brachial plexus Flashcards

1
Q

Components of Brachial Plexus

A

VPR of C5-C8 and greater part of T1

Small contri-butions from C4 and T2

Contributions to the brachial plexus from the ventral primary rami of C4 and T2 can vary

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2
Q

Components of Brachial Plexus - C4 is large

A

This is a prefixed type of plexus.

T2 is frequently lacking
T1 contribution is reduced.

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3
Q

Components of Brachial Plexus - C4 is reduced or absent

A

postfixed type of plexus.

C5 contribution is usually reduced
T1 is larger than normal
T2 is always present

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4
Q

Organization of Brachial Plexus

A

Remember To Drink Cold Beer

Roots
Trunks
Divisions
Cords
Terminal Branches

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5
Q

Roots

A

VPR of C5-T1 (small contributions from C4 & T2)

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6
Q

Trunks

A

Upper - C5, C6
Middle - C7
Lower - C8, T1

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7
Q

Divisions

A

Anterior
Posterior

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8
Q

Terminal Branches

A

Musculocutaneous nerve
Median nerve
Ulnar nerve
Axillary nerve
Radial nerve

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9
Q

The trunks and divisions of the brachial plexus are located

A

in the posterior triangle of the neck, emerging from between scalenus anterior and scalenus medius.

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10
Q

where does the subclavian artery arrise

A

posterior triangle of the neck

between scalenus anterior and scalenus medius.

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11
Q

neurovascular compression syndrome result from

A

if the scalenus anterior and scalenus medius spasm, they may compress the nerves and artery

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12
Q

clavicle and subclavius muscle and the brachial plexus

A

The brachial plexus then passes behind them

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13
Q

what muscle does the brachial plexus lie on

A

upper part of serratus anterior and subscapularis muscles

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14
Q

C5 and C6 receive gray rami from

A

middle cervical ganglion

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15
Q

C7 and C8 receive gray rami from

A

the cervicothoracic ganglion

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16
Q

T1 receives gray rami from and sends white rami to

A

the cervicothoracic ganglion

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17
Q

Supraclavicular branch of the brachial plexus

A

branches arising from the roots or trunks (proximal to the clavicle),

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18
Q

Infraclavicular branch of the brachial plexus

A

branches arising from the cords (distal to the clavicle)

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19
Q

Supraclavicular Branches names

A

Dorsal scapular nerve

Long thoracic nerve

Suprascapular nerve

The nerve to subclavius

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20
Q

Dorsal Scapular Nerve segmental

A

C5 VPR

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21
Q

Dorsal Scapular Nerve pierces what

A

pierces scalenus medius

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22
Q

Dorsal Scapular Nerve runs with what nerve

A

runs with the dorsal scapular artery to the vertebral border of the scapula

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23
Q

Dorsal Scapular Nerve innervation

A

twig to levator scapulae

then runs deep to rhomboids major and minor to innervate both of those muscles.

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24
Q

Long Thoracic Nerve segmental

A

C5, C6, C7 VPR

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25
Q

Long Thoracic Nerve innervates

A

serratus anterior

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26
Q

Long Thoracic Nerve runs with

A

lateral thoracic artery

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27
Q

Suprascapular Nerve segmental

A

C5, C6

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28
Q

Suprascapular Nerve arrise from what part of the brachial plexus

A

upper trunk

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29
Q

Suprascapular Nerve path

A

runs deep to trapezius –> suprascapular notch under the superior transverse scapular ligament –> supraspinous fossa –> spinoglenoid notch –> infraspinous fossa

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30
Q

Suprascapular Nerve run with

A

suprascapular artery

travels over the transverse scapular ligament

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31
Q

Suprascapular Nerve muscular innervation

A

supraspinatus and infraspinatus

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32
Q

Suprascapular nerve cut innervation

A

sensory branches to the shoulder joint, AC joint and scapula

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33
Q

infraclavicular branches names

A

lateral and medial pectoral nerves
upper and lower subscapular nerves
thoracodorsal nerve
axillary nerve
musculocutaneous nerve
medial cutaneous nerves of the arm and forearm
median nerve
ulnar nerve
radial nerve

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34
Q

Lateral Pectoral Nerve segmental

A

C5, C6, C7

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35
Q

Lateral Pectoral Nerve from what part of the brachial plexus

A

the lateral cord

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36
Q

Lateral Pectoral Nerve innervates

A

deep surface of pectoralis major.

forms a loop with the medial pectoral nerve to supply pectoralis minor.

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37
Q

Medial Pectoral Nerve segmental

A

C8, T1

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38
Q

Medial Pectoral Nerve from what part of the brachial plexus

A

the medial cord

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39
Q

Medial Pectoral Nerve innervation

A

supplies pectoralis minor.

also sends some branches to supply pectoralis major.

