circumflexa scapulae
- v. thoracodorsalis
- v. thoracica lateralis
- from the lateral thoracic region - v. thoracoepigastrica
- from the anterior and lateral trunk region
- more often it is a tributary of v. thoracica lateralis
- at the abdominal region joins to vv. epigastricae superficialis
- forms anastomosis between v. cava superior et inferior - plexus venosus areolaris
- from glandula mammaria - v. cephalica
- v. thoracoacromialis
Blood supply to the hand
Provided by 2 arcus palmares and 2 arterial networks
- Arcus palmaris superficialis
* Formed by terminal part of a. ulnaris
* Forms anastomosis with r. palmaris superficialis from a. radialis
> aa. digitales palmares communes arise from arcus superficialis
–> Each one divided into 2 aa. digitales palmares propriae:
- Supply the ulnar side of 2nd, 3rd and 4th finger and the radial side of 5th finger on
th palmar side
> a. digitalis palmaris digiti minimi from a. ulnaris: ulnar side of digiti minimi is supplied by
> 3 aa. digitales palmares from a. princeps pollicis supply pollicis and radial side of index finger on the palmar side
- Arcus palmaris profundus
- Formed by terminal part of a. radialis
- Forms anastomosis with r. palmaris profundus from a. ulnaris
> 3 aa. metacarpales palmares arise
- -> Receive aa. digitales palmares communes
- -> each gives off r. perforans that penetrates mm. interossei and join aa. metacarpale dorsales at the dorsal side of the wrist
- Rete carpale palmare
- Formed by:
» r. carpalis palmaris from a. radialis
» r. carpalis palmaris from a. ulnaris
» a. interossea anterior from a. interossea communis - Rete carpale dorsale
- Formed by:
» r. carpalis dorsalis from a. radialis
» r. carpalis dorsalis from a. ulnaris
» a. interossea anterior et posterior from a. interossea communis
> 3 aa. metacarpales dorsales arise from rete carpale dorsale
–> Each one divides into 2 aa. digitales dorsales:
Supply:
* ulnar side of 2nd, 3rd and 4th finger
* and radial side of 5th finger on the
dorsal side
a. digitales dorsalis digiti minimi supply
* Ulnar side of 5th finger
3 aa. digitales dorsales from a. metacarpalis dorsalis prima, which is a branch of a. radialis supply
- Pollicis
- and radial side of index finger on the dorsal side
Branches from a. subclavia also supply the shoulder gridle
- A. suprascapularis
- Arises from truncus thyrocervicalis
- Extends to venter inferior m. omohyoidei and n. suprascapularis to incisura scapulae
- Passes above lig. transversum scapulae superius
- Supply the muscles in fossa supraspinata and fossa infraspinata
- At collum scapulae there is anastomosis with a. subscapularis from a. axillaris - A. transversa colli
- from a. subclavia behind spatium interscalenum
- Passes dorsally between plexus brachialis
- Extends to m. levator scapulae
- Divides into ramus superficialis et profundus - –> r. superficialis
- supplies the upper portion of m. trapezius and other mm. superficialis pars posterior colli
- Sometimes receives blood from a. cervicalis superficialis
- Arises from truncus thyrocervicalis - –> r. profundus or a. dorsalis scapulae
- extends downwards along margo medialis
scapulae
- accompanied by n. dorsalis scapulae
- supply mm. rhomboidei and other mm. superficialis dorsi
a. axillaris
- Continuation of a. subclavia beneath margo externus costae prima
- Passes through apertura superior cavum axillare
- Placed medially, then behind m. pectoralis minor
» Surrounded by trunci plexus brachialis - Extends to apertura inferior cavum axillare
- Becomes a. brachialis
- in front of it is n. medianus and behind n. radialis
a. axillaris branches
2 braches in the region of trigonum clavipectorale:
1) a. thoracica superior
- Branches out at 1st and 2nd spatium intercostale
2) a. thoracoacromialis
- Short trunk that wings around upper border of m. pectoralis minor medially
- Penetrates fascia clavicopectoralis
Divides into 4 branches:
a. r. acromialis, from rete acromiale
b. r. clavicularis, supplies m. subclavius
c. r. deltoideus, passes to m. deltoideus
d. rr. pectorals, run to m. pectoralis major et minor and supply them
One branch in trigonum pectorale, that is placed behind m. pectoralis minor:
- a. thoracica lateralis
- arise at the lateral border of m. pectoralis minor
- passes along external side of m. serratus anterior below fascia pectoralis
- supplies m. serratus anterior, m. pectoralis major et minor and skin above them
» rr. mammarii lateralis supplies glandula mammaria
3 branches in trigonum subpectorale
1) a. subscapularis
- Largest branch of a. axiilaris, a short vessel
- At the level of lateral border of m. subscapularis gives off 2 branches
> >
- a. thoracodorsalis
- accompanied by n. thoracodorsalis
- extends to lateral border of scapula between m. serratus anterior, m. subscapularis and m. latissimus dorsi supplies these muscles
> >
- a. circumflexa scapulae
- passes through foramen trilaterum
- extends to fossa infraspinata
- forms anastomosis to a. suprascapularis from a. subclavia
- forms rete dorsalis scapulae
2) a. circumflexa humeri anterior
- A small branch in front of collum chirurgicum humeri
- Extends behind m. coracobrachialis and m. biceps brachii
- Lodges along sulcus intertubercularis to art. humeri
- Forms anastomosis with a. circumflexa humeri posterior
3) a. circumflexa humeri posterior
- a. circumflexa humeri posterior passes through foramen quadrilaterum with n. axillaris
- Supplies art. humeri and m. deltoideus
- Anastomosis with a. circumflexa humeri anterior
a. brachialis
- Continuation of a. axillaris behind the lower border of m. pectoralis major or the lower edge of m.
