Neuro Questions

Question 1

Dermatomes (upper)

Answer 1

C1 top of head
C2 side of head
C3 side of neck
C4 yoke
C5 over deltoids
C6 lateral forearm to thumb
C7 middle forearm into middle finger
C8 medial forearm into baby finger
T1medial elbow - need consent
T2 axilla - need consent

Question 2

Myotomes (upper)

Answer 2

C1-C2 neck flexion
C3 neck lateral flexion
C4 shoulder elevation
C5 shoulder abduction
C6 elbow flexion and wrist extension
C7 elbow extension and wrist flexion
C8 thumb extension and ulnar deviation
T1 hand intrinsics

Question 2

What division is dermatomes?

Answer 2

Sensory

Question 3

What is a normal result for dermatomes?

Answer 3

Equal sensation both sides

Question 4

What are normal results for myotomes?

Answer 4

Equal and adequate strength

Question 4

What division are myotomes?

Answer 4

Motor

Question 5

Deep tendon reflexes (upper)

Answer 5

C5-C6 Biceps
C7-C8 Triceps

Question 6

What division are deep tendon reflexes?

Answer 6

Both motor and sensory

Question 7

What is a normal result for deep tendon reflexes?

Answer 7

Equal responses both sides

Question 7

Myotomes (lower)

Answer 7

L1-L2 hip flexion
L3 knee extension
L4 ankle dorsiflexion
L5 great toe extension
S1 ankle plantar flexion, ankle eversion, hip extension, knee flexion
S2 knee flexion

Question 8

Deep tendon reflexes (lower)

Answer 8

L3-L4 Patella
S1-S2 Calcaneal

Question 8

Dermatomes (lower)

Answer 8

L1 around low back and around hips to ASIS
L2 down inner thigh - needs consent
L3 medial knee
L4 medial malleolus
L5 dorsal foot down 2nd and 3rd toes
S1 lateral bottom of foot
S1-S2 bottom of calcaneous

Question 9

Radial Nerve Pathway

Answer 9

• from the brachial plexus (C5 – T1)
• between anterior and middle scalenes
• dives under the clavicle, under pectoralis minor, and through the axilla
• takes a path along the lateral/posterior aspect of the arm, forearm, and hand
• winds around the spiral groove of the humerus, deep to lateral head of triceps brachii, to the anterior arm
• becomes superficial as it travels between brachialis and brachioradialis
• passes extensor carpi radialis longus and brevis
• crosses elbow to supinator
• divides into posterior and superficial branches
• posterior branch travels laterally and ends at the wrist
• superficial branch continues down the dorsal surface of the hand, between the 4th digit and thenar eminence

Question 10

Median Nerve Pathway

Answer 10

• from the brachial plexus (C5 – T1)
• between anterior and middle scalenes
• dives under the clavicle, under pectoralis minor,
  and through the axilla as part of a
  neurovascular bundle
• follows medial aspect of arm from axilla to
  cubital fossa
• leaves cubital fossa, and runs between heads
  of pronator teres
• goes deep to forearm flexors
• emerges superficial at the wrist, and travels
  through carpal tunnel, branching into the hand
• before the wrist, the palmar cutaneous branch
  travels superior to the carpal tunnel and
  innervates the skin of the thenar eminence

Question 10

median nerve innervated muscles

Answer 10

• pronator teres
• pronator quadratus
• flexor carpi radialis
• palmaris longus
• flexor digitorum superficialis
• flexor digitorum profundus (radial or lateral half)
• flexor pollicis longus
• thenar muscles

Question 11

Ulnar Nerve Pathway

Answer 11

from brachial plexus (C8 – T1)
* between anterior and middle scalenes
* dives under clavicle, under pectoralis
minor
* follows posterior wall of axilla, then
along medial triceps brachii
* at the elbow, goes between medial
epicondyle and olecranon process,
through the ulnar groove
* goes between heads of flexor carpi
ulnaris, then follows deep to flexor carpi
ulnaris to the wrist
* continues over carpal tunnel, between
pisiform and hook of hamate (Guyon’s
canal)
* divides into superficial and deep, and
continues into hand and fingers

Question 11

Ulnar nerve innervated muscles

Answer 11

• flexor carpi ulnaris
• flexor digitorum profundus (ulnar or
  medial half)
• hypothenar muscles
• 3rd and 4th lumbricals
• palmar interossei
• dorsal interossei
• adductor pollicis
• flexor pollicis brevis

Question 12

Radial nerve innervated muscles

Answer 12

• triceps brachii
• anconeus
• brachioradialis
• supinator

Extensors of forearm and hand:
* extensor carpi radialis longus
* extensor carpi radialis brevis
* extensor digitorum
* extensor carpi ulnaris
* extensor indicis
* extensor digiti minimi
* extensor pollicis longus
* extensor pollicis brevis
* abductor pollicis longus
* superficial branch innervates skin of dorsal hand

Question 13

Sciatic Nerve Pathway

Answer 13

The sciatic nerve is two independent nerves which travel
together as the sciatic nerve until reaching the popliteal fossa.
* from lumbosacral plexus (L4 - S1)
* passes throuh greater sciatic foramen and under
piriformis
* passes between ischial tuberosity and greater
trochanter
* follows adductor magnus down posterior leg
* splits at popliteal fossa into tibial and
common peroneal nerves
* tibial nerves travels posteriorly between heads of
gastrocnemius
* continues to ankle and around medial malleolus and
divides into medial and lateral plantar nerves
* common peroneal travels around and below
the head of the fibula
* divides into superficial and deep
* both travel laterally and anteriorly to the dorsal surface
of the foot

Question 14

Sciatic nerve innervated muscles (proximal to knee)

Answer 14

Tibial division
* hamstrings
* one half adductor magnus
Peroneal division
* biceps femoris (short head)

Question 15

Peroneal Nerve innervated muscles

Answer 15

• peroneal muscles
• ankle and digit extensors

Question 16

Tibial nerve innervated muscles

Answer 16

• gastrocnemius
• soleus
• popliteus
• plantaris
• ankle and digit flexors
• intrinsic foot muscles (plantar)