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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
What other things can also be supplied by the median nerve?
Periosteum Elbow, Radiocarpal, and mid carpal joints Can communicate with ulnar nerve in wrist
26
Draw Brachioplexus
Okay
27
Superior subscapular nerve comes off of which cord? Roots? Supplies?
Posterior 5 and 6 Subscapularis
28
Thoracodorsal nerve cord? Rootlets? Supplies?
Posterior C6 7 and 8 Latissimus dorsi
29
Inferior subsucapular nerve cord roots supply
posterior 5 and 6 Subscapularis and teres major
30
Axillary nerve cord Rootlets Supplies Which other branch is given off at same level?
Posterior 5 and 6 Deltoid and teres minor Superior lateral cutaneous nerve of the arm given off same level as branch to teres minor
31
Radial nerve cord Roots Supply
Posterior C5, 6 7 8 and T1 All muscles in posterior compartment of arm and forearm
32
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
Radial nerve
33
Which nerve travels posteriorly around the surgical neck of the humerus?
Axillary nerve
34
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
Superfical and Deep branches Superfical branch Deep Branch
35
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
Posterior cutaneous nerve of the arm Inferior lateral cutaneous nerve of the arm Posterior cutaneous nerve of forearm
36
What will muscular branches of the radial nerve given off in the arm supply?
All three heads of triceps Anconeus by way of branch to the medial head
37
Branches of the radial nerve that give off at the level of the lateral epicondyle supply what?
Brachioradialis Extensor carpi radialis longus
38
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?
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
39
Deep branch of the radial nerve gives off branches to which forearm muscles?
Extensor carpi radialis brevis Supinator Extensor digitorum Extensor digiti minimi Extensor carpi ulnaris Abductor pollicus longus Extensor pollicis brevis
40
What is the terminal branch of the deep branch of radial nerve? Supplies?
Posterior interosseous nerve Extensor pollicis longus Extensor indicis
41
Which nerve sends articular branches to the shoulder and wrist joints?
Radial nerve
42
Clinical considerations for the radial nerve
Wrist drop Triceps and brachioradialis reflex differences R/L
43
Which brachial plexus injury is a supraclavicular one? Infraclavicular?
Erb-Duchenne (waiters tip) Klumpke (Claw hand when try to extend fingers)
44
How many pairs of thoracic nerve roots? Each mixed nerve will divide into what?
12 Anterior and posteror rami
45
Postrior primary rami project posterior ward and divide into medial and lateral branches. what does themedial branch do?
Motor and sensory Supplies Semispinalis, Longissimus, and multifidis Sensory to skin paraspinalluy
46
What do the lateral branches of posterior primary rami do?
Supply longissimus, iliocostalis, and levaotor costarum Sensory to skin near the costal angles
47
What course do anterior primary rami generally follow? Which anterior primary ramus contributes to brachial plexus? Contribute to intercostobrachial nerve?
Rib above the nerve T1 T2 and T1
48
Each intercostal nerve gives off a lateral cutaneous branch which divides into what? They supply what?
Anterior branch and Posterior branch Overlying skin
49
Intercostal nerves terminate as what branches that supply the skin close to midline?
Anterior cutaneous branch
50
As intercostal nerves course along adjacent ribs, they give off a number of muscular branches to supply what?
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
Intercostal nerves will also supply adjacent what 4 things?
Blood vessels, bones, joints, and ligaments
52
Which subcostal nerve is the largest of the thoracic nerves? It contributes to lumbar plexus and may supply skin as far as inferior buttocks
Subcostal nerve
53
How does each thoracic nerve communicate with the sympathetic trunk?
By way of white and gray communicants
54
What is relationship between white and gray communicans?
Gray is medial to white
55
Can you describe the sympathetic pathways associated with the gray and white rams communicans???
Nope
56
How are the 5 lumbar nerves named? Each nerve root divides into what?
For the vertebra above the nerve Anterior and posterior primary rami
57
Posterior primary rami of lumbar nerves divide into what? Supply?
Medial and lateral branches Medial supply multifidi Lateral supply erector spinae
58
Anterior primary rami of the lumbar nerves contribute to what?
Lumbar and sacral plexuses Communications with sympathetic trunk
59
How many lumbar sympathetic ganglia are there usually? Usually white rami communicans are associated with which nerves? Gray ones?
4 L1,2,3 All
60
What forms the lumbar plexus?
L1-L3 and part of L4 and part will receive contribution is from T12
61
What does the muscular branches from the anterior rami (L1, 2, 3 and 4 of the lumbar plexus supply?
L1 - quadratus lumborum and psoas minor L2 - quadratus lumborum and both psoas muscles L3 and L4 - quraduatus lumborum and psoas minor
62
The iliohypogastric nerve contains fibers from which rami? Where does it travel to? Gives off what branch? It supplies what?
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
The Iliohypogastric nerve continues as what? Supplies?
Anterior cutaneous branch Skin of the pubic region
64
Iliohypogastic nerve also supplies what two muscles?
Internal abdominal oblique Transverse abdominal
65
The ilioinguinal nerve contains fibers from which roots? Travels where? Supplies what sensory? Men? Women? Along its course what two muscles does it innervate?
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
The genitofemoral nerve contains fibers from which roots? Course? Divides into? Describe the branches.
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
Lateral cutaneous nerve of the thigh roots? Course? Supplies?
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
Femoral nerve contains roots? Forms where? Emerges where? travels?
