[image]O:

-In this picture the lateral anterior thoracic

Side branch of lateral cord recieving fibers from C5, C6, and C7

Course: Pieres costocoracoid membrane to reach deep surface of pectoral muscles; a communicating branch to the medial pectoral nerve passes anterior to the axillary artery and vein.

Innervates: Pimarly Pec major; but fibers pass to pec major via branch to medial pectoral nerve.

Proximal Attachment: Lateral third of clavicle, acromion and spine of scapula 

Lateral Attachment: Deltoid tuberosity of Humerus.

Innervation: Axillary Nerve (c5, c6)

Flexes, Extends and abducts the arm[image]

Proximal Attachment: infraspinous fossa of the scapula

Distal Attachment: Middle facet of greater tubercle of humerus

Innervation: Suprascapular Nerve C5, or C6

Laterally rotates arm and acts with the rotator cuff. This muscle is tested by holding arm at side, flexing elbow and and laterally rotating forearm.

[image]

Proximal Attachment: supraspinous fossa of the scapula

Distal: Superior facet of greater tubercle of the humerus

Innervation: Suprascapular Nerve (C5, C6)

Initiates and assists deltoid in abduction of arm and acts with rotator cuff muscles.

[image]

Proximal Attachment: Middle part of lateral border of scapula

Distal Attachment: Inferior facet of greater tubercle of humerus

Innervation: Axillary Nerve ( C5, C6)

Laterally rotates arm; and acts with rotator cuff muscles

[image] [image]

Proximal Attachment: Posterior surface of inferior angle of scapula

Distal Attachment: Medial lip of intertubercular sulcus of humerus

Innervation: Lower Subscapular Nerve (C5, C6)

Adducts and medially Rotates arm

[image]

Proximal Attachment: Subscapular Fossa (most anterior surface of scapula)

Distal Attachment: Lesser tubercle of humerus

Innervation: Upper and Lower Sub scapular nerves (C5, C6, C7)

Medially rotates arm; as part of rotator cuff, helps hold hear and humerus in glenoid cavity

[image]

Origin: inferior surface of the first part of the Subclavian Artery.

Course: Descends, inclining anteromedially, posterior end of clavicle and  first costal cartilage; enters thorax to descend in parasternal plane; gives rise to perforating branches, anterior intercostal, musculophenic, and superior epigastric arteries.

[image]

Origin:  Thyrocervical (or as a direct branch of the subclavian)

Course: Passes Inferolaterally crossing anterior scalene muscle, phrenic nerve, subclavian artery, and brachial plexus running laterally posterior and parallel to clavicle; next it passes over transverse scapular ligament to supraspinous fossa; then lateral to scapular spine )deep to acromoin) to infraspinous fossa on posterior surface of scapula.

[image]

Origin: First Branch of Axillary Artery (one of two)

 Course: Curls around superomedial border of pectoralis minor; then passes between it and pectoralis major to thoracic wall. Helps supply 1st and 2nd intercostal spaces and superior part of serratus anterior.[image]

Begins at the lateral border of 1st rib as the continuation of the subclavian artery and ends at the inferior border of the teres major. It has three branches:

Between the first rib and the pec minor:

-superior thoracic artery

Posterior to the pec minor:

-Acromical artery

-Lateral thoracic

Lateral border of the pec minor to the inferior border of teres major

- Subscapular (largest branch)

-Anterior circumflex

-Posterior circumflex humeral arteries.[image]

receive blood from the top (arch) of the aorta. The left subclavian artery supplies blood to the left arm and the right subclavian artery supplies blood to the right arm, with some branches supplying the head and thorax.

• On the left side of the body, the subclavian comes directly off the arch of aorta.
• On the right side of the body, the subclavian arises from the relatively short brachiocephalic artery (trunk) when it bifurcates into the subclavian and the right common carotid artery.

The usual branches of the subclavian on both sides of the body are the vertebral artery, the internal thoracic artery, the thyrocervical trunk, the costocervical trunk and the dorsal scapular artery. The subclavian becomes the axillary artery at the lateral border of the first rib.

