Peripheral Nerve Anatomy Flashcards
Spinal nerves split, converge, and branch to form ___ nerves
peripheral nerves
Trigeminal nerve = CN ___
CN V
Trigeminal nerve provides majority of ___ (sensory/motor) innervation of the ___
Trigeminal nerve provides majority of sensory innervation of the face
What is of anesthetic interest with the trigeminal nerve?
Trigeminal neuralgia–can block the trigeminal nerve to relieve pain
What are the (3) nerve branches of the trigeminal nerve?
- Ophthalmic
- Maxillary
- Mandibular
Glossopharyngeal nerve = CN ___
CN IX
Glossopharyngeal nerve innervates the ___pharynx, ___ palate, ___ portion of the tongue, ___ surface of the epiglottis
Glossopharyngeal nerve innervates the oropharynx, soft palate, posterior 1/3 portion of the tongue, pharyngeal surface of the epiglottis
Glossopharyngeal nerve blocks ___ reflex and ___ (anterior/posterior) pharynx
Glossopharyngeal nerve blocks gag reflex and posterior pharynx
Superior laryngeal nerve innervates base of ___, ___ (anterior/posterior) surface of epiglottis, ___ fold, and ___ (what paired cartilage?)
Superior laryngeal nerve innervates base of tongue, posterior surface of epiglottis, aryepiglottic fold, and arytenoids
Superior laryngeal nerve can be blocked by ___
Superior laryngeal nerve can be blocked by mucosal saturation
Superior laryngeal nerve arises from ___ (superior/inferior) ganglion of the ___ nerve (what CN?)
SLN arises from inferior ganglion of the vagus nerve
SLN descends behind the ___ (internal/external) carotid artery and at the level of greater Cornu of ___ bone
SLN descends behind the internal carotid artery and at the level of greater Cornu of hyoid bone
SLN divides into ___ and ___ branches
SLN divides into internal and external branches
SLN–external branch supplies ___ muscle
SLN–external branch supplies cricothyroid muscle
SLN–internal branch pierces the ___ membrane and supplies ___ (sensory/motor) innervation to the ___ and ___
SLN–internal branch pierces the thyrohyoid membrane and supplies sensory innervation to the larynx and hypopharynx
Recurrent laryngeal nerve innervates ___ and ___
RLN innervates vocal folds and trachea
Cervical plexus innervates muscles, joints, and skin in the ___ (anterior/posterior) neck; ventral rami C__-__
Cervical plexus innervates muscles, joints, and skin in the anterior neck; ventral rami C1-C4
Brachial plexus = large network of nerves that extend from ___ through ___; innervate the ___ (upper/lower) extremity
Brachial plexus = large network of nerves that extend from neck through axilla; innervate the upper extremity
Brachial plexus is composed of what (5) things?
- Ventral rami (roots)
- Trunks
- Divisions
- Cords
- Branches
Brachial plexus ventral rami (roots) = ___ (how many?)
5
Brachial plexus trunks = ___
3
Brachial plexus divisions = ___
6
Brachial plexus cords = ___
3
Brachial plexus branches = ___
4
BP roots, trunks, and divisions are found in the ___ of the neck, ___clavicular
BP roots, trunks, and divisions are found in the posterior triangle of the neck, supraclavicular
BP cords and branches are found in the ___, ___clavicular
BP cords and branches are found in the axilla, infraclavicular
What are the roots of the brachial plexus?
C5-T1
Be able to draw brachial plexus
.
What are the (3) trunks of the brachial plexus?
- Superior (C5-6)
- Middle (C7)
- Inferior (C8-T1)
Superior trunk = __ (what roots?)
C5-C6
Middle trunk = __
C7
Inferior trunk = __
C8-T1
Brachial plexus trunks are enveloped in fascial sheath–T/F?
True
Interscalene space emerges between ___ and ___ scalene muscles
anterior and middle scalene muscles
Interscalene space is used for block of ___
upper extremity
Why might you see an incomplete block with interscalene blocks?
Because person may have individual septa
Divisions of the brachial plexus = 3 ___/___ divisions + 3 ___/___ divisions
3 ventral/anterior divisions + 3 dorsal/posterior divisions
Ventral/anterior divisions supply ___ (flexor/extensor) portions
flexor
Dorsal/posterior divisions supply ___ (flexor/extensor) portions
extensor
In axilla, 3 dorsal divisions combine to form ___ cord
posterior cord
In axilla, 3 ventral divisions combine to form ___ and ___ cords
lateral and medial cords
Cords of brachial plexus are now named according to position relative to ___ artery
axillary artery
At lateral border of pectoralis minor, each cord of brachial plexus divides into 2 branches and become ___ nerves
peripheral nerves
Lateral cord branches into ___ nerve; ___ (lateral/medial) root of median nerve
- musculocutaneous nerve
- lateral root of median nerve
Medial cord branches into ___ nerve; ___ (lateral/medial) root of median nerve
- ulnar nerve
- medial root of median nerve
Posterior cord branches into ___ nerve and ___ nerve
- axillary nerve
- radial nerve
Axillary nerve is formed from __-__ (what roots?)
C5-6
Axillary nerve passes from __ to __
axilla to shoulder
Axillary nerve is __ (anterior/posterior) to the neck of humerus
posterior
Axillary nerve innervates ___
shoulder
Radial nerve is formed from __-__ (what roots?)
C5-T1
Radial nerve passes from __ to __
axilla to arm
Superficial branch of radial nerve innervates ___ of the hand onto the __, __, __, and __ fingers
dorsum of the hand onto the thumb, index, middle, and ring fingers
Deep branch of radial nerve innervates many of the muscles of the __ and __
wrist and hand
Where does the radial nerve divide into superficial/deep branches?
