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Gross II-Upper Limb

Zumpano Fall 2010

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)
Created by: mrw2013



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