Posterior Cervical Triangle And Intro To UE / Brachial Plexus Flashcards
The posterior cervical triangle (PCT) is a junction between the ____ and the ___ skeleton.
Upper extremity ; axial
The pectoral region of the PCT is the (anterior/posterior) triangle of the upper extremity to the axial skeleton
Anterior
The scapular region of the PCT is the (anterior/posterior) junction of the upper extremity to the axial skeleton
Posterior
The axillary region of the PCT is the (medial/lateral) junction of the upper extremity to the axial skeleton.
Lateral
The axillary region is located between what two regions of the posterior cervical triangle as well as the chest wall of the humerus?
Pectoral & Scapular
What are the boundaries in the axillary region?
Anterior, posterior, medial, lateral, base, and the apex
What is the anterior boundary of the axillary region made up of?
The anterior boundary of the pyramid is made up of the pectoralis major and minor.
What is the posterior boundary of the axillary region made up of?
The posterior boundary is made up of the teres major, the latissimus dorsi, and the subscapularis muscle.
What is the medial boundary of the axillary region made up of?
The medial boundary is made up of the serratus anterior muscle.
What is the lateral boundary of the axillary region made up of?
The lateral boundary is made up of a small portion of the humerus.
What is the apex of the axillary region made up of?
The apex is made up of the first rib, the clavicle, and the superior boarder of the scapula.
The axilla region creates a pyramid that is encased in a lot of _____ tissue and ____ and there is a sheet that surrounds the nerves and blood vessels that is called the axillary sheet
Connective; fat
What does the axillary sheet contain?
The axillary sheet contains the brachial plexus, the axillary artery, and the axillary vein
The ______ is the first site where you can see the major neurovascular structures of the upper extremities
Posterior Cervical Triangle
The posterior cervical triangle is the triangle that is created by the
Posterior boarder of the sternocleidomastoid (SCM), the anterior edge of the upper trapezius muscle, and the middle 1/3 of the clavicle
In the posterior cervical triangle, is there a lot of fat and connective tissue?
Yes (it is a very deep triangle)
What muscles make up the floor of the posterior cervical triangle?
The floor of the posterior cervical triangle is made up of the anterior scalene, middle scalene, posterior scalene, levator scapulae, and the splenius capitis.
As we open up and get rid of all of the fat and fascia in the PCT, what structures will you find?
As we open up and get rid of all of the fat and fascia in the PCT, you should find cutaneous branches of the cervical plexus, lymph nodes, superior portion of the brachial plexus (supraclavicular region), and the subclavian artery
What nerve runs somewhere between the middle and upper portion of the SCM?
The lesser occipital nerve
What nerve is around the middle of the SCM and runs straight superior to the ear (runs pretty much across the upper third of the SCM)?
The greater auricular nerve
What nerve runs from the middle of the SCM on the posterior boarder and comes out and wraps around the inferior third of the SCM?
The transverse cervical nerve
What nerves are a whole bunch of branches coming off above the clavicle and underneath the middle portion of the SCM?
The supraclavicular nerves
What nerve is a very superficial structure in the PCT and passes through the triangle and follows a line from the ear lobe down the neck to the tip of the shoulder and goes deep to the trapezius?
The spinal accessory nerve (cranial nerve XI)
What nerve has a potential for injury during surgery in the neck and if someone is carrying a heavy backpack on the base of their neck?
The spinal accessory nerve (cranial nerve XI)
The spinal accessory nerve innervates what two muscles?
The SCM and the trapezius
If you injure the spinal accessory nerve in the PCT and lacerate it completely, which muscle will be affected? If the nerve gets injured outside of the PCT, deeper in the neck and higher in the neck, then which muscle(s) will be affected?
If the nerve gets injured in the PCT after innervating the SCM, only the trapezius will be affected.
If the nerve gets injured outside of the PCT, deeper in the neck and higher in the neck then both muscles will be affected
In the PCT floor, there is a little gap called the ____
Scalene groove
The scalene groove is created by two muscles and a bone, name the two muscles and the bone.
The posterior boarder of the anterior scalene and the anterior boarder of the middle scalene, and a portion of the third rib
What is the opening in the floor that allows the brachial plexus to emerge?
The scalene groove
The section from the shoulder to the elbow is called what?
The arm or the brachium
What is the name of the region between the arm and forearm?
The elbow
What is another name for the elbow?
The cubital region
What is the name of the region between the elbow and wrist?
The forearm
What is another name for the forearm?
The antebrachium
What is the name of the region just distal to the wrist?
The hand
The ______ is superficial fascia and fat under the skin that runs all the way around the arm. This fascia contains lots of veins and subcutaneous nerves.
Subcutaneous tissue
Is the subcutaneous tissue loose or dense connective tissue?
Loose because it’s fascia
After removing the superficial fascia, what layer do you find?
Deep fascia
Deep fascia has this investing fascia that goes between muscles, works its way to the bone, and creates compartmentalization. What is this fascia called?
Septa
Since we know that deep fascia surrounds every muscle, how is it determined for the deep fascia to create the septa?
It is only the deep fascia that goes towards the bone that creates the septa.
How many compartments are there in the forearm?
