Cervical mets Flashcards
Myotomes for shoulder abduction
C5,C6
Myotomes for shoulder adduction
C6-C8
Myotomes for elbow flexion
C5,C6
Myotomes for elbow extension
C7-C8
Myotomes for wrist flexion
C6,C7
Myotomes for wrist extension
C7,C8
Myotomes for finger flexion
C7,C8
Myotomes for finger extension
C7,C8
Myotomes for finger abduction
C8,T1
Myotomes for finger adduction
C8,T1
Myotomes for triceps reflex
C7,C8
Myotomes for biceps reflex
C5,C6
Dermatomes for C4
Deltoid
Dermatomal distribution for C5
Lateral aspect of upper arm
Dermatomal distribution for C6
Lateral aspect of forearm, thenar eminence
Dermatomal distribution for C7
Middle finger and a bit of mid-palm region
Dermatomal distribution for C8
Medial aspect of forearm, pinkie, ring finger, hypothenar eminence
Dermatomal distribution for T1
Medial aspect of upper forearm
Dermatomal distribution for T2
Medial aspect of upper forearm and axilla
Describe the spinothalamic tract
Sensory, ascending tract, 3-order neuron pathway
Function: pain, temperature and fine touch
1st order neuron: DRG
2nd order neuron: synapses a couple levels above at the substantia gelatinosa –> decussates @ anterior white commissure and ascends to the thalamus
3rd order: synapses at the ventroposterolateral nucleus and then towards the post-central gyrus in the cortex - primary somatosensory cortex
Describe the corticospinal tract
Motor, descending tract, 2-order neuron pathway
Function: coordinate and voluntary movements
1st order: pre-central gyrus - primary motor cortex descends
90% pyramidal decussation - lower limbs - lateral corticospinal tract
The rest are upper limbs - anterior corticospinal tract
- anterior horn commissure decussation at level of innervation
2nd order: NMJ - innervates muscle
Describe the dorsal column medial lemniscus tract
Sensory, ascending tract, 3-order neuron pathway
Function: crude touch, proprioception and vibration
1st order: DRG peripherally
2rd order: cuneate (Lateral - above T6); gracile nucleus (medial - T6 and below)
pyramidal decussation
3rd order: ventroposterolateral nucleus at the thalamus
Ends - post-central gyrus of the primary somatosensory cortex
Describe UMN lesions clinically
UMN lesion - damage to neurons originating from brain cortices (internal capsule included) and spinal cord
Lesions: muscle wasting, hyper-reflexia, hypertonia, clonus and +ve Babinski sign
Describe LMN lesions clinically
LMN lesion - damage to the anterior horn, nerve roots/plexus, peripheral nerves
Lesions: hypotonia/flaccid, hypo-reflexia, no clonus, prominent muscle wasting, fasciculations
Distinctive features of cervical vertebrae
Bifid spinous process, 3x foramina (1 vertebral, 2 transverse - vertebral arteries). Thick discs relative to vertebral body. Articular facets - posterosuperior, anteroinferior
Distinctive features of thoracic vertebrae
Long spinous processes projecting inferiorly. Articular facets for ribs are present; oriented posteriolateral and anteromedial. Thin discs relative to vertebral body
Distinctive features of lumbar vertebrae
Largest vertebral bodies, thickest discs, large transverse processes. Articular facets are oriented medially and laterally.
