Anatomy Flashcards: Upper Extremity

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ANATOMY FLASHCARDS Upper Extremity Dear Anatomy Geek, Welcome to your Kenhub flashcards eBook. This eBook is laid out in a flashcard style format, which means that you can learn anatomy easily and on the go. Oh- and without having to deal with a tidal wave of handmade flashcards flying around. Result! So, how do I use this anatomy eBook? It couldn’t be simpler. On the first page, you will see an illustration of an anatomical structure along with a question asking you to identify it. Allow yourself a few seconds to recall the name of the structure you see as well as its purpose in the body. Once you think you’ve got it, flip the page. Here you will see the answer in English and Latin, as well as some additional information about the structure. It’s important to be honest with yourself. Did you get it right? If so, great! Move onto the next card. If not, make a note to come back to it later before you move onto the next card. And that’s it! It’s really that easy. Swipe the page to get started now. QUESTION What structure is shown here? Image by: National Library of Medicine ENGLISH Basilic vein LATIN Vena basilica Image by: National Library of Medicine QUESTION What structure is shown here? Image by: National Library of Medicine ENGLISH Serratus anterior muscle LATIN Musculus serratus anterior ORIGINS Ribs 1-9 INSERTIONS Medial border of the scapula INNERVATIONS Long thoracic nerve FUNCTIONS Elevates the ribs, laterally rotates the scapula, lowers the arm Image by: National Library of Medicine QUESTION What structure is shown here? Image by: National Library of Medicine ENGLISH Radial artery LATIN Arteria radialis Image by: National Library of Medicine QUESTION What structure is shown here? Image by: National Library of Medicine ENGLISH Teres minor muscle LATIN Musculus teres minor ORIGINS Lateral border of the scapula INSERTIONS Greater tubercle INNERVATIONS Axillary nerve FUNCTIONS Externally rotates the arm, weakly adducts the arm Image by: National Library of Medicine QUESTION What structure is shown here? Image by: National Library of Medicine ENGLISH Pronator quadratus muscle LATIN Musculus pronator quadratus ORIGINS Anterior margin of the ulna INSERTIONS Anterior margin of the radius INNERVATIONS Median nerve FUNCTIONS Pronates the forearm Image by: National Library of Medicine QUESTION What structure is shown here? Image by: National Library of Medicine ENGLISH Extensor carpi radialis brevis muscle LATIN Musculus extensor carpi radialis brevis ORIGINS Lateral epicondyle of the humerus INSERTIONS Base of the third metacarpal INNERVATIONS Radial nerve FUNCTIONS Abducts the hand, weakly flexes the elbow, extends the hand Image by: National Library of Medicine QUESTION What structure is shown here? Image by: National Library of Medicine.

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Redalyc.Variations in Branching Pattern of the Axillary Artery: a Study
Jornal Vascular Brasileiro ISSN: 1677-5449 [email protected] Sociedade Brasileira de Angiologia e de Cirurgia Vascular Brasil Astik, Rajesh; Dave, Urvi Variations in branching pattern of the axillary artery: a study in 40 human cadavers Jornal Vascular Brasileiro, vol. 11, núm. 1, marzo, 2012, pp. 12-17 Sociedade Brasileira de Angiologia e de Cirurgia Vascular São Paulo, Brasil Available in: http://www.redalyc.org/articulo.oa?id=245023701001 How to cite Complete issue Scientific Information System More information about this article Network of Scientific Journals from Latin America, the Caribbean, Spain and Portugal Journal's homepage in redalyc.org Non-profit academic project, developed under the open access initiative ORIGINAL ARTICLE Variations in branching pattern of the axillary artery: a study in 40 human cadavers Variações na ramificação do padrão da artéria axilar: um estudo em 40 cadáveres humanos Rajesh Astik1, Urvi Dave2 Abstract Background: Variations in the branching pattern of the axillary artery are a rule rather than an exception. The knowledge of these variations is of anatomical, radiological, and surgical interest to explain unexpected clinical signs and symptoms. Objective: The large percentage of variations in branching pattern of axillary artery is making it worthwhile to take any anomaly into consideration. The type and frequency of these vascular variations should be well understood and documented, as increasing performance of coronary artery bypass surgery and other cardiovascular surgical procedures. The objective of this study is to observe variations in axillary artery branches in human cadavers. Methods: We dissected 80 limbs of 40 human adult embalmed cadavers of Asian origin and we have studied the branching patterns of the axillary artery.
