Chapter 4: Upper Limb Flashcards

1
Q

The brachial plexus is formed by what nerves in the CNS?

A

ventral rami of C5 through T1 spinal nerves

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2
Q

What are the 5 major nerves that aris from the brachial plexus?

A

musculocutaneous
median,
ulnar,
axillary,
radial

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3
Q

The axillary and radial nerves contain the posterior or anterior division fibers?

A

posterior division fibers

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4
Q

The musculocutaneous, median, and ulnar nerves contain the posterior or anterior division fibers?

A

anterior division fibers

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5
Q

Are the palmer compartments of the upper limb inervated by anterior or posterior division fibers?

A

anterior

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6
Q

Be able to draw a diagram of the brachial plexus

A

Refer to image.

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7
Q

The musculocuatenous nerves are derived from what nerve roots?

A

C5
C6
C7

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8
Q

In general, what are the muscles innervated by the musculocutaneous nerves?

A

all the muscles of the anterior compartment of the arm

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9
Q

What are the primary actions of the muscles of the anterior portion of the arm?

A

flex elbow

supination (biceps brachii)

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10
Q

The median nerve is carried by what nerve roots?

A

C5-T1

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11
Q

What muscles does the median nerve innervate?

A

A. Forearm
anterior compartment except 1.5 muscle by ulnar nerve (flexor carpi ulnaris and the ulnar half of the flexor digitorum profundus.

B. Hand

Thenar commpartment
Central compartment
Lumbricals: Digits 2 and 3
First 3 1/2 digits dorsal 3 1/3 finger tips

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12
Q

What are the primary actions of the median nerve? In the forearm and the hand?

A

Forearm

  • flex wrist and all digits
  • pronation

Hand

Opposition of thumb
flex metacarpophalangeal (MP) and extend interphalangeal (PIP and DIP ) joints of digits 2 and 3

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13
Q

What are the roots that contribute to the ulnar nerve?

A

C8- T1

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14
Q

What muscles do the ulnar nerves innervate?

A

A. Forearm
Anterior Compartment: 1 (1/2)
muscles not innervated by the median nerve

B. Hand
* hypothenar compartment

  • central compartment
    -interossei muscles: palmer and dorsal
  • lumbricals: digits 4 & 5
  • adductor pollicis
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15
Q

What are the primary actions of the ulnar nerves on the muscles in the forearm?

A

flex wrist (weak) and digits 4 and 5

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16
Q

What are the nerve roots that form the axillary nerve?

A

C5-C6

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17
Q

What muscles are innervated by the axillary nerve?

A

deltoid
teres minor

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18
Q

What are the primary actions of the axillary nerve?

A

abduct shoulder 15 -110
Lateral rotation of shoulder

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19
Q

What are the nerve roots that the radial nerve is derived from?

A

C5-T1

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20
Q

What muscles are innervated by the radial nerve?

A

posterior compartment muscles of the arm and forearm.

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21
Q

What are the primary actions of the posterior compartment muscles of the arm and forearm?

A

extend MP, wrist, and elbow

supination (supinator muscle)

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22
Q

What muscles does the dorsal scapular nerve innervate?

A

rhomboids

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23
Q

What muscle/s does the long thoracic nerve innervate?

A

serratus anterior -protracts and rotates scapula superiorly

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24
Q

What muscles does the suprascapular nerve innervate?

A

Supraspinatus- abduct shoulder 1-15

Infraspinatus - laterally rotate shoulder

25
Q

What nerve roots make up the suprascapular nerve?

A

C5-6

26
Q

What muscle is innervated by the lateral pectoral nerve?

A

pectoralis major

27
Q

What muscle is innervated by the medial pectoral nerve?

A

pectoralis major and minor

28
Q

What muscle is innervated by the upper subscapular nerve?

A

subscapularis

29
Q

What muscle is innervated by the middle subscapular (thoracodorsal) nerve?

