This material was prepared for the use of the students of OTPT 102: Applied AnProfessions of the University of the Philippines, Ma

material was prepared for the use of the students of OTPT 102: Applied Anatomy and Kinesiology, AY 09-10 of the College of Allied MedicalProfessions of the University of the Philippines, Manila. Please obtain permission before use.

10 of the College of Allied Medical

This material was prepared for the use of the students of OTPT 102: Applied Anatomy and Kinesiology, AY 09-10 of the College of Allied MedicalProfessions of the University of the Philippines, Manila. Please obtain permission before use.

Learning Objectives:

At the end of the SGD and didactics, the student should be able to:1. Describe brachial plexus in terms of:

a. Roots, trunks, divisions, cords and branchesb. Pathwayc. Motor distributiond. Sensory distribution

2. Describe the arterial and venous circulation of the upper extremity in terms of:a. Vesselsb. Pathwayc. Distributiond. Function

3. Describe the lymphatic circulation of the upper extremity.

Materials to bring and use:1. Wires or strings of different colors (at least 5 colors)2. Colored pens (water-based or non-permanent so that the ink can be easily washed)3. Masking or transparent tape

Uniform1. Kinesiology suits for females2. Sleeveless shirts for males

_____________________________________________________________________________________

I. The Brachial PlexusA. Component nerve roots of the brachial plexus – the brachial plexus is made up of 5 nerve

roots. Name them1. _______2. _______3. _______4. _______5. _______

B. Parts of the brachial plexus1. The 5 nerve roots combine to form 3 trunks. What are they?

a.___________________b.___________________c. ___________________

2. Each trunk divides into 2 divisions (total of six). The anterior divisions and the posteriordivisions. These divisions will then combine to form the cords of the brachial plexus.Fill in the blanks below.

a.Two anterior divisions combine to form the ________________ cord.b.The remaining anterior division will continue as the _________ cord.c. The three posterior divisions will combine to form the ________ cord.

3. The five major branches of the brachial plexus arise from the cords. The majorbranches are listed below. Indicate from which branch they come from.

This material was prepared for the use of the students of OTPT 102: Applied Anatomy and Kinesiology, AY 09-10 of the College of Allied MedicalProfessions of the University of the Philippines, Manila. Please obtain permission before use.

Cords Branches

a.RadialAxillary

b. Musculocutaneousc.

Mediand.e. Ulnar

The table indicates that the radial and axillary nerves arise from a common cord (a);the musculocutaneous nerve arises from one cord (b); the median nerve comes fromthe joining of two cords (c & d); and the ulnar nerve is a branch of one cord.

4. The brachial plexus has several smaller branches, which are listed below. The smallerbranches arise from either directly from the nerve roots, the trunks, or the cords.Indicate in the table from where the small branches of the brachial plexus arise from.The first row is filled up to serve as an example.

Branches Source /s: state which nerve root/s,trunk/s, cord/s

Long thoracic nerve C5, C6, C7 nerve rootsSuprascapular nerveLateral pectoral nerveDorsoscapular nerveUpper subscapular nerveLower subscapular nerveThoraco dorsal nerveMedial pectoral nerveMedial brachial cutaneous nerveMedial antebrachial cutaneous nerve

5. The following is an illustration of the brachial plexus within the upper arm. Label theparts marked by the black lines.

6. The following is a schematic diagram of the brachial plexus. Label each part (markedby the red lines) at all levels from the nerve roots to the branches.

This material was prepared for the use of the students of OTPT 102: Applied Anatomy and Kinesiology, AY 09-10 of the College of Allied MedicalProfessions of the University of the Philippines, Manila. Please obtain permission before use.

7. Label the parts of the brachial plexus in another schematic illustration.

8. Use the space below to come up with your own schematic diagram of the brachialplexus. Make sure that all parts are represented in your illustration.

9. Fill-up the table below. Use another sheet if the responses will not fit. Use yourknowledge of muscle innervations from previous topics.

This material was prepared for the use of the students of OTPT 102: Applied Anatomy and Kinesiology, AY 09-10 of the College of Allied MedicalProfessions of the University of the Philippines, Manila. Please obtain permission before use.

NerveNerve rootscontributingto the nerve

Function(motor orsensory)

Musclesinnervated if

motor

Areas innervatedif sensory

Axillary C5 C6 Both Deltoid Teres

minor

Skin over lateralpart of the arm

Radial Ulnar Musculocutaneous Median Long thoracic Suprascapular Lateral pectoral Dorsoscapular Upper subscapular Lower subscapular Thoraco dorsal Medial pectoral Medial brachialcutaneous

Medial antebrachialcutaneous

C. Exercises (graded as a quiz)

1. Using colored wires or strings, develop a representation of the brachial plexus that youcan attach to a mounted skeleton using adhesive tape. Make sure that each componentis accurately represented in terms of origins, distribution and length. It is suggested thatyou use wires or strings of 5 different colors in order for you to be able to trace thebranches of the brachial plexus from the nerve roots. (Graded)

2. Choose a partner from your group mates. Using colored markers, mark the pathway ofeach branch of the brachial plexus on an extremity of your partner. Mark areassupplied by the sensory branches and the muscles innervated by the motor branches.(Graded)

II. Arterial Circulation of the Upper ExtremityA. Arterial pathway. The following are the names of the major parts of the arterial

system that supply the upper extremities. Using a schematic diagram, arrange theparts in the order that blood flows from the heart to the hands. Use a separate sheetfor your illustration. (Graded)

1. Ulnar artery2. Superficial palmar

arch3. Subclavian artery4. Radial artery5. Digital arteries

6. Deep palmar arch7. Brachial artery8. Axillary artery9. Ascending aorta10. Aortic arch

This material was prepared for the use of the students of OTPT 102: Applied Anatomy and Kinesiology, AY 09-10 of the College of Allied MedicalProfessions of the University of the Philippines, Manila. Please obtain permission before use.

B. The following are smaller branches of the arterial system for the upper extremities.Indicate from which major artery the following arise from.

Arterial branch OriginAnterior circumflexAnterior interosseusAnterior ulnar recurrentCommon interosseusInferior ulnar collateralInterosseus recurrentPosterior circumflexPosterior interosseusPosterior metacarpalPosterior ulnar recurrentProfunda brachiiRadial recurrentSuperior ulnar collateral

C. Using your answers from the previous segment, insert the arteries in the table in Binto your schematic diagram. Use a separate sheet. (Graded)

D. Exercise. Using the colored pens, illustrate the pathways of the arteries on oneextremity of your partner. Ensure accuracy of illustrations. (Graded)

III. Venous Circulation of the Upper ExtremityA. Venous circulation. Develop a schematic diagram representing the venous circulation for

the upper extremities. Trace the pathways from the most distal to the most proximal. Useyour experience in the arterial circulation to insert smaller branches contributing to theformation of bigger veins. (Graded)

1. Axillary vein2. Cephalic vein3. Venae comitantes4. Medial cubital vein5. Anterior median vein of

the forearm6. Basilic vein

7. Cephalic vein8. Median cubital vein9. Median basilic vein10. Median cephalic vein11. Dorsal venous network12. Palmar digital veins13. Subclavian vein

B. Exercise. Using the colored pens, illustrate the pathways of the veins on one extremity ofyour partner. Ensure accuracy of illustrations. (Graded)