(wiki pedia)

[image]

Largest and final branch of the axillary artery (diameter) but the shortest in length. Descends along the lateral border of the subscapularis on the posterior axillary wall, divides into the circumflex scapular and thoracodorsal arteries.

[image]

Third branch of the axillary artery, before the subscapular. These encircle the surgical neck of the humerus, the posterior and anterior anastamose with each other. The larger posterior humeral circumflex passes medially through the posterior wall of the axilla via the quadragular space. The smaller anterior branch passes laterally, deep to the corachobrachialis and biceps brachii, it gives off an ascending branch to the shoulder.

 [image]

O: Terminal Branch of the lateral cord: C5-C7

Course: Exits axilla by peircing coracobrachialis; descends between biceps brachii and brachialis, supllying both, continues as "lateral cutaneous nerve of the forearm

Innervates: Muscles of the anterior compartment of the arm ( corachobrachialis, biceps brachii and brachialis); skin of the lateral aspect of the forearm.

[image]

Arises from the medial aspect of the brachial artery near the middle of the humerus, and accompanies the ulnar nerve posterior to the medial epicondyle of the humerus. Here it anastamoses with the posterior ulnar recurrent artery and the inferior ulnar collateral artery.

 [image]

This is a terminal branch of the brachial artery in the cubital fossa. Its pulse can be palpated on the lateral side of the flexor carpi ulnaris tendon, where it lies anterior to the ulnar head. The "ulnar" nerve is on the medial side of the ulnar artery. Branches of this artery participate in the periarticular anastomosis of the elbow. It supplies the medial and central forearm, common flexor sheath and ulnar and median nerves.

[image]

The smaller terminal branch of the brachial artery in the cubital fossa. This arteries path is basically a line that runs from the midpoint in the cubital fossa to a point just medial to the styliod process of the radius.   Deep to the brachioradialis most of the way. At the distal forearm it lies just beneath the skin, where it can be palpated for pulse.

[image] 

Short branch of the ulnar artery, branching off about 1/3 the length of the ulna starting from the elbow. Goes lateral and deep, turning quickly to the posterior and anterior interosseous ateries. 

-In this picture "interosseous"

[image]

One of the terminal branches of the interosseous between the radius and ulna. Runs along the anterior aspect of the interosseous (io) membrane with the eponymous nerve. At the proximal border of the pronator quadratus, dives through the io membrane to join the superior ulnar collateral artery.

-Couldn't find a good picture, in this one the "volar interosseous"

[image]

[image]Origin

Lateral Root: a terminal branch of lateral (C6, C7)

Medial Root: a terminal branch of medial chord  (C8, T1)

So just: C6-T1

Course: Runs lateral to axillary artery; descends through arm adjacent to brachial artery, with nerve gradually crossing anterior to artery to lie medial to artery in cubital fossa

Innervates: Muscles of anterior forearm compartment (except for the flexor carpi ulnaris and ulnar half of flexor digitorum profundus), five intrinisic muscles in thenar (thumb) half of palm and palmar skin

Medial Cutaneous Nerve of Forearm

O: Side Branchs of medial cord; recieveing fibers from C8,T1

Course: Initially runs with ulnar nerve, but pierces deep fascia with basilic vein and enters subcutaneous tissue, dividing into anterior and posterior branches

Innervates: Skin of medial side of forearm as far as distal wrist

[image]

(in pic the medial anterior thoracic)

O:Side branch of medial cord, recieving fibers from C8,T1.

Course: Passes axillary artery and vein; then pierces pec minor and enters deep surfaces of pectoralis major; Inspite of its name it lies lateral to the lacteral pec. major nerve.

Innervates: Pec mino and sternocostal part of pec major.[image]

O: Side branch of medial chord: C8 and T1

Course: Smallest nerve of the plexus; runs along medial side of axillary and brachial veins; communicates with intercostobrachial nerve.

Innervates: Skin of medial side of the arm as far as the medial epicondyle of the humerus and olecranon of ulna

[image]

The 8 flexors and pronators of the forearm. Originate on the common flexor tendon of the medial epicondyle of the humerus, innervated by the median nerve, except for 1 1/2 exceptions: the ulnar portion of the flexor digitorum profundus and the flexor carpi ulnaris.

