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Neuro 400 > Class 3 > Flashcards

Class 3 Flashcards

0
Q

The ulnar nerve’s relationship to forearm muscles.

A

Under FCU and over FDP

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1
Q

Path of ulnar nerve

A

Inner/medial cord of brachial plexus
Posterior wall of axilla
Under pec minor (as do they all)
Coracobrachialis insertion
Medial triceps, posterior to medial epicondyle and Olecranon
Deep to FCU and above FDP
Over flex Ret and through Tunnel of Guyon (between hook of hamate and pisiform)

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2
Q

Ulnar claw hand

A

5 hyperextended at MCP and abducted at MCP an flexed at IP

Hypothenar mm wasting

Altered sensation in 5 and half of 4

Loss of lumbricals

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3
Q

Froment’s Sign

A

Results from ulnar nerve lesion

Adductor pollicis doesn’t work so can’t hold paper between thumb and index finger. Has to recruit FPL to flex DIP instead.

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4
Q

Tardy ulnar palsy

A

Common complication after elbow fracture.

Associated with callus or valgus deformity at elbow, which produce gradual stretching of nerve in ulnar groove.

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5
Q

Where can the ulnar nerve become compressed?

A 
Cubital tunnel (ulnar collateral ligament + FCU)
Between heads of FCU
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6
Q

What increased the chance of ulnar nerve compression?

A

Elbow Flexion

Valgus elbow

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7
Q

Thoracic outlet syndrome

A

Compression of brachial plexus from structures in thoracic outlet.

May also involve arteries and veins.

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8
Q

Thoracic outlet

A

Inter scalene triangle to inferior border of axilla.

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9
Q

Path of brachial plexus

A

Travels with subclavian artery
Btwn anterior and middle scalene
Then meets up with subclavian vein

Entire neurovascular bundle goes behind clavicle and under pec minor attachment and down arm.

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10
Q

Symptoms of TOS

A

Pain, numbness, weakness.
Tingling in arm, across upper thoracic area or over scapula
Trophic changes.

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11
Q

Causes of TOS

A 
Cervical rib (C7)
Anterior scalene syndrome
Scalene triangle syndrome
Costoclavicular syndrome 
Pec minor syndrome
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12
Q

Anterior scalene syndrome

A

TOS caused by brachial plexus being compressed between anterior and middle scalene

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13
Q

Scalene triangle syndrome

A

TOS caused by brachial plexus being caught in between anterior scalene (anterior), middle scalene (posterior) and R1 (inferior).

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14
Q

Costoclavicular syndrome

A

TOS caused by brachial plexus being compressed between clavicle and R1.

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15
Q

Pec Minor syndrome

A

TOS involving compression between the coracoid process and pec minor

Happens with hyperabduction with ER/extension

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16
Q

Lumbar plexus

A

Between heads of Psoas major, anterior to QL

Formed by anterior rami of spinal nerves L1-4

Supplies anterolateral abdominal wall, external genitals, part of lower limbs.

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17
Q

What nerves emerge from the lumbar plexus?

A 
Iliohypogastric
Ilioinguinal 
Genitofemoral
Lateral cutaneous nerve of the thigh 
Femoral
Obturator
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18
Q

Iliohypogastric nerve

A

L1
Anterior division of lumbar plexus

Ant-lat abdominal muscles
Skin of inferior abdomen and butt

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19
Q

Ilioinguinal nerve

A

L1
Anterior division of lumbar plexus

Ant-lateral muscles and skin of superior and medial thigh

Root of penis and scrotum

Labia majora and mons pubis

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20
Q

Genitofemoral nerve

A

L1-2
Anterior division of lumbar plexus

Cremaster muscle
Skin of middle anterior thigh
Scrotum and labia majora

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21
Q

Lateral cutaneous nerve of the thigh

A

L2-3
Posterior division of lumbar plexus

Skin of lateral, anterior and posterior thigh

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22
Q

Femoral nerve

A

Largest nerve in lumbar plexus

L2-4
Posterior division of lumbar plexus

Hip flexor muscles
Knee extensors
Skin of ant/med thigh and medial leg and foot

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23
Q

Obturator nerve

A

L2-4
Anterior division of lumbar plexus

Hip adductor muscles
Skin of medial thigh.