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Examination of the Shoulder Bruce S
Examination of the Shoulder Bruce S. Wolock, MD Towson Orthopaedic Associates 3 Joints, 1 Articulation 1. Sternoclavicular 2. Acromioclavicular 3. Glenohumeral 4. Scapulothoracic AC Separation Bony Landmarks 1. Suprasternal notch 2. Sternoclavicular joint 3. Coracoid 4. Acromioclavicular joint 5. Acromion 6. Greater tuberosity of the humerus 7. Bicipital groove 8. Scapular spine 9. Scapular borders-vertebral and lateral Sternoclavicular Dislocation Soft Tissues 1. Rotator Cuff 2. Subacromial bursa 3. Axilla 4. Muscles: a. Sternocleidomastoid b. Pectoralis major c. Biceps d. Deltoid Congenital Absence of Pectoralis Major Pectoralis Major Rupture Soft Tissues (con’t) e. Trapezius f. Rhomboid major and minor g. Latissimus dorsi h. Serratus anterior Range of Motion: Active and Passive 1. Abduction - 90 degrees 2. Adduction - 45 degrees 3. Extension - 45 degrees 4. Flexion - 180 degrees 5. Internal rotation – 90 degrees 6. External rotation – 45 degrees Muscle Testing 1. Flexion a. Primary - Anterior deltoid (axillary nerve, C5) - Coracobrachialis (musculocutaneous nerve, C5/6 b. Secondary - Pectoralis major - Biceps Biceps Rupture- Longhead Muscle Testing 2. Extension a. Primary - Latissimus dorsi (thoracodorsal nerve, C6/8) - Teres major (lower subscapular nerve, C5/6) - Posterior deltoid (axillary nerve, C5/6) b. Secondary - Teres minor - Triceps Abduction Primary a. Middle deltoid (axillary nerve, C5/6) b. Supraspinatus (suprascapular nerve, C5/6) Secondary a. Anterior and posterior deltoid b. Serratus anterior Deltoid Ruputure Axillary Nerve Palsy Adduction Primary a. Pectoralis major (medial and lateral pectoral nerves, C5-T1 b. Latissimus dorsi (thoracodorsal nerve, C6/8) Secondary a. Teres major b. Anterior deltoid External Rotation Primary a. Infraspinatus (suprascapular nerve, C5/6) b. Teres minor (axillary nerve, C5) Secondary a.
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Variations in the Branching Pattern of the Radial Nerve Branches to Triceps Brachii
Review Article Clinician’s corner Images in Medicine Experimental Research Case Report Miscellaneous Letter to Editor DOI: 10.7860/JCDR/2019/39912.12533 Original Article Postgraduate Education Variations in the Branching Pattern Case Series of the Radial Nerve Branches to Anatomy Section Triceps Brachii Muscle Short Communication MYTHRAEYEE PRASAD1, BINA ISAAC2 ABSTRACT Results: The branching patterns seen were types A 1 (3.6%), Introduction: The axillary nerve arises from the posterior cord B1 (1st pattern) 1 (3.6%), B2 (2nd pattern) 1 (3.6%), and C3 of the brachial plexus and supplies the deltoid and teres minor 22 (78.6%). Two new patterns observed were: type B2 muscles. Axillary nerve injuries lead to abduction and external (6th pattern) 1 (3.6%) and type D (2nd pattern) 2 (7.1%). The long rotation weakness. In such cases, branches to the heads of head had single innervation in 89.3% cases and the lateral and triceps brachii muscle have been transferred to the axillary nerve medial heads had dual innervation in 10.7% and 7.1% cases to establish reinnervation of the deltoid muscle. In addition, the respectively. triceps nerve branches can be nerve recipients to reinstitute Conclusion: The knowledge of the different branching patterns elbow extension. that are present will help surgeons to identify the most suitable Aim: To study the different branching patterns of the radial radial nerve branch to triceps brachii that can be used for nerve nerve branches to triceps brachii muscle. transfer to restore the motor function of the deltoid muscle or to reanimate the triceps brachii muscle.
