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229 Cards in this Set
- Front
- Back
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What components make up the intervertebral discs? (2)
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1) Anulus fibrosus - adheres to vertebral bodies
2) Nucleus pulposus - gelatinous central mass; shock absorber |
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How are the two divisions of the ANS distinguished anatomically?
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Based on where the cell bodies originate:
1) Sympathetic: lateral horn of gray matter of spinal cord segments from T1 - L2 2) Parasympathetic: brainstem and gray matter of spinal cord segments S2 - S4 |
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How many neurons do visceral motor nerves have?
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Two
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How many neurons do visceral sensory nerves have and where is it located?
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One - dorsal root ganglion
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How many spinal nerves are there?
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31 (8, 12, 5, 5, 1)
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How many vertebra are there?
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33 (7, 12, 5, 5, 4)
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Other than its muscles, what does the musculocutaneous nerve do?
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Enters forearm as lateral cutaneous nerve (C5, C6, C7)
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What are characteristics and causes of an axillary nerve injury?
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Caused by fracture of surgical neck of humerus - leads to atrophy of deltoid and loss of rounded contour to shoulder
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What are characteristics of shoulder dislocations?
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Commonly dislocates inferiorly and often tears labrum, anterior joint capsule, and/or subscapularis tendon
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What are characterstics and causes of radial nerve injury?
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Caused by mid-shaft humerus fracture - leads to wrist drop because it can't extend hand
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What are interspinous ligaments?
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Adjoin adjacent spinous processes?
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What are intertransverse ligaments?
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Adjoin adjacent transverse processes?
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What are ligamentum flava?
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Yellow, elastic fibers that adjoin adacent lamina of vertebra and help prevent hyperflexion
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What are main lymph ducts and where do they empty?
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Right lymphatic duct (from right limb) and thoracic lymphatic duct (from left limb) - both return to venous system via subclavian veins
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What are the characteristics of the two types of rami communicantes?
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1) White Ramus Communicans - where the spinal nerve enters the sympathetic chain
2) Gray Ramus Communicans - where the sympathetic ganglion in the chain goes from the axon to the targeted organ |
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What are the components of the two neuron system of the ANS?
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1) Preganglionic or presynaptic neurons and
2) Postganglionic or postsynaptic neurons |
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What are the deep back muscles?
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- True (intrinsic) muscles of the back
1) Splenious 2) Erector spinae complex 3) Transversospinalis complex |
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What are the divisions of a spinal nerve?
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1) Dorsal Ramus - innervates true back muscles, vertebral column joints, and overlying skin
2) Ventral Ramus - innervates anterior and lateral body wall and extremities |
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What are the intermediate muscles in the back and what do they do?
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1) Serratus posterior superior
2) Serratus posterior inferior - Aid in respiratory control |
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What are the divisions of the deep muscles of the back? (3)
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1) Superficial Intrinsic Layer
2) Intermediate Intrinsic Layer 3) Deep Intrinsic Layer |
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What are the seven processes of vertebra?
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1) Spinous process (1)
2) Transverse process (2) 3) Articular process (4) - two superior and two inferior from arch |
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What are the spinal nerve roots?
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1) Ventral Root - conveys motor (efferent) nerve fibers away from spinal cord
2) Dorsal Root - conveys sensory (afferent) nerve fibers toward spinal cord |
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What are the superficial muscles of the back and what do they do?
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1) Trapezius
2) Latissimus dorsi 3) Levator scapulae 4) Rhomboids - They produce and control limb movement |
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What are unique characteristics of cervical vertebra? (3)
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1) Transverse process contains transverse foramen for the passage of vertebral artery
2) Spinous process is short and forked except C7 3) Articular facets are in horizontal plane |
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What are unique characteristics of lumbar vertebra? (2)
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1) They have mammillary process
2) Articular facets are in sagittal plane, allow anterior/posterior flexion/extension |
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What are unique characteristics of sacrum? (2)
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1) Transverse ridges mark anterior fusion sites
2) Ventral foramina allow passage of ventral rami and spinal nerves (dorsal foramina on posterior side) |
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What are unique characteristics of thoracic vertebra? (2)
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1) Vertebral bodies and transverse processes have costal facets
2) Articular facets are in coronal plane (allow for rotational movement) |
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What are zygopophysial joints?
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Facet joints which are plane-like synovial joints between adjacent superior/inferior articular processes
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What areas of spine have primary curvature?
