Anatomy -- Upper Limb 2

Question 1

Define the axilla and its boundaries

Answer 1

Space between:

• Pectoralis major (anterior)
• Latissimus dorsi/subscapularis/ teres major (posterior)
• Serratus anterior muscles (medial)

Question 2

Axilla purpose

Answer 2

Pathway from the neck to the upper limb where vessels and nerves funnel

Question 3

Arteries with some sort of direct relation to the axillary artery

Answer 3

• Subclavian artery
• Brachial artery
• Circumflex humeral artery
• Deep brachial artery

Question 4

When does the subclavian artery become the axillary artery

Answer 4

Once it passes over the 1st rib

Question 5

When does the axillary artery become the brachial artery

Answer 5

Once the axillary artery passes the teres major

Question 6

Purpose of anastomoses in the axillary area

Answer 6

Reroute blood supply to extremities in case of ligature or compression

Question 7

Describe the relationship of the basilic vein to the axillary/brachial artery

Answer 7

Runs along the artery

Question 8

Describe the relationship of the cephalic vein to the axillary/brachial artery

Answer 8

Parallel and lateral

Question 9

Location of axillary lymph nodes

Answer 9

Around the basilic vein

Question 10

Roots of postfixed brchial plexus

Answer 10

C6 - T2

Question 11

Roots of normal brachial plexus

Answer 11

C5 - T1

Question 12

Describe the progression of the nerves from the brachial plexus

Answer 12

Mnemonic = Really Thirsty? Drink Cold Beer.

1. Roots (ventral rami of spinal nerves)
2. Trunks
3. Divisions
4. Cords
5. [Terminal] Branches

Question 13

Location of lateral and medial cords

Answer 13

Anterior to axillary artery

NOTE: Terminal branches form a big “M”

Question 14

Function of lateral and medial cords

Answer 14

Branches innervate anterior compartment of arm/forearm (=flexor muscles)

Question 15

Roots of lateral cord

Answer 15

C5, 6, 7

Question 16

Roots of medial cord

Answer 16

C8; T1

Question 17

Function of posterior cord

Answer 17

Innervation of posterior compartment of arm and forearm (=extensor muscles)

Question 18

Roots of posterior cord

Answer 18

C5 - 8; T1

Question 19

Terminal branches of lateral cord and their function(s)

Answer 19

• Musculocutaneous nerve (anterior compartment of arm)
• Median nerve (anterior compartment of forearm and hand)

Question 20

Terminal branch of medial cord and its function(s)

Answer 20

Ulnar nerve (forearm and hand)

Question 21

Terminal branches of posterior cord and their function(s)

Answer 21

• Axillary nerve (deltoid muscle)
• Radial nerve (posterior compartment of arm and forearm)

Question 22

Define Erb-Duchenne palsy and its cause

Answer 22

• Upper BP lesion causing Shy waiter’s tip position (limb hangs by side)
• Due to lateral hyperextension of neck

Question 23

Muscles affected by upper brachial plexus injury

Answer 23

Proximal

Question 24

Muscles affeced by lower brachial plexus injury

Answer 24

Distal muscles

Question 25

Define Dejerine-Klumpke palsy and its cause

Answer 25

* Lower BP lesion causing claw hand (weakness of all intrinsic muscles of hand) * Hyperabduction of arm (stretch of axilla)

Question 26

From where does the long thoracic nerve branch?

Answer 26

Brachial plexus from roots C5, 6, 7

Question 27

How to test for lesion of long thoracic nerve

Answer 27

Ask patient to do push up on the wall (force retraction)

Question 28

From where does the thoracodorsal nerve branch and what are its roots?

Answer 28

Brachial plexus from C6 - 8

Question 29

Muscles innervated by axillary nerve

Answer 29

Deltoid muscle

Question 30

Spinal level of axillary nerve

Answer 30

C5 - 6

Question 31

Muscles innervated by long thoracic nerve

Answer 31

Serratus anterior muscle

Question 32

Spinal levels of long thoracic nerve

Answer 32

C5 - 7

Question 33

Muscles innervated by the musculocutaneous nerves

Answer 33

Anterior compartment of arm

Question 34

Spinal levels of musculocutaneous nerves

Answer 34

C5 - 7

Question 35

Muscles innervated by thoraco-dorsal nerve

Answer 35

Latissimus dorsi

Question 36

Spinal levels of thorca-dorsal nerve

Answer 36

C6 - 8

Question 37

Muscles innervated by radial nerve

Answer 37

Posterior compartment of arm/forearm

Question 38

Spinal levels of radial nerve

Answer 38

C5 - T1

Question 39

Muscles innervated by median nerve

Answer 39

Anterior compartment of forearm and hand

Question 40

Spinal levels of median nerve

Answer 40

C5 - T1

Question 41

Muscles innervated by ulnar nerve

Answer 41

Forearm and hand

Question 42

Spinal levels of ulnar nerve

Answer 42

C8 - T1

Question 43

Define the quandrangular space

Answer 43

4 sided space bounded by: * Teres major (inferior) * Long head of triceps (medial) * Humerus (lateral) * Subscapularis muscle (superior)

Question 44

Define the triangular interval

Answer 44

3 sided space bounded by: * Teres major (superior) * Long head of triceps (medial) * Humerus (lateral)

Question 45

Through which space does the radial nerve cross?

Answer 45

Triangular interval

Question 46

Through which space does the axillary nerve cross?

Answer 46

Quadrangular space

Question 47

Which nerve is involved when the neck of the humerus is fractured?

Answer 47

Axillary nerve

Question 48

Which nerve is involved when the shaft of the humerus is fractured?

Answer 48

Radial nerve

Question 49

Which nerve is involved when the medial epicondyle of the humerus is fractured?

Answer 49

Ulnar nerve