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subscapular – biggest
Lymphatics (along border of
Dr. Elma subscapular muscle)
July 2, 2009 b. ant. humeral circumflex
I. Arterial Supply
- blood supply of the upper limbs leaves
the aortic arch through the
brachiocephalic trunk; which divides
into a right/left common carotid and
right/left subclavian arteries (only
called subclavian arter until before the
outer border of the first rib.)
DR SU – Deep Radial;
Superficial Ulnar
D. Ulnar Artery
– Larger of the two terminal arteries
– Begins at the cubital fossa
– Anterior compartment of arm
– Enters from in front of the flexor
retinaculum
– Lateral to ulnar nerve
– Forms part of superficial and deep
palmar arterial arches (mainly
superficial)
– Impt. Branches
a. Anterior ulnar recurrent a.
b. Posterior ulnar recurrent a.
3. Median cubital
– Connection between cephalic and
basilic at the cubital fossa
– Varies between persons
4. Basilic vein – radial side
– Brachial + basilic vein = axillary
– Venae comitantes with brachial
artery
C. Divisions
– Anterior and posterior divisions of – Radial Nerve (all the muscles in
each trunk the posterior arm and forearm
– Have no branches compartments)
After the axilla it immediately b. Lower trunk injury
enters the posterior compartment – (Klumpke’s paralysis) – loss of
of the upper arm ulnar flexion of the wrist and the
*** Median Nerve is formed by the use of many of the intrinsic
joining of the medial and lateral muscles of the hand results in the
cords claw like position
– Runs lateral to the brachial artery – Scalene syndrome – may be
(upperarm) and then crosses produced by spasms of anterior
halfway to continue on its medial and middle scalene muscles or by a
side cervical rib involving commonly the
– Emerges from the lateral border of lower trunk causing pain along the
the flexor digitorum superficialis median border of arm and atrophy
muscle and lies behind the flexor of some mall muscles of hand; or
retinaculum compress subclavian artery
– No branches in the upper arm causing ischemia of the heart
– Supplies most of the muscles of the
anterior forearm compartment 3. Injury to the cords
(except 1 ½ muscles which are Posterior cord injury
supplied by the ulnar nerve) – Saturday night palsy or crutch
– In the hand the thenar palsy
compartment muscles (opponens, – Loss of extensors of forearm, wrist
flexor and abductor pollicis and hand (ulnar nerve innervates
brevis) most intrinsic muscles of the hand
– Two lumbricals and anterior compartment
muscles)
a. Injury to upper trunk (Erb’s 2. GIVE 1 ARTERY ARISING FROM THE 3RD PART OF
THE AXILLARY ARTERY – Subscapular/Anterior
Duchenne paralysis) or waiter’s or Posterior humeral circumflex artery
tip position – upper limbs hangs 3. WHAT ARE THE TERMINAL BRANCHES OF THE
by the side in internal rotation BRACHIAL ARTERY? Radial and Ulnar Artery
4. WHAT ARTERY SUPPLIES THE TRICEPS BRACHII
MUSCLE? Brachial artery specifically
profunda artery
5. RADIAL ARTERY IS FOUND BETWEEN THE
TENDONS OF WHAT MUSCLES?
flexor carpi radialis and brachioradialis
muscle
6. THE DEEP PALMAR ARTERIAL ARCH ARISES
MAINLY FROM WHAT ARTERY? Radial Artery
(DR SU)
7. WHAT SUPERFICIAL VEIN PASSES THRU THE
DELTOPECTORAL GROOVE? Cephalic vein
8. SUPERFICIAL LYMPH VESSELS ON THE MEDIAL
SIDE OF THE UPPER LIMBS WILL DRAIN INTO
WHICH GROUP OF AXILLARY NODES? Lateral
Axillary node Central Axillary node
9. WHAT CARPAL BONE WILL BE OF HELP IN
LOCATING FOR THE PULSATION OF YOUR ULNAR
ARTERY? Pisiform
10. THE SUPERFICIAL PALMAR ARTERIAL ARCH ARISE 7. What nerve injury will produce claw hand
MAINLY FROM WHAT ARTERY? Ulnar Artery deformity? Lower trunk injury (Klumpke’s
paralysis)
8. The ulnar nerve will come from what cord?
Medial cord
9. The opponens pollicis muscle is innervated by
what nerve? Median nerve
On Innervation
1. From what roots will the long thoracic nerve
originate? C5, C6, C7
2. Give one muscle supplied by the
musculocutaneous nerve. (BBC, Brachialis,
biceps brachii, coracoradialis)
3. Cord/s of origin of the median nerve. Lateral
and medial cord
4. Give 2 nerves coming from the posterior cord of
the brachial plexus – radial nerve, axillary/
circumflex humeral nerve, middle
subscapularis, upper subscapularis
5. What nerve will innervate the posterior arm
compartment? Radial nerve
6. What nerve will provide cutaneous innervation to
the tips of 3 ½ fingers of the dorsal surface of
the hand? Median nerve