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anatomy4b

anatomy slides 4b

QuestionAnswer
***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.
Created by: Mikewagner85