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19 Cards in this Set

  • Front
  • Back
List the source, course and target for:
Long thoracic nerve
C5-7
comes off the roots and runs external to serratus anterior
Serratus anterior
List the source, course and target for:
Musculocutaneous
C5-7 (lateral cord)
Pierces the coracobrachialis
Coracobrachialis, biceps brachii & brachialis (BBC).
(continues as the lateral cutaneous N of forearm)
List the source, course and target for:
Median Nerve
C8 - T1 (Lateral and medial cords - middle of the "M")
Anterior to brachial artery in arm - medial in the fossa
Flexor muscles and palm
List the source, course and target for:
Medial cutaneous nerve of the forearm
C8 - T1 (comes off medial cord, proximal to ulnar N)
Medial to Brachial A in cubital fossa, ant to med epicondyle, pierces pronator teres, travels on top of flex dig superficialis.
Does the flexors (except those of Ulnar N; **anterior interosseous does pronator quadratus, flex dig profundus and flex pollicis longus), medial 2 lumbercals and the thenar compartment
List the source, course and target for:
Ulnar Nerve
C8 - T1 (continuation of lower trunk - medial cord)
runs down medial aspect of arm and posterior to medial epicondyle, btwn flexor carpi ulnaris and flex dig sup.
Flexor carpi ulnaris, ulnar portion of flex dig profundus all the interossei, medial 2 lumbercals and hypothenar muscles. Lateral dorsum of hand.
List the source, course and target for:
Upper subscapular N
C5 (first branch off posterior cord)
Passes posteriorly
Subscapularis
List the source, course and target for:
Thoracodorsal nerve
C6-8 (between upper and lower subscapular nerves, off the post cord)
Crosses subscapular and teres major
latissimus dorsi
List the source, course and target for:
Lower subscapularis
C6 (most distal branch from posterior cord)
Deep to circumflex scapular artery
Lower part of subscapularis and teres major
List the source, course and target for:
Axillary
C5&6 ( Terminal branch of posterior cord)
Into quadrangular fossa, (with posterior circumflex humeral artery). Winds around the surgical neck of the humerous giving rise to the lateral cutaneous nerve of the arm.
T minor, deltoid, shoulder joint
List the source, course and target for:
Radial
C5-T1 (posterior cord)
Deep to axillary artery, into radial grove between the long and medial heads of triceps. It splits in cubital fossa; superficial, and deep which pierces the supinator and is now the posterior inter-osseius.
Triceps, brachioradialis, supinator and extensors. Skin on posterior of entire arm and hand.
What nerve supplies the serratus anterior?
The long thoracic which takes a bit from C5 - T1
The brachial plexus contains which types of nerves?
Motor, somatic sensory and sympathetics
What type of injury (ie damage to which roots) would cause Erb-Duchenne paralysis? What does this look like?
Damage to C5 and C6. Aka porter's tip syndrome. Shoulder will be medially rotated, elbow extended and wrist flexed.
The brachial plexus is contained with the ______ sheath (which is a continuation of the ________ fascia).
Why is this significant?
What's outside the sheath?
B plexus is in axillary sheath, a continuation of prevertebral fascia.
You can put anesthetic into the sheath and it will run up and down, anesthetizing the plexus. T2 and the long thoracic nerve are OUTSIDE of the sheath.
What are 5 potential complications of injecting the axillary sheath?
1. pneumothorax
2. hitting the artery
3. Hitting the phrenic nerve (sits on top of the anterior scalene) --> paralyzing diaphragm
4. Hitting the recurrent laryngeal --> hoarseness
5. Honer's syndrome if anesthetic diffuses out and hits the sympathetic chain.
If a pt had severe pain in their C7,8 & T1 dermatomes, what's one (palliative) way to relieve this?
Cordotomy on contralateral side.
Put a needle in through the dentate ligament and sweep forward to sever the sensory fibers and prevent them from carrying pain to brain. ( may need to be done all the way up to C2-3)
Which nerve will provide shoulder stability even if all other nerves of the B plexus are lost?
Which nerve will supply the intrinsics of the hand?
Suprascapular nerve
T1
What do you do if someone has torn their B plexus but the roots are still attached to the spinal cord?
- a graft of what from where?
- which 3 nerves do you try to save and why?
- take the sural nerve b/c it's superficial (nerons will die but that's okay), use the schwann cells as scaffolding to guide the growing nerves
- Axillary nerve - to get deltoid so you can move your shoulder
Musculocutaneous nerve so that you can feel (ie prevent breakdown and loss)
Median nerve b/c supplies lots of muscles
What do you do if the roots of the B plexus are torn out of the spinal cord?
Can take neurons from the cervical plexus and/or the intercostals. But # of neurons in B plexus > # in Cervical plexus.
Try to save suprascapularis (stabilize the shoulder), axillary (flex the elbow) and musculocutaneous (sensation in hand)