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40
Q

Upper and Lower Subscapular Nerves
segmental

A

C5 and C6

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41
Q

upper subscapular nerve from what part of the brachial

A

posterior cord

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42
Q

upper subscapular innervation

A

subscapularis

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43
Q

lower subscapular nerve from what part of the brachial

A

posterior cord

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44
Q

lower subscapular nerve innervation

A

teres major and subscapularis.

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45
Q

Thoracodorsal Nerve segmental

A

C6, C7, C8

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46
Q

Thoracodorsal Nerve from what part of the brachial

A

posterior cord between the upper and lower subscapular nerves

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47
Q

Thoracodorsal Nerve innervation

A

lattissimus dorsi.

48
Q

Thoracodorsal Nerve runs with

A

thoracodorsal branch of the subscapular artery

49
Q

Axillary Nerve segmental

A

C5, C6

50
Q

Axillary Nerve from what part of the brachial

A

terminal branches of the posterior cord

51
Q

Axillary Nerve travels with what

A

posterior circumflex vessels to the back of the humerus.

52
Q

Axillary Nerve is part of what space

A

quadrangular space

with the posterior circumflex humeral artery and across the back of the surgical neck of the humerus

53
Q

Axillary Nerve musculature innervation

A

deltoid and teres minor.

54
Q

Axillary Nerve cutaneous branch

A

superior lateral cutaneous nerve of the arm

55
Q

superior lateral cutaneous nerve of the arm innervates what

A

skin over the lower deltoid.

56
Q

Musculocutaneous Nerve segmental

A

C5, C6, C7

57
Q

Musculocutaneous Nerve what part of the brachial

A

a terminal branch of the lateral cord

58
Q

Musculocutaneous Nerve pierces what muscle

A

the coracobrachialis

59
Q

Musculocutaneous Nerve descends where

A

between the biceps brachii and brachialis muscles

60
Q

Musculocutaneous Nerve innervation

A

coracobrachialis, biceps brachii and most of brachialis.

61
Q

Musculocutaneous Nerve becomes what nerve and where

A

Lateral to the biceps tendon, the musculoctaneous nerve pierces the deep fascia to become the lateral cutaneous nerve of the forearm

lateral cutaneous nerve of the forearm

62
Q

lateral cutaneous nerve of the forearm supplies what

A

supplies the skin of the lateral forearm

from the Musculocutaneous Nerve

63
Q

Medial Cutaneous Nerve of Arm segmental

A

C8, T1

64
Q

Medial Cutaneous Nerve of Arm what part of the brachial plexus

A

arises off the medial cord

65
Q

Medial Cutaneous Nerve of Arm receive a branch from where

A

intercostobrachial nerve from T2

66
Q

Medial Cutaneous Nerve of Arm descend where on the arm

A

descends on the arm medial to the brachial artery and basilic vein

67
Q

Medial Cutaneous Nerve of Arm supplies the skin of what

A

medial arm

68
Q

Medial Cutaneous Nerve of forearm segmental

A

C8, T1

69
Q

Medial Cutaneous Nerve of Forearm what part of the brachial plexus

A

arises from the medial cord

70
Q

Medial Cutaneous Nerve of Forearm perieces what

A

pierces the brachial fascia with the basilic vein and distributes its branches.

71
Q

Medial Cutaneous Nerve of Forearm innervation

A

skin over the biceps and the medial forearm.

72
Q

Median Nerve segmental

A

all - C5, C6, C7, C8, T1

73
Q

Median Nerve descends the arm with

A

brachial art

descends deep to flexor digitorum superficialis.

74
Q

Median Nerve cubital fossa

A

medial to the brachial artery

75
Q

Median Nerve where does it enter the forearm

A

between the two heads of pronator teres

potential area for entrapment,

76
Q

Median Nerve At the wrist

A

the median nerve lies between the tendons of flexor digitorum superficialis and flexor carpi radialis.

under the flexor retinaculum

77
Q

carpal tunnel

A

fascial tunnel at the wrist

a common site for entrapment of the median nerve.

78
Q

Branches of the Median Nerve - Autonomic fibers

A

to the brachial artery in the arm

79
Q

Branches of the Median Nerve - Articular branches

A

to the elbow and proximal radioulnar joints

80
Q

Branches of the Median Nerve - Muscular branches forearm

A

Pronator teres
Flexor carpi radialis
Palmaris longus
Flexor digitorum superficialis

81
Q

what branch does the median nerve give out

A

anterior interosseous nerve

82
Q

anterior interosseous nerve travels where

A

descends on the interosseous membrane with the anterior interosseous artery.

83
Q

Anterior interosseous nerve distribution - Articular branches to

A

Distal radioulnar jt
Radiocarpal and intercarpal jts
MCP and IP joints.

