hb2 week1.txt

  1. Platysma
    sheetlike muscle in the neck
  2. Intercostal nerves
    lateral and anterior cutaneous branches travel along with the intercostal artery and vein along the groove in the ribs
  3. Supraclavicular nerves
    dervied from ventral rami of spinal nerve C3 and C4, descend deep into platysma to supplement innervation of the superior part of the pectoral region
  4. Cephalic vein
    ascends along the anteriolateral aspect of the arm, passing through the deltopectoral triangle (between deltoid, clavicle, and pec major), courses deep to pec major to drain in axillary vein
  5. Glandualar tissue of breast
    embedded within fat and connective tissue, extends from 2-6th rib and from sterum to mid axillary line, composed of 16 lobes
  6. Axillary tail of breast
    gladular tissue extending into axilla
  7. Lactiferous sinus
    expandsion of lactiferous duct that hold reservoir of milk during lactation
  8. Lactiferous duct
    duct that milk travels through, exits at the nipple
  9. Suspensory ligaments (of Cooper)
    Supportive cnnective tissue bands within the superficial fascia, extend from membranous layer of superficial fascia to skin of breast
  10. Morphological Effects of Breast carcinoma
    Carcinoma can produce fibrosis or shortening of the suspensory ligaments, can produce characteristic orange peel appearance, dimpling of skin
  11. Retromammry space
    Between deep membranous layer of superficial fascia and the deep facia covering pectoralis major, filled with loos connective tissue, provides for significant breast motility
  12. Nipple
    cylindrical projection at the level of the 4th intercostal space
  13. Blood supply of breast
    multiple sources: perforatng branches of internal thoracis artery, anterior and posterior intercostal arteries, lateral thoracic artery (corresponding venous drainage)
  14. Lymphatic drainage of breast
    Most lymph drains to axillary lymph nodes, some following the internal thoracic artery to drainin the parasternal nodes
  15. Deep fascia of pectoral region
    Envelops muscles of pectoral region, covering superficial and deep surfaces
  16. Clavipectoral fascia
    deep fascia ensheathing the pectoralis minor
  17. Pectoralis major (origin/insertion)
    clavicular head (midline of clavicle), sternocostal head (sternum and costal cartilage of ribs 1-6)/both insert at the crest of the greater tubercle of the humerus
  18. Pec mjor (action)
    ADDUCTION, medial rotation, flexion (clavicular and sternocostal parts)
  19. Pec major (innervation)
    medial and lateral pectoral nerves
  20. Pectoralis minor (origin/insertion)
    Ribs 3-5 near costochondral joints/coracoid process of scapula
  21. Pectoralis minor (function)
    downward rotation, protraction, depression of the scapula
  22. Pectoralis minor (innervation)
    medial pectoral nerves
  23. Subclavius muscle (origin/insertion)
    first rib in costochondral joint/ groove for subclavius on inferior surface of clavicle
  24. Subclavius clinical correlate
    May projectclavian vessels and brachial plexu ffrom the adjacent sharp broken clavicle
  25. Serratus anterior (origin/insertion)
    upper nine ribs/costal surface of scapula, along medial border
  26. Serratus anterior (action)
    upward rotation, protraction, and depression (lower fibers only) of scapula
  27. Serratus anterior (innervation)
    long thoracic nerve
  28. Clinical correlate long thoracic nerve injury
    results in wingged scapcula, perhaps during mastectomy this could happen
  29. Lateral pectoral nerve
    branches form lateral cord of brachial plexus, innervates pectoralis major
  30. Medial pectoral nerve
    Branches from medial cord of brachial plexus, pierces through and innervates pec minor and pec major
  31. Nerve to subclavius
    branches from superior trunk of brachial plexus
  32. Long thoracic nerve
    innervates serratus anterior
  33. Superior thoracic artery
    small branch from proximal part of axillary artery, supplies superior part of the pectoral region
  34. Thoracoacromial artery
    arises form axillary artery posterior to pec minor, emerges through clavipectoral fascia medial to pectoralis minor and deep to pec major and gives rise to 4 branches
  35. Branches of thoracoacromial artery
    clavicular branch (courses medially), pectoral branch ( descend on the deep surface of pec major), deltoid branch (courses laterally and emerges from deltopectroal triangle), acromial branch (courses towards acromion, deep to deltoid)
  36. Lateral thoracic artery
    arises from axillary artery, posterior to pectoralis minor, distal to the origin of thoracoacrmoial artery, descends on the lateral thoracic wall
  37. What does shoulder movement generally result from (2)
    glenohumeral (glenoid in scapula and head of humerus) and scapulothoracic (between scapula and ribcage)
