upper limb+ forearm, wrist hand Flashcards
blood supply of upper limb (arterial supply)
- subclavian artery
- axillary artery
- brachial artery
- profunda brachii
- radial artery
- ulnar artery
when does subclavian artery become axillary artery?
at the border of the first rib
when does axillary artery become brachial artery?
at the inferior border of teres major
type of venous drainage (veins)
- deep veins
accompany arteries and usually take the same name - superficial veins
rub subcutaneously (under the skin)
deep vein- venous drainage
- palmar venous arches
- ulnar + radial
- brachial
- axially
superficial veins- venous drainage
- digital vs.
- palmar venous arches
- cephalic + basilic
- axillary
the axilla
- important area of passage for blood vessels and nerves
- including those of the brachial plexus
walls of the axilla
anterior
- pec major
- pec minor
medial wall
- thoracic wall
- serratus anterior
posterior
- subscapularis + teres major
lateral wall
- humerus
the brachial plexus
- a mixed nerve plexus
- carries both sensory and motor information
what does the brachial plexus innervate
- pectoral girdle
- upper limb & skin of arm
- forearm
- hand
what is brachial plexus divided into
- roots
- trunks
- divisions
- cords
- branches
roots
formed by contributions of spinal nerves
- C5-T1
(there is a C8 included even though C8 is not a thing)
nerves that come off the root
dorsal scapular nerve
- levator scapulae
- rhomboid major & minor
long thoracic nerve
- serratus anterior
- contributions from C5-C7 roots from the long thoracic nerve
trunks
- superior
- middle
- inferior
nerves off the trunks
superior truck: suprascapular nerve
- supraspinatus
- infraspinatus
divisions
3 anterior divisions
3 posteriors divisions
cords
once the anterior and posterior divisions have entered the axilla, they form 3 cords
- named by their position relative to the axillary artery
- lateral
- posterior
- medial
lateral cord
lateral pectoral nerve
- pec major
what nerve comes off medial cord
medial pectoral nerve
- pec major and minor
posterior cord
thoracodorsal nerve
- latissimus dorsi
subscapular nerves
- subscapularis
- teres major
branches
- musculocutaneous nerve (lateral cord)
- axillary nerve (posterior cord)
- median nerve (lateral & medial cord)
- radial nerve (posterior cord)
- ulnar nerve (medial cord)
musculocutaneous nerve
- muscles of anterior compartment of arm
- lateral cord
- C5-C7
axillary nerve
- deltoid & teres minor
- posterior cord
- C5, C6
median nerve
- muscles of anterior forearm
- muscles of hand
- lateral & medial nerve
- C5-T1
radial nerve
- posterior cord
- muscles of posterior arm and forearm
- C5-T1
ulnar nerve
- medial cord
- FCU, FDP, muscle of the hand
- C8-T1
what nerves would be impacted if the medial cord was damaged
- median n.
- ulnar n.
if the posterior cord of the brachial plexus was damage which of the following nerve (s) would be affect
a) axillary nerve
b) dorsal scapular nerve
c) ulnar nerve
d) radial nerve
e) musculocutaneous nerve
a), d)
radius- distal end
ulnar notch
- articulates with head of ulna
- forms distal radio-ulnar joint
styloid process (thin boney projection)
- stabilize wrist joint
- bigger
ulna- distal
round NOT flat
- styloid process
- process articulates at distal radio-ulnar joint
- can palpate process posteriorly
interosseous membrane
- fibrous sheath
- separates forearm muscles into anterior and posterior compartments
annular ligament
- think band surrounding head of radius
- maintains contact of radius with radial notch of ulna
- proximal radioulnar joint
- flexibility allows for pronation and supination
radioulnar ligaments
- stabilizers
- distal radioulnar joint
bones of the wrist
proximal row (lateral to medial)
Scaphoid–> Lunate–> Triquetrum–> pisiform
distal row (medial to lateral)
hamate–> capitate–> trapezoid–> trapezium
what can you not see from the dorsal view
- pisiform
- hook of hamate
what is on the hamate
hook of hamate
radiocarpal joint
- radius articulates with scaphoid, lunate, and triquetrum
- direct articulation
- synovial condylar (ellipsoidal joint)
ulnocarpal joint
- ulna connects with lunate and triquetrum
- no direct articulation
- common site of wrist injuries
(ligaments connect them together)
phalanges
- proximal interphalangeal joints
- distal interphalangeal joints
distal phalanx
middle phalanx
proximal phalanx - thumb (pollox) only has proximal and distal phalanges
metacarpals
- numbered 1-5 lateral to medial
- carpometacarpal joints
- metacarpal phalangeal joint
what joint does the thumb not have
no distal interphalangeal joint
