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FESSH exam 2022 > Brachial Plexus and Peripheral Nerve Anatomy > Flashcards

Brachial Plexus and Peripheral Nerve Anatomy Flashcards

1
Q

2 minnesregler for anatomy

A

RTDCB
Vertikalt:MARMU

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2
Q

How many vertebrae and roots?

A

C7 vertebrae but c( roots going out over the vertebrae

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3
Q

draw plexus in 20s

A

C5-T1, and RTDCB. 2 arrows and a straight line in the middle

T: Upper T gives 2 nerves (Supras, Subcl)

R: Dorsal Scapular from C5 + LTN C5-7

D: Strike is better than a spare

C: Lateral 1 LP
Posterior 3 Subscap: sup, mid/TD, inf
Anterior 3 MP,MBC,MABC

B: 2 waves and 1 long wave
MARMU

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4
Q

Trunk names?

A

Upper (C5-6)
Middle (C7)
Lower (CC8-T1)

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5
Q

Division names

A

Anterior (ant muscles/preaxillary compartment)
Posterior (postaxillary…)

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6
Q

Cords/fascicles

A
  • Lateral (from Anterior div compartment)
  • Posterior (post div)
  • Medial (ant fr lower cord)

Relation to axillary artery

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7
Q

M-shape

A

Lateral and medial cord gives musculocut, lateral root to median n.

Medial cord gives ulnar n and medial root to median n

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8
Q

Nerves from roots?

A 
Dorsoscapular n (C5) 
Longt Thorasic Nerve C5-7
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9
Q

Nerves from Trunks

A

Upper trunk:
Suprascap
Subclavius

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10
Q

Nerves from division

A

None

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11
Q

Nerves from Cords

A

Lateral: Lat Pectoral n (Communication with med. pect.)

Posterior: Lower, Middle (TD), Upper subscap

Medial: Medial AnteB + Brachial cut n
Medial Pectoral n

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12
Q

Trauma mekanism upper plexus inj

A

Extreme/violoent lateral flexion + simultaneously depressed shoulder

Or oblique force pushing arm and head in opposite direction

Shoulder dystocia, MC accident falling on shoulder

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13
Q

C5-6 inj called?

Symtoms?

Muscles affected?

A

Erb-Duchene paralysis

  • arm hangs limply at the side internally rotated
  • Pronated forearm (Waiters tip position)

Deltoid, supra/infraspinatus, biceps, brachialis, m. supinator

Rhomboids, levator scapulae, Serratus ant if avulsion

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14
Q

Lower Brachial plexus inj

  • trauma mechanism?
  • eponym?
  • symtoms?
A

Extreme abduction; holding on to at three falling or delivery pulled by the arm

Klumpke´s paralysis - partial lower plexus injury

Clawing, supinated extended wrist

Intrinsic minus hand ulnar FDP + FCU weakness, , C8 +T1 numbness, T1 injury may give Horner syndrome (mitosis, ptosis)

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15
Q

C8-T1 calles

A

Klumpkes paralysis

Claw hand

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16
Q

Serratus anterior innervation

A

Long Thoracic Nerve

(protracts and upperly rotates scapula. Keeps the scapula tight against the thoracic cage during arm movement)

17
Q

Axillary nerve innervates

A
  1. Deltoid (ant->flex, mid->abd, post->ext)
  2. T minor (ext rotation)
    + upper brachial lateral cutaneous nerve (post surface)
    Through Quadrangular space
18
Q

Radial nerve course?

A

Post chord, Triangular interval, dorsal radial groove, lat intermuscular septum, between BR/Brachialis, lat epicondyle, cubital fossa, divides, between supinator 2 heads/frohses arcade after division. Followed by a. profunda brachi. Superficial branch goes deep to BR and out subcutaneous 9cm prox to wrist between BR/ECRL.

(Ext kompartment (all) + dorsolat. skin arm + BR + Sup)

Tri, Post. Cut., Inferior lateral cut, post/lat antecbrachi cut, Anc, BR, ECRL
Deep branch: ECRB, Sup ->PIN (after sup): EDC, EDM, ECU, APL, EPB, EPL, EIP
Sup branch: skin

19
Q

Musculocutanous nerve

A

Flexor compartment
1. Coracobrachialis (shoulder flex + add shoulder)
2. Brachialis (flex elbow)
3. Biceps brachi (flex + sup)
+ LABCN Lateral Antebrachial Cutaneous Nerve

20
Q

Ulnar nerve innervation?

A
  • FCU
  • 1/2 FDP
  • Sens ulnar 1/3 of hand
  • Hypothenar muscles
  • All intrinsic hand muscles incl deep FPB head except:
  • Thenar, 1st two lumbricals,
21
Q

Median nerve innervation?

A

Branches: PT, FCR, PL, FDS, AIN (under PT), palmar skin branch, motorbranch to thumb, digital nerves

AIN: radial 1/2 FDP, FPL, PQ

Motor branch to thumb: LOAF

  • *L**ateral 2 lumbricals
  • *O**pponens
  • *A**bductor pollicis brevis
  • *F**lexor pollicis brevis (superficial head)

AIN (along interosseous membrane)

All flexor muscles except FCU + 1/2 FDP
Recurrent branch of median nerve (thenar motor)
Sens

22
Q

Dorsal scapular nerve

A

c5!
Rhomboids (Maj + min)+ lev scapula

23
Q

Suprascapular nerve

A

Upper trunk
Supraspin, infraspin, shoulder joint

24
Q

Subclavius

A

upper trunk
subclavius m
superis clavicle

25
Q

Lateral pect nerv

A

Lat cord
pect major

26
Q

What cord?
Innervates?

  1. upper subscap n
  2. middle subscap/TD
  3. lower subscap
A

Post cord

  1. Upper: m. Subscapularis
  2. Middle: m. LD
  3. Lower: Two branches: m. subscap + t. major

Teres major function similar to LD

27
Q

Medial pect + 2 grenar efter

A
  1. Pect maj (shoulder flex, int rotation, adduction) + min (protraction shoulder)
  2. MBCN, MABCN (cut)
28
Q

Quadrangular space
Triangular interval
Triangular space

A

TS (superior): Other side of triceps long head (medial) comparing to QS
Scapular circumflex artery

QS: long head triceps (med) - humeral shaft.
teres min (sup) - teres maj (inf)
Axillary n + post humeral circumflex artery

TI (inferior): Under TM
Teres maj (sup)
Long head of triceps (med)
Humerus shaft or lat head of triceps (lat)
Radial n + Profunda brachii artery

29
Q

Erb´s point?

A

2-3 cm above clavicle in upper trunk where C5-6 converge. Site of injury in Erb-Duschenne paralysis.

Distal to dorsal scapular nerve (rhomboids + elevator scapulae) and proximal to suprascapular nerve (supra and infraspinatus)

30
Q

Radial nerve innervation?

A

(Ext kompartment (all) + dorsolat. skin arm + BR + Sup)

Tri, Post. Cut., Inferior lateral cut, post/lat antecbrachi cut, Anc, BR, ECRL
Deep branch: ECRB, Sup ->PIN (after sup): EDC, EDM, ECU, APL, EPB, EPL, EIP
Sup branch: skin

31
Q

Median nerve course

A

Lateral+Medial chord

Medial to Biceps tendon with brachial artery in Bicipital aponeurosis

Enters cubital fossa between two head of PT (AIN branches here)

In forearm under FDS

FESSH exam 2022 (12 decks)

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