week 7 movement Flashcards
what is the route of the vasculature of the upper limb in terms of name?
subclavian artery –> axillary artery –> brachial artery –> radial and ulna artery
what are the three branches of the aortic arch?
left common carotid, left subclavian artery and braciocephalic trunk
what does the braciocephalic trunk split into?
right subclavian and common carotid artery
what is the first branch of the subclavian artery ?
vertebral artery that supplies the midbrain and brain –> bind to form the basilla artery
what is the second branch of the subclavian artery ?
the internal thoracic artery
what is the 3rd branch of the subclavian artery and what does it do?
thyrocervical trunk –> splits into smaller arteries –> supplies the neck and thyroid gland. Inferior thyroid artery is a branch and this supplies the thyroid gland
which vertebraes does the verterbal artery go through?
Passes through transverse foramina C6-C1
what is Subclavian steal syndrome?
Occlusion of the subclavian artery proximal to the vertebral artery origin causing reversed flow in the ipsilateral vertebral artery
how does the body get around Subclavian steal syndrome?
Blood is ‘stolen’ from the circular vertebrobasilar system to supply the distal territory of the occluded or stenosed artery –> gives time for the blockage to be fixed
what happens to the pressure of blood in the blocked subclavian artery aftery subclavian steal syndrome?
the pressure is reduced in the blocked subclavian artery compared to the unblocked because the flow of blood is reduced
at what point does the subclavian artery become the axillary artery?
at the lateral border of 1st rib
what are the three divisions of the axillary artery?
First part superior to pectoralis minor muscle:
Second part deep topectoralis minor muscle:
Third part inferior to pectoralis minor muscle:
what 2 arteries branch from the third part of the axillary artery?
anterior and posterior circumflex humeral artery –> go through the qaudrangular space –> wrap around the neck of the humerus –> anterior is shorter
what is the border of axillary to brachial artery?
inferior border of teres major muscle
main 3 branches of brachial artery?
Profunda brachii –>close to origion
Superior ulnar collateral artery
Inferior ulnar collateral artery
which of the main branches of brahcial artery runs deep into the arm?
profunda brachii
what arteries does the brachial artery split into at the cubital fossa?
ulna and radial artery –> forearm
what is the course of the profunda brachii and what does it supply?
Wraps around posterior surface of humerus
Runs in radial/spinal groove with radial nerve –> back of humerus
supplies the posterior muscles of the arm
how is the brachial artery commonly injured?
from both penetrating and blunt trauma usually associated with humeral fractures
what is the possibility of necrosis and loss of limb when there is ligation proximal to the profunda brachii artery
50% –> this is due to the fact there is no blood supply at all going to the arm –> no route for blood to go down
what is the possibility of nerosis and loss of limb when there is ligation distal to the profunda brachii artery ?
25% –> this is because there is collateration between the profunda brachii artery and lower blood vessels that can deliver blood supply to the arm and forearm –> reduce the chance
what is Peri-articular anastamoses?
Network of anastomoses of brachial and profunda brachii arteries in the arm with radial and ulnar arteries in the forearm.
why is there a need for Peri-articular anastamoses?
Ensures blood flow to the forearm even if elbow is fully flexed.
how is anastomosis of the medial side of the elbow joint formed?
superior and inferior ulna collateral arteries anastomose with the posterior and anterior recurrent arteries –> when there is compression of the brachial artery
how is anastomosis of the lateral side of teh elbow joint formed?
between the radial collatery artery (branch of the profunda brachii) and the radial reccurent artery ( branch of the radial artery)
what does the radial artery supply?
Supplies the anterolateral aspect of the forearm including flexors and extensors –> runs along the radial bone
what does ulna artery supply?
Supplies the medial side of forearm – mainly flexors and pronators
what branches come for the ulna artery?
Gives off common interosseous artery (trunk) near its origin.
what does the common interosseous artery split into?
This divides into anterior and posterior interosseous arteries which supply the middle of the flexor and extensor compartments respectively.
how is the superfecial palmer artery formed?
ulnar artery anastomoses with the superficial branch of the radial artery
what structures are supplied by the radial artery?
Thumb and lateral half of the 2nd finer supplied by the radial artery
how does the ulna artery enter the hand?
through the ulnar canal (Guyon’s canal) superficial to the flexor retinaculum
how does the radial artery enter the palmar surface of the hand?
Passes dorsally and crosses the floor of the anatomical snuff box.
Pierces 1st dorsal interosseous muscle and passes between the transverse and oblique heads of adductor pollicis to enter the palmer surface of the hand.
why is allen test done prior too?
before blood is taken from the radial artery for blood gases
what is the allen test testing for?
determine whether the patency of the radial or ulnar artery is normal–> to make sure there is a superfecial palmar arch and therefore no blood clot will form by drawing blood
what is the advantage of having a pulse point at the axillary artery?
Useful place to control blood flow to the upper limb in the event of injury to the brachial artery
what are the two points of palpating the brachial artery?
can palpatate the artery in the cleft between the tricep brachii and bicep brachii
also palpatate at the cubital fossa –> medial to the tendons of bicep brachii
how is ulna and radial artery palpated?
The radial and ulnar arteries can be palpated lateral to the tendons of flexor carpi radialis and ulnaris respectively.
Radial artery can also be palpated at the anatomical snuff box
where does dorsal venous drainage begin?
with dorsal venous arch which receives blood from digits
which veins drain from the dorsal venous arch on the lateral side?
Cephalic vein drains lateral side of dorsal venous arch
which veins drain from the dorsal venous arch on the medial side?
Basilic vein drains medial side of dorsal venous arch
what is the route of cephalic vein?
Runs through deltopectoral triangle
Pierces clavipectoral fascia
Drains into axillary vein
where do you take venepuncture?
at the median cubital vein
what structure connects the cephalic vein and the basilic vein?
the median cubital vein
what is the positioning of the median cubital vein?
lies superficial to the bicipital aponeurosis –> above the cubital fossa
What is the Venae Comitantes?
Two veins (sometimes more) that closely accompany an artery in such a manner that the pulsations of the artery aid venous return.
in vena comitantes what is the structure that keeps the veins and arteries together?
vascular sheath
At what point does the venae comitantes of the forearm stop?
when the brachial vein joins with the basilic vein at the axilia and forms the axiliary vein –> close to the heart now
what branch does axillary vein recieve blood from?
the cephalic vein
when does the axillary vein become the subclavian rein?
once it passess the clavicle
what is the route from the subclavian vein to the heart?
the subclavian vein joins with the internal jugular vein to form brachiocephalic veins
The two brachiocephalic veins join to form the superior vena cava
how is the axillary vein formed?
by the brachial venae commitantes and the basilic vein
what is the route of the venea commitantes?
venea commitants drain blood accompanying the deeper and supperficial palmer arch to the vaena commitants accompanying the ulna and raidal artery. These venae commitants unite at the cubital fossae to form the brachial venae commitants.
this will join with the basilic vein at the axillia to form the axillary artery
what is the route of the basilic vein?
drains the medial side of the foraearm , moves half way up the arm and then pierces deep to bind with deep veins and form the axillary vein
what arch do the digits 2 1/2 to 5 recieve blood from?
the superfecial palmar artery so mainly from the ulna artery
what arch do the digits 1 and 2 1/2 recieve blood from?
the deep palmar artery –> mainly radial artery
which side of the digit has the more dominant artery?
the medial side of each digit
which sides is the ulna and radial artery more dominant on?
the little finger –> medial –> ulna artery
the thumb –> lateral –> radial artery
