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PNS > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

What does the Brachial plexus supply?

What is it formed by?

May also receive fibers from?

Travels over ___ into the axilla

A

Upper extermities

anterior primary rami of C5 through T1

C4 or T2

Rib 1

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2
Q

Describe the BP medial to lateral

A 
Roots
Trunks
Divisions
Cords
Branches
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3
Q

Each BP root receives a _____ from sympathetic trunk

Passes between ___ and ___ scalene to the _____ triangle

Posterior and superior to the _____ artery

A

Gray ramus communicans

Anterior and Middle. Posterior

Sublcalvian

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4
Q

Which roots form the superior trunk?

Middle?

Inferior?

A

C5 and C6

C7

C8 and T1

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5
Q

Which trunks form the Lateral cord?

Medial cord?

Posterior cord?

(divisions)

A

Superior and Middle (anterior)

Inferior trunk (anterior)

Superior, Middle, Inferior (posteriror)

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6
Q

Cords are named for their location relative to what?

A

Axillary artery

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7
Q

Draw out BP

A

Okay

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8
Q

What muscles does the Dorsal scapular nerve supply?

What roots make it up?

A

Levator Scapula

Rhomboid Major

Rhomboid Minor

C5

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9
Q

What two muscles are supplied by the Suprascapular nerve?

What roots make it up?

A

Supraspinatus

Infraspinatus

C5 and C6

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10
Q

What does N2S supply?

Roots?

A

Subclavius

C5 and 6

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11
Q

What does the lateral pectoral nerve supply?

Roots?

A

Pectoralis Major

C5 C6 and C7

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12
Q

What roots make up Musculocutaneous nerve?

Muscles innervated ?

Continues into forearm as?

A

C5 C6 C7

Coracobrachialis
Biceps
Brachialis

Lateral cutaneous nerve of the forearm

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13
Q

Medial pectoral nerve roots?

Muscles?

A

C8 and T1

Pec major and Minor

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14
Q

Medial cutaneous nerve of he arm roots?

Supplies ?

Receives fibers from Where through a communication with what?

A

C8 and T1

Skin on medial arm between axilla and elbow

T2, Intercostobrachial nerve

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15
Q

Medial cutaneous nerve of Forearm roots?

Supply?

A

C8 and T1

Skin over anterior and medial forearm, skin over biceps

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16
Q

Ulnar nerve roots ?

Gives off how many branches in the arm?

Innervates what Forearm muscles?

A

C8, T1, sometimes C7

None

Flexor carpi ulnaris, medial half of flexor digitorum profundus

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17
Q

What are the two sensory branches in the forearm of the Ulnar nerve?

A

Dorsal branch of the ulnar nerve
Palmar branch of ulnar nerve

Supply skin

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18
Q

When the ulnar nerve travels deep to flexor carpi ulnaris and superficial to flexor retinaculum what two branches does it divide into?

What do they supply?

A

Superfical branch - palmar aspect of the little finger, medial half of ring finger

Deep branch - Abductor digit minimi, flexor digit minimi brevis, opponens digiti minimi, adductor pollicis, deep head of flexor pollicis brevis, ALL interossei, lumbricals 3 and 4

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19
Q

Ulnar nerve Clinical considerations

A

CLAW hand

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20
Q

Median nerve roots?

Gives oof how many branches in arm?

Innervates which muscles in forearm?

A

C6, C7, C8 and T1

None

Pronator teres, flexor carpi radialis, palmaris longus, flexor digitroum superficailias, and pronator quadratus (by way of anterior interosseous nerve of forearm

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21
Q

Where is the palmar branch of the median branch given off?

What does it supply?

A

Distal third of forearm

Skin of thenar eminence, lateral wrist, and palm

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22
Q

After median nerve passing through the carpal tunnel, how many common palmar digital nerves are there?

Which lumbrucials do they supply?

What three muscles does the first common palmar digital nerve supply?

A

Three

First two

Abductor pollicus longus
Flexor pollicus brevis
Opponents pollicus

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23
Q

Each common palmar digital nerve breaks off into what?

Supply?

A

Two proper palmar digital nerves

Sensory only to lateral 3.5 digits

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24
Q

Three clinical considerations with the median nerve

A

Carpal Tunnel

Hand of oath/benidicition

Unable to pronate

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25
Q

What other things can also be supplied by the median nerve?

