General Review Exam1

Question 1

What is one of the best ways to distinguish between spinal nerve or peripheral nerve damage?

Answer 1

Sensory findings: dermatomal or cutaneous distribution

Example: femoral nerve entrapment versus L4 nerve entrapment… Femoral nerve sensation innervates medial side of leg but stops at about medial malleolus whereas L4 nerve is tibialis anterior to the end of the big toe, so the cutaneous innervation is different

Question 2

Lumbar plexus

Answer 2

L1-4 VPR

Question 3

VPR

Answer 3

ventral primary rami make up plexuses that innervate limbs

Question 4

Dorsal primary Rami of C1

Answer 4

Innervates suboccipital muscles

Question 5

Ventral primary rami of C1

Answer 5

Very tiny and often nonexistent

Question 6

Dorsal primary rami of C2

Answer 6

Greater occipital nerve (back of head)

Question 7

Ventral primary rami of C2

Answer 7

All cutaneous branches

Lesser occipital nerve (C2)
Greater auricular nerve (C2-3)
Transverse cervical nerve (C2-3)
Supraclavicular nerve (C3-4)

These were all carry GSA, GVA, postggl GVE sympathetic (axons)

Question 8

Possible entrapment sites of lateral femoral cutaneous nerve

Answer 8

Sartorius, TFL, iliacus, and below inguinal ligament

Question 9

Iliopsoas vs femoral nerve

Answer 9

Sometimes the nerve to the iliopsoas is thought of as a branch of the femoral nerve, but sometimes they are separate, they are both posterior division chords. (L2-4)

Question 10

What nerve pierces through psoas major?

Answer 10

Genitofemoral nerve (L1-2) pierces through psi as major

This could be also causing referred genital pain due to entrapment

Question 11

Lateral femoral cutaneous nerve

Answer 11

(L2-3)

Cutaneous only, innervate skin of lateral thigh

Question 12

Which nerves could you damage in an inguinal hernia repair?

Answer 12

Ilioinguinal N
Genitofemoral N.
Iliohypogastric N.

Question 13

Entrapment of lateral femoral cutaneous nerve

Answer 13

Pain on anterior thigh stopping at knee

Name: meralgia peresthetica

Question 14

Cutaneous distribution of femoral nerve compared to L4 dermatome

Answer 14

The cutaneous distribution of the femoral nerve is the saphenous nerve which is a terminal branch of the femoral nerve. The saphenous nerve cutaneous innervation ends before the big toe whereas the L4 dermatome continues all the way to the big toe

Question 15

Obturator innervates

Answer 15

Adductors

Question 16

Why would a disk lesion at C5 be bad?

Answer 16

A disc lesion at C-5 would be bad because it affects the spinal cord, whereas at L5 there’s no spinal cord. The spinal cord is very hard to regenerate and not very possible at all

Question 17

What is the only parasympathetic job for the body wall/ limbs?

Answer 17

Erection is the only parasympathetic job for the body wall and limbs, this is the pudendal nerve (S2-4)

Question 18

Where is the only GVA for the gut?

Answer 18

The white ramus

Question 19

Splanchnic nerves

Answer 19

Innervates the organs of the abdominal pelvic cavity… * not part of the ventral primary ramus or the dorsal primary ramus*

The sympathetic splanchnic nerves arise from the sympathetic chain;

The splanchnic nerve goes from the paravertebral ganglia to the prevertebral ganglia

Info for later:
the parasympathetic splanchnic nerves arise from the S2-4 sacral plexus

Question 20

Where are the postganglionic sympathetic?

Answer 20

The paravertebral and prevertebral ganglia

Question 21

For pain, what are the GVAs going to follow

Answer 21

For pain, the GVAs are going to follow the sympathetic path

Question 22

Origin of the preganglionic:

Answer 22

All preganglionic sympathetics always pass through the white ramus!

Question 23

What axons make up cutaneous nerves?

Answer 23

GSA: pain, touch, stimulation
GVE postganglionic sympathetic
GVA: vessels, sweat glands, erector pili

Question 24

The suboccipital nerve

Answer 24

GSE and postganglionic GVE sympathetic. Innervates the suboccipital muscles, represents the dorsal primary ramus of C1
(not part of cervical plexus)

Can contribute to a cervicogenic headache*

Question 25

Do people with chronic pain have a high or low threshold

Answer 25

Low threshold Afferents

Question 26

Are the anterior scalenes innervated by the cervical plexus, brachial plexus, both, or neither?

Answer 26

Both the cervical plexus and the brachial plexus

Spasming of the scalenes can entrap the whole brachial plexus. Entrapment of the brachial plexus is called thoracic outlet syndrome

Question 27

What do you call entrapment of the brachial plexus and the subclavian vessels?

Answer 27

Thoracic outlet syndrome

Question 28

Symptoms of TOS

Answer 28

Tingling in arm and hand, pain and weakness, loss of sensation

Question 29

How fast can PNS axons regenerate?

Answer 29

2mm per day

Question 30

Where do the cell bodies for GSEs originate?

Answer 30

Ventral horn of the gray matter

Question 31

Lateral rotators of the hip are largely innervated by

Answer 31

The sacral plexus

Question 32

Discriminating touch and proprioception

Answer 32

Dorsal column

Question 33

Final common pathway

Answer 33

Ventral horn

GSE