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Anatomy > Nerves of the Upper Limb > Flashcards

Nerves of the Upper Limb Flashcards

1
Q

Origins of the brachial plexus

A

C5-C8 and T1

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2
Q

Dermatome: Upper lateral region of the arm

A

C5

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3
Q

Dermatome: palmar pad of the thumb

A

C6

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4
Q

Dermatome: Pad of the index finger

A

C7

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5
Q

Dermatome: Pad of the little finger

A

C8

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6
Q

Dermatome: Skin on medial aspect of the elbow

A

T1

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7
Q

Myotome: Abduction of arm at glenohumeral joint

A

C5

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8
Q

Myotome: Flexion of the elbow

A

C6

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9
Q

Myotome: Extension of the elbow

A

C7

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10
Q

Myotome: Flexion of the fingers

A

C8

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11
Q

Myotome: Abduction / Adduction of fingers

A

T1

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12
Q

Spinal nerve tested with biceps reflex

A

C6

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13
Q

Spinal nerve tested with triceps reflex

A

C7

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14
Q

Nerve that innervates all of the anterior compartment of the arm

A

Musculocutaenous nerve

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15
Q

Nerve that innervates all the muscles in the anterior compartment of the forearm except flexor carpi ulnas and medical 1/2 of flexor digitorum profundus

A

Median nerve

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16
Q

Innervates intrinsic muscles of hand apart from thenar muscles and lateral two lumbicals

