arm Flashcards

1
Q

Compartments of the arm

A

• The deep fascia of the arm.
• The humerus.
• The lateral and medial intermuscular septa

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2
Q

Muscles of the arm

A

four major arm muscles, three flexors (biceps
brachii, brachialis, and coracobrachialis) are in the
anterior (flexor)compartment , musculocutaneous nerve

one extensor (triceps
brachii) is in the posterior compartment, supplied by
the radial nerve

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3
Q

who are
stonger ant or
post

A

The flexor muscles of the anterior
compartment are almost twice as strong as the
extensors in all positions; consequently, we are
better pullers than pushers

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4
Q

Coraco-brachialis
• Origin:

A

Tip of coracoid process of
scapula (with the short head of
biceps brachii)

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5
Q

Coraco-brachialis insertion & innervation

A

Insertion: Middle of medial
aspect of humerus.
• Nerve supply: Musculocutaneous
nerve (C5, C6, C7)

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6
Q

Coraco-brachialis
action

A

Action: It helps in flexion and
adduction of the arm.

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7
Q

Biceps brachii
▪ Origin:

A

by 2 heads
• Short head: from the tip of coracoid
process of the scapula.
• Long head: from the sup

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8
Q

Biceps brachii insertion
& intervation

A

▪ Insertion:
• Posterior part of the radial tuberosity.
• By the bicipital aponeurosis into the
deep fascia of the forearm.
• Nerve supply: Musculocutaneous nerve.

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9
Q

Biceps
action

A

Flexor of the elbow.
• Powerful supinator of the flexed
forearm.
• Long head helps in stabilization of
shoulder joint.

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10
Q

bicipital aponeurosis
separates

A

the brachial artery
from median cubital vein.

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11
Q

The long head of biceps arises
inside the shoulder joint and
then leaves it to pass through
the bicipital groove. It is

A

intracapsular but
extrasynovial.

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12
Q

Brachialis
origin Insertion

A

• Origin: lower half of anterior
surface of humerus and the two
intermuscular septa.
• Insertion: Coronoid process and
tuberosity of ulna.

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13
Q

Brachialis nerve action

A

Nerve supply: Musculocutaneous
nerve. Some of the lateral part of
the brachialis is innervated by a
branch of the radial nerve.
• Action: Flexes forearm in all
positions

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14
Q

Triceps brachii
origin_ insertion

A

▪ Origin: by 3 heads
• Long head: infra-glenoid tubercle of
scapula.
• Lateral head: posterior surface of
humerus above the spiral groove.
• Medial head: posterior surface of
humerus below the spiral groove.
• Insertion: Proximal end of olecranon
process of ulna

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15
Q

Triceps brachii nerve
action

A

• Nerve supply: Radial nerve.
• Action:
• Main extensor of the elbow.
• Long head shares in stability of
shoulder.
• The long head helps in adduction of
abducted the arm.

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16
Q

mu sculo cutaneous nerve origin , termination

A

Origin: It is a branch of the lateral
cord of brachial plexus.
• Termination: It terminates by
continuing as the lateral cutaneous
nerve of the forearm.

17
Q

muscle pierce muscu… nerve

A

• The nerve descends lateral to 3
rd
part of axillary artery. The nerve
then pierces the coracobrachialis
then it passes between biceps and
brachialis.

18
Q

Musculocutaneous branches

A

Branches: Muscular branches to:
• Two heads of biceps brachii.
• Coracobrachialis.
• The greater part of brachialis.

19
Q

Anconeus
origin _action nerve insertion

A

• Origin: Lateral epicondyle of
humerus.
• Insertion: Lateral surface of
olecranon and superior part of
posterior surface of ulna.
• Nerve supply: Radial nerve
(C7, C8, T1).
• Action: Assists triceps in
extending forearm; stabilizes
elbow joint; may abduct ulna
during pronation

20
Q

Cubital fossa
boundaries

A

• Medially: pronator teres muscle.
• Laterally: brachioradialis muscle.
• Base: directed upwards and is formed by an imaginary line
connecting the 2 humeral epicondyles.
• Apex: Directed downwards and formed by the point of
overlap of brachioradialis over pronator teres.
.roof:• Skin.
• Superficial fascia containing median cubital vein, parts of basilic
and cephalic veins, medial and lateral cutaneous nerves of
forearm.
• Deep fascia.
• Bicepital aponeurosis.
• Floor: Brachialis muscle (medially) and supinator muscle (laterally)

21
Q

Cubital fossa
contents

A

From lateral to medial:
• Biceps tendon.
• Brachial artery.
• Median nerve.

