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MD2002 > Brachial And Lumbosacral Plexuses > Flashcards

Brachial And Lumbosacral Plexuses Flashcards

1
Q

What is the axilla

A

Important space between lateral wall of thorax and humerus

Acts as gateway to upper limb bounded by ribs, scapula and clavicle

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2
Q

Lines of the axilla

A

Anterior axillary line is in front of shoulder and down

Mid axillary line is straight through

Posterior is behind

Axillary fossa is the underarm

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3
Q

Anterior wall of the axilla

A

Pectoralis major
Underneath pectoralis minor
And underneath clavipectoral fascua (deep)

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4
Q

What makes up the anterior axillary fold

A

Pectoralis major

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5
Q

Function of pectoralis major

A

Movement of humerus at GH joint

Adduction
Medial rotation
Flexion of extended arm
Extension of flexed arm

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6
Q

Pectoralis minor attachments

A

Ribs 3-5 to coracoid process of scapula

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7
Q

Function of pectoralis minor

A

Stabilise scapula on thorax

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8
Q

What supplies pectoralis minor

A

Lateral and medial pectoral nerves

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9
Q

What is clavipectoral fascia continous with and where does it attach to

A

Neck fascia

Attaches to inferior skin of the armpit

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10
Q

What does clavipectoral fascia split to enclose

A

Pectoralis minor and subclavius

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11
Q

Subclavius attachments

A

1st rib costalcartilae to inferior surface of clavicle

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12
Q

Function of subclavius

A

To draw clavicle inferiorly

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13
Q

What muscles would you expect to see on chest

A

Deltoid at shoulder
Pectoralis major across chest with pectoralis minor underneath
Serratus anterior inferior to pectoralis major
Sternocleidomastoid muscle from sternum around neck

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14
Q

What is the medial wall of axilla made up of

A

Ribs and intercostal spaces

Serratus anterior

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15
Q

Where does serratus anterior attach

A

Ribs 1-8 to medial border of scapula

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16
Q

Function of serratus anterior

A

Protraction and lateral rotation of the scapula

Holds scapula on thoracic wall

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17
Q

What makes up lateral wall of axilla?

A

Narrow it is the bicipital groove

Proximal parts of biceps and coracobrachialis

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18
Q

Function of coracobrachialis

A

Flexes shoulder

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19
Q

Posterior wall of axilla

A

Subscapularis
Latissimus Dorsi
Teres major
Scapula

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20
Q

What do ventral rami of spinal nerves contain

A

Sensory
Motor
Sympathetic nerves

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21
Q

What forms the nerve plexuses

A

Spinal nerves with sensory motor and sympathetic nerves

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22
Q

What does the brachial plexus supply and via which ventral rami

A

Supplies upper limbs via ventral rami of c5-t1

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23
Q

What does the lumbar and sacra (lumbosacral) plexuses supply and via which rami

A

Lower limbs via ventral rami of L1 - S4

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24
Q

What does the dorsal ramus supply

A

Erector spinae muscles

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25
Q

What does ventral rami supply

A

Body wall and limb plexuses

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26
Q

Ventral rami come from which part of spinal cord

A

Cell body is in the anterior grey horn of the spinal cord

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27
Q

Where is axillary artery in relation to brachial plexus etc

A

Axillary artery goes under clavicle with brachial Lexus and is medial to T1 and branches over T1

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28
Q

Roots of brachial plexus

A

Ventral rami of spinal nerves
Lie in neck close to intervertebral foraminae
Long thoracic nerve passes inferiorly through apex f axilla on the ribs to supply serratus anterior (motor only)
Dorsal scapula passes posteriorly to the back to supply levator scapulae and rhomboids motor only

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29
Q

Trunks of brachial plexus

A

There are 3 superior middle and inferior
Lie in posterior triangle of neck posterior to scalenus anterior and subclavian artery
Branches from upper superior only

Suprascapular
Nerve to subclavius

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30
Q

Where is nerve to subclavius situated

A

Inferior to supply subclavius

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31
Q

Where is subscpaular nerve situated

A

Posterior to scapular region via suprascpaular notch to supply supraspinatus, infraspinatus

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32
Q

6 divisions of the brachial plexus

A

Each trunk gives rise to posterior and anterior

Lies posterior to clavicle and there are no branches

Anterior divisions supply muscles of anterior axilla, flexor muscles of limb and skin that overlies muscles

Posterior Division supply muscles of posterior wall of axilla, extensor muscles and skin that overlies those muscles

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33
Q

Cords of brachial plexus

A

Lie in axilla around 2nd part of axillary artery and named according to position relative to artery

Lateral medial and posterior to artery

The lateral cord has one branch the lateral pectoral nerve which passes anterior to supply pec major and minor

Posterior cord has 3 branches

34
Q

Which landmark marks location subclavian artery becomes axillary artery

A

1st rib

35
Q

Posterior cord has what branches

A

Radial and axillary

36
Q

Which artery does radial nerve travel with and where does it supply

A

Profunda brachii artery

Supplies extensor muscles of arm and forearm and posterior skin of arm forearm and hand (mixed motor and sensory)

37
Q

Where is axillary nerve located and what does it supply

A

C5 and c6

Surgical neck humerus
Posterior circumflex artery

Deltoid and teres minor and skin over lower part of deltoid

38
Q

All terminal divisions of brachial plexus carry what

A

Both motor and sensory fibres

39
Q

Musculotaneous branch is where and Carries what

A

C5 c6 c7

Pierces coracobrachialis and supplies flexor compartment of arm

Becomes lateral cutaneous nerve of forearm

40
Q

Lateral root of median nerve

A

C6 c7

Joins with medial root to form median nerve

41
Q

Medial root of median nerve

A

C8 T1

Joins with lateral root to form median nerve

42
Q

Median nerve

A

C6 7 8 T1
Travels with brachial artery
Most medial structure in cubital fossa
Supplies flexor muscles of forearm except 1half LOAF
Hand thumb muscles and lateral 2 Lumbricals
Skin over lateral palm and lateral 31/2 digits and nail beds

