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BRACHIUM

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... Forearm flexors Biceps also supinates forearm Innervation Innervation and functional ... wrist. Nerves in the Brachium ... of the wrist and hand. – PowerPoint PPT presentation

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Title: BRACHIUM


1
BRACHIUM
2
Fascial Septa
  • Divide arm into anterior and posterior
    compartments.

3
Medial Intermuscular Septum
  • From subcutaneous sheath to humerus.
  • Separates muscles of anterior arm from medial
    side of triceps complex.

4
Lateral Intermuscular Septum
  • From subcutaneous sheath to humerus.
  • Separates muscles of anterior arm from lateral
    side of triceps complex.

5
(No Transcript)
6
ANTERIOR BRACHIAL COMPARTMENT
7
Muscles
  • Components
  • Biceps brachii
  • Coracobrachialis
  • Brachialis
  • Function
  • Forearm flexors
  • Biceps also supinates forearm

8
Innervation
  • Innervation and functional neurological level
  • Musculocutaneous nerve
  • C5-6
  • Nerves passing through compartment (not
    innervating anterior compartment structures)
  • Median nerve.
  • Ulnar nerve
  • Through proximal part of anterior compartment.

9
Vascularization
  • Brachial artery
  • Basilic vein and venae comitantes

10
POSTERIOR BRACHIAL COMPARTMENT
11
Muscles
  • Components
  • Triceps brachii.
  • Anconeus.
  • Function
  • Forearm extensors.
  • Long head of triceps can extend shoulder
    (brachium).
  • Synergists in forearm supination.

12
Innervation/Vascularization
  • Innervation and functional neurological level
  • Radial nerve
  • C7
  • Vascular supply to compartment
  • Deep brachial artery

13
NERVES and VESSELS IN THE BRACHIUM
14
Median Nerve
  • Supplies flexor muscles on the radial side of the
    forearm.
  • Travels with the brachial artery
  • Lateral to artery in upper half of brachium.
  • Medial to artery in lower half of brachium.
  • Crosses cubital fossa superficially
  • With brachial artery
  • Deep to bicipital aponeurosis

15
Ulnar Nerve
  • Supplies flexor muscles on the ulnar side of the
    forearm.
  • Starts in anterior brachial compartment
  • Medial to brachial artery
  • Runs with superior ulnar collateral artery.

16
Ulnar Nerve
  • Pierces medial intermuscular septum
  • Enters posterior compartment of the brachium.
  • Passes around (superficial) medial epicondyle.
  • Passes into forearm between two heads of
    flexor carpi ulnaris muscle.

17
Radial Nerve
  • Supplies extensor muscles in posterior
    compartment of brachium as well as extensor
    muscles of the wrist and hand.
  • Also supplies brachioradialis muscle.
  • Descends posterior to the axillary artery
  • Spirals around the posterior surface of the
    humerus in the spiral (radial) groove.
  • Accompanied by deep brachial artery.

18
Radial Nerve
  • Pierces lateral intermuscular septum distal to
    deltoid insertion.
  • Passes into forearm
  • Between the brachialis medially and the
    brachioradialis laterally.
  • Divides into superficial and deep branches near
    lateral epicondyle.

19
Radial Nerve
  • Branches in the axilla and upper third of the
    arm
  • Muscular branch to long head of triceps.
  • Muscular branch to medial head of triceps.
  • Posterior brachial cutaneous nerve.

20
Radial Nerve
  • Branches in the radial groove in middle third of
    arm
  • Branch to lateral and medial triceps and
    anconeus.
  • Lower lateral brachial cutaneous nerve.
  • Posterior cutaneous nerve of the forearm.

21
Radial Nerve
  • Branches in the distal third of the arm
  • Branch to brachioradialis.
  • Branch to extensor carpi radialis longus
    (brevis?)
  • Articular branches to elbow joint.

22
Musculocutaneous Nerve
  • Pierces coracobrachialis in upper half or third
    of brachium.
  • Innervates muscles of anterior brachial
    compartment.
  • Pierces fascia lateral to biceps tendon
  • Continues as lateral cutaneous nerve of the
    forearm.
  • Supplies skin on lateral forearm as far as
    wrist.

23
Nerves in the Brachium
  • Medial brachial cutaneous nerve
  • Direct branch from medial cord.
  • Medial antebrachial cutaneous nerve
  • Direct branch from medial cord.

24
Cephalic Vein
  • Lateral continuation of dorsal venous arch.
  • Ascends in superficial fascia along lateral
    aspect of forearm and arm.
  • Passes through deltopectoral triangle.
  • Empties into axillary vein.

25
Basilic Vein
  • Medial continuation of dorsal venous arch.
  • Ascends in superficial fascia along lateral
    aspect of forearm and arm to middle of arm.
  • Pierces deep fascia and ascends in upper aspect
    of arm in deep fascia.
  • Joins venae comitantes to form axillary vein
  • Usually near inferior border of teres major.

26
Median Cubital Vein
  • Connects cephalic and basilic vein.
  • Extends diagonally across bicipital aponeurosis.
  • Receives blood from median antebrachial vein.
  • Drains blood from palmar hand.

27
Venae Comitantes
  • Veins that parallel arteries
  • Usually two per artery.
  • Countercurrent heat exchange.

28
Brachial Artery
  • Direct continuation of axillary artery.
  • Begins at inferior border of teres major.
  • Main branch is deep brachial artery.
  • Other branches
  • Superior ulnar collateral
  • To posterior ulnar recurrent.
  • Inferior ulnar collateral
  • To anterior ulnar collateral.

29
Relationships
  • Radial nerve to deep brachial artery in radial
    (spiral groove).
  • Brachial artery to median nerve.
  • Brachial artery to bicipital aponeurosis.
  • Superior ulnar collateral artery to medial
    epicondyle.

30
Relationships
  • Inferior ulnar collateral artery to medial
    epicondyle.
  • Radial collateral artery to lateral epicondyle.
  • Median cubital vein to bicipital aponeurosis.

31
Relationships
  • Ulnar nerve to medial epicondyle.
  • Musculocutaneous nerve to coracobrachialis
    muscle.
  • Musculocutaneous nerve to biceps and brachialis
    muscles.
  • Lateral cutaneous nerve of the forearm to the
    bicipital tendon.

32
CUBITAL FOSSA
33
Cubital Fossa Boundaries
  • Lateral
  • Brachioradialis muscle
  • Medial
  • Pronator teres muscle
  • Superior base
  • Line between two humeral epicondyles
  • Floor
  • Supinator and brachialis muscles

34
Cubital Fossa Contents
  • Lateral to medial
  • Biceps Tendon
  • Brachial Artery
  • Median Nerve
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