Thoroacromial Artery

Anatomy Final

Block 1 8/20/2008 1) Costocoracoid fascia is penetrated by: a. Thoroacromial artery (PACD) b. Lateral pectoral nerve c. Cephalic vein 2) Mastectomies: a. Radical: breast, muscle, lymph node b. Simple: breast c. Segmental: cancer portions only 3) Cooper’s Ligand: attaches breast to tissue 8/22/2008 1) Sensory = Afferent a. Dorsal root 2) Motor = Efferent a. Ventral root 3) Dorsal primary rami = innervates back 4) Ventral primary rami = innervates trunk, upper, lower limbs 5) White Communicating Rami = T1-L2 Outflow from CNS 6) Grey Communicating Rami = Entire Spinal column Inflow 7) SA, SE, VA all use one neuron system a. VE (autonomic nervous system) uses two neuron system i. Pre-ganglionic ii.Post-ganglionic 8/22/2008 1) Brachial Plexus C5-T1 2) Components: a. Roots b. Trunks c. Divisions d. Cords e. Terminal branches 3) Injuries: a. Compression (extra cervical rib) b. Hyperabduction of upper limb (Klumpke paralysis, falling from tree) injures lower trunk c. Traction injures upper trunk, excessive separation of the shoulder from the neck (waiter’s gate)

d. Infraclavicular injuries (poorly fitting crutches, Saturday night palsy) 8/25/2008 1) Clavicle functions as attachment for muscles, keeps limb away from trunk 2) Scapula functions as attachment for limb muscles, attaches to clavicle, not attached to trunk via bone 3) Muscles a. Trapezius i. CN 11 (accessory nerve) b. Latissimus Dorsi i. Thoracodorsal n. c. Levator Scapulae i. Dorsal scapular n. d. Rhomboids i. Dorsal scapular n. e. Pectoralis mj. And mn. i. Medial and lateral pectoral nn. f. Serratus Anterior i. Long thoracic n. 1. Injury to this never leads to winging of the scapula g. Deltoid i. Axillary n. h. Supraspinatus* * = part of rotator cuff i. Suprascapular n. i. Infraspinatus* i. Suprascapular n. j. Teres Minor* i. Axillary n. k. Teeres Major i. Subscapular n. l. Subscapularis* i. Subscapular n.

8/26/2008 1) Vertebrae a. Cervical Vertebrae (7) b. Thoracic Vertebrae (12) c. Lumbar Vertebrae (5) d. Sacral Vertebrae (5 fused) e. Coccyx (3-4 fused coccygeal vertebrae) 2) C1-C7 spinal nerves come out above vertebrae of same number.

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a. C8 comes out above T1 b. Spinal nerve T1-S4(?) come out beneath T1 vertebrae Spondylolithesis = condition where body of L5 slops forward on body of S Rupture of intervertebral disc a. Most common direction is posteriolateral b. The affected nerve is one spinal cord level higher than the vertebrae level that is located superior to the ruptured disk i. If disc between L4-L5 is ruptured, L5 spinal nerve is compressed Abnormal curvature/alterations a. Kyphosis = humpback b. Lordosis = exaggeration of lumbar secondary curvature (pregnant women, fat people) c. Scoliosis = sideways crookedness d. Sacralization = incorporation of L5 into sacrum e. Lumbarization = liberation of S1 i. Increased range of motion, decreased stability injury Termination of spinal cord (think lumbar punctures… don’t want to hit SC) a. Fetus = coccyx b. Newborn = L2-L3 c. Adult = L1 Erector spinae group a. Iliocostalis (lateral) b. Longissimus c. Spinalis (medial)

8/27/2008 1) Median Nerve a. Flexes fingers and wrist i. Diagnostic = index finger 2) Ulner Nerve a. Motor function of pinky b. “funny bone” 3) Radial Nerve a. Extension of fingers and wrist i. Wrist drop b. Situated on humerus c. Traces between brachialis and brachial radialis

8/29/2208 1) Hand bones a. Scaphoid b. Lunate c. Triquetrum d. Pisiform e. Trapezium f. Trapezoid g. Capitate h. Hamate 2) Nerves a. Radial Nerve i. All extensors of arm and forearm ii.NO intrinsic extensors b. Median i. Thumb muscles ii.Inability to flex digits 1, 2, 3 iii.Carpal Tunnel c. Ulner i. All intrinsic except thumb