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Pectoral Region and Axilla Doctors Notes Notes/Extra Explanation Editing File Objectives
Color Code Important Pectoral Region and Axilla Doctors Notes Notes/Extra explanation Editing File Objectives By the end of the lecture the students should be able to : Identify and describe the muscles of the pectoral region. I. Pectoralis major. II. Pectoralis minor. III. Subclavius. IV. Serratus anterior. Describe and demonstrate the boundaries and contents of the axilla. Describe the formation of the brachial plexus and its branches. The movements of the upper limb Note: differentiate between the different regions Flexion & extension of Flexion & extension of Flexion & extension of wrist = hand elbow = forearm shoulder = arm = humerus I. Pectoralis Major Origin 2 heads Clavicular head: From Medial ½ of the front of the clavicle. Sternocostal head: From; Sternum. Upper 6 costal cartilages. Aponeurosis of the external oblique muscle. Insertion Lateral lip of bicipital groove (humerus)* Costal cartilage (hyaline Nerve Supply Medial & lateral pectoral nerves. cartilage that connects the ribs to the sternum) Action Adduction and medial rotation of the arm. Recall what we took in foundation: Only the clavicular head helps in flexion of arm Muscles are attached to bones / (shoulder). ligaments / cartilage by 1) tendons * 3 muscles are attached at the bicipital groove: 2) aponeurosis Latissimus dorsi, pectoral major, teres major 3) raphe Extra Extra picture for understanding II. Pectoralis Minor Origin From 3rd ,4th, & 5th ribs close to their costal cartilages. Insertion Coracoid process (scapula)* 3 Nerve Supply Medial pectoral nerve. 4 Action 1. Depression of the shoulder. 5 2. Draw the ribs upward and outwards during deep inspiration. *Don’t confuse the coracoid process on the scapula with the coronoid process on the ulna Extra III.
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A Comprehensive Review of Anatomy and Regional Anesthesia Techniques of Clavicle Surgeries
vv ISSN: 2641-3116 DOI: https://dx.doi.org/10.17352/ojor CLINICAL GROUP Received: 31 March, 2021 Research Article Accepted: 07 April, 2021 Published: 10 April, 2021 *Corresponding author: Dr. Kartik Sonawane, Uncovering secrets of the Junior Consultant, Department of Anesthesiol- ogy, Ganga Medical Centre & Hospitals, Pvt. Ltd. Coimbatore, Tamil Nadu, India, E-mail: beauty bone: A comprehensive Keywords: Clavicle fractures; Floating shoulder sur- gery; Clavicle surgery; Clavicle anesthesia; Procedure review of anatomy and specific anesthesia; Clavicular block regional anesthesia techniques https://www.peertechzpublications.com of clavicle surgeries Kartik Sonawane1*, Hrudini Dixit2, J.Balavenkatasubramanian3 and Palanichamy Gurumoorthi4 1Junior Consultant, Department of Anesthesiology, Ganga Medical Centre & Hospitals, Pvt. Ltd., Coimbatore, Tamil Nadu, India 2Fellow in Regional Anesthesia, Department of Anesthesiology, Ganga Medical Centre & Hospitals, Pvt. Ltd., Coimbatore, Tamil Nadu, India 3Senior Consultant, Department of Anesthesiology, Ganga Medical Centre & Hospitals, Pvt. Ltd., Coimbatore, Tamil Nadu, India 4Consultant, Department of Anesthesiology, Ganga Medical Centre & Hospitals, Pvt. Ltd., Coimbatore, Tamil Nadu, India Abstract The clavicle is the most frequently fractured bone in humans. General anesthesia with or without Regional Anesthesia (RA) is most frequently used for clavicle surgeries due to its complex innervation. Many RA techniques, alone or in combination, have been used for clavicle surgeries. These include interscalene block, cervical plexus (superficial and deep) blocks, SCUT (supraclavicular nerve + selective upper trunk) block, and pectoral nerve blocks (PEC I and PEC II). The clavipectoral fascial plane block is also a safe and simple option and replaces most other RA techniques due to its lack of side effects like phrenic nerve palsy or motor block of the upper limb.