A

Periosteum

Elbow, Radiocarpal, and mid carpal joints

Can communicate with ulnar nerve in wrist

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26
Q

Draw Brachioplexus

A

Okay

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27
Q

Superior subscapular nerve comes off of which cord?

Roots?

Supplies?

A

Posterior

5 and 6

Subscapularis

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28
Q

Thoracodorsal nerve cord?

Rootlets?

Supplies?

A

Posterior

C6 7 and 8

Latissimus dorsi

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29
Q

Inferior subsucapular nerve cord

roots

supply

A

posterior

5 and 6

Subscapularis and teres major

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30
Q

Axillary nerve cord

Rootlets

Supplies

Which other branch is given off at same level?

A

Posterior

5 and 6

Deltoid and teres minor

Superior lateral cutaneous nerve of the arm given off same level as branch to teres minor

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31
Q

Radial nerve cord

Roots

Supply

A

Posterior

C5, 6 7 8 and T1

All muscles in posterior compartment of arm and forearm

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32
Q

What nerve spirals around to posterior of humerus from the medial bicipital sulcus?

It also passes into the forearm on anterior side of elbow after traveling between brachial is and brachioradialsis

A

Radial nerve

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33
Q

Which nerve travels posteriorly around the surgical neck of the humerus?

A

Axillary nerve

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34
Q

What does the radial nerve divide into at the level of the radial head? What do they supply?

Which branch follows the brachioradialis to the distal third of forearm where it travels between the muscle and the radius to the posterior surface of the hand?

Which penetrates the supinator muscle, gives off a series of branches to posterior forearm and terminates as posterior interosseous nerve

A

Superfical and Deep branches

Superfical branch

Deep Branch

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35
Q

Which branch of radial nerve branches off in the upper arm and supplies the skin on the posterior side of upper arm?

Which branches off the radius in the middle arm?

Given off in upper arm supplies narrow area of skin on lateral side of posterior forearm

A

Posterior cutaneous nerve of the arm

Inferior lateral cutaneous nerve of the arm

Posterior cutaneous nerve of forearm

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36
Q

What will muscular branches of the radial nerve given off in the arm supply?

A

All three heads of triceps

Anconeus by way of branch to the medial head

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37
Q

Branches of the radial nerve that give off at the level of the lateral epicondyle supply what?

A

Brachioradialis

Extensor carpi radialis longus

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38
Q

What does the superficial branch of the radial nerve turn into when it reaches the hand?

Sensory info to?

Superficial branch also gives off the?

A

Dorsal digital nerves

Radial side of posterior hand
Extensor side of thumb
Extensor side of proximal phalanges 2 and 4
Lateral half of extensor side of ring finger

Communicicating branch with the ulnar nerve

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39
Q

Deep branch of the radial nerve gives off branches to which forearm muscles?

A

Extensor carpi radialis brevis

Supinator

Extensor digitorum

Extensor digiti minimi

Extensor carpi ulnaris

Abductor pollicus longus

Extensor pollicis brevis

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40
Q

What is the terminal branch of the deep branch of radial nerve?

Supplies?

A

Posterior interosseous nerve

Extensor pollicis longus

Extensor indicis

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41
Q

Which nerve sends articular branches to the shoulder and wrist joints?

A

Radial nerve

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42
Q

Clinical considerations for the radial nerve

A

Wrist drop

Triceps and brachioradialis reflex differences R/L

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43
Q

Which brachial plexus injury is a supraclavicular one?

Infraclavicular?

A

Erb-Duchenne (waiters tip)

Klumpke (Claw hand when try to extend fingers)

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44
Q

How many pairs of thoracic nerve roots?

Each mixed nerve will divide into what?

A

12

Anterior and posteror rami

45
Q

Postrior primary rami project posterior ward and divide into medial and lateral branches. what does themedial branch do?

A

Motor and sensory

Supplies Semispinalis, Longissimus, and multifidis

Sensory to skin paraspinalluy

46
Q

What do the lateral branches of posterior primary rami do?

A

Supply longissimus, iliocostalis, and levaotor costarum

Sensory to skin near the costal angles

47
Q

What course do anterior primary rami generally follow?

Which anterior primary ramus contributes to brachial plexus?

Contribute to intercostobrachial nerve?

A

Rib above the nerve

T1

T2 and T1

48
Q

Each intercostal nerve gives off a lateral cutaneous branch which divides into what?

They supply what?

