Innervations Flashcards
The patient is elevating the shoulder against resistance. The thick upper part of the muscle can be seen and felt. This is the trapezius. What is the innervation?
Spinal accessory Nerve (Cranial Nerve XI); also C3, C4
The patient is pushing the palms of the hands hard against a wall with the elbows fully extended. The lower fibers of the trapezius can be seen and felt. What is the innervation?
The Spinal accessory nerve (CN XI) and C3, C4
The approximate area within which sensory changes may be found in lesions of the ____________. What are the nerve roots?
Complete brachial plexus lesion. C5, C6, C7, C8, T1
The approximate area within which sensory changes may be found in lesions of the ___________. What are the roots?
The upper roots of the brachial plexus; C5, C6.
The approximate area within which sensory changes may be found in the lesions of the __________. Which roots?
The lower roots of the brachial plexus (C8, T1)
The patient is pressing the palm of his hand backwards against the examiner’s hand. The muscle bellies can be felt and sometimes seen at the arrow. This represents the rhomboids. What is the nerve and roots?
The Dorsal Scapular Nerve, from roots C4 and C5
The patient is pushing against a wall. The left serratus anterior is paralyzed and there is winging of the scapula. What is the nerve and what are the roots?
Long thoracic nerve, roots C5, C6, C7
The upper arm is above the horizontal and the patient is pushing forward against the examiner’s hand. The clavicular head of the pectoralis major can be seen and felt. What is the nerve and what are the roots?
The lateral pectoral nerve innervates the clavicular head of the pectoralis major, roots C5 and C6
The patient is adducting the upper arm against resistance. The sternocostal head of the pectoralis major can be seen and felt at the arrow. What is the nerve and the roots?
The lateral and medial pectoral nerves innervate the sternocostal head of pectoralis major, roots C6, C7, C8
The patient is abducting the upper arm against resistance, the muscle belly can be felt and sometimes seen at the arrow. This is the suprapspinatus, what is the nerve and the roots?
The Suprascapular nerve, C5 and C6
The patient is externally rotating the upper arm at the shoulder against resistance. The examiner’s right hand is resisting the movement and supporting the forearm with the elbow at a right angle; his left hand is supporting the elbow and preventing abduction of the arm. The muscle belly of the infraspinatus can be seen and felt at the arrow. What is the nerve and roots?
The Suprascapular nerve innervates the infraspinatus. C5, C6
The upper arm is horizontal and the patient is adducting it against resistance. The lower arrow shows the muscle (latissimus dorsi) belly that can be seen and felt. The upper arrow points to teres major. What is the innervation and roots for latissimus dorsi?
Thoracodorsal nerve, C6, C7, C8
The muscle bellies of the latissimus dorsi can be felt to contract when the patient coughs. What is the innervation and roots?
Thoracodorsal nerve; C6, C7, C8
The patient is adducting the elevated upper arm against resistance. The muscle belly of the teres major can be seen and felt. What is the innervation and roots?
Subscapular nerve, C5, C6, C7
The approximate area in which sensory changes may be found in lesions of the ______________.
This shows the distribution of the lateral cutaneous nerve of the forearm which is a branch of the musculocutaneous nerve C5, C6
The patient is flexing the supinated forearm against resistance. The muscle belly of the biceps can be seen and felt. What is the innervation and the roots?
The musculocutaneous nerve, C5, C6
The approximate area within which sensory changes may be found in lesions of the ___________.
Axillary nerve, C5, C6.
The patient is abducting the upper arm against resistance. The anterior and middle fibers of the deltoid can be seen and felt. What is the innervation and what are the roots?
The axillary nerve, C5, C6
The patient is retracting the abducted upper arm against resistance. The posterior fibers of the deltoid can be seen and felt. What is the innervation and what are the roots?
The axillary nerve, C5, C6
The approximate area within which sensory changes may be found in high lesions of the _____________.
The radial nerve.
The approximate area within which sensory changes may be found in lesions of the ________________. What location would the damage be for this lesion?
The radial nerve, above the elbow but below the origin of the posterior cutaneous nerve of the forearm.
The patient is extending the forearm at the elbow against resistance. The long and lateral heads of the triceps can be seen and felt at the arrows. What is the innervation and roots?
Radial nerve, C6, C7, C8
The patient is extending and abducting the hand at the wrist against resistance. This is the extensor carpi radialis, and the mscuel belly and tendon can be felt and usually seen. What is the innervation and the roots?
Radial nerve, C5, C6
The patient is flexing the forearm against resistance with the forearm midway between pronation and supination. The brachioradialis muscle belly can be seen and felt. What is the innervation and what are the roots?
