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SGU: Upper Limb 1
Axilla, Brachial Plexus, Shoulder, Arm
| Question | Answer |
|---|---|
| serratus anterior innervation | long thoracic |
| serratus anterior blood supply | lateral thoracic |
| serratus anterior action | aBduction of arms above 90 degrees, protraction and rotation of scapula, keeps medial border and inferior angle of scapula opposed to thoracic wall |
| Loss of serratus anterior | UNABLE to aBduct above 90 degrees |
| Latissimus dorsi innervation | Thoracodorsal nerve |
| Latissiums dorsi blood supply | Thoracodorsal artery |
| Latissimus dorsi action | aDduction of humerous, extend and rotate humerous medial |
| Loss of Latissimus dorsi | Unable to pull body upward when climbing or doing a pull-up ie. loss of humerous aDduction |
| Teres Major innervation | lower/inferior subscapular nerve |
| Teres Major blood supply | Scapular circumflex artery |
| Teres Major Action | Medial rotation and extension of arm at glenohumeral joint |
| Subscapularis Action | medially rotates humerous |
| Subscapularis Innervation | upper and lower subscapular nerves (C5,6) |
| Subscapularis blood supply | subscapular artery |
| Pectoralis major action | flexes and aDducts the arm, medially rotates the arm |
| Pectoralis major innervation | medial and lateral pectoral nerve |
| Pectoralis major blood supply | pectoral branch of the thoracoacromial artery |
| Pectoralis minor action | pulls tip of shoulder down and protracts scapula |
| Pectoralis minor innervation | medial pectoral nerves |
| Pectoralis minor blood supply | pectoral branch of the thoracoacromial artery |
| Subclavius action | pulls tip of shoulder down; pulls clavicle medialy to stabilize sterno clavicular joint |
| Subclavius innervation | Nerve to subclavius |
| Subclavius blood supply | Clavicular branches of the thoracoacromial trunk |
| Serratus anterior loss of action | winged scapula and UNABLE to lift arm above 90 degrees |
| Describe the location of the three parts of the axillary artery | part 1: begins at subclavius artery and ends before pectoralis minor part 2: under pectoralis minor part 3: after pectoralis minor and before brachial artery |
| What artery branches off of the 1st part of the axillary artery? | superior thoracic artery |
| What arteries branch off of the 2nd part of the axillary artery? | thoracoacromial artery and the lateral thoracic artery |
| What muscle is supplied by the lateral thoracic artery? | serratus anterior |
| What muscles are supplied by the thoracoacromial arteries? | pectoralis major and minor, subclavius |
| arteries involved in anastomosis around the scapula | scapular artery anastomose with deep branch of the transverse cervical and the suprascapular artery. The posterior circumflex humeral artery anastomose with the suprascapular artery |
| What arteries branch off of the 3rd part of the axillary artery? | Subscapular, posterior and anterior humeral circumflex artery |
| What arteries branch off of the subscapular arter? | thoracodorsal and scapular circumflex artery |
| What muscle does the posterior humeral circumflex artery supply? | deltoid |
| What muscles does the scapular circumflex artery supply? | teres major and minor |
| Describe the extent of the axillary vein | axillary vein begins at the lower margin of teres major and is a continuation of the basilica vein. It branches off into the cephalic vein after teres minor and ends at the subclavian vein |
| clinical significance of the axillary sheath in local anaesthesia | Axillary sheath contains the axillary artery, vein and the brachial plexus. Anaesthesia in this sheath can lead to nerve block of the brachial plexus |
| anatomical relationships that are important for successful insertion of a catheter for central venous access | should be punctured in the midclavicular line or lateral to this line |
| At what point of the brachial plexus does the dorsal scapular nerve come off? | C5 root |
| At what point of the brachial plexus does the long thoracic nerve come off? | C5-7 root |
| At what point of the brachial plexus does the suprascapular nerve come off? | upper trunk |
| At what point of the brachial plexus does the nerve to subclavius come off? | upper trunk |
| What nerves come off of the lateral cord? | Lateral pectoral, musclocutaneous and contribution to the median |
| What nerves come off of the posterior cord? | (STARS): subscapular (upper), thoracodorsal, axillary, radial and subscapular |
| What nerves come off of the Medial cord? | Contributes to the median, Ulnar, (MP) medial pectoral, (MBC) medial brachial cutaneous, (MABC) medial anti-brachial (forearm) cutaneous |
| What is a pre-fixed brachial artery? | occurs when the C4 ventral ramus contributes to the brachial plexus |
| What is a post-fixed brachial artery? | when the T2 ventral ramus contributes to the brachial plexus |
| What syndrome can be caused by an upper brachial plexus injury? | Erb's Palsy |
| syndrome can be caused by a lower brachial plexus injury? | Klumpke's paralysis |
| Which lymphatic nodes in the axilla drain the upper limb? | lateral/humeral |
| List the axillary lymph nodes | posterior, anterior, lateral, central, apical |
