Module 2A &2B Flashcards
What spinal nerve components contribute to the formation of the brachial plexus?
Ventral Primary Rami - C5-T1
What are the main reasons for entrapped in the IVF area?
disc herniation or degenerative processes related to arthritis
What significant risk to injury does the cervical spine have that is not an issue in the lumbar spine?
Spinal cord
What parts of the body do the muscular branches consist of?
Bones, tendons/ligaments, muscles, and vessels
- GSA axons: joint receptors (Pacinian corpuscles, Ruffini end organs, nociceptors); proprioceptors (muscle spindles and GTOs); other nociceptors
- GVA axons: primarily arising in vascular elements responding pressure
- GSE axons: innervating skeletal muscle cells
- Postganglionic GVE axons: sympathetic innervation of the vessels serving the muscles, bones, and surrounding soft tissues
What parts of the body do the cutaneous branch consist of?
Skin
GSA axons: high and low threshold fibers (mechanoreceptors, thermoreceptors, chemoreceptors, and nociceptors)
• GVA axons: primarily vascular pressure
• Postganglionic GVE axons: sympathetic innervation of the vessels, erector pili, and the sweat glands.
How do we sort the brachial plexus?
Hint: R, T, D, C, MB
Roots: C5-T1
Trunks: Upper, Middle, and Lower
Divisions: Anterior and Posterior
Cords: Lateral, Medial, and Posterior
Main Branches: Musculocutaneous, Axillary, Median, Ulnar, Radial
How do we evaluate integrity of spinal nerves?
MSR Tests
Muscle strength is accessed bilaterally, as are all of the tests.
Grading is somewhat subjective but meant to be evaluated WITHIN that patient, based on fitness, level of health, and degree to which pain affects the movement. Age and gender may play a role.
Reflexes are evaluated on a + scale, where ++ is normal.
What is the muscle test done to test C5? What is the peripheral route?
Deltoid muscle
Axillary nerve
What is the reflex test done to test C5? What is the peripheral route?
Biceps
Musculocutaneous
Where is the sensory test done for C5?
Toward the superior and lateral portion of the arm
What is the muscle test done to test C6? What is the peripheral route?
Biceps brachii and wrist extension
Musculocutaneous and posterior interosseous
What is the reflex test done to test C6? What is the peripheral route?
Brachioradialis
Radial nerve
Where is the sensory test done for C6?
Middle portion of the arm toward the side of the thumb
What is the muscle test done to test C7? What is the peripheral route?
Triceps brachii and wrist flexors
Radial and median
What is the reflex test done to test C7? What is the peripheral route?
Triceps
Radial
Where is the sensory test done for C7?
Middle 3 fingers
What is the muscle test done to test C8? What is the peripheral route?
Finger flexors
Median
Median (and ulnar)
What is the reflex test done to test C8? What is the peripheral route?
Finger flexor reflex
Median
Where is the sensory test done of C8?
Pinky finger
What is the muscle test done to test T1? What is the peripheral route?
Finger adductors and/or abductors
Ulnar
What is the reflex test done to test T1? What is the peripheral route?
NONE; trick question
Where is the sensory test done of T1?
Medial portion of the arm by the elbow
What is Thoracic Outlet Syndrome caused by? What area is this cause by?
caused by entrapment of all / some the contributing VPR of the brachial plexus as it enters the upper extremity.
3 main areas where these entrapments can occur: between the middle and anterior scalenes
under the clavicle and subclavius muscle
under the tendon of the pectoralis major