the auxilla Flashcards
1
Q
what composes the superior border of the axilla?
A
the clavicle
scapula
1st rib
2
Q
what composes the inferior base of the axilla?
A
- axillary skin and fascia
at the lower borders of the pectoralis Major, teres major and latissimus dorsi
3
Q
what composes the anterior border of the axilla?
A
pectoralis muscles (major and minor)
4
Q
what composes the posterior border of the axilla?
A
subscapularis muscle
teres major
latissimus dorsi
5
Q
what composes the medial border of the axilla?
A
serratus anterior
6
Q
what composes the lateral border of the axilla?
A
humerus especially the intertubercular groove
7
Q
what are the contents of the axillary sheaths?
A
- Axillary Artery
- Axillary Vein
- Brachial Plexus (terminal branches
8
Q
what do the axillary sheaths wrap around?
A
they wrap around the major arteries
9
Q
what other components can be found in the axilla?
A
- axillary sheaths
- axillary lymphe nodes
- tendons of the biceps brachii and coracobrahialis
10
Q
What constitutes the subclavian artery
A
The branches of the subclavian artery include
- vertebral artery
- internal thoracic artery
- tyrocervicular trunk
- costocervical trunk
- dirsal scapular artery
11
Q
What is the neumomic to recall the constituents of the subclavian artery?
A
vIT C& (sometimes) D
12
Q
What constituent of the subclavian artery supplies the brain with blood?
A
The vertebral artery
13
Q
Where is the internal thoracic artery located?
A
Along the stermn on ether sides
Anterior thoracic wall
14
Q
Into what branches does the tyrocervical trunk diverge into?
A
- subscapular artery (supraspinatus and infraspinatus)
- the cervical arties located in the neck
- transverse cervical arteries along the trapezius
- inferior thyroid artery (along the thyroid)
15
Q
What artery will supply the first 2 posterior intercostal arteries?
A
The superior intercostal artery
16
Q
What arteries constitute the costocervical trunk?
A
- deep cervical artery
- superior intercostal artery
17
Q
What artery is often a branch of the subclavian artery?
What happens if it is not a branch of the subclavian artery?
What does it supply?
A
Dorsal scapular artery
- it arises instead from the transcerse cervical artery (thyrocervical trunk)
- it supplies the levator scapulae and rhomboid minor and major
18
Q
How is the axillary artery divided?
A
Into 1/3
- proximal (median)
- medial (middle)
- distal (lateral)
19
Q
Where is the proximal third of the axillary artery located (what does it border)?
What artery is found in this third?
A
Its located above the superior border of the pectoralis minor
In this third, the superior thoracic artery can be found
20
Q
Where is the median third of the axillary artery located?
What arteries can be found in this region?
A
It lies posterior or deep to the pectoralis minor
In this region we can find the thoracoacromial trunk and the lateral thoracic artery
21
Q
What does the thoracoacromial trunk branch off into?
A
Acromial
Deltoid
Clavicular and
Pectoral branches
22
Q
Where does the distal third of the axillary artery lie?
What arteries can be found in this region?
A
It lies below the inferior border of the pectoralis minor
In this region we can find the
Subscapular arteries which feeds the subscapularis
(This artery branches off into the thoracodorsal artery which feeds into the latissimus dorsi and the circumflex scapular artery which feeds into the teres minor and infraspinatus)
Anterior circumflex humeral artery which feeds the anterior arm muscles
Posterior circumflex artery which feeds into the posterior muscles of the arm and humeral head
23
Q
What does the axillary artery terminate as?
A
The brachial artery
24
Q
What are the 3 superficial veins of the upper limb?
A
Cephalic vein
Basilic vein
Median cubital vein
25
Where does the cephalic vein origin from?
The dorsal veinous network of the hand (lateral)
26
What vein courses along the following regions
Anterolateral forearm
Anterior to lateral epicondyle
Lateral to biceps
Into the deltopectoral triangle and finally drains into the axillary vein?
Cephalic vein
27
Where does the basilic vein origin from?
The dorsal venous network of the medial hand
28
What vein takes the following course to drain blood?
Anteromedial forearm
Anterior to medial epicondyle through the brachial fascia and continues into the axillary vein?
The basilic vein
29
Where does the medial cubital vein origin from?
From the cephalic vein near the cubital fossa
30
What is the course taken from the median cubital vein?
Superomedially across the cubital fossa and drains into the basilic vein
31
What is the clinical significance of the median cubital vein?
Venipuncture
| , the vein is very superficial hence easily accessible
32
How is the veinage in the shoulder arranged to prevent pooling of blood in extremities
Its is unidirectional
33
What are the 3 superficial veins that constitude the veinous drainage of the shoulder
Basilic vein
Cephalic vein
Median cubital vein
34
What do the deep veins accompany?
The major arteries
35
What does the axillary vein drain
The shoulder, arm, forearm and hand
36
What also drains into the axillary vein?
| Through which opening?
The cephalic vein
| Through the clavicopectoral fascia
37
The subclavian vein is the continuation of what vein?
