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Anatomy (TOPNOTCH SUPPLEMENT) > Upper Limb > Flashcards

Flashcards in Upper Limb Deck (35):
0

Arterial supply

Subclavian artery

Axillary artery

Brachial artery

Superficial palmar arch

Deep palmar arch

1

From arch of aorta to the lateral border of 1st rib

Subclavian artery

2

Branches of subclavian artery

Internal thoracic artery

Vertebral artery

Thyrocervical trunk

3

Continuous with superior epigastric artery which anastomoses with inferior epigastric artery (artery branch of external iliac artery

- provides collateral circulation if the abdominal aorta is blocked

Internal thoracic artery

4

3 branches of thyrocervical trunk

Suprascapular artery

Transverse cervical artery

Inferior thyroid artery

5

Collateral circulation around the shoulder

Surpascapular artery

Transverse cervical artery

6

Continuation of subclavian artery, extends from the lateral border of 1st rib to the inferior border of the TERES major muscle.

The tendon of Pectoralis minor muscles crosses the axillary artery anteriorly

Axillary artery

7

May be damaged by midshaft fracture of the humerus along with the radial nerve as they travel together in the posterior aspect of the humerus in the radial groove

Deep branchial artery (brachial artery)

8

Posterior to the tendons of flexor digitorum superficialis & profundus

Deep laceration at the metacarpal-carpal joint that cuts the deep palmar arch also compromises FLEXION of fingers

Deep palmar arch

9

Branches of Axillary artery

Thoracoacromial artery

Lateral thoracic artery

Anterior humeral circumflex artery

Posterior humeral circumflex artery

Subscapular artery

10

Branches of brachial artery

Deep brachial artery

Radial artery

Ulnar artery

11

Commencement: Arch of aorta

Termination: Lateral border of 1st rib

Subclavian artery

12

Commencement: Lateral border of 1st rib

Termination: Inferior border of teres major

Axillary artery

13

Commencement: lateral border of the teres major

Termination: cubical fossa

Branchial artery

14

COLLATERAL CIRCULATION

Around the shoulder

Transverse cervical artery

Suprascapular artery

Subscapular artery

Circumflex scapular artery

15

COLLATERAL CIRCULATION

Around the elbow

Superior ulnar collateral artery
- anastomoses with posterior ulnar recurrent artery

Inferior ulnar collateral artery
- anastomoses with anterior ulnar recurrent artery

Middle collateral artery
- anastomoses with interosseous recurrent artery

Radial collateral artery
- anastomoses with radial recurrent artery

16

COLLATERAL CIRCULATION

In the hand

Superficial palmar arch

Deep palmar arch

17

Most commonly used for access during long-term hemodialysis

Radial & Cephalic vein

18

Placement of ligatures

Subclavian or Axillary artery between the thyrocervical trunk & Subscapular artery

Brachial artery distal to the inferior ulnar collateral artery

19

Percutaneous arterial catheterization

Uses brachial artery if femoral artery approach is unavailable

Left brachial artery
- preferred because it allows access to the descending aorta without crossing the R Brachiocephalic trunk & L common carotid artery, thereby reducing risk of stroke

20

Brachial plexus

Ventral primary rami (C5-T1)
- between anterior & middle scalene muscles

Upper middle & lower trunks
- posterior triangle of the neck

3 anterior & 3 posterior divisions
- deep to the clavicle & are named according to their relation to the axillary artery

Lateral, medial & posterior cords
- axilla, deep to the Pectoralis minor muscle

21

5 terminal branches of BRACHIAL PLEXUS

MUSCULOCUTANEOUS nerve (C5,6,7)

AXILLARY nerve (C5,6)

RADIAL nerve (C5,6,7,8,T1)

MEDIAN nerve (C5,6,7,8,T1)

ULNAR nerve (C8,T1)

22

Arise from the brachial plexus proximal to the terminal nerves

Innervate the proximal limb muscles (shoulder girdle muscles)

Collateral nerves

23

COLLATERAL NERVE:

Dorsal scapular nerve

Structures innervated: RHOMBOIDS

24

COLLATERAL NERVE:

Long thoracic nerve

Structures innervated: SERRATUS ANTERIOR

25

COLLATERAL NERVE

Suprascapular nerve

Structures innervated: SUPRASPINATUS & INFRASPINATUS

26

COLLATERAL NERVE

Lateral pectoral nerve

Structures innervated: PECTORALIS MAJOR

27

COLLATERAL NERVE

Medial pectoral nerve

Structures innervated: PECTORALIS MAJOR & MINOR

28

COLLATERAL NERVE

Upper subscapular nerve

Structures innervated: SUBSCAPULARIS

29

COLLATERAL NERVE

Middle subscapular (thoracodorsal) nerve

Structure innervated: LATISSIMUS DORSI

30

COLLATERAL NERVE

Lower Subscapular nerve

Structures innervated: SUBSCAPULARIS & TERES MAJOR

31

COLLATERAL NERVE

Medial brachial cutaneous nerve

Structures innervated: SKIN OF MEDIAL ARM

32

COLLATERAL NERVE

Medial antebrachial cutaneous nerve

Structures innervated: SKIN OF MEDIAL FOREARM

33

Violent stretch between the head & shoulder (adduction traction of the arm & hyperextension of the neck)

Nerves damaged:
- Musculocutaneous
- Suprascapular
- Axillary
- Phrenic

Clinical sign:
- pronated & medially rotated arm (waiter's tip hand)
- ipsilateral paralysis of diaphragm

ERB-Duchenne's (C5 & C6, upper trunk)

34

Sudden upward pull of the arm (abduction injury)

Nerves damaged:
- Median
- Ulnar
- Sympathetic of T1
- spinal nerve

Clinical sign:
- loss of function of the wrist & hand
- Horner syndrome

KLUMPKE's (C8 & T1, lower trunk)