L2 - Nerve and blood supply to the upper limb Flashcards

1
Q

Which artery supplies the upper limb?

A

Subclavian artery

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2
Q

On the right hand side, the where does the subclavian artery branch off from?

A

Right brachiocephalic trunk

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3
Q

On the left side, where does the subclavian artery branch off from?

A

Arch of aorta

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4
Q

The subclavian artery passes through which structure over the 1st rib?

A

Scalene triangle

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5
Q

Which structures make up the scalene triangle?

A

Scalenus anterior
Scalenus medius
1st rib

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6
Q

How many parts does the scalenus anterior divide the subclavian artery into?

A

Three:

  1. Medial to Scalenus anterior
  2. Behind scalenus anterior
  3. Lateral to scalenus anterior
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7
Q

When does the subclavian artery become the axillary artery?

A

When it crosses the outer border of the 1st rib

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8
Q

What are the important divisions of the lateral part of the axillary artery?

A

Subscapular artery
Anterior circumflex humeral artery
Posterior circumflex humeral artery

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9
Q

What is significant about a trauma to the surgical neck of the humerus?

A

Could tear the anterior and posterior circumflex humeral arteries which wrap around the surgical neck

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10
Q

What is a large branch of the brachial artery?

A

Profunda brachii artery

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11
Q

Fracture to the shaft of the humerus might cause trauma to which artery?

A

Profunda brachii artery

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12
Q

Which artery goes through the quadrangular space?

A

The posterior circumflex humeral artery

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13
Q

Why is the spiral groove also called the radial groove of the humerus?

A

Because the radial nerve travels through this groove

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14
Q

Which artery travels with the radial nerve in the spiral groove of the humerus?

A

The profunda brachii artery

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15
Q

What does the brachial artery divide into in the cubital fossa?

A

The radial and ulnar arteries

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16
Q

Which is the smaller of the two terminal branches of the brachial artery?

A

Radial artery

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17
Q

The radial artery is covered by which muscle?

A

Brachioradialis muscle

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18
Q

The brachioradialis muscle allows you to do which movement?

A

Beer drinking arm movement - bringing a glass to your mouth

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19
Q

Where does the radial artery anastomose with the ulnar artery?

A

The deep palmar arch

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20
Q

Which structure does the radial artery travel through?

A

The anatomical snuff box

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21
Q

Which muscle covers the ulnar artery?

A

Flexor carpi ulnaris

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22
Q

Which branch of the ulnar artery forms the superficial palmar arch?

A

Deep branch: Common interosseous artery

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23
Q

Common interosseous artery divides into what arteries either side of the interosseous membrane?

A

Anterior and posterior interosseous arteries

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24
Q

Where do you find the deep palmar arch?

A

Draw a line from the tip of extended thumb to the base of the little finger

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25
Q

Where do you find the superficial palmar arch?

A

One finger’s breadth distal to the deep palmar arch

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26
Q

Which artery supplies the flexors of the arm?

A

Brachial artery

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27
Q

Which artery supplies the extensors of the arm?

A

Profunda brachii artery

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28
Q

Which nerve passes through the quadrangular space?

A

Axillary nerve

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29
Q

The radial artery pierces through which muscle?

A

The first dorsal interosseous muscle

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30
Q

Which vein to the veins in the upper limb drain into?

A

Axillary vein

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31
Q

Which vein does the axillary vein drain into?

A

Subclavian vein

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32
Q

The deep veins are what kind of veins?

A

Venae comitantes - they are paired with a deep artery and piggyback off it

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33
Q

Name the superficial/ subcutaneous veins

A

Cephalic vein

Basilic vein

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34
Q

Name the course of the cephalic vein

A

It runs up the lateral side of the forearm

35
Q

Name the course of the basilic vein

A

It runs up the medial side of the forearm

36
Q

The cephalic and basilic veins drain the ________ in the hand

A

Dorsal venous arch

37
Q

Which vein forms a bridge between the cephalic and basilica veins?

A

Median cubital vein

38
Q

The basilic and cephalic veins drain into which vein?

A

Axillary vein

39
Q

What do the basilic and cephalic veins pierce in order to drain into the axillary vein?

A

Fascia - axillary vein is deep

40
Q

Where does the lymph from the arm drain into?

A
Cubital nodes (basilic vein)
Deltopectoral node (cephalic vein)
& ultimately these all drain into the axillary nodes (axillary vein)
41
Q

What is the brachial plexus?

A

It is the nerve supply to the upper limb

It carries motor, sensory and sympathetic axons

42
Q

Why is the brachial plexus important?

