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LCRS Y2: Anatomy of the limbs > 5. The Brachial Plexus > Flashcards

5. The Brachial Plexus Flashcards

1
Q

What nervous element forms the roots of the brachial plexus?

A

Anterior rami C5-T1

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2
Q

Name each of the trunks of the brachial plexus and the nerves that run into them

A

Superior - C5, C6
Middle - C7
Inferior - C8, T10

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3
Q

Recall the general branching pattern of the brachial plexus

A

5 roots (C5-T1)
3 trunks (sup, mid, inf)
Each trunk divides into post and ant divisions
Posterior divisions converge to posterior cord
Anterior divisions of sup and mid trunk converge to form lateral cord
Anterior division of inferior trunk –> medial cord
Cords split to form peripheral nerves

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4
Q

What are the main nerves branching from the lateral cord?

A

Musculocutaneous

Median (via lateral root)

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5
Q

What are the main nerves branching from the posterior cord?

A

Radial

Axillary

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6
Q

What are the main nerves branching from the medial cord?

A

Ulnar

Median (via medial root)

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7
Q

Recall the roots that supply the musculocutaneous nerve

A

C5, C6, C7

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8
Q

Recall the roots that supply the axillary nerve

A

C5, C6

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9
Q

Recall the roots that supply the ulnar nerve

A

C8, T1

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10
Q

Recall the roots that supply the median nerve

A

C6, C7, C8, T1

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11
Q

Recall the roots that supply the radial nerve

A

All in BP (C5–> T1)

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12
Q

How are the cords named?

A

With respect to relationship to axillary artery

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13
Q

Recall the branches of the BP that only contain C5 fibres

A

Dorsal subscapular
Subclavius
Phrenic

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14
Q

Recall the branches of the BP that contain C5 and C6 fibres only

A

Upper and lower subscapular
Suprascapular
Axillary

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15
Q

Which nerve root fibres contribute to the thoracodorsal nerve?

A

C7 and C8

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16
Q

Recall the branches of the BP that contain C8 and T1 fibres only

A

Medial pectoral
Medial brachial cutaneous
Medial antebrachial cutaneous
Ulnar

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17
Q

In general, which nerve root fibres supply the shoulder girdle muscles?

A

C4-C7

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18
Q

In general, which nerve root fibres supply the shoulder joint and elbow flexor muscles?

A

C5 + C6

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19
Q

In general, which nerve root fibres supply the elbow joint extensors?

A

C7 + C8

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20
Q

In general, which nerve root fibres are involved in controlling wrist movement and coarse hand movements?

A

C6, C7 and C8

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21
Q

Recall the branches of the BP that contain C5,6 and 7 fibres only

A

Long thoracic

Lat. pectoral

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22
Q

In general, which nerve root fibres are involved in controlling fine hand movements?

A

C8 - T1

23
Q

Recall the mnemonic used to remember the organisation of the BP

A

Reach To Drink Cold Beer

Roots Trunks Divisions Cords Branches

24
Q

Recall the mnemonic used to remember the main branches of the BP

A 
Most Alcoholics Must Really Urinate:
Musculocutaneous
Axillary
Median
Radial 
Ulnar
25
Q

Recall the mnemonic used to remember the branches of the posterior cord

A 
ULTRA
Upper subscapular
Lower subscapular
Thoracodorsal
Radial
Axillary
26
Q

Recall the mnemonic used to remember the branches of the lateral cord

A

Must Love Lateral:
Musculotaneous
Lat. pectoral
Lat. median

27
Q

Recall the mnemonic used to remember the branches of the medial cord

A 
M4U
Medial pectoral
Medial cutaneous (arm)
Medial cutaneous (forearm)
Medial branch of median nerve
Ulnar
28
Q

Where does the musculocutaneous nerve run and what is its main function?

A

Deep in biceps

Flexion and extension

29
Q

What is the most likely cause of musculocutaneous nerve damage?

A

Breast cancer surgery

30
Q

What is the main result of a musculocutaneous nerve injury?

A

Loss of flexion and supination in forearm

31
Q

Where does the radial nerve run and what is its main function?

A

Runs posterior to humerus in radial groove

Motor to posterior arm and forearm

32
Q

What are the mian consequences of radial nerve injury?

A

Loss of sensation at anatomical snuff box
Loss of power grip
WRIST DROP

33
Q

Where does the median nerve run and what is its main function?

A

Runs through median cubital fossa and carpal tunnel

Supplies wrist, finger flexors, small muscles of thumb and index finger

34
Q

What are the main consequences of median nerve injury?

A

Wasting of thenar eminence

Loss of sensation and fine movement in lateral digits

35
Q

Where does the ulnar nerve run and what is its main function?

A

Runs posterior to medial epicondyle

Motor to small muscles of hand

36
Q

What is the main consequence of ulnar nerve injury?

A 
Ulnar claw (due to lumbrical deinnervation)
Loss of efficient adduct and abduction in fingers
37
Q

What is the most common cause of ulnar nerve injury?

A

Attempted suicide by cutting

38
Q

Describe the ulnar paradox

A

Clawing is worse when you injure nerve at wrist than elbow because FDP is also damaged and so flexion of fingers reduced, making appearance seem less clawed

39
Q

How do you test for ulnar nerve damage?

A

See LA notes

40
Q

What is the course of the axillary nerve and what is its main function?

A

Winds round surgical neck of humerus

Supplies deltoid and teres minor

41
Q

What is the main consequence of injury to axillary nerve?

A 
Deltoid wasting (loss of shoulder-roundness)
Loss of lateral cutaneous nerve sensation
42
Q

Why is the long thoracic nerve relatively susceptible to damage?

A

Relatively superficial

43
Q

What does the long thoracic nerve supply?

A

Serratus anterior - involved in scapula stabilisation

44
Q

What is the main consequence of injury to the long thoracic nerve

A

Winging of scapula

45
Q

What name is given to the palsy produced if the C5 C6 root is damaged

A

Erb’s palsy

46
Q

What is the most common cause of Erb’s palsy?

A

dystopia or traumatic fall to shoulder

47
Q

What nerves are most likely to be damaged in Erb’s palsy?

A

Musculocutaneous

Axillary

48
Q

Describe the presentation of Erb’s palsy

A

Loss of sensation in regimental patch
Atrophy of biceps, brachialis and deltoid
“Waiter’s tip”

49
Q

What name is given to the palsy produced if the C8 T1 root is damaged

A

Klumpke’s palsy

50
Q

What nerves are most likely to be damaged in Klumpke’s palsy?

A

Median

Ulnar

51
Q

Describe the presentation of Klumpke’s palsy?

A

Clawed hand

52
Q

What is the most common cause of Klumpke’s palsy?

A

Abnormal birth

53
Q

Which muscles are affected by a Klumpke’s palsy?

A

Intrinsic muscles of hand, wrist and finger flexors and forearm pronators

LCRS Y2: Anatomy of the limbs (7 decks)

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