Ch9 Major Plexuses Flashcards

1
Q

Cervical Plexus origin

A

XI

C1-C5

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2
Q

Cervical Plexus innervates

A

Neck muscles

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3
Q

Cervical plexus sensory of

A

neck and top of shoulder

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4
Q

C2, C3, C4 contribute to which nerve?

A

Phrenic

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5
Q

Brachial plexus roots

A

C5 - T1

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6
Q

Brachial plexus arise from

A

Cervical enlargement

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7
Q

Long Thoracic Nerve Injury mechanism

A

in sports

from traction or direct trauma under the arm

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8
Q

Long Thoracic Nerve signs

A

winging scapula

medial border of scapula, present abnormally posterior

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9
Q

Dorsal Scapular Nerve Injury sign

A

weakness of rhomboids

scapula moves away from spine (flaring)

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10
Q

Define Flaring

A

inferior border of scapula sits abnormally lateral

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11
Q

List Brachial Plexus- Trunks pathologies

A
Erb Palsy
Middle Trunk Injury
Klumpke Paralysis
Thoracic outlet syndrome
Scalene triangle
Costoclavicular Entrapment
Clavicle first rib
Pectoralis Minor Syndrome
Pancoast Syndrome
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12
Q

Erb Palsy affect ____ trunk of brackial plexus

A

upper

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13
Q

Erb Palsy is due to

A

traction injury to C5 and C6 nerve roots

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14
Q

a position that is a sign of erb palsy

A

waiter’s tip position

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15
Q

Define waiter’s tip position

A

internal rotation of arm, and flat writ

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16
Q

Middle Trunk Injury affect

A

C7 distribution

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17
Q

Klumpke Paralysis located in

A

Lower trunk of brachial plexus

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18
Q

Klumpke Paralysis is cased by

A

falling and hanging on Pancoast tumor

T1 transverse process or 1st rib fracture

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19
Q

Klumpke Paralysis signs

A

Ulnar nerve (C8 and T1 signs):

  • Wrist and finger flexion weakness
  • Hypothenar atrophy
  • Possible Horner syndrome
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20
Q

Thoracic outlet syndrome is tested by

A

RooTest (E.A.S.T)

very sensitive, but not specific

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21
Q

Thoracic outlet syndrome is compression of

A

brachial plexus and subclavian (or axillary) artery

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22
Q

Thoracic outlet syndrome signs and symptoms

A

weakness, Numbness and, tingling when working above head

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23
Q

Scalene triangle is caused by a compression of the

A

anterior scalene muscle or cervical rib

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24
Q

Scalene triangle tests

A

adson test

halstead test

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25
Q

Scalene triangle signs

A

involves subclavian artery but not the vein

  • Decreased pulse amputation
  • No hand swelling
  • Ulnar nerve is most effected
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26
Q

Clavicle first rib aka

A

Costoclavicular Entrapment

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27
Q

Costoclavicular Entrapment is tested by

A

Eden

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28
Q

Eden aka

A

costoclavicular test

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29
Q

Costoclavicular Entrapment due to

A

Elevation of first rib

Inferior clavicle on that side

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30
Q

Costoclavicular Entrapment is caused by

A

large breasts
bra strap
heavy bags on shoulder straps
seat belt injury

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31
Q

Costoclavicular Entrapment symptoms involves

A

hand swelling

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32
Q

Pectoralis Minor Syndrome is tested by

A

wright test

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33
Q

Pectoralis Minor Syndrome is caused by

A

over-development of pecs

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34
Q

Pectoralis Minor Syndrome sign and symptoms

A

weakness of rhomboids (dorsal scap n)

compression of axillary artery and vein

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35
Q

Pancoast syndrome is caused by

A

Apical lung tumor

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36
Q

Pancoast Syndrome signs

A

same as Horner Syndrome:
droopy eye constricted pupil, no facial sweating “anhidrosis”
may involve brachial plexus

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37
Q

Brachial Plexus -Divisions

A

Anterior - flexors

Posterior- extensors

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38
Q

Brachial Plexus- Medial trunk innervates

A

Pec minor

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39
Q

Brachial Plexus- Lateral trunk innervates

A

Pec Major

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40
Q

Brachial Plexus- Branches include which nerves?

A
Musculocutaneous
Axillary
Radial
Median
Ulnar
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41
Q

Musculocutaneous Nerve origin:

A

Lateral Cord

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42
Q

Musculocutaneous Nerve innervates

A

Biceps
brachialis
coracobrachialis

43
Q

Axillary Nerve origin

A

Posterior cord

44
Q

Axillary Nerve innervates

A

teres minor

deltoid

45
Q

Radial Nerve Origin

A

Posterior cord

46
Q

Radial Nerve innervates

A

Triceps
Brachioradialis
wrist and finger extensors

47
Q

Saturday night palsy aka

A

crutch palsy

48
Q

Saturday night palsy location

A

entrapment in the arm pit

49
Q

Saturday night palsy sign

A

damage to the spiral groove (honeymooner palsy)

50
Q

Honeymooner palsy signs

A

wrist drop

weakness of arm, hand, fingers

51
Q

Median Nerve orign

A

lateral and medial cords

52
Q

Median Nerve innervates

A
pronator teres
finger flexors
thenar eminence
flexor carpi radialis
palmaris longus
53
Q

