upper limb Flashcards

1
Q

Name the 5 peripheral nerves of the brachial plexus

A

Musculocutaneous
Axillary
Radial
Median
Ulnar

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2
Q

Lateral cord of brachial plexus

A

Musculocutaneous

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3
Q

Posterior cord of brachial plexus

A

Axillary and radial

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4
Q

Inferior cord of brachial plexus

A

Median and ulnar

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5
Q

Root of musculocutaneous

A

C5,6,7

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6
Q

Root of axillary

A

C5,6

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7
Q

Root of radial

A

C5-8, T1

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8
Q

Root of median

A

C5-8, T1

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9
Q

Root of ulnra

A

C8, T1

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10
Q

Narrate out the C5 to T1 dermatomes

A

C5: Lateral arm
C6: Lateral forearm to thumb
C7: 2nd and 3rd finger + middle palm
C8: 4th and little finger + medial side of palm and medial surface of forearm
T1: medial surface of arm

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11
Q

What muscles are innervated by the axillary nerve?

What movements do they control?

A
  1. Deltoid - abduction beyond 15 degrees
  2. Teres minor - lateral rotation of arm/part of rotator cuff muscle
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12
Q

What muscles are innervated by the musculocutaneous nerve?

What movements do they control?

A
  1. Bicep branchii - flexor and supinator (especially if forearm is flexed)
  2. Coracobrachialis - flex
  3. Brachialis - flex
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13
Q

What muscles are innervated by the radial nerve?

What movements do they control?

A

All the muscles along the back of the hand.

  1. Triceps branchii - extensor of forearm
  2. All the extensor muscles of forearm - extension of wrist and fingers
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14
Q

Nerve innervating trapezius

A

Cranial nerve 11 - spinal accessory

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15
Q

Nerve innervating rhomboid and levator scapulae

A

Dorsal scapular nerve

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16
Q

Nerve innervating Latissimus dorsi

A

Thoracodorsal nerve

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17
Q

Nerve innervating serratus anterior

A

Long thoracic nerve

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18
Q

What is the pathology associated with long thoracic nerve lesion?

A

Weakness of serratus anterior

When scapula is protracted, it pops out, creating an appearance of a winged scapula.

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19
Q

What is the nerve and muscle affected in winged scapula?

A

Long thoracic nerve

Serratus anterior

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20
Q

Nerve innervating pect major

A

Lateral and medial pectoral nerves

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21
Q

Nerve innervating pect minor

A

Medial pectoral nerves

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22
Q

Name the 4 rotator cuff muscles

A

Anterior: subscapularis
Posterior from top down:
1. Supraspinatus
2. Infraspinatus
3. Teres minor