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Thoracic and sacral
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What areas of the spine have secondary curvature and what causes it?
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Cervical (holding head upright) and lumbar (walking upright)
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What artculates with the olecranon fossa of humerus?
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Oclecranon process of proximal ulna when forarm is extended
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What articulates with the capitulum?
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Radius
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What articulates with the trochlea?
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Ulna
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What attaches to the infragelnoid tubercle?
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Long head of triceps
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What attaches to the supraglenoid tubercle?
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Long head of bicep
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What carpal bones make up the distal row (lateral to medial)?
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1) Trapezium (articulates with thumb)
2) Trapezoid 3) Capitate 4) Hamate (has hook of hamate) |
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What carpal bones make up the proximal row (lateral to medial)?
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1) Scaphoid (articulates with radius and is frequently broken)
2) Lunate (articulates with radius and is frequently dislocated) 3) Triquetrum 4) Pisiform |
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What components make up the intervertebral discs? (2)
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1) Anulus fibrosus - adheres to vertebral bodies
2) Nucleus pulposus - gelatinous central mass; shock absorber |
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What does the autonomic nervous system (ANS) innervate? (3)
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1) Viscera in body cavities
2) Smooth and cardiac muscle 3) Glands (sweat and salivary) |
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What does the intermediate intrinsic layer of the deep back muscles consist of?
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The erector spinae complex - important postural muscles
1) Iliocostalis (lateral) 2) Longissimus 3) Spinalis (medial) |
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What does the transverse humeral ligament do?
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Holds long head of bicep tendon in bicipital groove
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What innervates biceps brachii?
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Musculocutaneous nerve (C5, C6)
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What innervates brachialis?
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Muculocutaneous nerve (C5, C6)
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What innervates the anterior compartment of upper arm (flexor compartment)?
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Musculocutaneous nerve
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What innervates the deep muscles of the back and what is their function?
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Dorsal rami of spinal nerves - act specifically on vertebral column
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What innervates the latissimus dorsi?
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Thoracodorsal nerve (C6, C7, C8)
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What innervates the posterior (extensor) compartment of upper arm?
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Radial nerve
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What innervates the trapezius?
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Spinal accessory nerve (Cranial Nerve XI)
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What is action of biceps brachii?
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Flexes shoulder, flexes foraerm, powerful supinator
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What is an important component of the brachial fascia?
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The septa which connects brachial fascia to shaft of humerus - medial and lateral intermusuclar septa divide arm into anterior (flexor) and posterior (extensor) compartments
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What is important about the inferior ulnar collateral artery?
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It provides important anastomoses around elbow joint
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What is located above capitulum?
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Radial fossa
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What is located above trochlea?
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Coronoid fossa (coronoid process of ulna articulates here)
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What is the acronym to remember the erector spinae complex (lateral to medial)?
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I Like Standing
1) Iliocostalis 2) Longissimus 3) Spinalis |
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What is the anterior longitudinal ligament?
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Unites anterior surfaces of vertebral bodies and prevents hyperextension
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What is the craniosacral division of the ANS?
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Parasympathetic
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What is the glenoid labrum?
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Fibrocartilagenous ring that surrounds and "deepens" glenoid cavity
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What is the ligamentum nuchae?
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Broad, strong ligament of neck that provides attachment site for muscles
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What is the posterior longitudinal ligament?
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Unites posterior surfaces of vertebral bodies (located inside vertebral column)
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What is the purpose and structure of glenohumeral ligaments?
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Strengthens glenohumeral joint anteriorly - consists of superior, middle, and inferior ligaments
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What is the purpose of the coracoacromial ligament (arch)?
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Prevents superior shoulder dislocation
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What is the purpose of the intervertebral foramina?
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Provides passageway for spinal nerves and blood vessels to exit vertebral canal
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What is the sacral cornu?
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Horns at the inferor articular process of the S5 vertebra
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What is the sacral hiatus?
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An opening at the inferior aspect of the sacrum which represents the absence of formation of lamina and spinous process of S5 - important for epidurals
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What is the supraspinous ligament?
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Connects spinous process from sacrum to C7 and expands to ligamentum nuchae
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What is the sympathetic chain?
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Two parallel nerve cords that extend from syperior cervical ganglion to ganglion impar (where two trunks come together)
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What is the thoracolumbar division of the ANS?
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Sympathetic
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What is the thoracolumbar fascia?
