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Upper limbs (axilla 腋窩 (brachial plexus 臂神經叢 (分支圖 (C6, C7 (middle), C8…
Upper limbs
axilla 腋窩
posterior wall
quadrangular space
muscle
前面觀
外：humerus
下：teres major
上：subscapularis
內：long head of triceps branchii
後面觀
上：teres minor
nerve
axillary nerve
vessel
posterior circumflex humeral artery & vein
triangular interval
muscle
前面觀
上：teres major
外：humerus
內：long head of triceps branchii
後面觀
same
nerve
radial nerve
vessel
profounda branchii artery
triangular space
muscle
前面觀
外：long head of triceps branchii
下：teres major
上：subscapularis
後面觀
上：teres minor
vessel
circumflex scapularis artery
axillary artery
boundary
lateral margin of rib1~
lower border of teres major
rib1以上：subclavian artery
teres major以下：brachial artery
3 parts
1st
superior thoracic artery
subclavius 下方
2nd
thoraco-acromial artery
4 branches
acromial branch
pectoral branch
deltoid branch
clavicular branch
供應
anterior wall
被pactoralis minor 覆蓋
lateral thoracic artery
pactoralis minor 下緣
供應
medial & posterior wall
與long thoracic nerve伴行
3rd
subscapular artery
分支中最粗大
供應
posterior wall & posterior scapular
2 branches
circumflex scapular branch
triangular space
thoracodorsal artery
anterior circumflex humeral artery
走在肱骨前
posterior circumflex humeral artery
穿過
quadrangular space
走在肱骨後
比前旋肱動脈"粗"
axillary vein
basilic vein 貴要靜脈
向上的延伸
brachial plexus
臂神經叢
分支圖
C6
C7
middle
C8
inferior
medial cord
medial root
ulnar nerve
T1
C5
superior
posterior cord
radial nerve
axillary nerve
lateral cord
musculocutaneous nerve
lateral root
median nerve
ROOT
C5
dorsal scapular nerve
支配
levator scapulae
rhomboid minor
rhomboid major
C5、6、7
long thoracic nerve
走在前鋸肌"上方"(特殊)
支配
serratus anterior
TRUNK
superior (C5、6)
suprascapular nerve
支配
suprasinatus
infraspinatus
走在脊上、下肌深層，superior transverse scapular ligament下方
(suprascapular artery & vein走在韌帶上方)
to subclavius muscle
CORD
posterior cord
C5、6
upper subscapular nerve
支配
subscapularis
短
C6、7、8
middle subscapular nerve
(thoracodorsal nerve)
支配
latissimus dorsi
從肩胛下肌上方飛過~
C5、6
lower subscapular nerve
支配
teres major
subscapularis
medial cord
C8、T1
medial pectoral nerve
支配
pectoralis major
pectoralis minor
"穿過"胸小肌的肌肉質，又到胸大肌
T1
medial cutaneous nerve of arm
C8、T1
medial cutaneous nerve of forearm
lateral cord (C5、6、7)
lateral pectoral nerve
支配
pectoralis major
"繞過"胸小肌，去支配胸大肌
TERMINAL BRANCHES
C5、6、7
musculocutaneous nerve
支配
muscles of the arm
(flexor/anterior)
先穿過喙肱肌，走在二頭肌和肱肌之間
穿出後
前臂外側皮神經
C5、6
axillary nerve
穿過
quadrangular space
支配
deltoid
teres minor
C5、6、7、8、T1
radial nerve
支配
muscles of the whole arm
(extensor/posterior)
受傷
wrist drop
C5、6、7、8、T1
median nerve
支配
hand
大魚際肌群
most muscles of the forearm
(anterior)
C7、8、T1
ulnar nerve
支配
hand
小魚際肌群、掌側背測骨間肌
1.5 muscles of the forearm
(anterior)
受傷
clawhand
hand
bone
proximal row
dorsal view
scaphoid
舟狀骨 (橈側)
lunate
月狀骨
triquetrum/triquetral
三角骨
pisiform
豆狀骨 (尺側)
distal row
dorsal view
trapezium
大菱形骨 (橈側)
trapezoid
小菱形骨
capitate
頭狀骨
hamate
鉤狀骨 (尺側)
carpal arch
開口朝向手掌
trapezium
trapezoid
capitate
hamate
triquetrum
pisiform
(tubercle)
9條肌腱，1條神經
穿過carpal tunnel
median nerve
in tendon shealth
flexor pollicis longus tendon (1)
屈姆長肌肌鍵
in common flexor shealth
flexor digitorum superficialis tendon (4)
屈指淺肌肌腱
flexor digitorum profundus tendon (4)
屈指深肌肌腱
transverse carpal ligament / flexor retinaculum
