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Year 2: Neurobiology II > Lecture 6: Spinal nerves and plexus > Flashcards

Lecture 6: Spinal nerves and plexus Flashcards

1
Q

number of spinal nerves and their associated levels

A

31 pairs of spinal nerves

8 cervical

12 thoracic

5 lumbar

5 sacral

1 coccygeal

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2
Q

describe the location of the cervical spinal nerves

A

the first is located between the occiput and C1 vertebrae (motor only)

2-7 are located ABOVE corresponding cervical vertebrae

C8 under C7/above T1

+1 rule = i.e. nerve under C1 vertebrae = C1 + 1 = C2 nerve

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3
Q

what is the endoneurium

A

continuous part of the pia mater

wraps a SINGLE AXON

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4
Q

what is the perineurium

A

continuous component from arachnoid mater

wraps BUNDLES OF AXONS (form a fasicle)

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5
Q

what is the epineurium

A

continuous component from dura mater wrapping BUNDLES OF FASCICLES

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6
Q

describe blood supply to peripheral nerves

A

plexus of arterioles follow the peripheral nerves

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7
Q

what is a neuropraxia injury

A

compression injury with axon intact

endoneurium is intact

good chance of recovery

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8
Q

what is an axonotmesis injury

A

tear of an axon

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9
Q

what is a neurotmesis injury

A

tear of whole fascicle/nervee

disrupted endo-, peri, or even epineurium

poor chance of recovery

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10
Q

describe the size of a spinal nerve

A

very short

soon splits to dorsal and ventral rami

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11
Q

what are the branches of the dorsal rami and what do they supply

A

medial branch = vertebral disc, facet joints, intrinsic back mm, and skin

lateral branch = intrinsic back mm mainly and skin slightly

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12
Q

branches of the ventral ramus as well as their further sub-branches and function

A

cutaneous branch
- lateral cutaneous = anterior and posterior branches
- anterior cutaneous = lateral and medial branches

muscular branch = supplies intercostals, serratus posterior, and abdominal wall mm

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13
Q

myotomes tested in ASIA scale

A

5 UE and 5 LE

major limb mm of each

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14
Q

dermatomes test what; how does it vary from trunk to neck/extremities

A

segmental distribution of nn innervation

A delta - crude touch, sharp pain

trunk area = ventral and dorsal rami of spinal nn

neck and extremities = peripheral nn from plexus fromed by VENTRAL rami

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15
Q

cervical plexus is formed by what rami

A

ventral

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16
Q

nerves from the cervical plexus and their roots

A

Lesser occipital nerve - (C2)

Greater Auricular nerve - (C2-C3)

transverse cervical nerve - (C2-C3)

Supraclavicular nerve (C3-C4)

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17
Q

innervation at the mandibular angle

A

greater auricle nerve

around the TMJ; important to know this for differential dx

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18
Q

where does the supraclavicular nerve (C3-C4) exit

A

posterior 1/3 of the SCM

area is a nerve point; common place for dry needling

if mm is strained it can compress the nerve

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19
Q

C1 nerve (part of cervical plexus) goes to what mm

A

geniohyoid and thyrohyoid mm through hypoglossal nn (CN XII)

hikes onto CN XII

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20
Q

roots of ansa cervicalis and the target mm

A

superior root = C1 (through hypoglossal n)

inferior root (C2-C3)

target mm = infrahyoid neck mm

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21
Q

phrenic nn roots

A

C3-C5

acts like CPG; doesn’t take conscious thought to breathe

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22
Q

what ventral rami roots supply the brachial plexus

A

C5-T1

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23
Q

superior trunk of the brachial plexus roots

A

C5/C6

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24
Q

middle trunk of brachial plexus roots

A

C7

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25
Q

inferior trunk of brachial plexus roots

A

C8/T1

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26
Q

the 1st ribs separates what

A

C8/T1 nerve roots

can get impinged

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27
Q

each trunk of the brachial plexus gives out what

A

anterior and posterior divisions

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28
Q

lateral cord is formed by

A

anterior divisions of the superior and middle trunk

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29
Q

medial cord is formed by

A

anterior division of the inferior trunk

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30
Q

posterior cord is formed by

A

all posterior divisions (from superior, medial, and inferior trunk)

