Lecture 6 Axilla
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Questions and Answers

The axillary artery is divided into segments by the pectoralis minor muscle. Which segment is directly posterior to this muscle?

  • Distal segment
  • Second segment (correct)
  • Third segment
  • First segment

A patient is having difficulty with scapular protraction. Which muscle is MOST likely affected?

  • Trapezius
  • Latissimus dorsi
  • Serratus anterior (correct)
  • Rhomboid major

During a surgical procedure, a surgeon identifies the posterior humeral circumflex artery. Which nerve should the surgeon be MOST careful to avoid?

  • Ulnar nerve
  • Axillary nerve (correct)
  • Radial nerve
  • Musculocutaneous nerve

A patient presents with weakness in both the supraspinatus and infraspinatus muscles. Damage to which nerve, originating from the superior trunk of the brachial plexus, is MOST likely the cause?

<p>Suprascapular nerve (B)</p> Signup and view all the answers

Following a fall, a patient is diagnosed with a humeral fracture. The physician notes the fracture is at a location commonly associated with neurovascular complications. Which part of the humerus is MOST likely fractured?

<p>Surgical neck (C)</p> Signup and view all the answers

A patient has lost motor function in the deltoid and teres minor muscles following an injury. Which single nerve is MOST likely to have been damaged?

<p>Axillary nerve (A)</p> Signup and view all the answers

A patient reports difficulty abducting their arm and externally rotating the same arm. Which nerve is MOST likely damaged?

<p>Axillary nerve (A)</p> Signup and view all the answers

During a surgery involving the axilla, a surgeon must be cautious to protect a nerve that originates directly from the superior trunk of the brachial plexus. Injury to this nerve would MOST directly affect which muscular action?

<p>Shoulder abduction and external rotation (C)</p> Signup and view all the answers

A patient presents with decreased blood flow to the infraspinous fossa. Which artery is most likely affected?

<p>Circumflex scapular artery (A)</p> Signup and view all the answers

During a surgical procedure involving the latissimus dorsi, which nerve must be carefully identified and preserved to prevent muscle paralysis?

<p>Thoracodorsal nerve (C)</p> Signup and view all the answers

A patient exhibits nerve deficits originating from the inferior trunk of the brachial plexus. Which nerve roots are most likely involved?

<p>C8-T1 (C)</p> Signup and view all the answers

A surgeon is performing an axillary lymph node dissection and needs to identify the final group of nodes before lymphatic drainage enters the subclavian lymphatic trunk. Which nodes are they looking for?

<p>Apical nodes (B)</p> Signup and view all the answers

During elbow flexion, which anatomical structure on the humerus accommodates the coronoid process of the ulna?

<p>Coronoid fossa (B)</p> Signup and view all the answers

Radiographic imaging of a growing child's humerus reveals a distinct line near the proximal end. Which anatomical region does this line most likely represent?

<p>Houses the epiphyseal plate remnant (E)</p> Signup and view all the answers

Which of the following nerves is NOT directly derived from the posterior cord of the brachial plexus?

<p>Ulnar nerve (B)</p> Signup and view all the answers

Compression of the axilla, such as that caused by improperly fitted crutches, is most likely to directly affect which nerve, potentially resulting in 'Saturday night palsy'?

<p>Radial nerve (B)</p> Signup and view all the answers

A patient presents with an inability to abduct their arm and weakness in external rotation. Which nerve is MOST likely affected?

<p>Axillary nerve (A)</p> Signup and view all the answers

The lateral cord of the brachial plexus is formed by the fusion of which structures?

<p>Anterior divisions of the upper and middle trunks (A)</p> Signup and view all the answers

A surgeon is performing a procedure in the axilla and needs to identify the medial pectoral nerve. Which of the following describes its path and innervation?

<p>Arises from the medial cord and supplies both the pectoralis minor muscle, then continues to supply the pectoralis major muscle. (A)</p> Signup and view all the answers

Which of the following is the MOST accurate description of the flow of lymph through the axillary lymph nodes?

<p>Pectoral → Subscapular → Humeral → Central → Apical (D)</p> Signup and view all the answers

A patient who recently underwent a mastectomy presents with lymphedema in the affected arm. Which group of lymph nodes was MOST likely disrupted?

<p>Apical nodes (A)</p> Signup and view all the answers

A patient is diagnosed with lymphangitis in the upper limb due to an infection. Where would tenderness and swelling MOST likely be observed?

<p>Along the pathways of lymphatic vessels in the arm and axilla. (A)</p> Signup and view all the answers

Which nerve passes through the quadrangular space along with the posterior humeral circumflex artery?

<p>Axillary nerve (C)</p> Signup and view all the answers

If a tumor in the axilla compressed the medial cord of the brachial plexus, which of the following motor deficits would be MOST likely to occur?

<p>Weakness in finger adduction. (D)</p> Signup and view all the answers

A patient presents with weakness in shoulder abduction and external rotation. Which nerve, originating from the posterior cord of the brachial plexus, is most likely affected?

