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Neurology > Barajon - PNS > Flashcards

Barajon - PNS Flashcards

1
Q

What is a spinal nerve?

A

a spinal nerve is mixed (carries both motor and sensory neurons). there are 31 pairs in the body, each corresponding to vertebral segments of the vertebral column. (8 cervical, 12 thoracic, 5 lumbar, 5 sacral, 1 coccygeal).

each spinal nerve is formed by the combination of nerve fibres from the dorsal and ventral roots of the spinal cord.

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2
Q

what are the branches of each spinal cord?

A

each spinal cord divides into mixed dorsal and ventral rami.

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3
Q

what is the dorsal ramus of spinal nerves?

  • branches
  • innervates (rough)
A

each doral (posterior) ramus divides into medial and lateral branches. they supply the deep intervertebral muscles, long muscles of the back and overlying skin.

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4
Q

what does the posterior ramus of C1 supply?

A

the posterior ramus of C1 is also the suboccipital nerve. it supplies the suboccipital muscles.

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5
Q

what is the posteior ramus of C2?

A

the posterior ramus of C2 is also the greater occipital nerve and is a large sensitive medial branch.

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6
Q

what are the 4 suboccipital muscles supplied of the suboccipital nerve?

A

the suboccipital nerve of C1 supplies:

  1. rectus capitis posterior major
  2. rectus capitis posterior minor
  3. oblique capitis inferior
  4. oblique capitis superior
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7
Q

what do the anterior rami of spinal nerves form?

A

the anterior (ventral) rami of spinal nerves form plexuses.

  • cervical plexus (C1-C4/C5)
  • brachial plexus (C5-T1)
  • lumbar plexus (L1-L4)
  • Sacral plexus (L4-S3)
    + Pudendus (S2-S4) —– (sacral parasympathetic)
    + Coccygeal (S5-Co1)
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8
Q

why do plexuses form?

A

plexuses are formed dues to the fact that a muscle usually originates from more than one myotome (and a myotome more than one muscle) and therefore more than one nerve innervates it (and a nerve can innervate more than one muscle)

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9
Q

what is the posterior triangle of the neck?

  • boundries
  • contents
A

the posterior triangle of the neck is formed by:

  • clavicle (base)
  • sternocleomastoid muscle (anterior)
  • trapezius muscle (posterior)

contains the branches, roots and trunks of the cervical plexus
as well as CN XI, phrenic nerve

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10
Q

what is the composition of the cervical plexus?

A

anterior rami of C1 to C4 form the cervical plexus plus fibres from C5

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11
Q

what are the branch types of the cervical plexus?

A
  1. cutaneous branches
  2. muscular branches
  3. terminal branches
    + phrenic nerve (C3,4,5)
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12
Q

what do the cutaneous branches of the cervical plexus serve?

A

innevate the nexk, shoulder, thorax and ear regions

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13
Q

what do the muscular branches of the cervical plexus serve?

A
  • prevertebral muscles
    - anterior and lateral rectus capitis
    - longus capitis and coli
    - middle scalenus
    - lavator scapulae

plus

  • sternocleomastoid and trapezius (via CN XI)
  • some suprehyoidal muscles (via CN XII)
  • Infra superhyoidal muscles (via ansa cervicalis)
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14
Q

what is the ansa cervicalis and what does it serve?

A

the ansa cervicalis is a loop of fibres from C1, C2 and C3 that innervate muscles in the anterior triangle of the neck. two roots:
1. superior root of ansa cervicalis
- C1 and hypoglossal nerve fibres
- forms descending hypoglossal
(some fibres of C1 remain in the hypoglossal CN XI nerve once divided)

  1. inferior root of ansa cervicalis
    - C2-C3
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15
Q

what is the phrenic nerve?

- course and innervation

A

the phrenic nerves are formed from anterior rami of C4 + C3/C5 fibres.

course:

  • anterior surface of the anterior scalenus
  • between the subclavian artery and vein
  • anterior to apex of lungs
  • mediastinal face of lungs, anterior to hilum
  • to the diaphragm

innervate:

  • muscle branches: diaphragm
  • sensory branches: pleura, pericardium and peritoneum

phrenic nerve pain is usually felt as reffered pain (cutanous innervation by C4 anterior rami of spinal nerve)

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16
Q

what is the composition of the brachial plexus?

