Arm

Question 0

superficial veins of arm

Answer 0

cephalic nd basilic veins: go to axillary

Question 1

brachial artery

Answer 1

provides main arterial supply to arm and is continuation of axillary artery
begins at inferior border of teres major and ends in cubital fossa opposite neck of radius under cover of bicipital aponeurosis where it divides into radial and ulnar arteries
relatively superficial and palpable
anterior to triceps and brachialis
at first: medial to humerus where pulsations are palpable in medial bicipital groove
then passes anterior to medial supra-epicondylar ridge and trochlea of humerus
as it passes inferolaterally, brachial artery accompanies median nerve, which crosses nateriorly
give rise to profunda brachii artery and superior and inferior ulnar collateral arteries

Question 2

brachial vein

Answer 2

paired deep veins collectively constitute it
acoompany brachial artery
begins at elbow by union of accompanying veins of ulnar and radial arteries
ends by merging with basilic vein to form the axillary vein

Question 3

four main nerves passing through arm

Answer 3

median, ulnar, musculocutaneous, and radial

Question 4

median nerve

Answer 4

formed in axila by union of medial and lateral roots from medial and lateral cords of brachial plexus
runs distally in arm, initially on lateral side of brachial artery until it reaches the middle of the arm, where it croses to the medial side and contacts the brachialis
then descends into cubital fossa, where it lies deep to bicipital aponeurosis and median cubital vein

Question 5

ulnar nerve

Answer 5

arises from medial cord of brachial plexus, C8 and T1
psses distally, anterior to insertion of teres major and to long head of triceps, on medial side of brachial artery
around the middle of arm, pierces medial intermusculr septum with the superior ulnar collateral artery and descends between septum and medial head of triceps
passes posterior to medial epicondyle of the humerus to enter the forearm

Question 6

musculocutaneous nerve

Answer 6

arises from lateral cord of brachial plexus, pierces coracobrachialis and then continues distally between the brachialis and the biceps
after supplying all three muscles of anterior compartment of arm, the nerve emerges lateral to the biceps brachii as the lateral cutaneous nerve of the forearm

Question 7

radial nerve

Answer 7

enters arm posterior to brachial artery, medial to humerus and anterior to long head of triceps
descends inferolaterally with profunda brachii artery and curves around the humeral shaft in the radial groove
pierces the lateral intermuscular septum and continues inferiorly in the anterior compartment between brachialis and brachioradialis
in the cubital fossa, it divides into deep and superficial branches
supplies muscles in posterior compartments of the arm and forearm and the overlying skin

Question 8

cubital fossa

Answer 8

shallow triangular depression on anterior surface of elbow

superiorly: imaginary line connecting medial and lateral epicondyles
medially: pronator teres
laterally: brachioradialis
floor: brachialis and supinator muscles
roof: continuity of brachial and antebrachial (deep) fascia, reinforced by the bicipital aponeurosis, subcutaneous tissue and skin

Question 9

contents of cubital fossa

Answer 9

terminal part of brachial artery and commencement of its terminal branches (radial and ulnar arteries); brachial artery lies between biceps tendon and median nerve
deep accompanying veins of arteries
biceps brachii tendon
median nerve
radial nerve (dividing into superficial and deep branches)

Question 10

subcutaneous tissue overlying cubital fossa contains

Answer 10

median cubital vein: lies anterior to brachial artery

medial and lateral cutaneous nerves of forearm: related to basilic and cephalic veins

Question 11

biceps tendinitis

Answer 11

usually result of repetitive microtrauma in throwing sports

tendon of long head of biceps, enclosed by synovial sheath, moves back and forth in intertubercular sulcus

Question 12

rupture of tendon of long head of biceps

Answer 12

usually result of biceps tendinitis
normally torn from attachment to supraglenoid tubercle of scapula
snap or pop
detached muscle belly forms a ball near the center of the distal part of anterior aspect of arm: Popeye deformity

Question 13

bicipital myotatic reflex

Answer 13

relaxed limb passively supinated and partially extended at elbow
examiners thumb placed firmly on biceps tendon, hammer tapped at base of nail bed of thumb
positive response: flexion of elbow: confirms integrity of musculocutaneous nerve and C5 and C6 segments

Question 14

injury to musculocutaneous nerve

Answer 14

in axilla: usually inflicted by weapon like knife
results in paralysis of coracobrachialis, biceps and brachialis
flexion of elbow and supination of forearm greatly weakened
loss of sensation may occur on lateral surface of forearm supplied by lateral cutaneous nerve of forearm

Question 15

injury to radial nerve

Answer 15

superior to origin of its branchesto triceps brachii results in paralysis of triceps, brachioradialis, supinator and extensor muscles of wrist and finges
loss of sensation ocurs in skin
when injured in radial groove: triceps not completely paralyzed but weakened b/c only medial head affected, but other muscles paralyzed
wrist drop

Question 16

occulsion or laceration of brachial artery

Answer 16

emergency because paralysis of muscles results from ischemia in only a few hours
after this, fibrous scar tissue develops and causes involved muscles to shorten permanently: Volkmann ischemic contracture: flexion deformity
flexion of fingers and sometimes wrist results in loss of hand power

Question 17

measuring blood pressure

Answer 17

sphygmomanometer
cuff placed around arm and compresses brachial artery
stethoscope placed over artery in cubital fossa
cuff released and examiner detects sound of blood beginning to spurt through artery
first audible spurt: systolic blood pressure
as pressure completely released:point at which can no longer be heard: diastolic blood pressure

Question 18

compression of brachial artery

Answer 18

best place is near middle of arm
biceps pushed laterally to detect pulsations of artery
must be clamped distal to inferior ulnar collateral artery without producing tissue damage
ulnar and radial still receive blood through anastomoses