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PNS Exam Three > Thoracic And Lumbar Plexuses > Flashcards

Thoracic And Lumbar Plexuses Flashcards

1
Q

Each mixed thoracic nerve divides into what structures?

A

Anterior and posterior primary ramus

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2
Q

Each posterior primary ramus splits into what branches?

A

Medial and lateral

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3
Q

What muscles make up the motor supply of the medial branches of the posterior primary rami of the thoracic spinal nerves?

A

Semispinalis (upper six)
Longissimus (lower six)
Multifidi

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4
Q

What makes up the sensory supply of the medial branches of the posterior primary rami of the thoracic spinal nerves?

A

Skin paraspinally

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5
Q

What is different about the medial branches of the posterior rami of the thoracic spinal nerves compared to the cervical spinal nerves?

A

They are mixed in the thoracic region (both sensory and motor supply)

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6
Q

The lateral branches of the posterior primary rami of the thoracic spinal nerves increase in size in which direction?

A

Superior to inferior

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7
Q

Are the lateral branches of the posterior primary rami of the thoracic spinal nerves mixed like the medial branches?

A

Yes

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8
Q

What muscles make up the motor supply of the lateral branches of the posterior primary rami of the thoracic spinal nerves?

A

Longissimus, iliocostalis, levator costarum

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9
Q

What makes up the sensory supply of the lateral branches of the posterior primary rami of the thoracic spinal nerves?

A

Skin near the costal angles

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10
Q

What forms the first intercostal nerve?

A

Small branch from T1 (anterior primary ramus of T1 contributes to the brachial plexus)

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11
Q

Which anterior primary rami contribute to the intercostobrachial nerve?

A

T2 and sometimes T1

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12
Q

Each intercostal nerve gives off what branch to supply the overlying skin?

A

Lateral cutaneous branch (which divides into an anterior and posterior branch)

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13
Q

Intercostal nerves terminate as what?

A

Anterior cutaneous branches

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14
Q

What do the anterior cutaneous branches supply?

A

Skin close to the midline

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15
Q

How many pairs of thoracic roots are there?

A

12

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16
Q

What muscles are supplied by intercostal nerves?

A

Internal, external, and innermost intercostals, serratus posterior, transversus thoracis, transverse abdominal, internal and external abdominal oblique, rectus abdominus

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17
Q

What extra things besides muscles are supplied by the intercostal nerves?

A

Adjacent blood vessels, bones, joints, and ligaments

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18
Q

What is the largest of the thoracic nerves?

A

T12 (subcostal nerve)

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19
Q

What plexus does the subcostal nerve also contribute to?

A

Lumbar plexus

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20
Q

What is the sensory supply of the subcostal nerve?

A

Skin as far inferior as the superior buttocks

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21
Q

Which thoracic nerves communicate with the sympathetic trunk via white and gray rami communicans?

A

All

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22
Q

Which is more medial: white or gray ramus communicans?

A

Gray

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23
Q

At what levels do we find white ramus communicans?

A

T1-L2 (therefore, all thoracic nerves)

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24
Q

Describe the fibers of the gray ramus communicans.

A

Postganglionic sympathetic

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25
Q

Describe the fibers of the white ramus communicans.

A

Preganglionic sympathetic

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26
Q

How are the lumbar spinal nerves named?

A

For the bone above, just like the thoracics

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27
Q

The posterior primary rami of the lumbar nerves divide into what?

A

Medial and lateral branches

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28
Q

What do the medial branches of the posterior primary rami of the lumbar nerves supply?

A

Multifidi

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29
Q

What do the lateral branches of the posterior primary rami of the lumbar nerves supply?

A

Erector spinae group

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30
Q

The anterior primary rami of the lumbar nerves contribute to what plexuses?

A

Lumbar and sacral

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31
Q

Which lumbar nerves can have white rami communicans?

A

L1, L2, L3 (sometimes)

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32
Q

Which lumbar nerves have gray ramus communicans?

A

All of them

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33
Q

How many lumbar sympathetic ganglia do we see?

A

4

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34
Q

What forms the lumbar plexus?