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
Where does the femoral nerve give off branches to?
Abdomen and femoral triangle
70
Within abdomen, femoral nerve gives off muscular branches to which two muscles? Also sends to what?
Iliacus and pectineus Femoral artery
71
Once beyond the inguinal ligament, the femoral nerve divides into which two things?
WAnterior and Posterior division
72
Which three nerves come from the anterior division of the femoral nerve?
Intermediate cutaneous nerve of the thigh Medial cutaneous nerve of the thigh Nerve to the sartorius
73
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?
Intermediate cutaneous nerve of the thigh Femoral branch of genitofemoral nerve Medial cutaneous nerve of the thigh Saphenous nerve
74
The posterior division of femoral nerve has muscular branches that supply? Vascular branches that supply?
Sartorius, rectus femoris, vastus medialis, vasstus lateralis, vastus intermedialis Femoral artery
75
Femoral nerve terminates as the what nerve? travels? Supply?
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
Clinical considerations for Femoral nerve
Patellar reflex Sensory deficts
77
The Obturator nerve contains fibers from which roots? Which is the principal contributor? Which is most minimal? Course? Divides into?
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
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?
Anterior branch Femoral Hip Joint Adductor longus, Gracilis, Pectineus, Adductor brevis
79
The anterior branch of the obturator nerve may send fibers to connect with what , if present.
Accessory obturator nerve
80
Describe the course of the posterior branch of the obturator nerve. Supply?
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
Clinical considerations of the Obturator nerve
Muscular weakness Sensory deficits
82
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?
5 Cauda equina Anterior and posterior primary rami S1-S4 S5 Decrease size
83
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?
Medial Lateral
84
Which rami unite with coccygeal posterior rami to supply skin over the coccyx?
S4 and S5
85
How many sacral sympathetic ganglia are there? What do the anterior primary rami of each sacral nerve receive postganglionic sympathetic fibers from?
Three or Four Gray ramus communicans
86
Which rami form the sacral plexus? Which contributions are by way of the lumbosacral trunk? The plexus forms on anterior suface of what muscle?
L4, L5, S1-S3 and part of S4 L4 and L5 Piriformis muscle
87
The nerve roots that contribute to sacral plexus divide into what right after exiting their IVF/sacral foramen?
Anterior and posterior divisions
88
The nerve to the quadratus femurs and gemellus inferior contains fibers from which nerves? Leaves pelvis through?
L4, L5 and S1 nerves Greater sciatic foramen
89
The nerve to the obturator interns and gemellus superior carries fibers from which roots? Leaves pelvis by? Re enters pelvis via?
L5, S1, and S2 Greater sciatic foramen Lesser sciatic foramen
90
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
S2, S3, and S4 Greater sciatic foramen Lesser sciatic foramen Pudendal canal
91
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
Sensory, Anus, Anal Canal Motor to external anal sphincer
92
The perineal nerve off of the pudendal nerve divides into Deep and superficial branches Deep supplies? Superficial suppplies?
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
The terminal branch of the pudendal nerve is the dorsal nerve of the penis or clitoris Supplies?
Deep transverse perineum Urethral sphincter muscles Sensory in corpus cavernosum, glans penis and skin covering penis Corpus cavernosum, clitoris
94
Individual muscular branches off of the sacral plexus contains fibers from which root? Supply which two muscles?
S4 Levator ani and coccygeus
95
Pelvic splanchnic nerves contain fibers from which roots? Nerve to piriformis carries fibers from which roots?
S2, S3, and S4 S1 and S2
96
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?
L4 L5 and S1 Superior - Gluteus medius and minimus Inferior - gluteus medius, minimus, and TFL
97
Inferior gluteal nerve carries fibers from which roots? Leaves pelvis through greater sciatic foramen and innervates what?
L5, S1 and S2 Gluteus Maximus
98
The perforating cutaneous nerve contains fibers from which roots? Supplies? May be formed by branch of _____ nerve or be ____
S2 and S3 Lower medial buttocks Pudendal nerve or Absent
99
The Posterior cutaneous nerve of the thigh is formed by which roots? Ultimately communicates with which nerve? Supplies?
Anterior divisions of S2 and S3. Posterior division of S1 and S2 Sural nerve Posterior and medial thigh skin
100
Sciatic nerve is combo of which two nerves? Of which cords?
Tibial nerve and Common Fibular T - anterior L4 to S3 CF - posterior L4 to S2
101
Where does the sciatic nerve exit the pelvis? At what point does it split into its common fibular and tibial components?
Greater sciatic foramen 2/3 way to the knee
102
Common fibular nerve which cords? Supplies which muscle in thigh? Two sensory branches given off at lateral aspect of poplietal fossa?
L4 to S2 Biceps femoris Lateral sural cutaneous nerve Fibular communicating branch
103
The common fibular nerve eventually divides into a superficial and deep fibular nerve. What do they do?
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
Clinical considerations of the common fibular nerve
Steppage gait
105
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?>
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
The tibial nerve travels around the medial malleolus to plantar foot and terminates into medial and lateral plantar nerves. Supply?
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
Clinical considerations of the Tibial nerve?
Flexor paralysis Hammer Toes "Claw foot"
108
Coccygeal plexus formed by which rami?
S4 S5 and Co1?????? Anococcygeal nerves that carry sensory info from skin adjacent to coccyx and anus

PNS (5 decks)

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