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Year 2: Neurobiology II > Lecture 6: Spinal nerves and plexus > Flashcards

Lecture 6: Spinal nerves and plexus Flashcards

1
Q

number of spinal nerves and their associated levels

A

31 pairs of spinal nerves

8 cervical

12 thoracic

5 lumbar

5 sacral

1 coccygeal

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2
Q

describe the location of the cervical spinal nerves

A

the first is located between the occiput and C1 vertebrae (motor only)

2-7 are located ABOVE corresponding cervical vertebrae

C8 under C7/above T1

+1 rule = i.e. nerve under C1 vertebrae = C1 + 1 = C2 nerve

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3
Q

what is the endoneurium

A

continuous part of the pia mater

wraps a SINGLE AXON

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4
Q

what is the perineurium

A

continuous component from arachnoid mater

wraps BUNDLES OF AXONS (form a fasicle)

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5
Q

what is the epineurium

A

continuous component from dura mater wrapping BUNDLES OF FASCICLES

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6
Q

describe blood supply to peripheral nerves

A

plexus of arterioles follow the peripheral nerves

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7
Q

what is a neuropraxia injury

A

compression injury with axon intact

endoneurium is intact

good chance of recovery

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8
Q

what is an axonotmesis injury

A

tear of an axon

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9
Q

what is a neurotmesis injury

A

tear of whole fascicle/nervee

disrupted endo-, peri, or even epineurium

poor chance of recovery

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10
Q

describe the size of a spinal nerve

A

very short

soon splits to dorsal and ventral rami

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11
Q

what are the branches of the dorsal rami and what do they supply

A

medial branch = vertebral disc, facet joints, intrinsic back mm, and skin

lateral branch = intrinsic back mm mainly and skin slightly

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12
Q

branches of the ventral ramus as well as their further sub-branches and function

A

cutaneous branch
- lateral cutaneous = anterior and posterior branches
- anterior cutaneous = lateral and medial branches

muscular branch = supplies intercostals, serratus posterior, and abdominal wall mm

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13
Q

myotomes tested in ASIA scale

A

5 UE and 5 LE

major limb mm of each

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14
Q

dermatomes test what; how does it vary from trunk to neck/extremities

A

segmental distribution of nn innervation

A delta - crude touch, sharp pain

trunk area = ventral and dorsal rami of spinal nn

neck and extremities = peripheral nn from plexus fromed by VENTRAL rami

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15
Q

cervical plexus is formed by what rami

A

ventral

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16
Q

nerves from the cervical plexus and their roots

A

Lesser occipital nerve - (C2)

Greater Auricular nerve - (C2-C3)

transverse cervical nerve - (C2-C3)

Supraclavicular nerve (C3-C4)

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17
Q

innervation at the mandibular angle

A

greater auricle nerve

around the TMJ; important to know this for differential dx

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18
Q

where does the supraclavicular nerve (C3-C4) exit

A

posterior 1/3 of the SCM

area is a nerve point; common place for dry needling

if mm is strained it can compress the nerve

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19
Q

C1 nerve (part of cervical plexus) goes to what mm

A

geniohyoid and thyrohyoid mm through hypoglossal nn (CN XII)

hikes onto CN XII

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20
Q

roots of ansa cervicalis and the target mm

A

superior root = C1 (through hypoglossal n)

inferior root (C2-C3)

