MSS Wk 8 L Extra Neurovascular.pdf

MD1020 MSS Extra Lecture Week 8 Neurovascular Structures in the Elbow, forearm and wrist A/Prof Kate Domett [email protected] Questions to “Piazza” Cubital Fossa: Boundaries Superior: Line between lateral and medial epicondyles Lateral: Brachioradialis (medial border of muscle) Medial: Pro...

MD1020 MSS Extra Lecture Week 8 Neurovascular Structures in the Elbow, forearm and wrist A/Prof Kate Domett [email protected] Questions to “Piazza” Cubital Fossa: Boundaries Superior: Line between lateral and medial epicondyles Lateral: Brachioradialis (medial border of muscle) Medial: Pronator teres (lateral border of muscle) Roof: bicipital aponeurosis Floor: Brachialis Lateral Medial Anterior view Cubital Fossa: Contents Radial nerve •Biceps brachii tendon •Brachial artery Median nerve • Bifurcates into Ulnar and Radial arteries •Median nerve •Radial nerve • Deep to brachioradialis • Divides into deep and superficial branches Medial Lateral Anterior view Nerves of the Forearm Radial (C5 to C8, T1) Median (C6 to C8, T1) Ulnar (C(7), 8, T1) Arteries of the forearm Brachial Ulnar Ulnar: posterior interosseous artery to posterior compartment Ulnar: anterior interosseous artery to deep anterior & posterior compartments Radial 5 Lateral Medial Radial nerve Brachial artery Ulnar nerve Median nerve Ulnar artery Radial artery Anterior view Subclavian vein Axillary vein Cephalic vein Basilic vein Median cubital vein 7 Superficial veins @ cubital fossa Basilic vein Cephalic vein Median cubital vein Basilic vein Medial Lateral Anterior view Wrist Radial artery FCR FDS Flexor retinaculum FCU Ulnar n & a Median nerve Palmaris longus Brachio‐ radialis Radial nerve (superficial branch) 10 The ‘snuffbox’ Extensor pollicis longus Extensor pollicis brevis Abductor pollicis longus Trapezium Scaphoid 11 Radial nerve at the wrist •Only the superficial branch of the radial nerve enters the hand – it passes over the tendon of EPL on the dorsum of the wrist EPB EPL Dorsal 12 Carpal Tunnel Flexor retinaculum (ligament) Median nerve Anterior Lateral Extrinsic ms tendons Posterior Carpal bones Anterior view MRI Carpal tunnel and Wrist Ulnar artery Median nerve Ulnar nerve Flexor tendons Extensor tendons 14 Palmaris longus Median nerve Flexor carpi radialis Ulnar nerve & artery Flexor pollicis longus Radial artery FDS FDP Hamate Capitate Trapezium Trapezoid Motor Sensory Pronator teres Flexor carpi radialis Anterior view Flexor digitorum superficialis Flexor pollicis longus Pronator quadratus Thenar group Posterior view Anterior view Median Nerve