Upper Limb: Shoulder & Arm

Question 1

Which arteries branch off the 1st part of the axillary artery?

Answer 1

1) Superior thoracic artery

Question 2

What does the superior thoracic artery supply?

Answer 2

1) 1st 2 intercostal muscles

2) Superior aspect of serratus anterior

Question 3

Which position is the axillary vein in relation to the first part of the axillary artery?

Answer 3

Medial

Question 4

Which arteries branch off the 2nd part of the axillary artery?

Answer 4

1) Thoracoacromial artery

2) Lateral thoracic artery

Question 5

What does the lateral thoracic artery supply?

Answer 5

1) Axilla
2) Serratus anterior
3) Pectoralis major
4) Lateral breast in women
5) Subscapularis

Question 6

What does the thoracoacromial artery supply?

Answer 6

1) Pectoral branch: descends between both pec muscles and anastomoses with intercostal branches of int. mamm art & lat. thoracic
2) Acromial branch: Lateral over the coracoid process and under the Deltoid (gives branches here). Peirces deltoid and ends on the acromion in an arterial network formed by branches from the suprascapular, thoracoacromial, and posterior humeral circumflex arteries.
3) Clavicular branch: Runs upwards and medially to the sternoclavicular joint, supplying this articulation, and the Subclavius.
4) Deltoid branch: Arising with the acromial, it crosses over the Pectoralis minor and passes in the same groove as the cephalic vein, between the Pectoralis major and Deltoid, and gives branches to both muscles.

(eMRCS source)

Question 7

What nerve roots are affected in a Klumpke’s palsy?

Answer 7

C8, T1

Question 8

What are clinical features of a Klumpke’s palsy?

Answer 8

1) Claw hand (MCP joints extended and IP joints flexed)
2) Loss of sensation over medial aspect of forearm and hand
3) Horner’s syndrome
4) Loss of flexors of the wrist

(eMRCS source)