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Axillary Nerve Injury Associated with Sports
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Electrodiagnosis of Brachial Plexopathies and Proximal Upper Extremity Neuropathies
Electrodiagnosis of Brachial Plexopathies and Proximal Upper Extremity Neuropathies Zachary Simmons, MD* KEYWORDS Brachial plexus Brachial plexopathy Axillary nerve Musculocutaneous nerve Suprascapular nerve Nerve conduction studies Electromyography KEY POINTS The brachial plexus provides all motor and sensory innervation of the upper extremity. The plexus is usually derived from the C5 through T1 anterior primary rami, which divide in various ways to form the upper, middle, and lower trunks; the lateral, posterior, and medial cords; and multiple terminal branches. Traction is the most common cause of brachial plexopathy, although compression, lacer- ations, ischemia, neoplasms, radiation, thoracic outlet syndrome, and neuralgic amyotro- phy may all produce brachial plexus lesions. Upper extremity mononeuropathies affecting the musculocutaneous, axillary, and supra- scapular motor nerves and the medial and lateral antebrachial cutaneous sensory nerves often occur in the context of more widespread brachial plexus damage, often from trauma or neuralgic amyotrophy but may occur in isolation. Extensive electrodiagnostic testing often is needed to properly localize lesions of the brachial plexus, frequently requiring testing of sensory nerves, which are not commonly used in the assessment of other types of lesions. INTRODUCTION Few anatomic structures are as daunting to medical students, residents, and prac- ticing physicians as the brachial plexus. Yet, detailed understanding of brachial plexus anatomy is central to electrodiagnosis because of the plexus’ role in supplying all motor and sensory innervation of the upper extremity and shoulder girdle. There also are several proximal upper extremity nerves, derived from the brachial plexus, Conflicts of Interest: None. Neuromuscular Program and ALS Center, Penn State Hershey Medical Center, Penn State College of Medicine, PA, USA * Department of Neurology, Penn State Hershey Medical Center, EC 037 30 Hope Drive, PO Box 859, Hershey, PA 17033.
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Radial Medial Head Triceps Branch Transfer to Axillary Nerve by Axillary Approach Acesso Ao Nervo Axilar Por Via Axilar Anterior
THIEME 134 Review Article | Artigo de Revisão Radial Medial Head Triceps Branch Transfer to Axillary Nerve by Axillary Approach Acesso ao nervo axilar por via axilar anterior José Marcos Pondé 1 Lazaro Santos 2 João Pedro Magalhaes 2 Ana Flavia D ’Álmeida 2 1 Department of Neurosciences and Mental Health, Universidade Address for correspondence José Marcos Pondé, MD, PhD, Av. Paulo Federal da Bahia (UFBA), Salvador, Bahia, Brazil VI, 111, Pituba, Salvador, BA, Brazil 41810-000 2 Bahian School of Medicine and Public Health, Salvador, Bahia, Brazil (e-mail: [email protected]). Arq Bras Neurocir 2015;34:134 –138. - Abstract Objective To describe axillary approach for axillary nerve transfer with radial nerve branch in brachial plexus lesions. Methods Six patients aged 24 to 54 (mean 30) years with traumatic superior trunk brachial plexus injury underwent axillary approach between October 2011 and April 2012. On physical examination prior to surgery, they could not perform shoulder abduction, external rotation, or elbow ﬂexion. Surgical approach was made through axillary pathway without any muscular section. The transfer was done with the radial branch to the medial head of triceps. In addition to transfer to axillary nerve, each Keywords patient had spinal accessory nerve transferred to suprascapular nerve and ulnar nerve ► axillary nerve fascicle transferred to musculocutaneous nerve. ► brachial plexus Conclusion Theaxillary approach allowseasyaccesstoaxillarynerveand, therefore, is ► transfer a feasible pathway to transferences involving this nerve. Resumo Objetivo Apresentar via axilar por transferência de nervo axilar com ramo de nervo radial em lesões do plexus braquial. Métodos Seis pacientes com idade entre 24 e 54 anos (média de 30) com lesão braquial traumática do plexus no tronco superior submetidos a via axilar entre outubro de 2011 e abril de 2012.