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Multilayered fascia that surrounds and supports intrinsic back muscles - divided into anterior, middle, and posterior layers
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What is unique about coracobrachialis muscle?
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It is pierced and innervated by musculocutaneous nerve - provides useful landmark
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What kind of neurons make up somatic motor nerves?
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Multipolar
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What kinds of nuerons make up general sensory nerves?
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Pseudounipolar
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What makes up the intervertebral foramina?
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The superior vertebral notch (above pedicle) and the inferior vertebral notch (below pedicle)
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What makes up the superficial intrinsic layer of the deep back muscles?
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Splenious muscles in cervical region - extends neck or rotates it ipsolaterally
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What movement does the latissimus dorsi produce?
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Extends, adducts, and medially rotates humerus
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What muscle groups of the back are considered "extrinsic?"
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Superficial and intermediate muscle groups
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What muscles make up the deep intrinsic layer of the back muscles?
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Transversospinalis muscle group - connect transverse process to spinous process of more superior vertebrae
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What passes through the bicipital groove?
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Long head of biceps brachii
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What veins to superficial lymph vessels follow?
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Cephalic and basilic veins
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Where are cell bodies of general sensory nerves?
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Dorsal root ganglia
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Where are cell bodies of somatic motor nerves?
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Ventral horn
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Where are parasympathetic nerves found?
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Everywhere except the skin and limbs
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Where are postganglionic sympathetic neurons found?
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1) Paravertebral ganglia (sympathetic chain/trunk)
2) Prevertebral ganglia (located along aorta in abdomen) |
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Where are sympathetic nerves found?
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Where are sympathetic nerves found?
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Where does long head of biceps brachii insert?
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Supraglenoid tubercle
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Where does long head of triceps insert?
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Infraglenoid tubercle
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Where does radial nerve come from and what does it give rise to?
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Comes from posterior cord - gives rise to posterior cutaneous nerve
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Where does short head of biceps brachii insert?
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Coracoid process
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Where does the lateral head of triceps brachii insert?
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Posterior surface of humerus superior to radial groove (medial head inserts inferior to radial groove)
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Where is an important split of the brachial artery?
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At the profunda where it splits into the brachial artery and deep profunda brachial artery
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Where is brachial artery located?
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Along median nerve
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Where is brachialis located and what is its function?
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Deep to biceps brachii - primary flexor of forearm
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Where is deep profunda brachial artery found?
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Along the radial nerve
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Where is the radial groove and why is it important?
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Located on posterior humerus - passage of radial nerve and deep brachial artery
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Where is the serratus posterior inferior located?
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Deep to the latissimus dorsi
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Where is the serratus posterior superior located?
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Deep to the rhomboids
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Where is the superior ulnar collateral artery found?
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Along the ulnar nerve?
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What makes up the cubital fossa? (3)
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1) Superior border is imaginary line between medial and lateral epicondyles
2) Medial border is pronator teres 3) Lateral border is brachioradialis |
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What are the contents of the cubital fossa? (3)
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1) Tendon of biceps brachii
2) Brachial artery and terminal branches 3) Median nerve |
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What is a Colles' Fracture and what are it's characteristics?
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Distal radial fracture often from falling on outstretched hand - distal radial fracture fragment displaces dorsally which produces "dinner fork" deformity
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What makes up the thick band of fascia at the wrist?
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1) Extensor retinaculum (posterior)
2) Palmar carpal ligament (anterior) 3) Flexor retinaculum or transverse carpal ligament (deep and distal to palmar carpal ligament and forms root of carpal tunnel) |
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What are the superficial flexor-pronator muscles? (5)
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1) Pronator teres
2) Flexor carpi radialis 3) Palmaris longis 4) Flexor carpi ulnaris 5) Flexor digitorum superficialis |
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What innervates the superficial flexor-pronator muscles and what is the exception?
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Median nerve - except flexor carpi ulnaris is innervated by ulnar nerve
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What are the deep flexor-pronator muscles? (3)
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1) Flexor digitorum profundus
2) Flexor pollicis longus 3) Pronator quadratus |
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What innervates the deep flexor-pronator muscles and what is the exception?
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Anterior interosseous nerve (AIN - branch of median nerve) except lateral 1/2 of flexor digitorum profundus innervated by ulnar nerve
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What two muscles cause pronation of forearm and what are their characteristics?