84
Q

Anterior interosseous nerve distribution - Muscular branches

A

deep muscles of anterior forearm:

Flexor digitorum profundus (lat. 1/2)
Flexor pollicis longus
Pronator quadratus

85
Q

Branches of Median Nerve - Muscular branches hand

A

Superficial head of flexor pollicis brevis
Abductor pollicis brevis
Opponens pollicis
1st and 2nd lumbricals

86
Q

Median nerve - The cutaneous distribution

A

palmar surface of the hand and fingers from the thumb to the lateral side of the ring finger, and the corresponding nail beds on the dorsum of the fingers

87
Q

Ulnar Nerve segmental

A

C7, C8, T1

88
Q

Ulnar Nerve is from where in the brachial plexus

A

terminal branch of the medial cord

89
Q

Ulnar Nerve descends the medial arm with

A

superior ulnar collateral artery

90
Q

Ulnar Nerve passes through what fascia bridge

A

Arcade of Struthers

91
Q

where does the Ulnar Nerve pass at the elbow

A

passes behind the medial epicondyle through the Cubital Tunnel

area of entrapment

92
Q

what is the Arcade of Struthers

A

a fascial bridge formed between the medial intermuscular septum and the medial head of the triceps

area for entrapment

93
Q

Ulnar Nerve in the anteromedial forearm passes where

A

passes between the two heads of flexor carpi ulnaris

94
Q

in the forearm what does the Ulnar Nerve descend with

A

ulnar artery.

95
Q

At the wrist the location of the Ulnar Nerve

A

ulnar nerve is lateral to the flexor carpi ulnaris tendon and medial to the ulnar artery

96
Q

what does the Ulnar Nerve passes into the hand with and where

A

It passes into the hand with the ulnar artery, both deep to the volar carpal ligament but superficial to the flexor retinaculum

97
Q

Tunnel of Guyon

A

an osseofibrous tunnel

created by:
created between the pisiform and the hook of the hamate
covered by the volar carpal ligament
floor of the tunnel is formed by the flexor retinaculum and the pisohamate ligament.

potential site of entrapment

98
Q

Ulnar Nerve travels with what in the hand and under what

A

deep palmar branch of the ulnar artery

Tunnel of Guyon

99
Q

Branches of the Ulnar Nerve - Articular branch

A

Articular branch to elbow

100
Q

Branches of the Ulnar Nerve - Muscular branches

A

Flexor carpi ulnaris
Flexor digitorum profundus (medial 1/2)
- Palmaris brevis

101
Q

Branches of the Ulnar Nerve - Cutaneous branches

A

to palmar and dorsal medial hand, little finger and medial side of the ring finger

102
Q

Deep terminal branch is muscular - ulnar nerve

A

Abductor digiti minimi
Flexor digiti minimi
Opponens digiti minimi
Interossei
3rd & 4th lumbricals
Adductor pollicis
Deep head of flexor pollicis brevis

103
Q

Radial Nerve travels where in the arm

A

radial nerve passes behind the arm and descends in the radial groove of the humerus between the lateral and medial heads of the triceps

104
Q

what does the Radial Nerve travel with in the arm

A

arteria profunda brachii

105
Q

what does the Radial Nerve pierce to get to the front of the arm

A

pierces the lateral intermuscular septum to reach the anterior surface

106
Q

what does the Radial Nerve do in front of the lateral epicondyle

A

divides into superficial and deep branches.

107
Q

deep branch of Radial Nerve travels where

A

passes between the two heads of the supinator through the Arcade of Frosche

area of entrapment

108
Q

what does the deep Radial Nerve emerge as after piercing the supinator

A

posterior interosseous nerve

109
Q

Radial Nerve - muscular branches

A

Triceps brachii
Anconeus
Brachioradialis
Brachialis (C7 from radial; C5,6 from musculocutaneous)
Extensor carpi radialis longus

110
Q

Radial Nerve - sensory nerves

A

Posterior cutaneous nerve of arm
Inferior lateral cutaneous nerve of arm
Posterior cutaneous nerve of forearm

Articular branches to elbow joint

111
Q

Superficial Branch of Radial Nerve supplies what

A

divides into 4 or 5 dorsal digital nerves to supply the skin of
- lateral thenar eminence
- dorsal thumb
- index and middle fingers
- lateral half of ring finger

(up to the nail beds)

112
Q

Deep brach of the Radial Nerve - descends between and travels with what

A

superficial and deep extensor muscles of the forearm with the posterior interosseous artery.

113
Q

deep brach of the Radial Nerve - musculature

A

Extensor carpi radialis brevis
Supinator
Extensor digitorum
Extensor digiti minimi
Extensor carpi ulnaris
Extensor pollicis longus
Extensor indicis
Abductor pollicis longus
Extensor pollicis brevis

114
Q

Radial Nerve segmental

A

C5, C6, C7, C8, T1

the largest branch of the brachial plexus

115
Q

Radial Nerve

A