Ch9 Major Plexuses Flashcards
(104 cards)
1
Q
Cervical Plexus origin
A
XI
C1-C5
2
Q
Cervical Plexus innervates
A
Neck muscles
3
Q
Cervical plexus sensory of
A
neck and top of shoulder
4
Q
C2, C3, C4 contribute to which nerve?
A
Phrenic
5
Q
Brachial plexus roots
A
C5 - T1
6
Q
Brachial plexus arise from
A
Cervical enlargement
7
Q
Long Thoracic Nerve Injury mechanism
A
in sports
from traction or direct trauma under the arm
8
Q
Long Thoracic Nerve signs
A
winging scapula
medial border of scapula, present abnormally posterior
9
Q
Dorsal Scapular Nerve Injury sign
A
weakness of rhomboids
scapula moves away from spine (flaring)
10
Q
Define Flaring
A
inferior border of scapula sits abnormally lateral
11
Q
List Brachial Plexus- Trunks pathologies
A
Erb Palsy Middle Trunk Injury Klumpke Paralysis Thoracic outlet syndrome Scalene triangle Costoclavicular Entrapment Clavicle first rib Pectoralis Minor Syndrome Pancoast Syndrome
12
Q
Erb Palsy affect ____ trunk of brackial plexus
A
upper
13
Q
Erb Palsy is due to
A
traction injury to C5 and C6 nerve roots
14
Q
a position that is a sign of erb palsy
A
waiter’s tip position
15
Q
Define waiter’s tip position
A
internal rotation of arm, and flat writ
16
Q
Middle Trunk Injury affect
A
C7 distribution
17
Q
Klumpke Paralysis located in
A
Lower trunk of brachial plexus
18
Q
Klumpke Paralysis is cased by
A
falling and hanging on Pancoast tumor
T1 transverse process or 1st rib fracture
19
Q
Klumpke Paralysis signs
A
Ulnar nerve (C8 and T1 signs):
- Wrist and finger flexion weakness
- Hypothenar atrophy
- Possible Horner syndrome
20
Q
Thoracic outlet syndrome is tested by
A
RooTest (E.A.S.T)
very sensitive, but not specific
21
Q
Thoracic outlet syndrome is compression of
A
brachial plexus and subclavian (or axillary) artery
22
Q
Thoracic outlet syndrome signs and symptoms
A
weakness, Numbness and, tingling when working above head
23
Q
Scalene triangle is caused by a compression of the
A
anterior scalene muscle or cervical rib
24
Q
Scalene triangle tests
A
adson test
halstead test
25
Scalene triangle signs
involves subclavian artery but not the vein
- Decreased pulse amputation
- No hand swelling
- Ulnar nerve is most effected
26
Clavicle first rib aka
Costoclavicular Entrapment
27
Costoclavicular Entrapment is tested by
Eden
28
Eden aka
costoclavicular test
29
Costoclavicular Entrapment due to
Elevation of first rib
| Inferior clavicle on that side
30
Costoclavicular Entrapment is caused by
large breasts
bra strap
heavy bags on shoulder straps
seat belt injury
31
Costoclavicular Entrapment symptoms involves
hand swelling
32
Pectoralis Minor Syndrome is tested by
wright test
33
Pectoralis Minor Syndrome is caused by
over-development of pecs
34
Pectoralis Minor Syndrome sign and symptoms
weakness of rhomboids (dorsal scap n)
| compression of axillary artery and vein
35
Pancoast syndrome is caused by
Apical lung tumor
36
Pancoast Syndrome signs
same as Horner Syndrome:
droopy eye constricted pupil, no facial sweating “anhidrosis”
may involve brachial plexus
37
Brachial Plexus -Divisions
Anterior - flexors
| Posterior- extensors
38
Brachial Plexus- Medial trunk innervates
Pec minor
39
Brachial Plexus- Lateral trunk innervates
Pec Major
40
Brachial Plexus- Branches include which nerves?
