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REVIEW OF BLOOD SUPPLY OF HAND( Series 01) – Anatomy

REVIEW OF BLOOD SUPPLY OF HAND( Series  01) – Anatomy

BASIC REVIEW

Main Arteries Involved:

1.       Subclavian Artery

2.       Axillary Artery

3.       Brachial Artery

4.       Radial Artery

5.       Ulnar Artery

SUBCLAVIAN ARTERY:

Left Subclavian artery arises from Aorta

Right Subclavian artery arises from brachiocephalic truck

When the subclavian arteries cross the lateral edge of the 1st rib, they enter the axilla, and are called axillary arteries.

AXILLARY ARTERY

It passes through the axilla just under the pectoralis minor muscle enclosed within the axillary sheath.

At the level of the humeral surgical neck, the posterior and anterior circumflex humeral arteries arise.

The subscapular artery, the largest branch of the axillary artery, arises at the lower border of the Subscapularis muscle.

The axillary artery becomes the brachial artery at the level of the teres major muscle.

BRACHIAL ARTERY

The brachial artery is the main source of blood for the arm

Immediately distal to the teres major, the brachial artery gives rise to the profunda brachii – the deep artery of the arm (It supplies structures in the posterior aspect of the arm).

The brachial artery descends down the arm immediately posterior to the median nerve.

When it crosses the cubital fossa, underneath the brachialis muscle, the brachial artery terminates by bifurcating into the radial and ulnar nerves.

RADIAL and ULNAR ARTERY:

The radial artery supplies the posterior aspect of the forearm and the ulnar artery supplies the anterior aspect.

The two arteries anastomose in the hand, by forming two arches, the superficial palmar arch, and the deep palmar arch.

Causes for Soft First heart sound

Causes for Soft First heart sound

(I MiT RAP where I is for first sound)

Mitral Regurgitation

Tricuspid Regurgitation

Right or left ventricular dysfunction

Acute AR

Prolonged PR interval

Calcified valve in tricuspid or mitral stenosis

Klinefelter’s syndrome

Klinefelter’s syndrome

Affects 1 in 1000 males

Karyotype :  47XXY or 46XY/47XXY mosaicism

The main pathological abnormality is dysgenesis of the seminiferous tubules. Mostly by puberty hypogonadism is evident.

Clinical features :

·         Usually presents during adolescents with gynecomastia and failure to progress normally through puberty.

·         Small, firm testis

·         Tall stature (due to delayed or lack of epiphyseal closure)

·         Learning difficulties and behavioural disorders (rarely)

·         Predisposition to type 2 DM in later life.

·         46XY/47XXY mosaicism may pass through the puberty uneventfully and is usually diagnosed as a part of infertility treatment.

Diagnosis

                Karyotype analysis.

Treatment

                Androgen replacement

MCQ - Surgery

ANSWER : B. Recombinant human erythropoietin 

MCQ SURGERY

Answer is :           C. Below verumontanum

MALE URETHRA RELEVANT ANATOMY

MALE URETHRA RELEVANT ANATOMY

It has four parts

1.       Prostatic

2.       Membranous

3.       Bulbar

4.       Penile

What is Verumontanum?

                It’s a small hillock of tissue indented at its crown by a pit called utriculus masculinus which marks the proximal extent of the external urethral sphincter and is an important landmark for urologists performing transurethral prostate resection.

What is Navicular Fossa?

              The penile urethra becomes dilated at the glans penis where is called navicular fossa.

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Commonest site of urethral injury during pelvic fracture?

              Membranous urethra