A

Anterior primary rami of L1-L3, part of L4, and T12 through a communication with L1

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35
Q

What muscles are supplied by the muscular branches of the anterior primary rami of the lumbar plexus?

A

Quadratus lumborum, psoas major, psoas minor if present

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36
Q

What muscles are supplied by L1?

A

Quadratus lumborum and psoas minor

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37
Q

What muscles are supplied by L2?

A

Quadratus lumborum and both psoas muscles

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38
Q

What muscles are supplied by L3 and L4?

A

Quadratus lumborum and psoas major

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39
Q

The iliohypogastric nerve contains what fibers?

A

T12 and L1

40
Q

What is the course of the iliohypogastric nerve?

A

Anterior and inferior between the quadratus lumborum and the kidney, then through the transverse abdominal muscle and in between it and the internal abdominal oblique

41
Q

What is the sensory supply of the the lateral cutaneous branch of the iliohypogastric nerve?

A

Posterolateral gluteal region

42
Q

What is the sensory supply of the anterior cutaneous branch of the iliohypogastric nerve?

A

Skin of the pubic region

43
Q

What muscles are supplied by the iliohypogastric nerve?

A

Internal abdominal oblique and transversus abdominus

44
Q

What fibers are contained in the ilioinguinal nerve?

A

T12 and L1

45
Q

What is the course of the ilioinguinal nerve?

A

Similar to iliohypogastric but is transmitted through the inguinal canal
Leaves the canal through the superficial inguinal ring and travels with the spermatic cord (round ligament in females)

46
Q

What is the sensory supply of the ilioinguinal nerve?

A

Skin of the upper medial thigh, base of penis and anterior scrotum in men, mons pubis and labium majus in females

47
Q

What muscles are supplied by the ilioinguinal nerve?

A

Internal abdominal oblique and transversus abdominus

48
Q

The genitofemoral nerve contains what fibers?

A

L1 and L2

49
Q

When passing anteriorward through the psoas major, what does the genitofemoral nerve divide into?

A

Genital and femoral branches

50
Q

Which branch of the genitofemoral nerve passes through the inguinal canal?

A

Genital branch

51
Q

What is the motor supply of the genital branch of the genitofemoral nerve?

A

Cremaster muscle

52
Q

What is the sensory supply of the genital branch of the genitofemoral nerve?

A

Skin of the superior anterior scrotum in males

Skin of the mons pubis and labium majus in females

53
Q

How can we test for the cremasteric reflex?

A

Scrap sharp side of the reflex hammer over the medial thigh and one testicle will contract and rise

54
Q

The cremasteric reflex involves what nerve?

A

Genital branch of genitofemoral nerve

55
Q

What is the supply of the femoral branch of the genitofemoral nerve?

A

Skin of the upper anterior thigh

56
Q

What is the course of the femoral branch of the genitofemoral nerve?

A

Into the thigh posterior to the inguinal ligament

57
Q

What fibers are contained in the lateral cutaneous nerve of the thigh?

A

L2 and L3

58
Q

What is the supply of the lateral cutaneous nerve of the thigh?

A

Skin of the lateral thigh, superior to the knee

59
Q

What is the course of the lateral cutaneous nerve of the thigh?

A

Leaves abdominal cavity by passing posterior to the inguinal ligament
Travels to the sartorius and through the fascia lata to reach the skin

60
Q

What is the largest branch of the lumbar plexus?

A

Femoral nerve

61
Q

What fibers are contained in the femoral nerve?

A

L2, L3, and L4

62
Q

All branches of the femoral nerve are given off in what locations?

A

Abdomen, femoral triangle

63
Q

What is the course of the femoral nerve?

A

Posterior to psoas major, then emerges lateral to the psoas, anterior to the iliacus
Posterior to inguinal ligament and enters femoral triangle just lateral to femoral artery
Inferior and medially through adductor canal
Into the leg, medially to the knee

64
Q

What branches of the femoral nerve are given off in the abdomen?

A

Muscular branches to iliacus and pectineus, some fibers to the femoral artery

65
Q

When does the femoral nerve divide into anterior and posterior divisions?

A

Once past the inguinal ligament

66
Q

The anterior division of the femoral nerve gives rise to which three nerves?