A

anterior rami of spinal nerves C5 to T1 + (C4/T2)

- Connects with the paravertebral chain via 5 grey rami communicantes and 1 white communicante

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17
Q

what are the components of the brachial plexus?

A
  • roots: from C5-T1
  • trunks: superior (C5/C6), middle (C7), inferior (C8/T1)
  • divisions: 6 divisions, 2 from each trunk (anterior and posterior)
  • cords: lateral, posterior, medial (arranged around axillary artery
  • terminal nerves
  • roots, trunks, and cords also have collateral branches
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18
Q

what are the collateral branches of roots of brachial plexus?

A
  1. dorsal scapular nerve&raquo_space;> rhomboids and levator scapulae

2. long thoracic nerve&raquo_space;> seratus anterior

19
Q

what are the collateral branches of trunks of brachial plexus?

A
  1. suprascapular nerve
    nerve to subclavius muscle
    both from superior trunk (only trunk to give rise to collaterals)
20
Q

what are the collateral branches of the lateral cord of brachial plexus?

A
  1. lateral pectoral nerve&raquo_space;> pectoralis major
21
Q

what are the collateral branches of the medial cords of brachial plexus?

A
  1. medial pectoral nerve&raquo_space;> pectoralis minor
  2. medial cutanous nerve of the arm
  3. medial cutanous nerve of the forearm
22
Q

what are the collateral branches of the posterior cord of brachial plexus?

A
  1. superior subscapular nerve&raquo_space;> supra + infra spinatus
  2. thoracodorsal nerve (middle subscapular)&raquo_space;> latissimus dorsi
  3. inferior subscapular nerve&raquo_space;> infra spinatus +teres major
23
Q

what are the terminal branches of the brachial plexus and from what cords do they arise?

A
  1. musculocutanous nerve (lateral cord)
  2. axillary nerve (posterior cord)
  3. radial nerve (posterior cord)
  4. median nerve (lateral and medial cords)
  5. ulnar nerve (medial cord)
24
Q

what is the musculocutanous nerve?

A

the musculocutanous nerve araises from the lateral cord of the brachial plexus.

the musculocutanous nerve supplies all muscles in the anterior compartment of the arm.

  • flexion of arm
  • flexion of forearm
  • supination of forearm

the lateral antebrachial nerve araises from the musculocutanous nerve and supplies the skin of the forearm

25
Q

what is the axillary nerve?

  • origin
  • muscle innervation
  • cutaneous innervation
A

the axillary nerve arises from the posterior cord of the brachial plexus.

the axillary nerve supplies the teres minor and the deltoid:

  • abduction of arm
  • lateral rotation of arm

the axillary nerve also supplies the skin of the shoulder

26
Q

what is the radial nerve?

  • origin
  • muscle innervation
  • cutaneous innervation
A

the radial nerve is a terminal branch of posterior cord of the brachial plexus.

the radial nerve innervates the muscles in the posterior compartments of the arma nf forearm.
- (travels through the lateral intermuscular septum)

the radial nerve also innervates the skin of the arm, forearm and hand

27
Q

what is the median nerve?

  • origin
  • muscle innervation
  • cutaneous innervation
A

the median nerve is a terminal branch of the lateral and medial cords of the brachial plexus.

the medial nerve supplies the muscles in the anterior compartment of the forearm and some of the hand muscles.

also the skin of the hand

28
Q

what is the ulnar nerve?

  • origin
  • muscle innervation
  • cutaneous innervation
A

the ulnar nerve is a terminal branch of the medial cord of the brachial plexus

the ulnar nerve innervates most intrinsic muscles of the hand and two muscles in the anterior compartment of the forearm.

also supplies the skin of the hand (little finger, some palm)

29
Q

what is the composition of the lumbosacral plexus?

