Brachial Plexus Flashcards by Alyssa caprara

What does the brachial plexus supply?

the upper extremities

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what forms the brachial plexus?

anterior rami of C5- T1, sometimes C4 and T2

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Where is it located?

laterally over rib 1 into the axilla

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where do the roots travel?

between anterior and middle scaliness into posterior triangles. Posterior and superior to the subclavian artery

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What roots make up the superior, middle, and inferior trunk?

superior= C5&C6
middle= C7
inferior= C8&T1

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What does the anterior division supply?

the anterior compartments of the arm and forearm

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What does the posterior division supply?

the posterior compartments of the arm and forearm

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How are the cords named?

By their relationship to the axillary nerve

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What is included in the lateral cord?

anterior divisions of the superior and middle trunks (C5,C6,C7)

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What is included in the medial cord?

the anterior divisions of the inferior cord (C8&T1)

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What is included in the posterior cord?

the posterior divisions of the superior, middle and inferior cords (C5-T1)

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Once in the forearm, what does the musculocutaneous nerve become?

lateral cutaneous nerve of the forearm

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what does the lateral cutaneous nerve of the forearm supply ?

sensory for the skin over the lateral aspect of the forearm

NOT THE HAND

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What branches come off the medial cord?

Medial pectoral nerve, medial cutaneous nerve of the arm, medial cutaneous nerve of the forearm, ulnar nerve, median nerve

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What does the medial pectoral nerve supply?

pectorals major and minor

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What does the medial cutaneous nerve of the arm supply?

sensory for the skin of the medial arm between the axilla and the elbow

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What nerve does the medial cutaneous nerve of the arm communicate with to receive fibers from T2?

intercostalbrachial nerve

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What does the medial cutaneous nerve of the forearm supply?

sensory for the skin over biceps brachia and anterior/medial aspects of the forearm distal to the wrist

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What nerve is considered the “funny bone” and where is it located?

the Ulnar nerve; the sulcus for the ulnar nerve on the posterior side of the medial epicondyle

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What two muscle heads does the ulnar nerve pass between?

the two heads of the flexor carpi ulnaris

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What muscle does the ulnar nerve innervate?

flexor carpi ulnaris and flexor digitorum profundus

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What two branches are given off by the Ulnar nerve?

Dorsal and Palmar nerve

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Which supplies the ulnar side of the posterior hand?

The dorsal branch of the ulnar nerve

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What does the palmer branch supply?

sensory to the skin over the hypothenar eminence

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Does the Ulnar nerve pass superficial or deep to the flexor retinaculum?

superficial

After passing superficial to the flexor retinaculum, what does the ulnar nerve split into? Which is sensory?

superficial (sensory) and deep branches

What does the superficial branch supply?

the paler aspect of the little finger and medial half of the ring finger

What does the deep branch supply?

``` abductor digiti minimi flexor digiti minimi brevis opponens digiti minimi adductor pollicis deep head of the flexor pollicis brevis all interossei (dorsal and palmer) lumbercles 3&4 ```

What is the clinical consideration of the ulnar nerve?

Claw hand

What is claw hand?

when open handed, digits 2-5 are flexed

What fibers are in the median nerve?

C6, C7, C8, T1 (lateral and medial cord)

Where does the median nerve travel through?

medial bicipital sulcus, crosses elbow and enteres forearm between two heads of pronator trees muscles

What 5 muses does the median nerve supply in the forearm?

``` pronator teres flexor carpi radialis palmaris longus flexor digitorum superficialis pronator quadratus ```

Which branch of the median nerve is given off in the distal 1/3 of the forearm?

