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Anatomy > Cubital Fossa > Flashcards

Cubital Fossa Flashcards

1
Q

Subclavian artery

A

Origin: Right- from the brachiocephalic trunk
Left-arises directly from the aortic arch
-ends at the lateral border of the first rib by becoming the axillary artery

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2
Q

Thyrocervical trunk

A
  • short vessel arising from the first part of the subclavian artery supplies this region via two branches
    1. Transverse cervical artery
    2. Suprascapular artery
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3
Q

Transverse cervical artery

A
  • branch of thyrocervical trunk
  • passes laterally through the root of the neck to the anterior border of the trapezius
  • may bifurcate into a deep branch (dorsal scapular) and a superficial branch (superficial cervical)
  • then passes deep to the trapezius in company with the spinal accessory nerve
  • supplies trapezius and elevator scapulae
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4
Q

Suprascapular artery

A
  • branch of thyrocervical trunk
  • -passes laterally through the root of the neck running deep to and parallel to the clavicle
  • then deep to trapezius to follow the suprascapular nerve
  • passes superior to the superior transverse scapular ligament and then lies directly on the scapula
  • descends lateral along the spinoglenoid notch of the scapular neck. To arrive in the infraspinous fossa
  • supplies supraspinous, infraspinous, and the acromioclavicular and glenohumeral joints.
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5
Q

Dorsal scapular artery

A
  • arises from the 2nd or 3rd part of the subclavian (75%) or from transverse cervical artery (25%)
  • courses laterally and posteriorly in the root of the neck
  • passes through the diverging fiber of the brachial plexus
  • turns inferiorly and courses anterior to the elevator scapulae and then rhomboid muscles along the medial border of the scapula in company with the dorsal scapular nerve
  • supplies rhomboid major and minor, lavator scapulae, and serratus anterior
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6
Q

Axillary artery

A
  • continuation of subclavian a.
  • lateral border of rib 1 to the lower border of the Teres muscle.
  • continues into the arm as the brachial artery.
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7
Q

Pec minor subdivides the axillary artery into 3 parts:

A
  1. Rib 1 to medial border of pec minor
    - superior thoracic artery
  2. deep to pec minor.
    - lateral thoracic artery
    - Thoracoacromial artery
  3. Lateral border of axillary artery, follows subscapularis
    - subscapular
    - anterior circumflex humeral a.
    - posterior circumflex humeral a.
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8
Q

Superior thoracic artery

A

First part of axillary

-supplies the proximal regions of the medial and anterior axillary walls

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9
Q

Lateral thoracic artery

A

2nd part of axillary a

  • arises from anterior surface of the axillary
  • follows pec minor and supplies the medial/anterior walls
  • in females it contributes the blood supply to the breast
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10
Q

Thoracoacromial artery

A

2nd part of axillary a.

  • penetrates the clavipectoral fascia, then divides into 4 smaller branches to the anterior axilla.
    1. Pectoral branch- gives blood supply to the breast
    2. Deltoid branch- accompanies the cephalic vein
    3. Acromial branch
    4. Clavicular branch
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11
Q

Subscapular artery

A

3rd part of axillary a.
-largest branch of the axillary artery, follows the subscapularis
I. Circumflex scapular- (through the triangular space) enters the infraspinous fossa, to anastomoses with the suprascapular artery, and the deep branch of the transverse cervical artery (dorsal scapular artery)
II. Thoracodorsal-to deep surface of latissimus dorsi

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12
Q

Anterior circumflex humeral artery

A

-arises from the lateral side of the axillary, travels anterior to the surgical neck to anastomose with Posterior circumflex humeral artery

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13
Q

Posterior circumflex humeral artery

A
  • passes through the quadrangular space
  • supplies the surrounding muscles and the glenohumeral joint
  • anastomosis with branches from the profunda brachii.
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14
Q

Deep branch of transverse cervical a.

A

-from the thyrocervical trunk from the subclavian artery (or dorsal scapular directly from subclavian)

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15
Q

Suprascapular artery

A

-from the thyrocervical trunk

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16
Q

Circumflex scapular branch

A

-along with Deep branch of transverse artery and suprascapular artery form an anastomotic network

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17
Q

Quadrangular space

Boundaries and contents?

A
  • Teres minor superiorly, Teres major inferiorly, long head of triceps brachii medially, and surgical neck of humerus laterally
    Contents- axillary nerve and the posterior circumflex humeral artery
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18
Q

Triangular space

Boundaries and content?

A
  • Teres minor, Teres major, and long head of triceps brachii

- circumflex scapular vessels

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19
Q

Triangular interval

Boundaries and contents?

A
  • long head of triceps brachii, shaft of humerus, and Teres minor
  • radial nerve an profunda brachii artery
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20
Q

Deltopectoral triangle

Boundaries and contents

A
  • clavicle, deltoid, and pec major

- cephalic vein and deltoid branches of the Thoracoacromial artery; coracoid process pal patted deep within

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21
Q

Brachial artery

A
  • continuation of the axillary artery at the level of the inferior border of the teres major muscle.
  • ends near neck, divides into radial and ulnar arteries.
  • lies on the anterior surfaces of the coracobrachialis and the brachialis muscles
  • closely associated with the median nerve
22
Q

Profunda brachii (deep brachial)

A
  • largest branch of the brachial artery.
  • gives off three branches
    1. Ascending branch
    2. Middle collateral artery
    3. Radial collateral artery
23
Q

Ascending branch

A

-runs superiorly between the long and lateral head of the triceps to anastomose with a descending branch of the posterior circumflex humeral artery.

24
Q

Middle collateral artery

A

-descends within the medial head of the triceps brachii toward the elbow to anastomose with the interosseus recurrent artery.

