The Cutaneous Nerves that supply the upper limb along with vessels are embedded in this structure?
Superficial Fascia
These two major veins originate from a network of veins located on the dorsum of the hand
Cephalic Vein
Basilic Vein
On what side of the dorsum of the hand does the Cephalic Vein originate?
Radial Side
The Cephalic vein runs laterally through the forearm and than will penetrate deeply through? and drain into?
Deltopectoral Triangle, to drain into the Axillary Vein
At the base of the axilla the Basilic Vein joins what vein to form the Axillary Vein
2 Brachial Veins
How are the Cephalic and Basilic Vein connected to deeper veins?
Through Perforating Veins
How do the Basilic and Cephalic vein communicate with each other?
In front of the elbow by an obliquely directed vein called Median Cubital Vein
What shape does the Median Cubital vein have?
V shaped
What vein joins the Median Cubital int he anterior aspect of the forearm?
Median Antebrachial Vein
What happens to the Basilic vein after receiving from the Median Cubital Vein?
It will dive through the deep arm fascia and ascends up along with the arms neuromuscular bundle, deep between anterior and posterior compartments
What happens to the Axillary vein after it passes over the 1st rib?
becomes the Subclavian Vein
Name the 5 Cutaneous Nerves innervating the skin of the arm:
Medial Brachial - off the medial cord T1
Intercostobrachial - T1-T2
Posterior Brachial - off Radial nerve C5,6 T1
Superior Lateral Brachial Cutaneous - off Axillary nerve C5
Inferior Lateral Bracial Cutaneous - off Radial Nerve
How many cutaneous nerves innervate the skin of the forearm?
3
Lateral Antebrachial
Medial Antebrachial
Posterior Antebrachial
The lateral antebrachial nerve is accompanied by what vessels?
Cephalic Vein
The lateral antebrachial nerve is a continuation of what branch from the Brachial Plexus?
Musculocutaneous
The Medial Antebrachial nerve takes its origin from where?
The Medial Cord of the Brachial Plexus C8 T1
What vessel accompanies the Medial Antebrachial nerve?
Basilic Vein
The Posterior Antebrachial nerve takes origin from where?
The Radial Nerve
What vessels accompany the Posterior Antebrachial Nerve?
None!
The branches of how many major nerves innervate the skin of the hand?
3
Median Nerve
Ulnar Nerve
Superficial Radial Nerve
From where what cords in the Brachial Plexus does the Median Nerve originate?
Lateral and Medial Cords
Proximal to the wrist the Median Nerve gives a branch off called?
Superficial Palmar Branch of Median Nerve
What part of the hand does the Superficial Palmar Branch of the Median Nerve innervate?
Lateral 2/3 of palm’s skin
As the Median Nerve reaches the palm through the carpel tunnel, it breaks into how many branches?
6
What is the name of the first branch of the Median Nerve in the hand? Where does it go?
Recurrent Motor Branch - innervates the three Thenar muscles of the hand.
How many of the 6 branches of the Median Nerve in the hand innervate muscle?
3!
1st, 4th and 5th
Branches 2, 3 & 4 of the Median Nerve in the hand are called?
Proper Palmar Digital Nerves
Branches 5 & 6 of the Median Nerve in the hand are called?
Common Palmar Digital Nerves
The first two branches of the Proper Palmar Digital Nerves are for what part of the hand?
The thumb’s skin, and the other one is for the radial side of the index finger.
Branches 5 & 6 of the Common Palmar Digital nerves are unique why?
Each will divide into two Proper Palmar Digital Nerves as they reach the bases of their corresponding digits - one between the index and middle and the other between the middle & ring finger
Does the Median Nerve also innervate the dorsal surface of digits?
Yes
What cord gives rise to the Ulnar Nerve?
Medial Cord
How many cutaneous branches does the Ulnar Nerve give off?
2
Dorsal Cutaneous Branch of Ulnar Nerve
Superficial Palmar Branch of Ulnar Nerve
The Dorsal Cutaneous Branch of the Ulnar nerve is for what aspect of the hand?
Dorsomedial 1/3 of the hand and the dorsal surfaces of the medial half of ring finger and the 5th finger.
What nerve will innervate the medial 1/3 surface of the palm?
Superficial Palmar Branch of Ulna
The Superficial Palmar Branch of Ulna is also innervating this tiny muscle of the hand:
Palmaris Brevis
From underneath what muscle does the Superficial Radial Nerve emerge?
Brachioradialis muscle tendon
The Superficial Radial Nerve innervates what portion of the hand?
Lateral 2/3 dorsum of the hand and lateral 3 & 1/2 digits
Out of the 3 nerves Median, Ulnar and Radial what ones innervate the palmar surface of the hand?
Median and Ulnar
What nerves innervate the dorsum of the hand?
Median, Ulnar, and Radial
What is the name of the investing fascia of the arm muscles?
Deep Brachial Fascia
The septa of the Deep Brachial Fascia divide the arm into how many compartments? What are the names of the compartments?
Anterior and Posterior
How many muscles are in the anterior compartment of the arm? What are they?
3
Biceps Brachii, Brachialis, Coracobrachialis
Where does the long head of the Biceps Brachii originate?
Supraglenoid Tubercle of the scapula
Where does the short head of the Biceps Brachii originate?
Coracoid process of scapula
What is the Bicepital Aponeurosis?
Makes the roof of the cubital fossa, and is part of the Biceps tendon that has flattened out and attached to the deep fascia over the Pronator Teres muscle.
What is the main action of the Biceps?
Supinate the forearm when the forearm is flexed at the elbow.
