Week 11 Flashcards

1
Q

Brachial plexus roots

Where do they come out from
What is different about the cervical and thoracic nerve roots?

A

C5, C6, C7, C8, T1

Each root comes out between 2 vertebrae

The cervical roots come out above their respective vertebrae (C5 root comes out above C5 vertebrae)
There is no C8 vertebrae so this comes out between c7 and t1.

The thoracic root comes out below its respective vertebrae (t1 root comes out between t1 and t2)

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2
Q

What happens to the brachia plexus roots early on?

Where do they go between?

A

C5 and C6 join
C7 remains on its own
C8 and T1 join

They go between 2 muscles, the anterior scalene and the medial scalene

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3
Q

The brachial plexus trunks’

A

3 trunks form
The c5 and c6 form the superior trunk
The c7 forms the middle trunk
The c8 and t1 forms the inferior trunk

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4
Q

Brachial plexus anterior and posterior divisions

A

The superior and middle trunks’ anterior divisions join
The inferior trunks’ anterior division remains on its own

All of the trunks’ posterior divisions join

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5
Q

The cords of the brachial plexus

A

The lateral cord is made up of the anterior divisions of the superior and middle trunks

The posterior cord is made up of all the posterior divisions

The medial cord is made up of the anterior division of the inferior trunk

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6
Q

The terminal branches of the brachial plexus

A

The lateral cord terminates in the musculocutaneous nerve and it gives fibres (along with the medial cord) wich forms the median nerve

The medial cord terminates in the ulnar nerve

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7
Q

The terminal branches of the brachial plexus

A

The lateral cord terminates in the musculocutaneous nerve and it gives fibres (along with the medial cord) wich forms the median nerve

The medial cord terminates in the ulnar nerve

The posterior cord terminates in the axillary nerve and the radial nerve

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8
Q

What nerve comes off the c5 root

What muscle does it innervate

A

The dorsal scapular nerve

Innervates the levator scapulae, rhomboids

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9
Q

What comes off the c5, c6 and c7 roots

What does it innervate

A

The long thoracic nerve

Serratus anterior

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10
Q

What nerves leave at the superior trunk

What does it innervate

A

The subclavian nerve and the supra scapula nerve

Innervates the supraspinatus and infraspinatus anterior

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11
Q

What nerves leave at the lateral cord

A

The lateral pectoral nerve

Innervates the pec major

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12
Q

What nerves leave at the posterior cord

What does it innervate

A

The upper, middle (thoraco-dorsal nerve) and lower subscapular nerve

Innervates the subscapularis

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13
Q

What nerves leave at the medial cord

A

The medial pectoral nerve
Medial cutaneous nerve of forearm
Medial cutaneous nerve of the arm

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14
Q

The axillary nerve

Brief course

Innervation

Sensory nerve distribution

A

Comes off the posterior cord
Wraps inferiorly underneath the neck of humerus

Innervates teres minor

Brings sensory information from just below proximal area of shoulder joint

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15
Q

The radial nerve

A

Comes into the posterior compartment of the upper arm and sits alongside the spiral groove of the arm, then wraps towards the anterior, crossing anteriorly over the elbow joint. Keeps going down on the radial and ends at the back of the thumb and first 3 fingers

Sensory distribution
-anteriorly it innervates lateral bicep area
-posteriorly it innervates a large area - upper arm, elbow and in hand (thumb and first 3 fingers)

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16
Q

Musculocutaneous nerve

A

Comes down to the anterior compartment of the forearm
Descends between the brachialis and the biceps brachii

Sensory distribution
-lateral side of anterior arm

17
Q

Median nerve

A

Comes down the medial part of anterior arm, crosses over elbow anteriorly, passes centrally at wrist through carpal tunnel. Branches then supply the fingers

Sensory distribution
-palmar aspect of hand - thumb and first 3 fingers
-dorsal aspect of hand - tips of thumb and first 3 fingers

18
Q

Ulnar nerve

A

Runs down the medial part of anterior arm, runs posteriorly at the elbow. Runs down medial forearm

Sensory distrubution
-palmar/dorsal aspect of hand - forth and firth finger

19
Q

Acromioclavicular joint (ACJ) injury

A

Direct impact to the lateral aspect of the acromion with the arm in adduction

Falling onto an outstretched arm

20
Q

Acromioclavicular joint (ACJ) injury
Static and dynamic stabilisers

A

S - acromioclavicular ligament: anterior-posterior stability
D - deltoid and trapezius

21
Q

Anterior glenohumeral joint dislocation

A

Indirect force often with a combination of extension, abduction and external rotation

22
Q

Other names for tennis and golfers elbow

A

Tennis elbow = lateral epicondylitis
Golfers elbow = medial epicondylitis

23
Q

Lateral epicondylitis

A

Overuse injury to forearm muscles which originate on the lateral epicondyle of the humerus
Primarily involves the extensor carpi radialis brevis
Inserts into 3rd metacarpal - extends the wrist

Tennis elbow is named due to the repetitive nature of maintaining wrist extension against force in a backhand position

24
Q

Medial epicondylitis

A

Overuse of muscles which originate on the medial epicondyle
Primarily flexor carpi radialis and pronator teres

25
Q

Insertion and action of the muscles in medial epicondylitis

A

Flexor Carpi Radialis:
Insertion: Bases of 2nd and 3rd Metacarpal (anterior aspect)
Action: Flexion and radial deviation of the wrist
Pronator teres:
Insertion: Lateral surface of radius
Action: Pronation of forearm at the proximal radioulnar joint, flexion of the forearm at the elbow joint

Therefore
Golfer’s elbow stems from repetitive stress of wrist flexion/elbow pronation

26
Q

Boxers fracture

A

Most common site of injury is to the neck of the fifth Metacarpal, 10% of all hand fractures
Mechanism of injury: Direct axial load with a
clenched fist

27
Q

Stingers and burners

A

Nueropraxia of the brachial plexus
Very common in contact sports