A

latissimus dorsi

30
Q

What muscle is innervated by the lower subscapular nerve

A

subscapularis and teres major

31
Q

What area of the body is innnervated by the medial brachial cutaneous nerve?

A

skin of medial arm

32
Q

What muscle is innervated by the medial brachial cutaneous nerve?

A

skin of medial arm

33
Q

What part of the body is innervated by the antebrachial cutaneous nerve?

A

skin of medial forearm

34
Q

Why is palm sensation not affected by carpal tunnel syndrome?

A

the superficial palmar cutaneous branch of the median nerve passes superficial to the carpal tunnel

35
Q

The skin of the palm of the hand is supplied by what nerves?

A

median and ulnar

36
Q

How much of the hand does the median nerve innervate

A

lateral 3 1/2 digits and the adjacent area of the lateral palm and thenar surface and tips of 3 1/2 digits on dorsal surface

37
Q

The ulnar nerve supplies what parts of the hand?

A

medial 1 1/2 digits and the hypothenar eminence

38
Q

What parts of the hand does the radial nerve supply?

A

skin of the dorsum of the hand in the area of the first dorsal web space, including the skin over the snuffbox

dorsum of first 3 1/2 fingers outside of the fingertips

39
Q

What is another name for Erb-Duchenne Palsy?

A

Waiter’s Tip Syndrome

40
Q

Where is the lesion found in an individual with Erb-duchenne Palsy?

A

Trauma damages C5 and C6 nerve roots

41
Q

What are common causes of Erb-Duchenne Palsy?

A

occurs when the head and shoulder are forcibly separated (e.g accident or birth injury or herniation of disk)

42
Q

What nerves are primarily affected in Erb-Duchenne Palsy?

A

axillary, suprascapular, and musculocutaenous nerves

43
Q

What muscles are affected in Waiter’s Tip?

A

loss of intrinsic muscles of the shoulder and muscles of the anterior arm

deltoid
infraspinatus
biceps brachii

44
Q

Because of how Erb Duchenne what are some symptoms that may be caused?

A

loss of medial rotation due to infraspinatus dysfunction

Loss of deltoid innervation > inability to raise the arm

Loss of biceps brachii leads to inability to flex or supinate forearm

sensory loss on lateral forearm to base of thumb

45
Q

Where is the lesion found in Klumpke’s paralysis?

A

C8 and T1

46
Q

What is a common cause of Klumpke’s Paralysis?

A

usually occurs when the upper limb is forcefully abducted above the head (e.g grabbing an object when falling, thoracic outlet syndrome, birth injury)

47
Q

What nerves are primarily affected in Klumpke’s Paralysis?

A

ulnar nerve

48
Q

What muscles are primarily affected in Klumpke’s paralysis?

A

the intrinsic muscle of the hand with a weakness of the median innervated muscle of the hand

49
Q

Major sign of Klumpke’s palsy?

A

sign is combo of “claw hand” and “ape hand”

sensory loss on medial forearm and medial 1 1/2 digits

50
Q

Is it possible for a person with Klumpke’s Paralysis to show signs of Horner syndrome?

A

yes

51
Q

Which dermatome is affected when there is a lesion at C5?

A

lateral border of the upper arm

52
Q

Which dermatome is affected when there is a lesioned root at C6?

A

lateral forearm to thumb

53
Q

What is the dermatome affected when there is a lesion at C8?

A

medial forearm to little finger

54
Q

What is the dermatome affected when there is a lesion at T1?

A

medial arm to elbow

55
Q

What are muscles affected when there are C5 lesions?

A

deltoid
rotator cuff
serratus anterior
biceps
brachioradialis

56
Q

What are muscles affected when C6 is lesioned?

A

biceps
brachioradiallis
brachialis
supinator

57
Q

Reflex test for C6?

A

biceps tendon

58
Q

Is elbow extension spared in lesions of the radial nerve distal to the axilla?

A

yes

59
Q

Laceration of the radial nerve at the wrist symptoms?

A
  • no motor loss
  • sensory loss only on dorsal aspect of thumb (first dorsal web space)