Nerves of the Upper Limb Flashcards

1
Q

What types of nerves make up the brachial plexus?

A

ventral rami of the spinal nerves

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2
Q

What does the brachial plexus provide?

A

somatomotor and somatosenstory innervation to the upper extremity

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3
Q

What is the cervical enlargement?

A

ventral rami of spinal nerves C5-T1
-gives rise to brachial plexus

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4
Q

What muscles does the brachial plexus pass through?

A

the anterior and middle scalene muscles

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5
Q

What is the space in which the brachial plexus passes through the scalene muscles called?

A

the interscalene space

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6
Q

What is the supraclavicular region?

A

the region that above the clavicle

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7
Q

Where does the subclavian artery run?

A

posterior to the anterior scalene with the brachial plexus
-not with the subclavian v.

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8
Q

What is an interscalene block?

A

administration of anesthesia into the interscalene space to block the brachial plexus

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9
Q

What nerve can also be affected by an interscalene block?

A

the phrenic nerve
-affect breathing

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10
Q

where does the axillary artery travel?

A

runs in the middle of the brachial plexus

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11
Q

does the brachial plexus travel anterior or posterior to clavicle?

A

posterior

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12
Q

where does the axillary vein travel?

A

“entangled” with branches of the brachial plexus

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13
Q

what surrounds the brachial plexus along with the axillary a. and v. as it runs into the axilla?

A

axillary sheath
(concentration of fascia NOT a tube)

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14
Q

what is an area of cutaneous sensory innervation supplied by a single spinal nerve?

A

dermatome

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15
Q

what dermatome is supplied by C4?

A

supraclavicular and upper shoulder region

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16
Q

what dermatome is supplied by C5?

A

upper lateral arm and shoulder

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17
Q

what dermatome is supplied by C6?

A

posterolateral arm and lateral forearm

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18
Q

what dermatome is supplied by C7?

A

middle of forearm and hand

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19
Q

what dermatome is supplied by C8?

A

posteromedial forearm and medial hand

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20
Q

what dermatome is supplied by T1?

A

medial arm

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21
Q

what dermatome is supplied by T2-T4?

A

axillary region

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22
Q

why is there not a 1:1 correspondence between named cutaneous nerves and dermatomes?

A

bc names nerves may be comprised of more than 1 spinal nerve and thus will span more than one dermatome

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23
Q

an individual named muscle in limbs are supplied by how many spinal nerves?

A

more than one spinal nerve

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24
Q

what is a group of muscles that receive motor innervation from a single spinal nerve?

A

myotome

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25
Q

can myotomes overlap?

A

yes

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26
Q

what myotome is supplied by C4?

A

shoulder elevation

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27
Q

what myotome is supplied by C5?

A

shoulder abduction; elbow flexion

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28
Q

what myotome is supplied by C6?

A

elbow flexion; wrist extension

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29
Q

what myotome is supplied by C7?

A

elbow extension; wrist flexion

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30
Q

what myotome is supplied by C8?

A

thumb and finger extension

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31
Q

what myotome is supplied by T1?

A

intrinsic hand muscles

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32
Q

what myotome is supplied by T2?

A

intercostal muscles

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33
Q

what divisions do each trunk of the brachial plexus have?

A

anterior and posterior

34
Q

the anterior divisions of the brachial plexus trunks contribute to what?

A

the medial and lateral cord

35
Q

anterior divisions of the brachial plexus tend to?

A

flex

36
Q

the posterior divisions of the brachial plexus trunks contribute to what

A

the posterior cord

37
Q

posterior divisions of the brachial plexus tend to?

A

extend

38
Q

what nerve supplies the anterior compartment of the arm?

A

musculocutaneous nerve

39
Q

what nerve supplies the posterior compartment of the arm?

A

radial nerve

40
Q

what nerve supplies the anterior compartment of the forearm and hand?

A

ulnar & radial nerves

41
Q

what nerve supplies the posterior compartment of the forearm and hand?

A

radial nerve

42
Q

what innervates the shoulder (pectoral girdle) region?

A

nerves that come directly from the roots, trunks, or cords of the brachial plexus

43
Q

what innervates the arm (brachial) region?

A

nerves from the medial cord (cutaneous), the musculocutaneous n. (anterior), and the radial n. (posterior)

44
Q

what innervates the forearm (antebrachial) region?

A

a branch from the medial cord (cutaneous), the median and ulnar nn. (anterior), and the radial n (posterior)

45
Q

what supplies motor innervation to the hand?

A

median and ulnar nerves

46
Q

what supplies sensation innervation to the hand?

A

median, ulnar and radial

47
Q

what parts of the brachial plexus lie in the supraclavicular region?

A

roots (rami) and trunks

48
Q

what parts of the brachial plexus lie in the infraclavicular region?