  38. What two muscles are responsible for first 90 deg of should abduction
    deltoid and supraspinatus
  39. What muscles allow should abduction greater than 90 deg?
    serratus and rhomboids
  40. What are the scapular fixator muscles?
    serratus and rhomboids
  41. What muscles make up the rotator cuff?
    (SITS) supraspinatus, infraspinatus, teres minor, subscapularis
  42. What joints make up the shoulder?
    Scapulo thoracic, acromio clavicular (3 ligaments), sternoclavicular
  43. What ligaments make up the acromio clavicular joint (acromion process, coracoid process, clavicle)?
    coraco acromial ligament, coracoclavicular ligament, acromioclavicular ligament
  44. What joints make up the elbox?
    humero-ulnar joint/ulnar collateral ligament (throchlea and olecranum), radio humeral joint/radial collateral ligament (between capitulum and radial head), proximal ulner joint (annular ligament)
  45. Bursa
    a sac lined by synovial membrane, filled with synovial fluid it is like a cushion
  46. Bursitis:
    inflamed burse, causes pain with motion
  47. Bursa in shoulder joint
    subacromial bursa, subdeltoid bursa
  48. Bursa in elbow
    olecranon bursa (a subcutaneous bursa)
  49. Supraspinatus muscle (origin/insertion)
    supraspinatus fossa/greater tuberosity of humerus
  50. Infraspinatus muscle (origin/insertion)
    Infra spinous fossa/greatere tuberosity of humerus
  51. Teres major (origin/insertion)
    inferior angle of scapula/lesser tuberosity
  52. Pectoralis major (origin/insertion)
    clavicle, sternum, ribs/humerus
  53. Pectoralis minor (origin/insertion)
    ribs 3,4,5/coracoid process of scapula
  54. Deltoid (origin/insertion)
  55. Subscapularis (origin/insertion)
    anterior fossa of scapula/lesser tuberosity of humerus
  56. Biceps short head (origin/insertion)
    coracoid process os scapula/radius
  57. Biceps long head (origin/insertion)
  58. Where is the ascultaroy triangle?
    On back, bordered by the medial border of the Scapula, Latissimus dorsi, Trapezius
  59. Function of pectoralis major
    Adduction of arm
  60. Function of Pectoralis minor?
    Depression of shoulder
  61. Function of deltoid
    Abduction of arm
  62. Function of biceps?
    Flexion of forearm, supinates arm
  63. Function of Coracobrachialis
    Felxion of the forearm, adduction
  64. Function of triceps?
    Extension of arm
  65. Nerve roots that make up the Brachial Plexus
    • C5-T1
    • Denervation of this muscle as a result of suprascapular nerve injury results in elimination of external rotation of shoulder
    • infraspinatus
  66. What muscle does shoulder adduction? What is it innervated by?
    latissimus dorsi, thoracodorsal nerve
  67. What nerve supplies the Trapezius?
    Spinal accessory (not in brachial plexus)