latissimus dorsi - Lies in sulcus bicipitalis medialis
- rr. musculares supply mm. anterior brachii superficialis
- Covered by aponeurosis of m. biceps brachii in fossa cubuti
- At the level of collum radii it divides into terminal branches: a. radialis and a. ulnaris
- accompanied by deep nodi lymphoidei brachiales
a. brachialis gives off following branches
- a. profunda brachii
- Arise beneath the tendon of m. latissimus dorsi
- Accompanied by n. radialis
- Passes into canalis n. radialis
- rr. musculares to mm. posterior brachii
- Terminal branches a. collateralis radialis et medialis arise into canalis nervi radialis - –> a. collateralis radialis
* Passes along sulcus cubitalis anterior lateralis
* Forms anastomosis with a. recurrens radialis from a. radialis - –> a. collateralis medialis
o Passes along sulcus cubitalis posterior lateralis
o Forms anastomosis to a. interossea recurrens from a. interossea
posterior
> > both aa. Collaterialis and their anastomoses form rete articulare cubiti
- . a. collateralis ulnaris superior
- Arise after a. profunda brachii
- Passes together with n. ulnaris
- Extends to sulcus cubitalis posterior medialis - a. collateralis ulnaris inferior
- Arise above epicondylus medialis humeri
- Transveres m. brachialis anteriorly
- Lies in sulcus cubitalis anterior medialis
- Forms anastomosis to ramus anterior from a. recurrens ulnaris
> > > Both aa. collateralis ulnaris form rete anrticulare cubiti
a. radialis
- Arise at the level of collum radii
- It is a terminal branch of a. brachialis
- Runs along sulcus radialis antebrachii together with 2 vv. radiales and r. superficialis n. radialis
- Covered by fascia antebrachii and the skin at the distal part of sulcus radialis above processus
styloideus radii - Reaches processus styloideus radii
- Passes to the dorsal side of the wrist to the “snuff box”
–> Snuff box is limited by tendons of m. abductor pollicis longus et m. extensor pollicis brevis from
the one side. From the other side limited by tendon of m. extensor pollicis longus. - Penetrates spatium interosseum between 1st and 2nd ossa metacarpale and m. interosseus dorsalis
- On the palmar side of the wrist a. radialis terminates as arcus palmaris profundus
- Forms anastomosis with r. palmaris profundus from a. ulnaris
a. radialis branches
Gives off 7 branches (one missing)
1) a. recurrens radialis
- Arises at fossa cubiti laterally from a. radialis
- Runs along sulcus cubitalis anterior lateralis
- Forms anastomosis with a. collateralis radialis from a. profunda bachii
» Both take part in the formation of rete articulare cubiti
2) rr. musculares
- Supply mm. antebrachii anterior et lateralis
3) r. palmaris superficialis
- Arises from a. radialis at the level of processus styloideus radii
- On the palmar side of the wrist it gives blood supply to thenar muscles group and the skin over them
> > Makes anastomosis with with terminal branch of a. ulnaris
–> Form arcus palmari superficialis
4) r. carpalis palmaris
- Arises from a. radialis at the lower part of antebrachii
- Forms anastomosus with r. carpalis palmaris from a. ulnaris
- Branches from rete carpi palmare
5) r. carpalis dorsalis
- Arise from a. radialis at the dorsal side of the wrist in the “snuff box”
- Gives off 3 branches aa. digitales dorsales
- -> Supply:
* the dorsal side of index finger from radial side
* and the pollicis
6) a. princeps pollicis
- Arise from a. radialis at the palmar side of the wrist
- Gives off 3 branches aa. digitales palmares
- -> Supply:
* the palmar side of the thumb
* and the radial side of the index finger
a. ulnaris
- Arises at the level of collum radii beneath m. pronator teres
- Accompanied by 2 vv. ulnares and n. ulnaris
- Extends along sulcus ulnaris antebrachii reaching to the wrist
- Placed laterally from os pisiforme
- Passes through canalis carpi ulnaris with v. ulnaris and n. ulnaris to the palmar side of the wrist
- Makes anastomosis with r. palmaris superficialis from a. radialis to arcus palmaris superficialis
- accompanied by deep nodi lymphoidei antebrachii
a. ulnaris branches
Gives off 6 branches:
1) a. recurrens ulnaris
- Arises from the beginning of a. ulnaris