A

Ulnar nerve

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17
Q

Innervates all the muscles in the posterior compartment of the forearm

A

Radial nerve

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18
Q

Nerve that innervates the skin on the anterolateral aspect of the forearm

A

Musculocutaenous nerve

–> Lateral cutaneous nerve of the forearm

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19
Q

Nerve that innervates the palmar surface of the lateral 3 and 1/2 digits

A

Median nerve

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20
Q

Nerve that innervates the palmar surface of the medial one and 1/2 digits

A

Ulnar nerve

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21
Q

Nerve that supplies the skin of the posterior forearm and elbow

A

Radial nerve

–>Posterior cutaneous nerve of the forearm

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22
Q

Nerve that supplies the dorsolateral surface of the hand

A

Radial nerve

–> Superficial branch

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23
Q

Nerve that passes around the surgical neck of the humerus

A

Axillary nerve

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24
Q

Nerve that spirals around the humerus in a groove

A

Radial nerve

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25
Nerve that passes behind the medial epicondyle of the humerus
Ulnar nerve
26
Order of divisions of brachial plexus
5 roots 3 trunks 6 divisions 3 cords 4 nerves
27
Superior trunk of the brachial plexus
Formed by C5 and C6 spinal roots
28
Middle trunk of the brachial plexus
Formed by continuation of the C7 spinal root
29
Inferior trunk of the brachial plexus
Formed by C8 and T1 spinal roots
30
Cords of the brachial plexus
Named in relation to their position to the 2nd part of the axillary artery 3 cords The posterior cord contains all of the posterior divisions and hence goes on to supply the posterior aspect of the UL
31
Lateral cord of the brachial plexus
Formed by the anterior divisions of the superior and middle trunk Hence received innervation from the C5, C6 and C7 spinal roots
32
Posterior cord of the brachial plexus
Formed by all of the posterior divisions, from superior middle and inferior trunks Hence contains innervation from C5 - T8
33
Medial cord of the brachial plexus
Formed from the lone anterior division of the inferior trunk Hence received innervation from C8 and T1
34
Dorsal scapular nerve
Branch of C5 root of the brachial plexus Passes posteriorly piercing the middle scalene --> medial border of scapula Motor: Rhomboid major Rhomboid minor
35
Long thoracic nerve
Originates from anterior rami of C5-C7 Passes vertically down the neck through the axillary inlet --> down medial wall of the axilla Motor Serratus anterior
36
Nerve branches of the superior trunk of the brachial plexus
Suprascapular nerve C5 and C6 (superior trunk) Motor: supraspinatous, infaspinatous Subclavius nerve C5 and C6 (superior trunk) Motor: subclavius muscle
37
Suprascapular nerve
Branch of the superior trunk of the brachial plexus C5 and C6 (as it is from the superior trunk) Passes laterally to the posterior triangle - -> supra-scapular foramen - ->enters posterior scapular region Motor Supraspinatous Infraspinatous
38
Nerve to the subclavius muscle
Branch of the superior trunk of the brachial plexus C5 and C6 (as it is from the superior trunk) Passes anterioinferiorly over subclavian artery and vein Motor Subclavius muscle
39
Branches of the cords of the brachial plexus
Lateral Cord x1 -Lateral pectoral nerve Median Cord x3 - Medial pectoral nerve - Medial cutaneous nerve of the arm - Medial cutaneous nerve of the forearm Posterior Cord x4 - Superior sub-scapular nerve - Thoracodorsal nerve - Inferior sub-scapular nerve - Axillary nerve
40
Terminal nerves of the brachial plexus
Musculocutaneous nerve -Upper 1/2 of Lateral cord Median nerve - Bottom 1/2 of lateral cord - Upper 1/2 of of medial cord Radial nerve -Posterior cord Ulnar nerve -Bottom 1/2 of medial cord
41
Cords that produce the Musculocutaneous nerve
Upper 1/2 of lateral cord
42
Cords that produce the Median nerve
Bottom 1/2 of lateral cord | Upper 1/2 of medial cord
43
Cords that produce the Radial nerve
Posterior cord
44
Cords that produce the Ulnar nerve
Bottom 1/2 of medial cord
45
Lateral pectoral nerve
Proximal branch of the lateral cord of the brachial plexus Passes anteriorly with the thoraco-acromial artery and pierces the clavipectoral fascia Motor Pectoralis major muscle
46
Musculocutaneous nerve
Large terminal branch of the lateral cord Passes lateral to penetrate the coracobrachialis muscle and pass between the biceps brachii and brachialis muscle Innervates all three flexors in anterior compartment of the arm Terminates as lateral cutaneous nerve of the forearm
47
Medial pectoral nerve
Most proximal branch of the medial cord of the brachial plexus Receives a communicating branch from the lateral pectoral nerve Passes anteriorly between axillary artery and vein Passes through pectoralis minor, some fibres make it to pectoralis major Motor Pectoralis minor muscle
48
