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Clinical Anatomy Block 2 > Upper limb (Fasciae Muscles of Pectoral Girdle and Arm) > Flashcards

Upper limb (Fasciae Muscles of Pectoral Girdle and Arm) Flashcards

1
Q

What does the Superficial fascia contain?

A
  1. Fat
  2. Superficial blood vessels
  3. Superfical lymph vessels and nodes
  • Known as the Cubital or supratrochlear nodes
    • Located above the medial epicondyle of the humerus
  1. Superficial fascia of the neck has the Platysma
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2
Q

What are Superficial veins?

A
  1. Cephalic
  2. Basilic
  3. Median cubital
  4. Median antebrachial

*All located in the Cubital Fossa for venipuncture

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3
Q

What nerves are in the Brachial plexus of the Superficial Fascia?

A
  1. Lateral pectoral nerve
  2. Lateral antebrachial cutaneous nerve
  3. Superficial branch of radial nerve
  4. Medial brachial cutaneous nerve
  5. Medial antebrachial cutaneous nerve
  6. Dorsal branch of ulnar nerve
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4
Q

What are the Cervical plexus nerve in the Superior Fascia?

A
  1. Supraclavicular nerves
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5
Q

What is the Deep Fascia of the Pectoral?

A
  1. Invests pectoralis major
  2. Continuous with the Axillary and Deltoid fascia
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6
Q

What is the Axillary fascia?

A
  1. Forms the floor of the Axilla and Clavipectoral fascia
  2. Clavipectoral fascia has two parts:
  • Costocoracoid membrane
    • Contains:
      • Pectoralis minor
      • Subclavius
      • Cephalic vein
      • Lateral pectoral nerve
      • Throacoacromial artery
  • Suspensory ligament of the axilla
  1. Continuous with: Latissimus dorsi fascia
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7
Q

What is the Deep fascia of the Brachial fascia?

A
  1. Medial intermuscular septa
  • Contains:
    • Ulnar nerve
    • Superior ulnar collateral artery
  1. Lateral intermuscular septa
  • Contains:
    • Radial nerve
    • Radial collateral branch (deep brachial artery)
  1. Intermuscular septa
  • Attach to supracondylar ridge of the humerus
  • Divides arm into anterior and posterior fascial compartments
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8
Q

What is the Deep fascia of the Antebrachial fascia?

A
  1. Contains the Cubital fossa that forms the Bicipital aponeurosis
  • Connected to biceps brachii tendon
  • Protects neurovascular structures (brachial artery and medial nerve)
  1. Antebrachial fossa attaches to the posterior border of ulna
  • Connecting with:
    • Medial and Lateral Intermuscular septum
  • Both attach to the bone of the forearm with the ulna, radius, and interosseous membrane
  • They divide the forearm into anterior and posterior fascial compartments
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9
Q

What is teh Deep fascia at the Wrist?

A

Forms:

  1. Extensor retinaculum
  • Fibrous septa extend to the distal third dorsal surface of the radius and ulna to form 6 separate tunnels
  • Tunnels
    • Allows some tendons of the posterior compartment of the forearm to pass into the hand
    • Lined by synovial sheath
      • Extends above and below the retinaculum on the tendons
  1. Palmar carpal ligament
  • Contains:
    • Palmar branch of median and ulnar nerve
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10
Q

What is the Deep fascia at the Hand?

A

Forms:

  1. Flexor retinaculum
  • Superficially contains the Ulnar vessels and nerve
  • Upper border:
    • At the level of the distal transverse skin crease on the anterior surface of the wrist
    • Continous with the antebrachial fascia
  • Lower border:
    • Attached to the apex of the palmar aponeurosis
  • Carpal tunnel contains:
    • Flexor digitorum superficialis
    • Flexor digitorum profundus
    • Flexor carpi radialis
    • Flexor pollicis longus
    • Median nerve
      1. Palmar aponeurosis
      2. Fibrous digital sheaths
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11
Q

What is the Deep fascia of Palmar aponeurosis?

A
  1. Provides attachment, protection, and making a grip more efficient
  2. Attachments:
  • Palmaris longus tendon
  • Four digital bands
    • Each diverge around the flexor tendons and fibrous digital sheath
  1. Extends: Medially and Laterally
  • Medial fibrous septum
    • Attaches to 5th metacarpal bone
  • Lateral fibrous septum
    • Attaches to 3rd metacarpal bone
  1. Septums divide palm into:
  • Hypothenar compartment
  • Thenar compartment
  • Midpalmar compartment
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12
Q

What is Dupuytren’ contracture?

A
  1. Fibrous degeneration
  2. Excessive formation of collagen affecting the digital bands
    * Most common affecting 4th and 5th digital bands
  3. Results in TRIGGER FINGER
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13
Q

What is Compartment syndrome?

A
  1. Affects Fascial compartments
  2. Painful condition from increased pressure within a closed body space, especially forearm or leg
  3. Two types acute or chronic
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14
Q

What is Acute Compartment syndrome?