  68. What muscle supplies the Levator Scapula?
    Dorsal scapular
  69. What nerve supplies the Rhomboid major and Rhomboid minor?
    Dorsal scapular
  70. What nerve supplies the Serratus anterior?
    Long thoracic
  71. What nerve supplies the Supraspinatus?
    suprascapular nerve
  72. What nerve supplies the infraspinatus?
  73. What nerve supplies the Deltoid?
  74. What nerve supplies the Teres minor?
  75. What nerve supplies the Pectoralis major?
    Medial and Lateral Pectoral nerves
  76. What nerve supplies the Pectoralis minor?
    Medial Pectoral
  77. What nerve supplies the Latissimus Dorsi?
  78. What nerve supplies the Teres Major?
  79. What nerve supplies the Subscapularis muscle?
    Subscapularis nerve
  80. What nerve supplies the Coracobrachialis?
  81. What nerve supplies Brachialis?
  82. What nerve supplies the Biceps?
  83. What nerve supplies the Triceps?
    Radial nerve
  84. Complete destruction of the brachial plexus denervates all 14 muscles except?
    Trapezius and Levator Scapular
  85. Muscles responsible for Abduction of shoulder (predominant first)
    Supraspinatues (Suprascapular n.), Deltoid (Axillary n.), Trapezius (Spinal accessory n.)
  86. Muscles responsible for Adduction of shoulder (predominant first)
    Latissimus dorsi (Thoracodorsal n.), Teres major (Subscapular n.), Subscapularis (Subscapular n.)
  87. Muscles responsible for Anterior flexion of shoulder
    Combined effort, several muscles involved
  88. Muscles responsible for External rotation of shoulder (predominant first)
    Infraspinatus (Suprascapular nerve), Teres minor (Axillary n.)
  89. Muscles responsible for internal rotation of shoulder (predominant first)
    Latissimus dorsi (Thoracodorsal n.), Subscapularis (Subscapular n.), Pectoralis major (Lat/Med Pectoral Nerves)
  90. Muscles responsible for Extension of shoulder (predominant first)
    Latissimus dorsi (Thoracodorsal n.), Triceps (Radial n.)
  91. Muscles responsible for Scapulothoracic motion of shoulder
    Rhomboids (Dorsal scapular n.), Levator (Dorsal scapular), Serratus (Long thoracic n.), Pectoralis minor (Medial pectoral nerve)
  92. Muscles responsible for Elbow flexion
    Biceps brachii (Musculocutaneous n.), Brachialis (Musculocutaneous n.)
  93. Muscles responsible for Elbow Extension
    Triceps (Radial n.)
  94. Axilla
    Pyramidal space Anterior and Posterior walls created by Clavicle, 1st ribs, Scapula, Ribs of thorax, arm
  95. Lateral wall of the axilla
  96. Medial Wall of the axilla
    Ribs (thorax)
  97. Base of the axilla
    Axillary fossa
  98. What passes through the axilla
    Axillary vein, axillary artery, Portions of the brachial plexus, Axillary lymphatic nodes (involved in hand infection and breast cancer)
  99. What is the differences between the right and left subclavian arteries?
    On the right, the brachiocephalic trunk comes off of the Aorta and gives rise to the right subclavian artery, on the left the subclavian comes directly off the aorta
  100. Where does the Axillary artery begin?
    The Subclavian Artery turns into the Axillary artery at the level of the 1st rib
  101. Where does the Axillary artery end?
    The Axillary artery ends at the Teres Major muscle and becomes the Brachial artery
  102. How many parts are there on the Axillary artery?
  103. How many branches come off the Axillary artery?
  104. What branches off the first part of the Axillary artery?
    Supreme thoracic
  105. What branches off the second part of the Axillary artery?
    thoracoacromial, lateral thoracic
  106. What branches off the third part of the Axillary artery?
    Posterior humeral circumflex, anterior humeral circumflex, subscapular
  107. Apex of the axilla
    Passage from axilla to neck (area between clavicle, first rib, scapula)
  108. What provides collateral circulation to the upper extremity?
    branches from the subclavian artery
  109. What artery supplies the humeral head and is usually damaged in fractures of the surgical neck of the humerus?
    Anterior humeral circumflex

    • How many trunks are in the brachial plexus? What are they formed by?
