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Peripheral Neurology > upper body > Flashcards

upper body Flashcards

1
Q

What nerve roots make the cervical plexus?

A

ventral roots of C1-C5, also have CN XI spinal accessory and CN XII hypoglossal

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2
Q

How many branches arise from each root of the cervical plexus?

A 
C1- 3
C2- 5
C3- 7
C4- 3
C5- 1, brachial plexus
ansa cervicalis- 6
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3
Q

What are the branches of the C1 ventral rami?

A
  1. hypoglosal, via communication branch with C2
  2. descending cervicalis
  3. CN X vagus, via communication branch with C2
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4
Q

What are the branches of the C2 ventral rami?

A
  1. communicating with C1
  2. lessor occipital
  3. muscular to SCM
  4. communicating to CN XI spinal accessory
  5. communicating to ansa cervicalis
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5
Q

what are the branches of the C3 ventral rami?

A
  1. communicating to lessor occipital
  2. greater auricular
  3. transverse cervical
  4. communicating to CN XI spinal accessory
  5. communicating to ansa cervicalis
  6. supraclavicular
  7. phrenic
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6
Q

what are the branches of the C4 ventral rami?

A
  1. supraclavicular
  2. phrenic
  3. branch to C5
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7
Q

What contribution does C5 make to the cervical plexus

A

branch to phrenic

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8
Q

What are the branches of ansa cervicalis

A

roots C1-3

  1. Geniohyoid
  2. geniothyroid
  3. superior belly of omohyoid
  4. sternothyroid
  5. sternohyoid
  6. inferior belly of omohyoid
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9
Q

What are the rami that form the brachial plexus?

A

ventral C4,C5-T1

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10
Q

What are the different sections of the brachial plexus?

A
  1. rami
  2. trunks
  3. divisions
  4. cords
  5. branches
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11
Q

what branches come off the rami of the brachial plexus

A
  1. C5 branch to phrenic (4-5)
  2. C5-8muscular banches to longus colli and scalenes
  3. C5-7 long thoracic
  4. C5 dorsal scapular (5)
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12
Q

What are the trunks of the brachial plexus

A
  1. C5-6 superior
  2. C6 middle
  3. C7, T1 inferior
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13
Q

What are the branches off the trunks of the brachial plexus?

A
  1. C5,6 suprascapular
  2. C5,6 muscular to subclavius
  3. none off middle and inferior
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14
Q

What are the divisions of the brachial plexus?

A
  1. C5-C7 superior cord sends a branch to the middle cord
  2. C5-T1 middle cord sends a branch to the superior cord
  3. C8, T1 inferior cord sends a branch to the middle cord
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15
Q

What are the cords of the brachial plexus?

A

1, lateral

  1. posterior
  2. medial
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16
Q

What are the branches off the cords of the BP?

A
  1. C5-7 lateral pectoral off lateral cord
  2. C5-6 upper and lower subscapular off posterior cord
  3. C6-8 thoracodorsal off posterior cord
  4. C8, T1 medial pectoral off medial cord
  5. C8, T1 medial antebrachial cutaneous off the medial cord
  6. T1 medial brachial cutaneous off medial cord
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17
Q

What are the terminal branches of the brachial plexus?

A
  1. C5-7 musculocutaneous off lateral cord
  2. C5-6 axillary off posterior cord
  3. C5-C8 radial posterior cord
  4. C5-T1 median medial and latera cord
  5. C7-T1 ulnar off medial cord
18
Q

What is the path of the BP in the cervical region?

A

1.As it exits the cervical region it joints the subclavian artery
2.Passes between the anterior and middle scalenes
3.Inferior trunk is in contact with the subclavian atery, rib and Gibson’s fascia
3.It is incased in the prevertebral fascia
the upper roots joint together at Erb’s point 2-3 cm above the clavical and behind SCM

19
Q

What is the pathway of the musculocutaneous nerve?

A
  1. branch off lateral cord
  2. passes through coracobrachialis
  3. travels through brachials and biceps
  4. emerges about 3cm proximal and 4 cm medial to lateral epicondyle
  5. continues as lateral antebrachial cutaneous
20
Q

What does musculocutaneous innervate

A
  1. C5-6 coracobrachialis
  2. C5-6 biceps
  3. C5-6 biceps
  4. C5-6 cutaneous lateral forearm
21
Q

What is the pathway of the axillary nerve?

A
  1. terminal branch from posterior cord at the level of coracoid process
  2. passes under the supscap and comes out of the quadralateral space
  3. branches into anterior, posterior and muscular to long head of triceps
  4. anterior and posterior innervate muscle
  5. terminates as superior lateral cutaneous
22
Q

What is the quadralateral space?

A

interval between teres minor, teres major, long head triceps, humerus

23
Q

What does the axillary nerve innervate?

A
  1. C5-6 long head triceps
  2. C5-6 anterior and posterior branches deltoid
  3. C5-6 teres minor
  4. C5-6 cutaneous lateral shoulder
24
Q

What is the pathway of radial nerve

A

1.From the posterior cord, Passes through axilla proceeding behind humerus along the spiral groove
2. gives off Posterior brachial cutaneous
3. 10-12 cm proximal to epicondyle it pierces the intermeuscular septum passing into the anterior extensor compartment
4.lies between brachialis and extensor muscles of the wrist
5. gives off dorsal antebrachial cutaneous
6. divides into superficial and PIN
A. Superficial radial sensory-travels down forearm > enters wrist between the radial styloid and Lister’s tubercle
B.Deep Posterior interosseous- passes through arcade of Froshe in the supinator
follows the dorsal interosseous membrane
becomes superficial in the distal half of the forearm and terminates

25
Q

What does the radial nerve in the upper arm innervate?

