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anatomy4b
anatomy slides 4b
Question | Answer |
---|---|
***Injury proximal to the origin of Triceps | *No extension of elbow (elbow is flexed) *No triceps reflex |
Injury proximal to the origin of Triceps: ***Wrist drop | (all extensor muscles and the Supinator are paralyzed), thumb is flexed and adducted |
Injury proximal to the origin of Triceps: Injury proximal to the origin of Triceps: | dorsolateral lower brachial region, posterior surface of forearm, dorsum of the hand and radial side of proximal phalanges |
Injury of the nerve in radial groove: | In fractures of humerus Triceps muscle is usually functioning Wirst drop and sensory loss in dorsolateral aspect of the forearm and hand Plus all other problems mentioned above |
Nerve injury in forearm: | Here the deep radial nerve is injured (wrist drop) Extension of the thumb and metacarpal joints is disturbed. Sensation is usually preserved |
Median Nerve injury: Above the elbow: Muscles in the arm are not affected Forearm and hand muscles are affected 1- All flexors of the wrist are paralyzed except? | Flexor carpi ulnaris and ulnar part of Flexor digitorum profundus. 3- Thumb flexors and abductor paralyzed but not Adductor (ulnar N.) (ape hand) |
(ape hand) | Thumb flexors and abductor paralyzed but not Adductor (ulnar N.) |
Median Nerve injury: Above the elbow: (HAND OF PAPAL BENEDICTION) | 1st and 2nd Lumbricals lost function and all together, inability to fully flex index and middle finger |
Injury at wrist Joint: (suicide or injury e.g.: hand out of car’s window) | Short muscles of the thumb paralyzed, not adductor. Thenar muscles atrophy (flattened, ape hand) Flexor pollicis longus functioning Sensory loss over Medial N. area |
Ulnar nerve injury: At wrist: (Claw hand) | 1- Fingers are hyperextended at metacarpophalangeal joints and flexed at interphalangeal joints (paralysis of interossei MM and 2 medial lumbricals |
Ulnar nerve injury: Tendon of flexor digitorum perfundus (2 medial ones) paralyzed, Therefore ? | flexion of the ring and little finger is not possible at distal phalangeal joints 3- Small muscles of the little finger are paralyzed |
Ulnar nerve injury: at wrist Abduction and Adduction of the fingers are ? | impaired ( paralysis of interossei MM, piano playing, writing.. Impaired) 5- Sensory loss over ulnar innervating area |
Ulnar nerve injury: Injury at elbow: | Paralysis of flexor carpi ulnaris and medial portion of Flexor digitorum profundus Ulnar deviation of the wrist is weakened, hand is abducted and extended |
Ulnar nerve injury: Injury at elbow: Abduction and Adduction of the fingers are ? | impaired ( paralysis of interossei MM, piano playing, writing.. Impaired) 5- Sensory loss over ulnar innervating area. |
Infraclavicular region (Deltopectoral triangle) | Borders: 1- Clavicle, 2- Deltoid, 3- Pectoralis major Skin innervation: medial, intermediate and Lateral supraclavicular nerves (cervical plexus) On deltoid region: innervation by axillary nerve |
Axillary region: (Pyramidal shape) Borders: | Pectoralis Major, Latis dorsi, ribs and intercostal muscles, humerus and coracobrachialis |
Volkmann's ischemic contracture is a deformity of the hand, fingers, and wrist caused by injury to the muscles of the forearm | lack of blood flow to the forearm. occurs when there is increased pressure due to swelling(compartment syndrome) |
Lymph nodes of the Axillary region: Arranged in 5 groups: | Pectoral, medial, apical, central and subscapular |
Drainage of Lymph nodes of the Axillary region: | subclavian lymphatic trunk to right lymphatic duct to right venous angle |
***Importance of Lymph nodes of the Axillary region | Breast Cancers may give metastasis to the axillary lymph node (75% of breast’s lymphatics drain here). Removal of the lymph nodes may be necessary |
Mastectomy: | removal of the breast |
Lymphangitis | n infection of the lymph vessels Red streaks from infected area to the armpit or groin (may be faint or obvious) Enlarged lymph nodes (glands) above the area of red streaks -- usually in the elbow, armpit, or groin |
Medial bicipital groove: Between biceps and intermuscular septa Contents: | Median N, Brachial artery and veins and basilic vein, medial cutaneous antebrachial nerve and ulnar N. medially |
Radial nerve is found | deep in the posterior brachial region in radial groove of humerus accompanied by deep brachial A and V. |
Dorsum of the Hand: | Radial artery (9) enters the Snuffbox and gives a dorsal branch which produces the dorsal arterial arch of the hand. Then it gives the principal artery of the thumb and then a main branch to join the deep palmar arch. |
Snuffbox: borders: | Tendon of extensor pollicis longus (superior) tendons of the ext. pollicis brevis and abductor pollicis longus (inferiorly). |
Contents of snuffbox: | 9- Radial artery 8- Superficial radial N. |