gross exam 2

What is the order (proximal to distal) of the components of the brachial plexus

roots, trunks, divisions, cords, branches

roots of the brachial plexus are the anterior rami of ______ and most of _____

C5-C8; T1

The roots of the brachial plexus enter the posterior triangle of the neck by passing between _________ and _________

anterior scalene; middle scalene

the roots lie superior and posterior to the

subclavian artery

The trunks of the brachial plexus originate from the ______________ & pass
laterally over the 1st rib

roots

The superior trunk is formed by

union of C5 and C6

The middle trunk the continuation of

C7 root

The inferior trunk is formed by:

C8 and T1

Each of the 3 trunks divides into an anterior & posterior ____________________.

divisions

The 3 anterior divisions give rise to the

peripheral nerves associated with anterior compartments of arm and forearm

The 3 posterior divisions give rise to nerves

associated with the posterior compartments of the arm and forearm

The cords originate from _________________ & are named for their positioning
around the ___________________________

divisions; axillary artery

The lateral cord is the union of the ____________________ divisions of the
_________________ & __________________ trunks

anterior; superior and middle

The medial cord is the continuation of the ___________________ division of the
_____________________ trunks

anterior; inferior

The posterior cord is the union of ____________________________ divisions.

posterior

What are the five terminal branches of the brachial plexus

musculocutaneous, ulnar, radial, median, axillary

dorsal scapular nerve pierces through

meddle scalene muscle

musculocutaneous nerve pierces through

coracobrachialis muscle

medial pectoral nerve pierces through

pectoralis major

myotome C5

shoulder abduction

myotome C6

Elbow flexion

myotome C7

elbow extension

myotome C8

finger flexion

myotome T1

finger abduction

dermatomes C4

shoulder tip

dermatomes C5

lateral shoulder/arm

dermatomes C6

thumb and lateral forearm

dermatomes C7

middle finger

dermatomes C8

pinky and medial hand

dermatomes T1

medial forearm and medial elbow

dermatomes T2

Axilla and medial upper arm

What is affected in Erb- duchenne palsy

C5-C6, suprascapular, axillary, and musculocutaneous nerve

What is the clinical presentation of Erb- Duchenne palsy

waiters tip deformity

What is affected in Klumpke’s palsy

C8-T1, ulnar and median nerve

clinical presentation of klumpke’s palsy

claw hand

what is a cervical ribs and what causes it

accessory rib articulating with C7, caused by thoracic outlet syndrome

what is thoracic outlet syndrome

compression of the brachial plexus, subclavian artery or subclavian vein

what are common compression sites for TOS

scalene triangle, costoclavicular space, subcoracoid space

Symptoms of TOS

pain, numbness, tingling in the upper limb, muscle weakness

Brachial artery originates

Axillary nerve

three major branches of the brachial artery

deep brachial, superior ulnar collateral, inferior ulnar collateral

The ____________________________ is the most used site for measuring blood
pressure

brachial artery

what are the terminal branches of the deep brachial artery

radial and middle collateral artery

where does the deep brachial artery pass through

triangular interval

the basilic vein joins the ___________________________ to form the ________________________

brachial veins; axillary vein

origin of basilic vein

superficial dorsal venous network

brachial vein origins

ulnar and radial veins

the brachial vein unite with the _________________ to form the _____________________________.

basilic vein; axillary vein

The ______________________________ supplies motor innervation to all
muscles of the anterior compartment of the arm & sensory innervation to the
lateral aspect of the arm via the __________________________________________

musculocutaneous nerve; lateral cutaneous nerve

The _________________________ is related to the brachial artery throughout its
course through the arm.

median

Where does the ulnar nerve pass at the elbow

posterior to the medial epicondyle (cubital tunnel)

What are the cutaneous branches of the radial nerve that originate in the axilla and arm

Sensory branches of the radial nerve

Which two branches penetrate through the lateral head of triceps brachii

Inferior lateral and posterior cutaneous nerve of the arm and forearm

The ______________________ nerve is most at risk with a mid-shaft humeral
fracture. The symptoms include ______________________ & sensory changes
over the posterolateral aspect of the hand

radial; wrist drop

what are the three joints of the elbow

humero-ulnar, humero-radial, proximal radio-ulnar

What elbow joint is a synovial hinge, and articulates the trochlear notch and trochlea

humero-ulnar

what elbow joint is synovial modified hinge, and articulates at the radial head and capitulum

humero-radial

what elbow joint is a synovial pivot, and articulates at the radial head and notch

proximal radio-ulnar joint

The inner membrane of the elbow joint is the __________________________.
What intracapsular, extrasynovial structures are present occupying the
humeral fossae

synovial membrane; fat pads

the radial collateral ligament resists

varus stress

the ulnar collateral ligament resists

valgus stress

The __________________________ ligament holds the head of the radius against
the ulna during pronation and supination of the forearm. It blends with the
____________________________

annular; radial collateral ligament

What is the sacciform recess? What does it do?