Axillary vein
38
The drainage recieved at the subclavian vein originates fromwhere?
From the scapular region
39
What is the lymphatic system responsible for?
The drainage of the extracellular fluids not picked up by the venous system
40
Where does lymphe from digits and palms drain into?
Into the lymphatic vessels and travels along the side superficial veins of the lymphe and continue towards the axillary lymphe nodes of the axilla
41
What accompanies the veins of the superficial system?
Lymphatic vessels of the upper limb
42
What are the axillary lymphe nodes responsible for
The lymphatic drainage of the upper limbs and most of the chest wall
43
Where are the lower axillary nodes located?
Lateral and deep to the pectoral muscles
44
What are the constituents of the lower axillary nodes
Pectoral nodes
Subscapular nodes
Humeral nodes
Central nodes
45
What are the constituents of the upper axillary nodes?
Apical nodes
| Venous angle
46
What do the apical nodes unite to form?
They form the subclavian lymphe trunksthat will drain into the left and right venous angles
47
What are the venous angles
Junctions of the jugular veins and subclavian veins that form the brachiocephalic trunk
48
Where does the brachial plexus originate from
C5-T1
49
What is the neumomic to recall the divisions of the brachial plexus?
Read the darn cadaver book
Or
Real thristy? Drink cold beer
50
How many roots are found in the brachial plexus?
What are they innervated by?
5
| Innervated by the anterior rami C5-T1
51
How many divisions are there in the trunk?
What are they called?
What is their respective innervation?
3
Superior C5-6
Middle C7
Inferior C8-T1
52
What are the name of the divisions of the brachial plexus?
| What is their location?
6 total
| 3 anterior and 3 posterior
53
How many cords are there in the brachial plexus
| What is their respective innervation
3
Lateral C5-7
Medial C8-T1
Posterior: C5-T1
54
What are the terminal branches of the brachial plexus?
What is their name and respective innervation?
What cord does it originate from
```
Musculocutaneous nerve: C5-7
Originated from lateral cord
Ulnar nerve: C7-T1
Originates from medial cord
Median nerve: C6-T1
Originates frkm lateral and medial cords
Axillary nerve: C5-6
Originates from posterior cord
Radial nerve: C5-T1
Originates from posterior cord
```
55
Whatcomponents of the brachial plexus are located above the clavicle in the neck?
Root
Trunks
Divisions
56
What component of the brachial plexus is formed at the clavicular level?
Cords
57
What component of the brachial plexus is found inferior to the clavicle?
The terminal branches
58
What artery transverse over the top of the transverse ligament of the scapula?
Suprascapular artery
59
Which artery comes to the back of the scapula?
Circumflex scapular artery
60
What is the utility in arteries anastomoses?
They allow for blood to continue to be shunt through the body if an artery is blocked
61
What artery can be found in the quadrangular space?
Posterior humeral circumflex artery
62
What artery is found in the triangular space?
Circumflex scapular artery
63
what nerves compose the suprascapular branches of the brachial plexus?
- long thoracic nerve
- dorsal scapular nerve
- nerve to subclavius
- suprascapular nerve
64
what is the innervation of the long thoracic nerve?
C5-C7
65
what is scapular winging?
an injury to the long thoracic nerve will cause for patient to be unable to protract their scapula, as a result the scapula is winged, or in hyper-retraction
66
in the drawing of the brachial plexus, where is the long thoracic nerve observed?
at the level of the roots. it descends all the way to T1
67
what is the innervation of the dorsal scapular nerve?
C4-C5
68
what muscle does the dorsal scapular nerve innervate?
Levator scapulae and Rhomboids
69
in the drawing of the brachial plexus, where is the dorsal scapular nerve observed?
it diverges from C5 before the root converges with C6
70
what does the dorsal scapular nerve travel along with?
with the dorsal scapular artery
71
what is the innervation of the nerve to subclavius?
C5-C6
72
where does the nerve to subclavius branch off of?
the superior trunk of the brachial plexus
73
what muscle does the nerve to subclavius innervate?
subclavius muscle
74
where does the suprascapular nerve pass through relative to the suprascapular notch?
in the opening of the notch
75
what is the innervation of the suprascapular nerve?
C4-C6
76
what muscles are innervated by the suprascapular nerve?
supraspinatus muscle and infraspinatus muscle
77
what are the infraclavicular branches of the brachial plexus that originate from the lateral cord?
-lateral pectoral nerve
78
what are the infraclavicular branches of the brachial plexus that originate from the posterior cord?
- upper subscapular nerve
- thoracodorsal nerve
- lower subscapular nerve
79
what are the infraclavicular branches of the brachial plexus that originate from the medial cord?
- medial pectoral nerve
- medial brachial cutaneous nerve
- medial antebrachial cutaneous nerve
80
what is the innervation of the medial pectoral nerve?
C8-T1
81
what muscle(s) are innervated by the medial pectoral nerve?
- pectoralis Minor
| - pectoralis Major
82
what is the innervation of the lateral pectoral nerve?
