Peripheral Nerves 1 (part 2)

Question 1

8 Cervical
12 Thoracic
5 Lumbar
5 Sacral
1 Coccygeal

Answer 1

Spinal Cord Segments (31 total)

Question 2

Spinal Cord rootlets gather together to make a spinal root (dorsal or ventral). The spinal roots then join peripherally into a spinal nerve.

Rootlets -> Roots -> Nerve

Answer 2

Spinal Cord Segments

Question 3

Sensory. Cell bodies are located peripherally in a dorsal root ganglion.
-Bring sensory (afferent) fibers to the spinal cord
-GSA/GVA fibers

Answer 3

Dorsal Spinal Root

Question 4

Motor. Cell bodies are located within the Ventral Gray Horn of the spinal cord
-Carry motor (afferent) fibers away from the spinal cord
-SE/GVE fibers

Answer 4

Ventral Spinal Root

Question 5

As soon as the spinal nerve is formed, it branches into Dorsal and Ventral ____ ____.

Answer 5

Primary Rami

Question 6

Mixed fibers
-Medial: Sensory
-Lateral: Motor

Answer 6

Dorsal Primary Rami

Question 7

Formed by the VPR of Spinal Nerves.
-Mixing of Axons gives the upper limbs their variability, excitability, and ability to carry out different tasks

Answer 7

Brachial Plexus

Question 8

A high block that uses a Cervical Approach via the Cricoid Cartilage (C4-C6). Injection goes into the interscalene gap (between the anterior and middle scalene)
-Provides anesthesia for the proximal upper limb (shoulder surgeries)

Answer 8

Interscalene Block

Question 9

A block that goes over the top of the clavicle to anesthetize the elbow region (upper limb)

Answer 9

Supraclavicular Approach

Question 10

A block done to anesthetize the wrist/hand (distal limb)

Answer 10

Axillary Approach

Question 11

A layer of connective tissue that is wound around the brachial plexus (Saran wrap). Keeps everything held together.
-Used in anesthesia: Inject medication into the space between this and the brachial plexus
-This holds the anesthesia in place like a bag around the brachial plexus

Answer 11

Axillary Sheath

Question 12

Where the proximal portion of the Brachial Plexus sits. Right behind the SCM, between the Anterior and Middle Scalene muscles
-Also contains the Subclavian Artery

Answer 12

Scalene Gap (notch/opening)

Question 13

About halfway down the SCM, where you can see C5-C8 & T1

Answer 13

Erb’s Point

Question 14

C5 & C6 VPR make the Upper
C7 VPR makes the Middle
C8 & T1 VPR make the Lower

Answer 14

Trunks

Question 15

The posterior divisions of the Upper, Middle, and Lower Trunks

Answer 15

Posterior Cord of the Brachial Plexus

Question 16

The anterior division of the upper trunk and the anterior division of the middle trunk

Answer 16

Lateral Cord of the Brachial Plexus

Question 17

The division of the lower trunk continues forward to the form the ____.

Answer 17

Medial Cord of the Brachial Plexus

Question 18

If you have C4 giving a contribution to C5

Answer 18

Pre-fixed Brachial Plexus

Question 19

If you have T2 giving a contribution to T1

Answer 19

Post-fixed Brachial Plexus

Question 20

As soon as the Subclavian Artery passes through the Scalene Gap and touches the lower border of the first rib, it changes into the ____.

Answer 20

Axillary Artery

Question 21

When the Axillary Artery gets to the lower border of the Teres Major muscle, it turns into the ____.

Answer 21

Brachial Artery

Question 22

The part of the Axillary artery from the 1st rib to the Pectoralis Minor muscle

Answer 22

1st part

Question 23

The part of the Axillary Artery that is covered by the Pectoralis Minor Muscle

Answer 23

2nd part

Question 24

The part of the Axillary Artery that is from the lower border of the Pectoralis Minor muscle to the Teres Major muscle.