A

Anterior branch and Posterior branch

Overlying skin

49
Q

Intercostal nerves terminate as what branches that supply the skin close to midline?

A

Anterior cutaneous branch

50
Q

As intercostal nerves course along adjacent ribs, they give off a number of muscular branches to supply what?

A

Internal intercostals

External costars

Serratus posterior

transverses thoracics

Transverse abdominal (7-11)

Internal abdominal oblique (7-11)

External abdominal oblique (7-11)

Rectus abdominus (7-11)

51
Q

Intercostal nerves will also supply adjacent what 4 things?

A

Blood vessels, bones, joints, and ligaments

52
Q

Which subcostal nerve is the largest of the thoracic nerves? It contributes to lumbar plexus and may supply skin as far as inferior buttocks

A

Subcostal nerve

53
Q

How does each thoracic nerve communicate with the sympathetic trunk?

A

By way of white and gray communicants

54
Q

What is relationship between white and gray communicans?

A

Gray is medial to white

55
Q

Can you describe the sympathetic pathways associated with the gray and white rams communicans???

A

Nope

56
Q

How are the 5 lumbar nerves named?

Each nerve root divides into what?

A

For the vertebra above the nerve

Anterior and posterior primary rami

57
Q

Posterior primary rami of lumbar nerves divide into what?

Supply?

A

Medial and lateral branches

Medial supply multifidi

Lateral supply erector spinae

58
Q

Anterior primary rami of the lumbar nerves contribute to what?

A

Lumbar and sacral plexuses

Communications with sympathetic trunk

59
Q

How many lumbar sympathetic ganglia are there usually?

Usually white rami communicans are associated with which nerves?

Gray ones?

A

4

L1,2,3

All

60
Q

What forms the lumbar plexus?

A

L1-L3 and part of L4 and part will receive contribution is from T12

61
Q

What does the muscular branches from the anterior rami (L1, 2, 3 and 4 of the lumbar plexus supply?

A

L1 - quadratus lumborum and psoas minor

L2 - quadratus lumborum and both psoas muscles

L3 and L4 - quraduatus lumborum and psoas minor

62
Q

The iliohypogastric nerve contains fibers from which rami?

Where does it travel to?

Gives off what branch? It supplies what?

A

T12 and L1

Anterior and inferior between quadratus lumorum and kidney then through transverse abdominal muscle and between it and internal abdominal oblique

Lateral cutaneous branch
Posterolateral glute region

63
Q

The Iliohypogastric nerve continues as what?

Supplies?

A

Anterior cutaneous branch

Skin of the pubic region

64
Q

Iliohypogastic nerve also supplies what two muscles?

A

Internal abdominal oblique

Transverse abdominal

65
Q

The ilioinguinal nerve contains fibers from which roots?

Travels where?

Supplies what sensory?
Men? Women?

Along its course what two muscles does it innervate?

A

T12 and L1

Similar to iliohypogastric. Through inguinal canal leaves via superficial inguinal ring

Sensory innervation to the skin of my medial thigh.
Base of penis and anterior scrotum. In females its mons pubis and labium majus.

Internal abdominal oblique
Transverse abdominal

66
Q

The genitofemoral nerve contains fibers from which roots?

Course? Divides into?

Describe the branches.

A

L1 and L2

Anteriorward through psoas major and divides into genital branch and femoral branch

Genital - travels through inguinal canal and supplies cremaster muscle and sensory to skin of superior anterior scrotum or mons pubis/labium magus

Femoral - passes into thigh posterior to inguinal ligament and supplies skin of upper anterior thigh

67
Q

Lateral cutaneous nerve of the thigh roots?

Course?

Supplies?

A

L2 and L3

Leaves abdominal cavity under inguinal pigment and goes anterior to sartorus through fascia kata to reach skin

Sensory to skin of lateral thigh superior to knee

68
Q

Femoral nerve contains roots?

Forms where?

Emerges where?

travels?

A

L2 L3 and L4

Forms posterior to psoas major

Lateral to the psoas and anterior to iliac us

Posterior to ingual ligament enters femoral triangle, runs inferior and medially through adductor canal into leg and medially to knee

69
Q

Where does the femoral nerve give off branches to?

A

Abdomen and femoral triangle

70
Q

Within abdomen, femoral nerve gives off muscular branches to which two muscles?

Also sends to what?

A

Iliacus and pectineus

Femoral artery

71
Q

Once beyond the inguinal ligament, the femoral nerve divides into which two things?

