Week 4: Vessels and Nerves of the UL

Question 1

Explain the basic arterial supply to the upper limb

Answer 1

• subclavian arteries arise from the brachiocephalic trunk on the right and arch of the aorta on the left
• subclavian continues as the axillary artery in the axilla
• axillary artery continues as the brachial artery in the arm
• brachial artery bifurcates into the radial and ulnar arteries (these supply the forearm and hand)

Question 2

What is the boundary for the axillary artery becoming the brachial artery?

Answer 2

teres major

Question 3

The brachial artery gives off a branch that is the major supplier to the posterior compartment of the arm. What is it called?

Answer 3

profunda brachii

Question 4

which artery does the ulnar artery give off?

Answer 4

common interosseous which gives off anterior and posterior interosseous

Question 5

Which artery is at risk in a:

1. Fracture of the humeral shaft
2. Supracondylar fracture

Answer 5

1. Profunda brachii

2. Brachial artery

Question 6

Which vein drains the deep veins of the upper limb?

Answer 6

brachial veins

Question 7

Which vein is a communication between the cephalic and basilic vein?

Answer 7

median cubital vein

Question 8

What is the name of the superficial vein that runs up the anterior aspect of the forearm and drains into the median cubital?

Answer 8

median antebrachial vein

Question 9

What is the superficial venous arch?

Answer 9

veins in the palm

Question 10

What is the dorsal venous network?

Answer 10

veins on the back of the hand

Question 11

Explain the deep vein drainage system of the hand

Answer 11

palmar and dorsal digital veins drain into the deep palmer venous arch and up through the veins of the forearm

Question 12

Explain how the radial nerve branches

Answer 12

Divides into two branches: superficial and deep

• superficial is sensory supply of skin
• deep branch continues as posterior interosseous nerve

supplies all posterior forearm muscles

Question 13

The ‘M’ shape of the brachial plexus leads us to be able to identify which nerves?

Answer 13

musculocutaenous, ulnar and median

Question 14

Which nerve innervates the deep muscles of the anterior compartment of the forearm?

Answer 14

median nerve (anterior interosseous nerve)

Question 15

What is the thenar eminence?

Answer 15

bulky muscle region at the bottom of the thumb/palm innervated by the recurrent branch of the median nerve:

• adductor pollicis brevis
• flexor pollices brevis

Question 16

What does the deep branch of the ulnar nerve supply?

Answer 16

• hypothenar eminence (raised area proximal to little finger)
• AP
• interossei
• medial 2 lumbricals

Question 17

Which areas of the hand does the radial nerve innervate?

Answer 17

-dorsal aspect of lateral hand and lateral 3 difits as far as the DIPJs of the 2nd and 3rd digits and the IPJ of the thumb

Question 18

Which areas of the hand does the median nerve innervate?

Answer 18

• middle and lateral palm

- dorsal aspec of lateral 3.5 digits distal to DIPJ of fingers and IPJ of thumb

Question 19

What areas of the hand does the ulnar nerve innervate?

Answer 19

• medial pal

- dorsum medial 2 digits excluding lateral 1/2 of tip of 4th digit, distal to DIPJ

Question 20

What is a myotome?

Answer 20

the muscle mass innverated by a single spinal nerve

Question 21

Spinal nerve C5 is tested by which movement?

Answer 21

shoulder abduction –> C5 contributes to axillary nerve which innervates deltoid which abducts the shoulder

Question 22

Spinal nerve C6 is tested by which movement?

Answer 22

Elbow flexion

Question 23

Spinal nerve C7 is tested by which movement?

Answer 23

Elbow extension

Question 24

Spinal nerve C8 is tested by which movement?

Answer 24

finger flexion, thumb extension

Question 25

Spinal nerve T1 is tested by which movement?

Answer 25

Finger abduction and adduction

Question 26

What is a green stick fracture?

Answer 26

fracture in a young person when the bone bends and breaks, but not into two pieces

Question 27

What is a colles fracture?

Answer 27

fracture through the most distal part of the radius

Question 28

What is the most common of the carpal bones to fracture?

Answer 28

scaphoid bone

Question 29

How do the ulnar artery and nerve travel in relation to the carpal tunnel?

Answer 29

superficially (along it)

Question 30

Which is the only tendon that can flex the distal phalanx?

Answer 30

flexor digitorum profundus (FDP)