Answer 24

3rd Part

Question 25

The artery beyond the lower border of the Teres Major muscle

Answer 25

Brachial Artery

Question 26

One of the terminal branches of the Posterior Cord. -Runs through the Axilla -Can be damaged with crutch-use

Answer 26

Axillary nerve

Question 27

A terminal branch of the Posterior Cord

Answer 27

Radial Nerve

Question 28

A distal extension of the Lateral Cord. -Has to be anesthetized on its own. Lies outside of the Axillary Sheath

Answer 28

Musculocutaneous Nerve

Question 29

Formed by contributions from the Lateral and Medial Cord. -Where the Lateral and Medial Cords join together at the midline

Answer 29

Median Nerve

Question 30

An extension of the Medial Cord

Answer 30

Ulnar Nerve

Question 31

Formed by C5, C6, and C7. Runs down the mid-axillary line -Avoid this area with chest tubes

Answer 31

Long Thoracic Nerve

Question 32

A tiny nerve that comes off of C5. -Pierces the Middle Scalene Muscle -Innervates the Levator Scapulae and Rhomboids Major and Minor muscles

Answer 32

Dorsal Scapular Nerve

Question 33

A very small nerve coming off of the Upper Trunk. -Innervates a muscle that exists between the 1st rib and clavicle to stabilize these two structures against each other

Answer 33

Nerve to the Subclavius Muscle

Question 34

A nerve that comes off of the Upper Trunk that innervates the Supraspinatus and Infraspinatus muscles (above and below the spine of the scapula).

Answer 34

Suprascapular Nerve

Question 35

A branch off of the Lateral Cord that innervates the Pectoralis Major Muscle

Answer 35

Lateral Pectoral Nerve

Question 36

A nerve that comes off of the Posterior cord and can have multiple branches. -Innervates the Subscapularis Muscle

Answer 36

Upper Subscapular Nerve

Question 37

A nerve that comes off of the Posterior Cord and runs across the back of the chest. -Innervates Latissimus Dorsi muscle.

Answer 37

Thoracodorsal Nerve

Question 38

A nerve that comes off of the Posterior Cord (most distal of the three branches) -Innervates the Subscapularis and Teres Major muscles

Answer 38

Lower Subscapular Nerve

Question 39

A nerve that comes off of the Medial Cord that innervates the Pectoralis Minor and Major muscles.

Answer 39

Medial Pectoral Nerve

Question 40

A nerve that comes off of the Medial Cord that supplies general sensation to the medial aspect of your arm.

Answer 40

Medial Brachial Cutaneous nerve

Question 41

A nerve that comes off of the Medial Cord that supplies general sensation to the medial part of the forearm.

Answer 41

Medial Antebrachial Cutaneous nerve

Question 42

Nerve that is derived from T2 (not in the Brachial Plexus) -Responsible for general sensation to the very anterior edge of the axillary region (proximal, medial portion of the arm) -Has to be blocked separately because it's not a part of the Brachial Plexus -Joins on with the Medial Brachial Cutaneous nerve later on

Answer 42

Intercostobrachial Cutaneous nerve

Question 43

An upper limb muscle that is innervated by CN XI (Spinal Accessory Nerve) -Has 3 parts: Upper, Middle, and Lower -Helps form the pectoral girdle with the shoulder, clavicle, and scapula. -Forms a U-shape on the lateral side of the shoulder where muscles attach. -Moves the shoulder girdle around to do work.

Answer 43

Trapezius muscle

Question 44

Origin: Superior Nuchal Line Insertion: Shoulder -Contracts to pick the shoulder up -Can reverse origin/insertion to extend the head back as well -CN XI

Answer 44

Upper Trapezius muscle

Question 45

Origin: Upper Thoracic Vertebra Insertion: Scapula (pectoral girdle) -Contracts: fibers run horizontally, so it retracts the scapula (pulls it back and into attention)

Answer 45

Middle Trapezius muscle

Question 46

Muscle that causes scapular depression (down) and also at the same time, flips the scapula up (upward rotation)

Answer 46

Lower Trapezius muscle