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23
Q

Nerve innervating subscapularis

A

Scapular nerve

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24
Q

Nerve innervating supraspinatus and infraspinatus

A

Suprascapular nerve

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25
Nerve innervating teres minor
Axillary nerve
26
Nerve innervating teres major This nerve also innervates the _
Scapular nerve Subscapularis muscle
27
Nerve innervating deltoid
Axillary
28
Nerve innervating triceps
Radial
29
Which muscle in the anterior flexor component of the forearm is NOT innervated by median nerve?
Flexor carpi ulnaris Flexor digitorum profundus (medial portion) Ulnar nerve
30
Which 2 muscles in the anterior flexor compartment of the forearm is innervated by the ulnar nerve?
Flexor carpi ulnaris Flexor digitorum profundus (medial portion)
31
Pass Fail Pass Fail (lateral to medial) Name the anterior forearm flexor muscles
Protonator teres Flexor carpi radialis Palmaris longus Flexor carpi ulnaris
32
Flexor carpi radialis controls the _ of the wrist while flexor carpi ulnaris controls the _.
Radialis - abduction Ulnaris - adduction
33
What are the 2 pronator muscles of the forearm and which nerve are they innervated by?
Pronator teres Pronator quadratus Median nerve
34
Name the 3 contents of the deep layer of anterior forearm. Hint: flex, flex, P
Flexor digitorum profundus Flexor pollicis longus Protonator quadratus
35
What is the muscle in the intermediate layer of the anterior forearm?
Flexor digitorum superficialis
36
Which nerve innervates the posterior forearm?
Radial - all the extensor muscles
37
Pollicis means
Thumb
38
Minimi means
Little finger
39
Which muscles controls the abduction of thumb and what nerve is it innervated by?
Abductor pollicis LONGUS - radial nerve ^ In posterior forearm Abductor pollicis BREVIS - median nerve ^ Found in hand near thumb
40
Name the 3 thenar muscles innervated by the median nerve
1. Abductor pollicis brevis 2. Opponens pollicis 3. Flexor pollicis brevis
41
In the hand, median nerve innervates LOAF. What does LOAF stand for?
Lumbricals (1st and 2nd) Opponens pollicis Abductor pollicis brevis Flexor pollicis brevis
42
Which thenar muscle is innervated by ulnar nerve?
Adductor pollicis
43
Name the 3 hypothenar muscles innervated by ulnar nerve
1. Opponens digiti minimi 2. Flexor digiti minimi brevis 3. Abductor digiti minimi
44
Palmar and dorsal interossei is innervated by?
Ulnar nerve
45
What is the function of lumbricals?
Extend DIP and flex MCP Like making a Z sign
46
What is the only action of the thumb that is not controlled by the median nerve and what muscle is it?
Adduction Adductor pollicis Ulnar nerve
47
What is the function of palmar and dorsal interossei?
PAD - palmar adducts DAB - dorsal abducts
48
Erb's palsy involves injury to the _
Upper roots of brachial plexus C5 and C6
49
What are the nerves affected in Erb's palsy? Hence what muscles/ movements are affected?
C5 and C6 Musculocutaneous: biceps Axillary: deltoid, teres minor Radial (partial) - extensors of wrist Cannot flex forearm - biceps Arms adducted - deltoid Medially rotated arm - teres minor Wrist is flexed - extensors of wrist
50
Describe the clinical presentation of Erb's palsy
Extension of elbow Arms adducted Arms medially rotated Wrist flexed (waiter's tip)
51
When are UPPER brachial plexus injuries more common?
1. Excessive pulling or stretching of infant's head during childbirth 2. Road traffic accident 3. Contact sports **Happen when the shoulder is forced down on one side of the body and the head is pushed to the other side in the opposite direction.
52
When are LOWER brachial plexus injuries more common?
Swing the kid using their extended hands. **More likely to be injured when the arm is forced above the head.
53
Klumpkle palsy involves injury to the _
Lower roots of brachial plexus C8 T1
54
What are the nerves affected in Klumpke's palsy? Hence what muscles/ movements are affected?
Ulnar Median All the flexors of forearm - flexion of wrist Pronator teres and quadratus - pronation of hand Lumbricals - extend DIP, flex MCP
55
Describe the clinical presentation of Klumpke's palsy
Supinated forearm (cannot pronate) Wrist is flexed due to wasting of flexor muscles Fingers are all flexed - looking like RAWR claw
56
What are the 2 common fractures as a result of fall of outstretched hand?
1. Scaphoid fracture 2. Colles fracture
57
What is Colle's fracture?
Radius is dislocated from carpal bone and is displaced posteriorly. Dinner fork deformity
58
Describe how I would know it is a claw hand caused by ulnar nerve lesion clinically
Ask patient to open up their palm. Inability to extend 4th and 5th finger fully.
59
Describe how I would know it is a claw hand caused by median nerve lesion clinically
Ask patient to clench their fist Inability to flex 1st,2nd and 3rd finger
60
What is the ulnar paradox?
The more distal the injury to the ulnar nerve (ie. at elbow vs at wrist), the more severe the claw hand deformity. At elbow, less severe. At wrist, more severe
61
What are the 3 types of elbow fractures?
Lateral epicondyle Supracondylar Medial epicondyle
62
Lateral epicondyle Supracondylar Medial epicondyle Name the nerve corresponding to each
Lateral: radial Supracondylar: median Medial: ulnar
63
Describe radial nerve lesion
Wrist drop Radial nerve supplies the extensor muscles of the forearm. Cannot extend wrist so hand just kind flops downwards. Radial also innervates supinator so weak supination (still got bicep branchii so can weakly supinate)