Palmer branch

What does the palmer branch supply?

sensory to the skin of the thenar eminence, lateral wrist and palm

Where does the Palmer Nerve pass through before dividing into the 3 common palmer digital nerves?>

the Carpal Tunnel

What happens the the palmer nerve after it passes through the carpal tunnel?

it divides into the 3 common palmer digital nerves

What muscles does the first common palmer digital nerve supply?

abductor pollicis brevis flexor pollicis brevis opponens pollicis

What do all three common palmer digital nerves supply?

the first two lumbercle muscles

Each common palmer digital nerve splits into two proper palmer digital nerves. What is their function?

sensory of the skin over the lateral three and a half digits

What does the median nerve communicate with and where?

the ulnar nerve in the wrist

What other structures does the median nerve supply?

periosteum | elbow, radiocarpal and midcarpal joints

What are the clinical considerations of the median nerve?

hand of oath carpal tunnel syndrome unable to pronate

What is carpal tunnel syndrome?

wrist inflammation at the level of the scalene triangle IVF

What nerves are involved in Carpal Tunnel Syndrome

Ulnar and median nerves

What branches off the posterior cord of the brachial plexus?

``` superior scapular nerve thoracodorsal nerve inferior subscapular nerve axillary nerve radial nerve ```

What are the fibers of the superior sub scapular nerve

C5 and C6

What does the superior sub scapular nerve supply?

subscapularis

What does the thoracodorsal nerve supply?

latissimus dorsi

What fibers does the thoracodorsal nerve contain?

C6, C7, C8

Where does the thoracodorsal nerve travel?

along the posterior axillary wall

What nerve fibers does the axillary nerve contain?

C5 &C6

What muscles does the axillary nerve supply?

deltoid and teres minor

Which nerve of the posterior cord travels around the neck of the humerus?

axillary nerve

What is the secondary branch given off the axially nerve at the same level as the branch to the teres minor?

superior lateral cutaneous nerve of the arm

What does the superior lateral cutaneous nerve of the arm supply?

sensory to the skin over the lateral shoulder and upper arm

What fibers does the inferior scapular nerve contain?

C5 and C6

What does the inferior scapular nerve supply?

subscapularis and teres major

what fibers does the radial nerve contain?

C5, C6, C7, C8, T1

What does the radial nerve supply?

most of the muscles in the posterior compartment of the arm and forearm

At the radial head, the radial nerve divides to become what 2 branches?

superficial branch of the radial nerve | deep branch of the radial nerve

Which radial nerve branch travels between brachioradialis and the radius to the posterior surface of the hand?

the superficial branch of the radial nerve

Which branch of the radial nerve penetrates the supinator muscle?

deep branch of the radial nerve

Which branch of the radial nerve branches off of the upper arm and supplies the skin on the posterior side of the upper arm?

posterior cutaneous nerve of the arm

which branch of the radial nerve branched off the radial in the middle arm?

inferior lateral cutaneous nerve of the arm

What branch of the radial nerve supplies the triceps brachii and anconeous?

the muscular branches off the arm

which branch of the radial nerve is given off in the upper arm and supplies the narrow area of skin on the lateral side of the posterior forearm?

lateral cutanous nerve of the forearm

what muscles are supplied by the branches given off at the level of the lateral epicondyle (radial nerve)?

brachioradialis and extensor carpi radialis longus

What does the superficial branch of the radial nerve supply?

sensory to the radial side of the posterior hand extensor side of the thumb extensor side of proximal phalanxes of digits 2 and 3 lateral half of extensor side of the ring finger

What does the deep branch of the radial nerve supply?

``` motor to extensor carpi radialis brevis supinator extensor digitorum extensor digiti minimi extensor carpi ulnaris abductor pollicis longus extensor pollicis brevis ```

Which branch of the radial nerve gives off a communicating branch to the ulnar nerve?

superficial branch of the radial nerve of the forearm

What is the terminal branch of the deep branch of the radial nerve?

posterior interosseous nerve

What does the posterior interosseous nerve supply?

exensor pollicis longus and extensor indicis

where does the radial nerve send articular branches to?

shoulder and wrist

what are the clinical considerations of the radial nerve?

wrist drop and triceps/brachioradialis reflexes

Which brachial plexus injury involves the supraclavicular?

Erb-Duchene

Which brachial plexus injury involves the infraclavicular?

Klumpke's

What nerves are damaged in Erb-Duchene?

damage to C5 &C6 (C7 if severe) | subscapular, musculocutaneous, and axillary

What muscles atrophy with Erb-Duchene?

deltoid, biceps brachii, brachialis, coracobrachialis

What other syndrome is associated with Klumpke?

Horner's Syndrome

What is hornet's syndrome?

stosis and miosis (dry eye) | difficulty using forearm and hand