Radial nerve, C5, C6
The patient is supinating the forearm against resistance with the forearm extended at the elbow. This is the supinator. What is the innervation and roots?
Radial nerve, C6, C7
The patient is extending and adducting the hand at the wrist against resistance. The extensor carpi radialis belly and tendon can be seen and felt. What is the innervation and what are the roots?
The posterior interosseus nerve, C7, C8
The patient’s hand is firmly supported by the examiner’s right hand. Extension at the metacarpophalangeal joints is maintained against the resistance of the fingers of the examiner’s left hand. The muscle belly of the extensor digitorum can be seen and felt. What is the nerve and innervation?
Posterior interosseus nerve; C7, C8
The patient is abducting the thumb at the carpo-metacarpal joint in a plane at right angles to the palm. The tendon can be seen and felt anterior and closely adjacent to the tendon of the extensor pollicus brevis. What is the innervation and root?
Posterior interosseus nerve; C7, C8
The patient is extending the thumb at the interphalangeal joint against resistance. This is the extensor pollicus longus. What is the innervation and roots?
The posterior interosseus nerve, C7, C8
The patient is extending the thumb at the metacarpophalangeal joint against resistance. The extensor pollicis brevis tendon can be seen and felt. What is the nerve and roots?
The posterior interosseus nerve C7, C8
The approximate areas within which sensory changes may be found in lesions of the ___________.
The median nerve in the forearm (note the palmar branch does NOT go through the carpal tunnel, so palm involvement is classically due to forearm lesion)
The approximate area within which sensory changes may be found in lesion of __________.
The median nerve in the carpal tunnel - note that the branch that serves the palmar aspect of the hand does NOT go through the carpal tunnel
The patient is pronating the forearm against resistance. The pronator teres muscle belly can be felt and sometimes seen. What is its innervation and roots?
Median nerve, C6, C7
The patient is flexing and abducting the hand at the wrist against resistance. This is the flexor carpi radialis tendon. What is the innervation and roots?
Median nerve, C6, C7
The patient is flexing the finger at the proximal interphalangeal joint against resistance with the proximal phalanx fixed. This test does not eliminate the possibility of flexion at the proximal interphalangeal joint being produced by flexor digitorum profundus. But this is the flexor digitorum superficialis. What is the innervation and roots?
Median nerve C7, C8, T1
The patient is flexing the distal phalanx of the index finger against resistance with the middle phalanx fixed. This is the flexor digitorum profundus I and II. What is the nerve and roots?
Anterior interosseus nerve C7 and C8
The patient is flexing the distal phalanx of the thumb against resistance while the proximal phalanx is flexed. This is the flexor pollicus longus. Innervation and roots?
Anterior interosseus nerve, C7 and C8
The patient is abducting the thumb at right angles to the palm against resistance. The abductor pollicis brevis can be seen and felt. What is the nerve and roots?
Median nerve C8, T1
The patient is touching the base of the little finger with the thumb against resistance. This is the opponens pollicis. Nerve and roots?
Median nerve, C8, T1
The patient is extending the finger at the proximal interphalangeal joint against resistance with the metacarpophalangeal joint hyperextended and fixed. This is the 1st lumbrical-interosseus muscle. Nerves and roots?
Median and ulnar nerves C8, T1
The approximate areas within which sensory changes may be found in lesions of the __________.
Ulnar nerve. A is above the origin of the dorsal cutaneous branch, B is below the origin of the dorsal cutaneous branch but above the origin of the palmar branch, and C is below the origin of the palmar branch
The approximate area within which sensory changes may be found in lesions of the _______________.
Medial cutaneous nerve of the forearm.
The patient is flexing and adducting the hand at the wrist against resistance. What are the nerves/roots for flexor carpi ulnaris?
Ulnar nerve, C7, C8, T1
The patient is flexing the distal interphalangeal joint against resistance while the middle phalanx is fixed. This is the flexor digitorum profundus III and IV. What is the nerve and roots?
Ulnar nerve, C7, C8
The patient is abducting the little finger against resistance. The muscle belly of the abductor digiti Minimi can be felt and seen. Nerve/roots?
Ulnar nerve, C8, T1
The patient is flexing the little finger at the metacarpophlangeal joint against resistance with the finger extended at both interphalangeal joints. This is the flexor digiti minimi. What is the nerve/roots?
Ulnar Nerve, C8, T1
The patient is abducting the index finger against resistance. The muscle belly of the dorsal interosseus muscle can be seen.
Ulnar nerve, C8, T1
The patient is adducting the index finger against resistance. The second palmar interosseus muscle is being tested. What are the nerves and roots?
The Ulnar Nerve C8, T1
The patient is adducting the thumb at right angles to the palm against the resistance of the examiner’s finger. This is the adductor pollicis. What nerve/roots?