<p>Axillary nerve (B)</p> Signup and view all the answers

During a surgical procedure in the axilla, a surgeon needs to ligate a branch of the thoracoacromial trunk to control bleeding. Which of the following arteries is a direct branch of this trunk?

<p>Deltoid artery (B)</p> Signup and view all the answers

A newborn presents with a 'claw hand' deformity and weakness in the intrinsic muscles of the hand following a difficult delivery. Which type of brachial plexus injury is most likely the cause?

<p>Klumpke's palsy (D)</p> Signup and view all the answers

A patient has difficulty flexing their elbow and supinating their forearm. Which nerve is most likely injured?

<p>Musculocutaneous nerve (A)</p> Signup and view all the answers

During a shoulder arthroscopy, surgeons must be cautious of the arterial supply to the deltoid muscle to minimize post-operative atrophy. Damage to which artery would most directly compromise the deltoid's blood supply?

<p>Deltoid branch of the thoracoacromial trunk (B)</p> Signup and view all the answers

A fracture of the midshaft of the humerus can damage a nerve as it passes through the triangular interval. Damage to what nerve is most likely, resulting in wrist drop?

<p>Radial nerve (A)</p> Signup and view all the answers

A patient undergoing treatment for lymphedema in the upper limb requires understanding of lymphatic drainage pathways. Where does most of the lymphatic drainage from the upper limb initially converge?

<p>Humeral (lateral) lymph nodes (A)</p> Signup and view all the answers

After a motorcycle accident, a patient exhibits paralysis of the biceps brachii and loss of sensation along the lateral forearm. Which nerve has most likely been damaged?

<p>Musculocutaneous nerve (C)</p> Signup and view all the answers

A patient has a compromised suprascapular artery. Which artery would be MOST crucial in providing collateral circulation to maintain blood flow around the scapula?

<p>Circumflex scapular artery (E)</p> Signup and view all the answers

A patient reports a loss of sensation on the lateral aspect of their forearm following an injury. Which nerve is MOST likely affected?

<p>Musculocutaneous nerve (C)</p> Signup and view all the answers

During a surgical procedure involving the scapula, both the upper and lower subscapular nerves are inadvertently damaged. Which muscle's function will be DIRECTLY impaired as a result?

<p>Subscapularis (C)</p> Signup and view all the answers

A weightlifter is performing a lat pulldown exercise. Which muscle is MOST directly involved in the adduction and medial rotation of their arm during this movement?

<p>Teres major (A)</p> Signup and view all the answers

A surgeon is preparing to ligate the largest branch of the axillary artery during a radical mastectomy. Which artery is MOST likely to be ligated?

<p>Subscapular artery (D)</p> Signup and view all the answers

A patient presents with wrist drop after fracturing the midshaft of their humerus. Which nerve was MOST likely injured?

<p>Radial nerve (E)</p> Signup and view all the answers

During a boxing match, a fighter forcefully protracts their scapula to deliver a punch. Which muscle is PRIMARILY responsible for this action?

<p>Serratus anterior (A)</p> Signup and view all the answers

A baseball player complains of shoulder pain and weakness when abducting their arm The doctor suspects damage to one of the rotator cuff muscles. If the teres minor is intact, but abduction is particularly weak in the initial 15 degrees, which rotator cuff muscle is MOST likely affected?

<p>Supraspinatus (B)</p> Signup and view all the answers

Which combination of anatomical structures primarily defines the superior boundary (apex) of the axilla?

<p>Clavicle, 1st rib, superior border of the scapula (C)</p> Signup and view all the answers

The serratus anterior muscle is innervated by the long thoracic nerve. What functional deficit would you expect to see if this nerve were damaged?

<p>Inability to protract the scapula, resulting in scapular winging. (B)</p> Signup and view all the answers

A fracture of the surgical neck of the humerus poses a risk to surrounding neurovascular structures. Why is the surgical neck more prone to fractures compared to the anatomical neck?

<p>The surgical neck has a smaller diameter than the anatomical neck. (D)</p> Signup and view all the answers

The intertubercular groove of the humerus houses which structure?

<p>Biceps brachii tendon (A)</p> Signup and view all the answers

What is the primary anatomical landmark used to divide the axillary artery into its three segments?

<p>Pectoralis minor muscle (B)</p> Signup and view all the answers

Which artery branches directly from the first segment of the axillary artery?

<p>Superior thoracic artery (B)</p> Signup and view all the answers

Which of the following arteries does NOT originate directly from the thoracoacromial trunk?

<p>Subscapular artery (C)</p> Signup and view all the answers

The circumflex scapular artery, which branches from the subscapular artery, passes through which anatomical space?

<p>Triangular space (D)</p> Signup and view all the answers

What is the most common positional relationship between the axillary artery and vein?

<p>The axillary vein lies anteromedial to the axillary artery. (A)</p> Signup and view all the answers

Which nerve roots primarily contribute to the formation of the brachial plexus?

<p>C5-T1 (B)</p> Signup and view all the answers

The dorsal scapular nerve, responsible for supplying the rhomboid muscles, originates from which nerve root?