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1) Pronator quadratus - initiates pronation distally
2) Pronator teres - assists pronator quadratus proximally |
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What innervates the pronator quadratus and pronator teres?
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Anterior interosseous nerve and the median nerve, respectively
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What are the three divisions of extensor muscles of forearm and what innervates them?
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1) Wrist
2) Digits 3) Thumb and abductors - All innervated by radial nerve |
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What are the extensors of the wrist? (3)
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1) Extensor carpi radialis lungus
2) Extensor carpi radialis brevis 3) Extensor carpi ulnaris |
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What are the extensors of the digits? (3)
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1) Extensor digitorum
2) Extensor indicis (deep to the digitorum) 3) Extensor digiti minimi |
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What is the extensor expansion hood of digits and where do the bands go?
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Where long tendons of digit extensors insert into the digits - central band goes to middle phalynx and lateral bands go to distal phalynx
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What are the extensors and abductors of the thumb?
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1) Abductor pollicis longus
2) Extensor pollicis brevis 3) Extensor pollicis longus |
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Where to ganglion or synovial cysts often present and originate?
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Present on dorsum of wrist - often on tendon of extensor carpi radialis/brevis
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What are the boundaries of the anatomical snuff box?
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1) Abductor pollicis longus
2) Extensor pollicis brevis 3) Extensor pollicis longus |
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What can be appreciated in the anatomical snuff box?
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Radial artery, scaphoid bone, and styloid process of radius
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What is the brachioradialis and what innervates it?
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It is a flexor muscle although it is considered in the posterior compartment - innervated by radial nerve (also courses beneath it)
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What is the supinator and what innervates it?
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Very unique appearance (on proximal forearm) and innervated by deep radial nerve
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What are the branches of the radial nerve?
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1) Superficial branch - cutaneous and sensory to hand
2) Deep branch - motor -- pierces supinator to enter extensor compartment and continues to posterior interosseous nerve |
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Where is the radial nerve found?
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Courses beneath brachioradialis
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Where is a common site of impingement of the ulnar nerve?
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"Canal of Guyon" - between hook of hamate and pisiform
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What flexors are supplied by the ulnar nerve?
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Lateral 1/2 of flexor digitorum profundus and flexor carpi ulnaris
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Where does the median nerve course?
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Between the flexor digitorum superficialis and profundus
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What are the branches of the median nerve?
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Anterior interosseous nerve and msucular branch (innervates all anterior muscles (flexors) except 1/2 of FDP and flexor carpi ulnaris) - also has palmar branch
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What is the annular ligament of the elbow and its signifigance?
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It blends with the radial collateral ligament and connects to ulna - forms a collar around radius to allow free movement of radioulnar joint - site of Nursemaid's Elbow
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What is Gamekeeper's or Skier's thumb?
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Rupture of ulnar collateral ligament resulting from hyperextension - often fractures base of proximal phalynx of thumb
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What is the primary nerve of flexors?
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Median nerve
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What are two sites of ulnar nerve entrapment?
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Posterior of medial epicondyle and canal of guyon
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What is the acronym for innervations of the radial nerve?
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BEST - brachioradialis, extensors, supinator, and triceps
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How many spinal nerves are there?
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31 (8, 12, 5, 5, 1)
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Where does the spinal cord exist in adults?
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2/3 of vertebral canal
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Where does the spinal cord end in adults?
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Around level of L2 vertebra - can be L1 or T12
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What is the cauda equina?
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Collection of lumbar and saccral/coccygeal nerve roots consisting of dorsal and ventral rami
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What is the dural sac?
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Surrounds spinal cord and extends from base of the skull to S2 level - past the end of the spinal cord
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What is the conus medullaris?
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Tapered terminal portion of spinal cord - around L2
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What is the filum terminale and it's two components?
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Remnant of caudal spinal cord that was tail of embryo:
1) Internal - from medullary core to end of dural sac 2) External - from end of dural sac to saccrum/coccyx to help anchor cord inferiorly |
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What are the three layers of meninges?
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1) Dura matter
2) Arachnoid matter 3) Pia matter |
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What is orientation of arachnoid matter?
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It is held against the dura matter from the pressure of CSF - it encloses the subarachnoid space which includes CSF, spinal cord, nerves, and dorsal root ganglia
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What is the dural sleeve?
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Lateral extension of dura matter through intervertebral foramina along ventral and dorsal roots
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What is located in the epidural space?