 5 Superficial : Pronator Teres, Flexor Carpi Radialis, Palmaris Longus, Flexor Carpi Ulnaris, Flexor Digitorum Superficialis. 

3 Deep: Flexor Digitorum Profundus, Flexor Pollicis Longus, Pronator Quadratus

(Deep layer not pictures)

[image]

12 extensors and suppinators, all Radial Nerve. 

 3 muscles of the Wrist: Extensors: Carpi Ulnaris, Carpi Radialis Longus, Carpi Radialis Brevis.

 3 muscles of the Fingers: Extensors: Digiti Minimi, Digitorum, Indicis.

3 Muscles of the Thumb: Extensors: Pollicis Longus, Pollicis Brevis, and Abductor Pollicis Longus

3 others: Aconeus, Supinator, Brachioradialis

[image]

Posterior Compartment (Superficial)

O: Supraepicondylar Ridge of Humerus

I: Lateral Distal Radius, next to Styloid Process

Nerve: Radial (C5, +C6+, C7)

Action: Flexor of forearm, best when arm is mid pronated (normal position)

[image]

Posterior Compartment : (Superficial)

O: Lateral Supraepicodylar ridge of humerus.

I: Dorsal aspect of base of 2nd metacarpal.

N: Radial Nerve: (C6, C7)

Action: Extend and abduct hand at the wrist joint;Active during fist clenching.[image]

Extensor Carpi Radialis Brevis:

Posterior Compartment : Superficial

O: Lateral Epicondyle of the Humerus (Common extensor Origin)

I: Extensor Expansion of the Medial 4 digits

A: Extend and abduct hand at the wrist joint

N: Deep Branch of Ra[image]dial: C7, C8

Posterior Compartment : Superficial

O: Common Extensor Origin (Lateral Epicondyle of the Humerus)

I: Extensor expansion of medial 4 digits.

N: Deep Branch of Radial Nerve

A: Extends medial 4 digits mostly at metacarpophalangeal joint, also at interphalangeal joint. 

[image]

Posterior Compartment : Superficial

O: Common Extensor Origin (Lateral epicondyle of humerus)

I: Extensor expansion of 5th digit.

N: Deep branch of radial nerve (C7, C8)

A: Extends fifth digit at metacarpophalangeal joint, secondarily at the interpahalangeal joint.

[image]

Posterior Compartment : Superficial

O: Lateral epicondyle of humerus; posterior border of ulna via a shared aponeurosis

I: Dorsal Aspect of base of the fifth metacarpal

N: Deep Branch of Radial Nerve, (C7, C8)

A: Extends and adducts hand at wrist joint. 

[image]

Posterior Compartment: (Deep)

O: Lateral epicondyle of the humerus, radial colateral and annular ligaments, supinator fossa, crest of ulna

I: Lateral, posterior and anterior surface of the proximal third of the radius.

N: Deep Branch of Radial Nerve ( C7, C8)

A: Supinates forearm; rotates radius to turn palm anteriorly or superiorly (if elbow is flexed)[image]

Posterior Compartment (Deep)

O: Posterior Surface of the distal Third of the Ulna and interosseous membrane.

I: Extensor Expansion of the 2nd Digit.

N: Posterior Interosseous Nerve (C7, C8). Continuation of deep branch of radial nerve.

A: Enables independent extension of second digit, synergist of wrist extension.[image]

Posterior Compartment (outcropping of deep layer)

O: Posterior Surface of proximal halves of ulna, radius, and interosseous membrane.

I: Base 1st metacarpal

N: Posterior Interossseous Nerve (C7, C8)

A: Abducts thumb and extends it at carpometacarpal joint. 

[image]

Posterior Compartment (Outcropping of Deep Layer)

O: Posterior Surface of middle third of ulna and interosseous membrane.

I: Dorsal aspect of base of distal phalanx of thumb.

N: Posterior Interosseous nerve (C7, C8)

A: Extends thumb at distal phalanx, as well as MCP, and CMP joints.[image]

Posterior Compartment (Outcropping of Deep Layer)

 O: Posterior Surface of distal Third of Radius and interosseous membrane.

