Exam III Flashcards
(206 cards)
1
Q
The brachial plexus is formed by:
A
Anterior primary rami of C5-T1 (May also receive some fibers from C4 and T2)
2
Q
Over which rib does the brachial plexus travel?
A
Laterally over rib 1, into the axilla
3
Q
Roots combine to form:
A
Trunks
4
Q
Trunks combine to form:
A
Divisions
5
Q
Divisions combine to form:
A
Cords
6
Q
Cords divide into:
A
Terminal nerves
7
Q
True/False: Each root receives a gray ramus communicans from sympathetic trunk.
A
True
8
Q
Between which two muscles do roots pass between into the posterior triangle?
A
Anterior and middle scalene muscles (NOT posterior scalene!)
9
Q
Roots travel posterior and superior to this structure.
A
Subclavian artery
10
Q
Roots at which cord levels combine to form the inferior trunk?
A
C8 and T1
11
Q
The root of C7 stays alone to become the:
A
Middle trunk
12
Q
The superior trunk is formed by which root(s)?
A
C5 and C6
13
Q
Which divisions do each trunk split into?
A
Anterior and posterior divisions
14
Q
How are cords named?
A
For relationship to the axillary artery
15
Q
The anterior divisions of the superior and middle trunks form the:
A
Lateral cord
16
Q
The medial cord is formed by:
A
Anterior division of the inferior trunk
17
Q
The union of the posterior division of all three trunks forms the:
A
Posterior cord
18
Q
The posterior cord is formed by:
A
The union of the posterior division of all three trunks
19
Q
The lateral cord contains fibers from:
A
C5-C7
20
Q
The lateral, medial and posterior cords lie in their respective area to which part of the axillary artery?
A
Second part
21
Q
The medial cord contains fibers from:
A
C8 and T1
22
Q
The posterior cord contains fibers from:
A
C5-T1 (whole plexus!)
23
Q
Which nerve contains fibers from ONLY C5?
A
Dorsal scapular nerve
24
Q
The dorsal scapular nerve contains fibers from:
A
C5
25
The dorsal scapular nerve supplies which muscles?
Levator scapula and both rhomboids
26
The dorsal scapular nerve supplies which muscle that also receives fibers from C3 and C4?
Levator scapula
27
The long thoracic nerve is formed from the roots of:
C5-C7
28
Which muscle is supplied by the long thoracic nerve?
Serratus anterior
29
Which nerves are supplied by the roots of C5-C7?
Long thoracic, lateral pectoral nerve, and musculocutaneous nerve
30
Which of the following does NOT contain fibers from the roots of C5-C7?
```
A. Musculocutaneous n.
B. Long thoracic n.
C. Medial pectoral n.
D. Lateral pectoral n.
E. All contain fibers from C5-C7
```
C. Medial pectoral nerve (C8 and T1)
31
Which nerves branch off of the superior trunk of the brachial plexus?
Suprascapular and nerve to the subclavius
32
The suprascapular nerve contains fibers from:
C5 and C6
33
Which muscles are supplied by the suprascapular nerve?
Supraspinatus and infraspinatus
34
The nerve to the subclavius contains fibers from _____ and supplies which muscle?
C5 and C6; subclavius
35
Which nerves branch off of the lateral cord of the brachial plexus?
Lateral pectoral and musculocutaneous nerves (as well as another terminal branch that contributes to the median nerve)
36
The lateral pectoral nerve contains fibers from:
C5-C7
37
Which muscle(s) is/are supplied by the lateral pectoral nerve?
Pectoralis major
38
Which muscle is supplied by both medial and lateral pectoral nerves?
Pectoralis major
39
The musculocutaneous nerve contains fibers from:
C5-C7
40
The musculocutaneous nerve supplies which muscles?
Coracobrachialis, biceps brachii (both heads) and brachialis
41
Which of the following is not supplied by the musculocutaneous nerve?
