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Anatomy 2 > Lecture 6: Thoracic & Pelvic Distal Limb Blood Vessels & Nerves; Perineural Blocks (Exam 1) > Flashcards

Lecture 6: Thoracic & Pelvic Distal Limb Blood Vessels & Nerves; Perineural Blocks (Exam 1) Flashcards

1
Q

What forms the brachial plexus

A

Formed by the ventral branches of spinal nerves C6 to T2

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2
Q

Describe the suprascapular nerve

A
  • Passes over the scapula
  • Supplies the supraspinatus & infraspinatus m.
  • Damage to this nerve can cause atrophy of these muscles (“Sweeny shoulder”) b/c of the loss of the muscles’ ability to fix the shoulder resulting in shoulder instability
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3
Q

Why is a suprascapular nerve injury common in horses

A
  • B/c they lack an acromion which would protect the nerve
  • The nerve is left exposed & vulnerable to injury when the horse hits its shoulder
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4
Q

What muscle is supplied by the subscapular n

A

Subscapularis m

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5
Q

Describe the axillary n

A
  • Located btw/ the subscapularis & teres major muscles
  • Supplies the muscles of the shoulder
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6
Q

Describe the musculocutaneous n

A
  • Innervates the muscles the flex of the shoulder
  • Provides autonomic innervation to the distal limb
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7
Q

Describe the median n

A
  • Runs w/ the brachial artery in the humeral region
  • Continues w/ the medial artery in the forearm
  • Responsible for the movement of the flexors including the digital & carpal flexors
  • Main autonomic innervation for the palmar surface of the distal limb
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8
Q

What is the axillais

A

A structure around the axillary blood vessels that joins the median nerve w/ the musculocutaneous nerve

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9
Q

Describe the radial n

A
  • Large nerve trunk that originates from the brachial plexus
  • Located medially
  • Hiding btw/ the heads of the triceps
  • later branch innervates the extensor muscles of the carpus & digit
  • Autonomic innervation to the distal limb
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10
Q

What nerve is this

A

Suprascapular

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11
Q

What is sweeny shoulder

A
  • Damage to the suprascapular nerve
  • Not uncommon in horses
  • Results in atrophy of supra & infraspinatus, shoulder instability, & shoulder “slip”
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12
Q

What nerve is this

A

Subscapular n.

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13
Q

What nerve is this

A

Axillary n

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14
Q

What nerve is this

A

Musculocutaneous n

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15
Q

Label the following:

A
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16
Q

Label the nerves

A
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17
Q

What nerve is this

A

Ulnar n

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18
Q

What is the action & innervation of the radial n

A
  • Action: Primary nerve responsible for extension in the forelimb
  • Innervation: Triceps muscle (extends the elbow joint) & Extensor muscles of the carpus & digits (Extend the wrist & fingers)
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19
Q

What is the action & innervation of the median nerve

A
  • Action: Flex the wrist & fingers
  • Innervation: Flexor muscles of the carpus & digits
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20
Q

How does the musculocutaneous n connect to the median nerve

A

Via the ansa axillaris

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21
Q

What are some symptoms of the ulnar nerve injury

A
  • Weakness or paralysis of the flexor muscles in the carpus
  • Difficulty w/ fine motor skills
  • Sensory loss
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22
Q

Describe a radial nerve injury

A
  • Inability to extend the carpus
  • Drooping of the limb
  • Difficulty w/ extension of the digits
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23
Q

Label the nerves w/ the corresponding autonomic zones

A
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24
Q

Label the following extensions of the nerves that give cutaneous innervation of the fore digit

A
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25
Q

Label the different colored lines indicating the nerves of the fore digit

A
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26
Q

Label the following nerves

A
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27
Q

What are the main arteries of the humeral region

A

Axillary & brachial artery

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28
Q

What is the main artery supply the carpus/digits

A

Median artery

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29
Q

What artery is a branch of the median artery supplying the medial aspect of the palm

A

Medial palmar artery

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30
Q

Which artery is a branch of the medial palmar artery supplying the lateral digit

A

Lateral digital palmar artery

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31
Q

Which artery is a branch of the medial palmar artery supplying the medial digit

A

Medial digital palmar artery

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32
Q

Which artery is a very small artery originating from the radial artery

A

Lateral palmar artery

33
Q

Which artery is a branch of the median artery contributing to the dorsal blood supply of the carpus

A

Radial artery

34
Q

Define the rete carpi dorsales

A

A network of small arteries providing the dorsal blood supply of the carpus

35
Q

Be able to describe the main arteries & branches off of them

A
36
Q

Label the following arteries

A
37
Q

Label the following arteries

A
38
Q

What nerves from the lumbosacral plexus

A

Nerves from the L4 to S2

39
Q

What does the lumbosacral plexus supplies

A

The proximal muscles of the pelvic limb

40
Q

What do the cranial & caudal gluteal nerves supply

A

The proximal muscles of the pelvic limb

41
Q

What does the femoral nerve supply

A

The quadriceps muscle & gives rise to the saphenous nerve

42
Q

Describe the saphenous nerve

A
  • Runs medially
  • Provides autonomic innervation to the medial part of the thigh & leg
43
Q

Describe the sciatic nerve

A

Divides into the tibial & common fibular nerves

44
Q

What does the tibial nerve supply

A

The caudal part of the leg & the plantar aspect of the foot

45
Q

What does the common fibular nerve supply

A

The cranial part of the leg & the dorsal aspect of the foot

46
Q

What does the obturator nerve supply

A

The adductor muscles of the thigh

47
Q

What can result if there is an injury to the obturator nerve

A

In abduction of the limb due to loss of adductor muscle function

48
Q

Describe the chiaticosiatic nerve

A

A large nerve that runs laterally deep to the biceps femoris muscle

49
Q

The (tibial/fibular) nerve runs caudal while the (tibial/fibular) nerve runs cranially