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Adipose tissue and the internal (epidural) venous plexus
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What are the characteristics of the internal (epidural) venous plexus?
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1) Drains blood from veins on spinal cord and vertebral bodies via basivertebral vein
2) No valves - so blood can move in either direction (can cause cancer to develop here or spread to brain) |
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What are the primary arteries of the spinal cord?
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Vertebral artery and intercostal arteries - they have longitudinal vessels that go vertically and feeder vessels that travel in/out of IV foramen
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What are the primary longitudinal arteries of spinal cord?
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Anterior and posterior longitudinal - reinforced by medullary arteries (largerst is great anterior segmented artery)
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What is the order of structures entered in a lumbar spinal tap?
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1) Supraspinous ligament
2) Interspinous ligament 3) Ligamentum flavum 4) Dural/arachnoid membrane |
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What is a caudal epidural block and its usefulness?
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Anesthetic injected into epidural space through sacral canal - common in peds to block lumbar/saccral nerve roots for hernia repair, circumcision, etc
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What causes herniated disc and where does the prolapse typically occur?
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A weakened (age or trauma) anulus fibrosus can tear and allow the nuclues pulposus to herniate - often occurs posterolaterally where anulus fibrosus is thin and poorly supported by posterior longitudinal ligament
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What are common sites of herniation and what nerves are usually affected? (2)
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1) b/w L4 and L5 - L5 nerve affected
2) b/w L5 and S1 - S1 nerve affected |
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What are enclosed by the fibrous digital sheaths?
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Tendons of the flexor digitorum profundus and superficialis
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What are the ligaments inside each fibrous digital sheath?
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Annular (5) and cruciform (4)
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What are synovial tendon sheaths and what is it called when they are inflammed?
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Tubular envelopes containing synovial membrane/fluid around tendons - tenosynovitis
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What muscles are in the hypthenar compartment and what innervates them?
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1) Abductor digiti minimi
2) Flexor digiti minimi 3) Opponens digiti minimi - Innervated by deep branch of ulnar nerve |
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What muscles are in the thenar compartment and what innervates them?
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1) Abductor pollicis brevis
2) Flexor pollicis brevis 3) Opponens pollicis - Innervated by recurrent branch of median nerve |
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What makes up the adductor compartment and its innervation?
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Adductor pollicis - deep branch of ulnar nerve
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Where are lumbricals located and what is their action?
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Arise from tendons of flexor digitorum profundis - they flex MCP joint and extend IP joint ("L" shape or "bye-bye" motion)
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What is the innervation of the four lumbricals?
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Lateral two - median nerve
Medical two - ulnar nerve |
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Where are the palmer interossei muscles located and what is their action/innervation?
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Metacarpals 2, 4, 5 - adductors innervated by deep branch of ulnar nerve - PADS
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Where are the dorsal interossei muscles located and what is their action/innervation?
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Metacarpals 2, 3, 4, 5 - abductors innervated by deep branch of ulnar nerve - PADS
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What are the extrinsic hand muscles?
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1) Flexor pollicis longus
2) Flexor digitorum profundus 3) Flexor digitorum superficialis |
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What is in the carpal tunnel and where does it pass?
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9 tendons (4 from FDP, 4 from FDS, 1 from flexor pollicis longus) and the median nerve - travels under transverse carpal ligament (aka flexor retinaculum)
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What are the branches of the median nerve?
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1) Recurrent branch - supplies thenar muscles
2) Motor fibers - innervate lateral two lumbricals 3) Common/proper branches - lateral 3.5 fingers 4) Palmar carpal branch - central palm area |
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What causes carpal tunnel syndrome and how does it present?
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Impingement of the median nerve - causes changes of sensation in lateral 3.5 digits and/or loss of motor function in thenar muscles
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Where does ulnar nerve pass into the hand?
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Over the flexor retinaculum along ulnar artery and through the canal of Guyon
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What are the branches of the ulnar nerve?
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1) Deep branch - intrinsic muscles of hand
2) Superficial branch (common/proper) - medial 1.5 digits |
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What are the main arteries in the hand and where do they primarily come from?
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1) Superficial palmar arch - ulnar artery
2) Deep palmar arch - radial artery |
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What spinal nerve root innervates all intrisic muscles of the hand?
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C8 and T1
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What is the action and innervation of the serratus anterior?