A

divisions, cords, and branches

49
Q

what is the order of the brachial plexus segments?

A

roots –> trunks –> divisions –> cords –> branches

Real Texans Drink Cold Beer

50
Q

the upper trunk of the brachial plexus is made up of which roots?

A

C5 and C6

51
Q

the middle trunk of the brachial plexus is made up of which roots?

A

C7

52
Q

the lower trunk of the brachial plexus is made up of which roots?

A

C8 and T1

53
Q

which divisions make up the lateral cord of the brachial plexus?

A

anterior divisions of upper and middle trunks

54
Q

which divisions make up the medial cord of the brachial plexus?

A

anterior division of the lower trunk

55
Q

which divisions make up the posterior cord of the brachial plexus?

A

posterior divisions of upper, middle, and lower trunks

56
Q

which cords make up the musculocutaneous branch of the brachial plexus?

A

lateral cord

57
Q

which cords make up the median branch of the brachial plexus?

A

lateral and medial cords

58
Q

which cords make up the ulnar branch of the brachial plexus?

A

medial cord

59
Q

which cords make up the radial branch of the brachial plexus?

A

posterior cord

60
Q

which cords make up the axillary branch of the brachial plexus?

A

posterior cord

61
Q

what additional nerves does the lateral cord of the brachial plexus give rise to?

A

lateral pectoral n.

62
Q

what additional nerves does the medial cord of the brachial plexus give rise to?

A

medial pectoral n.
medial brachial cutaneous n.
medial antebrachial cutaneous n.

63
Q

what additional nerves does the posterior cord of the brachial plexus give rise to?

A

upper subscapular n.
lower subscapular n.
thoracodorsal n.

64
Q

what additional nerves does the upper trunk of the brachial plexus give rise to?

A

subclavius n.
suprascapular n.

65
Q

what additional nerves does the C5 root of the brachial plexus give rise to?

A

dorsal scapular n.
long thoracic n.

66
Q

an injury to superior trunk (C5 and C6) can be called?

A

Erb’s palsey

67
Q

what are potential causes of Erb’s palsey?

A

-results from excessive, forceful increase in angle b/w neck and shoulder
-most common obstetric brachial plexopathy
-can also occur in adults from a fall onto the shoulder

68
Q

what is the clinical presentation of Erb’s palsey?

A

-arm will be adducted
-arm will be internally (medially) rotated at the elbow
-there will be pronation
-there will be extension

69
Q

what are the nerve deficits & affected muscles of Erb’s palsey?

A

-axillary n. (weakness in deltoid and teres minor)
-suprascapular n. (weakness in supraspinatus and infraspinatus)
-musculocutaneous n. (weakness in biceps)
-radial n. (weakness in brachioradialis and supinator, and wrist extensors)

70
Q

an injury to the axillary region affects which nerves?

A

C5-T1 (radial nerve)

71
Q

what are common causes of injury to axillary region?

A

improper use of crutches can compress and injure the nerve in the axilla

72
Q

what is the clinical presentation of an injury to the radial nerve in the axillary region?

A

-weakness when trying to push something away with arm
-difficulty extending the wrist
-difficulty extending the fingers and opening the hand
-“wrist drop” posture

73
Q

an injury at the spinal groove of humerus affects which nerves?

A

C5-T1 (compression of the radial nerve)

74
Q

what is the clinical presentation of an injury at the spiral groove of humerus?

A

-difficulty extending the wrist
-difficulty extending or straightening the fingers and opening the hand
-triceps retains strength because nerve fibers entering this muscle branch off proximal to the mid shaft of the humerus
-also causes “wrist drop” posture

75
Q

what are common causes of injury at spiral groove of humerus?

A

-compression of the radial nerve along the midshaft of the humerus in certain postions
-humeral fracture at midshaft (spiral groove fracture)

76
Q

what are common causes of injury to the axillary nerve?

A

-fracture to surgical neck of humerus
-anterior dislocation of glenohumeral joint
-rotator cuff repair surgery

77
Q

what is the clinical presentation of an injury to the axillary nerve?

A

-numbness in posterior deltoid region
-difficulty abducting arm
-diminished lateral rotation of arm
-deltoid muscle wasting (prolonged injury)

78
Q

an injury to the axillary nerve affects which nerves?

A

C5 and C6

79
Q

an injury to the long thoracic nerve affects which nerves?

A

C5, C6, and C7
(innervation to the serratus anterior muscles)

80
Q

what are common causes of an injury to the long thoracic nerve?

A

-penetrating wound to the axillary region
-surgical removal of axillary lymph nodes

81
Q

what is the clinical presentation of an injury to the long thoracic nerve?

A

-cannot raise arms above 90 degrees
-“winged scapula”