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Upper Limbs > Brachial Plexus > Flashcards

Brachial Plexus Flashcards

1
Q

Brachial plexus consists of

A

Roots
Trunks
Divisions
Cords Branches

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2
Q

Roots constitute of what

A

Anterior primary Rami of spinal nerves C5-T1
With contributions from C4 and T2

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3
Q

Root C5and C6 form

A

Upper trunk

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4
Q

Root C7 forms

A

Middle trunk

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5
Q

Root C8 and T1 forms

A

Lower trunk

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6
Q

The trunks lie where

A

They lie in the neck between the scalenus anterior and scalenus medius covered by axillary sheath from prevertebral fascia

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7
Q

The trunks divide into how many divisions

A

2 divisions , ventral and dorsal and they join to form cords

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8
Q

Lateral cord is formed by

A

Union of ventral divisions of upper and middle trunks

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9
Q

Medial cord is formed by

A

Ventral division of lower trunk

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10
Q

Posterior cord is formed by

A

Dorsal divisions of upper, middle and lower trunks

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11
Q

List the branches of the roots

A

Long thoracic nerve or nerve to serratus anterior(C5-C7)

Dorsal scapular nerve or nerve to rhomboids(C5)

Branches to longus and scaleni muscles (C5-C8)

Phrenic nerve (Main root is from C4 ,C5 contributes little )

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12
Q

Dorsal scapular nerve supplies

A

Rhomboids

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13
Q

Long thoracic nerve supplies

A

Serratus anterior

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14
Q

Phrenic nerve

A

Sole motor nerve supply to the diaphragm

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15
Q

Upper trunk gives how many branches

A

2

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16
Q

List the branches of upper trunk

A

Suprascapular(C5-C6)

Nerve to subclavius (C5-C6k

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17
Q

Suprascapular nerve supplies

A

Supraspinatus and Infraspinatus

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18
Q

Nerve to subclavius supplies

A

Subclavius muscle

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19
Q

Lateral cord has how many branches

A

3

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20
Q

List the branches of lateral cord

A

Lateral pectoral

Musculocutaneous

Lateral root of median nerve

All C5-C7

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21
Q

Lateral pectoral nerve supplies

A

Pectoralis major and minor

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22
Q

Musculocutaneous supplies

A

Muscles of anterior arm which includes….. Mention them

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23
Q

Lateral root of median nerve

A

It joins the medial root of median nerve forming median nerve
Median nerve supplies muscles of anterior compartment of forearm and thenar eminence.

24
Q

Branches of medial cord are how many

A

5

25
Q

List branches of medial cord

A

Medial pectoral (C8-T1)

Medial cutaneous nerve of arm(C8-T1)

Median cutaneous nerve of forearm(C8-T1)

Ulnar nerve(C8-T1)

Median root of median nerve (C8-T1)

26
Q
A

Pectoralis major and minor

27
Q

Carries sensory impulse from a small area of medial side of arm

A

Medial cutaneous nerve of arm

28
Q

Carries sensory impulse from a large area of medial side of forearm

A

Medial cutaneous nerve of forearm

29
Q

Ulnar nerve supplies

A

Hypothenar eminence

15 intrinsic muscles of palm

One an half muscles of anterior forearm

30
Q

Joins lateral root of median nerve and gets distributed with branches of median nerve

A

Median root of median nerve

31
Q

Posterior cord has how many branches

A

5

32
Q

List them

A

Upper subscapular C5-C6

Lower subscapular C5-C6

Nerve to latissimus dorsi C6-C8

Axillary or circumflex C5-C6

Radial C5-C8, T1

33
Q

Supplies subscapularis muscle

A

Upper subscapscular and Lower Subscapular

34
Q

Supplies teres major

A

Lower subscapular

35
Q

Supplies deltoid and Teres minor

A

Axillary or circumflex nerve

36
Q

What is the thickest branch of brachial plexus

A

Radial nerve

37
Q

Radial nerve supplies

A

3 heads of triceps brachii

12 muscles on posterior forearm

38
Q

Upper limb is supplied near the trunk by

A

Supraclavicular branches of cervical plexus

Intercostobrachial branch of 2nd intercostal nerve

39
Q

Blood supply to brachial plexus

A

Vertebral artery

Thyrocervical trunk with its branches

Suprascapular artery

Transverse cervical arteries

40
Q

Site of Erbs paralysis

A

Erbs point- located in upper trunk of brachial plexus.6 nerves meet there.

41
Q

Cause of injury

A

Undue separation of the head
from the shouder which can be seen in
1 Birth injury
2.Fall on the shoulder
3. During anaesthesia.

42
Q

Nerve root involved

A

Mainly C5
Partly C6

43
Q

Muscles paralysed

A

Mainly biceps brachii,
deltoid,
brachialis
brachioradialis.

Partly supraspinatus,
infraspinatus
supinator

44
Q

Deformity and position of limb

A

The deformity is known as’policeman’s tip hand’

Arm: Hangs by the side; it is adducted and medially
rotated.
Forearm: Extended and pronated.

45
Q

What movements are lost

A

.Abduction and lateral rotation of the arm at
shoulder joint.
• Flexion and supination of the forearm.
• Biceps and supinator jerks are lost.
• Sensations are lost over a small area over the
lower part of the deltoid.

46
Q

Klumpkes paralysis

A
47
Q

Site of injury

A

Lower trunk of the brachial plexus.

48
Q

Cause

A

Undue abduction of the arm, as in
clutching something with the hands after a fall from a
height, or sometimes in birth injury.

49
Q

Nerve root involved

A

Mainly T1

Partly C8

50
Q

Muscles paralyzed

A

Intrinsic muscles of the hand (T1).
•Ulnar flexors of the wrist and fingers (C8)

51
Q

Deformity of hand

A

Claw hand .

52
Q

Injury to serratus anterior other name

A

Nerve of bell

53
Q

Cause

A

1 Sudden pressure on the shoulder from above.

2 Carrying heavy loads on the shoulder.

54
Q

Deformity

A

Winging of the scapula, i.e. excessive
prominence of the medial border of the scapula.

55
Q

Disability

A

Loss of pushing and punching actions.
During
attempts at pushing, there occurs winging of the
scapula

•Overhead abduction of shoulder girdle is partly
affected due to intact trapezius muslce.

56
Q

Clinical Problem 1

A patient came with inability to: (i) abduct right
shoulder, (ii) flex elbow joint, and (iii) supinate the
forearm
•What is the site of injury of the nerves?
•What is the point called?
•What are the nerves affected?

A

The site of injury is called Erb’s point.

Six nerves are involved:

i.Ventral ramus of cervical five segment of
spinal cord
ii.Ventral ramus of cervical six segment of spinal
cord
These two rami join to form the upper trunk.
iii.Suprascapular nerve from upper trunk
iv.Nerve to subclavius from upper trunk
v.Anterior division of upper trunk
vi.Posterior division of upper trunk

These divisions give fibres to deltoid, brachialis,
biceps brachii, supinator, so the arm cannot be
abducted.
The elbow is extended and forearm is
pronated.
This paralysis is called Erb’s paralysis.

Upper Limbs (7 decks)

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