Upper limb 1 Flashcards
Anterior wall
Posterior wall
Medial wall
Lateral wall
of axilla made up of what
Anterior wall - pec major and minor
Posterior wall - subscapularis
Medial wall - thoracic wall + serratus anterior
Lateral wall - intertubercular sulcus of humerus
Apex (axillary inlet) of axilla located at
Lateral border of 1st rib
Contents of axilla
Axillary artery Axillary vein Brachial plexus Axillary lymph nodes Tendons of short head of biceps brachii & coracobrachialis
Axillary artery is a continuation of what artery + what does axillary continue as
Subclavian
Brachial
What point does the subclavian become the axillary artery
Lateral border of 1st rib
What point does the axillary become the brachial artery
Inferior border of teres major
Brachial plexus is the ventral rami of
C5-T1
Brachial plexus:
5 roots –> 3 … –> 6 … –> 3 … –> 5 …
3 trunks - superior, middle, inferior
6 divisions - each trunk divides into anterior + posterior division
3 cords - different divisions combine to form lateral, posterior + medial cord (see other flashcard)
5 major branches - given off by the 3 cords
What nerve roots of the brachial plexus form the
- superior trunk
- middle trunk
- inferior trunk
Superior - C5 + C6
Middle - C7
Inferior - C8 + T1
What is erb’s point
Auscultation point for heart sounds + murmurs at the left sternal border 3rd intercostal space
What is erb’s palsy + what is the characteristic clinical sign
Injury to upper trunk (C5-6) of brachial plexus –> characteristic ‘waiter’s tip’ sign where
- shoulder is internally rotated
- elbow extended + pronated
- wrist flexed
Causes of erb’s palsy
Usually due to large size or shoulder dystocia (shoulders too wide) in neonates so too big to fit through birth canal
In adults - high impact injuries
What group of muscles are affected in erb’s palsy if it is the upper trunk of brachial plexus that is affected
C5 - elbow flexors (brachialis, biceps brachii, corachoradialis + brachioradialis)
C6 - wrist extensors (extensor carpi radialis longus (ECRL), extensor carpi radialis brevis (ECRB), extensor digitorum (ED), extensor digiti minimi (EDM), extensor carpi ulnaris (ECU), abductor pollicis longus (APL), extensor pollicis brevis (EPB), extensor pollicis longus (EPL), and extensor indicis (EI))
What is klumpke’s palsy (RARE)
Injury to the inferior trunk of the brachial plexus
What group of muscles are affected in klumpke’s palsy if it is the inferior trunk of brachial plexus that is affected
Intrinsic muscles of hand
Ulnar flexors of wrist + fingers
The cords (lateral/posterior/medial) of the brachial artery are named in relation to what structure
Axillary artery in the axilla
In the axilla and the proximal aspect of the upper limb, the three cords give rise to five major nerve branches - name these
Musculocutaneous Axillary Median Radial Ulnar
The lateral cord of the brachial plexus is formed by the combination of which divisions (2)
The anterior division of the superior trunk
The anterior division of the middle trunk
The posterior cord of the brachial plexus is formed by the combination of which divisions (3)
The posterior division of the superior trunk
The posterior division of the middle trunk
The posterior division of the inferior trunk
The medial cord of the brachial plexus is formed by which division
The anterior division of the inferior trunk
Main branches of
- lateral cord
- posterior cord
- medial cord
Lateral - musculocutaneous nerve, lateral root of median nerve
Posterior - axillary nerve, radial nerve
Medial - ulnar nerve, medial root of median nerve
Superficial veins of the upper limb
Dorsal venous arch
Cephalic vein
Basilic vein
Median cubital vein
What vein joins the cephalic and basilic vein + this vein shunts blood from cephalic to basilic or basilic to cephalic
Median cubital - shunts blood from cephalic to basilic
Dermatomes of upper limb
- regimental badge patch area
- thumb
- middle finger
- pinky
- axilla
C5 C6 C7 C8 T1
All lymphatics in the upper limb drain into which group of lymph nodes
Axillary
What 2 bones make up the pectoral girdle, connecting the upper limb to the axial skeleton
Scapula and clavicle