2: LO's Neurovasculature of the Upper Limb

Specify the location of the median cubital vein and explain its clinical significance.

At the elbow, the median cubital vein connects the cephalic vein laterally, with the basilic vein medially. Routinely used for venipuncture & as a site for an intravenous cannula.

Specify the principle joint action controlled by and the location of sensory testing for each of the ventral primary rami that contribute to the brachial plexus; be able to apply this information in assessing sensory and motor deficits in the upper limb.

C5: shoulder abduction C6: elbow flexion C7: elbow extension C8: finger flexion T1: finger abduction

Specify the locations of lymph nodes that drain the upper limb.

Lymph from the upper limb drains to the axillary lymph nodes. The axillary lymph nodes receive three streams of lymph, one from the upper extremity, one from the adjacent thoracic/upper abdominal wall/breast, & one from the back. The three currents meet & merge deep within the axilla. Lymph from the axillary lymph nodes drains to a subclavian trunk which empties into the venous angle on both sides.

Distinguish the origins, routes and terminations of the cephalic and basilic veins.

The superficial veins of the upper extremity are the basilic vein, which travels along the medial aspect of the upper extremity, and the cephalic vein, which travels along its lateral side. Both superficial veins originate from the dorsal venous network on the dorsum of the hand. The basilic vein originates from the medial side of the dorsal venous network. From here it passes proximally onto the anterior surface of the forearm just distal to the elbow. It continues proximally midway up the arm where it pierces the deep fascia. The basilic vein becomes the axillary vein when it is joined by the brachial vein. From its origin on the lateral aspect of the wrist the cephalic vein passes laterally around the distal forearm to reach the anterolateral surface of the forearm. The cephalic vein continues proximally across the elbow and up the arm and into the clavipectoral triangle (deltopectoral groove). At the base of the clavipectoral triangle the cephalic vein pierces the deep fascia to enter the axilla where it drains into the axillary vein.

Specify the spinal cord segments assessed by the following deep tendon reflexes: biceps, triceps, brachioradialis.

biceps brachii: used to assess the C5 and C6 spinal cord levels. brachioradialis: used to assess the C6 spinal cord level. triceps brachii: used to assess the C7 spinal cord level.