2
In your forearm, your anterior compartment starts out at the (medial/lateral) side of the elbow and runs to the anterior side of the wrist. The posterior compartment runs from the (medial/lateral) side of the elbow and runs to the posterior surface of the wrist.
Medial; Lateral
Muscles within a compartment tend to have similar functions
Muscles in a compartment are innervated predominantly by one nerve
T or F
True
The anterior divisions of the nerves of the brachial plexus innervate the (anterior/posterior) compartment muscles.
Anterior
The posterior divisions of the nerves of the brachial plexus innervate the (anterior/posterior) compartment muscles.
Posterior
Vessels (arteries and veins) tend to run (with/against) the corresponding nerves in connective tissue bundles (neurovascular bundles) that are surrounded by connective tissue.
With
What is the name of the connective tissue that surrounds the neurovascular bundles ?
Sheaths
The brachial plexus starts with ___ spinal nerves and ends up with ____ terminal nerves.
5;5
The bones that connect the UE to the trunk are the ____ and the ______
Clavicle; Scapula
The clavicle and the scapula articulate with the bones of the thorax at the _____ joint
Sternoclavicular (SC)
The medial end of the clavicle articulates with the sternum to form the ______ joint
Sternoclavicular (SC)
The lateral end of the clavicle articulates with the acromion, forming the _____ joint
Acromio-clavicular (AC joint)
What is the name of the well marked groove on the anterior aspect of the proximal humerus?
Bicipital groove
What runs in the bicipital groove?
The tendon of the longhead of the biceps
At the proximal end of the bicipital groove, what two structures do you find?
The lesser and greater tubercles
What is another name for the bicipital groove?
The intertubercular groove (because it is between two tubercles)
Rotation which moves the front of the arm towards the body is called what?
Internal rotation
Rotation which moves the front of the arm away from the body is called what?
External rotation
What nerve emerges near the posterior boarder of the SCM, running downward and backward across the splenius muscle, and passing beneath the trapezius ?
The spinal accessory nerve (cranial nerve 11)
What are some of the nerves we learned in class that are a part of the cervical plexus ?
The lesser occipital, greater auricular, supraclavicular, and transverse cervical nerves.
Many of the branches of the cervical plexus arise around the (medial/posterior) boarder of the SCM
Posterior
The greater occipital nerve is found more (medially/laterally) than the lesser occipital nerve
Medially
The inferior belly of the ____ divides the posterior cervical triangle into an upper triangle (occipital triangle) and a lower triangle (supraclavicular triangle)
Omohyoid
The cervical plexus and brachial plexus are exiting the neck between what two muscles?
The anterior and middle scalenes
The cervical plexus is (superior/inferior) to the brachial plexus
Superior
The _____ nerve is directed inferiorly and splits into three branches
Supraclavicular
The _______ nerve runs parallel to the posterior boarder of the SCM
Lesser occipital
The nerve that emerges from the SCM and enters the deeper surface of the trapezius is what?
The spinal accessory nerve
Above and below the glenoid fossa are the _____ tubercle and the ____ tubercle.
Supraglenoid; infraglenoid
The brachial plexus starts at ___ of the spinal cord and terminates at ___
C5;T1
For the brachial plexus: Left To Right – Remember To Drink Cold Nector
R - Rami To - Trunks Drink - Divisions Cold - Cords Nector - Terminal nerves
For the brachial plexus: Top To Bottom – M A R M U
M - Musculocutaneous A - Axillary R - Radial M - Median U - Ulnar
In the brachial plexus, the ___ and ___ nerve roots come together to form the superior trunk
C5 & C6
In the brachial plexus the ___ nerve root feeds into its own trunk which is the middle trunk
C7
In the brachial plexus the ___ and ___ nerve root come together to form the inferior trunk
C8 & T1
In the brachial plexus the superior trunk branches into an ____ and ____ division
Anterior & Posterior
In the brachial plexus the middle trunk branches into an ____ and ____ division
Anterior & Posterior
In the brachial plexus the inferior trunk branches into an ___ and _____ division
Anterior & Posterior
When drawing the anterior and posterior division in the inferior trunk of brachial plexus, draw the posterior division on “top” and the anterior division on the “bottom”.
Roger that
All of the posterior divisions in the brachial plexus come together to form the _____ cord that branches into the ____ and _____ nerves
Posterior; Axillary & Radial
The anterior divisions of the superior and middle trunks come together to form the _____ cord that branches into the ____ and _____ nerves
Lateral ; Musculocutaneous & Median
The anterior division of the inferior trunk all by itself makes the _____ cord which branches to the___ and ___ nerves
Medial ; Median & Ulnar
What innervates the serratus anterior?
The long thoracic nerve (C5-C7)
Most of the merging, diverging, and merging of the brachial plexus predominantly occurs in the _____ region of the posterior cervical triangle.
Axillary
Anything above the clavicle is considered the ____ region
Supraclavicular
The _____ and the ___ are what is found in the supraclavicular region
Trunks; Ventral rami
The ventral rami of what segments are found in the supraclavicular region?
C5-T1
A prefix plexus is when the nerve plexus runs from __ to ___ instead of C5 to T1
C4 to C8
A postfixed plexus is when the nerve plexus runs from ___ to ____ instead of C5 to T1
C6 to T2
Are there any dorsal rami in the brachial plexus?
No