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Laterally rotates and protracts the scapula - long thoracic nerve (C5,6,7, reach your arms to heaven)
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What causes winged scapula and how does it present?
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Damage to long thoracic nerve - unable to abduct arm above head and scapula won't stay against thoracic wall
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What are the superficial posterior shoulder muscles?
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1) Trapezius
2) Latissimus dorsi - Extrinsic shoulder muscles |
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What are the deep posterior shoulder muscles?
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1) Levator scapula
2) Major and minor rhomboids - Extrinsic shoulder muscles |
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What is the action and innervation of the trapezius?
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Shrugs shoulders - CN XI (spinal accessory nerve)
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What is the action and innervation of the latissimus dorsi?
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Adducts and extends upper arm - thoracodorsal nerve
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What is the action and innervation of the levator scapula?
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Elevates and rotates scapula - dorsal scapular nerve
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What is the action and innervation of the rhomboids?
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Deep to trapezius, retract and rotate scapula - dorsal scapular nerve
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What are the muscles of the scapulohumeral area?
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1) Deltoid
2) Teres major 3 - 6) Rotator cuff muscles - SITS - supraspinatus, infraspinatus, teres minor, subscapularis |
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What is the action and innervation of the deltoid?
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Principal abductor of upper arm (although supraspinatus does first 15 degrees) - axillary nerve
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What is the action and innervation of the teres major?
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Adducts and medially rotates arm - lower subscapular nerve
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What is the action and innervation of the supraspinatus?
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Initiates abduction of the arm - suprascapular nerve (most commonly injured muscle/tendon of the rotator cuff)
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What is the action and innervation of the infraspinatus?
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Laterally rotates arm - suprascapular nerve
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What is the action and innervation of the teres minor?
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Laterally rotates arm - axillary nerve
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What is the action and innervation of the subscapularis?
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Medially rotates and adducts arm - upper and lowersubscapular nerves
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Where do rotator cuff muscles insert?
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Greater tubercle - S,I,T
Lesser tubercle - Subscapularis |
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What is the function of subacromial bursa?
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Separate deltoid and supraspinatus to reduce friction
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What makes up the suprascapular notch?
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Covered by superior transverse scapular ligament - suprascapular nerve passes through it to innervate spinatus muscles and suprascapular artery passes over ligament
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What passes through quadrangular space?
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Axillary nerve and posterior circumflex humeral artery
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What are the boundaries of the quandrangular space?
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Teres major, long head of triceps, teres minor, and surgical neck of humerus
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What passes through the triangular space?
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Circumflex scapular artery
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What are the boundaries of the triangular space?
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Teres major, teres minor, long head of triceps
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What is the C5 dermatome?
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Tip of shoulder
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What is the C6 dermatome?
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Thumb
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What is the C7 dermatome?
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Index finger
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Wat is the C8 dermatome?
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Middle finger
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What is the T1 dermatome?
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Medial arm
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What is the cervicoaxillary inlet?
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Passage of axillary artery, ven, and brachial plexus
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What are the ligaments of the sternoclavicular joint?
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Anterior/posterior SC ligament, interclavicular ligament, costoclavicular ligament
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What are the ligaments of the acromioclavicular joint?
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1) AC ligament - superior strength
2) Coracoacromial ligament 3) Coracoclavicular extrinsic ligaments |
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What are the 3 degrees of AC dislocation?
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1st) Stretch or minor tear of AC ligament
2nd) Rupture of AC ligament with subluxation of joint 3rd) AC and coracoclavicular ligaments torn - "shoulder separation" |
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What is the action and innervation of the pectoralis major?
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Adductor and medial rotator of arm - medial and lateral pectoral nerve
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What is the action and innervation of the pectoralis minor?
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Stabilized scapula and some respiratory action - medial pectoral nerve (some by lateral pectoral nerve which courses along medial border)
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What are the main branches of the axillary artery?
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1) Subscapular
2) Anterior and posterior humeral circumflex |
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What is the progression and landmarks of the subclavian artery?
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Subclavian until 1st rib, axillary until teres minor, then brachial
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What are the five segments of the brachial plexus?
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1) Roots
2) Trunks 3) Divisions 4) Cords 5) Branches - "Real Tarheels Drink Cold Beer" |
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What are the roots of the brachial plexus?
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C5, C6, C7, C8, T1
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What are the three trunks of the brachial plexus and their root?
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1) Superior - C5, C6
2) Middle - C7 3) Inferior - C8, T1 |
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What are the divisions of the brachial plexus?
