Name the muscle, nerve root, nerve and reflex! Flashcards
Shoulder abduction- muscle, nerve root/nerve, reflex
Deltoid
C5 (+C6)= lateral aspect of upper arm (C5) and lat lower arm and thumb (C6)
Axillary nerve ( small band over deltoid)
Shoulder adduction- muscle, nerve root/nerve, reflex
Latissimus dorsi and pectoralis major
(C6), C7, (C8)= lateral aspect of fore arm and hand particularly middle finger (C7)
Thoracodorsal nerve (purely motor no sensory area)
Elbow flexion- muscle, nerve root, nerve, reflex
Biceps
C5, C6 = lateral aspect of upper arm (C5) and forearm, thumb and index finger (C6)
Musculocutaneous nerve (lateral aspect of forearm) Reflex: biceps
Elbow extension- muscle, nerve root, nerve, reflex
Triceps
(C6), C7, (C8) = lateral aspect of forearm and hand particularly middle finger
Radial nerve: anatomical snuffbox and ext. aspect of forearm
Reflex: triceps +/- brachioradialis
Wrist extension- muscle, nerve root, nerve, reflex
Extensor carpi radialis longus, extensor carpi ulnaris
(C5, C6), C7, (C8)- lateral aspect of forearm, thumb and index finger
Radial and posterior interosseous nerve: lateral forearm , thumb, index finger, snuff box
What are the findings in a C7 radiculopathy?
- weakness of shoulder adduction (but not abduction)
- weakness of elbow extension
- weakness of wrist ext and flexion
- wasting of triceps and forearm
- Loss of triceps reflex
How do you differentiate a high radial nerve injury from a C7 radiculopathy?
A radial nerve injury spares wrist flexion (C7 and C8, median and ulnar nerves)
Wrist flexion- muscle, nerve root, nerve and reflex
Flexor carpi radialis, flexor carpi ulnaris
C6, C7 : lateral aspect of forearm, thumb, 1st and middle finger
Median and ulnar nerve: thumb, index and middle finger
Finger extension- muscle, nerve root, nerve and reflex
Extensor digitorum
C7 (C8)- little finger, ring finger, middle finger
Posterior interosseous nerve (branch of radial nerve) - no sensory area
Finger flexion- muscle, nerve root, nerve and reflex
Flexor digitorum superficialis and profundus
C8: little finger and 1/2 ring finger
Reflex is finger flexion
Median: palmer aspect of lateral hand, thumb, index, middle and 1/2 ring finger
Ulnar: palmar aspect of medial side of hand, little and 1/2 ring finger
Index finger aBDuction
First dorsal interosseous
(C8), T1: little finger, 1/2 ring finger, ulnar aspect of palm and mainly medial forearm
Ulnar: palmar aspect of medial side of hand, little and 1/2 ring finger
Little finger aBDuction
Abductor digiti minimi
(C8), T1: little finger, 1/2 ring finger, ulnar aspect of palm and mainly medial forearm
Ulnar: palmar aspect of medial side of hand, little and 1/2 ring finger
Thumb aBDuction
Abductor pollicis brevis
(C8), T1:little finger, 1/2 ring finger, ulnar aspect of palm and mainly medial forearm
Median: palmar aspect of lateral hand, thumb, index, middle and 1/2 ring finger
Thumb opposition
Opponens pollicis
(C8), T1: little finger, 1/2 ring finger, ulnar aspect of palm and mainly medial forearm
Median: palmar aspect of lateral hand, thumb, index, middle and 1/2 ring finger
Thumb flexion
Flexor pollucis brevis
(C8), T1: little finger, 1/2 ring finger, ulnar aspect of palm and mainly medial forearm
Median: palmar aspect of lateral hand, thumb, index, middle and 1/2 ring finger
Finger adduction
Palmar interossei
(C8), T1: little finger, 1/2 ring finger, ulnar aspect of palm and mainly medial forearm
Ulnar: palmar aspect of medial side of hand, little and 1/2 ring finger
What muscles are supplied by the median nerve? How do you test?
LOAF: all T1 including thenar eminance
- lateral lumbricals
- opponens pollicus
- Abductor pollicis brevis
- Flexor pollicis brevis
Pronators of forearm (C6)
flexor carpi radialis- wrist flexor (C7)
Long finger flexors via anterior interosseous branch of the median nerve including flexor digitorum profundus, superficialis to index/middle fingers (C8)
Test opposition (thumb to little finger in O) or test palmar abduction
What muscles are supplied by ulnar nerve? Whats the test?
All the hand muscles except LOAF
- Hypothenar muscles
- Medial 2 lumbricals
- Interrosei (palmar addict & dorsal abduct the fingers)
- Adductor pollicis (T1)
- Medial wrist flexors (C8)
Cross index and middle fingers
Grip paper between index finger and thumb without flexing thumb IP joint (Froments sign)
What muscles are supplied by the radial nerve? WHat is the test?
- wrist extensors (C8)
- Brachioradialis, supinator (both C6) and triceps (C7)
Posterior interosseous branch supplies extensors of fingers- wrist drop if weak
Test wrist dorsiflexion (extension) and sensation in snuff box
HOw do you tell the difference between a median, ulnar and T1 radiculopathy?
Assess:
- Abductor pollicis brevis- pointing thumb up with hand flat
- First dorsal interosseous
APB weak and FDI normal = median nerve lesion
APB normal and FDI weak= ulnar nerve lesion
Weakness of both = T1 radiculopathy
Hip flexion
Iliopsoas muscle
L1, L2, (L3) : groin and antero-medial thigh
Femoral: groin and upper thigh anteriorly (lateral cutaneous nerve of thigh). Patellar reflex.
Hip extension
Gluteus maximus
L5, S1: lateral lower leg, dorsum and sole of foot
Inferior gluteal nerve: purely motor
Knee flexion
Hamstrings
L5, S1: lateral lower leg and dorsum and sole of foot
Sciatic nerve: outer aspect of leg, dorsum, sole and inner aspect of foot
Knee extension
Quadriceps femoris
L3, L4: anteromedial thigh and lower leg
Femoral: anteromedial thigh and inner leg
Reflex: patellar
Ankle dorsiflexion
Tibialis anterior
L4, L5: lower leg and dorsum of foot
Deep peroneal: 1st interosseous web space (between big and second toe)
Ankle plantarflexion
Gastrocneumius
S1: Anterolateral aspect of lower leg, little toe and sole of foot
Tibial nerve: Anterolateral aspect of lower leg, little toe and sole of foot
Ankle inversion
Tibialis posterior
L4, (L5, S1): lower leg and foot
Tibial nerve:Anterolateral aspect of lower leg, little toe and sole of foot
Ankle eversion
Peroneus longus and brevis
L5: lateral lower leg and top of foot except little toe
Peroneal nerve: lateral lower leg and dorsum of foot
How can you differentiate a common peroneal palsy, sciatic nerve palsy and L5 radiculopathy?
Ankle inversion
- preserved if common peroneal
- weak if L5 or sciatic nerve palsy
If sciatic nerve palsy- absent ankle jerk, weak ankle dorsi & plantarflexion
If L5 radiculopathy- hip extension would be weak
What is the nerve root and nerve of ankle jerk? If absent what does it indicate?
S1
Via tibial branch of sciatic
Absent indicates
- lesion of tibial nerve (far less common than the peroneal nerve)
- Complete lesion of sciatic nerve
- S1 radiculopathy (most common cause)
