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Molecules and Energetics Block 1 > The Brachial Plexus > Flashcards

The Brachial Plexus Flashcards

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1
Q

What is the brachial plexus formed by?

A

Ventral primary rami of spinal nerves C5 through T1

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2
Q

Can damage to the plexus or any of its parts lead to both sensory and motor damage?

A

Yes-each of the rami contain both sensory and motor aspects.

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3
Q

True or False. Does the given terminal branch of the plexus contain fibers from multiple spinal elements?

A

True

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4
Q

The long thoracic nerve contains fibers from what spinal segments?

A

C5, C6, and C7

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5
Q

Where is the proximal portion of the plexus located?

A

Neck

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6
Q

Where is the distal portion of the plexus located?

A

Axilla

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7
Q

Where do the ventral primary rami that make up the plexus originate from?

A

Intervertebral foramina between similary # vertebrae

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8
Q

Where is the position of the first rib?

A

C-8 and T-1

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9
Q

How is the plexus divided? Think mneumonic…

A

Roots; Trunks; Divisions; Cords; Branches

“Randy Taylor Drinks Cold Beers”

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10
Q

Which spinal segments form the upper trunk?

A

C-5 and C-6

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11
Q

What spinal segments form the middle trunk?

A

C-7

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12
Q

Which spinal segments form the lower trunk?

A

C-8 and T1

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13
Q

What does each trunk divide into?

A

Anterior and Posterior Division

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14
Q

What forms from the anterior divisions of the upper and middle trunks?

A

Lateral Cord

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15
Q

What cord does the anterior division of the lower trunk form?

A

Medical Cord

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16
Q

What do all three posterior divisions form?

A

Posterior Cord

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17
Q

How many branches arise from the roots?

A

2

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18
Q

How many branches arise from the trunks?

A

2

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19
Q

How many branches arise from the divisions?

A

0

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20
Q

How many branches arise from the cords?

A

13

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21
Q

If there is an injury to the upper roots of the plexus (C5-C6), what characteristics would you observe?

A

E.G. Erb-Duchenne Palsy
Paralysis of shoulder muscles, lack of innervation to the flexors and supinators of the arm
Arms protonated, shoulders slumped

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22
Q

What is a characteristic symptom that would occur if you had a lower plexus (C8-T1) injury?

A

Claw hand; major paralysis of the hand

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23
Q

What system is the lymphatic system part of?

A

Circulatory System

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24
Q

How does blood get from the arteries to the lymph system?

A

1) Arteries deliver oxygenated blood to tissues reaching the capillary bed
2) At the arterial side of the capillary bed, the hydrostatic pressure is great.
3) High pressure causes fluid from the blood to enter the interstitial spaces of the tissue
4) Fluid largely draw back up into the venous end of the system by plasma oncotic pressure BUT a small portion gets left behind and is drained from the tissues by recollection in lymphatic vessels

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25
Q

What is the duct that begins in the abdomen and receives lymph from 3/4 of the body?

A

Thoracic duct

26
Q

Where does blood from the upper 1/4 of the body drain to?

A

Right lymphatic duct

27
Q

What trunk does lymph drain from the upper limb?

A

Subclavian trunk

28
Q

What trunk does lymph drain from the lower limb?

A

Lumbar trunk

29
Q

What do lymph nodes contain that are important in initiating a response to foreign substances that might gain access to the lymphatic vessels?

A

Lymphocytes

30
Q

Around how many lymph nodes are found in the axilla?

A

20-30

31
Q

What are the 5 groups of the axillary lymph nodes?

A

1) Pectoral (anterior) nodes
2) Subscapular/Posterior nodes
3) Lateral nodes
4) Central nodes
5) Apical nodes

32
Q

What trunk receives lymph from the nodes of the apical nodes?

A

Subclavian trunk

33
Q

What do the pectoral/anterior nodes drain and where are they found?

A

1) Breast, superficial chest and abdomen

2) Lower border of pectoralis minor

34
Q

What do the subscapular (posterior) nodes drain and where are they found?

A

1) Superficial areas of the back down to the iliac crest

2) Subscapularis muscle

35
Q

What do the central nodes drain and where are they found?

A

1) Axillary fat

2) Pectoral, subscapular and lateral groups of nodes

36
Q

What do apical nodes receive lymph from?

A

1) Pectoral, Subscapular, Lateral, Central

37
Q

Where do infraclavicular nodes come form?

A

1) Deltopectoral triangle
2) Receive lymph from: Lateral part of the upper limb along the course of the cephalic vein and drain apical axillary nodes

38
Q

What is edema?

A

Accumulation of Fluid

39
Q

What is an important clinical consideration of lymph nodes?

A

Help cancer cells to metastazie from the primary lesion via the lymphatic channels

40
Q

What region is the mammary gland located in?

A

Pectoral gland

41
Q

The mammary gland is classified as what type of exocrine gland?

A

Subcutaneous exocrine gland

42
Q

Over which ribs, does the mammary gland fall over?

A

C-2 to C-6

43
Q

The mammary gland is divided into how many quadrants?

A

4

44
Q

Which quadrants of the mammary gland are most likely to be affected by cancer?

A

Lateral quadrants

45
Q

How many lobes is the mammory gland divided into and what are they separated by?

A

15-20 lobes which are drained by separate mammary ducts; connective tissue septum

46
Q

What are the structures called that may cause dimpling of the breast in cancer?

A

Suspensory ligments/Cooper’s Ligaments

47
Q

What separates the mammory gland from the deep fascia of the muscle?

A

Retromammary space

48
Q

What is a simple mastectomy?

A

Removal of the breast up to the retromammary space

49
Q

What is a radical mastectomy?

A

Removes the breast from the underlying muscle and many of the axillary lymph nodes

50
Q

What is the arterial blood supply of the breast from the medial quadrants?

A

Branches from the internal thoracic artery

51
Q

What is the arterial blood supply of the breast from the lateral quadrants?

A

1) Lateral Thoracic artery

2) Thoracoacromial artery

52
Q

Lymphatic vessels follow what kind of drainage patterns?

A

Venous drainage

53
Q

What are the lateral mammory venous drainage pathways?

A

Tributaries to the axillary vein

54
Q

What are the medial mammory venous drainage pathways?

A

Internal thoracic vein

55
Q

What nodes do the medial part of the breast drain into?

A

Parasternal nodes and up

56
Q

What nodes do the lateral part of the breast drain into?

A

Pectoral/anterior group of axillary nodes; and then drain to the central/apical groups of axillary nodes

57
Q

What is the most common route for metastatic disease of the breast?

A

Pectoral/anterior group of axillary nodes; and then drain to the central/apical groups of axillary nodes

58
Q

How do clinicians refer to the axillary nodes and what muscle are these classifications based off of?

A

Pectoralis Minor

1) Level I (lateral to muscle; most distal to upper arm)
2) Level 2 (deep to pectoralis muscle)
3) Level 3 (medial to the muscle and closet to the upper limb)

59
Q

What typically happened with the traditional removal of the axillary nodes in breast cancer patients or rad/onc?

A

1) Pitting edema of upper limb (lose lymphatic drainage of the upper limb)
2) Axillary dissection

60
Q

What is the new lymph node sparing procedure used to treat breast cancer?

A

Sentinel node biopsy

Molecules and Energetics Block 1 (4 decks)

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