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1) Anterior - go into medial and lateral cord (flexors)
2) Posterior - go into posterior cord (extensors) |
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What are the cords of the brachial plexus?
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1) Lateral
2) Medial 3) Posterior - Named relative to their position to the axillary artery |
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What leads into the lateral cord of the brachial plexus?
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Superior and middle trunks (anterior division)
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What leads into the medial cord of the brachial plexus?
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Inferior trunk (anterior division)
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What leads into the posterior cord of the brachial plexus?
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All three trunks (posterior division)
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What are the branches of the lateral cord of the brachial plexus?
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1) Musculocutaneous nerve - dives into coracobrachialis
2) Lateral root of median nerve |
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What are the branches of the medial cord of the brachial plexus?
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1) Medial root of median nerve
2) Ulnar nerve |
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What are the branches of the posterior cord of the brachial plexus?
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1) Axillary nerve (branches proximally)
2) Radial nerve |
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What is innervated by the musculocutaneous nerve?
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Flexors of arm (C5, 6, 7)
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What is innervated by the ulnar nerve?
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Intrinsic muscles of the hand and lateral 1.5 digits (C7, 8, T1)
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What is innervated by the axillary nerve?
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Deltoid and teres minor (C5, 6)
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What is innervated by the radial nerve?
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Extensors in arm and forarm (C5 - T1)
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What is innervated by the median nerve?
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Flexors of forearm and some hand (C5 - T1)
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What is unique about the intercostobrachial nerve?
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Only arm nerve that doesn't originate from the brachial plexus - cutaneous nerve to medial arm
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What muscles do the brachial plexus and subclavian arteries pass through in the neck region?
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Anterior and middle scalene muscles
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Innervation/presenting injury of damage to long thoracic nerve?
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Serratus anterior - damage causes winged scapula and limited abduction of arm over head
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Innervation/presenting injury of damage to suprascapular nerve?
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Supraspinatus - damage causes weak abduction
Infraspinatus - damage causes weak lateral rotation |
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Innervation/presenting injury of damage to thoracodorsal nerve?
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Latissimus dorsi - damage causes weak adduction and medial rotation of arm. General trouble climbing, rowing, getting up out of a chair.
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Innervation/presenting injury of damage to axillary nerve?
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Deltoid and teres minor - damage leads to loss of rounded contour of shoulder, limited abduction and later rotation of arm. Also loss of sensation to lateral shoulder area.
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Innervation/presenting injury of damage to musculocutaneous nerve?
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Anterior compartment muscles of arm - damage causes weak forearm flexion, supination, and sensory loss to lateral forearm
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What are causes and effects of upper brachial plexus injury?
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- Caused by extreme lateral stretching between head and shoulder
- Called "Erb's Palsy or Erb's-Duchenne Palsy" - Resulting limb is adduted, pronated, extended at elbow - "Waiter's tip hand" |
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What are causes and effects of lower brachial plexus injury?
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- Caused by sudden suprior pulling of upper extremity
- Called "Klumpke's Palsy" - Devastating injury that paralyzes short intrinsic muscles of hand - Results in claw hand and sensory loss to medial arm and hand |
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What are four characteristics of high median nerve injury?
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1) Weak/paralyzed anterior forearm muscles
2) Atrophy of thenar muscles (loss of opposition) 3) Sensory deficits in lateral 3.5 fingers 4) Hand of Benediction when making fist |
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What are causes and characteristics of radial nerve damage?
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- Caused by humeral fracture near radial groove
- Paralyzed wrist/finger extensors - Wrist drop |
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What are effects of ulnar nerve damage?
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- Affect intrinsic hand muscles
- Difficulty performing fine motor tasks - Sensory loss to medial 1.5 digits - "Ulnar Claw Hand" |
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What are the general nerve roots on the anterior arm?
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Shoulder - C5, C6
Upper Arm - C5, C6 Forearm Superficial - C6, C7, C8 Deep - C7, C8, T1 Hand - C8, T1 |
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What are the exceptions to the general nerve roots on the anterior arm?
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BS muscles - brachioradialis and supinator both innervated by C5, C6
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What are the differences of the general nerve roots on the posterior arm?
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Upper arm - C6, C7, C8 (versus C5, C6 on anterior)
Forearm - C6, C7, C8 (versus T1 on deep anterior arm) |
