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CNS CLERKSHIP > Clinical Testing of Spinal Nerves > Flashcards

Clinical Testing of Spinal Nerves Flashcards

1
Q

Describe somatic general sensory supply of spinal nerves.

A
  • Provided by sensation specific receptors in all body wall structures.
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2
Q

What senses are experienced via somatic general sensory supply?

A
  • Touch.
  • Temperature.
  • Proprioception.
  • Vibration.
  • Pain.
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3
Q

Describe somatic motor function of spinal nerves.

A

Somatic motor axons synapse on all body wall skeletal muscle fibres - e.g. to enable locomotion.

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4
Q

Describe sympathetic motor function of spinal nerves.

A
  • Motor supply to organs.
  • Sympathetic axons carried on spinal nerves.
  • Synapse on the glands of the body wall and smooth muscle fibres.
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5
Q

What carries sympathetic axons?

A

Spinal nerves.

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6
Q

Where do sympathetic axons synapse?

A
  • Body wall glands.

- Smooth muscle fibres.

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7
Q

How do spinal reflexes arise?

A

Spinal cord allows for segmental synapses between somatic sensory axons and somatic motor axons.

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8
Q

Where do posterior rami supply skin?

A

Central strip down the back and posterior neck.

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9
Q

Anterior rami form which plexuses?

A
  • Cervical.
  • Brachial.
  • Lumbar.
  • Sacral.
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10
Q

The lower anterolateral trunk wall is supplied by what nerves?

A

Iliohypogastric and ilioinguinal.nerves.

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11
Q

Iliohypogastric and ilioinguinal nerves are formed from the anterior ramus of which spinal nerve?

A

L1

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12
Q

Femoral nerve roots.

A

L2-L4.

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13
Q

What type of axons are found in the femoral nerve?

A
  • Sensory, motor and sympathetic.
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14
Q

How many true dermatomes does the area of cutaneous innervation of the femoral nerve cross?

A

L2-4 i.e. 3 true dermatomes.

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15
Q

Anterolaterally, the neck skin is supplied by what?

A

Cervical plexus.

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16
Q

Cervical plexus arises from anterior rami of which spinal nerves?

A

C1-4.

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17
Q

Posterior neck and scalp skin is mainly supplied by the posterior rami of which spinal nerves?

A

C2-C8.

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18
Q

What is the “nerve point” of the neck?

A

Where sensory nerves of cervical plexus converge ans pass from superficial to deep fascia.

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19
Q

Where is the “nerve point” of the neck found?

A

At the midpoint of the posterior border of sternocleidomastoid.

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20
Q

What supplies the skin posterior to the external ear?

A

Lesser occipital branch of C2.

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21
Q

What supplies the skin over the angle of the mandible and some of the external ear?

A

Great auricular nerve - C2,3.

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22
Q

What supplies the skin over the anterior neck?

A

Transverse cervical C2,3.

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23
Q

What supplies the skin over the clavicle and the “shoulder tip”?

A

Supraclavicular nerves C3,4.

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24
Q

What nerve is responsible for the referred pain from the diaphragm to the shoulder?

A

Supraclavicular nerves C3,4.

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25
Q

LITTLE GOATS TREAD SOFTLY.

A
  • Lesser occipital.
  • Greater auricular.
  • Transverse cervical.
  • Supraclavicular.
  • Named nerve cutaneous innervation of anterolateral neck.
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26
Q

The anatomical snuff box is supplied by the cutaneous branches of which nerve?

A

Radial nerve.

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27
Q

Radial nerve roots.

A

C5-T1.

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28
Q

Anterior rami of which nerve roots are important for referred pain from the myocardium?

A

T1 and T2.

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29
Q

When testing sensory function of a peripheral nerve, to which part of the spinal cord does the action potential ultimately enter?

A

Posterior horn.

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30
Q

What should you examine to test the C1-4 motor axons (myotomes) of the cervical plexus?

A
  • Neck postural and strap muscles.

- Diaphragm.

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31
Q

What should you examine to test the C5-T1 motor axons (myotomes) of the brachial plexus?

A
  • Muscles of the upper limb.

- Extrinsic back muscles that move the upper limb or scapula.

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32
Q

What should you examine to test the motor axons (myotomes) of T2-L3?

A
  • Postural back muscles (posterior rami).
  • Intercostal muscles (anterior rami).
  • Anterolateral abdominal wall muscles.
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33
Q

Motor axons of the Lumbosacral plexus L1-S4 supply what?

A
  • Muscles of the lower limb.

- Perineal skeletal muscles.

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34
Q

The area of motor innervation of the femoral nerve crosses how many true myotomes?

