The Axilla & Brachial Plexus II Flashcards Preview

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Flashcards in The Axilla & Brachial Plexus II Deck (32)
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1
Q

upper lesions of the brachial plexus:

___ palsy

usually caused by an excessive increase in the angle b/n the ___ & ___

results in excessive ___ & ___ (___) of the nerve roots C5 & C6

examples:

  • newborns during a difficult ___
  • adults following a severe blow or fall on the ___
A

erb-duchenne

neck & shoulder

traction & tearing (avulsion)

  • delivery
  • shoulder
2
Q

upper lesions of the brachial plexus:
nerve lesions & muscle paralysis may involve the following:
nerves (4)

A

suprascapular nerve
nerve to the subclavius
musculocutaneous nerve
axillary nerve

3
Q

upper lesions of the brachial plexus:
nerve lesions & muscle paralysis may involve the following:
muscles:

suprascapular nerve (2)

nerve to the subclavius (1)

musculocutaneous nerve (3)

axillary (2)

A

supraspinatous
infraspinatous

subclavius

biceps brachii
brachialis
coracobrachialis

deltoid
teres minor

4
Q

upper lesions of the brachial plexus:
nerve lesions & muscle paralysis may involve the following:
suprascapular nerve:
action(s):

supaspinatous m

infraspinatous m

A

abductor of the arm at the shoulder

lateral rotator of the arm at the shoulder

5
Q

upper lesions of the brachial plexus:
nerve lesions & muscle paralysis may involve the following:
nerve to the subclavius:
action(s):

subclavius m

A

depresses the clavicle

6
Q

upper lesions of the brachial plexus:
nerve lesions & muscle paralysis may involve the following:
musculocutaneous nerve:
action(s):

biceps brachii

brachialis

coracobrachialis

A

supinator of forearm
flexor of forearm at the elbow
weak flexor of arm at the shoulder

chief flexor of forearm at elbow

flexes arm at shoulder

7
Q

upper lesions of the brachial plexus:
nerve lesions & muscle paralysis may involve the following:
axillary nerve:
action(s):

deltoid

teres minor

A

abductor of arm at shoulder

lateral rotator of arm at shoulder

8
Q

upper lesions of the brachial plexus:
result:

the upper limb hangs ___ by the side, medially ___ by the unopposed action of the ___ muscle

the forearm is ___ due to loss of action of the ___ (supination of the forearm)

loss of sensation along the (medial/lateral) side of the limb

“___” position

A

limply
rotated
pectoralis major muscle

pronated
biceps

lateral

waiter’s tip position

9
Q

lower lesions of the brachial plexus:

___ palsy

traction injuries caused by excessive (abduction/adduction) of the arm

results in ___ (___) of the C& & T1 roots of the plexus

the nerve most affected is the ___ nerve which supplies most of the small muscles of the ___

A

klumpke’s palsy

abduction

tearing (avulsion)

ulnar nerve
hand

10
Q

lower lesions of the brachial plexus:
examples:

newborn: forceful pull of the ___ limb during a difficult ___

child falling from a ___ (e.g., tree), clutching an object (single/double) handed (e.g., tree branch) to stop the fall

A

upper limb
delivery

height
single handed

11
Q

lower lesions of the brachial plexus:
result:

the hand has a ___ appearance caused by hyperextension of the ___ joints & flexion of the ___ joints

the ___ is unopposed by the lumbricals & interossei & extends the ___ joints

the ___ & lateral portion of the ___ are unopposed by the lumbricals & interossei & flex the middle & terminal ___ respectively

in addition, loss of sensation will occur along the (medial/lateral) side of the upper limb

A

clawed
metacarpophalangeal joints
interphalangeal joints

extensor digitorum
metacarpophalangeal joints

flexor digitorum superficialis

flexor digitorum profundus
phalanges

medial

12
Q

lesion of the long thoracic nerve:

the long thoracic nerve (C5, C6, C7) may be injured by blows or pressure on the (anterior/posterior) triangle of the neck, ___ wounds, during a ___ surgical procedure, or ___ injuries

A

posterior
stab
mastectomy
athletic

13
Q

lesion of the long thoracic nerve:

paralysis of the ___ muscle

the medial border of the ___ becomes prominent & protrudes (anteriorly/posteirorly) when someone pushes against a fixed object (___)

A

serratus anterior muscle

scapula
posteriorly
winging of the scapula

14
Q

lesion of the long thoracic nerve:

since the ___ can no longer be fixed to the (anterior/posterior) chest wall, the ___ is seriously weakened

(abduction/adduction) of the arm is seriously impaired b/c of weakened upward rotation of the ___