Ulnar nerve C8, T1
The approximate area within which sensory changes may be found in lesions of the _____________.
Lateral cutaneous nerve of the thigh
The approximate area within which sensory changes may be found in lesions of ___________.
The femoral nerve.
The approximate area within which sensory changes may be found in lesions of the ______________.
Obturator nerve
The approximate area within which sensory changes may be found in lesions of the _______________.
Posterior cutaneous nerve of the thigh
The approximate area within which sensory changes may be found in lesions of the ______________.
Sciatic nerve
The approximate area within which sensory changes may be found in lesions of the _____________ nerves
Sciatic AND posterior cutaneous nerve of the thigh
The approximate area within which sensory changes may be found in lesions of the _____________.
Superficial peroneal nerve
The approximate area within which sensory changes may be found in lesions of the ____________.
Deep peroneal nerve
The approximate area within which sensory changes may be found in lesions of the ___________.
Sural nerve
The approximate area within which sensory changes may be found in lesions of the _____________.
Tibial nerve
The approximate area supplied by the cutaneous nerves to the sole of the foot.
Just FYI
The patient is flexing the thigh at the hip against resistance with the leg flexed at the knee and hip. This is the Iliopsoas. What is the innervation and roots?
Branches from L1, L2, L3 spinal nerves and femoral nerve L1, L2, L3.
Patient is extending the leg against resistance with the limb flexed at the hip and knee. To detect slight weakness, the leg should be fully flexed at the knee. This is the quadriceps (rectus?) femoris. Which nerve and roots?
Femoral nerve, L2, L3, L4
Patient lies on the back with the leg extended at the knee and is adducting the limb against resistance. This tests the adductors. What is the innervation and nerve roots?
Obturator nerve, L2, L3, L4
The patient lies on the back and is internally rotating the thigh against resistance with the limb flexed at the hip and knee. This tests the gluteus medius and minimus. What is the nerve and its roots?
Superior gluteal nerve L4, L5, S1
The patient lies on his back with the leg extended and is abducting the limb against resistance. This is testing the gluteus medius, minimus, and tensor fasciae latae. What is the nerve and its roots.
Superior gluteal nerve L4, L5, S1
The patient lies on his back with the leg extended at the knee and is extending the limb at the hip against resistance. This tests the gluteus maximus. What is the nerve and its roots?
Inferior gluteal nerve, L5, S1, S2
The patient lies on his back with the limb flexed at the hip and knee and is flexing the leg at the knee against resistance. This tests the hamstring muscles. What is the nerve and roots?
Sciatic nerve - serves the semitendinosus, semimebranosus, and biceps; L5, S1, S2
The patient lies on his face and is flexing the leg th the knee against resistance. The tendons of the biceps laterally and the semitendinosus medially can be felt and seen. These are the hamstring muscles. What is the nerve and roots?
Sciatic nerve. Semitendinosus, semimembranosus, and biceps. L5, S1, S2
The patient lies on his back with the leg extended and is plantar-flexing the foot against resistance. To detect slight weakness, the patient should be asked to stand on one foot, raise the heel from the ground and maintain this position. This tests the gastrocnemius. What is the nerve and roots?
Tibial nerve S1 and S2
The patient lies on his back with the limb flexed at the hip and knee and is plantar-flexing the foot against resistance. This tests the soleus. What is the nerve and roots?
Tibial nerve, S1, S2
Thet patient is inverting the foot against resistance. This tests the tibialis posterior. What nerve and roots?
Tibial nerve, L4, L5
The patient is flexing the toes against resistance. This tests the flexor digitorum longus, and flexor hallicus longus. What is the nerve and the roots?
Tibial nerve, L5, L1, S2
The patient is cupping the sole of the foot, the small muscles of the foot can be felt and sometimes seen. What is the innervaiton of the “small muscles of the foot?”
Medial and lateral plantar nerves S1 and S2
The patient is dorsiflexing the foot against resistance. The muscle belly and tendon can be seen and felt. This is the tibialis anterior. Innervation, roots?
Deep peroneal nerve, L4, L5
The patient is dorsiflexing the toes against resistance. The tendons passing to the lateral four toes can be seen and felt. The extensor digitorum longus - what is the nerve/roots?
Deep peroneal nerve L5, S1
The patient is dorsiflexing the distal phalanx of the big toe against resistance. Extensor hallicus longus. What is the innervation/roots?
Deep peroneal nerve L5, S1
The patient is dorsiflexing the proximal phalanges of the toes against resistance. This is the extensor digitorum brevis. What is the innervation/roots?