I: Dorsal aspect of base of proximal phalanx of thumb.

N: Posterior Interosseous Nerve, (C7, C8), continuation of deep branch of radial nerve.

A: Extends thumb at the two closer joints: MCP, and CMC

[image]

O: Larger Terminal Branch of medial chord, made of T1 and C8

Course: Descends medial arm; passes posterior to medial epucondyle of humerus; then descends ulnar aspect of forearm to hand.

Innervates: Flexor Carpi Ulnaris and ulnar half of flexor digitorum profundus, most intrinsic muscles of the hand, skin of hand medial to axial line of digit 4.

[image]

O: Side branch of posterior cord, recieving branches only from C5

Course: Passes posteriorly, entering subscapularis directly

Innervates: Superior portion of subscapularis 

[image]

[image]

[image]

O: Anterior Ramii of C5, C6, C7

Couse: Passes laterally across cervial region (posterior trangle of the neck), descending posterior to C8 and T1 plexus, runs inferiorly on superficial surface of serratus anterior

Innervates: Serratus Anterior

[image]

From UW radiology atlas

Anterior Compartment (Superficial)

O: Medial Epicondyle of the humerus and coronoid process of ulna.

I: Middle of the lateral surface of the radius

N: Median Nerve (C6, C7)

A: Pronates and flexes the forearm at elbow

[image]

Flexor Carpi Radialis (FCR)

Anterior Compartment Superficial

O:Medial Epicondyle of the Humerus (Common Flexor Origin)

I: Base of the 2nd Metacarpal

N: Median Nerve (C6,C7)

A: Flexes and Abducts the Hands

[image]

Anterior Compartment Superficial

*Absent in 10% of people

O: Medial Epicondyle of the humerus (Common Flexor Origin)

I: Distal half of the flexor retinaculum and apex of the palmar aponeurosis

N: Median Nerve C7,C8

A: Flexes hand at wrist and tenses palmar aponeurosis

[image]

Anterior Compartment Superficial

One of the 1 & 1/2 exepctions to the rule of medial nerve innervation of the flexors.

O: Medial Epicondyle of the humerus, common flexor origin.

I: Pisiform bone (as a sessamoid) hook of hamate bone and 5th metacarpal bone.

N: Ulnar Nerve (C7 and C8)

A: Flexes and adducts hand (at wrist)

Anterior Compartment Intermediate Layer

O: Two heads: Humeroulnar head (Medial epicondyle and coronoid process

Radial Head (Superior hald of anterior border)

I: Shafts of middle phalances of medial four digits.

N: Median Nerve C7 C8 T1

A: Flexes middle phalanges at proximal interphalangeal joints of middle four digits; acting more strongly, it flexes proximal phalanges at the MCP joints.

[image]

Anterior Compartment Deep

The "1/2" in the 1&1/2 exceptions to median nerve innevation of the anterior compartment.

O: Two heads: Proximal three quarters of medial and anterior surfaces of ulna and interosseous membrane.

I: Medial: Bases of the 4th and 5th digits

Lateral: Bases of the distal Phalanges of the 2nd and 3rd digits

N: Medial: Ulnar Nerve (C8,T1)

Lateral: Anterior interosseous from Median (C8,T1)

Action: The heads flex the distal phalanges at thier insertions

[image]

Anterior Compartment Deep

O: Anterior surface of the radius and adjacent interosseous membrance

I: Base of distal phalanx of thumb

N: Anterior interosseous nerve from median nerve (C8,T1)

A: Flexes phalanges of 1st digit

[image]

Anterior Compartment Deep

O: Distal quarter of the anterior surface of the ulna

I: Distal Quarter of anterior Surface of the radius

N: Anterior interosseous nerve from median nerve (C8, T1)

A: Pronaters forearm; deep fibers bind radius and ulna together.

[image]

O: side branch of posterior chord, C6

Course: Passes inferolaterally, deep to subscapular artery and vein.

Innervates: Inferior portion of subscapularis and teres major.

