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MD2002 > Brachial And Lumbosacral Plexuses > Flashcards

Brachial And Lumbosacral Plexuses Flashcards

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1
Q

What is the axilla

A

Important space between lateral wall of thorax and humerus

Acts as gateway to upper limb bounded by ribs, scapula and clavicle

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2
Q

Lines of the axilla

A

Anterior axillary line is in front of shoulder and down

Mid axillary line is straight through

Posterior is behind

Axillary fossa is the underarm

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3
Q

Anterior wall of the axilla

A

Pectoralis major
Underneath pectoralis minor
And underneath clavipectoral fascua (deep)

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4
Q

What makes up the anterior axillary fold

A

Pectoralis major

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5
Q

Function of pectoralis major

A

Movement of humerus at GH joint

Adduction
Medial rotation
Flexion of extended arm
Extension of flexed arm

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6
Q

Pectoralis minor attachments

A

Ribs 3-5 to coracoid process of scapula

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7
Q

Function of pectoralis minor

A

Stabilise scapula on thorax

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8
Q

What supplies pectoralis minor

A

Lateral and medial pectoral nerves

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9
Q

What is clavipectoral fascia continous with and where does it attach to

A

Neck fascia

Attaches to inferior skin of the armpit

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10
Q

What does clavipectoral fascia split to enclose

A

Pectoralis minor and subclavius

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11
Q

Subclavius attachments

A

1st rib costalcartilae to inferior surface of clavicle

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12
Q

Function of subclavius

A

To draw clavicle inferiorly

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13
Q

What muscles would you expect to see on chest

A

Deltoid at shoulder
Pectoralis major across chest with pectoralis minor underneath
Serratus anterior inferior to pectoralis major
Sternocleidomastoid muscle from sternum around neck

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14
Q

What is the medial wall of axilla made up of

A

Ribs and intercostal spaces

Serratus anterior

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15
Q

Where does serratus anterior attach

A

Ribs 1-8 to medial border of scapula

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16
Q

Function of serratus anterior

A

Protraction and lateral rotation of the scapula

Holds scapula on thoracic wall

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17
Q

What makes up lateral wall of axilla?

