EXAM2_G10_G11_Pectoral_Axila Flashcards Preview

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Flashcards in EXAM2_G10_G11_Pectoral_Axila Deck (28)
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1
Q

What is the only bone articulation of the upper extremity with the Axillary skeleton?

A

Sternoclavicular joint

2
Q

What is intramuscular septa?

What function clinically?

What is compartment syndrome?

A

Deep fascia that divide UE regions into facial compartments

Contain and direct spread of infection/hemorrhage in limb;
Accumulation can result in compartment syndrome

Deltoid fascia
Biracial fascia
Antebrachial fascia
Palomar Fascia
Dorsal Fascia
Pectoral Fascia
Axillary Fascia
3
Q

What separates anterior and posterior compartments of the forearm?

A
Intermuscular septum (between radius and antebrachial fascia)
 and 

Interosseous membrane between radius and ulna

4
Q

Brachial Plexus:
What innervation? (CNS PNS SNS PSNS SOMATIC AUTONOMIC?)
What Rami?
What type of signals?

A
Somatic innervation (some autonomic-sns only)
(anterior primary rami of C5-T1 spinal cord segments)

Cutaneous sensation
Motor innervation

5
Q

Autonomic innervation of the brachial plexus? what type of autonomic motor innervation? (PSNS or SNS)

Where are the preganglionic neurons?
Where do they synapse?
Where are post ganglionic axons?
What do they innervate?

A

Sympathetic ONLY (no parasympathetic)
Preganglionic neurons (T1-T6)
Synapse in paravertebral (cervical) ganglia
-Postganglionic axons accompany somatic nerves of the brachial plexus to innervate:
-sweat/sebaceous glands
-arrector pili muscles
- vasculature

6
Q

CRPS
What is it?
What causes it?

A

Complex regional pain syndrome (CRPS)

  • dysfunction of SNS
  • can be caused by UE injury
7
Q

What makes up a dermatome?

A

All the peripheral nerves and fibers that take that single spinal cord segment.
IE: 5 peripheral nerves take C6 spinal nerve

8
Q

Where are the superficial veins?

A

Travel in subcutaneous tissue

communicate w/ deep veins via perforating veins

9
Q

Where is the venous drainage for the medial and lateral Upper extremity?

Where do they communicate?

WHAT VEIN IS NOT THERE?

A

cephalic - drains lateral UE into Axillary Vein

Basilic- drains medial UE -merges with brachial vein to form axillary vein

Communicate in Cubital fossa

NO THORACOACROMIAL VEIN!!!

10
Q

What merges with brachial vein to form axillary vein?

What is most common arrangement in cubital fossa? where blood is most commonly drawn from?

A

basilica vein

median cubital vein

11
Q

Where does lymph from deep veins and cubital lymph nodes drain?

A

Humeral (lateral) Axillary lymph nodes
drain into Central nodes and then drain into apical axillary lymph nodes then to supraclavicular nodes then into either the Right lymphatic duct or the Thoracic duct

12
Q

Where does lymph drain from skin? (superficial)?

A

Cubital lymph nodes-

  • rx lymph from vessels of basilic v.
  • drain into humeral lateral axillary lymph nodes
13
Q

Where do superficial lymph from cephalic vein drain? Where does that drain into?

A

Deltopectoral lymph nodes
drain into apical axillar lymph nodes
then supraclavicular>right lymphatic or thoracic duct

14
Q

Where do superficial lymph from basilic vein drain?

A

cubital lymph nodes

drain humeral lateral axillary lymph nodes

15
Q

Where is weakest point of clavicle?

A

middle/lateral 1/3 - most commonly broken bone

16
Q

What forms the floor of the dectopectoral triangle? What vein goes through the dectopectoral groove?

A

Costocoracoid membrane forms the floor

Cephalic vein travels through the deltopectoral triangle

17
Q

What ligament is superficial to the Flexor retinaculum? What travels between the two ligaments?

A

Palmar carpal ligament

  • Superficial palmar branch of radial artery
  • Ulnar artery and Ulnar nerve
  • Tendon of palmaris longus is superficial to the flexor retinaculum also.
18
Q

Flow of lymph from cubital all the way back

A

Cubital> Humeral > central > apical > supraclavicular > RLD or TD

19
Q

What are the contents of the Deltopectoral groove and Triangle? 3 things

what forms the floor?

A
  1. Cephalic vein
  2. Thoracoacromial Artery
  3. Lateral Pectoral nerve
  4. Costocoracoid membrane (floor of triangle)
20
Q
What are the boundaries of the Axilla?
Apex (what called) (what 3 structures)
base (what called) 
ant wall (what structure formed? what 4 structures)
post wall (structure and 4 borders)
med wall (2 borders)
lat wall (1 border)
A

APEX: cervico-axillary canal- (1st rib, clavicle, scapula)
BASE: axillary fossa- (axillary fascia, subcutaneous skin)

ANT WALL: (Pec major/minor- anterior axilary fold. Subclavius, clavicle)

POST WALL: (scapula, subscapularis, Lat dorsi, Teres Major, posterior axilary fold)

MED WALL: Thoracic wall, serratus anterior

LAT WALL: intertubercular sulcus

21
Q

What forms the anterior and posterior axillary folds

A

ant: pec major
post: teres major & Lat dorsi

22
Q

3 branches of the Axillary artery

What is the next distal branch of the brachial artery? What does it turn into as it runs distally?

A

1- superior thoracic artery

2- Thoracoacromial artery (CADS)
2- Lateral thoracic artery (w/ long thoracic Nerve)= SALT

3- Subscapular (ct- Circumflex scapular & thoracodorsal)
3- PCHA
3- ACHA

Profunda brachii artery> radial collateral> Radial recurrent

23
Q
Axillary Vein
Landmark?
When does it become subclavian vein? why important?
What are the tributaries?
Where does it arise from and morph into?
A
  • Inferior border of teres MAJOR
  • subclavian vein at lateral border of 1st rib (CENTRAL LINE)
  • Tributaries- just like axillary arteries EXCEPT NO THORACOACROMIAL VEIN
  • Arises from brachial veins and dumps into basillic veins then forms the Axillary vein.
24
Q

Humeral (lateral) lymph nodes
Where located?
Where is lymph from ? Where is it NOT from?

A

Lateral wall of axilla- medial and posterior to axillary vein
- lymph from UE (except lymph from cephalic vein)

25
Q

Pectoral (anterior) lymph nodes
Where at?
Where lymph from?

A

Along lateral thoracic vessels

- lymph from anterior thoracic wall/ Breast

26
Q

Subscapular (posterior) lymph nodes?

location and where lymph from?

A

posterior axillary fold along subscapular vessels

lymph from posterior thoracic wall/ scapula

27
Q

Central lymph nodes

Where and what lymph from?

A

Deep to pectoralis minor

Lymph from humeral, pectoral, and subscapular nodes

28
Q

Apical lymph nodes
Where at?
Where lymph from?
Where does lymph drain into?

A

Apex of axilla
Lymph from central nodes and deltopectoral nodes

Drains into supraclavicular nodes

then drains either into Right lymphatic duct or the Thoracic duct