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MSK > Upper Limb Nerves , Dermatomes & Myotomes > Flashcards

Upper Limb Nerves , Dermatomes & Myotomes Flashcards

1
Q

Branches that exit the brachial plexus “superior” to the clavicle and largely located in the cervical region are called:

A

Supraclavicular Branches

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2
Q

Branches exit plexus inferior to clavicle and are primarily located in the axilla/armpit are called:

A

Infraclavicular Branches (terminal Branches)

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3
Q

what important branches make up the supraclavicular branches

A

Long Thoracic Nerve
Suprascapular Nerve
Dorsal Scapular Nerve

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4
Q

what important branches make up the infraclavicular branches (hint: MARMU)

A

MARMU
Musculocutaneous (C5,6,7)
Axillary (C5/6)
Radial (C5 – T1)
Median (C5 – T1)
Ulnar (C8/T1)

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5
Q

origin of musculocutaneous nerve

A

terminal branch of lateral cord

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6
Q

functions of musculocutaneous nerve

A

motor function to anterior arm:
- coracobrachialis
- biceps
- brachialis
Sensory to
- the skin of the anterolateral forearm

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7
Q

Pathway of musculocutaneous nerve

A
  • the terminal branch of the lateral cord within the axilla
  • travels through the coracobrachialis muscle belly
  • innervates muscles of the anterior compartment of the arm
  • continues after passing the cubital fossa as the lateral cutaneous N. of the forearm
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8
Q

which is the most likely site of injury to the musculocutaneous nerve?

A
  • when it travels through the coracobrachialis muscle belly
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9
Q

origin of axillary nerve

A

the terminal branch of the posterior cord

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10
Q

the function of axillary nerve

A

motor to lateral shoulder:
- deltoid
- teres minor
sensory to:
- skin of lateral shoulder

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11
Q

Pathway of axillary nerve

A
  • heads posteriorly in axilla
  • travels through the quadrangular axillary space
  • wraps around the posterior aspect of the humeral neck
  • relationship with the surgical neck of humorous
  • innervates deltoid and teres minor
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12
Q

what is the most likely site of injury for the axillary nerve?

A

in the pathway where it has a relationship with the surgical neck of the humerus

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13
Q

“military patch syndrome” is an injury to which nerve

A

axillary

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14
Q

what occurs when a patient has “military patch syndrome”

A

weakness is abduction
weakness in lateral (external) rotation
numbness and tingling in the lateral shoulder

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15
Q

origin of the radial branch

A

the terminal branch of the posterior cord

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16
Q

the function of the radial branch

A

motor to:
- extensor muscles of the posterior arm
- extensor muscles of the posterior forearm
- brachoradialis
- supinator muscle

sensory to:
- skin of posterior arm, forearm and hand
- dorsal surface of digits 1,2,3 and lateral 1/2 of digit 4
(typically written as lateral 3.5 digits, dorsal surface)

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17
Q

radial nerve pathway

A
  • head posteriorly in axilla
  • travels posteriorly, inferior to the quadrangular axillary space
  • wraps around the posterior aspect of the humeral shaft
  • relationship with the radial groove of the humerus
  • innervates extensors of arm and forearm and supinator
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18
Q

what is the most likely site of injury for the radial nerve?

A

in the pathway at its relationship with the radial groove of the humerus

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19
Q

Radial nerve: sensory branches in the posterior arm

A

posterior cutaneous nerve of forearm
lower lateral cutaneous nerve of arm

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20
Q

The terminal deep branch of the radial nerve is ______. It innervates

A

motor
- innervates the muscles in the posterior compartment of the forearm

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21
Q

The terminal superficial branch of the radial nerve is ______. It innervates

A

sensory
- it contributes to the cutaneous innervation of the dorsal hand and fingers

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22
Q

Wrist drop is an indication of injury to which nerve

A

radial nerve

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23
Q

injury of the radial nerve results in the loss of what action?

A

Loss of extension of forearm, elbow, wrist and fingers

Weakness in supination (but not loss of because biceps also does supination)

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24
Q

origin of the median nerve

A

the terminal branch of lateral and medial cords

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25
Q

function of median nerve

A

motor to muscles of the anterior forearm and hand:
- flexors of the wrist
- pronators of the forearm
- flexors of digits 1,2,3

  • lumbrical 1 and 2
  • thenar muscles

sensory to:
- palmar surface of digits 1,2,3 and lateral 1/2 of digit 4 (typically written as lateral 3.5 digits, palmar surface)

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26
Q

pathway of the median nerve

A
  • heads inferiorly from the axilla, travelling down an anteromedial arm (within layers of muscle)
  • crosses anterior elbow within the cubital fossa
  • travels down the anterior forearm
  • enters hand via carpal tunnel
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27
Q

what are the TWO likely sites of injury for the median nerve?

A

when it crosses the anterior elbow within the cubital and when it enters the hand via the carpal tunnel

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28
Q

carpal tunnel syndrome is an injury of which nerve

A

the median nerve

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29
Q

the compression of the median nerve as it passes through the carpal tunnel. Name 4 possible causes of disease.

A

Carpal tunnel syndrome
- typing, mechanics, pregnancy and obesity

30
Q

where will carpal tunnel impact first? What does the patient often complain of?

