Anatomy of the Brachial Plexus
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Questions and Answers

What spinal nerve roots contribute to the formation of the brachial plexus?

  • C4, C5, C6, C7, T1
  • C3, C4, C5, C6, C7
  • C6, C7, C8, T1, T2
  • C5, C6, C7, C8, T1 (correct)
  • Which component of the brachial plexus lies in the axilla?

  • Roots
  • Cords (correct)
  • Divisions
  • Trunks
  • How many trunks are formed from the roots of the brachial plexus?

  • Two
  • Three (correct)
  • Four
  • Five
  • Which nerve is formed from the roots of the brachial plexus?

    <p>Dorsal scapular nerve</p> Signup and view all the answers

    From which trunk does the suprascapular nerve originate?

    <p>Upper trunk</p> Signup and view all the answers

    What is the function of the long thoracic nerve?

    <p>To innervate the serratus anterior</p> Signup and view all the answers

    What forms the lateral cord of the brachial plexus?

    <p>Anterior divisions of the upper and middle trunks</p> Signup and view all the answers

    Which nerve is a branch of the medial cord?

    <p>Medial pectoral nerve</p> Signup and view all the answers

    What is the anatomical position of the divisions of the brachial plexus?

    <p>Behind the clavicle</p> Signup and view all the answers

    Which spinal nerves are involved in the contribution to the phrenic nerve from the roots?

    <p>C3, C4, C5</p> Signup and view all the answers

    What hand position is characteristic of Klumpke's paralysis?

    <p>Claw hand</p> Signup and view all the answers

    Which nerve roots are primarily involved in Klumpke's paralysis?

    <p>C8 and T1</p> Signup and view all the answers

    What is a significant sensory loss associated with Klumpke's paralysis?

    <p>Along the medial border of the forearm and hand</p> Signup and view all the answers

    Which condition is characterized by the absence of autonomic signs?

    <p>Erb's paralysis</p> Signup and view all the answers

    Which of the following muscles is not paralyzed in Klumpke's paralysis?

    <p>Biceps brachii</p> Signup and view all the answers

    What is the primary surgical concern when approaching the axilla for lymph node excision?

    <p>Intercostobrachial nerve</p> Signup and view all the answers

    Which of the following symptoms is associated with Horner's syndrome?

    <p>Miosis</p> Signup and view all the answers

    What causes Erb's paralysis?

    <p>Excessive increase in the angle between the head and shoulder</p> Signup and view all the answers

    What type of nerve involvement is most affected in Klumpke's paralysis?

    <p>Both motor and sensory nerves</p> Signup and view all the answers

    What hand position is characteristic of Erb's paralysis?

    <p>Policeman's tip position</p> Signup and view all the answers

    Which of the following nerves is not typically implicated during axillary surgery?

    <p>Median nerve</p> Signup and view all the answers

    What is the typical deformity associated with Erb's paralysis?

    <p>Arm hanging medially rotated and extended</p> Signup and view all the answers

    Which nerve is NOT part of the medial cord contributions of the brachial plexus?

    <p>Thoraco-dorsal nerve</p> Signup and view all the answers

    What effect does Erb's paralysis have on the elbow position?

    <p>Extended and pronated</p> Signup and view all the answers

    Erb's point is located at which part of the brachial plexus?

    <p>Area where upper trunk nerves merge</p> Signup and view all the answers

    What is the role of the axillary nerve?

    <p>Innervates the deltoid muscle</p> Signup and view all the answers

    Which muscles are paralyzed leading to internal rotation of the arm in Erb's paralysis?

    <p>Supraspinatus and infraspinatus</p> Signup and view all the answers

    What is a common mechanism of injury for Klumpke's paralysis?

    <p>Traction during childbirth</p> Signup and view all the answers

    Which nerve is involved in providing sensation to the outer aspect of the arm?

    <p>Medial cutaneous nerve of arm</p> Signup and view all the answers

    Study Notes

    Anatomy of the Brachial Plexus

    • The brachial plexus is a network of nerves formed by the ventral rami of the lower four cervical and first thoracic spinal nerves (C5, C6, C7, C8, and T1). It has minimal contribution from C4 to T2.
    • The brachial plexus involves four main components: roots, trunks, divisions, and cords.
    • Roots: Five roots, composed of the anterior primary rami of C5-T1 spinal nerves; located in the neck, behind the anterior scalene muscle.
    • Trunks: Three trunks are formed by the fusion of the roots: Upper trunk (C5 and C6), Middle trunk (C7), and Lower trunk (C8 and T1) . They are located in the neck, between the anterior and middle scalene muscles.
    • Divisions: Each trunk divides into anterior and posterior divisions, located behind the clavicle.
    • Cords: The anterior and posterior divisions of the trunks unite to form three cords: Lateral cord, Medial cord, and Posterior cord situated in the axilla.

    Branches of the Brachial Plexus

    • From roots: Long thoracic nerve (C5, C6, C7) innervating the serratus anterior muscle; dorsal scapular nerve (C5) innervating the rhomboids. Additional branches supply the scalenus muscles and longus colli (C5, C6, C7, C8). There's also a contribution to the phrenic nerve (C5).
    • From trunks: Suprascapular nerve (C5 and C6) and nerve to subclavius (C5 and C6).
    • From cords:
      • Lateral cord: Lateral pectoral nerve (C5, C6, C7), lateral root of the median nerve (C5, C6, C7), and musculocutaneous nerve (C5, C6, C7).
      • Medial cord: Medial pectoral nerve (C8 and T1), medial cutaneous nerve of the arm (T1), medial cutaneous nerve of the forearm (C8 and T1), medial root of the median nerve (C8 and T1), and ulnar nerve (C7, C8, and T1).
      • Posterior cord: Radial nerve (C5, C6, C7, C8, and T1), axillary nerve (C5 and C6), thoracodorsal nerve (C6, C7, and C8), upper subscapular nerve (C5 and C6), and lower subscapular nerve (C5 and C6).

    Applied Anatomy

    • Erb's point: The region where the upper trunk of the brachial plexus is formed at the junction of the C5 and C6 nerve roots. This area is also where the suprascapular and nerve to the subclavius and also where the trunk divides into anterior and posterior divisions.
    • Erb's paralysis (upper plexus injury): Caused by excessive stretching of the upper plexus, often during a fall or birth injury. Characterized by adduction of the arm, medial rotation of the arm, extension of the elbow, and pronation of forearm (policeman's tip hand)
    • Klumpke's paralysis (lower plexus injury): Caused by hyperabduction of the arm (e.g., fall, certain deliveries). Characterized by claw hand due to paralysis of the flexor muscles of the wrist and fingers (C6, C7, and C8). It also involves loss of sensation along the medial border of the forearm and hand (T1) and sometimes includes Horner's syndrome.

    Additional Details

    • Surgical approaches to the axilla (armpit) may involve risk to intercostobrachial nerve, long thoracic nerve, thoracodorsal nerve, and thoracodorsal artery when the axillary lymph nodes are removed in breast cancer surgery.

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    Description

    This quiz explores the intricate anatomy of the brachial plexus, detailing its components like roots, trunks, divisions, and cords. Test your knowledge on the formation and organization of this essential network of nerves crucial for upper limb function.

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