target mm = infrahyoid neck mm

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21
Q

phrenic nn roots

A

C3-C5

acts like CPG; doesn’t take conscious thought to breathe

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22
Q

what ventral rami roots supply the brachial plexus

A

C5-T1

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23
Q

superior trunk of the brachial plexus roots

A

C5/C6

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24
Q

middle trunk of brachial plexus roots

A

C7

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25
inferior trunk of brachial plexus roots
C8/T1
26
the 1st ribs separates what
C8/T1 nerve roots can get impinged
27
each trunk of the brachial plexus gives out what
anterior and posterior divisions
28
lateral cord is formed by
anterior divisions of the superior and middle trunk
29
medial cord is formed by
anterior division of the inferior trunk
30
posterior cord is formed by
all posterior divisions (from superior, medial, and inferior trunk)
31
each cord of the brachial plexus gives out what
terminal branches of nn
32
what nerves of the brachial plexus are directly from the nerve roots
Dorsal scapular nerve (C4 and C5) Long thoracic nerve (C5, C6, and C7)
33
dorsal scapular nn supplies what mm
levator scapulae rhomboid major and minor
34
long thoracic nerve supplies what mm
serratus anterior SALT57 = serratus anterior, long thoracic, roots C5 through C7
35
nerves from the superior trunk of the brachial plexus
suprascapular nerve (C5 and C6) nerve to subclavius (C5 and C6)
36
suprascapular nerve supplies what
supra and infraspinatus
37
roots of the lateral cord
C5, C6, and C7
38
roots of lateral pectoral nerve and mm supplied
lateral pectoral nerve technically has a bridge to the medial as well; thus nn roots are C5-T1 supplies pec major
39
musculocutaneous nn roots
C5-C7
40
mm supplied by musculocutaneous nn and roots
coracobrachialis/biceps brachii (C5/C6) Brachialis (C5/C6) and some C7 from radial nn
41
skin supplied by musculocutaneous nn
lateral antebrachial nn is a branch from the musculocutaneous nerve supplies the lateral forearm; cutaneous innervation
42
what are the terminal branches of the lateral cord
lateral pectoral nerve (C5-T1 b/c branch to medial pectoral nn) musculocutaneous nerve (C5-C7) gives branch to median nerve (C5-C7 root portion)
43
roots of the medial cord of the brachial plexus
C8 and T1
43
terminal branches of the medial cord of the brachial plexus
medial pectoral nn medial brachial cutaneous nerve medial antebrachial cutaneous nerve ulnar nerve branch to median nerve
44
medial pectoral nerve (C8-T1) supplies what
pec major and minor
45
forearm mm innervated by the ulnar nn
flexor carpi ulnaris ulnar side 1/2 of flexor digitorium profundus
46
hand mm innervated by the ulnar nn
palmaris brevis ulnar side 2 lumbricals ulnar head of flexor pollicis brevis interossei/adductor pollicis hypothenar eminence mm
47
what are the mm of the hypothenar eminence
Abductor digiti minimi Flexor digiti minimi Opponens digiti minimi
48
cutaneous branch of the ulnar nn supplies what
dorsal and palmar sides of hand 1.5 digits
49
forearm mm supplied by the median nn
pronator teres flexor carpi radialis palmaris longus flexor digitorum superficialis Via anterior interosseous: -flexor pollicis longus -radial 1/2 flexor digitorum profundus -pronator quadratus
50
anterior interosseous nerve supplies what
flexor pollicis longus radial 1/2 flexor digitorum profundus pronator quadratus
51
mm of thenar eminence
abductor pollicis brevis flexor pollicis brevis (radial head) opponens pollicis
52
hand mm supplied by median nn
thenar eminence radial side 2 lumbricals
53
cutaneous branch of the median nerve supplies what
radial palmar side 3.5 fingers and dorsal DIP
54
roots of the posterior cord
C5-T1
55
terminal branches of the posterior cord
upper subscapular nn (C5-C6) middle subscap/thoracodorsal nn (C6-C8) lower subscapular nn (C5-C6) axillary nn (C5-C6) radial nn (C5-T1)
