Upper Extremity Neurovascular Structures

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17 Terms

1
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Brachial Plexus function/formed from/

  • Provides the vast majority of neural supply to the upper extremity

  • Formed from ventral rami of C5-T1 nerve roots


<ul><li><p>Provides the vast majority of neural supply to the upper extremity</p></li><li><p>Formed from ventral rami of C5-T1 nerve roots</p></li></ul><p></p>
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Divisions of the Brachial Plexus

  1. Roots

  2. Trunks

  3. Divisions

  4. Cords

  5. Branches

Remember To Drink Cold Beer


<ol><li><p>Roots</p></li><li><p>Trunks</p></li><li><p>Divisions</p></li><li><p>Cords</p></li><li><p>Branches</p></li></ol><p><strong>R</strong>emember<strong> T</strong>o<strong> D</strong>rink <strong>C</strong>old <strong>B</strong>eer</p><p></p>
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Brachial Plexus Roots & Trunks

  • Roots (5): Spinal nerve roots

    • C5

    • C6

    • C7

    • C8

    • T1

  • Trunks

    • Superior: C5-C6

    • Middle: C7

    • Inferior: C8-T1


<ul><li><p>Roots (5): Spinal nerve roots</p><ul><li><p>C5</p></li><li><p>C6</p></li><li><p>C7</p></li><li><p>C8</p></li><li><p>T1</p></li></ul></li><li><p>Trunks</p><ul><li><p>Superior: C5-C6</p></li><li><p>Middle: C7</p></li><li><p>Inferior: C8-T1</p></li></ul></li></ul><p></p>
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Brachial Plexus Divisions Components

Each trunk has anterior and posterior divisions

  • Anterior divisions of middle superior trunks forms lateral cords

  • Anterior divisions of inferior trunk becomes medial cord

  • Posterior divisions of all 3 unite to form posterior cord


<p>Each trunk has <strong><u>anterior</u></strong> and <strong><u>posterior</u></strong> divisions</p><ul><li><p><strong>Anterior</strong> divisions of middle superior trunks forms <strong>lateral</strong> cords</p></li><li><p><strong>Anterior</strong> divisions of inferior trunk becomes <strong>medial</strong> cord</p></li><li><p><strong>Posterior</strong> divisions of all 3 unite to form <strong>posterior</strong> cord</p></li></ul><p></p>
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Anterior vs Posterior Brachial Plexus Divisions

  • Anterior: innervates anterior musculature

  • Posterior: innervates posterior musculature


<ul><li><p>Anterior: innervates anterior musculature</p></li><li><p>Posterior: innervates posterior musculature</p></li></ul><p></p>
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Cords

  • Lateral

  • Medial

  • Posterior

Cords end by dividing into 5 terminal nerve branches


<ul><li><p>Lateral</p></li><li><p>Medial</p></li><li><p>Posterior</p></li></ul><p>Cords end by dividing into 5 terminal nerve branches</p><p></p>
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Lateral Cord divisions and its terminal branches

  • Lateral pectoral n.

    • Pec Major

  • 2 terminal branches

    • Musculocutaneous n.

      • Biceps brachii

      • Brachalis

    • Median n (lateral portion)


<ul><li><p>Lateral pectoral n.</p><ul><li><p>Pec Major</p></li></ul></li><li><p>2 terminal branches</p><ul><li><p>Musculocutaneous n.</p><ul><li><p>Biceps brachii</p></li><li><p>Brachalis</p></li></ul></li><li><p>Median n (lateral portion)</p></li></ul></li></ul><p></p>
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Medial Cord divisions and its terminal branches

Divides into:

  • Medial pectoral n

    • Pec major and minor

  • Medial brachial cutaneous n. (sensory only)

  • Medial antebrachial cutaneous n. (sensory only)

2 terminal branches:

  • Median n. (medial portion)

  • Ulnar n.

Continues on as ulnar nerve


<p>Divides into:</p><ul><li><p>Medial pectoral n</p><ul><li><p>Pec major and minor</p></li></ul></li><li><p>Medial brachial cutaneous n. (sensory only)</p></li><li><p>Medial antebrachial cutaneous n. (sensory only)</p></li></ul><p>2 terminal branches:</p><ul><li><p>Median n. (medial portion)</p></li><li><p>Ulnar n.</p></li></ul><p>Continues on as ulnar nerve</p><p></p>
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Posterior Cord divisions and its terminal branches

Divides into:

  • Upper subscapular n.

    • Supscapularis

  • Thoracodorsal n

    • Latissimus dorsi

  • Lower subscapular n.

    • Teres major

    • Subscapularis

2 terminal branches:

  • Axillary n.

  • Radial n.