```
A. Coracobrachialis
B. Long head- biceps brachii
C. Short head- biceps brachii
D. Brachialis
E. All are supplied by by MC nerve
```
E. All are supplied by MC nerve
42
The musculocutaneous nerve pierces the belly of which muscle?
Coracobrachialis
43
The musculocutaneous nerve continues between the biceps brachii and brachialis into the forearm to become the:
Lateral cutaneous nerve of the forearm
44
What is supplied by the lateral cutaneous nerve of the forearm?
Skin over the lateral aspect of the forearm, NOT THE HAND!
45
Which nerves branch off the medial cord of the brachial plexus?
Medial pectoral, medial cutaneous nerve of the arm/forearm, ulnar nerve and median nerve
46
Which branch of the medial cord is NOT supplied by C8 and T1?
Median nerve (C6-T1)
47
The medial pectoral nerve supplies which muscle(s)?
Pec major/minor
48
The medial pectoral nerve contains fibers from:
C8 and T1
49
Which branch of the medial cord receives some fibers from T2?
Medial cutaneous nerve of the arm
50
The medial cutaneous nerve of the arm receives some fibers from T2 via communication with the:
Intercostobrachial nerve
51
The medial cutaneous nerve of the forearm contains fibers from:
C8 and T1
52
The medial cutaneous nerve of the forearm supplies:
Skin over biceps brachii and skin over anterior and medial aspects of forearm distal to the wrist
53
What are the two terminal branches of the medial cord?
Ulnar and median nerves
54
The ulnar nerve contains fibers from:
C8 and T1 (sometimes C7)
55
The ulnar nerve travels medially to which structure in the medial bicipital sulcus?
Brachial artery
56
In which structure does the ulnar nerve travel medial to the brachial artery?
Medial bicipital sulcus
57
Which nerve is affected is you hit your "funny bone?"
Ulnar nerve
58
The ulnar nerve continues into the forearm between the two heads of which muscle?
Flexor carpi ulnaris
59
The ulnar nerve innervates which two muscles of the forearm?
Flexor carpi ulnaris and the medial half of the flexor digitorum profundus
60
Which branch of the ulnar nerve supplies the skin on the ulnar side of the posterior hand?
Dorsal branch
61
Which branch of the ulnar nerve supplies the skin over the hypothenar eminence?
Palmar branch
62
The dorsal branch of the ulnar nerve supplies:
The skin on the ulnar side of the posterior hand
63
The palmar branch of the ulnar supplies:
The skin over the hypothenar eminence
64
What is the name of the three terminal branches of the superficial branch of the ulnar nerve and what do they supply?
Proper palmar branches; supply palmar aspect of the 5th finger (pinky) and medial half of 4th finger (ring)
65
The deep branch of the ulnar nerve curves toward the thenar eminence to supply:
Abductor digiti minimi, Flexor digiti minimi brevis, opponens digiti minimi, adductor pollicis, deep head of the flexor pollicis brevis, all interossei muscles, and the 3rd/4th lumbricals
66
Which nerve would you expect to be compromised if a patient exhibited "claw hand?"
Ulnar nerve
67
Which nerve contains contributions from both the lateral and medial cords?
Median nerve
68
The median nerve contains fibers from:
C6-T1
69
In which structure does the median nerve travel through the arm?
Medial bicipital sulcus (same as ulnar nerve)
70
Between the heads of which muscle does the median nerve enter the forearm?
Pronator teres
71
Which two muscles of the forearm are NOT innervated by the median nerve?
Flexor carpi ulnaris and the medial half of the flexor digitorum profundus (both ulnar nerve)
72
Which nerve is given off by the median nerve in the elbow?
Anterior interosseous nerve of the forearm
73
The palmar branch of the median nerve supplies:
Skin of the thenar eminence, lateral wrist and palm
74
Which nerve supplies the periosteum?