Deep peroneal nerve, L5, S1
The patient is everting the foot against resistance. The upper arrow shows the tendon of peroneus brevis, the lower the tendon of peroneus longus. What is the innervation and roots?
Superfical peroneal nerve, L5, S1
Name 1-11
1) Supratrochlear
2) Supraorbital (1 and 2 make up the frontal nerve)
3) Lacrimal
4) infratrochlear
5) extrenal nasal (4 and 5 make up the nasociliary)
6) infraorbital
7) Zygomaticofacial
8) Zygomaticotemporal (7 and 8 make up the zygomatic)
9) auriculotemporal
10) buccal
11) mental
Name 12-17
12) Greater auricular
13) Lesser occipital
14) Greater occipital
15) Transverse cervical
16) C3 dorsal ramus
17) C4 dorsal ramus
Study the dermatomes for a minute
Here’s the backside
Study the dermatomes for a minute
Here’s the bottom
Trapezius
Spinal accesory nerve and C3, C4
Rhomboids
Brachial plexus: C4, C5
Serratus anterior
Brachial plexus: C5, C6, C7
Pectoralis major - clavicular head
Brachial plexus C5, C6
Pectoralis major - sternal head
Brachial plexus - C6, C7, C8
Supraspinatus
Brachial plexus C5, C6
infraspinatus
Brachial pelxus C5, C6
Latissimus dorsi
Brachial plexus C6, C7, C8
Teres major
Brachial plexus C5, C6, C7
Deltoid
Axillary nerve C5, C6
Biceps
Musculocutaneous nerve - C5, C6
brachialis
musculocutaneous nerve C5, C6
triceps
Radial nerve C6, C7, C8
brachioradialis
Radial nerve C5, C6
Extensor carpi radialis longus
radial nerve C5, C6
Supinator
posterior interosseus nerve C6, C7
Extensor carpi ulnaris
Posterior interosseus nerve C7, C8
extensor digitorum
posterior interosseus nerve - C7, C8
Abductor pollicus longus
Posterior interosseus nerve C7, C8
Extensor pollicus longus
Posterior interosseus nerve C7, C8
Extensor pollicus brevis
Posterior interosseus nerve C7, C8
Extensor Indicis
Posterior interosseus nerve, C7, C8
Pronator teres
Median nerve C6, C7
Flexor carpi radialis
Median nerve - C6, C7
Flexor digitorum superficialis
Median nerve C7, C8, T1
Abductor pollicis brevis
Median nerve C8, T1
Flexor pollicis brevis
Median nerve C8, T1
Opponens pollicis
Median nerve C8, T1
Lumbricals I and II
median nerve C8, T1
Pronator quadratus
Anterior interosseus nerve C7, C8
Flexor digitoum profundus I and II
Anterior interosseus nerve C7 C8
Flexor Pollicus Longus
Anterior interosseus nerve C7, C8
Flexor carpi ulnaris
Ulnar nerve C7, C8, T1
Flexor digitorum profundus III and IV
Ulnar nerve C7, C8
Hypothenar muscles
Ulnar nerve C8, T1
Adductor pollicus
Ulnar nerve C8, T1
Flexor pollicus brevis
Ulnar nerve C8, T1
Palmar interossei
Ulnar nerve C8, T1
Dorsal interossei
Ulnar nerve C8, T1
Lumbricals III and IV
Ulnar nerve C8, T1
Iliopsoas
Femoral nerve, L1, L2, L3
Quadriceps femoris (rectus femoris, vastus lateralis, intermedius, and medialis)
Femoral nerve L2, L3, L4
Gluteus medius and minimus and tensor fascia latae
Superior gluteal nerve L4, L5, S1
gluteus maximus
inferior gluteal nerve, L5, S1, S2
Semitendinosus
sciatic/tibial nerves L5, S1, S2
biceps (hamstrings)
Sciatic and tibial nerves, L5, S1, S2
Semimembranosus
Sciatic/tibial nerves L5, S1, S2
Gastrocnemius and soleus
Sciatic and tibial nerves, S1, S2
Tibialis posterior
Sciatic and tibial nerves, L4, L5
Flexor digitorum longus
Sciatic and tibial nerves L5, S1, S2
Small muscle of foot (abductor hallicus, abductor digiti minimi, and interossei)
Sciatic and tibial nerves S1, S2
Tibialis anterior
Sciatic and common peroneal nerves, L4, L5
Extensor digitorum longus
Sciatic and common peroneal nerves, L5, S1
Extensor hallicus longus
Sciatic and common peroneal nerves L5, S1
Extensor digitorum brevis
Sciatic and common peroneal nerves, L5, S1
Peroneus longus
Sciatic and common peroneal nerves L5, S1
Peroneus brevis
Sciatic and common peroneal nerves L5, S1