A

WAnterior and Posterior division

72
Q

Which three nerves come from the anterior division of the femoral nerve?

A

Intermediate cutaneous nerve of the thigh

Medial cutaneous nerve of the thigh

Nerve to the sartorius

73
Q

Which nerve of the anterior division of the femoral nerve divides and supplies skin of anterior thigh down to the knee? Communicates with what?

Which crosses anterior to femoral artery and sends branches to skin of medial thigh, medial knee and across to lateral patella? Communicates with what?

A

Intermediate cutaneous nerve of the thigh
Femoral branch of genitofemoral nerve

Medial cutaneous nerve of the thigh
Saphenous nerve

74
Q

The posterior division of femoral nerve has muscular branches that supply?

Vascular branches that supply?

A

Sartorius, rectus femoris, vastus medialis, vasstus lateralis, vastus intermedialis

Femoral artery

75
Q

Femoral nerve terminates as the what nerve?

travels?

Supply?

A

Saphenous nerve

Through adductor canal and crosses femoral artery, travels down leg

Skin medial and anterior to patella also supplies skin of medial leg and foot as continues down leg.

76
Q

Clinical considerations for Femoral nerve

A

Patellar reflex

Sensory deficts

77
Q

The Obturator nerve contains fibers from which roots?

Which is the principal contributor? Which is most minimal?

Course?

Divides into?

A

L2, L3 and L4

L3….L2

Medial to psoas major, posterior to common iliac vessels, descends into pelvis traveling on obturator internus. Leaves pelvis through obturator foramen

Anterior and Posterior branch

78
Q

Which branch of obturator nerve sends some branches to communicate with femoral nerve branches to form the sub sartorial plexus?

The termination of this branch supplies which artery? Which joint? Which four muscles?

A

Anterior branch

Femoral
Hip Joint
Adductor longus, Gracilis, Pectineus, Adductor brevis

79
Q

The anterior branch of the obturator nerve may send fibers to connect with what , if present.

A

Accessory obturator nerve

80
Q

Describe the course of the posterior branch of the obturator nerve.

Supply?

A

Through obturaor externs posterior to adductor brevis and anterior to adductor magnus

Obturator externus, adductor magnus, and adductor brevis if not supplied by anterior branch

Also knee joint

81
Q

Clinical considerations of the Obturator nerve

A

Muscular weakness

Sensory deficits

82
Q

How many pairs of sacral spinal nerves?

Descend inside dura to form much of what structure?

Each nerve divides into what two things?

Which travel through sacral foamina? Which through sacral hiatus?

Increase or decrease in size as go down?

A

5

Cauda equina

Anterior and posterior primary rami

S1-S4
S5

Decrease size

83
Q

Posterior primary rami of S1-S3 divide into medial and lateral branches.

Which ones supply adjacent multifidi?

Which comine with L5 and S4 branches to supply skin over buttocks?

A

Medial

Lateral

84
Q

Which rami unite with coccygeal posterior rami to supply skin over the coccyx?

A

S4 and S5

85
Q

How many sacral sympathetic ganglia are there?

What do the anterior primary rami of each sacral nerve receive postganglionic sympathetic fibers from?

A

Three or Four

Gray ramus communicans

86
Q

Which rami form the sacral plexus?

Which contributions are by way of the lumbosacral trunk?

The plexus forms on anterior suface of what muscle?

A

L4, L5, S1-S3 and part of S4

L4 and L5

Piriformis muscle

87
Q

The nerve roots that contribute to sacral plexus divide into what right after exiting their IVF/sacral foramen?

A

Anterior and posterior divisions

88
Q

The nerve to the quadratus femurs and gemellus inferior contains fibers from which nerves?

Leaves pelvis through?

A

L4, L5 and S1 nerves

Greater sciatic foramen

89
Q

The nerve to the obturator interns and gemellus superior carries fibers from which roots?

Leaves pelvis by?

Re enters pelvis via?

A

L5, S1, and S2

Greater sciatic foramen

Lesser sciatic foramen

90
Q

The pudendal nerve contains fibers from which rootlets?

Leaves pelvic cavity via?

Arches around the ischial spine and into the perineum via?

