Organisation of the Body
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| Arteries of the arm | Subclavian artery - passes between middle 1/3 of clavicle
Becomes the auxiliary artery at lateral edge of 1st rib
Passes behind mid clavicle and becomes brachial artery at inferior edge of teres major
Circumflex humeral artery
Profunda brachii artery
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| Auxiliary artery | 1st part - superomedial to pectoralis minor
2nd part - posterior to pectoralis minor
3rd part - inferior to pectoralis minor
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| Arterial anastomosis around shoulder | Subclavian - suprascapular, dorsal scapular
Axillary - circumflex scapular
These can bypass obstructions of 1st/2nd axillary artery
Can feel pulsation in brachial artery - humeral fractures!
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| Arteries of the forearm and hand | Palmar arches usually form anastomosis
Deep palmar arch - usually radial
Superficial palmar arch - usually ulnar
Ulnar gives off interosseous arteries
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| Arterial blood gas | Radial artery blood sample
Arteries sun deep so have to feel for pulse and insert needle deep
Not done is Allens test indicated palmar supply is mostly radial
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| Large veins of upper limb | Subclavian vein - continuation of axillary vain from lateral 1st rib
Axillary vein - sits anterior to axillary artery
Basilic vein - pierces deep fascia to join brachial veins
Cephalic vein - merges with axillary vein
Median cubital vein - IV access
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| Cardiac pacemaker leads | Needs to be inserted into venous circulation
Often at the point of joining just below the clavicle
Cephalic vein - venosomy to insert pacemaker
Can be inserted into axillary vein using Seldinger technique
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| The cubital fossa | A triangular region anterior to the elbow
Borders of interepicondylar line, brachioradialis and pronator teres
Contains biceps tendon, brachial artery, median nerve and superficial veins
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| The snuff box | Contains cephalic vein - site of IV access
Dorsal venous network
Extensor pollicis longus tendon
Superficial radial nerve
Radial artery
Adductor pollicis longus tendon
Extensor pollicis brevis
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| Lymphatic drainage of arm and breast | Axillary nodes - anterior and central
Parasternal nodes - median
Subdiaphragmatic nodes - inferior
Subareolar lymphatic plexus
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| Sentinel lymph node biopsy | Inject dye into tumour
See where lymphatic drainage moves to
First lymph node reached is biopsied to test if tumour has metastasized
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| Arteries of the leg | Common iliac artery
Internal iliac artery - pelvis and gluteal (gluteal arteries)
External iliac artery
Femoral circumflex arteries
Profunda femoris artery - deep
Femoral artery - superficial
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| Posterior compartment of thigh | Femoral pulse - back of knee
Femoral artery is under Sartorius
Subsartorial canal
Can see perforating branches of profunda femoris
Popliteal artery behind knee
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| Arteries of the lower leg | Femoral artery passes through adductor hiatus and becomes popliteal artery
Posterior tibial artery - deep - enters foot as plantar ateries
Anterior tibial artery - enters foot as dorsalis pedis artery
Fibular artery
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| Intermittent claudication | When there us a compromised blood supply to a limb due to blockage of an artery
Not seen at rest but causes pain in exercise
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| Veins of the lower limb | Saphenous veins originate from dorsal venous arch of foot
Short - posterior to lateral malleolus with sural nerve ascending to popliteal fossa
Long - anterior to medial malleolus with saphenous nerve ascending to femoral triangle
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| Varicose veins | Generally due to valve incompetence
Veins tend to run superficial to deep - muscles around deep veins aid venous return
Venous incompetence is often due to perforated valve - causes dilated veins prone to bleeding
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| Deep vein thrombosis | Venous pressure is low so blood is more likely to clot
Clots can make it to the heart and lungs
Presents as a unilateral swollen leg - often acute
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| Oedema of the lower limbs | Increased hydrostatic pressure - Ca channel blockers, heart failure, venous insufficiency, proximal DVT
Reduced oncotic pressure - liver failure, nephrotic syndrome
Lymphatic obstruction - post surgery, filariasis
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| Femoral triangle | Borders of inguinal ligament, sartorius and adductor longus
Contains femoral nerve, artery and vein NAVY
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| Popliteal fossa | A diamond shaped region posterior to the knee
Supracondylar fracture of femur can affect this
Contains popliteal artery, vein and tibial nerve
Borders of semimembranosus, semitendinosus, biceps femoris, gastrocnemius lateral and medial heads
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| Tarsal tunnel | T - Tibialis posterior
D - Flexor digitorum longus
A - Posterior tibial artery
V - Vein
N - Tibial nerve
H - Flexor Hallucis longus
Tom, Dick and Very Nervous Harry
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| List of upper limb arteries | Subclavian
Axillary
Brachial/profunda brachii artery
Radial
Ulnar
Superficial and deep palmar arches
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| List of lower limb arteries | Common iliac
Internal iliac
External iliac
Femoral/profunda femoris
Popliteal
Anterior tibial
Posterior tibial
Fibular
Plantar
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| List of upper limb veins | Dorsal venous arch
Cephalic
Basilic
Median cubital
Axillary
Subclavian
Deep veins and venae comitantes
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| List of lower limb veins | Dorsal venous arch
long saphenous
Short saphenous
Popliteal
Femoral
External iliac
Internal iliac
Common iliac
Deep veins and venae comitantes
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