Nerves

Question 1

Musckulocutaneous Nerve

Answer 1

Segment - C5 C6
Innervation - coracobrachialis, biceps, brachialis
Distribution - anterolateral surface of forearm

Question 2

Axillary Nerve

Answer 2

Segment - C5 C6
Innervation - deltoid, teres minor
Distribution - lateral arm over lower portion of delt

Question 3

Radial Nerve

Answer 3

Segment - C5-8, T1
Innervation - triceps, anconeus, brachioradialis, and supinator, wrist/finger/thumb extensors
Distribution - posterior are/forearm and radial sideof posterior hand

Question 4

Median nerve

Answer 4

Segment - C6, 7, 8, T1
Innervation - pronators, writs/finger flexors on radial side, most thumb muscles
Distribution - palmar aspects of thumb, 2nd, 3rd and radial half of 4th fingers

Question 5

Ulnar Nerve

Answer 5

Segment - C7 C8 T1
Innervation - flexor carpi ulnaris, felxor digitorum profundus (medial half), interossei, 4th and 5th lumbricals
Distribution - medial portion of 4th finger and 5th finger

Question 6

Sciatic Nerve

Answer 6

Segment - L4-S3
Innervation - HS and adductor magnus
Distribution - through its terminal branches of the tibial, superficial fibular, and deep fibular nerves

Question 7

Femoral Nerve

Answer 7

Segment - L2 L3 L4
Innervation - sartorius, quads, iliacus and pectineus
Distribution - middle ant thigh and medial thigh prox to knee

Question 8

Tibial Nerve

Answer 8

Segment - L4-S3
Innervation - gastroc/soleus, plantaris, popliteus and tib post
Distribution - posterolateral calf, ankle and heel

Question 9

Superficial Fibular Nerve

Answer 9

Segment - L5-S2
Innervation - fubularis longus/brevis
Distribution - anterolateral distal lower leg and ankle and most of dorsum of foot

Question 10

Deep Fibular Nerve

Answer 10

Segment - L4-S2
Innervation - tib ant, ext hallucis longus/brevis, ext dogitorum longus/brevis, fibularis tertius, 1st and 2nd dorsal interossei
Distribution - web space bwteen 1st and 2nd toes on the dorsum of foot

Question 11

CN 1

Answer 11

Olfactory
Fx- smell
Damage - anosmia (loss of smell)

Question 12

CN 2

Answer 12

Optic
Fx- sight, pupillary reflexes
Damage - monocular blindness, loss of pupillary constriction, absent blink reflex

Question 13

CN 3

Answer 13

Oculomotor
Fx- moves eye and elevates upper eyelid
Damage - ptosis, dilation of pupil, loss of accomodation of light reflex

Question 14

CN 4

Answer 14

Trochlear
Fx- motor nerve for superior oblique muscle
Damage -

Question 15

CN 5

Answer 15

Trigeminal
Fx- mastication and sensory nerve of head
Damage - loss of facial sensation, weak mastication, deviation of opened jaw to ipsilateral side

Question 16

CN 6

Answer 16

Abducens
Fx- abducts eye (via nerve supply to lateral rectus muscle)
Damage - diplopia, convergent squint (medial strabismus), and abductor paralysis or ipsilateral eye

Question 17

CN 7

Answer 17

Facial
Fx- facial expression, speeach articulation, winking ingestion or food/drink, taste/salivary and nasal secretions
Damage - ipsilateral facial paralysis, dry mouth, loss of taste anterior third of tongue

Question 18

What condition results from damage to CN 7?

Answer 18

Facial

Bell’s Palsy

Question 19

Injury/paralysis to what nerve causes foot drop and weakness in the intrinsic foot muscles?

Answer 19

Deep fibular nerve

Question 20

CN 8

Answer 20

Vestibulocochlear
Fx- hearing, maintenance of equilibrium
Damage - vertigo, nystagmus, tinnitus, loss of hearing

Question 21

CN 9

Answer 21

Glossopharyngeal
Fx - elevates pharynx, salivary secretion, taste
Damage - slight dysphagia, partial dry mouth, loss of taste on posterior 3rd or tongue

Question 22

CN 10

Answer 22

Vagus
Fx - phonation, visceral sensations/reflexes, cardiac depressor, bronchoconstrictor, GI tract peristolsis/secrection
Damage - palpitations, tachycardia, comiting, slowing of respiration, hoarseness, anesthesia of larynx

Question 23

CN 11

Answer 23

Accessory
Fx - deglutition and phonation, movement of head and shoulders
Damage - weakness in shrugging ipsilateral shoulder, turning head opposite side

Question 24

CN 12

Answer 24

Hypoglossal
Fx - movements of tongue
Damage - unilateral paralysis of tongue

Question 25

What are the DTR's and what level are they testing?

Answer 25

``` Biceps - C5-6 Brachioradialis - C6 Triceps - C7 Patellar tendon - L3, L4 Achilles tendon - S1, S2 ```

Question 26

Grading scale for reflexes

Answer 26

``` 0 = absent reflexes = areflexia 1+ = hyporeflexive, indicates LMN injury 2+ = normal 3+ = hyper-reflexive, indicates UMN injury ```

Question 27

How does neural tension testing work?

Answer 27

by stretching the peripheral nerves with specific mvm'ts, the mobility of the spinal dura and nerve roots can be tested

Question 28

SLR Biases

Answer 28

SLR - sciatic SLR + DF + EV = tibial nerve SLR + PF + INV = fibular nerve SLR + DF + INV = sural nerve

Question 29

What are two tests used to screen for spinal cord signs?

Answer 29

1. Ankle clonus leg in slight knee flex and rapidly DF ankle +ve with spasmodic alternations of muscle contraction 2.Babinkski's test stroke plantar aspect of foot from to heel to base of great toe +ve if great toe moves into DF and other toes fan