A
  1. C6-1 Triceps
  2. C5-6 brachioradialis
  3. C6-7 ECRL
  4. C5-6 anconeous
  5. cutaneous posterior upper arm
26
Q

What does the PIN of the radial nerve innervate

A 
C678
1.ECRB
2.supinator
passes through arcade of froshe
3.ECU
4.EDM
5.EDC
6.AbPL
7.EPL
8.EPB
9.EIP
27
Q

What does the superficial branch of the radial nerve innervate?

A

cutaneous Sensation to dorsum thumb, web space, lateral hand to ring finger to PIP

28
Q

What is the pathway of the median nerve?

A
  1. Follows brachial artery with ulnar nerve b/w biceps and brachialis on medial arm down to ligament of struther’s
  2. enters cubital fossa in front of brachilis insertion and behind biceps then dives b/w heads of pronator teres
  3. Anterior interosseuos branch comes off below lateral epicodyle 5-8 cm following membrane
  4. Passes between the superficial and deep flexors
  5. Palmar cutaneous branch comes off 5.5 cm proximal to radial styloid
  6. Passes through the carpal tunnel
  7. terminates in palmar muscular and cutaneous branches
29
Q

What does the median nerve innervate?

A

1.FCR (6,7)
2.FDS
3.PL
4.PT
Anterior innerosseous
5.FPL 81(67)
6.Lateral
7.FDP 8(71)
8.PQ 781
Wrist (8,1)
9.OP
10.OPB
11.AbPB
12.1st and 2nd lumbricals
13.palmar cutaneous
14.digital cutaneous

30
Q

What is the pathway of the ulnar nerve?

A
  1. travels medial to median following brachial artery
  2. Halfway down humerus pierce septum to travel behind the humerus through arcade of struther’s
  3. elbow it passes posteriorly between medial epicondyle and olecranon
  4. passes between to the two heads of the FCU
  5. travels down forearm deep to FCU
  6. splits DEEP and SUPERFICIAL 5 cm prox pisiform travels over flex retinaculum
  7. Palmar and dorsal cutaneous comes off prior to pisiform
  8. Pass through the tunnel of Guyon to terminate
31
Q

What does the ulnar nerve innervate?

A

1.FCU
2.FDP ulnar half
3 ODM
4.AbDM
5.FDM
6.3/4 Lumbricals
7.Dorsal innerossi
8.PI
9.AdP
10.palmar cutaneous
11.palmar digital
12.dorsal cutaneous

32
Q

What is the pathway and innervations of the dorsal scapular nerve?

A
  1. branch off C5 ventral rami
  2. pierces middle scalene
  3. innervates LS and RH
33
Q

What is the pathway and innervations of the long thoracic nerve?

A
  1. branches of ventral rami of C5-7
  2. pierces middle scalene and runs behind the BP
  3. passes between 1st and 2nd rib
  4. innervates serratus anterior
34
Q

What is the pathway and innervations of the suprascapular nerve?

A
  1. branch of the superior trunk (C56)
  2. runs between trap and omohoid
  3. runs through suprascapular notch
  4. articular branches to AC and GH
  5. innervtes Supraspinatus
  6. pass around the base of the spine of scapula to innervate infraspinatus
35
Q

What is the pathway and innervations of the subscapular nerves?

A
  1. branch off posterior cord C5,6
  2. runs down anterior surface of subscap giving upper and lower branches
  3. terminates at teres major
36
Q

What is the pathway and innervations of medial pectoral nerve?

A
  1. medial cord C81
  2. pass behind axillary artery
  3. innervates pec minor and pec major
37
Q

What is the pathway and innervations of lateral pectoral nerve?

A
  1. branch off the lateral cord C567
  2. pass over axiilary artery to pierce coracoclavicular fascia
  3. innervates pec major
38
Q

What is the pathway and innervations of the phrenic nerve

A
  1. ventral roots C3-5
  2. descends obliquely with the internal jugular vein across the anterior scalene
  3. deep to the prevertebral layer of deep cervical fascia and the transverse cervical and suprascapular arteries
  4. runs posterior to the subclavian vein as it enters the thorax
  5. runs anterior to the root of the lung and into the pericardium
  6. innervates the pericardium, medistinal pleura and diaphragm
39
Q

What types of neural fibers does the phrenic nerve carry

A
  1. sympathetic
  2. motor
  3. sensory
40
Q

What are the cutaneous innervations of the posterior head and neck?

A
  1. greater occipital (C2) up the back of the head
  2. 3rd occipital (C3) - central neck C1/2 level
  3. lessor occipital (C2/3)- lateral to GO
  4. greater auricular (C2/3)- behind the ear
  5. dorsal rami cutaneous (C2-4) posterior central neck
41
Q

What are the cutaneous innervations of the anterior and lateral neck?

A
  1. transverse cervical (C2,3)- anterior lateral neck below the level of the greater auricular (about C3)
  2. supraclavicular (C3,4)- inferior neck, clavicle and upper shoulder

Peripheral Neurology (2 decks)

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