Median Nerve pathological signs

A

weakness of the wrist flexion, abduction, thumb opposition, flexion of second, and third fingers
sensory loss of first 3 ½ fingers

54
Q

Carpal Tunnel Syndrome Median neuropathy is located in

A

entrapment in the carpal tunnel

55
Q

Carpal Tunnel Syndrome Median neuropathy is caused by

A

repetitive stress injury

56
Q

Carpal Tunnel Syndrome Median neuropathy is most common in (what population)

A

women over 30

57
Q

Carpal Tunnel Syndrome Median neuropathy signs

A

sensory loss as described
symptoms worse at night, better when shaking the hand
May radiate back to the up the arm

58
Q

CTS tests

A

Inspection: advanced cases may show thenar atrophy
Muscle testing: thumb opposition
Ortho test: phalen, tinel, prayer sign

59
Q

CTS management

A
  • Cervical adjustment
  • Shoulder adjustment
  • Elbow adjustment
  • Wrist adjustment
  • Strengthening of finger and wrist extensors
  • Proximation of the distal radioulnar joint (increase pronator quadratus strength)
60
Q

Ulnar Nerve origin

A

medial cord

61
Q

Ulnar Nerve innervates

A

hypothenar eminence
flexor carpi ulnaris
palmar and dorsal interossi

62
Q

Ulnar neuropathy is due to

A
  • Increased carrying angle at elbow

- Tunnel of guyon at wrist

63
Q

Ulnar neuropathy is tested by

A

tinel froment

64
Q

Ulnar neuropathy signs

A

weakness of wrist flextion, abduction, adduction,

sensory loss of fingers 4 and 5

65
Q

Claw Hand is extension at _____, and flexion at______

A

Extension at MCP (long extensors work

Flexion at PIP and DIP (long flexors work)

66
Q

Claw Hand is due to

A

wasting of the interossei muscle and short finger flexors of hypothenar eminence

67
Q

Lumbosacral Plexus oirgin

A

L1 - S4

68
Q

Lumbosacral Plexus innervate

A

Lower extremity and pelvis

69
Q

Iliohypogastric nerve origin

A

L1

70
Q

Iliohypogastric nerve function

A

sensory over pubic symphysis

71
Q

Ilioinguinal nerve origin

A

L1

72
Q

Ilioinguinal nerve innervation

A

sensory over the inguinal ligament

73
Q

Ilioinguinal nerve often cut during

A

abdominal surgeries

74
Q

Genitofemoral nerve origin

A

L1, L2

75
Q

Genitofemoral nerve innervates

A

sensory to upper inner thigh

motor to cremaster muscle

76
Q

Femoral nerve origin

A

L3,4,5

77
Q

femoral nerve innervates

A

Leg flexors at hip

Leg extensors at knee

78
Q

Obturator nerve origin

A

L2,3,4

79
Q

Obturator nerve innervates

A

thigh adductors

80
Q

Lateral femoral cutaneous nerve origin

A

L2, L3 posterior division

81
Q

Lateral femoral cutaneous nerve innervation

A

sensory to lateral femoral

82
Q

Lateral femoral cutaneous nerve entrapment aka

A

Meralgia paresthetica

83
Q

Meralgia paresthetica site of entrapment

A

blow ASIS under the inguinal ligament

84
Q

Meralgia paresthetica caused by

A

tight waist band/ belt

85
Q

Superior gluteal nerve origin

A

L4, L5, S1 anterior division

86
Q

Superior gluteal nerve innervation

A

: gluteus medius and minimus

87
Q

Inferior gluteal nerve origin

A

L4, L5, S1, S2 anterior division

88
Q

Inferior gluteal nerve innervation

A

gluteus maximus

89
Q

Sciatic nerve origin

A

L4, L5, S1, S2 anterior division

90
Q

Sciatic nerve innervation

A

Hamestrings

91
Q

2 Nerves that constitute sciatic

A

Tibial

Common peroneal

92
Q

Sciatic neuropathy/radiculopathy is caused by

A

posterior hip dislocation
acetabular fracture (dashboard injuires) muscular injection in buttocks
piriformis entrapment

93
Q

Sciatic neuropathy/radiculopathy symptoms

A

weakness of all foot and ankle muscles, knee flexors, Achilles reflex
sensory loss of foot, lateral leg below knee

94
Q

Sciatica is

A

paresthesia along the distribution of sciatic nerve

95
Q

Sciatica most commonly is caused by

A

lumbosacral nerve root compression by disc or osteophytes

96
Q

Sciatica May be caused by

A

distal entrapment

piriformis syndrome, chiropractic connections

97
Q

Posterior femoral cutaneous nerve origin

A

S1, S2, S3 posterior divisions

98
Q

Pudendal plexus origin

A

S1, S2, S3 anterior divisions

99
Q

Pudendal plexus innervates

A

pelvic floor, sphincters

100
Q

Peroneal (Fibular) Nerve Palsy Symptoms

A

weakness of foot inversion

101
Q

what can be in differential with Peroneal (Fibular) Nerve Palsy

A

L5 radiculopathy

102
Q

Morton Neuroma aka

A

Morton metatarsalagia

103
Q

Morton Neuroma is caused by

A

tight fitting shoes

104
Q

Morton Neuroma symptoms

A

pain
numbness
paresthesia between the third and fourth toes