What are common symptoms of thoracic outlet syndrome?
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Pain, numbness, tingling, and weakness in the upper limb.
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What are common symptoms of thoracic outlet syndrome?
Pain, numbness, tingling, and weakness in the upper limb.
What are the three types of phalanges in the hand?
Distal phalanx, Middle phalanx, Proximal phalanx.
What is the action of the Flexor pollicis brevis?
Flexes thumb.
What are the branches of the axillary artery?
Includes the superior thoracic artery and thoracoacromial artery.
Which muscle is responsible for the opposition of the thumb?
Opponens pollicis muscle.
What can happen if the ulnar artery is mistaken for a vein during injection?
It can result in disastrous gangrene with subsequent partial or total loss of the hand.
Where does the flexor digitorum profundus tendon insert?
On the base of the distal phalanx as a single tendon.
What is the purpose of the Allen test?
To test for occlusion of the radial or ulnar artery.
What is venipuncture and when is it performed?
A procedure performed on veins by applying a tourniquet to occlude venous return, making veins distended and visible.
What causes thoracic outlet syndrome?
Causes include abnormal insertion or spasm of scalene muscles, cervical rib, fractured clavicle, and physical trauma or repetitive strain injury.
What is the suprascapular artery?
A branch of the thyrocervical trunk that supplies the supraspinatus and infraspinatus muscles.
From where can the Radialis Indicis Artery arise?
From the deep palmar arch or the Princeps Pollicis artery.
What is the role of the Palmar Carpal Ligament?
It covers the tendons of the flexor muscles, median nerve, and ulnar artery and nerve.
Which muscles are involved in finger flexion?
Flexor digitorum superficialis and Flexor digitorum profundus.
What initiates the development of the limbs?
Activation of mesenchymal cells in the lateral plate somatic mesoderm.
What are limb buds composed of?
A mesenchymal core covered with ectoderm and capped by an apical ectodermal ridge.
What is the result of ulnar nerve injury on thumb movement?
Loss of adduction of the thumb.
What are the superficial muscles of the hand?
Lumbrical muscles, Adductor pollicis, Flexor pollicis brevis, Abductor pollicis brevis, Opponens pollicis, Tendon of flexor pollicis longus, Tendon of palmaris longus, Abductor digiti minimi brevis, Opponens digiti minimi, Tendon of flexor digitorum superficialis, Tendon of flexor digitorum profundus.
What condition results from loss of wrist extension due to radial nerve injury?
Wrist drop.
What muscles does the musculocutaneous nerve innervate?
Coracobrachialis, biceps, and brachialis muscles.
What branches arise from the ulnar artery?
Anterior Ulnar Recurrent Artery, Posterior Ulnar Recurrent Artery, Common Interosseous Artery.
Which muscles does the median nerve innervate in the forearm?
All anterior muscles except the flexor carpi ulnaris and the ulnar half of the flexor digitorum profundus.
How does the median nerve enter the palm of the hand?
Through the carpal tunnel deep to the flexor retinaculum.
What are the deep muscles of the hand?
Dorsal interosseous muscles, Adductor pollicis (transverse and oblique heads), Opponens pollicis, Opponens digiti minimi, Palmar interosseous muscles.
What veins contribute to the formation of the axillary vein?
The brachial veins and the basilic vein.
What does the dorsal scapular artery supply?
It supplies the levator scapulae, rhomboids, and serratus anterior muscles.
What is the extensor expansion also known as?
The extensor hood.
What muscles insert into the extensor expansion?
Lumbrical and interosseous muscles, extensor indicis, and extensor digiti minimi muscles.
What happens when the median nerve is injured?
Loss of pronation, opposition of the thumb, and flexion of the lateral two interphalangeal joints, along with flattening of the thenar eminence (ape hand).
What is the origin of the radial nerve?
It arises from the posterior cord and is the largest branch of the brachial plexus.
What is the function of the Abductor pollicis brevis?
It abducts the thumb.
