Deep veins
Paired, accompany brachial artery (venae comitantes)
Form at elbow from radial and ulnar veins
Have valves
Merge with basilic vein to form axillary veinLymphatics
All lymph from the arm drains to the axillary nodes
Lymph from breasts and thorax also drains to the nodesNerve Supply to Upper Limb
Brachial Plexus [C5-T1]
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Composed of
Roots (5)
Trunks (3)
Divisions (6)
Cords (3)
Branches (13+4 from roots)
Roots
Ventral rami of spinal nerves C5-T1
Give rise to
Dorsal scapular nerve (C5, possible contribution from C4)
Long thoracic nerve (C5-C7) to serratus anterior muscle
Trunks
Superior from ventral rami of C5 and 6
Branches
a. Nerve to subclavius muscle
b. Suprascapular nerve to supra- and infraspinatus, shoulder joint
Middle from ventral ramus of C7
Inferior from ventral rami of C8 and T1
Divisions
Anterior divisions of superior and middle trunks form lateral cord
Anterior division of inferior trunk continues as medial cord
Posterior divisions of all three trunks for posterior cord
Cords
Named by relationship to axillary artery, which they surround
Lateral
Medial
Posterior
Branches
Branches from lateral cord
Lateral pectoral nerve (C5-C7) to pectoralis major and minor muscles
Musculocutaneous (C5-C7)
Lateral root of median nerve (C6-C7)
Branches from medial cord
Medial pectoral nerve (C8-T1) to pectoralis minor and major
Ulnar nerve (C8-T1)
Medial brachial cutaneous nerve (C8-T1) supplies skin over medial surface of arm and proximal surface of forearm
Medial antebrachial cutaneous nerve (C8-T1) to skin over medial forearm
Median root of median nerve (C8-T1)
Branches from the posterior cord
Upper subscapular nerve (C5-C6) to subscapularis
Lower subscapular nerve (C5-C6) to teres major and subscapularis
Thoracodorsal nerve (C6-C8) to latissimus dorsi
Axillary nerve (C5-C6) to teres minor and deltoid (ends as the upper lateral brachial cutaneous nerve)
Radial nerve (C5-T1) supplies all extensors of the upper limb and sensation to skin overlying extensor region, including hand
Other facts
Anterior divisions supply the flexor parts of the upper limb
Posterior divisions supply the extensor parts of the upper limb
Each cord divides into two main terminal branches
Posterior→axillary and radial
Lateral→musculocutaneous and median
Medial→Median and ulnar
Supraclavicular part of plexus
Arises from roots and trunks
Approachable through posterior triangle of the neck
Dorsal scapular nerve
Nerve to subclavius
Suprascapular nerve
Long thoracic nerve
Infraclavicular part (cords and their branches) is in the axilla
Arise from cords