Fichas
Week 4.5
Fichas del conjunto (18)
- 1Describe the aortic supply of the head and neck-Brachiocephalic artery supplies the RHS
-Brachiocephalic splits into the right subclavian and right common carotid at the sternoclavicular level
-Left/right subclavian arteries supply the upper limbs - 2What are the anatomical segments of the arterial tree of the upper limb? What are borders?1) Subclavian artery: aortic arch (L) or sternoclavicular joint (R)
2) Axillary artery: crosses lateral border of first rib
3) Brachial artery: inferior border of teres minor muscle
4) Ulnar/radial artery: branchial artery ends at radial tuberosity
5) Deep/superficial palmar arches - 3What is the clinical usefulness of the arterial tree?Axillary artery: palpated in investigations of occlusion (difficult to do so)
Brachial artery: estimation of systemic blood pressure (at level of heard)
Radial artery: pulse, arterial samples for blood-gas analysis
Ulnar artery: difficult to palpate but possible - 4Describe the venous drainage of the upper limb2 parallel systems:
-superficial
-deep
Superficial veins drain into deep ones via perforators
Deep veins use the muscolu-venous pump to assist drainage into the SVC - 5What are the axial lines of the limbs?-Boundary line between 2 dermatomes supplied from discontinuous spinal levels
-Upper limb has anterior and posterior lines which communicate via the medial cubital vein
The borders mirror the veins:
-cephalic (on the radial side)
-basilic (on the ulna side) - 6Clinical importance of venous drainage-Getting blood samples
-Administering IV drugs
-Fluid replacement
-Route for blood transfusion - 7Describe the lymphatic drainage of the upper limb-Starts at tips of fingers and drains into clavicular lymph vessels
-Nodes: supratrochlear, axillary, infraclavicular
-Drainage occurs in 2 parallel systems: superficial and deep lymphatic channels - 8What is a dermatomyotome?Embryonic precursors of the adult dermis and muscle units
They eventually differentiate into the dermis and muscle in adults - 9What is a segmental nerve? What is it composed of?-A pair of nerves given out at each vertebral level
-Nerves exit via inter-vertebral foramina
-They travel with their equivalent segmental arteries/veins
-Dorsal and ventral roots (motor/autonomic) - 10Describe the nerve supply of the upper limb-Derived from C5-T1 (brachial plexus)
Includes:
-musculocutaneous nerve: C5-7
-axillary nerve: C5-6
-median nerve: C6-T1
-ulnar nerve: C7-T1
-radial nerve: C5-T1 - 11What does damage in the long thoracic nerve result in?Winged scapula
- 12What is a dermatome?An area of skin supplied by sensory nerve fibres from a single spinal nerve
- 13What is a sensory nerve territory?Territorial domains of skin supplied by sensory divisions of terminal nerves
- 14What are the effects of age on upper limb injuries?-Osteoporosis
-Soft tissues are weaker
-Slower healing
-Altered physiological responses
-Associated medical problems - 15What sort of things do you find out in a history?-Injury mechanism
-Complaints (eg. pain, swelling, loss of function, neurological symptoms)
-Previous health/medications
-Allergies - 16What sort of things do you look for in an examination?Look: deformity, scarring, swelling, colour
Feel: tenderness, crepitus, temperature
Move: active vs. passive movement - 17What are the principles of upper limb injury management?-Rest (slings, splints, plaster)
-Ice
-Elevation (decreases swelling)
-Analgesia
-Early mobilisation - 18What are the initial management priorities?-Pain relief (Entonox/'gas+air', morphine IV)
-Assessment (are nerves functioning?)
-X-ray
-Definitive treatment eg. reduction for shoulder dislocations
Información
- Descripción
- Distribution of blood supply and nerves of the upper limb
- Creado por
- Dolu Falowo
- Visitas
- 2
- Valoración
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