Medial cutaneous nerve of the arm (medial brachial cutaneous nerve)
Branch of the medial cord of the brachial plexus Passes through axilla into the arm where it penetrates deep fascia --> supplies skin over medial sure of the arm
49
Medial cutaneous nerve of the forearm
Branch of the medial cord of the brachial plexus just distal to that of the medial cutaneous nerve of the arm Passes from axilla into arm Gives off a branch to the skin overlying biceps brachii Continues down to penetrate the deep fascia with the basilic vein Continuing to supply skin over anterior surface of the forearm
50
Ulnar nerve
Large terminal branch of the medial cord of the brachial plexus Often received a communication branch from the lateral cord carrying C7 fibres Passes through arm and forearm --> Branch supplies flexor carpi ulnaris and medial 1/2 of flexor digitorum profundus Innervates all of the intrinsic muscles of the hand (except thenar muscles and lateral two lumbricals) Innervates skin over palmar surface of little finger and 1/2 of ring finger
51
Median Nerve
Formed by union of the bottom 1/2 of lateral cord and upper 1/2 of medial cord of the brachial plexus This occurs anterior to the third part of the axillary artery Passes into arm anterior to brachial artery Branches and supplies most of the anterior compartment of the forearm -Except flexor carpi ulnaris and medial half of flexor digitrorum profundus Median nerve continues into the hand and innervates - Thenar muscles - Lateral two lumbricals Palmar surface of lateral 3 and 1/2 fingers
52
Superior subscapular nerve
Branch of posterior cord of brachial plexus Supplies subscapularis muscle
53
Thoracodorsal nerve
Branch of the posterior cord of the brachial plexus Passes vertically along posterior axillary wall Penetrates and innervates latissimus dorsi
54
Inferior subscapular nerve
Branch of the posterior cord of the brachial plexus Passes inferiorly along posterior axillary wall Innervates subscapularis and teres major
55
Axillary nerve
Branch of posterior cord of brachial plexus Passes inferiorly and laterally along the posterior wall to exit through the quadrangular space Passes posteriorly around surgical neck of the humerus Motor Deltoid Teres minor Accompanied by posterior circumflex humeral artery
56
Radial Nerve
Major terminal branch of the posterior cord of the brachial plexus Passes out of the axilla into the posterior compartment lf the arm Passes through triangular interval composed of the inferior border of trees major, long head of the triceps brachial Accompanied by profonda brachii artery Now in the posterior compartment of the arm Innervates all the muscle in the posterior compartment of the forearm Skin on posterior surface of elbow and forearm, and dorsolateral surface of the hand
57
Superior lateral cutaneous nerve of the arm
Branch of the axillary nerve after passing through the quadrangular space Loops around posterior deltoid muscle Innervate skin over deltoid
58
Nerve supplying anterior compartment of the arm
Musculocutaenous nerve - Coracobrachialis - Biceps brachii - Brachialis
59
Nerve supplying Coracobrachialis
Musculocutaneous nerve C5, C6, C7 O: Apex of coracoid process I: Linear roughening on mid shaft of humerus F: flexion at glenomhumeral
60
Nerve supplying Biceps brachii
Musculocutaneous nerve C5, C6 O: Long head - Supraglenoid tubercle Short head - apex of coracoid process I: radial tuberosity F: Powerful flexor of the forearm at the elbow + supinator of the forearm
61
Nerve supplying brachialis
Musculocutaneous nerve C6 +small radial contribution C7 O: Anterior aspect of humerus, medial and lateral, and adjacent inter muscular septae I: Tuberosity of ulna F: Powerful flexor or forearm at elbow
62
Nerve that supplies triceps brachii
Radial nerve C7 (hence when testing triceps reflex one is testing C7) Origin Long-head: infraglenoid tubercle Lateral-head: high up posterior humerus Medial-head / deep head: posterior humerus lower down Radial nerve runs in between lateral and medial head I: olecranon F: Extension of elbow
63
Course of the musculocutaneous nerve
Musculocutaneous nerve is formed by the upper hand of the lateral cord It passes out of the axilla and enters the arm by passing through the corachobrachialis muscle It passes diagonally down the arm in between biceps brachii and brachialis Gives branches to anterior compartment of the arm Emerges laterally to tendon of biceps brachii and continues as lateral cutaneous nerve of the forerarm
64
Course of the median nerve
Formed by lateral and medial cords of brachial plexus Enters arm from axilla at the inferior margin go tires major muscle Passes vertically down medial side of the arm in the anterior compartment next to the brachial artery Proximally: lies lateral to brachial artery Distally: lies medial to brachial artery Lies anterior to elbow joint Branches to pronator teres muscle -Only branch in the arm
65
Course of the ulnar nerve
Enters arm with median nerve and axillary artery Middle of arm it pierces the medial inter muscular septum and enters the posterior compartment Lies anterior to the medial head of the triceps brachii muscle Passes posteriorly to medial epicondyle at elbow