Median nerve
75
Patients with an affected median nerve would demonstrate:
Carpal tunnel syndrome and an inability to pronate
76
Which nerves branch off of the posterior cord of the brachial plexus?
Superior and inferior subscapular, thoracodorsal, axillary and radial nerves
77
The superior subscapular nerve contains fibers from _____ and supplies the _____.
C5 and C6; subscapularis
78
The thoracodorsal nerve contains fibers from _____ and supplies the _____.
C6-C8; latissimus dorsi
79
The inferior subscapular nerve contains fibers from _____ and supplies the _____.
C5 and C6 (same as superior SS); subscapularis and teres major
80
The axillary nerve contains fibers from _____ and supplies the _____.
C5 and C6; deltoid and teres minor
81
The sensory branch of the axillary nerve that comes off at the same level of the teres minor is called the:
Superior lateral cutaneous nerve of the arm
82
The superior lateral cutaneous nerve of the arm supplies:
Skin over the lateral shoulder and upper arm
83
The radial nerve contains fibers from:
C5-C8 and sometimes T1
84
The radial nerve enters the forearm after traveling between which muscles?
Brachialis and brachioradialis
85
The deep branch of the radial nerve penetrates which muscle?
Supinator
86
Muscular branches of the radial nerve supply:
All three heads of triceps brachii and anconeus,
87
Branches of the radial nerve, that are given off at the level of the lateral epicondyle, will supply:
Brachioradialis and extensor carpi radialis longus
88
A patient presents with reduced triceps and brachioradialis reflexes. You would suspect damage to which nerve?
Radial nerve
89
Which nerves are implicated in Erb-Duchenne palsy?
Suprascapular, musculocutaneous and axillary nerves
90
A patient who presents with Erb-Duchenne palsy would experience atrophy to which muscles?
Brachialis, biceps brachii and deltoid
91
Which muscles are primarily affected in Klumpke's palsy?
Hand muscles (thenar/hypothenar interossei)
92
True/False: Each mixed thoracic spinal nerve will divide into a posterior and anterior primary ramus.
True
93
Which muscles are supplied by medial branches of the posterior primary ramus in thoracic spinal nerves?
Semispinalis (Upper 6), longissimus (Lower 6) and multifidi
94
Which muscles are supplied by lateral branches of the posterior primary ramus in thoracic spinal nerves?
Longissimus, iliocostalis and levator costarum
95
The intercostobrachial nerve contains fibers from:
The anterior primary rami of T2 (and sometimes T1)
96
Which muscles are supplied by thoracic spinal nerves 7-11?
Transverse abdominal, internal and external abdominal oblique and rectus abdominus
97
What is the name of the T12 spinal nerve?
Subcostal nerve
98
The largest of the thoracic nerves is the:
Subcostal nerve (T12)
99
True/False: Each thoracic nerve communicates with the sympathetic trunk by way of both white and gray rami communicans.
True
100
The medial branches of the posterior primary rami of lumbar nerves supply the _____, while the lateral branches supply the _____.
Multifidi; Erector spinae group
101
How many lumbar sympathetic ganglia communicate with the sympathetic trunk?
Four
102
True/False: There will be white rami communicans associated with each lumbar nerve, and there will be gray rami communicans associated with L1 and L2 nerves.
False; there will be white rami communicans associated with L1/L2 (sometimes L3), and there will be gray rami communicans associated with each lumbar nerve
103
The lumbar plexus is formed by:
Anterior primary rami of L1-L3 and part of L4 (will also receive contribution from T12 via communication with L1)
104
Muscular branches of the lumbar plexus supply which muscles?
L1- Quadratus lumborum and psoas minor
L2- Quadratus lumborum and both psoas muscles
L3/L4- Quadratus lumborum and psoas major
105
The iliohypogastric nerve contains fibers from:
T12 and L1
106
Which nerve supplies the posterolateral gluteal region?
