Nerves and muscles Flashcards

1
Q

Name the 5 peripheral nerves of the brachial plexus

A

Musculocutaneous
Axillary
Radial
Median
Ulnar

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2
Q

Lateral cord of brachial plexus

A

Musculocutaneous

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3
Q

Posterior cord of brachial plexus

A

Axillary and radial

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4
Q

Inferior cord of brachial plexus

A

Median and ulnar

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5
Q

Root of musculocutaneous

A

C5,6,7

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6
Q

Root of axillary

A

C5,6

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7
Q

Root of radial

A

C5-8, T1

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8
Q

Root of median

A

C5-8, T1

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9
Q

Root of ulnra

A

C8, T1

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10
Q

Narrate out the C5 to T1 dermatomes

A

C5: Lateral arm
C6: Lateral forearm to thumb
C7: 2nd and 3rd finger + middle palm
C8: 4th and little finger + medial side of palm and medial surface of forearm
T1: medial surface of arm

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11
Q

What muscles are innervated by the axillary nerve?

What movements do they control?

A
  1. Deltoid - abduction beyond 15 degrees
  2. Teres minor - lateral rotation of arm/part of rotator cuff muscle
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12
Q

What muscles are innervated by the musculocutaneous nerve?

What movements do they control?

A
  1. Bicep branchii - flexor and supinator (especially if forearm is flexed)
  2. Coracobrachialis - flex
  3. Brachialis - flex
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13
Q

What muscles are innervated by the radial nerve?

What movements do they control?

A

All the muscles along the back of the hand.

  1. Triceps branchii - extensor of forearm
  2. All the extensor muscles of forearm - extension of wrist and fingers
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14
Q

Nerve innervating trapezius

A

Cranial nerve 9

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15
Q

Nerve innervating rhomboid and levator scapulae

A

Dorsal scapular nerve

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16
Q

Nerve innervating Latissimus dorsi

A

Thoracodorsal nerve

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17
Q

Nerve innervating serratus anterior

A

Long thoracic nerve

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18
Q

What is the pathology associated with long thoracic nerve lesion?

A

Weakness of serratus anterior

When scapula is protracted, it pops out, creating an appearance of a winged scapula.

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19
Q

What is the nerve and muscle affected in winged scapula?

A

Long thoracic nerve

Serratus anterior

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20
Q

Nerve innervating pect major

A

Lateral and medial pectoral nerves

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21
Q

Nerve innervating pect minor

A

Medial pectoral nerves

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22
Q

Name the 4 rotator cuff muscles

A

Anterior: subscapularis
Posterior from top down:
1. Supraspinatus
2. Infraspinatus
3. Teres minor

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23
Q

Nerve innervating subscapularis

A

Scapular nerve

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24
Q

Nerve innervating supraspinatus and infraspinatus

A

Suprascapular nerve

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25
Q

Nerve innervating teres minor

A

Axillary nerve

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26
Q

Nerve innervating teres major

This nerve also innervates the _

A

Scapular nerve

Subscapularis muscle

27
Q

Nerve innervating deltoid

A

Axillary

28
Q

Nerve innervating triceps

A

Radial

29
Q

Which muscle in the anterior flexor component of the forearm is NOT innervated by median nerve?

A

Flexor carpi ulnaris
Flexor digitorum profundus (medial portion)

Ulnar nerve

30
Q

Which 2 muscles in the anterior flexor compartment of the forearm is innervated by the ulnar nerve?

A

Flexor carpi ulnaris
Flexor digitorum profundus (medial portion)

31
Q

Pass Fail Pass Fail (lateral to medial)

Name the anterior forearm flexor muscles

A

Protonator teres
Flexor carpi radialis
Palmaris longus
Flexor carpi ulnaris

32
Q

Flexor carpi radialis controls the _ of the wrist while flexor carpi ulnaris controls the _.

A

Radialis - abduction
Ulnaris - adduction

33
Q

What are the 2 pronator muscles of the forearm and which nerve are they innervated by?

A

Pronator teres
Pronator quadratus

Median nerve

34
Q

Name the 3 contents of the deep layer of anterior forearm.

Hint: flex, flex, P

A

Flexor digitorum profundus
Flexor pollicis longus
Protonator quadratus

35
Q

What is the muscle in the intermediate layer of the anterior forearm?

A

Flexor digitorum superficialis

36
Q

Which nerve innervates the posterior forearm?