A

3.

- L2, L3 and L4 spinal nerves.

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35
Q

How to test C5 myotome?

A

Shoulder abduction.

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36
Q

Which muscle is tested for C5 myotome (shoulder abduction)?

A

Deltoid.

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37
Q

How to test C6 myotome?

A

Elbow flexion.

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38
Q

Which muscle is tested for C6 myotome (elbox flexion)?

A

Biceps brachii.

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39
Q

How to test the C7 myotome?

A

Elbow extension.

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40
Q

Which muscle is tested for C7 myotome (elbow extension)?

A

Triceps brachii.

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41
Q

How to test the C8 myotome?

A

Finger flexion.

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42
Q

Which muscle is tested for C8 myotome (finger flexion)?

A

Flexor digitorum superficialis.

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43
Q

How to test the T1 myotome?

A

Finger abduction.

44
Q

Which muscle is tested for T1 myotome (finger abduction)?

A

Dorsal interossei.

45
Q

How to test the L3 myotome?

A

Knee extension.

46
Q

Which muscle is tested for L3 myotome (knee extension)?

A

Quadriceps femoris.

47
Q

How to test the L4 myotome?

A

Ankle dorsiflexion.

48
Q

Which muscle is tested for L4 myotome (ankle dorsiflexion)?

A

Tibialis anterior.

49
Q

How to test the L5 myotome?

A

Great toe extension.

50
Q

Which muscle is tested for L5 myotome (great toe extension)?

A

Extensor hallucis longus.

51
Q

How to test the S1 myotome?

A

Ankle plantarflexion.

52
Q

Which muscle is tested for S1 myotome (ankle plantarflexion)?

A

Gastrocnemius.

53
Q

How to test the S2 myotome?

A

Knee flexion.

54
Q

Which muscle is tested for S2 myotome (knee flexion)?

A

Biceps femoris.

55
Q

APs of peripheral nerves are generated by voluntary intention where?

A

Primary somatosensory cortex.

56
Q

APs of peripheral nerves are conducted via what axons of the corticospinal tract?

A

Upper motor neuron axons.

57
Q

APs of peripheral nerves continue alone UMN axons to which horn of the spinal cord?

A

Anterior.

58
Q

UMN axons of peripheral nerves synapse with what to stimulate an AP?

A

LMNs.

59
Q

With regards to peripheral nerves, after UMN synapse with LMN to stimulate APs, the AP then continues along axons to what?

A

Spinal nerve.

60
Q

UMN lesions cause what?

A

Spasticity.

61
Q

LMN lesions cause what?

A

Flaccidity.

62
Q

Reflex testing of Biceps brachii tests what spinal levels?

A

C5 and C6.

63
Q

Reflex testing of Triceps brachii tests what spinal levels?

A

C7.

64
Q

Reflex testing of Brachioradialis tests what spinal levels?

A

C6.

65
Q

Reflex testing of knee jerk tests what spinal levels?

A

L3

66
Q

Reflex testing of ankle jerk tests what spinal levels?

A

S1

67
Q

Name the peripheral nerve motor innervation to the muscles of facial expression.

A

CN VII.

68
Q

Name the peripheral nerve motor innervation to the muscles of mastication.

A

CN V3.

69
Q

Name the peripheral nerve motor innervation to the muscles of the tongue.

A

CN XII.

70
Q

Name the peripheral nerve motor innervation to the muscles of the soft palate.

A

CN X (pharyngeal plexus).

71
Q

Name the peripheral nerve motor innervation to the neck postural muscles.

A

Posterior rami of cervical spinal nerves.

72
Q

Name the peripheral nerve motor innervation to the strap muscles of the neck.

A

Cervical plexus C1-3.

73
Q

Name the peripheral nerve motor innervation to the diaphragm.

A

Phrenic nerve C3,4,5 from the cervical plexus.

74
Q

Name the peripheral nerve motor innervation to the sternocleidomastoid and trapezius muscles.

A

CN XI.

75
Q

Name the peripheral nerve motor innervation to the muscles of the pharynx.

A

CN X mainly.

76
Q

Name the peripheral nerve motor innervation to the intrinsic muscles of the larynx.

A

CN X.

77
Q

Name the peripheral nerve motor innervation to the intercostal muscles.

A

Intercostal nerves.

78
Q

Name the peripheral nerve motor innervation to the anterolateral abdominal wall muscles.

A

Thoracoabdominal nerves.

79
Q

Name the peripheral nerve motor innervation to the erector spinae and transversospinalis muscle groups.

A

Posterior rami of spinal nerves.