56
roots of upper subscap and mm it innervates
C5-C6 subscapularis
57
rots of the middle subscapular nn/thoracodorsal nn and mm innervated
C6-C8 latissimus dorsi
58
lower subscapular nerve roots and mm it innervates
C5-C6 subscapularis and teres major
59
axillary nn roots
C5-C6
60
radial nn roots
C5-T1
61
target mm of axillary nn
deltoid teres minor
62
cutaneous branch of the axillary nn innervates what region
shoulder girdle along deltoid
63
arm/elbow mm innervated by radial nn
triceps brachioradialis anconeus supinator
64
forearm mm innervated by radial nn
abductor pollicis longus extensor pollicis brevis extensor carpi radialis longus/brevis extensor pollicis longus extensor digitorum extensor indicis extensor digiti minimi extensor carpi ulnaris
65
nn of lumbar plexus directly from the ventral rami and their corresponding roots
iliohypogastric = T12 - L1 iliolingual = L1 genitofemoral = L1-L2
66
anterior division of the lumbar plexus gives off what nn, what are their roots, and what do they supply
obturator nn (L2-L4) - medial thigh lumbosacral trunk (L4-L5) - continues for sacral plexus
67
posterior division of the lumbar plexus supplies what
lateral and anterior thigh
68
posterior division of the lumbar plexus gives off what nn
lateral femoral cutaneous nn (L2-L3) Femoral (L2-L4)
69
target mm of obturator nn
pectineus obturator externus adductors (except adductor magnus HS head) gracilis
70
general functions of mm innervated by obturator nn
Hip ADD/IR Hip ER (pectineus and obturator externus) Knee flex Knee IR (gracilis)
71
target mm of femoral nn
iliopsoas sertorius pectineus quadriceps
72
what is special about pectineus innervation
innervated by obturator nn AND femoral
73
general functions of mm supplied by femoral nn
Hip flexion and ER knee ext and IR
74
cutaneous branch of femoral nn supplies what
anterior thigh medial leg to foot arch (saphenous nn)
75
roots of lumbosacral trunk
L4-L5
76
roots of sacral spinal nn
S1-S4
77
ventral/anterior division of the sacral plexus gives off what nn and what are their roots
tibial nn L4-S3 pudendal nn S2-S4 pelvic splanchnic nn S2-S4, parasympathetic motor
78
dorsal/posterior division of the sacral plexus gives off what nn and what are their roots
common fibular nn L4-S2 superior gluteal nn L4-S1 inferior gluteal nn L5-S2
79
roots of posterior femoral cutaneous nn
S1-S3
80
mm supplied by superior gluteal nn L4-S1
glut med glut min TFL
81
mm supplied by inferior gluteal nn L5-S2
glut max
82
thigh mm innervated by common fibular nn
biceps femoris SH
83
leg mm innervated by the common fibular nn
superficial - fibularis longus/brevis deep branch - tibialis anterior - extensor digitorum longus - extensor hallucis longus - fibularis tertius - foot mm (ext hallucis/digitorium brevis)
84
general functions of mm supplied by common fibular nn
knee flexion and ER ankle/foot - DF - IV - toe EXT - PF - EV
85
cutaneous branch (superficial and deep) of the common fibular nn supplies what regions
superficial = lateral leg and dorsum of foot deep = dorsum of food between the 1st and 2nd digit
86
mm innervated by the tibial nn
HS except biceps femoris SH adductor magnus HS head posterior leg mm?? all foot intrinsic except extensor brevis
87
general functions of mm supplied by the tibial nn
hip ext knee flex, IR, ER ankle PF, IV, ADD, toe flex
88
cutaneous branch of the tibial nn supplies what regions
posterior leg to lateral foot (sural nn) sole of foot
89
radiculopathy vs peripheral neuropathy
radiculopathy = segmental distribution (multiple peripheral nn) peripheral neuropathy = localized region (single or multi peripheral nn)
90
discs in the cervical region
C2-C7 no C1 disc
91
how to name nn impinged by a disc
corresponding disc is above the vertebrae (C2 disc is above C2 vertebrae) impinged nn root number = +1 C5 disc herniation (disc above C5) would compress C6 nn root (C5+1)
92

Year 2: Neurobiology II (10 decks)

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