C5-C7
83
what muscle(s) are innervated by the lateral pectoral nerve?
pectoralis major
84
in the drawing of the brachial plexus, where is the suprascapular nerve observed?
from the superior trunk (convergence of C5-C6) on the superior side
85
in the drawing of the brachial plexus, where is the nerve to subclavius observed?
from the superior trunk (convergence of C5-C6) on the inferior side
86
in the drawing of the brachial plexus, where is the medial pectoral nerve observed?
on the inferior side of the medial cord, closest to divisions
87
in the drawing of the brachial plexus, where is the lateral pectoral nerve observed?
superior to the lateral cord
88
what is the innervation of the upper and lower subscapular nerve?
C5-C6
89
what muscle is innervated by the upper subscapular nerve?
subscapularis
90
what muscle is innervated by the lower subscapular nerve?
subscaularis & teres major
91
in the drawing of the brachial plexus, where is the upper subscapular nerve observed?
inferior side of the posterior cord, closest to divisions
92
in the drawing of the brachial plexus, where is the lower subscapular nerve observed?
inferior side of the posterior cord, farthest to divisions
93
what is the innervation of the thoracodorsal nerve?
C6-C8
94
what muscle is innervated by the thoracodorsal nerve?
Latissimus dorsi
95
in the drawing of the brachial plexus, where is the thoracodorsal nerve observed?
central branch on inferior side of the posterior cord
96
what are the terminal branches of the brachial plexus?
- musculocutaneous nerve
- ulnar nerve
- median nerve
- axillary nerve
- radial nerve
97
what are the terminal branches travelling anterior to axillary artery?
- musculocutaneous nerve
- ulnar nerve
- median nerve
98
what are the terminal branches travelling posterior to axillary artery?
- axillary nerve
| - radial nerve
99
what is the innervation of the musculocutaneous nerve?
C5-C7
100
the musculocutaneous nerve is the continuation of what?
the lateral cord of the brachial plexus
101
what is the motor innervation of the musculocutaneous nerve?
anterior compartment of the arm
102
what is the sensory innervation of the musculocutaneous nerve?
terminal branch= lateral antebrachial cutaneous nerve (skin of lateral forearm)
103
what is the innervation of the ulnar nerve?
C7-T1
104
the ulnar nerve is the continuation of what?
medial chord of the brachial plexus
105
where does the ulnar nerve travel?
down the medial side of the arm posterior to the medial epicondyle (funny bone)
106
what is the motor innervation of the ulnar nerve?
anterior forearm and hand
107
what is the sensory innervation of the ulnar nerve?
1.5 digits of the medial hand
108
what is the innervation of the median nerve?
C6-T1
109
the median nerve is the convergence of what?
of the lateral and medial cords
110
where does the median nerve travel along?
travels along mid-line of the arm, through cubital fossa and along midline of anterior forearm into the hand
111
what is the motor innervation of the median nerve?
most of the anterior compartment of the forearm and part of the hand
112
what is the sensory innervation of the median nerve?
3.5 digits of the lateral hand
113
what is the innervation of the axillary nerve?
C5-C6
114
what is the motor innervation of the axillary nerve?
deltoid and teres minor (posterior compartments of the arm, forearm and hand)
115
what is the sensory innervation of the axillary nerve?
lateral shoulder
116
in what space can the axillary nerve be found?
in quadrangular space
| as it travels to the inferior lateral border of the scapula
117
what is the innervation of the radial nerve?
C5-T1
118
what is the motor innervation of the radial nerve?
posterior compartment of the arm and forearm
119
what is the sensory innervation of the radial nerve?
posterior arm, forearm, thumb and 2.5 digits of the hand
120
where does the radial nerve travel?
posterior to humerus in radial groove, anterior to lateral epicondyle of humerus, down some lateral and posterior aspects of the forearm (bifurcates at this point)
121
what space does the radial nerve pass through?
the triangular interval
122
the lateral antebrachial cutaneous nerve is the terminal branch of what nerve?
musculocutaneous nerve
123
where do the medial brachial cutaneous nerve and medial antebrachial cutaneous nerve branch from?
from the medial cord
124
what region does the dermatome of C6 cover?
the thumb
| superior region of the forearm and arm
125
what region does the dermatome of C7 cover?
index and middle finger (peace sign) as well ad middle region of the arm and forearm
126
what region does the dermatome of C8 cover?
the ring finger and pinkey as well as the inferior region of the arm and forearm
127
does C5 dermatome go into the hand?
no
128
what movement is permitted by myotomes C1-C2?
Neck flexion/extension
129
what movement is permitted by myotomes C3?
neck lateral flexion
130
what movement is permitted by myotomes C4?
shoulder elevation
131
what movement is permitted by myotomes C5?
shoulder flexion
abduction
lateral rotation
132
what movement is permitted by myotomes C6-C8?
shoulder extension
adduction
medial rotation
133
what is the riddle to recall myotomes of the upper limbs?
```
C1-C2, i nod to you
C3, don’t tickle me
C4, i’m not sure
C5, feel alive
C6-C7-C8, close the gate
```