    • 3 trunks (C5-T1); upper (C5 and C6), middle (C7), lower (C8, T1)
  110. What are the three important nerves that branch off the brachial plexus but within the axilla?
    Suprascapular, axillary nerve, musculocutaneous
  111. What are the main terminal branches of the brachial plexus?
    Ulnar, Radial, Median
  112. Where does the suprascapular nerves arise from?
    upper trunk of the brachial plexus
  113. Where does the Dorsal scapular nerve arise from?
  114. What are the "roots" (C5-T1) formed by?
    The anterior primary ramus from the mixed spinal nerve
  115. What forms the mixed spinal nerve?
    the dorsal and ventral roots from the spinal cord
  116. Are plexus roots extravertebral or intravertebral?
  117. Are spinal nerve roots extravertebral or intravertebral?
  118. What are the 2 nerves that branch of the roots in the brachial plexus?
    Dorsal scapular and long thoracic
  119. What is the important nerve that branches off a trunk in the brachial plexus?
    suprascapular branches off the upper trunk
  120. What do the trunks of the brachial plexus divide into?
    anteriior and posterior divisions
  121. Does anything branch off the divisions in the Brachial Plexus?
  122. What do the divisons form in the Brachial Plexus?
    3 cords, lateral, medial and posterior (named with respect to their position in respect to the axillary artery)
  123. What forms the Posterior Cord of the Brachial Plexus?
    Posterior divisions of the Superior, middle and Inferior trunks
  124. What forms the Lateral Cord of the Brachial Plexus?
    Anterior divisions of the Superior and Middle trunk
  125. What forms the Medial Cord of the Brachial Plexus?
    The Anterior division of the Inferior trunk
  126. What are the main branches from the Lateral Cord (3)?
    Lateral pectoral nerve (to pec major), terminal branch: Musculocutaneous nerve (to biceps and brachialis), terminal branch: Lateral componet of median nerve
  127. What are the main branches from the Medial Cord (5)?
    Medial pectoral nerve (to pec major and minor), Medial brachial cutaneous, Medial antebrachial cutaneous, terminal branch: Medial component of median nerve, terminal branch: Ulnar nerve
  128. What are the main branches from the Posterior Cord (5)?
    Subscapular lower, SUbscapular upper, Thoracodorsal (Latissimus dorsi), terminal branch: Axillary (deltoid, teres minor), terminal branch: Radial nerve
  129. What are the nerves that emerge from the Axilla?
    Ulnar, Radial, Median- control remaining upper extremity (arm, forearm, hand)
  130. What is the Ulnar the terminal branch of?
    Medial cord
  131. What is the Radial nerve the terminal branch of?
    Posterior cord
  132. What does total inury to the brachial plexus result in?
    flail insensate arm
  133. What does upper plexus injury (C5, C6, C7) result in?
    Supraclavicular, upper plexus controls shoulder and elbow - "bad shoulder, good hand"
  134. What does lower plexus injury result in (C8, T1)?
    infraclavicular, controls hand motions, has little effect on should- "band hand, good shoulder" **RARE** usually would involved whole plexus
  135. How many paravertebral ganglion are in the sympathetic cervical chain?
    3 (inferior, middle, superior)
  136. Stellate ganglion
    cervico thoracic ganglion, fusion of the inferior cervical ganglion at the 7th cervical vertebra with the first thoracic ganglion
  137. Horner's syndrome
    Caused by total lower plexus injury, first order sympathetic fibers terminate in the intermediolateral cell column at the level of C8-T2, second otder preganglionic pupillomotor fibers exit the spinal cord at T1, damage results in Miosis (pupillary constriction)
  138. Rotator cuff borders
    above: Teres minor, lateral: Humerus, medial: Long Head of Triceps, Below: Teres major
  139. What passes through the rotator cuff?
    Axillary nerve, Posterior Humeral Circumflex artery
Card Set
hb2 week1.txt
anterior thorax and upper extremity