A

the lumbosacral plexus is formed from anterior rami of spinal nerves L1-L4 plus anastomoses of T12.

  • white communicantes from L1, L2
  • grey communicantes from L1, L2, L3, L4
30
Q

where does the lumbosacral plexus emerge?

A

the lumbosacral plexus emerges relative to the psoas major muscle.

31
Q

what are the long collateral branches fo the lumbosacral plexus?

A
  • iliohypogastric nerve (L1)
  • ilioinguinal nerve (L1)
  • genitofemoral nerve (L1, L2)
32
Q

what does the ilioinguinal nerve supply?

A

muscular branches of the ilioinguinal nerve supplies the internal obique and transversus abdominis

plus cutanous branches

33
Q

what does the iliohypogastric nerve supply?

A

the muscular branches fo the iliohypogatric nerve suppies the internal oblique and the transversus abdominis

plus cutanous branches.

34
Q

what does the genitofemoral nerve supply?

A

muscular branches of the genitofemoral nerve supply the cremasteric muscle

plus cutanous branches

35
Q

what are the terminal branches of the lumbar plexus?

A
  1. femoral nerve

2. obturator nerve

36
Q

what is the obturator nerve?

  • origin/course
  • muscular
  • cutaneous
A

the obturator nerve is a terminal branch of the lumbar plexus, made up of L2, L3, L4 anterior rami of spinal nerves.

the obturator nerve crosses the sacro-iliac joint, enters the obturator canal to the medial compartment of the thigh.

the obturator nerve supplies the obturator externus, adductor magnus, adductus longus and adductus bravis and the gracile muscle.

plus cutaneous branches that supply the skin of the inferiomedial thigh and internal knee.

37
Q

what is the femoral nerve?

  • origin
  • muscular
  • cutaneous
A

the femoral nerve is a terminal branch of the lumbar plexus.

the femoral nerve supplies the lower lateral border of the psoas below the inguinal ligament, plus the femoral triangle.
suplies muscles:
  - sartorius
  - pectineus
  - quadriceps
  - ileopsoas
  - adductor longus

plus cutaneous branches supply the anteromedial thigh. and branches of the femoral (saphenous) supply the medial leg and foot.

38
Q

what is the lumbosacral trunk?

A

the lumbosacral trunk is formed from anterior rami of spinal nerve S1-S4

it supplies the minor pelvis, anterior face of the piriform muscle.

each anterior ramus divides into an anterior and posterior division

39
Q

what are the collateral branches of the sacral plexus?

A
  1. posterior: superior and inferior gluteal nerve
  2. anterior: nerve to obturator internus and superior gemelus
    nerve to quadratus femoris and inferior gemelus
40
Q

what is the pudenal nerve?

A

the pudenal nerve is formed of anterior rami of spinal nerves S2-S4. it supplies the skeletal muscles of the perineum and skin.

41
Q

what is the sciatic nerve?

  • origin
  • muscles
A

the sciatic nerve is formed by the combination of the tibial and common peronal nerve int he posterior region of the thigh. it contains fibres from the anterior rami of spinal nerves L4 to S3

the sciatic nerve innervates the thigh muscles:

  • biceps
  • semimembranous
  • semitendinosus
  • adductor magnus
42
Q

what are intercostal nerve?

- groups

A

intercostal nerves arise from anterior branches of the thoracic nerve.
intercostal nerves run in the intercostal spaces and give off lateral and anterior cutanous branches.

the nerve from the superior group (T1-T6) run up to the sternum and innervate:

  • intercostal muscles
  • tranversus thoracis
  • levator costal
  • posterior serratus

the nerves from the inferior group (T7-T12) reach the linea alba and innervate:

  • transversus abdominis
  • external and interal oblique
  • pyramidal
43
Q

what is the lateral cutanous branch of the second intercostal muscle called?
what is the 12th intercostal muscle called?

A
  1. intercostobrachial nerve

2. subcostal nerve

44
Q

where does the first intercostal nerve originate?

A

the brachial plexus

Neurology (4 decks)

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