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ANAT102 > Topic 6: Nerve supply of the Upper Limb > Flashcards

Topic 6: Nerve supply of the Upper Limb Flashcards

1
Q

What is a plexus?

A

Complex plait of nerves originating from ventral rami of spinal nerves
–> ventral rami = anterior divisions of spinal nerves

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2
Q

What does a plexus do?

A

redistributes nerve fibres from several spinal levels BEFORE forming peripheral nerves
–> gives some redundancy of nerve supply

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3
Q

Parts of the Brachial plexus

A
  1. roots
  2. trunks
  3. divisions
  4. cords
  5. branches
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4
Q

What does the Brachial plexus supply

A

all muscles of the upper limb

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5
Q

Root values of the brachial plexus

A

C5-T1

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6
Q

TRUNKS

1. Upper

A

merges from the C5 &6 roots

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7
Q

TRUNKS

2. middle

A

comes from the root C7

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8
Q

TRUNKS

3. lower

A

merges from the root values C8 & T1

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9
Q

DIVISIONS

A

anterior & posterior divisions that come off trunks

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10
Q

CORDS

1. lateral cord

A
  • lateral to axillary artery

- merge of the anterior divisions

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11
Q

CORDS

2. posterior cord

A
  • posterior to the axillary artery

- merge of the posterior divisions

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12
Q

CORDS

3. Medial

A
  • medial to the axillary artery

- originates just from the anterior division off the lower trunk

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13
Q

BRANCHES

A
  1. Musculocutaneous nerve
  2. axillary nerve
  3. radial nerve
  4. median nerve
  5. ulnar nerve
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14
Q

ORIENTATION

Where do the roots emerge between?

A

between scalene (neck) muscles (anterior & middle)

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15
Q

ORIENTATION

Where are the trunks?

A

superior to the clavicle

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16
Q

ORIENTATION

Cords

A
  • inferior to the clavicle

- named by their position relative to axillary artery

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17
Q

Branches from the roots & distribution

1. Dorsal scapular

A

rhomboids

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18
Q

Branches from the roots & distribution

2. Long thoracic (C5-C7)

A

serratus anterior

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19
Q

Branches from the trunks & their dist

1. suprascapular nerve

A

supraspinatus, infraspinatus

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20
Q

Branches from the trunks & their dist

2. nerve to subclavius nerve

A

Subclavius

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21
Q

How many branches are there from cords?

A

14

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22
Q

branches from cords(not peripheral)

A
  1. upper subscapular
  2. lower subscapular
  3. thoracodorsal
  4. medial cutaneous nerve of arm
  5. medial cutaneous nerve of forearm
  6. medial pectoral
  7. lateral pectoral
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23
Q

Branches from the cords (peripheral)

A
  1. axillary
  2. radial & posterior interosseus branch (PIN - pins supinator)
  3. musculocutaneous
  4. median and its anterior interosseus branch
  5. ulnar
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24
Q