What does the Upper Subscapular Nerve innervate?
It innervates the upper portion of the subscapularis muscle.
What is the function of the lumbrical muscles?
They flex the metacarpophalangeal joints and extend the interphalangeal joints.
Which nerve innervates all flexor muscles in the anterior compartment of the arm?
Musculocutaneous nerve.
Where is the axillary vein formed?
At the lower border of the teres major muscle.
What does the Superior Ulnar Collateral Artery accompany?
The ulnar nerve behind the medial intermuscular septum and medial epicondyle.
Which nerve innervates the Opponens pollicis?
Median nerve.
What do the common palmar digital arteries bifurcate into?
Proper palmar digital arteries, which supply the adjacent sides of the fingers.
What is the Ulnar Artery in relation to the Brachial Artery?
It is the larger medial branch of the brachial artery in the cubital fossa.
What is Volkmann contracture caused by?
Ischemic necrosis of the forearm flexor muscles.
Where does the ulnar nerve commonly get injured?
In the cubital tunnel behind the medial epicondyle.
What is crutch palsy?
It is paralysis of the arm caused by pressure from the crosspiece of a crutch, resulting in loss of function of the extensors.
What muscles does the anterior interosseous nerve supply?
Flexor digitorum profundus, flexor pollicis longus, and pronator quadratus.
What is thoracic outlet syndrome?
A syndrome involving the compression of neurovascular structures such as the brachial plexus and subclavian vessels in the thoracic outlet.
What is the significance of the ulnar pulse?
It is palpable just to the radial side of the insertion of the flexor carpi ulnaris into the pisiform bone.
What does the musculocutaneous nerve continue into the forearm as?
Lateral antebrachial cutaneous nerve.
What is the axillary artery?
The central structure of the axilla, extending from the outer border of the first rib to the inferior border of the teres major muscle.
What is the main termination of the ulnar artery?
The superficial palmar arterial arch.
What do the Deep Palmar Arch give rise to?
Three palmar metacarpal arteries.
What area does the Medial Antebrachial Cutaneous Nerve innervate?
It innervates the skin on the medial side of the forearm.
What commonly causes injury to the radial nerve?
A fracture of the midshaft of the humerus.
What are the two main branches of the ulnar artery?
The superficial palmar arch and the deep palmar branch.
What is a characteristic hand deformity resulting from ulnar nerve injury?
Claw hand.
Where does the radial artery arise?
As the smaller lateral branch of the brachial artery in the cubital fossa.
What is the anatomical significance of the radial pulse?
It can be felt proximal to the wrist between the tendons of the brachioradialis and flexor carpi radialis muscles.
What forms the Median Nerve?
It is formed by heads from both the medial and lateral cords.
Which nerve crosses superficially over the flexor retinaculum?
Ulnar nerve.
What does the Axillary Nerve innervate?
It innervates the deltoid and teres minor muscles.
What is the anatomical origin of the brachial plexus?
Ventral primary rami of the lower four cervical nerves and the first thoracic nerve (C5–T1).
Where does the ulnar artery enter the hand?
Anterior to the flexor retinaculum, lateral to the pisiform bone, and medial to the hook of the hamate bone.
What artery anastomoses with the radial recurrent artery?
The intermuscular septum ends in front of the lateral epicondyle by anastomosing with the radial recurrent artery of the radial artery.
What does the anterior interosseous artery supply?
It descends with the anterior interosseous nerve and perforates the interosseous membrane to anastomose with the posterior interosseous artery.
Where does the Deep Palmar Arch pass?
Between the transverse and oblique heads of the adductor pollicis muscle.
Where does the Medial Brachial Cutaneous Nerve run?
It runs along the medial side of the axillary vein.
What is the origin of the Median Nerve?
C5–T1.
What is the nail bed?
The skin underneath the nail, rich in sensory nerve endings and blood vessels.
What does the superficial branch of the ulnar nerve innervate?
