Neuro Questions Flashcards
Dermatomes (upper)
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
Myotomes (upper)
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
What division is dermatomes?
Sensory
What is a normal result for dermatomes?
Equal sensation both sides
What are normal results for myotomes?
Equal and adequate strength
What division are myotomes?
Motor
Deep tendon reflexes (upper)
C5-C6 Biceps
C7-C8 Triceps
What division are deep tendon reflexes?
Both motor and sensory
What is a normal result for deep tendon reflexes?
Equal responses both sides
Myotomes (lower)
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
Deep tendon reflexes (lower)
L3-L4 Patella
S1-S2 Calcaneal
Dermatomes (lower)
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
Radial Nerve Pathway
- 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
Median Nerve Pathway
- 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
median nerve innervated muscles
- pronator teres
- pronator quadratus
- flexor carpi radialis
- palmaris longus
- flexor digitorum superficialis
- flexor digitorum profundus (radial or lateral half)
- flexor pollicis longus
- thenar muscles
Ulnar Nerve Pathway
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
Ulnar nerve innervated muscles
- 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
Radial nerve innervated muscles
- 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
Sciatic Nerve Pathway
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
Sciatic nerve innervated muscles (proximal to knee)
Tibial division
* hamstrings
* one half adductor magnus
Peroneal division
* biceps femoris (short head)
Peroneal Nerve innervated muscles
- peroneal muscles
- ankle and digit extensors
Tibial nerve innervated muscles
- gastrocnemius
- soleus
- popliteus
- plantaris
- ankle and digit flexors
- intrinsic foot muscles (plantar)