Lateral cutaneous branch of the iliohypogastric nerve
107
The anterior cutaneous branch of the iliohypogastric nerve supplies:
Skin of the pubic region
108
Which two muscles are supplied by the iliohypogastric nerve?
Internal abdominal oblique and transverse abdominal muscles
109
The ilioinguinal nerve contains fibers from:
T12 and L1 (same as iliohypogastric)
110
Which muscles are innervated by the ilioinguinal nerve?
Internal abdominal oblique and transverse abdominal muscles (same as iliohypogastric)
111
The genitofemoral nerve contains fibers from:
L1 and L2
112
The genital branch of the genitofemoral nerve provides motor supply supply to _____ and sensory supply to _____.
Cremaster; skin of superior anterior scrotum (males) or skin of the mons pubis and labium majus (females)
113
What does the femoral branch supply?
Sensory to skin of upper anterior thigh
114
The lateral cutaneous nerve of the thigh contains fibers from:
L2 and L3
115
The lateral cutaneous nerve of the thigh leaves the abdominal cavity by passing under the:
Inguinal ligament
116
Which nerve travels anterior to the sartorius and through the fascia lata?
Lateral cutaneous nerve of the thigh
117
Which nerve is the largest in the lumbar plexus? It contains fibers from?
Femoral nerve; L2-L4
118
Within the abdomen, the femoral nerve gives off muscular branches to which muscles?
Iliacus and pectineus
119
The anterior division of the femoral nerve gives off:
Intermediate cutaneous nerve of the thigh and medial cutaneous nerve of the thigh (sensory nerves)
120
The posterior division of the femoral nerve gives off:
Muscular and vascular branches
121
Which muscles are innervated by the muscular branches in the posterior division of the femoral nerve?
Quad muscles (sartorius, rectus femoris and all 3 vastus muscles)
122
Which nerve is transmitted through the adductor canal and is a continuation of the articular branches of the femoral nerve?
Saphenous nerve
123
Which nerves form the lumbar plexus?
Iliohypogastric, ilioinguinal, genitofemoral, lateral cutaneous, obturator and femoral nerves (I twice Get Laid On Fridays)
124
The obturator nerve contains fibers from:
L2-L4
125
Which lumbar nerve is the principal contributor to the obturator nerve? Which one is minimal?
L3 (L2 is the least)
126
The anterior and posterior branches of the obturator nerve are initially separated by the obturator externus. Which muscle separates them after that?
Adductor brevis
127
Which plexus is formed by branches of the femoral nerve and anterior branches of the obturator nerve?
Subsartorial plexus
128
The termination of which nerve supplies the femoral artery?
Anterior branch of the obturator nerve
129
Which muscles are innervated by the anterior branch of the obturator nerve?
Adductor longus, gracilis, pectineus and adductor brevis
130
Which muscles are innervated by the posterior branch of the obturator nerve?
Obturator externus and adductor magnus (as well as adductor brevis, if not supplied by the anterior branch)
131
How many pairs of thoracic, lumbar and sacral spinal nerves are there?
12 thoracic, 5 lumbar and 5 sacral (22 pairs = 44 total nerves)
132
Which sacral spinal nerve travels through the sacral hiatus?
S5 (S1-S4 travel through the 4 anterior/posterior sacral foramina)
133
Which posterior primary rami of sacral nerves divide into medial and lateral branches?
S1-S3
134
The medial branches of S1-S3 supply:
Adjacent multifidi
135
The lateral branches of S1-S3 supply:
Combine with L5 and S4 to supply skin over the butt
136
Which sacral posterior primary rami combine with the coccygeal posterior primary rami to supply the skin over the coccyx?
S4 and S5
137
How many sacral sympathetic ganglia communicate with the sympathetic trunk?
3 or 4
138
True/False: The posterior primary ramus of each sacral nerve will receive postganglionic sympathetic fibers via gray rami communicans.