Palmaris brevis and the skin over the palmar and dorsal surfaces of the medial one-third of the hand.
What branches does the Median Nerve give rise to in the cubital fossa?
The anterior interosseous nerve.
Where does the Radial Nerve occupy?
It occupies the musculospiral groove on the back of the humerus.
What is a major consequence of radial nerve injury?
Loss of function in the extensors of the forearm, hand, metacarpals, and phalanges.
What is the role of the fibrous digital sheath?
It encases the tendons of the flexor muscles, providing support and guiding their movement.
What does the flexor digitorum superficialis tendon split into?
Two medial and lateral bands that insert on the base of the middle phalanx.
What does the axillary vein continue as?
The subclavian vein at the inferior margin of the first rib.
What does the Inferior Ulnar Collateral Artery anastomose with?
The anterior ulnar recurrent branch of the ulnar artery.
What is the primary action of the Adductor pollicis?
Adducts thumb.
What condition is characterized by a flexion deformity of fingers due to thickening of the palmar fascia?
Dupuytren contracture.
What is the function of the Ulnar Nerve?
It runs down the medial aspect of the arm but does not branch in the brachium.
What is the function of the matrix in the nail bed?
Produces hard keratin and is responsible for nail growth.
What is the function of the deep branch of the ulnar nerve?
Innervates the hypothenar muscles, medial two lumbricals, all interossei, adductor pollicis, and usually the deep head of the flexor pollicis brevis.
What is the anatomical relationship of the flexor retinaculum?
It is continuous with the palmar aponeurosis and covers the tendons in the palm.
What happens when the proximal ends of the synovial sheaths rupture?
Infection can spread to the midpalmar space.
What forms the deep and superficial venous arches of the upper limb?
A pair of venae comitantes that accompany each of the deep and superficial palmar arterial arches.
How do the deep veins of the arm and forearm relate to the arteries?
They follow the course of the arteries as their venae comitantes.
What does the Princeps Pollicis Artery descend along?
The ulnar border of the first metacarpal bone under the flexor pollicis longus tendon.
What does the Princeps Pollicis Artery divide into?
Two proper digital arteries for each side of the thumb.
What is the origin of the Abductor pollicis brevis?
Flexor retinaculum, scaphoid, trapezium.
What is the function of the Palmar Aponeurosis?
It protects the superficial palmar arterial arch, palmar digital nerves, and long flexor tendons.
What forms the Deep Palmar Arch?
The main termination of the radial artery and usually the deep palmar branch of the ulnar artery.
What commonly causes injury to the ulnar nerve?
A fracture of the medial epicondyle.
What does the Medial Pectoral Nerve innervate?
It innervates the pectoralis minor muscle and reaches the overlying pectoralis major muscle.
What happens if the brachial artery is tied off distal to the inferior ulnar collateral artery?
Sufficient blood reaches the ulnar and radial arteries via existing anastomoses around the elbow.
What forms the floor of the anatomical snuffbox?
The scaphoid and trapezium bones.
How is the axillary artery divided?
It is divided into three parts by the pectoralis minor muscle.
What is the structure of fingernails composed of?
Keratinized plates consisting of the root, body, and free border.
What does the deep branch of the radial nerve innervate?
The supinator muscle and extensor muscles of the forearm.
What structure does the Median Nerve pass through at the elbow?
The cubital fossa, deep to the bicipital aponeurosis.
What does the Dorsal Carpal Branch form when it joins with other arteries?
The dorsal carpal rete.
What symptoms are associated with ulnar nerve injury?
Funny bone symptoms, which can occur due to damage at the medial epicondyle.
What muscle is paralyzed due to long thoracic nerve injury?
Serratus anterior muscle.
Who is commonly affected by Tennis Elbow?
Tennis players and violinists.
What hand position is characteristic of Erb palsy?
Waiter’s tip hand.
What causes Klumpke paralysis?
Difficult breech delivery, cervical rib syndrome, or abnormal scalene muscle insertion.