| Which lymphatic nodes in the axilla drain the back, neck and shoulder? | posterior/scapula |
| Which lymphatic nodes in the axilla drain the brests, chest and abdominal wall? | anterior/pectoral |
| What are the lymph nodes of the brest? | axillary, ipsilateral and contralateral parasternal |
| Trapezius action | powerful aBductor of humerus above horizontal |
| Trapezius dysfunction | DIFFICULTY abducting arm above horizontal |
| Trapizius innervation | spinal accessory |
| Trapizius blood supply | superficial transverse cervical |
| Deltoid action | aBductor of humerous above 15 degrees |
| Deltoid innervations | axillary nerve |
| Deltoid blood supply | posterior circumflex artery and deltoid branch of thoracoacromial artery |
| Levator scapulae action | elevates scapula |
| Levator scapulae innervations | dorsal scapular |
| Levator scapulae blood supply | dorsal scapular |
| Rhomboid major and minor action | retracts and elevates scapula |
| Rhomboid major and minor dysfunction | lateral shift in position of scapula |
| Rhomboid major and minor blood supply | dorsal scapular |
| Rhomboid major and minor innervations | dorsal scapular |
| Supraspinatus action | initiation of aBduction from 0-15 degrees |
| Supraspinatus innervations | suprascapular nerve |
| Supraspinatus blood supply | suprascapular |
| Supraspinatus dysfunction | UNABLE to initiate humerus aBduction |
| Infraspinatus action | lateral rotation of humerus |
| Infraspinatus innervations | suprascapular nerve |
| Infraspinatus blood supply | suprascapular artery |
| Teres minor action | lateral rotation of humerous |
| Teres minor innervations | axillary nerve |
| Teres minor blood supply | scapular circumflex artery |
| Long head of triceps brachii action | extensor of forearm & accessory extensor and aDductor of arm |
| Long head of triceps brachii innervations | radial nerve |
| Long head of triceps brachii blood supply | deep brachial artery |
| Biceps brachii action | flexor and supinator of forearm |
| Coracobrachialis action | flexor and adductor of arm |
| Biceps brachii innervaton | musculocutaneous |
| Biceps brachii blood supply | brachial artery |
| Coracobrachialis innervations | musculocutaneous |
| Coracobrachialis blood supply | brachial artery |
| Brachialis action | flexor of forearm |
| Brachialis innervations | musculocutaneous (radial to lateral part of muscle) |
| Brachialis blood supply | brachial artery |
| Anconeus action | extension of forearm |
| Anconeus innervation | radial nerve |
| Triceps Brachii action | extension of forearm at elbow joint |
| Triceps brachii innervation | radial nerve |
| triceps brachii blood supply | deep brachial artery |
| What surrounds the quadrangular space? | inferior margin of subscapularis, surgical neck of humerus, superior margin of teres major, lateral margin of long head of triceps |
| What passes through the quadrangular space? | axillary nerve and posterior humeral circumflex artery and vein |
| In general, what muscles in the upper limb are innervated by the musculocutaneous nerve? | all muscles in anterior compartment of arm |
| In general, what muscles in the upper limb are innervated by the median nerve? | most flexors in the forearm, thenar muscles in the hand |
| In general, what muscles in the upper limb are innervated by the radial nerve? | all muscles in posterior compartment of arm and forearm |
| In general, what muscles in the upper limb are innervated by the Ulnar nerve? | most intrinsic muscles in hand, flexor carpi ulnaris and medial half of flexor digitorum profundus |
| What nerve innervates the skin of the posterior upper limb? | radial nerve |
| What nerve innervates the skin of the anterior lateral part of the upper limb? | musculocutaneous nerve |
| What nerve innervates the skin of the fifth digit and medial half of fourth? | Ulnar nerve |
| What nerve innervates the skin of the anterior first, second, third and lateral half digits including the tips? | median nerve |
| What nerve innervates the skin of the posterior arm and forearm, first, second, third and lateral half digits? | radial nerve |
| What spinal root innervates the lateral dermatome of the upper limb and thumb? | C6 |
| What spinal root innervates the digits 2 and 3 AND posterior dermatome of the upper limb? | C7 |
| What spinal root innervates digits 4 and 5 AND medial upper limb dermatome? | C8 |
| What spinal roots innervate the anteriolateral and anteriomedial dermatome of the upper limb respectively? | C5 and T1 |
| What ligament are you most likely to tear if you fall on the point of your shoulder? | coracoclavicular ligament |
| Where muscle tendon is lateral to the radial pulse? | flexor carpi radialis tendon |
| A patient comes in with loss of feeling in the posterior forearm and arm, exhibits wrist drop and impaired grip strenght. What nerve is damaged? | radial nerve |
| An patient sufferes an injury at or above the elbow such as a medial epicondyle fracture and has sensory loss of little and half of ring fingers. Patient exhibits claw hand. What nerve is severed? | ulnar nerve |
| There is a flattening of the thenar eminence in a patients hand. What nerve is severed? | median nerve |
Created by:
mnoronha
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