A

scapula
posterior
triceps brachii

abduction
scapula

15
Q

thoracic outlet syndrome (tos):

condition involving compression of ___ nerves, ___ vessels, or both, b/c of an inadequate passageway just above the ___ rib & behind the ___

symptoms include:

  • neck, shoulder, & arm ___
  • ___
  • impaired ___ to the extremeties
A

brachial plexus nerves
subclavian vessels

first rib
clavicle

  • pain
  • numbness
  • circulation
16
Q

thoracic outlet syndrome (tos):

brachial plexus trunks & subclavian vessels are subject to compression or irritation as they course through passageways from the base of the neck to the axilla (3)

A

interscalene triangle (most important)
costoclavicular triangle
subcoracoid space

17
Q

thoracic outlet syndrome (tos):
interscalene triangle:
muscles:

anterior: ___
posterior: ___
inferior: ___

A

anterior scalene

middle scalene

medial border of first rib

18
Q

thoracic outlet syndrome (tos):
costoclavicular triangle:
bones:

anterior: ___

postero-medial: ___

postero-lateral: ___

A

middle third of clavicle

first rib

upper border of scapula

19
Q

thoracic outlet syndrome (tos):
subcoracoid space:

beneath the ___ process

just deep to the ___ muscle

A

coracoid process

pectoralis minor muscle

20
Q

thoracic outlet syndrome (tos):

___ symptoms occur in 95% of cases

C8 & T1 nerve roots most commonly involved producing ___ & ___ along the ___ nerve distribution

A

neurologic symptoms

pain
paresthesia
ulnar nerve

21
Q

axillary artery:

direct continuation of the ___ artery

extends from the (medial/lateral) border of the ___ rib to the (superior/inferior) border of the ___ muscle

A

subclavian artery

lateral border of the first rib
inferior border of the teres major muscle

22
Q

axillary artery:

divided into three parts by the ___ muscle:

  • first part: (above/below) the muscle
  • second part: (in front of/behind) the muscle
  • third part: (above/below) the muslce

by convention, the medial, lateral, & posterior cords of the ___ plexus are amed according to their relationship to the ___ segment of the axillary artery

A

pectoralis minor muscle

  • above
  • behind
  • below

brachial plexus
middle segment

23
Q

branches of the axillary artery:

first part (1)

second part (2)

third part (3)

A

superior (supreme) thoracic artery

thoracoacromial trunk
lateral thoracic artery

subscapular artery
anterior & posterior circumflex humeral arteries

24
Q

branches of the axillary artery:
first part:
superior (supreme) thoracic artery:

helps supply the ___ & the ___ muscle

A

first two intercostal spaces

serratus anterior muscle

25
Q

branches of the axillary artery:
second part:
thoracoacromial trunk:

arises beneath the ___ muscle

passes above the upper border of the ___ muscle

pierces the ___ fascia

gives off regional branches

A

pectoralis minor muscle

pectoralis minor

clavipectoral fascia

26
Q

branches of the axillary artery:
second part:
lateral thoracic artery:

arises beneath the ___ muscle

passes below the ___ muscle running along the (medial/lateral) side of the ___

A

pectoralis minor m

pectoralis minor m
lateral
thorax

27
Q

branches of the axillary artery:
second part:
lateral thoracic artery:

formerly called the ___ artery b/c it’s a chief source of blood supply to the breast

also supplies:

  • ___ m’s
  • ___ m
  • contents of the ___
A

external mammary artery

pectoral m’s
seratus anterior m
axilla

28
Q

branches of the axillary artery:
third part:
subscapular artery:

passes (upward/downward) & (forward/backward)

divides into two main trunks (2)

A

downwrad
backward

circumflex scapular artery
thoracodorsal artery

29
Q

branches of the axillary artery:
third part:
subscapular artery:
circumflex scapular artery:

passes around the (medial/lateral) border of the ___

b/n the ___ & ___ m in the ___ space

A

lateral border
scapula

scapula
teres major m
triangular space

30
Q

branches of the axillary artery:
third part:
thoracodorsal artery:

passes (upward/downward) along the ___

joined by the ___ n

both supply the ___ m

A

downward
axilla

thoracodorsal n

latissimus dorsi m

31
Q

branches of the axillary artery:
third part:
anterior & posterior circumflex humeral arteries:

posterior circumflex humeral artery is (smaller/larger)

they pass around the surgical neck of the ___ & anastomose w/ ___

posterior circumflex runs in the ___ space w/ the ___ n

A

larger

humerus
anastomose

quadrangular space
axillary n

32
Q

axillary vein:

direct continuation of the ___ vein as it crosses the lower border of the ___ muscle

tributaries (3)

A

basilic vein
teres major muscle

venae comitantes of the brachial artery
cephalic vein
tributaries corresponding to the branches of the axillary artery

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