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11 Cards in this Set
- Front
- Back
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Brachial Plexus: which roots does it come from and what happens to roots?
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C5-T1 Ventral Rami roots make up BP
The roots will form trunks The trunks will divide to form divisions The divisions will form cords Cords will have terminal branches (long branches running to forearm, hand, etc) |
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Brachial Plexus: what is the relationship with it in respect to the Axillary artery?
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It forms an M shape around the Axillary artery
One aspect of the M will have lateral cord, other aspect of the M will have the Medial Cord The V shaped portion of the M will have Lateral roots and medial roots respectively |
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Innervation of upper limb: pattern?
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The innervation of the upper limb follows a compartmentalized pattern.
Example: In the arm (brachium), the medial and lateral intermuscular septa divide the anterior and posterior compartments Anterior contains flexors and posterior has extensors Anterior compartment (biceps, brachialis,) innervated by musculocutaneous nerve Posterior Compartment (triceps) - radial nerve |
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Forearm Compartmentalization
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Forearm is made up of antebrachium and hand
Anterior Compartment: Flexor Muscles : innervated by the ulnar and median nerves Posterior Compartment: extensor muscles: innervated by the Radial Nerve |
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Injuries to superior trunk (C5 and C6 Spinal nerve roots)
Erbs Palsy |
Can result from excessive, foreful increase in angle between neck and shoulder. (could happen due to issues in delivery)
Sensory Deficits: Lateral aspect of upper limb will lose some sensation. Motor Deficits; loss of arm abduction, elbow flexion, loss of forearm supination, weakness of wrist extension Clinical Presentations: Upper limb adducted, medially rotated, extended elbow and flexed wrist (TIS will be in waiter's tip position) |
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Injury to Inferior Trunk C8 and T1 spinal nerve roots:
Klumpke's Palsy |
Can happen when limb is suddenly/forcefully pulled in the superior direction
Sensory Deficit: Medial aspect of upper limb (except axilla) Motor Deficit: Loss of precise finger movement, weakness in forearm pronation, weakness of wrist and finger flexion, weakness of wrist and finger extension Clinical Presentation: claw hand, wasting of the intrinsic hand muscles, attempted extension of digits (will leave 4th and 5th digits flexed |
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Radial Nerve Injury C5-T1
Saturday Night Palsy |
Radial nerve is posterior and travels in the radial nerve groove and the deep brachial artery also is around here.
Causes: midshaft fractures of humerus, improper use of crutches Extensor (posterior) compartments are affected Clinical Presentation: Wrist drop, paresthesia and or pain along course of nerve Saturday night palsy: nerve gets pinched due to sleep position resulting in loss of ability to extend wrist and digits |
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Axillary Nerve Injuries (C5 and C6)
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Causes: fracture to surgical neck of humerus, dislocation of the glenohumeral joint, improper usage of backpack
Impaired or lost function of deltoid and teres minor Clinical Presentation: Patient would be unable to fully abduct their arm, may have reduced ability to laterally rotate arm Paresthesia/pain along course of nerve |
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Injury to Long Thoracic Nerve (C5, C6, C7)
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Causes: nerve damage during surgical removal of lymph nodes/tissues in axillary region, penetration trauma to axillary region
Affects: serratus anterior Clinical Presentation: winged scapula and will not be able to raise the arm past 90 degrees |
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Ulnar Nerve Injuries : C8, T1, and often C7
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Causes: fracture of medial epicondyle of humerus, fracture of proximal ulna, slashed medial wrist
Affects posterior compartment Affects: flexors of wrist, digits, and intrinsic hand muscles Clinical Presentation: radial deviation at wrist joint, loss of abduction and adduction of fingers, weak wrist flexion and loss of flexion of some digits. The loss of these functions depend on the location of where the nerve is damaged. |
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Injuries to Median Nerve C6-T1 Spinal Nerve roots
Pope's blessing Ape Hand |
Causes: Injured by fracture of humerus abov e the condyles, slashing of the wrist, or by inflammation or irritation of carpal tunnel
Affected: flexors of wrist and digits, intrinsic hand muscles (especially those that move thumb), paresthesia and/or pain along affected areas of median nerve Pope's blessing: inability to flex second and third digits when attempting to make a fist Ape hand: thenar eminence atrophy and loss of thenar opposition |