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31
Q

each cord of the brachial plexus gives out what

A

terminal branches of nn

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32
Q

what nerves of the brachial plexus are directly from the nerve roots

A

Dorsal scapular nerve (C4 and C5)

Long thoracic nerve (C5, C6, and C7)

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33
Q

dorsal scapular nn supplies what mm

A

levator scapulae

rhomboid major and minor

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34
Q

long thoracic nerve supplies what mm

A

serratus anterior

SALT57 = serratus anterior, long thoracic, roots C5 through C7

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35
Q

nerves from the superior trunk of the brachial plexus

A

suprascapular nerve (C5 and C6)

nerve to subclavius (C5 and C6)

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36
Q

suprascapular nerve supplies what

A

supra and infraspinatus

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37
Q

roots of the lateral cord

A

C5, C6, and C7

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38
Q

roots of lateral pectoral nerve and mm supplied

A

lateral pectoral nerve technically has a bridge to the medial as well; thus nn roots are C5-T1

supplies pec major

39
Q

musculocutaneous nn roots

A

C5-C7

40
Q

mm supplied by musculocutaneous nn and roots

A

coracobrachialis/biceps brachii (C5/C6)

Brachialis (C5/C6) and some C7 from radial nn

41
Q

skin supplied by musculocutaneous nn

A

lateral antebrachial nn is a branch from the musculocutaneous nerve

supplies the lateral forearm; cutaneous innervation

42
Q

what are the terminal branches of the lateral cord

A

lateral pectoral nerve (C5-T1 b/c branch to medial pectoral nn)

musculocutaneous nerve (C5-C7)

gives branch to median nerve (C5-C7 root portion)

43
Q

roots of the medial cord of the brachial plexus

A

C8 and T1

43
Q

terminal branches of the medial cord of the brachial plexus

A

medial pectoral nn

medial brachial cutaneous nerve

medial antebrachial cutaneous nerve

ulnar nerve

branch to median nerve

44
Q

medial pectoral nerve (C8-T1) supplies what

A

pec major and minor

45
Q

forearm mm innervated by the ulnar nn

A

flexor carpi ulnaris

ulnar side 1/2 of flexor digitorium profundus

46
Q

hand mm innervated by the ulnar nn

A

palmaris brevis
ulnar side 2 lumbricals
ulnar head of flexor pollicis brevis
interossei/adductor pollicis
hypothenar eminence mm

47
Q

what are the mm of the hypothenar eminence

A

Abductor digiti minimi

Flexor digiti minimi

Opponens digiti minimi

48
Q

cutaneous branch of the ulnar nn supplies what

A

dorsal and palmar sides of hand 1.5 digits

49
Q

forearm mm supplied by the median nn

A

pronator teres
flexor carpi radialis
palmaris longus
flexor digitorum superficialis

Via anterior interosseous:
-flexor pollicis longus
-radial 1/2 flexor digitorum profundus
-pronator quadratus

50
Q

anterior interosseous nerve supplies what

A

flexor pollicis longus
radial 1/2 flexor digitorum profundus
pronator quadratus

51
Q

mm of thenar eminence

A

abductor pollicis brevis

flexor pollicis brevis (radial head)

opponens pollicis

52
Q

hand mm supplied by median nn

A

thenar eminence

radial side 2 lumbricals

53
Q

cutaneous branch of the median nerve supplies what

A

radial palmar side 3.5 fingers and dorsal DIP

54
Q

roots of the posterior cord

A

C5-T1

55
Q

terminal branches of the posterior cord

A

upper subscapular nn (C5-C6)

middle subscap/thoracodorsal nn (C6-C8)

lower subscapular nn (C5-C6)

axillary nn (C5-C6)

radial nn (C5-T1)

56
Q

roots of upper subscap and mm it innervates

A

C5-C6

subscapularis

57
Q

rots of the middle subscapular nn/thoracodorsal nn and mm innervated

A

C6-C8

latissimus dorsi

58
Q

lower subscapular nerve roots and mm it innervates

A

C5-C6

subscapularis and teres major

59
Q

axillary nn roots

A

C5-C6

60
Q

radial nn roots

A

C5-T1

61
Q

target mm of axillary nn

A

deltoid

teres minor

62
Q

cutaneous branch of the axillary nn innervates what region

A

shoulder girdle along deltoid

63
Q

arm/elbow mm innervated by radial nn

A

triceps
brachioradialis
anconeus
supinator

64
Q

forearm mm innervated by radial nn

A

abductor pollicis longus
extensor pollicis brevis
extensor carpi radialis longus/brevis
extensor pollicis longus
extensor digitorum
extensor indicis
extensor digiti minimi
extensor carpi ulnaris

