MSCT Week 2: Upper Limb II Flashcards
1
Q
All of the major nerves that innervate the upper limb originate from…
A
The Brachial Plexus
2
Q
The brachial plexus is a _______ plexus formed by the ________ Rami of ____ to ____ and most the the ________________ of ____.
A
The brachial plexus is a somatic plexus formed by the anterior rami of C5 to C8 and most the anterior ramus of T1.
3
Q
Brachial Plexus location
A
It originates in the neck, passes laterally and inferiorly over rib 1, enters the axilla, and associates with the axillary artery
4
Q
Brachial plexus parts from proximal to distal
5 listed
A
- Roots
- Trunks
- Divisions
- Cords
- Terminal branches
5
Q
Identify
A
6
Q
Identify
A
7
Q
Step 1 of drawing the brachial plexus
A
8
Q
Step 2 of drawing the brachial plexus
A
9
Q
Step 3 of drawing the brachial plexus
A
10
Q
Step 4 of drawing the brachial plexus
A
11
Q
Step 5 of drawing the brachial plexus
A
12
Q
Step 6 of drawing the brachial plexus
A
13
Q
Identify sensory innervation
A
14
Q
If a nerve is severed as a particular location, the function of the nerve proximal to the injury is?
A
Normal
15
Q
The musculocutaneous nerve is
A
a terminal branch of the lateral cord and immediately enters the anterior compartment of the arm and runs between the brachialis and biceps brachii muscles
16
Q
The median nerve is?
3 listed
A
- A terminal branch from both the lateral and medial cords in the axilla and runs distally in association with the brachial artery in the medial aspect of the arm
- The nerve crosses anterior to the elbow joint and enters the forearm’In the upper part of the forearm the median nerves gives off a deep branch (anterior interosseous nerve) and continues through the forearm into the hand through the carpal tunnel
17
Q
Identify
A
18
Q
the Ulnar Nerve is?
A
- A terminal branch of the medial cord that runs distally in association with the brachial artery and median nerve in the medial aspect of the arm
- The nerve passes posterior to the medial epicondyle of the humerus and enters the forearm
19
Q
The nerve passes posterior to the medial epicondyle of the humerus and enters the forearm
A
The ulnar Nerve
20
Q
The nerve travels down the medial aspect of the forearm close to the ulna and divides into a superficial and deep branch at the wrist
A
The Ulnar Nerve
21
Q
Identify
A
22
Q
The Axillary nerve is?
A
A terminal branch of the posterior cord that exits through the posterior wall of the axilla and passes posterior to the surgical neck of the humerus
23
Q
A terminal branch of the posterior cord that exits through the posterior wall of the axilla and passes posterior to the surgical neck of the humerus
A
The axillary nerve
24
Q
The Radial Nerve is?
A
- A terminal branch of the posterior cord that passes out of the axilla into the posterior compartment of the arm in close association to the posterior aspect of the shaft of the humerus
- The nerve enters the forearm posterior to the lateral epicondyle of the humerus and travels to the posterior aspect of the hand
- As it travels through the forearm it gives off a deep branch, (posterior interosseous nerve)
25
A terminal branch of the posterior cord that passes out of the axilla into the posterior compartment of the arm in close association to the posterior aspect of the shaft of the humerus
The Radial Nerve
26
The nerve enters the forearm posterior to the lateral epicondyle of the humerus and travels to the posterior aspect of the hand
The Radial Nerve
27
As it travels through the forearm it gives off a deep branch, (posterior interosseous nerve)
The Radial Nerve
28
Identify
29
Loss of a nerve results in?
Atrophy disuse of that muscle
30
A movement that is accomplished by 2 or more muscles innervated by different nerves when only one of the nerves is damaged will result in?
Weakness of the movement
31
A movement that is accomplished by muscles that are all innervated by the same nerve when damaged will result in?
Complete loss of movement
32
Loss of muscle function nearly always results in the opposite function/motion being?
Dominant
33
In addition to a motor deficit, injury to a nerve is often associated with a...
sensory loss as well
34
When thinking about lesions of nerves in the upper limb remember these
6 listed
35
The 2 most common injuries to the axillary nerve are?
* Anterior dislocation of the humerus
* Fracture of the surgical neck of the humerus
36
The most common injury to the Radial nerve is?
midshaft fractures of the humerus
37
Outcomes of damage to the axillary nerve
38
Outcomes of damage to the Radial nerve
39
Identify
40
Common injuries to the Median Nerve?