False, ANTERIOR primary rami will receive those fibers from gray rami communicans
139
The coccygeal plexus is formed by:
Anterior rami of S4, S5 and Co1 nerves
140
The nerves of the coccygeal plexus give rise to:
Anococcygeal nerves that carry sensory information from the skin adjacent to the coccyx and anus
141
If a patient presents with hammer toes, "claw foot," or flexor paralysis, you'd suspect damage to which nerve?
Tibial nerve
142
```
The posterior cord of the brachial plexus gives rise to each of the following EXCEPT:
A. Thoracodorsal nerve
B. Long thoracic nerve
C. Inferior subscapular nerve
D. Axillary nerve
```
B. Long thoracic nerve (formed from roots of C5-C7)
143
The superior gluteal nerve is named for its relationship to the:
Piriformis muscle
144
Your patient demonstrates a high steppage gait. What muscles/nerves are affected in this condition?
Dorsiflexors supplied by the deep fibular nerve
145
Which level of the sacral plexus supplies the levator ani and coccygeal muscles?
S4
146
S4 supplies which muscles?
Levator ani and coccygeus muscles
147
The lateral cutaneous nerve of the forearm is the terminal branch of which nerve?
Musculocutaneous nerve
148
The anterior division of the femoral nerve will supply which muscle?
Sartorius (via nerve to the sartorius)
149
Which lumbar nerves supply the quadratus lumborum?
L1-L4
150
Which branch of the pudendal nerve supplies the bulbospongiosus and the ischiocavernosus?
Deep perineal branch
151
Which nerve supplies muscles in the anterior compartment of the leg?
Deep fibular nerve
152
The interossei muscles of the foot are supplied by which nerve?
Deep branch of the lateral plantar nerve
153
True/False: A winging scapula may indicate damage to the long thoracic nerve.
True
154
True/False: The sciatic nerve typically divides into tibial and common fibular in the proximal part of the thigh.
False; Distal 2/3 of the thigh
155
True/False: Carpal tunnel syndrome typically affects all five digits of the hand.
True
156
True False: The sacral multifidi are supplied by the medial branch of the posterior primary rami of S1-S3.
True
157
True/False: The pectineus muscle is supplied exclusively by the obturator nerve.
False; not always
158
Which nerve supplies muscles originating on the posterior surface of the scapula?
Suprascapular nerve
159
The sacral plexus is formed by:
Anterior primary rami of L4-S3 and part of S4
160
Contributions from L4 and L5 are by way of the:
Lumbosacral trunk
161
The sacral plexus forms on the anterior surface of which muscle?
Piriformis muscle
162
L4, L5 and S1 nerve roots make up which nerves?
Nerve to the quadratus femoris and gemellus inferior and the superior gluteal nerve
163
The pudendal nerve contains fibers from:
S2-S4
164
Fibers from L5, S1 and S2 combine to form which nerves?
Nerve to the obturator internus and gemellus superior
165
Which branches come off the pudendal nerve within the pudendal canal?
Inferior rectal and perineal nerves
166
Inferior rectal nerves of the pudendal nerve provide motor supply to:
External anal sphincter
167
Deep perineal branches of the pudendal nerve supply which muscles?
External anal sphincter, bulbospongiosus, ischiocavernosus and superficial transverse perineus
168
What is the name of the terminal branch of the pudendal nerve?
Dorsal nerve of the penis (males) or clitoris (females)
169
The dorsal nerve supplies which muscles?
Deep transverse perineus and urethral sphincter muscles
170
Individual muscular branches off the sacral plexus contain fibers from ______ and supply which muscles?
S4; levator ani and coccygeus muscles
171
The pelvic splanchnic nerves contain fibers from:
S2-S4 (same as pudendal nerve)
172
The nerve to the piriformis carries fibers to the piriformis from which sacral cord levels?