A

Because it contains mixed nerves - contains axons from multiple spinal nerves - which is needed to supply large muscle groups as they need innervation from more than one spinal nerve

43
Q

The brachial plexus is divided into:

A

Roots, trunks, divisions, cords & terminal branches

44
Q

What are the roots of the brachial plexus?

A

Ventral/ anterior primary rami of C5 - T1 spinal nerves

45
Q

Which nerves branch off the roots?

A

Dorsal scapular nerve

Long thoracic nerve

46
Q

Which muscles are supplied by the dorsal scapular nerve?

A

Rhomboids

Levator scapulae

47
Q

Which muscles are supplied by the long thoracic nerve?

A

Serratus anterior

48
Q

Which spinal nerve contribute to the dorsal scapular nerve?

A

C4 & C5

49
Q

Which spinal nerves contribute to the long thoracic nerve?

A

C5, C6 & C7

50
Q

What are myotomes?

A

Functional groups of muscles innervated by motor axons of the spinal nerves

51
Q

What is the function of the C5 myotome?

A

Shoulder abduction and adduction

52
Q

What is the function of the C6/C7 myotome?

A

Elbow flexion and extension

53
Q

What is the function of the C7/C8 myotome?

A

Wrist flexion and extension

54
Q

What is the function of the C8/T1 myotome?

A

Movement of the digits

55
Q

The roots of the brachial plexus form?

A

The trunks

56
Q

Which structure do the trunks pass through?

A

The scalene triangle

57
Q

Which nerve branches off the superior trunk?

A

Suprascapular nerve

58
Q

Each trunk divides into?

A

Anterior and posterior divisions

59
Q

The anterior divisions consist of axons to..?

A

Flexor compartments

60
Q

The posterior divisions consist of axons to..?

A

Extensor compartments

61
Q

The anterior divisions of the brachial plexus form the..?

A

Lateral and medial cords

62
Q

The posterior divisions of the brachial plexus form the..?

A

Posterior cord

63
Q

The cords of the brachial plexus sit under which structure?

A

The pectoralis minor

64
Q

The cords are named in relation to which structure?

A

The axillary artery

65
Q

Where does the lateral cord sit in relation to the axillary artery?

A

Lateral side of the axillary artery

66
Q

Where does the posterior cord sit in relation to the axillary artery?

A

Posterior to the axillary artery

67
Q

What are the terminal branches of the lateral cord?

A

Musculocutaneous nerve &

Lateral part of the median nerve

68
Q

What are the terminal branches of the median cord?

A

Medial part of the median nerve &

Ulnar nerve

69
Q

What are the terminal branches of the posterior cord?

A

Radial nerve

Axillary nerve

70
Q

The musculocutaneous nerve pierces through which muscle?

A

Coracobrachialis muscle

71
Q

The musculocutaneous nerve becomes the ______ which supplies the _____

A

Lateral cutaneous nerve to the forearm

supplies the skin of the forearm

72
Q

The musculocutaneous nerve gives off branches which supply the..?

A

Muscles of the upper arm

73
Q

Median nerve does NOT innervate

A

anything in the upper arm

74
Q

Median nerve innervates:

A

Flexor muscles of the forearm EXCEPT flexor carpi ulnaris &
Intrinsic muscles of the hand

75
Q

The median nerve provides?

A

Motor innervation to the anterior forearm and lateral hand
Sensory innervation to: skin of lateral palm of hand D1, D2, D3 & half D4 and skin from distal interphalangeal joints in D1, D2, D3 & half D4 on dorsum of hand

76
Q

The ulnar nerve innervates which muscle?

A

Flexor digitorum profundus

77
Q

Ulnar nerve provides:

A

Motor innervation to: medial side of the anterior forearm and hand
Sensory innervation to: skin on the medial dorsum of hand and half of D4 and D5 on palm of hand

78
Q

The radial nerve innervates:

A

Extensor muscles

79
Q

Radial nerve provides:

A

Motor innervation to: the posterior/ extensor compartments of the arm and forearm
Sensory innervation to: posterior arm and posterior forearm and skin of lateral dorsum of hand

80
Q

Axillary nerve provides:

A

Motor innervation to: deltoids & teres minor

Sensory innervation to: badge area of arm

81
Q

What are all the terminal branches of the brachial plexus?

A
Musculocutaneous nerve 
Median nerve
Ulnar nerve
Radial nerve 
Axillary nerve
82
Q

What is a dermatome?

A

“An individual area of skin innervated by a single spinal nerve”

83
Q

Cutaneous innervation by the terminal branches

A

looks different to a dermatome map

84
Q

Terminal branches contain

A

axons from multiple spinal nerves