THE BIG FIVE

1. Musculocutaneous

A

First branch; only goes to anterior arm

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25
THE BIG FIVE | 2. Axillary nerve
Next; dives deep into axilla
26
THE BIG FIVE | 3. Radial nerve
Next; dives deep between heads of triceps (find out which heads)
27
THE BIG FIVE | 4. Median nerve
- formed by 2 cords (posterior & medial) | - runs straight down midline of anterior arm
28
THE BIG FIVE | 5. Ulnar
most inferior branch formed by only one cord (medial)
29
DISTRIBUTION OF THE BRANCHES OF THE BRACHIAL PLEXUS | Axillary Nerve root value
C5,6
30
DISTRIBUTION OF THE BRANCHES OF THE BRACHIAL PLEXUS | Axillary Nerve motor distribution
deltoid, teres minor
31
DISTRIBUTION OF THE BRANCHES OF THE BRACHIAL PLEXUS | Axillary Nerve sensory distribution
skin over deltoid, shoulder jt
32
DISTRIBUTION OF THE BRANCHES OF THE BRACHIAL PLEXUS | Radial nerve root value
C5-T1
33
DISTRIBUTION OF THE BRANCHES OF THE BRACHIAL PLEXUS | Radial nerve motor distribution
all UL extensors, brachoradialis, supinator, AbdPL
34
DISTRIBUTION OF THE BRANCHES OF THE BRACHIAL PLEXUS | Radial nerve sensory distribution
- skin of the posterior arm, forearm and hand (lateral 3.5 digits), wrist & elbow jts
35
DISTRIBUTION OF THE BRANCHES OF THE BRACHIAL PLEXUS | Musculocutaneous root value
C5,6,7
36
DISTRIBUTION OF THE BRANCHES OF THE BRACHIAL PLEXUS | Musculocutaneous motor distribution
coracobrachialis, biceps brachii, brachialis
37
DISTRIBUTION OF THE BRANCHES OF THE BRACHIAL PLEXUS | Musculocutaneous sensory distribution
- skin of lateral forearm to base of thumb (via the lateral cutaneous nerve of the forearm), elbow jt
38
DISTRIBUTION OF THE BRANCHES OF THE BRACHIAL PLEXUS | Median nerve root value
C5-T1
39
DISTRIBUTION OF THE BRANCHES OF THE BRACHIAL PLEXUS | Median nerve motor distribution
FCR, PL, both pronators, FDS, FDP (lat), FPL, AbdPB, FPB, OppPoll, lat 2 lumbricals HALF LOAF
40
DISTRIBUTION OF THE BRANCHES OF THE BRACHIAL PLEXUS | Median nerve sensory distribution
- skin of the lateral 3.5 digits and corresponding palm, wrist and elbow jts
41
DISTRIBUTION OF THE BRANCHES OF THE BRACHIAL PLEXUS | Ulnar nerve RV
C8-T1
42
DISTRIBUTION OF THE BRANCHES OF THE BRACHIAL PLEXUS | Ulnar nerve motor dist
FCU, FDP(medial), PB, AbdDM, FDM, OppDM, med 2 lumbricals, addPoll, all interossei
43
DISTRIBUTION OF THE BRANCHES OF THE BRACHIAL PLEXUS | Ulnar nerve sensory dist
skin of the medial 1.5 digits and corresponding palm, wrist jt
44
Where does the musculocutaneous nerve originate from?
the lateral cord (C5-C7)
45
Course of the musculocutaneous nerve
1. starts lateral to axillary artery 2. descends & pierces the corachobrachialis 3. runs between biceps & brachialis
46
Branches of the musc nerve
lateral cutaneous nerve of forearm
47
Vulnerable sites
- not especially vulnerable to injury | - injuries @ birth could be a cause
48
Where does the axillary nerve originate from?
posterior cord (C5-6)
49
Course of the axillary nerve
- starts posterior to axillary artery - dives deep into shoulder (quad space) - supplies shoulder jt - ant branch winds around neck of humerus to supply deltoid - post branch to supply deltoid & teres minor
50
What does the ant branch of the axillary nerve supply
winds around neck of humerus to supply deltoid
51
What does post branch of axillary nerve supply?
deltoid & teres minor
52
Branches of the axillary nerve
superior/ upper lateral cutaneous nerve of arm (vaccine area)
53
Axillary nerve vulnerable to injury
shoulder dislocation (because wraps around humeral neck)
54
Where does the radial nerve originate from?
posterior cord (C5-T1)
55
Course of the radial nerve
- lies posterior to axillary artery - ducks deep between lat & med heads of triceps brachii - travels in radial groove on humerus - enters anterior arm between brachioradialis & brachialis (cubital fossa) - crosses elbow joint anteriorly & divides
56
Branches of radial nerve | 1. deep branch radial/ posterior interosseus nerve
- pierces supinator - then runs along posterior surface of interosseus membrane - travels into posterior forearm & innervates everything
57
Branches of the radial nerve | 2. superficial branch radial
only innervates skin & jts
58
Injury of the radial nerve
- fracture of humerus (radial groove) - incorrect technique with crutches - arcade of Frohse - --> entrapment between supinator heads
59
Where does the median nerve originate from
- lateral cord (C5-C7) | - medial cord (C8-T1)
60
Where do median nerve cords unite?
anterior to axillary artery
61
Where does the median nerve travel?
deep to biceps brachii
62
what muscle does the median nerve travel on top of?
brachialis
63
What accessory structure does Median nerve travel deep to?
deep to bicipital aponeurosis in cubital fossa
64
What muscle does Med nerve run between
between heads of pronator teres | - then deep to FDS
65
what accessory structure does the median nerve travel deep to to enter the hand?
the flexor retinaculum via carpal tunnel
66
ulnar nerve originates from:
medial cord (root value C8-T1)
67
what muscle does the ulnar nerve travel anterior to?
triceps brachii
68
what landmarks does the ulnar nerve travel in between (near elbow)?
between the medial epicondyle of the humerus and the olecranon
69
how does the ulnar nerve enter the anterior forearm?
by passing through heads of FCU
70
what muscle does ulnar nerve run along lateral to ulnar artery?
FDP
71
how does the ulnar nerve enter the hand?
by passing anterior to flexor retinaculum just lateral to the pisiform
72
Branch of the median nerve
interosseous branch
73
where is the anterior interosseus branch of the median nerve formed?
cubital fossa
74
where does the anterior interosseous branch of the median nerve travel?
on anterior surface of interosseous membrane
75
injury of the median nerve:
- deep cuts to the forearm - superficial cut at wrist - entrapment between heads of pronator teres - carpal tunnel syndrome
76
injury of ulnar nerve:
- at the groove behind the medial epicondyle - superficial cut at wrist - fall onto hand/ compression in Guyon's canal (between hook of hamate & pisiform)
77
SMALLER BRANCHES Branches from the cords Lateral pectoral nerve
innervates pectoralis major | - from lateral cord
78
BRANCHES FROM THE CORDS | Upper subscapular
subscapularis | - posterior cord
79
BRANCHES FROM THE CORDS | Thoracodorsal
Lat dorsi | - posterior cord
80
BRANCHES FROM THE CORDS | Lower subscap
lower subscapularis & teres minor | - posterior cord
81
BRANCHES FROM CORDS - MEDIAL CORD
1. medial pectoral nerve (pec minor & part of major) 2. medial cutaneous nerve of Arm 3. medial cutaneous nerve of forearm
82
BRANCHES FROM THE ROOTS | 1. dorsal scapular
rhomboids
83
BRANCHES FROM THE ROOTS | 2. long thoracic
serratus anterior
84
BRANCHES FROM THE TRUNKS | 1. suprascapular
supraspinatus, infraspinatus (comes from superior trunk)
85
BRANCHES FROM THE TRUNKS | 2. nerve to subclavius
subclavius (comes from superior trunk)
86
what is the nerve entering corachobrachialis?
musculocutaneous nerve
87
nerves of the "M"
1. musculocutaneous 2. median nerve 3. ulnar nerve
88
what are the feet of the "m"
medial and lateral cords

ANAT102 (9 decks)

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