A

Radial - all the extensor muscles

37
Q

Pollicis means

A

Thumb

38
Q

Minimi means

A

Little finger

39
Q

Which muscles controls the abduction of thumb and what nerve is it innervated by?

A

Abductor pollicis LONGUS - radial nerve

^ In posterior forearm

Abductor pollicis BREVIS - median nerve

^ Found in hand near thumb

40
Q

Name the 3 thenar muscles innervated by the median nerve

A
  1. Abductor pollicis brevis
  2. Opponens pollicis
  3. Flexor pollicis brevis
41
Q

In the hand, median nerve innervates LOAF. What does LOAF stand for?

A

Lumbricals (1st and 2nd)
Opponens pollicis
Abductor pollicis brevis
Flexor pollicis brevis

42
Q

Which thenar muscle is innervated by ulnar nerve?

A

Adductor pollicis

43
Q

Name the 3 hypothenar muscles innervated by ulnar nerve

A
  1. Opponens digiti minimi
  2. Flexor digiti minimi brevis
  3. Abductor digiti minimi
44
Q

Palmar and dorsal interossei is innervated by?

A

Ulnar nerve

45
Q

What is the function of lumbricals?

A

Extend DIP and flex MCP

Like making a Z sign

46
Q

What is the only action of the thumb that is not controlled by the median nerve and what muscle is it?

A

Adduction

Adductor pollicis

Ulnar nerve

47
Q

What is the function of palmar and dorsal interossei?

A

PAD - palmar adducts
DAB - dorsal abducts

48
Q

Erb’s palsy involves injury to the _

A

Upper roots of brachial plexus C5 and C6

49
Q

What are the nerves affected in Erb’s palsy?

Hence what muscles/ movements are affected?

A

C5 and C6

Musculocutaneous: biceps
Axillary: deltoid, teres minor
Radial (partial) - extensors of wrist

Cannot flex forearm - biceps
Arms adducted - deltoid
Medially rotated arm - teres minor
Wrist is flexed - extensors of wrist

50
Q

Describe the clinical presentation of Erb’s palsy

A

Extension of elbow
Arms adducted
Arms medially rotated
Wrist flexed (waiter’s tip)

51
Q

When are UPPER brachial plexus injuries more common?

A
  1. Excessive pulling or stretching of infant’s head during childbirth
  2. Road traffic accident
  3. Contact sports

**Happen when the shoulder is forced down on one side of the body and the head is pushed to the other side in the opposite direction.

52
Q

When are LOWER brachial plexus injuries more common?

A

Swing the kid using their extended hands.

**More likely to be injured when the arm is forced above the head.

53
Q

Klumpkle palsy involves injury to the _

A

Lower roots of brachial plexus
C8 T1

54
Q

What are the nerves affected in Klumpke’s palsy?

Hence what muscles/ movements are affected?

A

Ulnar
Median

All the flexors of forearm - flexion of wrist

Pronator teres and quadratus - pronation of hand

Lumbricals - extend DIP, flex MCP

55
Q

Describe the clinical presentation of Klumpke’s palsy

A

Supinated forearm (cannot pronate)

Wrist is flexed due to wasting of flexor muscles

Fingers are all flexed - looking like RAWR claw

56
Q

What are the 2 common fractures as a result of fall of outstretched hand?

A
  1. Scaphoid fracture
  2. Colles fracture
57
Q

What is Colle’s fracture?

A

Radius is dislocated from carpal bone and is displaced posteriorly.

Dinner fork deformity

58
Q

Describe how I would know it is a claw hand caused by ulnar nerve lesion clinically

A

Ask patient to open up their palm.

Inability to extend 4th and 5th finger fully.

59
Q

Describe how I would know it is a claw hand caused by median nerve lesion clinically

A

Ask patient to clench their fist

Inability to flex 1st,2nd and 3rd finger

60
Q

What is the ulnar paradox?

A

The more distal the injury to the ulnar nerve (ie. at elbow vs at wrist), the more severe the claw hand deformity.

At elbow, less severe. At wrist, more severe

61
Q

What are the 3 types of elbow fractures?

A

Lateral epicondyle
Supracondylar
Medial epicondyle

62
Q

Lateral epicondyle
Supracondylar
Medial epicondyle

Name the nerve corresponding to each

A

Lateral: radial

Supracondylar: median

Medial: ulnar

63
Q

Describe radial nerve lesion

A

Wrist drop

Radial nerve supplies the extensor muscles of the forearm. Cannot extend wrist so hand just kind flops downwards.

Radial also innervates supinator so weak supination (still got bicep branchii so can weakly supinate)