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Surgical Anatomy MMB8033 Newcastle > Upper Limb > Flashcards

Upper Limb Flashcards

1
Q

Draw the brachial plexus

A

HAHAHAHAH

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2
Q

Deltopectoral approach set up?

A

GA, supine, arm abducted and on radiolucent board

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3
Q

Landmarks and incision for deltopectoral approach?

A

Acromion, clavicle. coracoid. From coracoid along deltopectoral groove

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4
Q

Why deltopectoral approach?

A

Extensible, east access to anterior shoulder joint

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5
Q

First thing to identify and preserve along groove?

A

cephalic vein with its fat layer- reflect medially- have to tie off tributies to deltoid when dissecting

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6
Q

Fascia to expose in groove?

A

Clavipectoral fascia

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7
Q

What tendon is underneath the clavipectoral fascia?

A

conjoined tendon- made up of short head of biceps and coracobrachialis attaching onto the coracoid

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8
Q

What muscles make up the rotator cuff?

A

Subscapularis- internal rotation
Supraspinatus- abduction
Infraspinatus- external rotation
Teres minor- external rotation

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9
Q

Quadrangular space contents and boarders?

A

Axillary nerve, posterior circumflex humeral vessels

Teres minor
Triceps
Teres major
humerus

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10
Q

Triangular space contents and boarders?

A

Circumflex scapular artery

Teres minor
Teres major
Triceps

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11
Q

Triangular interval contents and boarders?

A

Radial nerve

Teres major
Triceps
Triceps

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12
Q

Incision for deltoid splitting approach?

A

Anterior acromion, 4-6 cm distally along deltoid

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13
Q

Where should you divide the deltoid?

A

between the anterior and middle third, normally a fatty streak is present

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14
Q

What to watch out for in deltoid splitting approach?

A

Axillary nerve- therefore do not extend too inferiorly,

damage will cause loss of flex only

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15
Q

Where is the worse place to damage the axillary nerve?

A

Just below the humeral neck

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16
Q

Internervous plane of deltopectoral approach?

A

Medial and lateral pectoral- pec major

axillary- deltoid

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17
Q

Internervous plane for henry’s approach to humerus

A

between the brachialis (musculocutaneous n. and radial n., deltoid insertion divides the muscles innervation)
brachioradialis (radial n.)

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18
Q

Use of henry’s approach to humerus?

A

Access to proximal 4/5ths of humerus

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19
Q

Landmarks for henry’s humerus?

A

Coracoid process, bicipital tubercule on radial head

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20
Q

Incision for henry humerus?

A

Lazy s across joints, make a curved incision over the lateral border of the biceps centered over the fracture site

21
Q

What muscle identify and reflect/divide for henry’s humerus?

A

The brachialis and biceps are retracted medially and the brachioradialis laterally

22
Q

What nerves needed to be identified and avoided, where do they lie for henry’s humerus?

A

Radial nerve- between brachialis and brachioradialis
Lateral antebrachial nerve- This terminal branch of the musculocutaneous nerve is injured at the distal end of the incision as it exits the biceps laterally

23
Q

Use of posterior approach to humerus?

A

access to inferior 2/3rds of humerus

24
Q

Landmarks for posterior approach to humerus?

A

medial and lateral epicondyles, olecranon, deltoid insertion on the humerus.

25
Q

Incision for posterior humerus?

A

Curve around olecranon

olecranon to deltoid attachment

26
Q

Which muscles are to be split in post humerus?

A

short and long head of triceps

27
Q

Which nerve andwhere? post humerus?

A

Radial nerve on middle head of biceps

28
Q

Henry’s elbow use?

A

Vascular access to brachial artery- emergency

Long head of biceps rupture repair

29
Q

Landmarks for henry elbow

A

5cm prox to flex crease
lateral boarder of biceps brachii
medial boarder of brachioradialis

30
Q

Incision for henry elbow

A

Lazy s, follow medial boarder of brachioradialis

continue between brachioradialis and protnator teres

31
Q

What neurovascular structures are at danger for henry’s elbow

A

Median cubital vein

medial antebrachial cutaneous nerve

32
Q

Where does the long head of biceps insert?

A

radial tuberosity

33
Q

Nerve vulverable in posterior approach to elbow?

A

ulnar

34
Q

lateral/radial approach to elbow use?

A

radial head/ capitalu

35
Q

Incision for lateral elbow?

A

Lat humerus to lat epicondyle, betwee ECRB and ECRL

36
Q

What ligament is on the radial head?

A

annular lig

37
Q

What neurovascular structures are at risk in the lateral approach to the elbow?

A

Anterior- posterior interosseus nerve

prox- radial nerve

38
Q

medial approach to elbow use

A

ulnar nerve, medial epicondyle/coranoid #

39
Q

nerve at risk in medial approach?

A

ulnar nerve

40
Q

Henry’s forearm internervous plane?

A

prox- brachioradialis (radial) and pronator teres (median)

distally- brachioradialis (radial) and FCR (median)

41
Q

What artery is beneath brachioradialis?

A

radial artery

42
Q

What nerve splits at the intermuscular septum to a sensory and motor branch?

A

radial
posterior interosseous
superficial sensory

43
Q

Which muscles can be released to access the anterior radial head?

A

pronator teres
FPL
Quadrator teres

44
Q

Which muscles should you avoid releasing and why?

A

supinator

damage to PIN

45
Q

Incision for carpal tunnel?

A

4th metacarpal
2-3 cm distal to palmar crease
use palmarus longus as a guide

46
Q

Layers for carpal tunnel release?

A

skin, fat, ApoN of FLP, flexor retinaculum

47
Q

What structure is medial to carpal tunnel?

A

ulnar nerve in Guyon’s canal

48
Q

What variant can happen in the carpal tunnel?

A

Median nerve

Motor branch to the thumb coming off through flexor retinaculum

49
Q

Carpal bones?

A 
Scaphoid
Lunate
Triquentum
Pisiform
Trapezium
Trapezioid
Capitate
Hamate

Surgical Anatomy MMB8033 Newcastle (6 decks)

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