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Gross II-Upper Limb
Zumpano Fall 2010
Question | Answer |
---|---|
The anterior shoulder/arm is innervated by what nerves? | Supraclavicular n Upper later brachial cutaneous n. Intercostobrachial n. Medial brachial cutaneous n. Lower lateral brachial cutaneous n. |
The posterior shoulder/arm is innervated by what nerves? | Supraclavicular n. Upper lateral brachial cutaneous n. Intecostobrachial n. Posterior brachial cutaneous n. Lower lateral brachial cutaneous n. Posterior antebrachial cutaneous n. |
Upper lateral brachial cutaneous n. comes from what nerve? | axillary n. |
What nerves emerge from radial nerve? | Lower lateral brachial cutaneous n., Posterior brachial cutaneous n. & Posterior antebrachial cutaneous n. |
What nerve supplies most of the skin in posterior limb? | Radial n. |
Most lymph drainage is into what n? | Axillary |
What marks the boundary of shoulder and pectoral region? | Deltopectoral triangle |
Anterior axillary fold is formed by what muscle? | pec major |
Posterior axillary fold is formed by what muscle? | latissimus dorsi, teres major, subscap |
Branches of thoracoacromial a. and muscles they supply | Acromial- Deltoid & glenohumeral joint Pectoral - pec major & minor, breast Clavicular - Subclavius & sternoclavicular joint Deltoid - pec major & deltoid |
What supplies the breast? | Lateral mammary a. (which are branches of lateral thoracic a.), pectoral branch of thoracoacromial trunk, anterior intercostal a. (branches of internal thoracic a.) |
What muscles connects the anterior thorax to scapula? | Pec major |
What muscle connects first rib to clavicle? | subclavius |
Coraco-pectoral tunnel lies between what two structures? | Pec minor & coracoid process of scapula |
Injury to long thoracic n. leads to what condition? | Scapular winging - (when supporting weight with outstretched arms, medial border of scap will rise off posterior thoracic wall b/c serratus ant isn't protracting scap) |
Hypertrophy of subclavius leads to what? | compression of brachial plexus - numbness & tingling in medial aspect of hand |
Hypertrophy of pec minor results in what? | Rounded shoulder posture, narrow coraco-pectoral tunnel causing thoracic outlet symptoms |
Medial wall of axillary fold? | serratus anterior |
Lateral wall of axilla? | intertubercular sulcus |
Why are the central group of lymph nodes and intercostobrachial nerve clinically important? | In breast cancer the nodes get enlarged and compress intercostobrachial n. referring pain to upper medial aspect of arm |
Why is there pain in left side of chest & medial aspect of left arm during a heart attack? | Pain --superficial cardiac plexus (formed by cardiac branches of L sup cervical ganglion & vagus)--> CNS Preganglionic sympathetic fibers in cardiac branches originate from T1-T5 |
What nerve comes off of first part of axillary a.? | superior/supreme thoracic |
What nerves come off second part of axillary a.? | thoraco-acromial & lateral thoracic a. |
What nerves come off third part of axillary a.? | subscapular a., anterior & posterior humeral circumflex a. |
What is the largest branch of axillary a.? | subscapular artery |
After teres major the axillary artery changes name to be? | brachial artery |
Sx of entrapment of median n. in carpal tunnel? | sensory disturbances in lateral half of hand & weakness in thenar muscles |
Sx of entrapment of median n as it passes through pronator teres? | Same sx as carpal tunnel entrapment + weakness in wrist flexion, flexion of lateral 3 finger, pronation of forearm |
sx of ulnar n. entrapment at Canal of Guyon? | weakness of intrinsic hand muscles & parasthesia in skin over medial 2 digits |
Sx of ulnar n. entrapment in ulnar groove (post. aspect of medial epicondyle) | unable to make a tight fist with 4th & 5th digits (since ulnar portion of flexor digitorum profundus sends tendons to digits 4 & 5) |
Where is the axillary nerve vulnerable to entrapment? And what are the symptoms? | Quadrangular space. Inability to abduct shoulder after first 15 degree (supraspinaturs initiates shoulder abduction) and some weakness in lateral rotation (teres minor) |