A

Narrow it is the bicipital groove

Proximal parts of biceps and coracobrachialis

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18
Q

Function of coracobrachialis

A

Flexes shoulder

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19
Q

Posterior wall of axilla

A

Subscapularis
Latissimus Dorsi
Teres major
Scapula

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20
Q

What do ventral rami of spinal nerves contain

A

Sensory
Motor
Sympathetic nerves

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21
Q

What forms the nerve plexuses

A

Spinal nerves with sensory motor and sympathetic nerves

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22
Q

What does the brachial plexus supply and via which ventral rami

A

Supplies upper limbs via ventral rami of c5-t1

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23
Q

What does the lumbar and sacra (lumbosacral) plexuses supply and via which rami

A

Lower limbs via ventral rami of L1 - S4

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24
Q

What does the dorsal ramus supply

A

Erector spinae muscles

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25
What does ventral rami supply
Body wall and limb plexuses
26
Ventral rami come from which part of spinal cord
Cell body is in the anterior grey horn of the spinal cord
27
Where is axillary artery in relation to brachial plexus etc
Axillary artery goes under clavicle with brachial Lexus and is medial to T1 and branches over T1
28
Roots of brachial plexus
Ventral rami of spinal nerves Lie in neck close to intervertebral foraminae Long thoracic nerve passes inferiorly through apex f axilla on the ribs to supply serratus anterior (motor only) Dorsal scapula passes posteriorly to the back to supply levator scapulae and rhomboids motor only
29
Trunks of brachial plexus
There are 3 superior middle and inferior Lie in posterior triangle of neck posterior to scalenus anterior and subclavian artery Branches from upper superior only Suprascapular Nerve to subclavius
30
Where is nerve to subclavius situated
Inferior to supply subclavius
31
Where is subscpaular nerve situated
Posterior to scapular region via suprascpaular notch to supply supraspinatus, infraspinatus
32
6 divisions of the brachial plexus
Each trunk gives rise to posterior and anterior Lies posterior to clavicle and there are no branches Anterior divisions supply muscles of anterior axilla, flexor muscles of limb and skin that overlies muscles Posterior Division supply muscles of posterior wall of axilla, extensor muscles and skin that overlies those muscles
33
Cords of brachial plexus
Lie in axilla around 2nd part of axillary artery and named according to position relative to artery Lateral medial and posterior to artery The lateral cord has one branch the lateral pectoral nerve which passes anterior to supply pec major and minor Posterior cord has 3 branches
34
Which landmark marks location subclavian artery becomes axillary artery
1st rib
35
Posterior cord has what branches
Radial and axillary
36
Which artery does radial nerve travel with and where does it supply
Profunda brachii artery Supplies extensor muscles of arm and forearm and posterior skin of arm forearm and hand (mixed motor and sensory)
37
Where is axillary nerve located and what does it supply
C5 and c6 Surgical neck humerus Posterior circumflex artery Deltoid and teres minor and skin over lower part of deltoid
38
All terminal divisions of brachial plexus carry what
Both motor and sensory fibres
39
Musculotaneous branch is where and Carries what
C5 c6 c7 Pierces coracobrachialis and supplies flexor compartment of arm Becomes lateral cutaneous nerve of forearm
40
Lateral root of median nerve
C6 c7 Joins with medial root to form median nerve
41
Medial root of median nerve
C8 T1 | Joins with lateral root to form median nerve
42
Median nerve
C6 7 8 T1 Travels with brachial artery Most medial structure in cubital fossa Supplies flexor muscles of forearm except 1half LOAF Hand thumb muscles and lateral 2 Lumbricals Skin over lateral palm and lateral 31/2 digits and nail beds
43
Ulnar nerve
Posterior to elbow Supplies 11/2 flexors of forearm Supplies intrinsic muscles in hand and skin over palm and medial 11/2 digits
44
Traction injury to upper trunk (c5c6)
Erb-Duchenne Palsy or Erbs paralysis High energy trauma motorcylcle/birth Paralysis in muscles of arm and shoulder such as deltoid biceps and brachialis Loss of sensation to lateral forearm Presents as waiters tip position hanging limb (addicted shoulder, medial rotation of arm, elbow extended)
45
Traction injury to lower trunk (c8t1)
Klumpke's palsy / paralysis Occur birth if limb pulled Paralysis of intrinsic hand muscles, flexor muscles of wrist and fingers, forearm pronator Loss of sensation to medial forearm and little finger Claw hand (wrist and fingers flexed and forearm supinated)
46
Lumbar and sacral plexus is made up on nerves
Lumbar plexus L1-4 | Sacral L4-S4
47
Where does lumbrar and sacral plexuses innverate
Lower limb | Pelvis and perineum
48
What are the largest nerves from the plexuses entering the thigh
Femoral nerve L2-4 | Sciatic nerve L4-S3
49
Where is lumbar plexus located
Within psoas major muscle anterior to transverse processes of lumbar vertebrae
50
Which nerves supply the lower Limb
``` Ilioinguinal Lateral cutaneous of the thigh Genitofemoral Femoral (s and m) Obturator (s and m) ```
51
What are the base apex and medial aspects of the femoral triangle
Inguinal ligament base Sartorial muscle laterally apex Adductor longus muscle medial Muscular floor of triangle is pectineus medially and iliopsoas laterally Roof is fascia lata
52
Within the femoral triangle
Lateral - femoral nerve (l2-4) Middle - femoral artery Medial - femoral vein
53
What does the femoral sheath enclose
Femoral artery and vein NOT the nerve
54
The femoral nerve
Supplied by l2,3,4 Latest branch descending in abdomen through pelvis to mid point of inguinal ligament Behind inguinal ligament to thigh Passes through femoral triangle Articular branches to hip and knee joints Terminal cutaneous branch is the saohenous nerve which continues with artery and vein through adductor canal to leg
55
What does femoral nerve supply
Anterior thigh muscles (hip flexors, knee extensor) and skin of anteromedial thigh and medial leg and foot
56
Sacral plexus
Surface of posterior pelvic wall anterior to piriformis muscle Superior gluteal, inferior gluteal and sciatic(ms) and posterior femoral cutaneous nerves supply lower limb Also has smal branches such as nerve to piriformis, obturator internus and quadratus femoris
57
Sciatic nerve
L4,5,S1,2,3 Greater sciatic foramen Supplies no structures in gluteal region however Runs ndeep to gluteus maximus midway between ischial tuberosity and greater trochanter behind hip joint
58
What does sciatic nerve supply
Posterior thigh muscles All of leg and foot muscles Skin to most of leg and foot via two branches tibial and common fibulae
59
Where does sciatic nerve branch (bifurcation)
Apex of popliteal fossa Can branch near piriformis too
60
Tibial branch
From sciatic | Descends in politest fosssa and posterior to leg to foot passing posteriorly and inferiorly to medial mallelous
61
What does tibial nerve supply
Posterior muscles in leg and knee joint skin of posterlateral leg Sole of foot Lateral foot
62
Common fibulae (perineal)
L4,5,S1,2 Smaller branch Descends laterally in popliteal fossa towards lateral compartment of leg before branching
63
What does common fibulae nerve supply
Short of biceps and muscles in anterior and lateral leg Skin of upper lateral leg Lower poser player all leg, anterolateral leg and dosrum of foot
64
Myotomes - Proximal and distal muscles are supplied
Proximal muscles supplied by neurones from superior roots deltoid c5c6 Distal muscles supplied by neurones from inferior roots intrnic muscles of hand T1
65
Muscles that share action in joint are supplied by neurones originating form same spinal segment
Deltoid c5c6 | Supraspinatus c5c6
66
Antagonistic muscles supplied by two segments usually run in numerical sequence
Flexion elbow c5c6 | Extension elbow c7c8
67
Abduction of shoulder controlled by
C5
68
Flexion of elbow controlled
C6
69
Extension elbow controlled
C7
70
Flexion of fingers controlled
C8
71
Abduction and adduction of fingers
T1
72
Biceps tendon tap tests
C6
73
Triceps tendon tap tests
C7
74
How are sensory neurones delivers
By peripheral cutaneous nerves
75
C5 dermatomes test
Upper lateral side of arm
76
C6 dermatomes test
Pad of thumb
77
C7 dermatomes test
Pad of index finger
78
C8 dermatomes test
Pad of little finger
79
T1 dermatomes test
Skin on medial side of elbow
80
What are dermatomes used for
Test for spinal cord damage and can help to determine level of damage

MD2002 (22 decks)

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