25
Q

Radial collateral artery

A
  • continuation of the profunda brachii which perforates the lateral Intermuscular septum and runs anterior to the elbow to anastomose with the radial recurrent artery (branch of radial artery).
  • closely associated with the radial nerve
26
Q

Nutrient humeral artery

A

-arises from the brachial artery in the middle of the arm and passes into the nutrient foramen on the anteromedial aspect of humerus

27
Q

Superior ulnar collateral artery

A
  • branches from brachial artery about the middle of the arm, descends with the ulnar nerve to the posterior aspect of the medial epicondyle.
  • passing posterior to the elbow joint, it anastomoses with the posterior ulnar recurrent artery.
28
Q

Inferior ulnar collateral artery

A
  • originates immediately proximal to the elbow joint from the brachial artery
  • crosses anterior to the elbow to anastomose with the anterior ulnar recurrent artery.
29
Q

Cubital fossa

Boundaries?

A

-triangular space anterior to the elbow
Roof-skins, deep fascia and bicipital aponeurosis
Proximal boundary- line connecting the humeral spicondyles
Lateral boundary- brachioradialis
Medial boundary- pronator peres
Floor- formed by the brachialis and supinator muscles

30
Q

Cubital fossa

Contents lateral–> medial

A

Lateral to medial

  1. Deep branch of the radial nerve
  2. Radial recurrent artery
  3. Tendon of the biceps brachii
  4. Brachial artery (perhaps its ulnar/radial derivatives; and related veins)
  5. Median nerve
  6. Anterior ulnar recurrent artery
31
Q

Superficial veins of arm

A

Cephalic and basilic

  • arise from the dorsal venous network of the hand, and interconnected by the median cubital vein and terminate in the axillary vein
  • connect to deep veins by perforating fascia to merge deeper
32
Q

Deep veins

A
  • paired deep veins (venae comitantes) accompany/parallel the deep arteries, often forming a network of anastomosing vessels around the artery.
  • deep brachial veins merge with the basilic vein to form the axillary vein near the inferior border of the teres major.
33
Q

Cubital (supratrochlear) nodes

A
  • in distal limb

- found along the basilica vein, just proximal to the elbow.

34
Q

6 groups of lymph nodes in the axilla

A
  1. Humeral group-receives most of the lymph from the upper limb, drains to central group.
  2. Subscapular group-drains the scapular and posterior thoracic regions, drains to central group.
  3. Pectoral- drains the anterior thoracic wall, including the breast, drains to central and apical groups
  4. Central group- receives drainage from the humeral, subscapular, and pectoral groups, drains into apical group
  5. Infraclavicular- adjacent to the cephalic vein, receives drainage from area, including breast
  6. Apical group- receives drainage from the central and infraclavicular groups, and form the subclavian lymphatic trunk
    Left side-subclavian lymphatic trunk drains into the thoracic duct
    Right side- may be joined by the jugular and bronchomediastinal trunks to form the righ lymphatic duct
35
Q

Forearm

A

-contains muscles that are the prime movers of the wrist and hand and the nerves and blood supply of these muscles as they also extend distally beyond the forearm

36
Q

Wrist region (carpus)

A

Contains the wrist joint and the proximal portion of the hand, the carpus.

37
Q

Wrist joint (radiocarpal joint)

A
  • between distal surface of the radius and the two most lateral carpal bones of the proximal row (scaphoid, lunate)
  • carpal bones are shaped and arranged to form an anterior concavity with a taut retinaculum completing a tunnel (carpal tunnel) of which pass most tenons of anterior forearm muscles and neurovasculature to supply the hand
38
Q

Hand

A

-contains carpal bones, the metacarpals, and the fingers formed by phalanges

39
Q

Radioulnar Joints

A
  1. Proximal radioulnar joint
  2. Interosseus membrane
  3. Distal radio-ulnar joint
40
Q

Interosseus membrane

A

-strong, fibrous interconnection between the radius and ulna not only binds the two bones together, but also helps to transmit distal forces from the radius to the ulna

41
Q

Distal radio-ulnar joint

A
  • head of the ulna articulates with the ulnar notch of the radius
  • during pronation and supination, the radius rotates on the ulna.
  • held together by triangular fibrocartilage complex (TFCC)
42
Q

Radiocarpal (wrist) joint

A
  • distal part of the radius and triangular fibrocartilage of the wrist articulate with the concave surface formed by three proximal-row carpal bones (scaphoid, lunate, and triquetrum)
  • head of ulna is NOT in wrist joint.
43
Q

Intercarpal joints

A

-held together by interosseus ligaments with help to delineate joint cavities.

44
Q

Carpometacarpal

A

-thumb has its own separte carpometacarpal joint between the trapezium and the first metacarpal.

45
Q

Interphalangeal joints

A

-function as pure hinge-joints (flexion-extension) due to restriction created by ulnar and radial collateral ligaments

46
Q

Elbow movements

A
  • hinge joint

- can flex/extend in sagittal plane

47
Q

Forearm (radioulnar) movement

A
  • 2 synovial and 1 syndesmotic joint

- can probate/supinate around long axis

48
Q

Wrist (radiocarpal) movements

A
  • condyloid joint

- flex/extend (sagittal plane) and abduct/ adduct (frontal)

49
Q

Fingers 2-5 movement of Metacarpophalangeal joints and Proximal and Distal Interphalangeal joints

A

MP-can extend/flex (sagittal) and abduct/adduct (frontal plane)
PIP and DIP- can flex/extend (sagittal plane)

50
Q

Thumb (finger 1) movements

A

CMC joint- flex/extend (oblique plane) and abduct/adduct (perpendicular to flex/extend plane)
MP joint- can flex/extend (parallel CMC joint)
Interphalangeal (IP)- can flex/extend (parallel CMC joint)

Anatomy (4 decks)

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