<p>Divides into:</p><ul><li><p>Upper subscapular n.</p><ul><li><p>Supscapularis</p></li></ul></li><li><p>Thoracodorsal n</p><ul><li><p>Latissimus dorsi</p></li></ul></li><li><p>Lower subscapular n.</p><ul><li><p>Teres major</p></li><li><p>Subscapularis</p></li></ul></li></ul><p>2 terminal branches:</p><ul><li><p>Axillary n.</p></li><li><p>Radial n.</p></li></ul><p></p>
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Brachial Plexus branches

  • Musculocutaneous

  • Axillary

  • Median

  • Radial

  • Ulnar


<ul><li><p>Musculocutaneous</p></li><li><p>Axillary</p></li><li><p>Median</p></li><li><p>Radial</p></li><li><p>Ulnar</p></li></ul><p></p>
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Axillary Branch motor and sensory

Motor:

  • Deltoid

  • Teres minor

Sensory:

  • Skin over the lower deltoid


<p>Motor:</p><ul><li><p>Deltoid</p></li><li><p>Teres minor</p></li></ul><p>Sensory:</p><ul><li><p>Skin over the lower deltoid</p></li></ul><p></p>
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Ulnar Branch motor and sensory

Motor:

  • Forearm

    • FCU

    • FDP (4 & 5)

  • Thenar

    • Hypothenar muscles

    • Adductor pollicis

    • FPB

  • Fingers:

    • Palmer interosseous

    • Dorsal interosseous

    • 4&5 Lumbricles

  • Digiti Minimi

    • Abductor digiti minimi

    • Opponens digit minimi

    • Flexor digiti minimi

Sensory:

  • Little finger

  • ½ of 4th (ring)


<p>Motor:</p><ul><li><p>Forearm</p><ul><li><p>FCU</p></li><li><p>FDP (4 &amp; 5)</p></li></ul></li></ul><ul><li><p>Thenar</p><ul><li><p>Hypothenar muscles</p></li><li><p>Adductor pollicis</p></li><li><p>FPB</p></li></ul></li><li><p>Fingers:</p><ul><li><p>Palmer interosseous</p></li><li><p>Dorsal interosseous</p></li><li><p>4&amp;5 Lumbricles</p></li></ul></li><li><p>Digiti Minimi</p><ul><li><p>Abductor digiti minimi</p></li><li><p>Opponens digit minimi</p></li><li><p>Flexor digiti minimi</p></li></ul></li></ul><p>Sensory:</p><ul><li><p>Little finger</p></li><li><p>½ of 4th (ring)</p></li></ul><p></p>
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Median Branch motor and sensory

Motor:

  • Flexor and pronator muscles in the anterior compartment of the forearm (except FCU and part of FDP - innervated by ulnar nerve)

  • Thenar Muscles and lateral 2 lumbricals in the hand

Sensory:

  • Lateral aspect of palm

  • 3 and a half fingers on the anterior (palmar) surface of the hand

  • 3 ½ distal digits dorsally


<p>Motor:</p><ul><li><p>Flexor and pronator muscles in the <u>anterior compartment of the forearm</u> (except FCU and part of FDP - innervated by ulnar nerve)</p></li><li><p>Thenar Muscles and lateral 2 lumbricals in the hand</p></li></ul><p>Sensory:</p><ul><li><p>Lateral aspect of palm</p></li><li><p>3 and a half fingers on the anterior (palmar) surface of the hand</p></li><li><p>3 ½ distal digits dorsally</p></li></ul><p></p>
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Radial Branch motor and sensory

Motor:

  • Triceps brachii

  • Extensor muscles in the forearm

Sensory:

  • Posterior forearm

  • Lateral aspect of the dorsum of the hand

  • Dorsal surface of the lateral three and a half digits


<p>Motor:</p><ul><li><p>Triceps brachii</p></li><li><p>Extensor muscles in the forearm</p></li></ul><p>Sensory:</p><ul><li><p>Posterior forearm</p></li><li><p>Lateral aspect of the dorsum of the hand</p></li><li><p>Dorsal surface of the lateral three and a half digits</p></li></ul><p></p>
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<p>What nerve is matches the red, purple, and yellow regions</p>

What nerve is matches the red, purple, and yellow regions

Red: Radial

Purple: Median

Yellow: ulnar

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Upper Extremity Arteries

  • Subclavian

  • Axillary

  • Brachial

  • Radial

  • Ulnar


<ul><li><p>Subclavian</p></li><li><p>Axillary</p></li><li><p>Brachial</p></li><li><p>Radial</p></li><li><p>Ulnar</p></li></ul><p></p>
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Upper Extremity Arteries (hand)

  • Deep palmar arch

  • Superficial palmar arch


<ul><li><p>Deep palmar arch</p></li><li><p>Superficial palmar arch</p></li></ul><p></p>