A

Acute:

  • Develops when swelling or bleeding occurs within a compartment (b/e fascia doesn’t stetch or expand)

Causes:

  • Fracture of a bone
  • Badly bruised muscle
  • Crush injuries
  • Tight casts (contricting bandages)
  • Anabolic steriod use

Clinical:

  • Increase pressure within compartment
  • Compresses veins causing impaired venous drainage
  • Accumulation of waste products and swelling
  • Tissue pressure compromises arterial blood flow resulting in muscle and nerve ischemia

Manifestations:

  • Lack of oxygenated blood
  • Pain
    • Classic sign and increase when muscles are streched/squeezed
  • Paresthesias
    • Tingling or burning sensation (Nerve irritation)

Late Manifestations: (Indicates permanent tissue injury)

  • Absence of distal pulse
  • Paralysis

Treatment:

  • Surgical emergency (called Fasciotomy)
    • Incision of the skin and fascia of the affected compartment to allow more space for the muscle to swell
    • No effective nonsurgical treatment
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15
Q

What is Chronic Compartment Syndrome?

A
  1. Also known as Exertional compartment syndrome
  • Reoccuring syndrome from exercise or work
  • Subsides when activity is stopped but resume when activity is resumed
  1. Symptoms:
  • Numbness
  • Visible muscle bulging
  • Difficulty moving affected limb
  1. Treatment:
  • Not a surgical emergency
  • Avoid activity causing the condition
  • Physical therapy
  • Anti-inflammatory drugs
  • Surgical treatment (Fasciotomy, if regular treatment fails)
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16
Q

What is the Pectoralis major?

A
  1. Attaches:
  • Clavicular head
    • Clavicle (medial half)
  • Sternal head
    • Sternum
  • Superior 6 costal cartilages
  • Aponeurosis of external abdominal oblique
  1. Insection:
    * Intertubercular groove (lateral lip)
17
Q

What is the Pectoralis minor?

A

Anterior thoracoappendicular muscle

  1. Origin:
    * 3rd to 5th ribs
  2. Insection:
    * Coracoid process of scapula
18
Q

What is the Subclavius?

A

Anterior thoracoappendicular muscles

  1. Origin:
    * 1st rib and costal cartilage
  2. Insertion:
    * Inferior surface of clavicle
19
Q

What is the Serratus anterior?

A

Anterior throacoappendicular muscle

  1. Origin:
    * First 8 ribs
  2. Insertion:
    * Medial border of scapula
20
Q

What is the Trapezius?

A

Posterior thoracoappendicular muscles

  1. Origin:
  • Occipital bone
  • Ligamentum nuchae
  • C7 to T12 spinous process
  1. Insertion:
  • Clavicle (lateral 1/3)
  • Scapula (spine/acromion)
21
Q

What is the Latissimus dorsi?

A
  1. Origin:
  • Lower 6 thoracic vertebrae
  • Thoracolumbar fascia (Iliac crest)
  • Inferior 4 ribs
  1. Insertion:
    * Intertubercular groove
22
Q

What is the Levator scapulae and Rhomboids?

A
  1. Levator scapulae origin:
    * C1 to C4 transverse process
  2. Rhomboid Minor origin:
    * C7 to T1 Vertebrae Spinous processes
  3. Rhomboid Major origin:
    * T2 to T5 Spinous processes
  4. Insertion for Levator scapulae and Rhomboids
    * Medial border of scapula
23
Q

What is the Deltoid muscle?

A

Scapulohumeral Muscles

  1. Origin:
  • Clavicle (lateral 1/3)
  • Scapula (spine/acromion)
  1. Insertion:
    * Deltoid tuberosity
24
Q

What is the Teres major?

A

Scapulohumeral Muscles

  1. Origin:
    * Scapula (inferior angle)
  2. Insertion:
    * Intertubercular groover (medial lip)
25
Q

What is the Rotator cuff?

A

4 Muscles (3 posterior and 1 anterior)

  • Insertion: Teres minor, Supraspinatus, and Infraspinatus
    • Greater tubercle
      1. Teres Minor
  • Origin: Scapula (lateral border)
    2. Supraspinatus
  • Origin: Supraspinatus fossa
    3. Infraspinatus
  • Origin: Infraspinatus fossa
    4. Subscapularis
  • Origin: Subscapular fossa
  • Insertion: Lesser Tubercle
26
Q

What is the Biceps brachii?

A
  1. Origin:
  • Short head: Coracoid process
  • Long head: Supraglenoid tubercle
  1. Insertion:
    * Radial tuberosity
  2. Clinical:
  • Rupture of long head tendon of biceps brachii results in POPEYE deformity
    • Localized bulge at distal part of arm
27
Q

What is the Brachialis muscle?

A
  1. Origin:
    * Humerus
  2. Insertion:
    * Coronoid process/tuberosity of Ulna
28
Q

What is the Coracobrachialis muscle?

A
  1. Origin:
    * Coracoid process
  2. Insertion:
    * Humerus
29
Q

What is the Triceps brachii?

A
  1. Origin:
  • Long head: Infraglenoid tubercle
  • Lateral head: Superior to radial groove
  • Medial head: Inferior to radial groove
  1. Insertion:
    * Olecranon

Clinical Anatomy Block 2 (7 decks)

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