- Divides at art. cubiti into 2 branches: r. anterior and r. posterior
1a. > r. anterior runs along sulcus cubitalis anterior medialis, forms anastomosis
with a. collateralis ulnaris inferior from a. brachialis
1b. > r. posterior runs along sulcus cubitalis posterior medialis, forms anastomosis
with a. collateralis ulnaris superior from a. brachialis
2) rr. musculares
- Supplies blood to mm. antebrachii anterior at the ulnar side
3) a. interossea communis
- Arises from a. ulnaris at the upper third of antebrachii
- Divides into:
3a. > a. interossea anterior
* Runs along anterior side of membrana interossea antebrachii
* Extends to m. pronator quadratus
* Penetrates membrana interossea
* Goes to the dorsal side
* Forms rete carpi dorsale
* rr. musculares supply blood to mm. profundi antebrachii anterior
* aa. nutririae to antebrachii bones
* a. interossea anterior also braches to rete carpi palmare
3b. > a. interossea posterior
* Penetrates membrana interossea antebrachii at the proximal part of
antebrachii and extends to the dorsal side
* Runs between mm. antebrachii posterior superficialis et profundi
* Gives off a. interossea recurrens, which runs along sulcus cubitalis
posterior lateralis and forms anastomosis with a. collateralis media
from a. profunda brachii
* Terminates in rete carpale dorsale
4) r. carpalis palmaris
- Arises over the wrist joint and forms rete carpale palmare
5) r. carpalis dorsalis
- Arises over the wrist joint and forms rete carpale dorsale
6) r. palmaris profundus
- Arises at the carpal region and supplies mm. digiti minimi and overlying skin
- Makes anastomosis with terminal part of a. radialis to form arcus palmaris profundus
art.humeri
innervated by
- n. suprascapularis
- nn. subscapulares sensory neurons
- n. axillaris
Supplied by
- a. circumflexa humeri posterior
- a. circumflexa humeri anterior lodges along sulcus intertubercularis to art. humeri
lateral border of scapula
a. subscapularis
n. thoracodorsalis
art. radiocarpalis
rr. articulares n. interosseous antebrachii n.radialis on radial side
rr. articulates from n. medianus
r. profundus n. ulnaris (ulnar side)
r. profundus a. ulnaris
v. cephalica reaches it
m. triceps brachii
innervated: rr. musculares n. radialis
supplied by: a. brachialis, a. circumflexa humeri posterior
F. Extensio antebrachii
Caput longum - Extensio et Adductio brachii
m. anconeus
innervated: rr. musculares n. radialis
supplied by: a. interrossea recurrens from a. ulnaris
F. Extensio antebrachii
m. pectoralis major
innervated: nn. pectoralis (lateralis)
supplied by:
- rr. pectorals a. thoracicacromialis a. axillaris
- a. thoracica lateralis
F. Adductio brachii
Rotatio interna brachii
Flexio brachii – pars clavicularis
- a. brachialis continuation of a. axillaris behind the lower border of m. pectoralis major
m. rhomboideus minor et major
innervated: n. dorsalis scapulae
supplied by: a. dorsalis scapulae s. r. profundus a. traversa colli
moves scapula medially towards spine
m. supraspinatus
abductio brachii
innervated: n. suprascapularis
supplied by: a. suprascapularis, a. dorsalis scapulae s. r. profundus a. traversa colli
m. infraspinatus
rotatio externa brachii
innervated: n. suprascapularis
supplied by: a. suprascapularis, a. circumflexa scapulae
m. teres major
innervated: Nn. Subscapulares motor neurons
supplied by: a. subscapularis, a. circumflexa humeri posterior, a. circumflexa scapulae
F. Adductio brachii
Extensio brachii
Rotatio interna brachii
m. subclavius
innervate: N. subclavius
supplied by: r. clavicularis a. thoracoacromialis from a. axillaris
F. Elevatio costae prima and depression clavicula
m. coracobrachialis
innervated: rr. musculares N. musculocutaneous
supplied by: a. Brachialis, a. Circumflexa humeri anterior
F. Flexio brachii
Adductio brachii
Rotatio interna brachii
N. musculocutaneous penetrates it
m. flexor digitorum superficialis
innervated: rr. musculares Nervus medianus
supplied by:
- A.ulnaris
- A. Radialis
- A.recurrens anterior from a.ulnaris
N. medianus lodges between it and profundus
F. Flexio phalangis mediae
Flexio phalangis proximalis
Flexio manus
m. flexor digitorum profundus
