SPR L1 Neurovascular Anatomy of the Upper Limb Flashcards
Learning Outcomes (for general perusal)
- Describe the superficial veins of the upper limb
- Describe the axillary artery and branches of this vessel
- Describe the formation of the brachial plexus of nerves
Describe the nomenclature of the upper limb
Shoulder to elbow = arm
elbow to fingers = forearm
Describe the compartments in the
- Upper Limbs
- Lower Limbs
- Anterior Cs contain flexor muscles, Posterior Cs contain extensor muscles
- Anterior Cs contain extensor muscles Posterior Cs contain flexor muscles
OPPOSITE WAY AROUND
Limb Rotation
Describe limb rotation in the following stages of gestation
- 5 Weeks
- 6 Weeks
- 7 and 8 Weeks
- Upper and lower limbs have formed as ‘finlike’ projections, point laterally and caudally
- The upper and lower limbs have become flexed anteriorly which results in the elbow and knee joints pointing laterally; the palmar aspect of the hands and plantar aspect (sole) of the feet face the trunk. (within 1 week, digits have formed)
- The upper and lower limbs have undergone 90-degree torsion, however, in opposite directions: the elbows point caudally and the knees point cranially
At what point in gestation does limb rotation occur?
Weeks 5-8
Venous Drainage of the Upper Limb
- Outline the main Veins in the upper limb
- Which runs laterally?
- Which runs medially?
- Which joins the above two veins?
- Cephalic, Basilic and Median Cubital Vein
- Cephalic Vein
- Basilic Vein
- Median Cubital Vein
Where does the cephalic vein run?
In the Deltopectoral groove between the deltoid and pectoralis major
Arterial Supply of the Upper Limb
Name the main arteries in the upper limb
- Axillary Artery
- Brachial Artery (very superficial)
- Ulnar Artery
- Radial Artery
- Superficial Palmar Arch
- Deep Palmar Arch
(R and U involved in formation of palmar arches
What are the branches of the 1st part of the axillary artery?
Superior Thoracic Artery
What are the branches of the 2nd part of the axillary artery?
Acromiothoracic artery (thoracoacromial artery)
Lateral Thoracic Artery
What are the branches of the 3rd part of the axillary artery?
Anterior and Posterior Circumflex Humoral Arteries
Subscapular Artery
Name the branches of the axillary artery
Superior Thoracic (1st part)
Acromiothoracic Artery (2nd part)
Lateral Thoracic Artery (2nd Part)
Subscapular Artery (3rd Part)
Anterior Circumflex Humoral Artery (3rd Part)
Posterior Circumflex Humoral Artery (3rd Part)
What are the boundaries to each part of the Axillary Artery?
Medial to Pectoralis Minor = 1st Part
Just behind Pectoralis Minor = 2nd Part
Lateral to Pectoralis Minor = 3rd Part
What is the beginning of the axillary artery?
Axillary continuous with subclavian artery
Become axillary once the SC passes over the lower border of the first rib
Where does each of these supply?
- 1st part of the axillary artery?
- 2nd part
- 3rd part
- Upper anterior part of the chest wall
- Acromial region, clavicle and pectoral region, deltoid region
- Humerous, glenohumoral joint (circumflex arteries) and subscapular region (subscapular artery)
Brachial Plexus
Material covered (for general perusal)
- The discrete components of the brachial plexus and how the plexus is formed
- Where these discrete components are located
- The five main terminal branches of the plexus
- Important anatomical relations
Brachial Plexus
Describe the
- Roots
- Trunks
- Divisions
- Cords
- (Branches)
- Anterior Rami of spinal nerves C5, C6, C7, C8, T1
- Upper, middle and lower
- Anterior and Posterior
- Medial, lateral and posterior
Nb. each trunk gives off an anterior and posterior division
What are the 5 main terminal branches of the brachial plexus?
Musculocutaneous Nerve
Median Nerve
Ulnar Nerve
Axillary Nerve
Radial Nerve
Where do the roots of the brachial plexus come from?
Anterior Rami of C5, C6, C7, C8 and T1
Coming off the spinal cord in an ant and post root (not the roots previously mentioned), then spinal nerve is formed then ant ramus and post ramus
Brachial Plexus
- Where can the roots be found?
- What is the upper trunk formed by?
- How does the C7 root travel?
- What is the lower trunk formed by?
- Where are the trunks located?
- What all converge?
- What forms the lateral cord?
- With what are the cords of the BC closely related?
- What are the cords?
- What does the radial nerve innervate?
- In the prevertebral area of the neck
- C5,C6 roots
- By itself
- C8 and T1 roots
- In the Posterior Triangle of the neck
- The 3 posterior trunk divisions
- Upper two Anterior Divisions (of the Upper and middle trunk)
- The second part of the axillary artery (named accordingly)
- Lateral, posterior, and medial cord. (all in relation to 2nd part of axillary artery)
- Posterior compartment of arm and forearm
Discuss the important relations of the brachial plexus
identify the 1st, 2nd & 3rd parts of the axillary artery
Can you locate the medial & lateral cords of the brachial plexus?
Medial to Pectoralis minor is first part, Just Behind Pminor is second part, Just lateral to Pminor is the third part
Medial and lateral cords are labelled (named according to relation with axillary artery)
Give examples of ways the brachial plexus can be damaged?
- Falling on outstretched palms
- During birth
- Swinging from a tree
Additional Info Source (for general perusal)
Clinically Oriented Anatomy
7th Edition: Pages 726 – 730