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Original Article
[Downloaded free from http://www.internationalshoulderjournal.org on Tuesday, January 27, 2009] Original Article A contribution to the calculation of a safe deltoid split Gulihar Abhinav, Balasubramanian Sivaraman, Nixon Matthew, Taylor Grahame J.S. ABSTRACT Leicester Medical School and GlenÞ eld Hospital, Leicester, UK. Purpose: Traditional teaching suggests that a safe deltoid split should extend no more than 5 cm from the lateral edge of the acromion. However, there are reports of nerves lying within this Correspondence: Mr Abhinav Gulihar distance. Our aim was to redeÞ ne the safe maximum split and also to study the inß uence of arm Department of Orthopedics, length and position. GlenÞ eld Hospital, Materials and Methods: Thirty cadaveric shoulders were dissected using the deltoid-splitting Leicester LE3 9QP UK. E-mail: [email protected] approach and the acromion-axillary nerve distance was measured in the neutral position, in abduction, and in adduction. This was correlated to upper arm length. Deltoid splits were measured at the end of 13 deltoid-splitting shoulder operations. Results: The mean acromion-axillary nerve distance was 6.0 cm (SD 0.6; range 4.5–6.5). Abduction brought the nerve closer by 1.5 cm. There was a strong correlation with upper arm length (r = 0.82) but the presence of high individual variability did not allow calculation of a safe deltoid split. The mean deltoid split in 13 open shoulder operations was 3.4 cm. Conclusions: Taking the mean acromion-axillary nerve distance minus three standard deviations as the safe deltoid split would protect 99.7% of nerves.
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5. Upper Extremity Neuroanatomy
5. UPPER EXTREMITY compartments of the NEUROANATOMY arm). The brachial plexus divisions INTRODUCTION pass posterior to the mid-point of Regional anesthesia of the upper extremity in- the clavicle through volves two major nerve plexuses, the cervical plexus the cervico-axillary and the brachial plexus. A detailed understanding of canal. the anatomy of these nerve plexuses and surrounding • Three cords. The structures is essential for the safe and successful prac- divisions coalesce tice of regional anesthesia in this area of the body. to form three cords. The anterior CERVICAL PLEXUS divisions of the superior and middle The cervical plexus is formed from a series of nerve trunk form the loops between adjacent anterior rami of cervical nerve lateral cord. The roots C1 through C4. The cervical plexus is deep to the anterior division of sternocleidomastoid muscle and medial to the scalene the inferior trunk muscles. The deep branches of the plexus are motor becomes the medial nerves. They include the phrenic nerve (diaphragm cord. The posterior muscle) and the ansa cervicalis nerve (omohyoid, divisions of all sternothyroid, and sternohyoid muscles). The named three trunks unite nerves of the superficial cervical plexus are branches to form the posterior from the loops and emerge from the middle of the ster- Figure 5-1. Dissection of the superficial cervical plexus in the posterior triangle cord. The cords are nocleidomastoid muscle (Figure 5-1): BRACHIAL PLEXUS named based on their relationship to the axillary artery (as this • Lesser occipital nerve (C2): innervates the skin The brachial plexus is formed from the five roots neurovascular bundle passes in its sheath into posterior to the ear.
