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MD2002 > Brachial and Lumbo-Sacral Plexuses > Flashcards

Brachial and Lumbo-Sacral Plexuses Flashcards

1
Q

What does the anterior wall of the axilla consist of?

A

+ Pectoralis major
+ Pectoralis minor/subclavius
+ Clavipectoral fascia (deep)

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2
Q

What is pectoralis major palpable as?

A

The anterior axillary fold

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3
Q

What is the movement of the humerus at the GH joint?

A

+ Adduction
+ Medial rotation
+ Flexion
+ Extension

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4
Q

Where does pectoralis minor attach?

A

+ Ribs 3-5

+ Coracoid process of the scapula

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5
Q

What supplies pectoralis minor?

A

Medial pectoral nerves

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6
Q

Where does the subclavius attach?

A

from superior border of 1st rib to inferior surface of middle 1/3 of clavicle

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7
Q

What is the medial wall of the axilla composed of?

A

+ Ribs and intercostal spaces

+ Serratus anterior

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8
Q

Where does serratus anterior attach?

A

Ribs 1-9 to medial margin of scapula

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9
Q

What are the movements and functions of serratus anterior?

A

+ Superior external rotation of scapula
+ Draws scapula internally and forwards
+ Lowers the arm from a raised position
+ Elevation of ribs

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10
Q

What parts of the biceps and coracobrachialis are sometimes included in the contents of the axilla?

A

The proximal parts

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11
Q

What structures form the lateral wall of the axilla?

A

+ bicipital wall

+ proximal parts of biceps and coracobrachialis

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12
Q

What structures from the posterior wall of the axilla?

A

+ subscapularis
+ latissimus dorsi
+ teres major

+ scapula

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13
Q

where does the radial nerve pass?

A

posteriorly through lower triangular space with profunda brachii artery

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14
Q

what does the radial nerve supply?

A

+ all extensor muscles of arm and forearm

+ posterior skin of arm, forearm and hand

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15
Q

what are the roots of the radial nerve?

A

C5-8, T1

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16
Q

what are the roots of the axillary nerve?

A

C5-6

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17
Q

where does the axillary nerve pass?

A

through quadrilateral space and lies on surgical neck of humerus with posterior circumflex humeral artery

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18
Q

what does the axillary nerve supply?

A

+ deltoid
+ teres minor
+ skin over lower part of deltoid

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19
Q

what are the roots of the musculocutaneous nerve?

A

C5-7

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20
Q

where does musculocutaneous lie?

A
  • it pierces coracobrachialis

- travels between brachialis and biceps brachii

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21
Q

what does musculocutaneous supply?

A

flexor compartment of arm (BBC)

- biceps brachii, brachialis, coracobrachialis

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22
Q

what does muculocutaneous become in the forearm?

A

lateral cutaneous nerve

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23
Q

what are the roots of the median nerve?

A

C5-8 (lateral cord)

T1 (medial cord)

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24
Q

where does the median nerve lie?

A

in the cubital fossa - travels with brachial artery

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25
Q

what does the median nerve supply?

A

+ all flexor muscles of forearm (except 1.5)
+ thumb (thenar) muscles except 1 and lateral 2 lumbricals
+ skin over lateral palm
+ latter 3 1/2 digits including nail beds

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26
Q

what are the roots of the ulnar nerve?

A

C8, T1

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27
Q

where does the ulnar nerve lie?

A

passes posterior to the elbow

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28
Q

what does the ulnar nerve supply?

A 
\+ 1.5 flexors of forearm
\+ majority of intrinsic muscles in hand
(1 thenar muscle, all hypothenar and interosseal muscles and medial 2 luumbricals)
\+ skin over palm
\+ medial 1.5 digits
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29
Q

what is caused by a traction injury to the upper trunk (C5, C6)?

A

Erb-Duchenne Palsy/Erb’s Paralysis

30
Q

what are symptoms of Erb-Duchenne Palsy?

A

+ paralysis of muscles in arm and shoulder (deltoid, biceps, brachialis)
+ loss of sensation to lateral forearm

31
Q

what is the presentation of Erb-Duchenne Palsy?

A

+ “waiter’s tip position”
+ hanging limb
(adducted shoulder, medial rotation of arm, elbow extended)

32
Q

what is caused by a traction injury to the lower trunk (C8, T1)?

A

Klumpke’s Palsy/Paralysis

33
Q

what are the main causes of Erb-Duchenne Palsy?

A

+ high energy trauma (motorcycle/horse)

+ during birth (shoulder dystocia)

34
Q

what are the main causes of klumpke’s palsy?