A

Intermediate cutaneous nerve of the thigh, medial cutaneous nerve of the thigh, nerve to the sartorius

67
Q

What is the supply of the intermediate cutaneous nerve of the thigh?

A

Skin on the anterior thigh down to the knee

Lateral branch communicates with femoral branch of genitofemoral nerve

68
Q

What is the supply of the medial cutaneous nerve of the thigh?

A

Skin of the medial thigh, medial knee, and knee across to the lateral side of the patella
Some branches supply skin of the medial leg through communications with the the saphenous nerve

69
Q

With what other nerve does the intermediate cutaneous nerve of the thigh communicate with for its supply?

A

Femoral branch of the genitofemoral nerve

70
Q

With what other nerve does the medial cutaneous nerve of the thigh communicate with for its supply?

A

Saphenous nerve

71
Q

What does the nerve to the sartorius supply?

A

Sartorius muscle

72
Q

What makes up the posterior division of the femoral nerve?

A

Muscular branches to quadriceps, vascular branches to femoral artery and its branches, articular branches to knee joint

73
Q

The femoral nerve continues into the leg as what nerve?

A

Saphenous nerve

74
Q

What muscular branches are given off in the femoral triangle from the posterior division of the femoral nerve?

A

Sartorius, rectus femoris, vastus lateralis, vastus medialis, vastus intermedialis

75
Q

The saphenous nerve is transmitted through what opening?

A

Adductor canal

76
Q

The saphenous nerve lies medial to what structure as it emerges from the adductor canal?

A

Femoral artery

77
Q

What is the supply of the saphenous nerve as it emerges from the adductor canal?

A

Skin medial and anterior to the patella

78
Q

What is the supply of the saphenous nerve in the leg?

A

Skin of the medial leg and foot

79
Q

The saphenous nerve travels with what vascular structure in the leg?

A

Great saphenous vein

80
Q

How can one check for sensory deficits by analyzing the femoral nerve?

A

Checking dermatome levels

81
Q

What tendon reflex can be used to analyze function of the femoral nerve?

A

Patellar reflex

82
Q

What fibers are contained in the obturator nerve?

A

L2, L3, and L4

83
Q

Which nerve is the primary contributor to the obturator nerve?

A

L3 (L2 contribution is minimal)

84
Q

Through what opening does the obturator nerve leave the pelvis?

A

Obturator foramen

85
Q

What separates the anterior and posterior branch of the obturator nerve?

A

First by the obturator externus then by the adductor brevis

86
Q

What is the course of the obturator nerve?

A

Medial to psoas major, posterior to common iliac vessels, descends into their pelvis traveling on the obturator internus

87
Q

The anterior branch of the obturator nerve travels posterior to what muscles?

A

Pectineus and adductor longus

88
Q

What forms the subsartorial plexus?

A

Branches from the anterior branch of the obturator nerve with branches of the femoral nerve

89
Q

What does the subsartorial plexus supply?

A

Skin of the medial thigh

90
Q

What does the termination of the anterior branch of the obturator nerve supply?

A

Femoral artery

91
Q

To which joint does the anterior branch of the obturator nerve send articular branches?

A

Hip joint

92
Q

What muscles are supplied by the anterior branch of the obturator nerve?

A

Adductor longus, gracilis, pectineus (usually), adductor brevis (usually)

93
Q

The anterior branch of the obturator nerve may send fibers to connect with what other nerve if it is present?

A

Accessory obturator nerve

94
Q

The anterior branch of the obturator nerve sends fibers to what other nerves to contribute to the supply of the skin on the upper medial side of the leg?

A

Medial cutaneous nerve of the thigh and the saphenous nerve

95
Q

What is the course of the posterior branch of the obturator nerve?

A

Through the obturator externus, posterior to the adductor brevis, anterior to the adductor magnus

96
Q

What muscles are supplied by the posterior branch of the obturator nerve?

A

Obturator externus, adductor magnus, adductor brevis if not supplied by anterior branch

97
Q

To which joint does the posterior branch of the obturator nerve send articular branches?

A

Knee joint

PNS Exam Three (3 decks)

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