supplied by: A. ulnaris A. Interossea anterior R.posterior a. Recurrens ulnaris A.collateralis ulnaris inferior (a.brachialis)
N. medianus lodges between it and superficialis
F. Flexio phalangis distalis
Flexio phalangis mediae
Flexio phalangis proximalis
Flexio manus
Inn. N. interosseus antebrachii anterior from Nervus medianus, rr. musculares n. ulnaris,
m. abductor pollicis brevis
abductio pollicis
innervated: rr. musculares nn. digitales
palmares communes of n. medianus in b. 1-3 metacarpals
supplied by: R.palmaris superficialis a. Radialis
m. opponens pollicis
oppositio pollicis
innervated: rr. musculares nn. digitales
palmares communes of n. medianus in b. 1-3 metacarpals
supplied by: R. Palmaris superficialis from a.radialis and A. Princeps pollicis
mm. lumbricales
innervated: rr. musculares nn. digitales
palmares communes of n. medianus in b. 1-3 metacarpals
r. profundus n. ulnaris: 3-4
supplied by:arcus palmaris superficialis, a. Metacarpales dorsales, aa. Digitales palmares communes
- flexio phalangis proximalis
- extensio phalanx mediae et
disalis
m. flexor pollicis brevis (caput
superficiale)
supplied by: A. Princeps palmaris A. Carpalis palmaris a. Radialis
F. Flexio pollicis
Inn. Nervus medianus (caput superficiale)
r. profundus n. ulnaris (caput profundum)
( rr. musculares nn. digitales
palmares communes of n. medianus in b. 1-3 metacarpals)
m. flexor carpi radialis
flexio et abductio manus
innervated: rr. musculares Nervus medianus
supplied by: A.recurrens ulnaris posterior, A.radialis
m. palmaris longus
flexio manus
innervated: rr. musculares Nervus medianus
supplied by: A. Recurrens anterior A.ulnaris
m. pronator quadratus
pronatio antebrachii et manus
innervated: N. interosseus antebrachii anterior from Nervus medianus
supplied by: A. Interossea anterior
All mm. interossei palmares et dorsales
o Palmares – adductio manus
o Dorsales – abductio manus
innervated: r. profundus n. ulnaris
supplied by: A. Metacarpales palmares/aa. Digitales palmares communes, R. Profundus A. Digitales palmares communes
M. adductor pollicis
innervated: r. profundus n. ulnaris
supplied by: A. Princeps pollicis, Arcus palmaris profundus
m. flexor carpi ulnaris
innervated: rr. musculares n. ulnaris
supplied by: A. Recurrens posterior
lateral muscle group antebrachii
o M. brachioradialis
o M. extensor carpi radialis longus
o M. extensor carpi radialis brevis
innervated: r. profundus n. radialis
supplied by: A. Collateralis radialis, A. Radialis, A. Recurrens radialis
Posterior muscle group 1st layer of antebrachii
o M. extensor digitorum
o M. extensor digiti minimi
o M. extensor carpi ulnaris
innervated: r. profundus n. radialis
supplied by: a. interossea posterior
Posterior muscle group 2nd layer of antebrachii
o M. abductor pollicis longus o M. extensor pollicis brevis o M. extensor pollicis longus o M. extensor indicis o M. supinator
innervated: r. profundus n. radialis
supplied by: a. interossea posterior
Mm. profundi antebrachii posterior
Inn. n. interosseus antebrachii posterior from n. radialis
supplied by: a. interossea posterior
Musculus abductor pollicis longus Musculus extensor pollicis brevis Musculus extensor pollicis longus Musculus extensor indicis Musculus supinator
Musculus flexor digitorum profundus
Musculus flexor pollicis longus
Musculus pronator quadratus
m. deltoideus
Pars acromialis x abduction brachii Pars clavicularis et Pars spinalis x adduction brachii Pars clavicularis et Pars acromialis x flexio brachii Pars acromialis et Pars spinalis x extension brachii Pars clavicularis x rotation interna brachii Pars spinalis x Rotatio externa brachii
Inn. n. axillaris
Supplied by a. Circumflexa humeri, a. Thoraacromialis (r. Deltoideus And acromialis), a. Subscapularis, A. Brachialis
M. teres minor
F. Rotatio externae et extension brachii
Inn. Nervus axillaris
Supllied by circumflexa posterior And scapulae
m. trapezius
r. superficialis a. transversa colli
F.
- The upper part (pars descendes): elevates the scapula - The middle part (pars transversa): move scapula and clavicle backwards medially towards the vertebral column
- The lower part (pars ascendens): depresses the scapula