65
Q

nn of lumbar plexus directly from the ventral rami and their corresponding roots

A

iliohypogastric = T12 - L1

iliolingual = L1

genitofemoral = L1-L2

66
Q

anterior division of the lumbar plexus gives off what nn, what are their roots, and what do they supply

A

obturator nn (L2-L4) - medial thigh

lumbosacral trunk (L4-L5) - continues for sacral plexus

67
Q

posterior division of the lumbar plexus supplies what

A

lateral and anterior thigh

68
Q

posterior division of the lumbar plexus gives off what nn

A

lateral femoral cutaneous nn (L2-L3)

Femoral (L2-L4)

69
Q

target mm of obturator nn

A

pectineus

obturator externus

adductors (except adductor magnus HS head)

gracilis

70
Q

general functions of mm innervated by obturator nn

A

Hip ADD/IR

Hip ER (pectineus and obturator externus)

Knee flex

Knee IR (gracilis)

71
Q

target mm of femoral nn

A

iliopsoas

sertorius

pectineus

quadriceps

72
Q

what is special about pectineus innervation

A

innervated by obturator nn AND femoral

73
Q

general functions of mm supplied by femoral nn

A

Hip flexion and ER

knee ext and IR

74
Q

cutaneous branch of femoral nn supplies what

A

anterior thigh

medial leg to foot arch (saphenous nn)

75
Q

roots of lumbosacral trunk

A

L4-L5

76
Q

roots of sacral spinal nn

A

S1-S4

77
Q

ventral/anterior division of the sacral plexus gives off what nn and what are their roots

A

tibial nn L4-S3

pudendal nn S2-S4

pelvic splanchnic nn S2-S4, parasympathetic motor

78
Q

dorsal/posterior division of the sacral plexus gives off what nn and what are their roots

A

common fibular nn L4-S2

superior gluteal nn L4-S1

inferior gluteal nn L5-S2

79
Q

roots of posterior femoral cutaneous nn

A

S1-S3

80
Q

mm supplied by superior gluteal nn L4-S1

A

glut med

glut min

TFL

81
Q

mm supplied by inferior gluteal nn L5-S2

A

glut max

82
Q

thigh mm innervated by common fibular nn

A

biceps femoris SH

83
Q

leg mm innervated by the common fibular nn

A

superficial
- fibularis longus/brevis

deep branch
- tibialis anterior
- extensor digitorum longus
- extensor hallucis longus
- fibularis tertius
- foot mm (ext hallucis/digitorium brevis)

84
Q

general functions of mm supplied by common fibular nn

A

knee flexion and ER

ankle/foot
- DF
- IV
- toe EXT
- PF
- EV

85
Q

cutaneous branch (superficial and deep) of the common fibular nn supplies what regions

A

superficial = lateral leg and dorsum of foot

deep = dorsum of food between the 1st and 2nd digit

86
Q

mm innervated by the tibial nn

A

HS except biceps femoris SH

adductor magnus HS head

posterior leg mm??

all foot intrinsic except extensor brevis

87
Q

general functions of mm supplied by the tibial nn

A

hip ext

knee flex, IR, ER

ankle PF, IV, ADD, toe flex

88
Q

cutaneous branch of the tibial nn supplies what regions

A

posterior leg to lateral foot (sural nn)

sole of foot

89
Q

radiculopathy vs peripheral neuropathy

A

radiculopathy = segmental distribution (multiple peripheral nn)

peripheral neuropathy = localized region (single or multi peripheral nn)

90
Q

discs in the cervical region

A

C2-C7

no C1 disc

91
Q

how to name nn impinged by a disc

A

corresponding disc is above the vertebrae (C2 disc is above C2 vertebrae)

impinged nn root number = +1

C5 disc herniation (disc above C5) would compress C6 nn root (C5+1)

92
Q
A

Year 2: Neurobiology II (10 decks)

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