Brachial Plexus

Question 1

All anterior divisions converge on muscles that do what

Answer 1

Flexion

Question 2

All posterior divisions converge on muscles that do what

Answer 2

extension

Question 3

The long thoracic nerve receives components from what cervical nerves

Answer 3

C5,C6,C7

Question 4

The superior trunk is composed of what spinal nerves

Answer 4

C5,C6

Question 5

The suprascapular comes off what trunk

Answer 5

Superior trunk

Question 6

The nerve to subclavius comes off the

Answer 6

superior trunk

Question 7

innervation of the upper limb follows a _______ pattern

Answer 7

compartementalized pattern

Question 8

THe anterior compartement of the upper arm is innervated by (flexors of the elbow joint)

Answer 8

musculocutaneous nerve

Question 9

The posterior compartement of the upper arm is innervated by (extensors of the elbow joint

Answer 9

Radial nerve

Question 10

The anterior compartment of the forearm (antebrachium) and hand is innervated by

Answer 10

Ulnar and median nerves

Question 11

The posterior compartements of the forearm (antebrachium) and hand are innervated by

Answer 11

Radial nerve

Question 12

What separates the anterior and posterior compartments of the forearm (antebrachium)

Answer 12

The interosseous membrane

Question 13

What nerve does more innervation of the hand the median or the ulnar

Answer 13

The ulnar

Question 14

What innervates more of the forearm (antebrachium) median or ulnar

Answer 14

median

Question 15

What does the median nerve innervate in the hand

Answer 15

mostly the thumb

Question 16

Presentation of injuries to superior Trunk

Answer 16

Upper limb is adducted, medially rotated and elbow is extended and wrist is flexed (this is the “waiter’s tip” position)

Question 17

Injuries to the superior trunk can be result of

Answer 17

excessive, forceful increase in angle between neck and shoulder

Question 18

Erb’s palsy

Answer 18

Injury to superior trunk

• sensory deficits: lateral aspect of upper limb
• motor deficits:
  - loss of arm abduction
  - loss of elbow flexion
  - loss of forearm supination
  - weakness of wrist extension

Presentation: upper limb is adduct, medially rotated and elbow is extended and wrist is flexed (this is the “waiter’s tip” position)

Question 19

How can injuries to the inferior trunk occur

Answer 19

limb is suddenly and/or forcefully pulled in a superior direction

Question 20

Klumpke’s palsy

Answer 20

• Injury to inferior trunk (C8 and T1)
• Sensory deficits: medial aspect of upper limb (except axilla)
• Motor deficits:
  
  • loss of precision finger movements
  • weakness in forearm pronation
  • weakness of wrist and finger extension
  • weakness of wrist and finger flexion

presentation: Primary clinical sign is “claw-hand” and there may also be wasting of intrinsic hand muscles. seen with attempted extension of digits, leaving 4th and 5th digits flexed

Question 21

Injuries to the radial nerve (C5-T1 spinal nerve roots) can occur

Answer 21

• with mid-shaft fracture of the humerus
• improper use of crutches
• compression of that nerve (Saturday night palsy)

Question 22

Symptoms of radial nerve injury

Answer 22

• extensors compartments affected
• “wrist drop”
• paresthesia and/or pain along course of nerves

Question 23

What is Saturday night palsy

Answer 23

radial nerve gets pinched due to certain sleep position resulting in loss of ability to extend wrist and digits
- results in paresthesia and/or pain along course of nerve

Question 24

Injuries to axillary nerve (C5 and C6 spinal nerve roots) can occur from

Answer 24

• Can occur with fractures to the surgical neck of humerus or dislocation of the glenohumeral joint
• Improper use of backpack (Quadrangular space syndrome; can also involve compression of posterior circumflex humeral artery)

Question 25

The brachial plexus is made up of the ventral rami of what spinal nerves

Answer 25

(C5-T1)

Question 26

Injuries to the axillary nerve (C5 and C6) can occur

Answer 26

- with fractures to the surgical neck of the humerus or dislocation of the glenohumeral joint - improper use of backpack (Quadrangular space syndrome; can also involve compression of posterior circumflex humeral artery)

Question 27

Symptoms of injury to axillary nerve (C5 and C6)

Answer 27

- patient would be unable to fully abduct their arm, and may have a diminished ability to laterally rotate arm - paresthesia and/or pain along course of the nerve

Question 28

Injuries to the long thoracic nerve (C5,C6,C7) causes

Answer 28

- this nerve can be damaged during surgical removal of lymph nodes or other tissues in the axillary region - penetrating trauma to the axillary region can also damage this nerve

Question 29

What are the symptoms of injuries to the long thoracic nerve

Answer 29

- Serratus anterior is affected | - "winged scapula", inability to raise arms past 90 degrees

Question 30

Injuries to the Ulnar nerve (C8, T1, and often C7) causes

Answer 30

- fracture of the medial epicondyle of humerus can damage this nerve. - Fracture of proximal ulna may also result in damage - Slashed wrist (medial side)

Question 31

Injuries to the Ulnar Nerve (C8,T1,and often C7) will result in

Answer 31

- damage will involve flexors of wrist, digits, and intrinsic hand muscles - radial deviation at wrist joint, loss of abduction and adduction of fingers, weak wrist flexion and some loss of flexion of digits - losses depend on where nerve is damaged

Question 32

Injuries to the median Nerve (C6-T1) can be caused from

Answer 32

-injured by fracture of the humerus above the condyles, slashing of the wrist, or by inflammation or irritation in the carpal tunnel (Carpal Tunnel Syndrome)

Question 33

Injuries to the median nerve (C6-T1) result in

Answer 33

- flexors of wrist and digits affected, also intrinsic hand muscles, particularly those that move digit 1 (thumb) - "Pope's blessing" (when making a fist, unable to flex second and third digits) seen with attempted flexion of digits, where 2nd and 3rd digits are left extended - "ape hand" (thenar eminence atrophy and loss of thinner opposition) - Paresthesia and/or pain along median nerve

Question 34

"Pope's Blessing" is

Answer 34

- caused by injury to the median nerve (C6-T1) - when making a fist, unable to flex second and third digits - seen with attempted flexion of digits, where 2nd and 3rd digits are left extended

Question 35

What is "ape hand"

Answer 35

- caused by injury to the median nerve (C6-T1) | - thenar eminence atrophy and loss of thinner opposition