At the elbow
Radial nerve motor responses to stimulation–wrist ___ (flexion/extension), metacarpo-phalangeal ___ (flexion/extension), thumb ___ (ab/adduction)
wrist extension, metacarpi-phalangeal extension, thumb abduction
Musculocutaneous nerve roots = __
C5-C7
Motor response to musculocutaneous nerve stimulation = ___
biceps flexion
Median nerve roots = __
C5-T1
Median nerve descends the arm with ___ artery
brachial artery
Median nerve passes into forearm through ___
carpal tunnel
Median nerve innervates forearm ___ (pronators/supinators)
forearm pronators
Median nerve innervates wrist ___ (flexors/extensors)
wrist flexors
Median nerve innervates finger ___ (flexors/extensors)
finger flexors
Median nerve innervation thumb–__duction and __
abduction and opposition
Median nerve motor response to stimulation–wrist ___ (flexion/extension), finger ___ (flexion/extension), thumb ___
wrist flexion, finger flexion, thumb opposition
Ulnar nerve roots = __
C8-T1
Ulnar nerve innervates __ and __ surface of hand
dorsal and medial surface of hand
Ulnar nerve innervates dorsal surface of __ and __ fingers
dorsal surface of ring and little fingers
Motor response to ulnar nerve stimulation = ulnar __ of the wrist; metacarpo-phalangeal __ (extension/flexion); thumb __duction
ulnar deviation of the wrist; metacarpo-phalangeal flexion; thumb adduction
Lumbosacral plexus is formed by ventral rami __-__; may include __
L1-S5; may include T12
Lumbosacral plexus innervates __ and __
lower abdomen and lower extremities
Iliohypogastric nerve is formed by __-__
T12-L1
Iliohypogastric nerve innervates __; skin over __ and __
parietal peritoneum; skin over inferior abdomen and buttocks
Ilioinguinal nerve is formed by __-__
T12-L1
Ilioinguinal nerve terminates on the anterior __ or __
anterior scrotum or labia majora
Ilioinguinal nerve innervates __; __; portions of external __
parietal peritoneum; superior/medial thigh; portions of external genitalia
Genitofemoral nerve is formed by __-__
L1-L2
Genitofemoral nerve terminates on anterior __ or __
anterior scrotum or labia majora
Genitofemoral nerve innervates skin covering __; skin on __ or __
skin covering femoral hiatus; skin on scrotum or labia majora
Pudendal nerve comes from anterior division of __-__
S2-S4
Pudendal nerve innervates muscle and skin of __
perineum
Lateral femoral cutaneous nerve roots = posterior division __-__
posterior division L2-3
Lateral femoral cutaneous nerve innervates __ to level of __
lateral aspect of thigh to level of knee
Posterior femoral cutaneous nerve roots = anterior and posterior division of __-__
anterior and posterior division of S1-S3
Posterior femoral cutaneous nerve innervates __, __ to __
posterior thigh, hip to mid calf
Obturator nerve = anterior divison __-__
anterior division L2-4
Obturator nerve controls __duction, __ and __ of hip
adduction, flexion and extension of hip
Obturator nerve innervates __
medial thigh
Femoral nerve = posterior divison __-__
posterior division L2-L4
Where does the femoral nerve split? What does it split into?
Below inguinal ligament, splits into anterior and posterior branches
What does the posterior branch of femoral nerve contain?
Saphenous nerve
Femoral nerve position from medial-lateral
VAN
vein, artery, nerve
Femoral nerve position from lateral-medial
NAVEL
nerve, artery, vein, empty space, ligament
Femoral nerve innervates what (5) muscles?
- Rectus femoris
- Vastus lateralis
- Vastus intermedius
- Vastus medialis
- Sartorious
Femoral nerve innervates anterior or posterior thigh?
Anterior thigh
Saphenous nerve branches from what nerve?
Femoral nerve–posterior branch
Saphenous nerve innervates __ leg from __ to __
medial leg from knee to arch of foot
Stimulation of saphenous nerve = __ muscle contraction (__like across thigh); patellar __
sartorious muscle contraction (bandlike across thigh); patellar twitch (snap)
Sciatic nerve is formed by junction of what (2) nerves?
- Tibial nerve
- Common peroneal nerve
Tibial nerve roots = __-__
anterior L4-S3
Common peroneal nerve roots = __-__
posterior L4-S2
Sciatic nerve = hip __ (extension/flexion); __ (extension/flexion) of knee
hip extension; flexion of knee
The tibial and common peroneal nerves join to form __ nerve
sciatic nerve
Tibial and common peroneal nerves begin from the same sheath–T/F?
True
(2) branches of tibial nerve
- Medial plantar nerve
- Lateral plantar nerve
Two branches of the tibial nerve innervate __ (dorsal/plantar) surface of foot
plantar surface of foot
(2) branches of common peroneal nerve
- Superficial
- Deep
Superficial branch of common peroneal nerve innervates __ and __ surface of foot
lateral/dorsal surface of foot
Deep branch of common peroneal nerve innervates skin between __ and __
skin between hallux and second toe
Sural nerve is formed from union of branch from __ and __ nerves
tibial and common peroneal nerves
Sural nerve travels with __ nerve
saphenous
Sural nerve innervates posterior __ of foot, posterior __, __ tendon above ankle
posterior sole of foot, posterior heel, achilles tendon above ankle
Motor response to tibial nerve stimulation = __(plantar/dorsi)flexion of foot and toes, __(e/in)version of foot
plantarflexion of foot and toes, inversion of foot
Motor response to superficial peroneal nerve stimulation = __duction of foot, __(e/in)version of foot
abduction of foot, eversion of foot
Motor response to deep peroneal nerve stimulation = __(plantar/dorsi)flexion of foot
dorsiflexion of foot