A

the median nerve in the hand (motor and sensory)
- The patient often complains of numbness and tingling in the first 3.5 digits and weakness of thumb movement

31
Q

as the condition of carpal tunnel progresses, where can sensory changes radiate into?

A

the forearm and even the axilla

32
Q

how do you relieve symptoms of carpal tunnel?

A

To relieve symptoms, partial or complete surgical division of the flexor retinaculum may be necessary – this is known as ‘carpal tunnel release

33
Q

ape hand deformity is an indication of injury to which nerve?

A

median nerve
- Smaller muscles will show atrophy quicker!!!
Such as thenar muscles that support the thumb

The thumb is pulled closer to the hand because abduction is function is lost

34
Q

if injury to the median nerve occurs at the elbow, what will occur?

A

Loss of flexion of the wrist
Loss of flexion of fingers
Loss of thumb movement
loss of Pronation
Sensation in the hand

35
Q

origin of ulnar nerve

A

terminal branch of medial cord

36
Q

function of ulnar nerve

A

Motor to medial forearm and hand:
- Medial ½ of flexor digitorum profundus
Hand intrinsics
- Lumbricals 3&4
- Hypothenar group
- Palmer and Dorsal Interossei

Sensory to:
- palmer and Dorsal surface of medial ½ of digit 4
- And all if digit 5 (typically written as medial 1.5 digits)

37
Q

pathway of ulnar nerve

A

heads inferiorly from the axilla, travelling down the anteromedial arm (protected by muscle)
- passes posterior to medial epicondyle
- travels down the medial forearm
- enters hand external to carpal tunnel

38
Q

what is the most likely site of injury to the ulnar nerve?

A

when it passes posterior to the medial epicondyle

39
Q

injury to ulnar nerve results in:

A

ulnar claw hand
- Significant Loss of hand functions 2,3,4,5
Small muscles are higher risk for developing atrophy

40
Q

Cutaneous Supply from Brachial Plexus: Median

A

Palmer surface of lateral 3.5 digits

41
Q

Cutaneous Supply from Brachial Plexus: Ulnar

A

Palmer and dorsal surface of medial 1.5 digits

42
Q

Cutaneous Supply from Brachial Plexus: Radial

A

Dorsal surface of lateral 3.5 digits

43
Q

There are ___ pairs of spinal nerves exiting off spinal cord

A

31

44
Q

Nerves are _____ matter pathways that provide a route for motor and sensory signals to travel between ___ and ____

A

WHITE
PNS and CNS

45
Q

_________ carries sensory/afferent information INTO the CNS so it can ascend in the cord to reach the cortex

A

Posterior/Dorsal root

46
Q

___________ root carries motor/efferent information OUT of CNS that has descended from the cortex to the cord

A

Ventral/Anterior

47
Q

Ventral and dorsal roots come together to form a __________ in the intervertebral foramen

A

spinal nerve

48
Q

is a specific area on the skin innervated by a specific spinal root

A

Dermatome

49
Q

is a specific group of muscles innervated by a particular spinal root.

A

Myotome

50
Q

Testing both dermatome and myotomes can provide important clinical feedback about the function of

A

spinal nerves

51
Q

Dermatome: T1

A

medial aspect of the upper arm

52
Q

Dermatome: C8

A

C8 little finger

53
Q

Dermatome: C7

A

C7 middle finger

54
Q

Dermatome: C4

A

collarbone area

55
Q

Dermatome: C5

A

middle part of anterior arm

56
Q

Dermatome: C6

A

C6 lateral aspect of the forearm and the thumb

57
Q

Myotome: C5

A

deltoid
abduction of the arm at should

58
Q

Myotome: C6

A

bicep
flexion of the arm at the elbow

59
Q

Myotome: C7

A

tricep
extension of the arm at the elbow

60
Q

Myotome: C8

A

small muscles of the hand
finger flexion

61
Q

Myotome: T1

A

small muscles of the hand
finger abduction

62
Q

Clinical test: __

Dermatome = sensation of skin of anterior/lateral arm (skin over deltoid)

Myotome = muscle strength of deltoid (arm abduction)

A

C5

63
Q

Clinical Test: ___

Dermatome = sensation of anterior skin of thumb

Myotome = muscle strength of biceps (elbow flexion)

A

C6

64
Q

Clinical Test: ___

Dermatome = sensation of anterior skin of digits 2 and 3

Myotome = muscle strength of triceps (elbow extension)

A

Clinical Test: C7

65
Q

Clinical Test: ____

Dermatome = sensation of skin of digits 4 and 5

Myotome = muscle strength of finger flexors

A

Clinical Test: C8

66
Q

Clinical Test: ____

Dermatome = sensation of skin of antero/medial elbow

Myotome = muscle strength of finger abductors

A

Clinical Test: T1

67
Q

stimulus to receptors to ________ neuron, to the spinal cord to _______ neuron to effector to response

A

sensory neuron to motor neuron

68
Q

deep tendon reflexes for C7

A

head of the hammer at the posterior elbow

69
Q

deep tendon reflexes for C5

A

head of hammer at anterior the elbow

70
Q

deep tendon reflexes for C6

A

the butt of the hammer at the radial wrist

MSK (30 decks)

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