橫腕韌帶 包覆
muscles
palmaris brevis muscle
掌短肌
palmar aponeurosis
掌腱膜
thenar muscles
大魚際肌群
flexor pollicis brevis
屈拇短肌
abductor pollicis brevis
外展拇短肌
opponens pollicis
拇對指肌
recurrent branch of median nerve 支配
hypothenear muscles
小魚際肌群
flexor digiti minimi brevis
屈小指短肌
abductor digiti minimi
外展小指肌
opponens digiti minimi
小指對指肌
deep branch of ulnar nerve 支配
adductor pollicis
內收拇肌
ulnar nerve 支配
lumbricals (4)
蚓狀肌
1&2
median nerve 支配
3&4
deep branch of ulnar nerve 支配
dorsal interossei (4)
背側骨間肌
palmar interossei (3)
掌側骨間肌
artery
radial artery
淺分支接合形成
superficial palmar arch
淺掌弓
common palmar digital artery
總掌指動脈
proper palmar digital artery (2)
ulnar artery
nerve
手掌
第1、2、3、4半指
median nerve
第4半、5指
ulnar nerve
手背
第1、2、3、4半指尖端
median nerve
第1、2、3、4半指
radial nerve
第4半、5指
ulnar nerve
brachial artery
3 branches
profonda branchii artery
(deep branchii)
radial collateral artery
middle collateral artery
triangular interval
superior ulnar collateral artery
inferior ulnar collateral artery
延伸
ulnar artery
anterior ulnar recurrent artery
接
肱骨內上髁"前"
posterior ulnar recurrent artery
接
肱骨內上髁"後"
common interosseous artery
posterior interosseous artery
分出
recurrent interosseous artery
接
anterior interosseous artery
radial artery
radial recurrent artery
接
boundary
lower border of teres major
以上：axillary artery
以下：brachial artery
上肢神經支配(大概念)
anterior
上臂
musculocutaneous nerve
前臂
most
median nerve & 其分支
1.5
flexor carpi ulnaris muscle
ulnar nerve
flexor digitorum profundus muscle
手
大魚際肌群
median nerve
小魚際肌群
掌側背側骨間肌
ulnar nerve
posterior
整條手臂
radial nerve
forearm
anterior
superficial layer
muscles
共同origin
medial epicondyle of humerus
pronator teres
旋前圓肌
flexor carpi radialis
橈側屈腕肌
palmaris longus
掌長肌
flexor carpi ulnaris
尺側屈腕肌
ulnar nerve
可見血管&神經
brachial artery & median nerve
ulnar artery & nerve
median nerve
intermediate layer
muscles
flexor digitorum superficialis
屈指淺肌
可見血管&神經
radial nerve & artery
median nerve
radial artery
ulnar artery
median nerve
deep layer
muscle
flexor digitorum profundus
屈指深肌
第2、3指由anterior interosseous nerve支配
第4、5指由ulnar nerve支配
flexor pollicis longus
屈拇長肌
anterior interosseous nerve
pronator quadratus
旋前方肌
anterior interosseous nerve
可見血管&神經
median nerve
ulnar nerve & artery
anterior interosseous nerve & artery
common interosseous nerve
nerve
median nerve
anterior interosseous nerve
(正中神經的分支)
ulnar nerve
posterior
superficial layer
6 muscles
common origin
lateral epicondyle of humerus
brachioradialis
肱橈肌
extensor carpi radialis longus
橈側伸腕長肌
extensor carpi radialis brevis
橈側伸腕短肌
extensor digitorum
伸指肌
extensor digiti minimi
伸小指肌
extersor carpi ulnaris
尺側伸腕肌
radial nerve
deep layer
5 muscle
supinator
旋後肌
abductor pollicis longus
外展拇長肌
snuff box
extensor pollicis brevis
伸拇短肌
extensor pollicis longus
伸拇長肌
extensor indicis
伸食指肌
可見血管&神經
posterior interosseous artery
deep branch of radial nerve
走在旋後肌之下
穿出
posterior interosseous nerve
superficial branch of radial nerve
走在肱橈肌之下，旋後肌之上
posterior interosseous nerve
nerve
radial nerve
posterior interosseous nerve
(橈神經的分支)
前骨間神經 [辨識]
deep layer
2.在pronator teres 有分支出來
3.與anterior interosseous artery一起走
cephalic vein
頭靜脈
注入
median cubital vein
正中肘靜脈
上肢抽血首選位置
basilic vein
貴要靜脈
過 teres major 下緣
改名
ROOT
TRUNKS
DIVISIONS
CORDS
TERMINAL BRANCHES
(PERIPHERAL NERVES)
前下後上
※ulnar nerve & artery 沒有經過carpal tunnel & cubital fossa