```
Musculocutaneous
Axillary
Radial
Median
Ulnar
```
41
Musculocutaneous Nerve origin:
Lateral Cord
42
Musculocutaneous Nerve innervates
Biceps
brachialis
coracobrachialis
43
Axillary Nerve origin
Posterior cord
44
Axillary Nerve innervates
teres minor
| deltoid
45
Radial Nerve Origin
Posterior cord
46
Radial Nerve innervates
Triceps
Brachioradialis
wrist and finger extensors
47
Saturday night palsy aka
crutch palsy
48
Saturday night palsy location
entrapment in the arm pit
49
Saturday night palsy sign
damage to the spiral groove (honeymooner palsy)
50
Honeymooner palsy signs
wrist drop
| weakness of arm, hand, fingers
51
Median Nerve orign
lateral and medial cords
52
Median Nerve innervates
```
pronator teres
finger flexors
thenar eminence
flexor carpi radialis
palmaris longus
```
53
Median Nerve pathological signs
weakness of the wrist flexion, abduction, thumb opposition, flexion of second, and third fingers
sensory loss of first 3 ½ fingers
54
Carpal Tunnel Syndrome Median neuropathy is located in
entrapment in the carpal tunnel
55
Carpal Tunnel Syndrome Median neuropathy is caused by
repetitive stress injury
56
Carpal Tunnel Syndrome Median neuropathy is most common in (what population)
women over 30
57
Carpal Tunnel Syndrome Median neuropathy signs
sensory loss as described
symptoms worse at night, better when shaking the hand
May radiate back to the up the arm
58
CTS tests
Inspection: advanced cases may show thenar atrophy
Muscle testing: thumb opposition
Ortho test: phalen, tinel, prayer sign
59
CTS management
- Cervical adjustment
- Shoulder adjustment
- Elbow adjustment
- Wrist adjustment
- Strengthening of finger and wrist extensors
- Proximation of the distal radioulnar joint (increase pronator quadratus strength)
60
Ulnar Nerve origin
medial cord
61
Ulnar Nerve innervates
hypothenar eminence
flexor carpi ulnaris
palmar and dorsal interossi
62
Ulnar neuropathy is due to
- Increased carrying angle at elbow
| - Tunnel of guyon at wrist
63
Ulnar neuropathy is tested by
tinel froment
64
Ulnar neuropathy signs
weakness of wrist flextion, abduction, adduction,
| sensory loss of fingers 4 and 5
65
Claw Hand is extension at _____, and flexion at______
Extension at MCP (long extensors work
| Flexion at PIP and DIP (long flexors work)
66
Claw Hand is due to
wasting of the interossei muscle and short finger flexors of hypothenar eminence
67
Lumbosacral Plexus oirgin
L1 - S4
68
Lumbosacral Plexus innervate
Lower extremity and pelvis
69
Iliohypogastric nerve origin
L1
70
Iliohypogastric nerve function
sensory over pubic symphysis
71
Ilioinguinal nerve origin
L1
72
Ilioinguinal nerve innervation
sensory over the inguinal ligament
73
Ilioinguinal nerve often cut during
abdominal surgeries
74
Genitofemoral nerve origin
L1, L2
75
Genitofemoral nerve innervates
sensory to upper inner thigh
| motor to cremaster muscle
76
Femoral nerve origin
L3,4,5
77
femoral nerve innervates
Leg flexors at hip
| Leg extensors at knee
78
Obturator nerve origin
L2,3,4
79
Obturator nerve innervates
thigh adductors
80
Lateral femoral cutaneous nerve origin
L2, L3 posterior division
81
Lateral femoral cutaneous nerve innervation
sensory to lateral femoral
82
Lateral femoral cutaneous nerve entrapment aka
Meralgia paresthetica
83
Meralgia paresthetica site of entrapment
blow ASIS under the inguinal ligament
84
Meralgia paresthetica caused by
tight waist band/ belt
85
Superior gluteal nerve origin
L4, L5, S1 anterior division
86
Superior gluteal nerve innervation
: gluteus medius and minimus
87
Inferior gluteal nerve origin
L4, L5, S1, S2 anterior division
88
Inferior gluteal nerve innervation
gluteus maximus
89
Sciatic nerve origin
L4, L5, S1, S2 anterior division
90
Sciatic nerve innervation
Hamestrings
91
2 Nerves that constitute sciatic
Tibial
| Common peroneal
92
Sciatic neuropathy/radiculopathy is caused by
posterior hip dislocation
acetabular fracture (dashboard injuires) muscular injection in buttocks
piriformis entrapment
93
Sciatic neuropathy/radiculopathy symptoms
weakness of all foot and ankle muscles, knee flexors, Achilles reflex
sensory loss of foot, lateral leg below knee
94
Sciatica is
paresthesia along the distribution of sciatic nerve
95
Sciatica most commonly is caused by
lumbosacral nerve root compression by disc or osteophytes
96
Sciatica May be caused by
distal entrapment
| piriformis syndrome, chiropractic connections
97
Posterior femoral cutaneous nerve origin
S1, S2, S3 posterior divisions
98
Pudendal plexus origin
S1, S2, S3 anterior divisions
99
Pudendal plexus innervates
pelvic floor, sphincters
100
Peroneal (Fibular) Nerve Palsy Symptoms
weakness of foot inversion
101
what can be in differential with Peroneal (Fibular) Nerve Palsy
L5 radiculopathy
102
Morton Neuroma aka
Morton metatarsalagia
103
Morton Neuroma is caused by
tight fitting shoes
104
Morton Neuroma symptoms
pain
numbness
paresthesia between the third and fourth toes
