Anatomy Flashcards
Dermatomes
Pharynx innervation
IX: glosopharyngeal
XII: hypoglossal
cartilages of the larynx
hyoid
thyroid
cricoid
aretynoid (attached to cricoid and have attached to them the VCs)
epiglottic
Larynx Innervation
CN X
- SLN
- RLN
SLN
- internal laryngeal branch: pierces thyrohyoid membrane–sensation from epiglottis to vocal cords
- external laryngeal branch: cricothyroid muscle (tensor of vocal cords)
RLN
- sensation below vocal cords, motor to all laryngeal muscles except cricothyroid
- bilateral injury–adduction of vocal cords and rapid, severe respiratory obstruction
- enters larynx psoterior to cricothyroid articulation–blocked by transtracheal approach
- RLN runs in a groove between trachea and esophagus–blocked by stellate ganglion block
Tracheal Innervation
Vagus CN X
Roots of brachial plexus
anterior primary divisions C5-8 +T1, with contributions from C4 and T2
Division of brachial plexus
Robert Taylor Drinks Cold Beer
Roots
Trunks
Divisions
Cords
Branches
Roots
-anterior primary division of C8-T1, emerge from intervebral foramina, fuse above first rib
Trunks
-above first rib
Divisions
-Each trunk forms anterior and posterior divisions
Cords
- 3 cords: medial, lateral, posterior
- medial/lateral:flexor surfaces of UE
- posterior cord: extensor surfaces of UE
Branches-Terminal nerves
Lateral/medial cord: lateral/medial head of median
medial cord: ulnar
lateral cord: musculocutaneous
posterior cord: axillary, radial
axillary nerve block
- prevertebral fascia forms axillary perivascular sheath, which envelopes the brachial plexus and axillary artery
- median nerve: above ax artery
- ulnar nerve: below ax artery
- radial nerve: posterior/inferior to artery–needle passes posterior wall of ax artery
- misses musculocutaneous b/c came off already
interscalene block
- at level C6/cricoid cartilage
- between anterior and middle scalene muscles
- brachial plexus and subclavian artery run together
- needle enters skin posterior to posterior border of sternocleidomastoid muscle behind the EJ
- anterior scalene is just posterior to the posterior aspect of sternocleidomastoid at the level of the cricoid
supraclavicular block
- enter skin 1-2 cm above midpoint of clavicle and elicit paresthesias as needle advanced toward 1st rib
- when first rib contacted, needle moved in anteroposterior direction until paresthesias elicited
cutaneous nerves of the hand