A

+ during birth if limb pulled excessively

+ breaking a fall from height

35
Q

what are the symptoms of klumpke’s palsy?

A

+ paralysis of:

  • intrinsic hand muscles
  • flexor muscles of wrist and fingers
  • forearm pronator

+ loss of sensation to medial forearm and little finger

36
Q

how does klumpke’s palsy present?

A

claw hand (wrist and fingers flexed, forearm supinated)

37
Q

what are the roots of the lumbar plexus?

38
Q

what are the roots of the sacral plexus?

39
Q

where is the lumbar plexus located?

A

+ within psoas major

+ anterior to transverse process of lumbar vertebrae

40
Q

which nerves supply the lower limb in the lumbar plexus?

A 
\+ ilioingual
\+ lateral cutaneous of thigh
\+ genitofemoral
\+ femoral
\+ obturator
41
Q

what are the boundaries of the femoral triangle?

A

BASE: inguinal ligament

APEX: sartorius

MEDIAL: adductor longus

42
Q

what are the roots of the femoral nerve?

43
Q

what does the floor of the femoral triangle consist of?

A

pectineus and iliopsoas

44
Q

what is enclosed within the femoral sheath?

A

femoral artery and vein

45
Q

what does the femoral nerve supply?

A

+ some anterior thigh muscles (hip flexors, knee extensors)

+ skin of anteromedial thigh and medial leg and foot

46
Q

what is the terminal branch of the femoral nerve?

A

saphenous nerve

47
Q

where is the sacral plexus located?

A

+ surface of posterior pelvic wall

+ anterior to piriformis muscle

48
Q

which nerves supply the lower limb in the sacral plexus?

A

+ superior gluteal
+ inferior gluteal
+ sciatic
+ posterior femoral cutaneous

49
Q

what are the roots of the sciatic nerve?

A

L4-5, S1-3

50
Q

what muscles does the sciatic nerve supply?

A

+ biceps femoris, and semitendinosus with semimembranosus

51
Q

where does the sciatic nerve branch?

A

at the apex of the popliteal fossa, occasionally near piriformis

52
Q

what are the roots of the tibial nerve?

A

L4-5, S1-3

53
Q

which is the larger of the two branches of the sciactic nerve?

54
Q

where does the tibial nerve lie?

A

+ descends in popliteal fossa

+ passes posteriorly and inferiorly to medial malleolus

55
Q

what does the sciatic nerve supply?

A

+ posterior muscles in leg and knee joint: thigh extensors, leg flexors) (hamstring muscles)
+ skin of posterolateral leg, sole of foot and lateral foot

56
Q

what are the roots of the common fibular/peroneal nerve?

A

L4-5, S1-2

57
Q

where does the common fibular/peroneal nerve lie?

A

descends laterally in the popliteal fossa towards lateral compartment of leg

58
Q

what does the common fibular/peroneal nerve supply?

A

+ short head of biceps
+ muscles in anterior and lateral leg
+ skin of upper lateral leg, lower posterolateral leg, anterolateral leg and dorsum

59
Q

what joint movements are used to test C5 myotome?

A

abduction of shoulder

60
Q

what joint movements are used to test C6 myotome?

A

flexion of the arm at elbow

61
Q

what joint movements are used to test C7 myotome?

A

extension at the elbow

62
Q

what joint movements are used to test C8 myotome?

A

flexion of fingers

63
Q

what joint movements are used to test T1 myotome?

A

abduction and adduction of fingers

64
Q

what is the function of the axilla?

A

gateway to upper limb

65
Q

what is a distinguishing feature of medial pectoral nerve?

A

can be seen piercing pectoralis minor

66
Q

what nerves are branches of the posterior cord?

A
  • radial

- axillary

67
Q

which nerve does not supply anything in the arm?

A

median nerve

68
Q

which nerve does not supply anything in the arm?

A

median nerve

69
Q

where does the sciatic nerve enter the gluteal region?

A

inferior to piriformis (infrapiriform space?greater sciatic foramen)

70
Q

what is the origin of pec major?

A
  • medial half of clavicle
  • anterior surface of manubrium of sternum
  • anterior surface of body of sternum
  • ribs 1-6 costal cartilage
  • aponeurosis of external abdominal oblique
71
Q

what is the insertion of pec major?

A

lateral lip of intertubercular sulcus of humerus

72
Q

what nerve supplies pec major?

A

lateral and medial pectoral nerves

MD2002 (85 decks)

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