S1 and S2
173
The superior gluteal nerve contains fibers from:
L4, L5 and S1 (same as nerve to QF and GI)
174
Which branch of the superior gluteal nerve supplies the gluteus medius/minimus and tensor fascia lata?
Inferior branch
175
Which branch of the superior gluteal nerve supplies just the gluteus medius and minimus?
Superior branch
176
The inferior gluteal nerve carries fibers from _____ and innervates which muscle?
L5, S1 and S2; gluteus maximus
177
Which nerve travels through the sacrotuberous ligament?
Perforating cutaneous nerve
178
Which structure does the perforating cutaneous nerve travel through?
Sacrotuberous ligament
179
The perforating cutaneous nerve contains fibers from:
S2 and S3
180
Which nerves are formed by both anterior and posterior divisions of the sacral plexus?
Posterior cutaneous nerve of the thigh and the sciatic nerve
181
The posterior cutaneous nerve of the thigh is formed by fibers from:
Anterior divisions of S2 and S3 and posterior divisions of L4-S2
182
The sciatic nerve is formed by fibers from:
Anterior divisions of L4-S3 and posterior divisions of L4-S2
183
The sciatic nerve is a combination of which two nerves?
Tibial and common fibular nerves
184
The tibial nerve is more medially located and is formed by:
Anterior divisions of L4-S3
185
The common fibular nerve is more laterally located and is formed by:
Posterior divisions of L4-S2
186
As the sciatic nerve travels below the piriformis, it continues to travel on the posterior aspect of which muscle?
Adductor magnus
187
Which muscle is supplied by the common fibular nerve before it separates from the tibial nerve?
Short head of biceps femoris
188
Which branch of the common fibular nerve supplies the skin on the lateral aspect of the leg?
Lateral sural cutaneous nerve
189
The lateral sural cutaneous nerve supplies:
Skin on the lateral aspect of the leg
190
The sural nerve is formed by the combination of:
Fibular communicating branch and medial sural cutaneous nerve
191
Which nerve is formed by the combination of the fibular communicating branch and medial sural cutaneous nerve?
Sural nerve
192
Which nerve supplies the fibularis longus and brevis?
Superficial fibular nerve
193
What are the branches of the superficial fibular nerve?
Medial dorsal cutaneous and intermediate dorsal cutaneous nerves
194
The branches of the superficial fibular nerve supply:
Skin over the dorsum of the foot, except for the skin between the first two toes
195
The terminal branch of which nerve supplies the skin between the first two toes?
Deep fibular nerve
196
While still combined with the common fibular nerve, tibial nerve fibers are sent to which muscles?
Long head of biceps femoris, semitendinosus, semimembranosus and adductor magnus
197
In the popliteal fossa, the tibial nerve gives off muscular branches to which muscles?
Popliteus, gastrocnemius (both heads), soleus and plantaris
198
Which branch of the tibial nerve gives rise to the interosseous nerve of the leg?
Popliteal nerve
199
The popliteal nerve gives rise to:
Interosseous nerve of the leg
200
Which nerve supplies the Tom, Dick and Harry muscles (tibialis posterior, flexor digitorum longus and flexor hallucis longus)?
Tibial nerve
201
Which branch of the tibial nerve supplies the skin over the medial heel?
Medial calcaneal branches
202
What are the names of the terminal branches of the tibial nerve?
Medial and lateral plantar nerves
203
The medial plantar nerve provides motor fibers to which muscles?
Abductor hallucis, flexor digitorum brevis and flexor hallucis brevis
204
Common plantar nerves provide motor supply to _____ and sensory supply to _____.
Motor: 1st/2nd lumbricals
Sensory: skin between toes via proper plantar digital nerves
205
The superficial branch of which nerve supplies the skin around the 5th digit (pinky toe)?
Lateral plantar nerve
206
Which branch of the lateral plantar nerve is sensory? Which one is motor?
Sensory: Superficial branch
Motor: Deep branch