What hand deformity results from Klumpke paralysis?
Claw hand.
What is the Bicipital Aponeurosis?
A structure that originates from the medial border of the biceps tendon and lies on the brachial artery and median nerve.
What is the thenar space?
The lateral space containing the flexor pollicis longus tendon and flexor tendons of the index finger.
What is trigger finger?
A condition caused by stenosing tenosynovitis, leading to pain and clicking during finger movement.
What does the thoracoacromial artery supply?
It has pectoral, clavicular, acromial, and deltoid branches.
What does the deep palmar branch of the ulnar artery anastomose with?
The radial artery, completing the deep palmar arch.
Where does the Ulnar Artery descend?
Behind the ulnar head of the pronator teres muscle and lies between the flexor digitorum superficialis and profundus muscles.
What does the flexor retinaculum form?
The carpal tunnel on the anterior aspect of the wrist.
What causes Tennis Elbow (lateral epicondylitis)?
Chronic inflammation or irritation of the origin of the extensor muscles of the forearm from the lateral epicondyle due to repetitive strain.
What is the action of the Dorsal interossei?
Abduct fingers, flex metacarpophalangeal joints, extend interphalangeal joints.
What treatment options are available for Golfer’s Elbow?
Injection of glucocorticoids or avoidance of repetitive bending of the forearm.
What are the symptoms of carpal tunnel syndrome?
Pain and paresthesia in the hand supplied by the median nerve.
What is Cubital Tunnel Syndrome?
A condition resulting from compression on the ulnar nerve in the cubital tunnel, causing numbness and tingling in the ring and little fingers.
What bones make up the wrist and hand?
Capitate, Hamate, Triquetrum, Pisiform, Lunate, Scaphoid, Trapezium, Trapezoid.
What is the significance of the superficial branch of the radial nerve?
It crosses superficially over the area extending from the lateral margin of the radius to the styloid process of the ulna.
When do the upper limb buds arise during development?
At week 4.
What is the eponychium?
The narrow band of epidermis from the proximal nail fold onto the nail.
How does the ulnar nerve enter the hand?
Superficial to the flexor retinaculum and lateral to the pisiform bone.
What injury commonly affects the Axillary Nerve?
Fracture of the surgical neck of the humerus or inferior dislocation of the humerus.
How is the synovial sheath of the little finger connected to the common synovial sheath?
It is usually continuous with the ulnar bursa.
What muscle does the musculocutaneous nerve innervate?
Biceps brachii, brachialis, and coracobrachialis muscles.
What is the Extensor Retinaculum?
A thickening of the antebrachial fascia on the back of the wrist that subdivides into compartments for extensor tendons.
What is the role of the Profunda Brachii (Deep Brachial) Artery?
It descends posteriorly with the radial nerve and gives off branches that anastomose with the posterior humeral circumflex artery.
Which fingers are affected in claw hand due to ulnar nerve injury?
The ring and little fingers.
What muscles are paralyzed due to ulnar nerve injury?
Palmar and dorsal interossei muscles and the medial two lumbricals.
What branches arise from the radial artery?
Radial Recurrent Artery, Palmar Carpal Branch, Superficial Palmar Branch, Dorsal Carpal Branch.
How does the Median Nerve enter the forearm?
Between the humeral and ulnar heads of the pronator teres muscle.
What is tenosynovitis?
Inflammation of the tendon and synovial sheath.
What happens with an injury to the musculocutaneous nerve?
Weakness of supination and flexion of the forearm, and loss of sensation on the lateral side of the forearm.
What encloses the brachial plexus?
Axillary sheath, formed by a prolongation of the prevertebral fascia.
What movements occur at the proximal and distal radioulnar joints?
Pronation and Supination.
What is boutonniere deformity?
Abnormal flexion of the middle phalanx and hyperextension of the distal phalanx due to tendon injury.
Where does the Median Nerve run in the arm?
Down the anteromedial aspect of the arm, medial to the brachial artery on the brachialis muscle.