66
Course of the radial nerve
Formed by the posterior cord of the brachial plexus Enters arm by crossing inferior margin of trees major muscle Accompanied by the profunda brachii artery, the radial nerve enters the posterior compartment of the arm passing through the triangular interval As the radial nerve passes diagonally from medial to lateral in the posterior compartment it lies in the radial groove On the lateral side it passes anteriorly to pierce the lateral inter muscular septum and enter the anterior compartment Enters forearm anterior to lateral epicondyle just beneath brachioradialis
67
Innervation of flexor carpi ulnaris
Innervated by the ulnar nerve C8 O: Medial head: Medial epicondyle of humerus Ulnar head: Olecranon and posterior ulna I: Pisiform bone Extends to the hamate and metacarpal via the pisohamate and pisometacarpal ligament F: Flexes wrist and ADDucts wrist
68
Innervation of flexor carpi radialis
Innervated by median nerve C6 C7 O: Medial epicondyle of humerus I: Base of II and III metacarpals F: Flexes and ABducts wrist
69
Innervation of palmaris longus
Innervated by median nerve C7 C8 O: medial epicondyle of humerus I: Palmar aponeurosis F: Flexes wrist
70
Innervation of pronator teres
Innervated by median nerve C6 C7 O: Humeral head: Medial epicondyle and adjacent supracondylar ridge Ulnar head: Medial side of coronoid process I: Lateral mid shaft of radius F: Pronates forearm
71
Innervation of flexor digitorum superficialis
Innervated by median nerve C8 Two heads: Humeri-Ulna head: Medial epicondyle of humerus and coronoid process of ulna Radial head: Oblique line of radius Ulnar artery and median nerve pass between the two heads and run under FDS I: Four tendons pass through carpal tunnel and split over base of proximal phalanx, insert on middle phalanx F: flexion of metacarpal and PIP
72
Innervation of flexor digitorum profundus
Innervated in two halves Ulna/medial side: Ulna nerve Interosseus side: Anterior interosseous nerve (Median nerve) C8 O: Anterior and medial surface of ulna + interosseous membrane I: Distal phalanx, passing through split of FDS F: Flexion of DIP, PIP and metacarpal
73
Innervation of flexor pollicis longus
Innervated by the anterior interosseous nerve (Median nerve C8) O: Anterior surface of radius and radial 1/2 of interosseous membrane I: Distal phalanx of thumb F: flexion of metacarpal and interphalangeal joint of thumb
74
Innervation of pronator quadratus
Innervated by anterior interosseous nerve (Median nerve) C8 O: Distal anterior surface ulna I: Distal anterior surface of radius F: Pronation
75
How to tell if carpal tunnel or proximal median nerve pathology?
Test palmar branch which passes over flexor retinaculum | Innervates skin over base and central palm
76
Seven muscles of the superficial extensor compartment of the forearm
Brachioradialis Extensor carpi radialis longus Extensor carpi radialis brevis Extensor digitorum Extensor digiti minimi Extensor carpi ulnaris Anconeus
77
Innervation of the brachioradialis
Innervated by the radial nerve C6 Before division into superficial and deep branches O: Proximal part of lateral supraepichondylar ridge of humerus and adjacent intermuscular septum I: Lateral surface of distal end of radius F: Accessory flexor of elbow joint when forearm is mod-pronated Within posterior compartment
78
Innervation of extensor carpi radialis longus
Innervated by radial nerve C6 before division of superficial and deep branches O: Distal part of lateral supraepichondylar ridge of humerus and adjacent intermuscular septum I: Dorsal surface of base of metacarpal II F: Extension and ABduction of wrist
79
Innervation of extensor carpi radialis brevis
Innervated by the Deep branch of the radial nerve C7 BEFORE penetrating supinator muscle O: Lateral epicondyle of humerus and adjacent intermuscular septum I: Dorsal surface of base of metacarpal II and III F: Extension and ABduction of wrist
80
Innervation of extensor digitorum
Innervated by posterior interosseous nerve C7 O: Lateral epicondyle of humerus and adjacent intermuscular septum and deep fascia I: Four tendons running through extensor hoods inset on base of middle and distal phalanx F: Extends fingers and wrist
81
Innervation of extensor digit minimi
Innervated by posterior interosseous nerve C7 O: Lateral epicondyle of humerus and adjacent intermuscular septum along with extensor digitorum I: Extensor hood of little finger F: Extension of little finger
82
Innervation if extensor carpi ulnaris
Innervated by posterior interosseous nerve C7 O: Lateral epicondyle of humerus + posterior border of ulna I: Tubercle on base and side of metacarpal V F: Extension and Adduction of wrist
83
Innervation of anconeus
Innervated by radial nerve C6 C7 C8 via branch to medial head of triceps brachii O: Lateral epicondyle of humerus I: Olecranon and proximal posterior surface off ulna F: Abduction of ulna in pronation + Accessory extensor at elbow
84
Innervation of the deep extensors of forearm