43
Q

Ulnar nerve

A

Posterior to elbow
Supplies 11/2 flexors of forearm
Supplies intrinsic muscles in hand and skin over palm and medial 11/2 digits

44
Q

Traction injury to upper trunk (c5c6)

A

Erb-Duchenne Palsy or Erbs paralysis

High energy trauma motorcylcle/birth

Paralysis in muscles of arm and shoulder such as deltoid biceps and brachialis
Loss of sensation to lateral forearm

Presents as waiters tip position hanging limb (addicted shoulder, medial rotation of arm, elbow extended)

45
Q

Traction injury to lower trunk (c8t1)

A

Klumpke’s palsy / paralysis

Occur birth if limb pulled

Paralysis of intrinsic hand muscles, flexor muscles of wrist and fingers, forearm pronator
Loss of sensation to medial forearm and little finger

Claw hand (wrist and fingers flexed and forearm supinated)

46
Q

Lumbar and sacral plexus is made up on nerves

A

Lumbar plexus L1-4

Sacral L4-S4

47
Q

Where does lumbrar and sacral plexuses innverate

A

Lower limb

Pelvis and perineum

48
Q

What are the largest nerves from the plexuses entering the thigh

A

Femoral nerve L2-4

Sciatic nerve L4-S3

49
Q

Where is lumbar plexus located

A

Within psoas major muscle anterior to transverse processes of lumbar vertebrae

50
Q

Which nerves supply the lower Limb

A 
Ilioinguinal
Lateral cutaneous of the thigh
Genitofemoral
Femoral (s and m)
Obturator (s and m)
51
Q

What are the base apex and medial aspects of the femoral triangle

A

Inguinal ligament base
Sartorial muscle laterally apex
Adductor longus muscle medial

Muscular floor of triangle is pectineus medially and iliopsoas laterally
Roof is fascia lata

52
Q

Within the femoral triangle

A

Lateral - femoral nerve (l2-4)
Middle - femoral artery
Medial - femoral vein

53
Q

What does the femoral sheath enclose

A

Femoral artery and vein NOT the nerve

54
Q

The femoral nerve

A

Supplied by l2,3,4
Latest branch descending in abdomen through pelvis to mid point of inguinal ligament
Behind inguinal ligament to thigh
Passes through femoral triangle
Articular branches to hip and knee joints
Terminal cutaneous branch is the saohenous nerve which continues with artery and vein through adductor canal to leg

55
Q

What does femoral nerve supply

A

Anterior thigh muscles (hip flexors, knee extensor) and skin of anteromedial thigh and medial leg and foot

56
Q

Sacral plexus

A

Surface of posterior pelvic wall anterior to piriformis muscle

Superior gluteal, inferior gluteal and sciatic(ms) and posterior femoral cutaneous nerves supply lower limb

Also has smal branches such as nerve to piriformis, obturator internus and quadratus femoris

57
Q

Sciatic nerve

A

L4,5,S1,2,3

Greater sciatic foramen
Supplies no structures in gluteal region however
Runs ndeep to gluteus maximus midway between ischial tuberosity and greater trochanter behind hip joint

58
Q

What does sciatic nerve supply

A

Posterior thigh muscles
All of leg and foot muscles
Skin to most of leg and foot via two branches tibial and common fibulae

59
Q

Where does sciatic nerve branch (bifurcation)

A

Apex of popliteal fossa

Can branch near piriformis too

60
Q

Tibial branch

A

From sciatic

Descends in politest fosssa and posterior to leg to foot passing posteriorly and inferiorly to medial mallelous

61
Q

What does tibial nerve supply

A

Posterior muscles in leg and knee joint skin of posterlateral leg
Sole of foot
Lateral foot

62
Q

Common fibulae (perineal)

A

L4,5,S1,2

Smaller branch
Descends laterally in popliteal fossa towards lateral compartment of leg before branching

63
Q

What does common fibulae nerve supply

A

Short of biceps and muscles in anterior and lateral leg
Skin of upper lateral leg
Lower poser player all leg, anterolateral leg and dosrum of foot

64
Q

Myotomes - Proximal and distal muscles are supplied

A

Proximal muscles supplied by neurones from superior roots deltoid c5c6

Distal muscles supplied by neurones from inferior roots intrnic muscles of hand T1

65
Q

Muscles that share action in joint are supplied by neurones originating form same spinal segment

A

Deltoid c5c6

Supraspinatus c5c6

66
Q

Antagonistic muscles supplied by two segments usually run in numerical sequence

A

Flexion elbow c5c6

Extension elbow c7c8

67
Q

Abduction of shoulder controlled by

A

C5

68
Q

Flexion of elbow controlled

A

C6

69
Q

Extension elbow controlled

A

C7

70
Q

Flexion of fingers controlled

A

C8

71
Q

Abduction and adduction of fingers

A

T1

72
Q

Biceps tendon tap tests

A

C6

73
Q

Triceps tendon tap tests

A

C7

74
Q

How are sensory neurones delivers

A

By peripheral cutaneous nerves

75
Q

C5 dermatomes test

A

Upper lateral side of arm

76
Q

C6 dermatomes test

A

Pad of thumb

77
Q

C7 dermatomes test

A

Pad of index finger

78
Q

C8 dermatomes test

A

Pad of little finger

79
Q

T1 dermatomes test

A

Skin on medial side of elbow

80
Q

What are dermatomes used for

A

Test for spinal cord damage and can help to determine level of damage

MD2002 (22 decks)

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