Which muscle is responsible for thumb opposition?
Opponens pollicis.
What is the lunula?
The half-moon shape distal to the eponychium.
What condition results from long thoracic nerve injury?
Winged scapula.
What is the role of the bicipital aponeurosis in relation to the Median Nerve?
The Median Nerve passes deep to the bicipital aponeurosis in the cubital fossa.
What is the pathway of the suprascapular nerve?
Runs laterally across the posterior cervical triangle and passes through the scapular notch under the superior transverse scapular ligament.
What is mallet finger?
Permanent flexion of the distal phalanx due to an avulsion of the extensor tendon.
What is the pathway of the Anterior Humeral Circumflex Artery?
It passes anteriorly around the surgical neck of the humerus and anastomoses with the posterior humeral circumflex artery.
What commonly causes injury to the long thoracic nerve?
A stab wound or during radical mastectomy or thoracic surgery.
What is Erb–Duchenne paralysis caused by?
A birth injury during a breech delivery or violent head displacement.
What is Golfer’s Elbow (medial epicondylitis) caused by?
A small tear or inflammation in the origin of the flexor muscles of the forearm from the medial epicondyle.
What is the significance of the interosseous membrane for the anterior interosseous nerve?
It descends on the interosseous membrane between the flexor digitorum profundus and flexor pollicis longus.
What does the common synovial flexor sheath (ulnar bursa) contain?
The tendons of both the flexor digitorum superficialis and profundus muscles.
What is the insertion point for the Lumbricals?
Lateral side of extensor expansion.
How do puncture injuries affect the synovial sheaths of the digits?
They can cause infection of the synovial sheaths.
What is Nursemaid’s elbow?
A radial head subluxation that occurs in toddlers when lifted by the wrist.
What is the Carrying Angle?
The angle formed laterally by the axis of the arm and forearm when the elbow is extended, deviating 5–15 degrees laterally.
What does the Brachial Artery divide into?
It divides into the radial and ulnar arteries at the level of the radial neck.
What branches does the ulnar nerve divide into?
Superficial and deep branches at the root of the hypothenar eminence.
Where do the roots of the brachial plexus pass?
Between the scalenus anterior and medius muscles.
Where does the Subscapular Artery arise?
At the lower border of the subscapularis muscle.
How does the Posterior Humeral Circumflex Artery run?
It runs posteriorly with the axillary nerve through the quadrangular space.
What causes carpal tunnel syndrome?
Compression of the median nerve due to reduced size of the carpal tunnel.
What does the lateral pectoral nerve primarily innervate?
Pectoralis major muscle.
What are the two branches of the Subscapular Artery?
The thoracodorsal artery and the circumflex scapular artery.
What does the dorsal scapular nerve innervate?
Rhomboids and frequently the levator scapulae muscles.
What does the Lateral Thoracic Artery supply?
It supplies the pectoralis major, pectoralis minor, serratus anterior muscles, axillary lymph nodes, and gives rise to lateral mammary branches.
What is the function of the Circumflex Scapular Artery?
It passes posteriorly into the triangular space and ramifies in the infraspinous fossa, anastomosing with branches of the dorsal scapular and suprascapular arteries.
What is the function of the Interosseous Membrane of the Forearm?
It provides attachments for deep extrinsic flexor, extensor, and abductor muscles of the hand.
What does the Thoracodorsal Artery supply?
It supplies the latissimus dorsi muscle and the lateral thoracic wall.
Where does the Brachial Artery extend from?
From the inferior border of the teres major muscle to its bifurcation in the cubital fossa.
What happens if the axillary artery is ligated between the thyrocervical trunk and the subscapular artery?
Blood from anastomoses in the scapular region can reach the subscapular artery, reversing flow to reach the axillary artery distal to the ligature.
What is the anatomical position of the Brachial Artery in relation to the biceps tendon?
It lies medial to the biceps tendon, lateral to the median nerve, and deep to the bicipital aponeurosis.