Vessels & Nerves of the Upper Limb

Question 1

Axillary artery - origin, track and end?

Answer 1

• Origin: Continuation of Subclavian artery
• Track:
  
  • First part– proximal to pectoralis minor
  • Second part– posterior to pectoralis minor
  • Third part– distal to pectoralis minor
• Branches
  • The anterior and posterior circumflex humeral arteriesform ananastomotic networkaround the surgical neck of the humerus and can be damaged in cases of fracture.
• End: lower border of the teres major by becoming brachial artery

Question 2

Axillary artery branches?

Answer 2

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(First part)
Superior thoracic artery

(Second part)
Thoracoacromial artery
Lateral Thoracic Artery

(Third part)
Subscapular artery
Anterior Circumflex
Posterior Circumflex

Question 3

Axillary Nerve - origin, track?

Answer 3

Origin:
- Posterior cord of the brachial plexus (C5, C6)

Track:
- Travels posteriorly and laterally around the surgical neck of the humerus
- Passes through the quadrangular space with the posterior circumflex humeral artery

Question 4

Axillary Nerve - supplies?

Answer 4

• Supplies the deltoid and teres minor muscles

-Terminates as the superior lateral cutaneous nerve of the arm supplying the regimental badge area

Question 5

What is the superficial palmar arch?

Answer 5

It is formed mainly by the arch of the superficial division of the ulnar artery and is completed by the superficial palmar branch of the radial artery.

Question 6

What is the effect of an injury to the axillary nerve?

Answer 6

• Inability to abduct the shoulder over 15ᵒ
• Loss of sensation over the badge area

Question 7

What is the blood supply to the scaphoid bone?

Answer 7

• Scaphoid bone primarily receives blood supply from lateral and distal branches of the radial artery via palmar and dorsal branches.
• The blood supply is abundant to middle and distal bone but neglects the proximal portion which relies on retrograde flow.

Question 8

How do you test the ulnar artery using Allen’s test?

Answer 8

• Elevate the hand and ask the patient to make a fist for 30 seconds.
• Apply pressure on both ulnar and radial arteries to occlude both.
• While still elevated, open the hand, it should be blanched.
• Release pressure over the ulnar artery, color should return in 7 seconds.

Question 9

What is the importance of the Lister tubercle?

Answer 9

Bony prominence on the dorsal surface of distal radius.
Serves as a pulley for the tendon of the EPL tendon which runs around it.

Question 10

Median, Radial & Ulnar Nerves Motor & Sensory Supply

Answer 10

Loaf muscles - Lateral two lumbricals, Opponens pollicis, Abductor pollicis brevis, flexor pollicis brevis