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24
Q

L1

A

Iliohypogastric nerve

Ilioinguinal nerve

25
Q

L1-L2

A

Genitofemoral nerve

26
Q

L2-L3

A

Lateral cutaneous nerve of the thigh

27
Q

L2-L4

A

Femoral nerve

Obturator nerve

28
Q

Injury to femoral nerve

A

Can’t extend knee or flex hip
Wasting if quads
No sensation over ant/med thigh

29
Q

Injury of obturator nerve

A

Paralysis of adductors

No sensation over medial thigh

30
Q

Meralgia paresthetica

A

Entrapment of lateral cutaneous nerve near ASIS as nerve passes under inguinal ligament

Sensory alteration/burning pain in lateral thigh.

31
Q

Sacral Plexus

A

L4-S4

Mostly anterior to sacrum
Supplies buttocks, perineum, lower limbs

32
Q

Nerves of the sacral plexus

A 
1 Superior gluteal
2 Inferior gluteal
3 Nerve to piriformis
4 Nerve to quadrator femoris & inf. gemellis
5 Nerve to obturator internus & sup. gemellis
6 Perforating cutaneous
7 Posterior cutaneous nerve of the thigh
8 Sciatic
9 Tibial
10 Common fibular
11 Pudendal
33
Q

Superior gluteal nerve

A

L4-S1

Glute min, glute med, TFL

34
Q

Inferior gluteal nerve

A

L5-S2

Glute max

35
Q

Nerve to piriformis

A

S1-2

Piriformis

36
Q

Nerve to quadrator femoris & inferior gemellis

A

L4-S1

Quadrator femoris
Inferior gemellis

37
Q

Nerve to obturator internus & superior gemellis

A

L5-S2

Obturator internus
Superior gemellis

38
Q

Perforating cutaneous nerve

A

S2-3

Skin of inferior and medial buttocks

39
Q

Sciatic nerve

A

L4-S3

Largest and longest nerve in the body

Hamstrings, adductor Magnus

Bundle of tibial and common Fibular which split at knee

40
Q

Tibial nerve

A

L4-S3

Branch of sciatic

Gastrocnemius, soleus, plantaris, popliteus, tib post, FDL and FHL

Branches into medial and lateral plantar at foot.

41
Q

Medial plantar nerve

A

Branch of Tibial

Adductor hallucis, FDB, FHB, skin of medial plantar foot.

42
Q

Lateral plantar nerve

A

Branch of tibial

Foot mm not served by medial plantar nerve

43
Q

Common fibular nerve

A

L4-S2

Branch of sciatic.

Divides into superficial and deep fibular

44
Q

Superficial fibular nerve

A

Branch of common fibular

Fib long, fib brev, and skin of distal anterior leg and foot dorsum.

45
Q

Deep fibular nerve

A

Branch of common fibular

Tib ant, EHL, fib tertius, EDL, EDB and skin of toes 1 and 2.

46
Q

Pudendal Nerve

A

S2-4

Muscles of perineum
Skin of penis, scrotum, clitoris, labia majora and minora, and vagina.

47
Q

L4-S1

A

Superior gluteal

N to QF and Inf Gem

48
Q

L4-S2

A

Common fibular

49
Q

L4-S3

A

Sciatic nerve

Tibial nerve

50
Q

L5-S2

A

Inferior gluteal

N to Ob Int and Sup Gem

51
Q

S1-S2

A

Piriformis

52
Q

S1-S3

A

Post Cut N of the Thigh

53
Q

S2-S3

A

Perforating cutaneous nerve

54
Q

S2-S4

A

Pudendal

55
Q

Route of sciatic nerve

A

Sciatic foramen
Under (or through) piriformis
Between Ischial tuberosity and greater trochanter

Goes deep, follows adductor Magnus

Splits at popliteal fossa into tibial and common fibular

56
Q

Route of tibial nerve

A

Goes between heads of gastrocs

Superficial between medial malleolus and Achilles.

Goes around malleolus and travels deep to flexor retinaculum

Divides into medial and lateral plantar nerves

57
Q

Route of common fibular nerve

A

Travels around and below head of fibula

Splits into superficial and deep fibular nerves

Deep fib: deep to EDL and down to dorsum of foot

Superficial fib: down lateral leg to foot.

58
Q

Tarsal Tunnel syndrome

A

Tibial nerve compressed as it passes through tarsal tunnel

Pain and paesthesia in sole of foot
Worse after long periods of standing or walking.

Night waking (like carpal tunnel)

59
Q

Tarsal tunnel

A

Formed by medial malleolus, calcaneous, and talus on one side; deltoid ligament on the other.

60
Q

Symptoms of sciatic nerve compression

A

Pain from buttocks and down lateral leg and foot

Foot drop. Paralysis of dorsiflexors and everters.

61
Q

Nerve to the Piriformis

A

S1-S2

Piriformis

Neuro 400 (10 decks)

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