Материал: Kaplan USMLE-1 (2013) - Anatomy

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Section Ill • Gross Anatomy

Table 111-4-4. Effects of Lesions to Branches ofthe Brachial Plexus

 

 

Lesioned

Axillary

Musculo-

Radial

Median

Ulnar

Nerve

(CS, C6)

cutaneous

(CS, C6, C7, CS)

(C6, C7, CS, Tl)

(CS, Tl)

 

 

 

 

(CS, C6, C7)

 

 

 

Altered

Lateral arm

Lateral forearm

Dorsum of hand

Lateral 31/i

Medial 11/i digits;

sensation

 

 

over first dorsal

digits; lateral

medial palm

 

 

 

 

 

 

interosseous and

palm

 

 

 

 

anatomic snuffbox

 

 

Motor

Abduction at

Flexion of

Wrist extension

Wrist flexion

Wrist flexion

weakness

shoulder

forearm

Metacarpo-

Finger flexion

Finger spreading

 

 

 

 

 

Supination

phalangeal

Pronation

Thumb adduction

 

 

 

extension

 

 

 

Thumb

Finger extension

 

 

 

Supination

 

 

 

opposition

 

 

 

 

 

 

Common sign

 

 

Wrist drop

Ape hand

Claw hand

oflesion

 

 

 

Hand of

Radial deviation

 

 

 

 

 

 

 

 

benediction

at wrist

 

 

 

 

Ulnar deviation

 

 

 

 

 

at wrist

 

Causes of

Surgical neck

Rarely lesioned

Saturday night palsy

Carpal tunnel

Fracture of medial

lesions

fracture of

 

Midshaft fracture of

compression

epicondyle of

 

humerus

 

 

humerus

 

 

humerus

Supracondylar

 

 

 

 

 

Dislocated

 

Subluxation of

fracture of

Fracture of hook

 

humerus

 

humerus

of hamate

 

 

radius

 

 

 

 

 

 

 

 

Dislocated humerus

Pronator teres

Fracture of clavicle

 

 

 

syndrome

 

 

 

 

 

 

292 MEDICAL

Chapter If • Upper Limb

ARTERIAL SUPPLYAND MAJOR ANASTOMOSES

Arterial Supply to the Upper Limb (Figure 111-4-3)

Subclavian artery

Branch ofbrachiocephalic trunk on the right and aortic arch on the left.

Axillaryartery

•From the first rib to the posterior edge of the teres major muscle

•Three major branches:

-Lateral thoracic artery-supplies mammary gland; runs with long thoracic nerve

-Subscapular artery-collateral to shoulder with suprascapular branch of subclavian artery

-Posterior humeral circumflex artery-at surgical neck with axillary nerve

Brachial artery

Profunda brachii artery with radial nerve in radial groove-at midshaft of hu­ merus

Radial artery

Deep palmar arch

Ulnarartery

•Common interosseus artery

•Superficial palmar arch

MEDICAL 293

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