T2 L2: Nerve and blood supply to the upper limb Flashcards
What are the 3 branches of the arch of the aorta?
Brachiocephalic trunk, left common carotid artery and right subclavian artery
The left subclavian artery branches off the brachiocephalic trunk
When does the subclavian artery pass through the scalene triangle?
When it passes over the first rib
What are the 3 divisions of the subclavian artery and how are they divided?
1st: medial to scalenus anterior
2nd: behind scalenus anterior
3rd: Lateral to scalenus anterior
What are the branches from each division of the subclavian artery?
1st: TVI.
- Thyrocervical trunk to thyroid, cervical and scapular. It contributes to the scapular anastomosis
- Vertebral artery
- Internal thoracic artery
2nd: Costocervical trunk
3rd: Dorsal scapular artery (can be from 3rd or 2nd division) that contributes to the scapular anastomosis
When does the subclavian artery become the axillary artery?
As is crosses outer border of the 1st rib
What are the 3 divisions of the axillary artery and how are they divided?
1st: Medial to pectoralis minor
2nd: behind pectoralis minor
3rd: Lateral to pectoralis minor
At which point does the axillary artery become the brachial artery?
After the lower border of teres major
Which divisions of the axillary artery are closely associated with the brachial plexus?
The 1st and 2nd divisions
Which 2 arteries branch off the 3rd division of the axillary artery?
- Subscapular branch to the scapular anastomosis
- Anterior/posterior circumflex humeral artery to the neck/shaft of the humerus
Which artery can be damaged when there is a fracture to the neck of humerus?
The anterior/posterior circumflex artery
Which artery supplies the flexors of the upper limb?
The brachial artery
Which artery supplies the extensors of the upper limb?
The profunda brachii artery (a large branch from the brachial artery)
It travel across the spiral/radial groove of the humerus
When does the brachial artery divide?
At the cubital fossa
Which 2 arteries does the brachial artery divide into?
Into the radial (lateral) and ulnar (medial) artery
Which nerve accompanies the profunda brachii artery in the spiral groove?
The radial nerve
Which artery forms the deep palmar arch
Radial artery
How does the radial artery travel through the wrist to the palm?
At the wrist, the radial artery winds around to the dorsal hand and goes through the anatomical snuff box and then pierces the first dorsal interosseus muscles towards the surface of the palm
Which artery forms the superficial palmar arch?
The ulnar artery
Which muscle covers the radial artery?
The brachioradialis muscle
Which muscle covers the ulnar artery?
The flexor carpi ulnaris muscle
Where is the deep palmar arch compared to the superficial arch?
Deep: below flexor tendons
Superficial: above flexor tendons
Where does blood drain from the upper limbs?
Into the axillary vein and then the subclavian vein
What types of veins are deep upper limb veins?
Paired venae comitantes that accompany arteries
What are the 2 types of superficial veins in the upper limb?
Cephalic (lateral) and basilic (medial)
From the dorsal venous arch
What are the 3 branches of superficial vein the the forearm?
Cephalic vein, median cubital vein, and the basilic vein
What are the 3 lymph nodes in the upper limbs?
The deltopectoral node, axillary nodes, and cubital nodes
What are the 5 divisions of the brachial plexus?
Root, trunk, divisions, cords, terminal branches
Which vertebrae release the nerves of the brachial plexus?
C5, C6, C7, C8, and T1
What does C5 innervate in the arm?
The deltoid muscle (arm abductor)
What does C6 innervate in the arm?
The biceps (forearm flexors)
What does C7 innervate in the arm?
The triceps (Forearm extensors, wrist flexors/extensors)
What does C8 innervate in the arm?
The digit flexors/extensors
What does T1 innervate in the arm?
The intrinsic hand muscles
Which nerves combine to form each trunk of the brachial plexus?
C5+C6: superior trunk
C7: middle trunk
C8+T1: Inferior trunk
Which triangle do the brachial plexus trunks pass through?
The scalene triangle
From which trunk does the suprascapular nerve branch from?
The superior trunk
Describe the divisions that each of the trunks of the brachial plexus form
Each trunk creates an anterior and posterior division
Which divisions combine to form each of the cords?
- All the posterior division fuse to form the posterior cord
- Superior and middle anterior divisions form the lateral cord
- The Inferior anterior division continues as the medial cord
Named in relation to the axillary artery
Where are the cords of the brachial plexus found?
Under pectoralis minor
What does the lateral cord terminate as?
The musculocutaneous nerve and lateral part of the median nerve
To which parts of the upper limb does the musculocutaneous nerve provide motor and sensory info?
Motor: anterior arm
Sensory: Lateral forearm
What does the medial cord terminate as?
The medial part of the median nerve and ulnar nerve
To which parts of the upper limb does the median nerve provide motor and sensory info?
Motor: anterior forearm and lateral hand
Sensory: lateral palm and d1,2,3 and half d4
To which parts of the upper limb does the ulnar nerve provide motor and sensory info?
Motor: Medial side anterior forearm and hand
Sensory: Medial hand, half d4, and d5
What does the posterior cord terminate as?
The radial and axillary nerve
To which parts of the upper limb does the radial nerve provide motor and sensory info?
Motor: posterior arm and posterior forearm
Sensory: Posterior arm, posterior forearm, and lateral dorsum hand
Deep branch is motor and superficial branch is sensory
To which parts of the upper limb does the axillary nerve provide motor and sensory info?
Motor: deltoid and teres minor
Sensory: badge area of arm
What are the names of all the terminal branches in the upper limb?
Musculocutaneous nerve Axillary nerve Median nerve Radial nerve Ulnar nerve