4 listed
* Fractures of the elbow
* Fractures of the distal humerus
* fractures of the Carpal tunnel
* Carpal Tunnel Syndrome
41
Outcomes of damage to the Median Nerve from supraepicondylar fractures of the humerus
42
Identify
43
Outcomes of damage to the median nerve from Carpal Tunnel Syndrome, fracture or laceration
44
Damage outcomes to the deep branch of the median nerve
45
Deep branch of the Median Nerve AKA
Anterior Interosseous Nerve
46
Anterior Interosseous Nerve AKA
Deep Branch of the Median Nerve
47
Damage outcomes to the anterior Interosseous Nerve
48
Identify
49
What nerve is injured
50
Common injuries to the Ulnar Nerve
2 listed
* Fractures of the medial epicondyle or compression of the nerve against the bone
* Fractures or lacerations to the ventral medial side of the wrist
51
Identify
52
Ulnar Nerve damage outcomes of entrapment at the elbow or epicondyle fracture
53
which nerve is indicated by this test
ulnar nerve test
54
Ulnar Nerve damage outcomes of wrist fracture or laceration
55
Common Lesions of the Musculocutaneous nerve
Lesions of the musculocutaneous nerve are not common but can occur
56
Outcomes of damage to the musculocutaneous nerve
57
Identify
58
Most common lesions of the brachial plexus
* Upper brachial plexus injury (birth injury, fall on the shoulder)
* Lower brachial plexus injury (birth injury, severe abduction of the arm)
59
Upper brachial plexus injury nerves involved
3 listed
* musculocutaneous nerve
* axillary nerve
* suprascapular nerve
60
Lower brachial plexus injury nerves involved
Primarily involves the Ulnar nerve
61
Erb's Palsy AKA
Upper Brachial Plexus Injury
62
Klumpke's Palsy AKA
Lower Brachial plexus injury
63
Klumpke's Palsy Causes
An undue abduction of the arm or birth injury
64
Klumpke's Palsy Nerves
2 listed
* Ulnar Nerve
* Median Nerve (can also be involved)
65
Klumpke's Palsy Deformity
2 listed
* Ulnar Claw hand due to the unopposed action of the long flexors and extensors of the fingers
* Hyperextension of the MP joints and flexion at the IP joints
66
Klumpke's Palsy Disability
3 listed
* intrinsic muscles of the hand
* ulnar flexors of the wrist and fingers
* Sensations lost over a small area along the ulnar border of the forearm and hand
67
Erb's Palsy Causes
Undue separation of the head from the shoulder commonly encountered in birth injury or fall on the shoulder
68
Erb's Palsy Nerves
* Musculocutaneous nerve
* axillary nerve
* suprascapular nerve
69
Erb's Palsy Deformity
* Arm hangs by the side
* it is abducted and medially rotated
* The forearm is extended and hand pronated
70
Erb's Palsy Disability
3 listed
Loss of Function
* Abduction and lateral rotation of the arm
* Flexion and supination of the forearm
* Sensations lost over a small area over the lower part of the shoulder
71
what is this?
Erb's Palsy
72
What is this?
Klumpke's Palsy
73
The vascular supply to the upper limb originates from the?
Subclavian Artery in the inferior part of the neck
74
The subclavian continues anterior or posterior to the clavicle?
Posterior
75
The subclavian enters the axilla where it?
Changes its name to the axillary artery
76
The subclavian gives off a branch in the neck called?
Thyrocervical Trunk
77
Thyrocervical Trunk important in?
The collateral circulation of the shoulder
78
Axillary artery branches
5 Listed
* Superior Thoracic
* Thoracoacromial
* Lateral Thoracic
* Subscapular
* anterior humeral circumflex
79
After giving off __ branches the axillary artery becomes the?
* 5 branches
* brachial artery in the arm
80
The brachial artery branches
One major branch the Deep Brachial
81
The deep brachial supplies...
the posterior compartment
82
Anterior to the elbow the brachial artery splits into
The radial and ulnar arteries
83
Identify
84
Identify
85
The radial and ulnar arteries run to the hand and anastomose with one another as the?
Superficial and deep palmar arches
86
Collateral circulation around the shoulder: blockages of the axillary artery between the origins of the thyrocervical trunk and subscapular arteries may be bypassed by
anastomoses between the branches of the thyrocervical trunk (suprascapular artery, transverse cervical and dorsal scapular artery)
and
branches of the subscapular artery (circumflex artery)
87
Identify
88
Identify
89
Collateral circulation around the elbow: Blockages of the brachial artery between the origin of the superior and inferior ulnar collaterals and the bifurcation of the brachial artery may be bypassed by?
The collateral branches of the radial and ulnar arteries and the brachial and deep brachial arteries
90
Identify
91
Collateral circulation around the wrist: Blockage of either the radial or ulnar artery in the distal forearm may be bypassed by the?
Anastomoses established between these two arteries through the superficial and deep palmar arches
92
Identify
93
Identify
94
Identify
95
Identify
96
Upper Limb Overview
97
Nerve Lesion O verview
98
Overview of muscles in the post forearm
99
Nerve Lesion Overview
100
Anterior forearm muscle overview
101
Ant Int Oss syndrome
102
Ulnar Lesions
103
Muscles of the hand
104
deep intrinsic muscles of the hand
105
Erb's Overview
106
Klumpke's Palsy Overview
107
Vascularization of the upper limb Over iew
108
Collateral Circulation of the Shoulder
109
Collateral Circulation of the Elbow
110
Collateral Circulation of the Wrist and Hand
111
PQ1
112
PQ2
113
PQ3