a pocket of synovial membrane; accommodates rotation of radial head

vascular supply to the elbow joint is derived from

collateral and recurrent branches of the brachial, profunda, radial, and ulnar arteries

Cubital tunnel syndrome involves impaired function of the _______.

ulnar nerve

An avulsion fracture involving the olecranon process involves the
_____________________________ muscle

triceps

what makes up the cubital fossa

pronator teres, brachioradialis, brachialis muscle

What are the major contents of the cubital fossa from lateral to medial?

tendon of biceps brachii, brachial artery, median nerve

What is the bicipital aponeurosis? What does it protect?

covering for the brachail artery and median nerve

the median nerve lies medial to the ___________________________ & leaves the
cubital fossa by passing between:

brachail artery

The radial nerve at the cubital fossa involves a superficial branch that continues

into the forearm deep to the brachioradialis

The radial nerve at the cubital fossa involves a deep branch that passes

between the two heads of the supinator muscles

The __________________________ connects the cephalic vein with the basilic
vein

median cubital vein

The ___________________________ separates the median cubital vein from the
brachial artery & median nerve. What other structures are within the roof of
the cubital fossa?

bicipital aponeurosis; medial and lateral cutaneous nerves of the forearm

Pronator teres syndrome involves entrapment of the ______________nerve. It occurs between the 2 heads of the _______________________muscle.

median; pronator teres

What are the symptoms of pronator teres syndrome & where do they present?

pain in the proximal anterior forearm, paresthesia along the distribution of the median nerve

The ________________ nerve & ___________________ artery pass deep to the flexor digitorum superficialis between the two heads.

median; ulnar

What do the flexor digitorum profundus tendons do in route to the insertion at the distal phalanges of digits 2-5?

pass through the split formed by superficialis to get to the attachment cite

The interosseus membrane connects the __________ & ___________.

medial and lateral borders of radius and ulna

Vessels pass through the interosseus membrane by passing either between the:

anterior and posterior compartments superior to the upper margin; inferior aperture

Which structures (& where) provide stability during pronation & supination?

annular ligament at proximal joint; interosseous membrane along radius and ulna; articular discs at distal joint

Which muscles are involved in supination?

biceps brachii and supinator

Which muscles are involved in pronation

pronator teres and pronator quadratus

Anterior dislocation of the head of the radius at the elbow, fracture of the proximal third of the ulna

monteggia fracture

fracture of distal third of the radius, partial dislocation of the head of the ulna at the wrist joint

Galeazzi’s fracture

fracture and posterior displacement of the distal end of the radius

colles fracture

The terminal branches of the brachial artery are the

radial and ulnar artery

The radial recurrent artery is a branch of the ____________ artery that contributes to the _________________________.

deep brachial; elbow anastomosis

the radial artery branches in the hand

deep palmar arch, princeps pollicis, radialis indicis artery

major blood supply to the thumb

princeps pollicis artery

blood supply to lateral side of index finger

radialis indicis artery

The anterior ulnar recurrent artery & the posterior ulnar recurrent artery contribute to the _______________________.

elbows anastomosis

The common interosseus artery is a branch of the __________ artery that divides into the

ulnar artery; anterior and posterior interosseous artery

The anterior interosseus artery supplies the _________________________________________ and terminates by joining the __________________

muscles of the deep compartment of the forearm; radius and ulna

The posterior interosseus artery supplies the ___________________ & terminates by joining the ______________.

superficial extensor muscle; dorsal carpal arch

The major branch of the posterior interosseus artery is the
_________________ - this artery contributes to the elbow anastomosis.

recurrent interosseus artery

The superficial palmar arch is formed by the _________________. It
gives rise to the:

ulnar artery: palmar digital artery and common palmer digital arteries

The dorsal carpal arch is formed by an anastomosis between the:

dorsal carpal branch of the radial and ulnar artery

In the hand, the ulnar artery (and its branches) primarily supply the

medial side of digit 2, and digits 3-5

The radial artery (and its branches) primarily supply the:

lateral side of digit 2 and thumb