80
Q

Axillary nerve is the named nerve motor innervation of which muscles in the upper limb?

A

Deltoid and teres minor.

81
Q

Radial nerve is the named nerve motor innervation of which muscle in the posterior compartment of the arm?

A

Triceps brachii.

82
Q

Radial nerve is the named nerve motor innervation of which muscles in the posterior compartment of the forearm?

A
  • Brachioradialis.
  • Supinator.
  • ALL extensors of carpus and digits.
  • Abductor pollicis longus.
83
Q

Musculocutaneous nerve is the named nerve motor innervation of which muscles in the upper limb?

A

ALL of anterior compartment of arm.

  • Biceps brachii.
  • Brachialis.
  • Coracobrachialis.
84
Q

Musculocutaneous nerve has which spinal roots?

A

C5,6,7.

85
Q

Axillary nerve has which spinal roots?

A

C5,6.

86
Q

Radial nerve has which spinal roots?

A

C5-T1.

87
Q

Median nerve is the named nerve motor innervation of which muscles in the anterior compartment of the forearm?

A

Anterior compartment of forearm.

  • Pronator (teres and quadratus).
  • Flexor carpi radialis.
  • Palmaris longus.
  • Flexor digitorum superficialis.
  • Lateral half of flexor digitorum profundus.
  • Flexor pollicis longus.
88
Q

Median nerve is the named nerve motor innervation of which muscles of the hand?

A
  • Thenar muscles.

- Lumbricals 1&2.

89
Q

Median nerve has which spinal roots?

A

C5-T1.

90
Q

Ulnar nerve has which spinal roots?

A

C7-T1.

91
Q

Ulnar nerve is the named nerve motor innervation of which muscles in the anterior compartment of the forearm?

A
  • Flexor carpi ulnaris.
  • Medial half of flexor pollicis longus.
  • Adductor pollicis.
92
Q

Ulnar nerve is the named nerve motor innervation of which muscles of the hand?

A
  • Hypothenar muscles.
  • Lumbricals 3 & 4.
  • ALL interossei, both dorsal and palmar.
93
Q

Femoral nerve has which spinal roots?

A

L2-4.

94
Q

Femoral nerve is the named nerve motor innervation to which muscles of the lower limb?

A
  • Quadriceps femoris.
  • Sartorius.
  • Pectineus.
95
Q

Obturator nerve is the named nerve motor innervation to which muscles of the lower limb?

A

ALL of the medial compartment of thigh.

  • Obturator externus.
  • Gracilis.
  • Adductor brevis.
  • Adductor magnus.
  • Adductor longus.
96
Q

Tibial division of the sciatic nerve is the named nerve motor innervation to which muscle groups of the lower limb?

A
  • Posterior compartment of thigh.
  • Posterior compartment of leg.
  • Sole of foot.
97
Q

Name the muscles of the posterior compartment of the thigh innervated by the tibial division of the sciatic nerve?

A
  • Semimembranosus.
  • Semitendinosus.
  • Long head of biceps femoris.
98
Q

Name the muscles of the posterior compartment of the leg innervated by the tibial division of the sciatic nerve?

A
  • Gastrocnemius.
  • Soleus.
  • Plantaris.
  • Popliteus.
  • Tibialis posterior.
  • Flexors of the digits.
99
Q

Name the muscles of the sole of the foot innervated by the tibial division of the sciatic nerve.

A

ALL intrinsic muscles of the sole of the foot.

100
Q

Spinal roots of tibial division of sciatic nerve?

A

L4-S3.

101
Q

Spinal roots of common fibular division of sciatic nerve?

A

L4-S2.

102
Q

Name the muscles of the lower limb receiving innervation via the common fibular division of sciatic nerve.

A

Short head of biceps femoris.

103
Q

Name the muscles of the lower limb receiving innervation via the superficial fibular branch of the sciatic nerve.

A

Lateral compartment of leg:

  • Fibularis longus.
  • Fibularis brevis.
104
Q

Name the groups of muscles of the lower limb receiving innervation via the deep fibular branch of the sciatic nerve?

A
  • Anterior compartment of leg.

- Dorsum of foot.

105
Q

Name the muscles of the anterior compartment of the leg receiving innervation via the deep fibular branch of the sciatic nerve.

A
  • Tibialis anterior.
  • Extensor digitorum longus.
  • Extensor hallucis longus.
106
Q

Name the muscles of the dorsum of the foot receiving innervation via the deep fibular branch of the sciatic nerve.

A
  • Extensor digitorum brevis.

- Extensor hallucis longus.

CNS CLERKSHIP (43 decks)

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