T or F
The Biceps will supinate the extended forearm
False
What is the main function of the Coracobrachialis??
Adduction and helps in flexion at the shoulder joint.
What is the origin and insertion of the Brachialis muscle?
O: The shaft of the humerus
I: Tubercle of Ulnar bone
What is the most powerful flexor of the elbow?
Brachialis Muscle
All 3 muscles of the anterior compartment of the arm are innervated by what nerve?
Musculocutaneous Nerve C5,6,7
What happens to the Musculocutaneous nerve after it pierces the Coracobrachialis?
It passes deep between the Biceps and Brachialis, proximal to the cubital fossa it emerges out superficially and changes names to Lateral Antebrachial Cutaneous Nerve
What vein descends down with the Lateral Antebrachial Cutaneous nerve?
Cephalic Vein
How many muscles are in the posterior compartment of the arm?
1 - Triceps
This head of the Triceps takes origin from the proximal lateral aspect of the humerus, superior to radial groove.
Lateral Head
What head of the Triceps does not cross the shoulder joint?
Lateral
What head of the Triceps will cross the shoulder joint posteriorly?
Long head
Where do all three heads of the Triceps insert?
They come together into a common tendon and insert on the olecranon process of the ulna.
What nerve innervates all 3 heads of the Triceps?
Radial nerve
In the radial/spiral groove what does the Radial Nerve do?
Gives cutaneous branches for the inferior lateral aspect of the arm, and for dorsal aspect of forearm.
Radial Nerve damage can cause this condition?
Wrist drop
When the radial nerve is damaged below the radial groove what will happen to the arm?
We would lose sensation from the dorsal aspect of the forearm but we would still be able to extend at the elbow because the long and lateral heads of the Tricep muscles are innervated by Radial Nerve above radial groove.
This muscle will help the Triceps with extension of the forearm
Anconeus
The Neurovascular Bundle in the arm consists of:
Median Nerve with Brachial Artery and Veins
Medial Antebrachial Cutaneous Nerve with Basilic Vein
Ulnar Nerve with Superior ulnar collateral vessels.
The muscles of the anterior compartment of the forearm are divided into 2 groups by this structure…
Transverse Intermuscular Septum
This group of forearm muscles is characterized by having a common flexor tendon that takes origin from the medial epicondyle of the humerus?
Superficial Group
Name the 5 superficial forearm muscles from lateral to medial
- Pronator Teres
- Flexor Carpi Radialis
- Palmaris Longus
- Flexor Carpi Ulnaris
The flexor carpi radials helps with adduction or abduction?
Abduction
What muscle of the superficial anterior forearm inserts into the flexor retinaculum then continues into the Palmar Aponeurosis?
Palmaris Longus
What muscle is missing in some of us or about 12% of us?
Palmaris Longus
What muscle surrounds the pisiform and inserts into the hook of the Hamate, and the base of the 5th Metacarpal bone?
Flexor Carpi Ulnaris
Name the functions of Flexor Carpi Ulnaris?
Flexes hand
Helps in flexion of elbow
With the help of this extensor muscle the Flexor Carpi Ulnaris also helps to do what movement of the hand?
Adduction
How many tendons does the Flexor Digitorum Superficialis break into?
4 - index, middle, ring and pinky.
What does the tendons of the Flexor Digitorum Superificialis do before insertion into the phalanges?
The 4 tendons divides into two slips
What joints of the hand does the Flexor Digitorum Superficialis NOT flex?
DIP - distal interphalangeal joints.
Name the 3 deep muscles of the anterior compartment of the forearm
Flexor Pollicis Longus
Flexor Digitorum Profundus
Pronator Quadratus
How are the flexor digitorum superficialis and profundus similar and how are they different?
Same function to flex the wrist however the profundus does not function across the elbow but it does across the DIP.
What is the deep branch of the Median Nerve called?
Anterior interosseous nerve
How many muscles does the Anterior Interosseous nerve innervate?
2 &1/2: Flexor pollicis longus, pronator quadratus and lateral half of flexor digitorum profundus.
In total the median nerve innervates how many muscles of the forearm?
6.5
How many muslces of the forearm does the Ulnar nerve innervate?
1.5: Flexor Carpi Ulnaris, and medial half of the flexor digitorum profundus.
List the structures that make up the borders of the cubital fossa.
Lateral: Brachioradialis Muscle
Medial: Pronator Teres Muscle
Roof: Bicipital Aponeurosis
Floor: Brachialis Muscle
What structure is located on the roof of the cubital fossa, superficial to the Aponeurosis?
Median Cubital Vein
What are the 3 main contents of the cubital fossa covered by the Bicipital Aponeurosis?
Biceps Tendon
Brachial Artery
Median Nerve
BAN
What happens to the Radial nerve when it reaches the cubital fossa?
Divides into Superficial and Deep Radial Nerves
What artery runs with the radial nerve?
Profunda Brachii or Deep Brachial Artery
The Profunda Brachii divides into what two segments while in the radial groove?
Radial Collateral Artery
Middle Collateral Artery
The middle collateral artery after descending down deep to the triceps will anastomose with what other artery?
Interosseous Recurrent artery
The superior ulnar collateral artery will anastomose with what other artery as it runs through the notch of the ulnar nerve behind the medial epicondyle of the humerus?
Posterior Ulnar Recurrent Artery
What is the 3rd branch of the Brachial Artery within the arm?
Inferior Ulnar Collateral
What is unique about the Inferior Ulnar Collateral artery?
It has 2 veins accompanying it, but no nerve.
In the Cubital Fossa, the Brachial Artery terminates into:
Ulnar and Radial Arteries