All innervated by posterior interosseous nerve - branch of radial nerve Supinator Abductor pollicis longus Extensor pollicis brevis Extensor pollicis longus Extensor indicis
85
Innervation of supinator
Innervated by posterior interosseous nerve -branch of radial nerve C6 O: Two heads Superficial part: Lateral epicondyle of humerus, radila collateral and annular ligaments Deep part: supinator crest of ulna I: Lateral surface of radius superior to anterior oblique line F: Supination
86
Innervation of Abductor pollicis longus
Innervated by posterior interosseous nerve -branch of radial nerve C7 O: Posterior surfcae of ulna and radius + interosseous membrane (distal to supinator and anconeus) I: Lateral side of base of metacarpal I F: Abduction of metacarpal of thumb + accessory extensor
87
Innervation of extensor pollicis brevis
Innervated by posterior interosseus nerve -branch of radial nerve C7 O: Posterior surface of radius (distal to abductor pollicis longus) and adjacent interosseous membrane I: Dorsal surface of base of proximal phalanx of the thumb F: Extends metacarpophalangeal joint of the thumb
88
Innervation of extensor pollicis longus
Innervated by posterior interosseous nerve -branch of radial artery C7 O: Posterior surface of ulna + adjacent interosseous membrane, distal to the abductor pollicis longus I: Dorsal surface of base of distal phalanx of thumb F: Extends metacarpophalangeal and interphalangeal joints of thumb
89
Innervation of extensor indicis
Innervated by posterior interosseous nerve -branch of radial nerve C7 O: Posterior surface of ulna + adjacent interosseous membrane, distal to extensor pollicis longus I: Extensor hood of index finger F: Extension of index finger
90
Course of the Radial Nerve
Radial nerve passes to lateral wall of antecubital fossa deep tp brachioradialis - -> supplies brachioradialis - -> supplies extensor carpi radialis longus and brevis Becomes posterior interosseous nerve after emerging from the two heads of supinator muscle
91
Innervation of the intrinsic muscles of the hand
Deep branch of the ulnar nerve innervated all the intrinsic muscles of the hand apart from -Lateral two lumbricals -Thenar muscles =Median nerve ``` This includes: Palmaris brevis Interossei Adductor pollicis brevis Thenar muscles Medial two lumbricals ```
92
Innervation of the thenar muscles
Innervated by recurrent branch of median nerve T1 Opponens pollicis Abductor pollicis brevis Flexor pollicis brevis
93
Innervation of the hypothenar muscles
Innervated by the deep branch of the ulnar nerve T1 Opponens digiti minimi Abductor digiti minimi Flexor digiti minimi
94
Innervation of palmaris brevis
Innervated by the superficial branch of the ulnar nerve T1 O: Palmar aponeurosis and flexor retinaculum I: Dermis of the skin on the medial margin of the hand F: Improved grip by deepending cup during flexion
95
Innervation of the dorsal interossei
Innervated by the deep branch of the ulnar nerve x4 muscles T1 O: Adjacent side of metacarpals I: Extensor hood and base of proximal phalanges of index, middle and ring finger F: ABduction
96
Innervation of the palmar interossei
Innervated by deep branch of the ulnar nerve T1 O: sides of metacarpals I: Extensor hood: F: ADduction of fingers
97
Innervation of the lumbricals
Innervated by: Medial two: Ulnar (deep branch) Lateral two: Median (digital branch) O: Tendons of flexor digitorum profundus I: Extensor hood of index, ring, middle and little finger F: Flex MCP whilst extending interphalangeals
98
Innervation of opponens pollicis
Innervated by recurrent branch of median nerve T1 O: Tubercle of trapezium and dlexor retinaculum I: Lateral margin of metacarpal I F: Medially rotates thumb
99
Innervation of abductor pollicis brevis
Innervated by recurrent branch of median nerve T1 O: Tubercles of scaphoid and trapezium and adjacent flexor retinaculum I: Proximal phalanx and extensor hood of thumb F: Abducts thumb at metacarpophalangeal
100
Innervation of flexor pollicis brevis
Innervated by the recurrent branch of the median nerve T1 O: Tubercle of trapezium and adjacent flexor retinaculum I: Proximal phalanx of thumb F: Flexes thumb at metacarpophalangeal
101
Innervation of opponens digiti minimi
Innervated by deep branch of ulnar nerve T1 O: Hook of hamate and flexor retinaculum I: Medial aspect of metacarpal V F: Laterally rotates metacarpal V
102
Innervation of abductor digiti minimi
Innervated by deep branch of ulnar nerve T1 O:Pisiform, pisohamate ligament, tendon of flexor capri ulnaris I: Proximal phalanx of little fingers F: Abducts little finger
103
Innervation of flexor digiti minimi
Innervated by deep branch of ulnar nerve T1 O: Hook of hamate and flexor retinaculum I:Proximal phalanx of little finger F: Flexion of little finger at metacarpophalangeal joint
104
Innervation of Adductor pollicis
Innervated by Deep branch of ulnar nerve T1 O: Two heads Transverse head - metacarpal III Oblique head - Capitate and bases of metacarpals II and III I: Base of proximal phalanx and extensor hood of thumb (often contains sesamoid bone) F: Adducts thumb

Anatomy (22 decks)

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