Nerve to the left of Latissimus dorsi nerve

[image]

Posterior Compatment (Level???? Clinically oriented does not consider this a foarearm muscle, rather an arm)

O: Lateral Epicondyle of the humerus

i: Lateral surface of the olecranon and superior part of the posterior part surface of the ulna.

N: Raidal Nerve (C7, C8, T1)

A: Assists triceps in extending forearm; stabilizes elbow joint. May abduct ulna during during pronation.

[image]

O: Side branch of poasterior cord, recieving fibers from C6,C7, C8

Course: Arises between upper and lower subscapular nerves and runs inferolaterally along posterior wall to apical part of L dorsi.

Innervates: L. Dorsi[image]

O: Supeior Trunk, recieving fibers from C5 and C6

Course: Passes laterally across lateral cervical region  (posterior traingle of the neck), superior to brachial plexus, then though scapular notch inferior to superior transverse scapular ligament

Innervates: Supraspinatus and infraspinatus and gleno humeral joint.

[image]

O: Superior Trunk recieves fibers from C5, and C6.

Couse: Descends posterior to clavicle and anterior to brachial blexus qne subclavian artery often giving and accesory root to the phrenis nerve.

Innervates: Subclavius and sternoclavicular joint. Acessory phrenic root innervates diaphragm.

O: Terminal Branch of posterior cord, recieving from C5, C6.

Course: Exits Axillary fossa posteriorly, passing through quadrangal space with posterior circumflex humeral artery; gives rise to superior lateral brachial cutaneous nerve; then inds around surgical neck of humerus deep to deltoid.

Innervates: Deltoid, teres minor, glenohumeral joint, skin of superolateral arm.[image]

O: Larger terminal branch of posterior cord (largest branch of plexus) receving fibers from C5-T1.

Course: Exits axillary fossa posterior to axillary artery; passes posterior to humerus in radial groove with deep brachial artery between lateral and medial heads of triceps; perforates lateral intermuscular septum; enters cubital fossa dividing into superficial (cutaneous) and deep (motor) radial nerves.

Innervates: All muscles of posterior compartments of arm and forearm; skin of posterior inferolateral arm, posterior forearm, and dorsum of hand lateral to axial line of digit 4.

[image]

O: terminal branches of common interosseous artery, between radius and ulna.

Course: Passes posterior aspect of interosseous membrane giving rise to recurrent interosseous artery, runs distally between superifcial and deep extensor muscles supplying both, repalced distally by anterior interosseous artery.

[image]

Palmar and Dorsal Carpal branches of the Radial Artery

[image]

Participate in the periarticular arterial anastomosis around the wrist by anastamosing with the corresponding branches of the ulnar artery and terminal branches of the anterior and posterior interosseous arteries, forming palmar and doral carpal arches.

-From wikipedia.

The deep palmar arch is accompanied by a pair of venae comitantes which constitute the deep palmar venous arch. It receives the veins corresponding to the branches of the arterial arch: the palmar metacarpal veins.

-

From the lateral side of the arch, paired radial veins accompany the radial artery. From the medial side, paired ulnar veins do the same.

Follow the same course as the radial and ulnar arteries, but in pairs.  Unite with each other to form veins to form the brachial vein.

[image]

From the Wiki.

In human anatomy, the brachial veins are venae comitantes of the brachial artery in the arm proper. Because they are deep to muscle, they are considered deep veins. Their course is that of the brachial artery (in reverse): they begin where radial veins and ulnar veins join (corresponding to the bifurcation of the brachial artery). They end at the inferior border of the teres major muscle. At this point, the brachial veins join the basilic vein to form the axillary vein.

[image]

-From greys.

