Exam 2 Spinal Nerves/ Cervical Plexus

Question 1

What are the numbers for each spinal group that make up the spinal nerve pairs

Answer 1

• 8 cervical pairs
• 12 thoracic pairs
• 5 lumbar pairs
• 5 sacral nerve pairs
• 1 coccygeal nerve pair

Question 2

What do the anterior (ventral or motor) roots carry

Answer 2

Efferent axons from cell bodies

Question 3

Where are the cell bodies located from the efferent information carried by the anterior (ventral or motor) roots

Answer 3

In the anterior (ventral) or lateral (if present) horns

Question 4

How is the anterior roots of the spinal nerves connected to the spinal cord

Answer 4

By a series of rootlets

Question 5

What do the posterior roots of spinal nerves cary

Answer 5

Axons from cell bodies in the dorsal root ganglion

Question 6

What is another name for the dorsal (posterior) root ganglion

Answer 6

Just spinal ganglion

Question 7

What is type of roots are carried in the posterior/dorsal roots of the spinal nerves

Answer 7

Sensory

Question 8

Where do the posterior roots attach after being separated into a number of rootlets

Answer 8

Posterolateral sulcus

Question 9

Where are spinal ganglia typically located

Answer 9

Either inside or just medial to the IVF beyond the dura mater innervated by the epineuranium

Question 10

For the posterior roots of C1 and C2 where are their ganglia located

Answer 10

On their respective vertebral arches

Question 11

Where are the sacral ganglia located for the posterior roots

Answer 11

Within the vertebral column outside the dura

Question 12

Where are the coccygeal ganglia located for the posterior roots

Answer 12

Located inside the dura mater

Question 13

After combining the spinal nerves become what type of spinal nerve

Answer 13

Mixed!

Question 14

What branch is given off shortly after the spinal nerves combine to make it mixed

Answer 14

A meningeal branch is given off

Question 15

What are two other names for the meningeal branch given off

Answer 15

• recurrent meningeal

- sinuvertebral

Question 16

What is present at all spinal nerves

Answer 16

The meningeal branch

Question 17

Where does the meningeal branch re-enter the vertebral canal and what happens to it

Answer 17

The IVF and divides into ascending, descending, and transverse branches

Question 18

What does the meningeal branch do

Answer 18

Provides somatosensory and sympathetic supply to the dura, blood vessels, periosteum, ligaments, and IVD’s in the anterior and lateral portions of the canal

Question 19

The mixed spinal nerve divides into two primary rami what are they

Answer 19

• posterior (dorsal) primary ramus

- anterior (ventral) primary ramus

Question 20

The posterior (dorsal) primary ramus splits into what with what exception

Answer 20

Lateral and medial branches EXCEPT C1, so C2 and below

Question 21

The posterior (dorsal) primary ramus is smaller or larger than the anterior ramus except where

Answer 21

Smaller EXCEPT C1, S4, and S5

Question 22

The posterior (dorsal) primary ramus carries motor innervation to where

Answer 22

Deep back muscles

Question 23

The posterior (dorsal) primary ramus carries sensory info from where

Answer 23

The skin paraspinally (either side of the spine)

Question 24

Where does the anterior (ventral) primary ramus motor fibers innervate

Answer 24

Anterior and lateral trunk muscles as well as extremities

Question 25

Where does the anterior (ventral) primary ramus carry sensory info to

Answer 25

Skin of extremities and anterior/lateral trunk

Question 26

What does the anterior rami contribute to

Answer 26

The great plexuses

Question 27

Where is the sympathetic chain communications located

Answer 27

Either at or just medial to bifurcation of the mixed spinal nerve

Question 28

What does the white ramus communicans carry

Answer 28

Myelinated axons from cell bodies located in lateral horn cells at cord levels T1 - L2

Question 29

Where do preganglionic sympathetic fibers of the sympathetic chain enter

Answer 29

Via the white rami communicans

Question 30

What do preganglionic sympathetic fibers entering the sympathetic chain do?

Answer 30

- synapse in a sympathetic chain ganglion | - pass through via splanchnic nerves

Question 31

What do gray ramus communicans carry

Answer 31

Unmyelinated postganglionic sympathetic axons from cell bodies in sympathetic chain to the spinal nerve

Question 32

Are preganglionic sympathetic fibers of the white ramus communicans myelinated or unmyelinated?

Answer 32

Usually myelinated

Question 33

Gray communicans is associated with what in regards to spinal nerve levels

Answer 33

Associated with every spinal nerve = meaning every spinal nerve carries post gang symp fibers

Question 34

For cervical posterior rami C1 is named what?

Answer 34

Suboccipital nerve

Question 35

For cervical posterior rami what is C1 motor supply

Answer 35

To the suboccipital muscles

Question 36

What suboccipital muscles does C1 spinal nerve supply

Answer 36

- rectus capitis posterior major and minor - obliquus capitis superior and inferior - semispinalis capitis

Question 37

For cervical posterior rami what is the name of C2 medial branch and what does it do

Answer 37

The greater occipital nerve, sensory innervation to posterior neck and scalp

Question 38

What is the theme associated with cervical posterior rami

Answer 38

Medial=sensory | Lateral = motor

Question 39

For cervical posterior rami what does the C2 lateral branch do

Answer 39

it is Motor supply to semispinalis capitis, longissimus capitis, splenius capitis muscles

Question 40

For cervical posterior rami what is the name of C3 medial branch and what does it do

Answer 40

Least occipital nerve; sensory supply from skin of posterior neck

Question 41

For cervical posterior rami what does the C3 lateral branch do

Answer 41

Motor supply to muscles same as C2 = semispinalis capitis, longissimus capitis, splenius capitis muscles

Question 42

For cervical posterior rami what does the C4-C8 medial branches do

Answer 42

Sensory from skin of posterior neck

Question 43

For cervical posterior rami what does the C4-C8 lateral branches do

Answer 43

Motor supply to iliocostalis cervicis, longissimus cervicis, and captitis

Question 44

What forms the cervical plexus

Answer 44

Anterior (primary) rami of C1-C4 spinal nerves

Question 45

What do the nerve roots of the cervical plexus do?