22
Q

where, stethoscope is placed in BP measuring

A

During measuring of the blood pressure the
stethoscope is placed on the brachial artery in the cubital fossa just
medial to the tendon of biceps (landmark).

23
Q

Median nerve Origin course branches

A

• Origin:
• Medial root: C. 8, T.1 (from medial cord of
brachial plexus).
• Lateral root: C.5, 6, 7 (from lateral cord of
brachial plexus).
• The two roots unite to form the median nerve
lateral to the 3
rd part of axillary artery.
• Median nerve in the axilla and arm:
• Course:
• The nerve descends lateral to the 3
rd part of
axillary artery and upper half of brachial artery.
• At the middle of arm (level of insertion of
coracobrachialis) it crosses in front of the
brachial artery from lateral to medial.
• It then descends medial to the brachial artery
down to the cubital fossa.
• It enters the forearm by passing between the 2
heads of pronator teres.
• Branches: The median nerve has no branches in
the arm.

24
Q

Ulnar nerve

A

• Origin:
- It is a branch of medial cord of brachial plexus.
- Fibres of C7 come from lateral root of median
nerve.
• Ulnar nerve in the axilla and arm:
• Course:
• The nerve descends close to the medial side
of 3
rd part of axillary artery and upper half
of brachial artery.
• At the middle of the arm (level of insertion
of coracobrachialis) it pierces the medial
intermuscular septum to reach the posterior
compartment.
• It descends down to the back of medial
epicondyle.
• It enters the forearm by passing between
the 2 heads of flexor carpi ulnaris muscle.
• Branches: The ulnar nerve has no branches
in the arm.

25
Q

Radial nerve

A

• Origin: From the posterior cord of
brachial plexus.
• Radial nerve in the axilla and arm:
• Course:
• The nerve descends posterior to 3
rd
part of axillary artery and upper part
of brachial artery.
• Then it passes through the lower
triangular space to reach the spiral
groove with the profunda brachii
artery; here it lies between the
medial and lateral heads of triceps.
Thereafter, it pierces the lateral
intermuscular septum to reach the
front of arm where it descends
between the brachialis and
brachioradialis muscles.

▪ Branches in the axilla:
• Muscular branches to long and medial heads of triceps
• Posterior cutaneous nerve of the arm •
▪ Branches in the spiral groove:
• Muscular branches to the lateral and medial heads of triceps.
• Muscular branch to the anconeus muscle.
• Lower lateral cutaneous nerve of the arm
• Posterior cutaneous nerve of the forearm.

▪ Branches in the groove between brachialis and
brachioradialis:
• Muscular branch to the lateral part of brachialis.
• Muscular branch to brachioradialis.
• Muscular branch to extensor carpi radialis longus.

• Termination : the radial nerve terminates in front of the
lateral epicondyle where it divides into:
– Superficial terminal branch (continuation of radial nerve).
– Deep terminal branch called posterior interosseosus nerve.

26
Q

Brachial artery origin termination

A

• Origin: as a continuation of the axillary
artery at the lower border of teres major
muscle.
• Termination: opposite the neck of radius by
dividing into two terminal branches.

27
Q

Brachial artery course

A

• The artery descends in the anterior
compartment of the arm accompanied with
its 2 venae commitants. Along its whole
course, the artery is relatively superficial.
• In the upper part of the arm, the median
nerve lies on the lateral side of the artery
while the ulnar nerve and basilic vein lie on
its medial side.
• At the middle of the arm, the median nerve
crosses in front of the artery, from the
lateral to the medial side and continues
along the medial side of the brachial artery
down to the cubital fossa.

28
Q

Brachial artery branches

A

1-Profunda brachii artery, the largest
branch that accompanies the radial
nerve in the spiral groove. It gives an
ascending branch. The profunda brachii
ends by giving anterior and posterior
descending arteries that share in
anastomosis around elbow.
2-Muscular branches.
3-Nutrient artery to the humerus.
4-Superior ulnar collateral artery.
5-Inferior ulnar collateral artery: which
divide into anterior and posterior
branches.
6- Terminal branches:
• Radial artery.
• Ulnar artery

29
Q

❖Changes that occur at the level of insertion of
coracobrachialis:

A

• The median nerve: crosses in front of brachial artery from
lateral to medial.
• The ulnar nerve: pierces the medial intermuscular septum to
reach the posterior compartment.
• The radial nerve & profunda brachii artery: descend on the
back of humerus through the spiral groove.
• The basilic vein: pierces the deep fascia to ascend medial to
brachial artery.
• The medial cutaneous nerve of the arm and forearm: pierces
the deep fascia to pass through the superficial fascia.
• The nutrient artery of the humerus: enters into the bone.