<p>C5 (D)</p> Signup and view all the answers

Erb-Duchenne palsy, often resulting in a 'waiter's tip' deformity, typically involves damage to which nerve roots of the brachial plexus?

<p>C5 and C6 (D)</p> Signup and view all the answers

Klumpke's palsy, involving the lower nerve roots of the brachial plexus, primarily affects which muscle group?

<p>Intrinsic hand muscles (C)</p> Signup and view all the answers

The suprascapular nerve and suprascapular artery both travel to the supraspinous and infraspinous fossae. What is their relationship as they pass the scapular notch?

<p>The nerve passes under, and the artery passes over the ligament. (A)</p> Signup and view all the answers

Which nerve emerges from the superior trunk of the brachial plexus?

<p>Nerve to subclavius (D)</p> Signup and view all the answers

Flashcards

Axillary Artery: Second Segment

The second segment of the axillary artery.

Serratus Anterior Function

Protracts the scapula (moves it forward) and stabilizes it against the thoracic wall.

Posterior Humeral Circumflex Artery Companion

The axillary nerve.

Superior Trunk Brachial Plexus Branch

The suprascapular nerve.

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Common Humerus Fracture Site

The surgical neck of the humerus.

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Axillary Nerve Function

Innervates the deltoid and teres minor muscles.

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Divisions of Brachial Plexus

Connects the trunks to the cords in the brachial plexus, splitting into anterior and posterior segments.

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Cords of Brachial Plexus

Convergence site of divisions, named by their position relative to the axillary artery (lateral, medial, posterior).

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Musculocutaneous Nerve

Motor: anterior arm muscles. Cutaneous: lateral forearm.

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Ulnar Nerve

Supplies anterior forearm and hand muscles.

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Median Nerve

Receives branches from medial and lateral cords, supplying anterior forearm and hand muscles.

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Axillary Nerve

Arises from posterior cord; supplies deltoid and teres minor.

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Radial Nerve

Major branch of posterior cord; supplies posterior arm and forearm muscles (extensors).

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Pectoral Nodes

Found along the medial wall; receive lymph from anterior wall and breast tissue.

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Subscapular Nodes

Located posteriorly; receive lymph from the posterior thoracic wall.

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Humeral (Lateral) Nodes

Located laterally; drain lymph from most of the upper arm.

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Circumflex Scapular Artery

Passes through the triangular space to supply the infraspinous fossa.

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Thoracodorsal Nerve

Arises from the posterior cord to supply the latissimus dorsi muscle.

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Inferior Trunk of Brachial Plexus

Formed by the convergence of both the C8 and T1 nerve roots.

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Apical Nodes

Located at the apex of the axilla and receive lymph drainage from the central nodes.

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Coronoid Fossa

A depression on the anterior distal humerus that accommodates the coronoid process of the ulna during elbow flexion.

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Anatomical Neck of Humerus

A remnant of the epiphyseal plate.

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Deltoid Artery

A branch of the thoracoacromial trunk that supplies the deltoid muscle.

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Klumpke's Palsy

Results from tearing the lower roots of the brachial plexus (C8-T1).

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Deltoid Branch

Supplies blood to the deltoid muscle.

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Humeral Lymph Nodes

Receives most of the lymphatic drainage from the upper limb.

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Axilla

Pyramidal region deep to the shoulder, acting as a 'gateway' for structures between the neck and upper limb.

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Superior Boundary of the Axilla

Clavicle, 1st rib, and scapula.

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Anterior Boundary of the Axilla

Pectoral region of the shoulder, ending at the anterior axillary fold.

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Posterior Boundary of the Axilla

Scapula, scapulohumeral muscles, and latissimus dorsi, ending at the posterior axillary fold.

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Medial Boundary of the Axilla

Lateral border of the rib cage and overlying musculature.

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Serratus Anterior Muscle

Broad muscle originating from ribs 1-8, inserting on the medial border of the scapula, and protracts the scapula.

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Innervation of Serratus Anterior

Long thoracic nerve.

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Humerus

Bone of the upper arm, articulating with the scapula proximally, and radius/ulna distally.

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Surgical Neck of Humerus

Common fracture site on humerus.

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Greater and Lesser Tubercles

Attachment sites for rotator cuff muscles on the humerus.

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Floor of the Axilla

Axillary fascia and overlying skin.

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Axillary Artery

Continuation of the subclavian artery; divided into 3 regions by pectoralis minor.

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Brachial Plexus

Bundle of nerves from C5-T1 spinal nerves, supplying the shoulder and upper appendage.

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Roots of Brachial Plexus

Ventral rami of C5-T1 emerging between scalene muscles.

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Trunks of Brachial Plexus

Convergence of C5, C6 (superior), continuation of C7 (middle), convergence of C8, T1 (inferior).

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Subscapularis Muscle

Innervated by both upper and lower subscapular nerves.

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Teres Major Function

Assists in medial rotation and adduction of the arm.

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Subscapular Artery

Largest branch of the axillary artery.

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