Answer 45

Form a series of communicating loops

Question 46

In the cervical plexus what communicates with the loop formed by C1 and C2

Answer 46

The inferior vagal ganglion

Question 47

In the cervical plexus what carries proprioceptive info to communicated with loop formed by C2/C3 and C3/C4

Answer 47

The spinal accessory nerve

Question 48

Where does the spinal accessory nerve carry proprioceptive info from in the cervical plexus

Answer 48

The SCM to C2/C3 loop and the trapezius to C3/C4 loop

Question 49

The hypoglossal nerve communicates with C1 fibers that later separate to become what

Answer 49

The superior root of the ansa cervicalis

Question 50

What forms the superior root of the ansa cervicalis

Answer 50

The hypoglossal nerve communicates with C1 fibers that later separate from the hypoglossal nerve

Question 51

What do C1 spinal nerve fibers supply when it remains with the hypoglossal nerve

Answer 51

Thyrohyoid and geniohyoid

Question 52

What three gray rami communicans carry postgang symp fibers and to what loop

Answer 52

Vasomotor, sudomotor, pilomotor to loop between C1/C2 and roots of C3/C4 spinal nerves

Question 53

The lesser occipital nerve carries fibers from where

Answer 53

C2 and occasionally C3 spinal nerve to supply skin on superior 1/3 of auricle and skin behind the ear

Question 54

The lesser occipital nerve has communications with what

Answer 54

The greater occipital nerve and great auricular nerve

Question 55

What may be implicated by communications of lesser occipital nerve with the greater occiptal nerve and great auricular nerve

Answer 55

May be implicated in cases of cervicogenic headache

Question 56

The great auricular nerve carries fibers from where?

Answer 56

C2 and C3

Question 57

Where does the great auricular nerve divide into anterior and posterior branches

Answer 57

Once entering the parotid gland

Question 58

What does the anterior branch of the great auricular nerve combine with

Answer 58

The facial nerve to supply skin over parotid gland

Question 59

What does the posterior branch of the great auricular nerve do

Answer 59

Supplies sin over mastoid process

Question 60

The transverse cutaneous nerve of the neck carries fibers from where

Answer 60

C2/C3

Question 61

After the transverse cutaneous nerve divides into ascending and descending branches what does it supply

Answer 61

Skin over the platysma muscle

Question 62

The trunks of C3/C4 combine to form a trunk that gives rise to what

Answer 62

Medial, intermediate, and lateral supraclavicular nerves

Question 63

What does the medial supraclavicular nerve supply

Answer 63

Skin inferior to sternal end of clavicle, as far inferior as the second rib

Question 64

The intermediate supraclavicular nerve supplies what

Answer 64

Skin over deltoid and pectoralis major, as far inferior as second rib

Question 65

Lateral supraclavicular nerve supplies what

Answer 65

Skin over superior and lateral aspects of the shoulder

Question 66

Deep branches of the cervical plexus are divided into what

Answer 66

Medial and lateral series

Question 67

Where does the lateral series of the cervical plexus pass

Answer 67

Into the posterior triangle consisting of communicating and muscular branches

Question 68

Spinal accessory nerve may recieve communicating branches of the lateral series from where

Answer 68

C2-C4

Question 69

What 4 muscles are associated with the muscular branches of the lateral series of the cervical plexus

Answer 69

SCM receives proprioception from C2/C3, trap receives proprioception fibers from C3/C4, levator scap is innervated by C3/C4 motor and sensory, middle scalene receives fibers from C3/C4

Question 70

Where does the medial series of the cervical plexus pass through

Answer 70

Through the anterior triangle

Question 71

Communicating branches of the medial series of the cervical plexus are between where

Answer 71

Vagus and loop between C1/C2

Question 72

What are the communicating branches of the medial series

Answer 72

- vagus and loop of C1/C2 - 3/4 gray rami communicans from superior cervical ganglion to upper 4 cervical nerves - fibers from C1 communicating with hypoglossal nerve, then separating from hypoglossal to form sup. Root of ansa cervicalis

Question 73

Muscular brances of the medial series are sent to

Answer 73

- rectus capitis lateralis ; C1 - rectus capitis anterior ; C1,C2 - longus capitis; C1-3 - longus colli; C2-C4

Question 74

What forms the inferior root of the ansa cervicalis

Answer 74

Medial series branches from C2/C3 combine

Question 75

What does the ansa cervicalis supply

Answer 75

Sternohyoid, sternothyroid, and both bellies of omohyoid

Question 76

What forms the phrenic nerve

Answer 76

Medial series fibers from C3, C4, C5 with C4 contributing the most

Question 77

The phrenic nerve descends through the neck to where

Answer 77

Anteriorly to the anterior scalene muscle

Question 78

The phrenic nerve receives postgang symp fibers from where

Answer 78

Cervical ganglia

Question 79

The phrenic nerve supplies what

Answer 79

The diaphragm