Brachial Plexus Lecture Flashcards

1
Q

Fill in the Blank:

The brachial plexus is made up of the ___ ____ of cervical and thoracic spinal nerves (C5-T1).

A

VENTRAL RAMI

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2
Q

True or False:

The nerves of the anterior division of the brachial plexus innervate only flexion muscles.

A

True

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3
Q

Out of the root, trunk, divisions, cords, and branches, which are supraclavicular and which are infraclavicular?

A

Supraclavicular

  • roots
  • trunks

Infraclavicular

  • divisions
  • cords
  • branches (nerves)
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4
Q

Which cervical ventral rami does the dorsal scapular nerve come off of?

A

C5

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5
Q

Which cervical ventral rami does the roots for the long thoracic nerve come from?

A

C5-C7

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6
Q

Which nerves come off the upper trunk of the brachial plexus?

A
  • nerve to subclavius
  • suprascapular nerve
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7
Q

Which cords come off the anterior divisions of the brachial plexus?

A
  • lateral cord
  • medial cord
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8
Q

Which cord comes off the posterior division of the brachial plexus?

A
  • posterior cord
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9
Q

Which nerve comes off the lateral cord?

A

lateral pectoral nerve

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10
Q

Which nerves come off of the medial cord of the brachial plexus?

A
  • medial pectoral nerve
  • medial brachial cutaneous nerve
  • medial antebrachial cutaneous nerve
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11
Q

Which nerves come off the posterior cord of the brachial plexus?

A
  • upper subscapular nerve
  • lower subscapular nerve
  • thoracodorsal nerve
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12
Q

What are the two terminal (named nerves) branches that come from the posterior compartment?

A
  • radial nerve
  • axillary nerve
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13
Q

What are the three terminal (names nerves) branches that come off the anterior compartment?

A
  • musculocutaneous nerve
  • median nerve
  • ulnar nerve
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14
Q

For the arm(brachium), what divides the anterior and posterior compartments?

A

medial and lateral intermuscular septa

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15
Q

Which nerve (flexors of elbow joint) is found in the anterior compartment of the arm (brachium)?

A

musculocutaneous nerve

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16
Q

Which nerve (extensors of elbow joint) is found in the posterior compartment of the arm (brachium)?

A

radial nerve

17
Q

Which two nerves are found in the anterior compartment of the forearm (antebrachium)?

A
  • ulnar nerve
  • median nerve
18
Q

Which nerve is found in the posterior compartment of the forearm (antebrachium)?

A

radial nerve

19
Q

What condition can be caused by an injury to the superior trunk (C5 and C6 spinal nerve roots) of the branchial plexus? Most typically a result from excessive, forceful increase in angle between the neck and shoulder.

A

Erb’s Palsy

20
Q

What are the sensory deficits of Erb’s Palsy?

A

lateral aspect of upper limb

21
Q

What are the motor deficits seen with Erb’s Palsy?

A

Motor Deficits:

  • loss of arm abduction
  • loss of elbow flexion
  • loss of forearm supination
  • weakness of wrist extension
22
Q

How does a patient typicaly present with Erb’s Palsy?

A
  • upper limb is adducted
  • upper limb is medially rotated
  • elbow is extended
  • wrist is flexed

** “waiter’s tip” position **

23
Q

What is the condition that results to an injury to the inferior trunk (C8 and T1 spinal nerve roots) of the brachial plexus?This typically can occur when the limb is suddenly and/or forcefully pulled in a superior direction.

A

Klumpke’s Palsy

24
Q

What sensory deficits are seen in a patient with Klumpke’s Palsy?

A

medial aspect of upper limb (except axilla)

25
Q

What motor deficits are typically seen in a patient with Klumpke’s Palsy?

A

Motor Deficits:

  • loss of precision finger movements
  • weakness in forearm pronation
  • weakness of wrist and finger extension
  • weakness of wrist and finger flexion
26
Q

How does a patient with Klumpke’s Palsy typically present in the clinic?

A

Primary clinical sign is “claw-hand”.

There may also be wasting of intrinsic hand muscles.

Seen with attempted EXTENSION of digits, leaving 4th and 5th digits flexed.

27
Q

What are the results to an injury to the radial nerve (C5-T1 spinal nerve roots) of the brachial plexus?

A
  • can occur with mid-shaft fractures of the humerus
  • improper use of crutches
  • extensors compartments affected
  • “wrist drop”
  • “Saturday Night Palsy” (nerve gets pinched due to certain sleep position resulting in loss of ability to extend wrist and digits)
  • paresthesia and/or pain along course of nerve
28
Q

What are the results of an injury to the axillary nerve (C5 and C6 spinal neve roots) of the brachial plexus?

A
  • can occur with ractures to the surgical neck of the humerus or dislocation of the glenohumeral joint
  • improper use of backpack (quadrangular space syndrome; can also involve compression of posterior circumflex humeral artery)
  • can result in impaired or lost function of deltoid and teres minor
  • patient would be unable to fully abduct their arm, and may have a diminished ability to laterally rotate arm
  • paresthesia and/or pain with along course of nerve
29
Q

What are the results if an injury to the long thoracic nerve (C5, C6, C7 spinal nerve roots) of the brachial plexus occurs?

A
  • this nerve can be damaged during surgical removal of lymph nodes or other tissues in the axillary region
  • penetrating trauma to the axillary region can also damage this nerve
  • serratus anterior is affected
  • “winged scapula”, inability to raise arms past 90 degrees
30
Q

What is the result of an injury that occurs to the ulnar nerve (C8, T1, and ofter C7) of the brachial plexus?

A
  • fracture of medial epicondyle of humerus can damage this nerve.
    • fracture of proximal ulna may also result in damage
  • slashed wrist (medial side)
  • damage will involve flexors of wrist, digits, and intrinsic hand muscles
  • radial deviation at wrist joint, loss of ab- and adduction of fingers, weak wrist flexion and some loss of flexion of digits
  • losses depend on where nerve is damaged
31
Q

What are the results of an injury to the median nerve (C6-T1 spinal nerve roots) of the brachial plexus?

A
  • can be injured by fracture of the humerus above the condyles, slashing of the wrist, or by inflammation or irritation in the carpal tunnel (Carpal Tunnel Syndrome)
  • flexors of wrist and digits affected, also intrinsic hand muscles, particularly those that move digit 1 (thumb)
  • “Pope’s Blessing” (when making a fist, unable to flex second and third digits). Seen with attempted FLEXION of digits, where 2nd and 3rd digits are left extended
  • “Ape Hand” (thenar eminence atrophy and loss and thenar opposition)
  • paresthesia and/or pain along median nerve
32
Q
A