A

Tibial;fibular

50
Q

What does the tibial nerve innervate

A

The distal limb of the pelvic limb

51
Q

What nerve gives rise to the lateral & medial plantar nerves & what do they supply

A
  • Tibial nerve
  • Supplies the plantar aspect of the foot
52
Q

Describe the metatarsal nerves

A

Small deep nerves located btw/ the metatarsal bones & the interosseous ligament

53
Q

What does the fibular nerve divide into

A

The deep & superficial fibular nerves

54
Q

Describe the deep fibular nerve

A

Gives rise to the lateral & medial dorsal metatarsal nerves which supply the dorsal aspect of the foot

55
Q

Describe the superficial fibular nerve

A

This nerve supplies the cranial part of the leg & the dorsal aspect of the foot

56
Q

What nerve is this (dark blue & light blue arrow)

A
  • Dark blue: Femoral
  • Light blue: Saphenous
57
Q

What nerve is this

A

Obturator n

58
Q

Label the following

A
59
Q

What nerve is this (Dark blue arrow, proximal light blue arrow, distal light blue arrow)

A
  • Dark blue: Sciatic
  • P light blue: Tibial
  • D light blue: Common fibularis (Peroneal)
60
Q

Label the autonomic & cutaneous zones nerves

A
61
Q

Label the branches each nerve involved in the cutaneous innervation of the hind digit

A
62
Q

Label the following different colored lines with the correct nerve/branch

A
63
Q

Label the different branches of the arteries starting with the femoral artery

A
64
Q

Use this diagram to label the arteries

A
65
Q

What arteries does the femoral give rise to

A

The popliteal artery & caudal tibial artery

66
Q

What does the saphenous artery supply

A

The medial part of the foot

67
Q

Describe the popliteal artery

A
  • Gives rise to the cranial tibial artery
  • Supplies the dorsal aspect of the foot
68
Q

Describe the caudal tibial artery

A
  • Supplies the plantar aspect of the foot
  • Branches into the plantar lateral artery & the plantar medial artery
69
Q

Describe the digital arteries

A

When the plantar lateral & medial arteries reach the digits they become the lateral digital artery & the medial digital artery

70
Q

Where is the deep plantar arch

A

Btw/ the plantar lateral & medial arteries

71
Q

What branches off from the deep plantar arch

A

Lateral & medial plantar metatarsal arteries

72
Q

What branches off from the medial plantar artery

A

Medial digital plantar artery

73
Q

Describe the lateral digital plantar artery

A

Branches off from the medial plantar artery but the lateral plantar artery also contributes to its supply

74
Q

Describe a palmar digital nerve block

A
  • Insert the needle over the neurovascular bundle @ the proximal border of the collateral cartilage
  • 1.5 ml per site
  • Palmar digital nerves
  • numbs the most distal part of the digit (sole, navicular apparatus, coffin joint, distal flexor tendon sheath, distal sesamoidean ligaments, & loss of skin sensation @ the heel)
75
Q

Describe an abaxial sesamoid nerve block

A
  • Insert the needle @ the abaxial surface of the sesamoid w/ the needle pointed distally
  • 2 ml per site
  • Palmar digital nerves
  • Numbs the foot, middle phalanx, pastern joint, distal P1, Distal SDF & DDF, distal sesamoidian ligaments, Distal annular ligament, & +/- fetlock joint
76
Q

Describe a low 4 point block

A
  • Insert the needle distal to the button of the splint medially & laterally; insert the needle SQ btw/ the suspensory ligament & the DDF tendon
  • 1 - 2 ml per site
  • Palmar metacarpal/metatarsal nerves (adjacent to the splint) & palmar nerves (btw/ suspensory & DDF tendon)
  • Numbs all structures prev mentioned, fetlock joint, suspensory branches, & more proximal SDF/DDF tendons
77
Q

What is the difference in a low 4 point block in the hind limb

A
  • performed the same as the forelimb
  • Will not reliably anesthetize the skin dorsally (impt for suturing a laceration; less impt for a lameness work up)
  • Can do a dorsal ring block to anesthetize the skin
78
Q

Describe a high 4 point block in the front limb

A
  • Inject SQ on dorsal surface of the DDFT through the fascia (carpal retinaculum flexorum) just distal to the CMC joint; flex the limb & insert the needle along the splint bones pointed @ palmar MC3
  • 2 to 5 ml per site
  • Medial & lateral palmar nerves along w/ the medial & lateral palmar metacarpal n
  • Numbs the flexor tendons, splint bones, interosseous ligaments (btw/ MC2/4 & MC3), proximal suspensory ligament, & the inferior check ligament
79
Q

Describe a high 4 (6) point block in the hind limb

A
  • 1.5 in needle inserted 1 cm distal to TMT on either side & hit the back of the MC3 non wgt, a 25g 5/8 in needle deposits 3 to 5 ml through the fascia over the DDFT on medial & lateral side, finally a 2cm distal to the TMT @ 10 & 2 o’clock positions on the dorsal cannon bone
  • 3 to 5 ml per site
  • Medial & lateral plantar nerves, Medial/lateral plantar metatarsal nerve, & dorsal metatarsal n
  • Numbs everything distal to the TMT except the dorsum over the cannon bone & dorsal cannon
  • Necessary for lacerations not commonly clinically relevant

Anatomy 2 (14 decks)

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