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WEEK 23:
Introduction to the upper limb 2:
| Question | Answer |
|---|---|
| myotomes | unilateral embryological muscle mass receiving innervation from a single spinal cord segment/ spinal nerve where most muscles are made up of more than one myotome |
| cutaneous innervation | area of skin which is supplied by a specific cutaneous nerve |
| most cutaneous nerves of upper limb derived from | brachial plexus |
| cutaneous nerves to the shoulder derived from | cervical plexus |
| axillary artery | continuation of the subclavian artery which is divided into 3 pars by the pectoralis minor |
| 3 parts of the axillary artery | (First part – 1 branch Superior thoracic a.) (Second part – 2 branches Thoracoacromial a. Lateral thoracic a.) (Third part – 3 branches Subscapular a. Anterior humeral circumflex a. Posterior humeral circumflex a) |
| brachial artery | continuation of axillary artery travelling in the anterior compartment of the arm where branches supply anterior and posterior compartment |
| branches of the brachial artery | Profunda brachii (deep brachial) a., Muscular branches to anterior compartment of the arm, Humeral nutrient artery, Superior ulnar collateral a., and Inferior ulnar collateral a. |
| ulnar artery | larger of the 2 terminal branches of the brachial artery which descends through the medial aspect of the anterior compartment of the forearm and ends by forming the superficial palmar arch |
| forearm branches of the ulnar artery | Muscular branches to neighbouring muscles, Anterior and posterior ulnar recurrent branches, Common interosseous artery, and Arterial anastomosis around the wrist joint |
| hand branches of the ulnar artery (1) | superficial palmar arch |
| radial artery | smaller of the two terminal branches of the brachial artery and descends through the lateral aspect of the anterior compartment of the forearm and ends by forming the deep palmar arch |
| forearm branches of the radial artery | Muscular branches to neighbouring muscles, Radial recurrent artery, and Superficial palmar branch |
| hand branches of the radial artery (1) | deep palmar arch |
| arterial anastomoses of UL | connections between 2 arteries providing an alternate pathway for blood to continue flowing allowing perfusion to tissues even if one artery is damaged, forming around joints usually |
| superficial veins location | lie in superficial fascia |
| dorsal venous arch drains where | into cephalic and basilic veins |
| cephalic vein | joins the terminal part of axillary vein (on the lateral thumb side when supinated) |
| basilic vein | merges with the accompanying vein (L. venae comitantes) of the axillary artery to form the axillary vein (on the medial pinky side when supinated) |
| median cubital vein | in the middle of the cephalic and basilic vein and often gives off a branch (deep cubital vein to anastomose with brachial vein) |
| deep veins | lie internal to deep fascia and continually mix and travel with and have the same name as the arteries of UL |
| superficial lymphatic vessels | ascend mostly with superficial veins (cephalic and basilic eg) and terminate in the humeral axillary lymph nodes |
| deep lymphatic vessels | accompany major deep veins in the UL (radial, ulnar, and brachial) and terminate in the humeral axillary lymph nodes |
| why are superficial veins used for venepuncture | the veins are more prominent and therefore more accessible |
| what are common sites of venous access (3 | Medial cubital vein – venepuncture, Dorsal venous network of the hand, cephalic and basilic veins – long term introduction of fluids (intravenous feeding), and Cubital veins – also a site for the introduction of cardiac catheters |
| fascia and compartments of UL | skin, subcutaneous tissue (superficial fascia) and deep fascia (brachial fascia in the arm and antebrachial fascia in forearm) |
| compartments of UL | anterior (flexor) and posterior (extensor) fascial compartments, including arm (by medial and lateral intermuscular septa and humerus), and forearm (by interosseous membrane by radius and ulna) |
| fascia of the palm | continuous with antebrachial fascia and the fascia of the dorsum of the hand |
| palmar fascia made of | thin (thenar eminence - thenar fascia, and hypothenar eminence - hypothenar fascia), thick (centrally - palmar aponeurosis), and fingers (digital sheaths) |
| osseofascial compartment syndrome (compartment syndrome) | pathological condition characterised by elevated interstitial pressure in a closed osseofascial compartment resulting in microvascular compromise (restriction of capillary blood flow- this can be acute or chronic and usually caused by soft tissue injury |
| symptoms of osseofascial compartment syndrome | painful, pale, pulseless, paraethetic (sensations that are not painful but 'tingling' , and paralysis |
| treatment for osseofascial compartment syndrome | fasciotomy (let fluid out) then treat underlying cause that caused the osseofascial compartment syndrome |
| anatomical snuff box | when thumb is extended a triangular hollow appears between tendon of the extensor pollicis longus (EPL) medially and the tendons of the extensor pollicis brevis (EPB) and abductor pollicis longus (APL) laterally |
| floor of snuff box made of (2) | scaphoid and trapezium and is crossed by radial artery |
| scaphoid fracture caused by FOOSH injuries | cause tenderness to palpation |
| where do the superficial and deep lymphatic vessels terminate | in humeral axillary lymph nodes |
| median cubital vein is used for | venepuncture |
| dorsal venous network of the hand (basilic and cephalic) veins are used for | introduction of fluids via IV feeding |
| cubital veins are used for | introduction of cardiac catheters |
| deep fascia of the UL can be split into (2) | brachial fascia (arm) and antebrachial fascia (forearm) |
| anterior fascial compartment of the UL | flexor |
| posterior fascial compartment of UL | extensor |
| the arm is divided into anterior and posterior fascial compartments by | medial and lateral intermuscular septa and humerus |
| the forearm is divided into anterior and posterior fascial compartments by | interosseous membrane, radius and ulna |
| thin parts of the palmar fascia (2) | thenar eminence (covered by the thenar fascia) and hypothenar eminence (covered by the hypothenar fascia) |
| thenar eminence is covered by | thenar fascia |
| hypothenar eminence is covered by | hypothenar fascia |
| thenar fascia covers | thenar eminence |
| hypothenar fascia covers | hypothenar eminence |
| thenar compartment location | thumb side |
| hypothenar compartment location | pinky side |
| thick part of the palmar fascia | centrally (covered by palmar aponeurosis) |
| osseofascial compartment syndrome leads to | microvascular compromise (restriction of capillary blood flow) |
| osseofascial compartment syndrome can be (2) | acute or chronic |
| common cause of osseofascial compartment syndrome | soft tissue injury |
| borders of the anatomical snuff box | medially - tendon of extensor pollicis longus (EPL) and tendons of the extensor pollicis brevis (EPB) and laterally - abductor pollicis longus |
Created by:
kablooey
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