Lecture 6: Distal limb vessels Flashcards
Brachial plexus goes from C6- __
T2
list the nerves for the thoracic limb Dr.P said we needed to focus on
- Suprascapular
- Musculocutaneous
- Median
- Radial
- Ulnar
what muscles are innervated by the Suprascapular n.
supraspinatus m.
infraspinatus m.
what is “sweeny” or “dancing” shoulder
- Damage to suprascapular nerve
Damage to suprascapular nerve not uncommon in horses.
why?
Horses are very strong and horses DONT have an acromion so their nerve is more exposed
“Sweeny” Shoulder (damage to the suprascapular nerve) results in atrophy of
supra and infraspinatus, shoulder
instability, and shoulder “slip”
What does the Subscapular n. supply
subscapularis m.
what does the Axillary n. supply
located between the subscapular m. and teres major
supplies the muscles of the shoulder
what does the Musculocutaneous n. supply
innervates the flexors of shoulder and some part of distal limb
what does the median n. innervate
MAIN innervation of palmar side of hand
runs with brachial and median a. moved digital and carpal flexor
what does the radial nerve innervate
all the extensors (triceps, extensor or carpal/digits)
located between the heads of the triceps
what does the ulnar nerve innervate
lateral side; flexors of carpus and digits
**share root with median n.
identify the nerve
- Suprascapular n
identify the nerve
- Subscapular
identify the nerve
axillary n.
identify the nerve
- Musculocutaneous n.
identify the nerve
median nerve
what nerve is this
radial nerve
identify the nerve
ulnar n.
what nerve is affected here
Radial nerve; cannot extend carpus
EXAM Q:
name 2 muscles that extend the carpus
extensor carpi radialis
common digital extensor
identify the autonomous zones
Cutaneous Innervation of the fore digit: Musculocutaneous n.
Craniomedial antebrachium
Cutaneous Innervation of the fore digit: Ulnar n.
Caudal antebrachium
Cutaneous Innervation of the fore digit: Median n.
Medial antebrachium
What does the Ulnar n. turn into (2)
Dorsal branch n.
Lateral Palmar n. (with the communicating branch of the median n.)
What does the Median n. turn into (2)
Medial Palmar n.
Lateral Palmar n. (with the ulnar n.)
what does the Musculocutaneous n. turn into
Medial cutaneous antebrachial n.
What does the Lateral Palmar n. split into
Lateral and Medial Palmar metacarpal
what does the medial palmar n. turn into
medial digital palmar n.
where are the Lateral and Medial Palmar metacarpal n. located
small and deep between Metacarpal 3 and interosseous ligament
What are the main arteries we need to focus on for the thoracic limb
1.Axillary Artery
2. Brachial Artery
3. Median Artery
From the median artery, what does it divide into
what is the main blood supply to the manus
Median a.
what does the radial artery divide into
T/F the dorsal blood supply of the manus is BETTER in comparison to the palmar aspect of the manus
False; poorer
Pelvic Limb Innervation: LS Plexus L4-___
S2
Pelvic Limb Innervation
List the important nerves
- Cranial and caudal gluteal
- Femoral–Saphenous
- Obturator
- Ischiatic (Sciatic) (2)
1. Tibial
2. Common Fibularis (Peroneal) (Superficial/Deep)
What does the femoral n. supply
Supplies the quadriceps
Does the saphenous n. run medially or laterally
medially
what does the obturator n. innervate
Adductor muscles(gracilis, adductor, pectineus)
**remember sartorius is innervated by saphenous n.
what does the sciatic n divide into
Tibial n.
Common fibularis (Peroneal)
What are the two branches of the Common fibularis (Peroneal)
Superficial and deep
What area of the leg does the Tibial n (of the Sciatic) innervate
plantar part of the leg
(Flex toe and extend hock)
What area of the leg does the Common fibularis n (of the Sciatic) innervate
dorsal part of the leg (extend toe and flex hock)
identify the nerve
Femoral
* Saphenous
identify the nerve
Obturator
identify the nerve and artery
Obturator n. and a.
identify nerve
Sciatic
* Tibial
* Common fibularis (Peroneal)
identify the autonomous and cutaneous zones
Cutaneous innervation of the hind digit:
what nerve innervates the Craniomedial tibia
Saphenous n.
what is the cutaneous innervation of the Fibular n.
Cranial tibia
what is the cutaneous innervation of the Tibial n.
Caudal tibia
Cutaneous innervation of the hind digit
what is the MAIN innervation on the plantar side
tibial n.
Common fibular n. divides into the Superficial and Deep fibular n.
what does the Superficial and Deep fibular divide into?
what does the tibial n. split into
- Caudal Cutaneous Sural n.
- Lateral Plantar n.
- Medial Plantar n.
what does the Lateral Plantar n. (off of the tibial n.) turn into
From the Femoral a. what does it turn into
Saphenous
Popliteal (branch off into cranial tibial)
Caudal tibial
Lateral and medial plantar
What is the deep plantar arch a branch of
Medial plantar a.
Deep plantar arch divides into (2)
Lateral plantar metatarsal a.
Medial plantar metatarsal a.
The Medial plantar metatarsal a. divides into
Medial digital plantar
Lateral digital plantar
Cranial tibial turns into (2)
Dorsal pedal a.
Dorsal metatarsal a.
Palmar Digital Nerve Block
what nerves are involved?
Palmar Digital Nerves
Palmar Digital Nerve Block
* Anesthetizes:
- Sole
- Navicular Apparatus
- Coffin joint
- Distal flexor tendon sheath
- Distal sesamoidean ligaments
- Loss of skin sensation at the
heel
Abaxial Sesamoid Nerve Block
Nerve involved
- Nerves: Palmar Digital Nerves
Abaxial Sesamoid Nerve Block
- Anesthetizes:
Low 4-Point Block
what nerves are involved
- Palmar metacarpal/metatarsal nerves
(adjacent to splint) - Palmar nerves (between suspensory and DDFT)
Low 4-Point Block
Anesthetizes:
all parts from the Palmar and Abaxial nerve block
Low 4 Point Block Hind limb
T/F Will not reliably anesthetize the skin
dorsally
True
**Performed the same as the forelimb
Low 4 Point Block Hind limb
what is this kind of nerve block helpful with vs. not helpful with
- Important for suturing a laceration
- Less important for a lameness work up
Low 4 Point Block Hind limb
Can do a _____ring block to anesthetize the skin
dorsal
High 4 Point Block Front Limb
what nerves are involved
Anesthetizes:
Nerves:
* Medial and lateral palmar nerves
* Medial and lateral palmar metacarpal
nerves
High 4 (6) Point Block Hind Limb
what nerves are involved?
Anesthetizes:
Nerves:
* Medial and lateral plantar nerves
* Medial and lateral plantar metatarsal nerves
* Dorsal metatarsal nerves
where do you insert the needle for a palmar digital nerve block
over the neurovascular bundle (proximal border of collateral cartilage)
where do you insert the needle for a abaxial sesamoid nerve block
at abaxial surface of sesamoid, go distally