  The cephalic vein (Fig. 574) begins in the radial part of the dorsal venous net-work and winds upward around the radial border of the forearm, receiving tributaries from both surfaces. Below the front of the elbow it gives off the vena mediana cubiti (median basilic vein), which receives a communicating branch from the deep veins of the forearm and passes across to join the basilic vein. The cephalic vein then ascends in front of the elbow in the groove between the Brachioradialis and the Biceps brachii. It crosses superficial to the musculocutaneous nerve and ascends in the groove along the lateral border of the Biceps brachii. In the upper third of the arm it passes between the Pectoralis major and Deltoideus, where it is accompanied by the deltoid branch of the thoracoacromial artery. It pierces the coracoclavicular fascia and, crossing the axillary artery, ends in the axillary vein just below the clavicle.

sited.[image]

 The basilic vein (v. basilica) (Fig. 574) begins in the ulnar part of the dorsal venous network. It runs up the posterior surface of the ulnar side of the forearm and inclines forward to the anterior surface below the elbow, where it is joined by the vena mediana cubiti. It ascends obliquely in the groove between the Biceps brachii and Pronator teres and crosses the brachial artery, from which it is separated by the lacertus fibrosus; filaments of the medial antibrachial cutaneous nerve pass both in front of and behind this portion of the vein. It then runs upward along the medial border of the Biceps brachii, perforates the deep fascia a little below the middle of the arm, and, ascending on the medial side of the brachial artery to the lower border of the Teres major, is continued onward as the axillary vein.

[image]

The axillary vein (v. axillaris) begins at the lower border of the Teres major, as the continuation of the basilic vein, increases in size as it ascends, and ends at the outer border of the first rib as the subclavian vein. Near the lower border of the Subscapularis it receives the brachial veins and, close to its termination, the cephalic vein; its other tributaries correspond with the branches of the axillary artery. It lies on the medial side of the artery, which it partly overlaps; between the two vessels are the medial cord of the brachial plexus, the median, the ulnar, and the medial anterior thoracic nerves. It is provided with a pair of valves opposite the lower border of the Subscapularis; valves are also found at the ends of the cephalic and subscapular veins.

[image]

Origin

Short head: tip of coracoid process of scapula; Long head: supraglenoid tubercle of scapula

Insertion

Tuberosity of radius and fascia of forearm via bicipital aponeurosis

Action

Supinates forearm and, when it is supine, flexes forearm

Innervation

Musculocutaneous nerve (C5 and C6 ) (C5, C6)

Arterial Supply

Muscular branches of brachial artery

[image]

[image]Origin

Long head: infraglenoid tubercle of scapula; Lateral head: posterior surface of humerus, superior to radial groove; Medial head: posterior surface of humerus, inferior to radial groove

Insertion

Proximal end of olecranon process of ulna and fascia of forearm

Action

Chief extensor of forearm; long head steadies head of abducted humerus

Innervation

Radial nerve (C6, C7 and C8) (C6, C7, C8)

Arterial Supply

Branches of deep brachial artery

Origin

Tip of coracoid process of scapula

Insertion

Middle third of medial surface of humerus

Action

Helps to flex and adduct arm

Innervation

Musculocutaneous nerve (C5, C6 and C7) (C5, C6, C7)

Arterial Supply

Muscular branches of brachial artery

[image]

[image]Origin

Distal half of anterior surface of humerus

Insertion

Coronoid process and tuberosity of ulna

Action

Major flexor of forearm -- flexes forearm in all positions

Innervation

Musculocutaneous nerve (C5 and C6) (C5, C6)

Arterial Supply

Muscular branches of brachial artery, recurrent radial artery

Origin

Clavicular head: anterior surface of medial half of clavicle; Sternocostal head: anterior surface of sternum, superior six costal cartilages, and aponeurosis of external oblique muscle

Insertion

Lateral lip of intertubercular groove of humerus

Action

Adducts and medially rotates humerus; draws scapula anteriorly and inferiorly; Acting alone: clavicular head flexes humerus and sternocostal head extends it

Innervation

Lateral and medial pectoral nerves; clavicular head (C5 and C6, sternocostal head (C7, C8, and T1) (C5, C6, C7, C8, T1)

Arterial Supply

pectoral branch of the thoracoacromial trunk

[image]

Origin

Spinous processes of inferior 6 thoracic vertebrae, thoracolumbar fascia, iliac crest, and inferior 3 or 4 ribs

Insertion

Floor of intertubercular groove of humerus

Action

Extends, adducts, and medially rotates humerus; raises body toward arms during climbing

Innervation

Thoracodorsal nerve (C6, C7, and C8) (C6, C7, C8)

Arterial Supply

Thoracodorsal artery[image]