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Upper Limb- Blood & nerve supply; effects of nerve injury

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Lufukuja G. 3

Clavipectoral fascia

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Applied anatomy The cubital fossa is the

common site for sampling and transfusion of blood and

intravenous injections because of the prominence and accessibility of veins.

Usually, the median cubital vein or basilic

vein is selected

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Applied anatomy.. The median cubital vein lies directly on the deep fascia,

crossing the bicipital aponeurosis(grace Deux (Fr. grace of God) tendon), which separates it from the underlying brachial artery and median nerve and

provides some protection to the latter.

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Anastomosis around the elbow joint

8LG

Anastomosis …

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Lufukuja G. 11

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• The musculocutaneous nerve has a segmental origin - C5-C6. As its name suggests, it has both motor and sensory fibres. The nerve usually passes through the coracobrachialis and between the biceps and the brachialis and at the elbow it becomes the lateral antebrachial cutaneous nerve. Above the elbow it supplies only motor nerves but below the elbow it contains only sensory fibres

• Lesions of the nerve produce weakness of flexion at the elbow and weakness of supination. Weakness of elbow flexion and forearm supination.Sensory loss over the lateral and volar aspect of the forearm.

• Weak or absent biceps tendon reflex. Being a lower motor neurone lesion, other expected signs include poor muscle tone, marked wasting and possibly fasciculation

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• Median nerve palsy. If the median nerve is damaged, the ability to abduct and oppose the thumb may be lost due to paralysis of the thenar muscles (ape-hand deformity)

• Sensory loss in the thumb, index finger, middle finger, and the radial aspect of the ring finger

• Weakness in forearm pronation and wrist and finger flexion

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• Carpal Tunnel Syndrome: a painful condition of the hand and fingers caused by compression of a median nerve where it passes over the carpal bones through a passage at the front of the wrist, alongside the flexor tendons of the hand. It may be caused by repetitive movements over a long period, or by fluid retention, and is characterized by sensations of tingling, numbness, or burning.

• Pressure on or injury to the ulnar nerve

• Abnormal sensations in the little finger and part of the ring finger, usually on the palm side

• Loss of coordination of the fingers• Numbness, decreased sensation• Pain, Tingling, burning sensation• Weakness and clumsiness of the

hand• An ulnar claw, also known as claw

hand,  is an abnormal hand position that develops due to a problem with the ulnar nerve.

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• Injury to the radial nerve usually causes symptoms in the back of the hand, near the thumb, and in the index and middle fingers. Symptoms may include:

• sharp or burning pain• numbness or tingling• trouble straightening the arm• trouble moving the wrist and fingers• “drooping” of the wrist and fingers (not

being able to extend or straighten the wrist and fingers), also called “wrist drop” and “finger drop”

• weak hand grip

THANK YOU

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