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Study of Variations in the Origin and Distance of Origin of Axillary Nerve Ijcrr of the Posterior Cord of Brachial Plexus
Original Article STUDY OF VARIATIONS IN THE ORIGIN AND DISTANCE OF ORIGIN OF AXILLARY NERVE IJCRR OF THE POSTERIOR CORD OF BRACHIAL PLEXUS Santosh M. Bhosale, Nagaraj S. Mallashetty Assistant Professor, Department of Anatomy, S.S.I.M.S & R.C, Davangere-577004, Karnataka, India. ABSTRACT Background: Variations in the origin of axillary nerve from the posterior cord of brachial plexus and its distance of origin from mid clavicular point are important during surgical approaches to the axilla and upper arm, administration of anesthetic blocks, interpreting effects of nervous compressions and in repair of plexus injuries. The patterns of branching show population differ- ences. Data from the South indian population is scarce. Objective: To describe the variations in the origin of the axillary nerve from the posterior cord of brachial plexus and its distance of origin from mid- clavicular point in the South Indian population. Materials and methods: Forty brachial plexuses from twenty formalin fixed cadavers were explored by gross dissection. Origin and order of branching of axillary nerve and its distance of origin from mid- clavicualr point was recorded. Representative pho- tographs were then taken using a digital camera (Sony Cybershot R, W200, 7.2 Megapixels). Results: In forty specimens studied, 87.5% of axillary nerve originated from the posterior cord of brachial plexus and in 12.5% of specimens axillary nerve took origin from common trunk along with thoracodorsal or lower subscapular nerve or both. In 32.5% of the specimens axillary nerve had origin from posterior cord of brachial plexus at a distance of 4.6-5.0cm from mid-clavicular point.
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Advanced Neuroanatomic Understanding of the Shoulder and Implications for Pain Management
Advanced Neuroanatomic Understanding of The Shoulder and Implications for Pain Management Maxim S. Eckmann, MD Professor/Clinical, Department of Anesthesiology Executive Director of Pain Medicine University of Texas Health Science Center at San Antonio Disclosures ▪ Employment ▪ University of Texas Health Science Center at San Antonio ▪ Research Support ▪ Avanos Medical Inc – cadaver donation ▪ Fellowship Education Grants ▪ Abbot ▪ Boston Scientific ▪ Medtronic ▪ Speaker Panel / Course Director ▪ Dannemiller, Inc. ▪ American Society of Regional Anesthesia and Pain Medicine ▪ Investments ▪ Insight Dental Systems ▪ iKare MTRC (Behavioral Health) Leveraging Increasingly Peripheral Nerve Blockade in Acute and Chronic Pain Gains and Losses ISB (interscalene block); STB (superior trunk block); LPB (lumbar plexus block); ACB (adductor canal block); Road Map: Joint Analgesia Progression LFCN (lateral femoral cutaneous nerve); IPACK (infiltration between popliteal artery and capsule of knee); PECS (pectoralis block) Plexus Level Peripheral Nerve, Plane Level *,** Articular Level** Field** Suprascap* Sup Cerv Plx Articular Ns ISB Shoulder Axillary* PECS I,II ? SS, Ax, LP, STB*? Lateral Pec* (adjunct)* SubScap… Femoral Joint / ACB** / Knee Neuraxial LPB Sciatic Genicular Ns Wound IPACK** Obturator Injection Femoral “3-in-1” LPB Articular Ns Hip Sciatic ?Quad Fem / SPB Fem / Obt Obturator Sup Glut * Diaphragm Sparing **Motor Movement Sparing Proximal: Progressive loss of: o Dermatome o Cutaneous, muscular anesthesia. Distal: o Myotome/Sclerotome o Osteotome/Capsulotome o Osteotome/Capsulotome Progressive gain of: o Motor Block o Motor function o Motor preservation Evolving understanding: Shoulder Joint Selected Developments in Regional Anesthesia for the Upper Extremity and Shoulder • Axillary (brachial plexus) block • Interscalene Block • Complications Interscalene Block Development and Complications • Multiple Approaches (e.g. Anterolateral, Posterior, etc.) • Single Injection and Continuous Techniques 1.
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