Then travels through what to reach the dorsal side of the penis or clitoris

A

S2, S3, and S4

Greater sciatic foramen

Lesser sciatic foramen

Pudendal canal

91
Q

The inferior rectal nerves branch off of the Pudendal nerve within the pudendal canal and they carry ____ info from the skin around the ____ and inferior 2/3 of ____ canal

____ supply to ____ anal sphincter

A

Sensory, Anus, Anal Canal

Motor to external anal sphincer

92
Q

The perineal nerve off of the pudendal nerve divides into Deep and superficial branches

Deep supplies?

Superficial suppplies?

A

External anal sphincter
Bulbosponsiosus
Ischicavernonsus
Superficial transverse perineus

Sensory from posterior scrotum, urethral mucosa and bulb of penis or labium majus external urethral orifice and vestibule

93
Q

The terminal branch of the pudendal nerve is the dorsal nerve of the penis or clitoris

Supplies?

A

Deep transverse perineum
Urethral sphincter muscles

Sensory in corpus cavernosum, glans penis and skin covering penis

Corpus cavernosum, clitoris

94
Q

Individual muscular branches off of the sacral plexus contains fibers from which root?

Supply which two muscles?

A

S4

Levator ani and coccygeus

95
Q

Pelvic splanchnic nerves contain fibers from which roots?

Nerve to piriformis carries fibers from which roots?

A

S2, S3, and S4

S1 and S2

96
Q

The superior gluteal nerve is made up of which roots?

Leaves through greater sciatic foramen and splits into superior and inferior branches. which supply what?

A

L4 L5 and S1

Superior - Gluteus medius and minimus

Inferior - gluteus medius, minimus, and TFL

97
Q

Inferior gluteal nerve carries fibers from which roots?

Leaves pelvis through greater sciatic foramen and innervates what?

A

L5, S1 and S2

Gluteus Maximus

98
Q

The perforating cutaneous nerve contains fibers from which roots?

Supplies?

May be formed by branch of _____ nerve or be ____

A

S2 and S3

Lower medial buttocks

Pudendal nerve or Absent

99
Q

The Posterior cutaneous nerve of the thigh is formed by which roots?

Ultimately communicates with which nerve?

Supplies?

A

Anterior divisions of S2 and S3. Posterior division of S1 and S2

Sural nerve

Posterior and medial thigh skin

100
Q

Sciatic nerve is combo of which two nerves?

Of which cords?

A

Tibial nerve and Common Fibular

T - anterior L4 to S3

CF - posterior L4 to S2

101
Q

Where does the sciatic nerve exit the pelvis?

At what point does it split into its common fibular and tibial components?

A

Greater sciatic foramen

2/3 way to the knee

102
Q

Common fibular nerve which cords?

Supplies which muscle in thigh?

Two sensory branches given off at lateral aspect of poplietal fossa?

A

L4 to S2

Biceps femoris

Lateral sural cutaneous nerve
Fibular communicating branch

103
Q

The common fibular nerve eventually divides into a superficial and deep fibular nerve. What do they do?

A

Superficial - fibularis longus, brevis, and splits into medial and intermediate dorsal cutaneous nerves

Deep - Tibialis anterior, extentsor digitorum longus and brevis, extensor hallicus longus and brevis, fibularis tertius

104
Q

Clinical considerations of the common fibular nerve

A

Steppage gait

105
Q

The tibial nerve is which cords?

While still combined to common fibular it supplies which muscles?

In popiteal fossa it supplies?

In the leg?

Terminates as?

Sensory branch?>

A

L4 - S3

Biceps, Semitendinosus, Semimembranosus, Adductor Magnus

Popliteus, gastrocnemius, soleus, plantaris

Flexor digitiorum longus, flexor hallicus brevis

Interosseous nerve of the leg

Medial calcaneal branches

106
Q

The tibial nerve travels around the medial malleolus to plantar foot and terminates into medial and lateral plantar nerves. Supply?

A

Medial - abductor halluces, flexor digitorum brevis, flexor hallucis brevis. Divides into common plantar digital nerves

Motor lumbrical 1 and 2 and sensory skin of toes by proper plantar digital nerves

Lateral - superficial branch supplies skin around 5th digit

Deep branch adductor halluces, flexor digit minimi brevis, lateral lumbricals, interossei muscles

107
Q

Clinical considerations of the Tibial nerve?

A

Flexor paralysis
Hammer Toes
“Claw foot”

108
Q

Coccygeal plexus formed by which rami?

A

S4 S5 and Co1??????

Anococcygeal nerves that carry sensory info from skin adjacent to coccyx and anus

PNS (5 decks)

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