Brachial Plexus and Upper Limb Innervation
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Questions and Answers

What symptom is commonly associated with high lesions of the median nerve?

  • Inability to extend the index finger
  • Weakness in wrist flexion
  • Loss of sensory perception in the little finger
  • Loss of thumb opposition (correct)

    • Which of the following conditions is least likely to cause carpal tunnel syndrome?

  • Repetitive wrist activities
  • Hypothyroidism
  • Fracture of the femur (correct)
  • Diabetes

    • What is the primary motor function affected by a radial nerve lesion?

  • Flexion of the elbow
  • Adduction of the thumb
  • Abduction of the fingers
  • Extension of the wrist (correct)

    • The ulnar nerve primarily innervates which of the following muscles?

    <p>Flexor carpi ulnaris</p> Signup and view all the answers

    Which anatomical structure is most closely associated with the potential injury to the radial nerve?

    <p>Lateral epicondyle of the humerus</p> Signup and view all the answers

    What is the origin of the inferior trunk of the brachial plexus?

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

    Which cord of the brachial plexus is formed solely by the anterior division of a trunk?

    <p>Medial cord</p> Signup and view all the answers

    What is the primary function of the anterior divisions of the trunks in the brachial plexus?

    <p>Forming the lateral and medial cords</p> Signup and view all the answers

    How many secondary trunks are formed from the three trunks of the brachial plexus?

    <p>Three secondary trunks</p> Signup and view all the answers

    From which spinal roots does the brachial plexus originate?

    <p>C5-T1</p> Signup and view all the answers

    Which structure surrounds the brachial plexus as indicated in the provided content?

    <p>Brachial artery</p> Signup and view all the answers

    What is the relationship between the anterior divisions and the secondary trunks of the brachial plexus?

    <p>Anterior divisions merge to form the lateral and medial cords</p> Signup and view all the answers

    What features distinguish the cords of the brachial plexus?

    <p>They result from the merging of anterior and posterior divisions</p> Signup and view all the answers

    Which muscles are primarily innervated by the axillary nerve?

    <p>Deltoid and teres minor</p> Signup and view all the answers

    What is the main function of the musculocutaneous nerve?

    <p>Flexion of the arm at the elbow</p> Signup and view all the answers

    Which nerve is most likely to be injured in a humeral fracture near the head?

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

    What sensory area is innervated by the radial nerve?

    <p>Dorsal aspect of the hand</p> Signup and view all the answers

    Which function is NOT associated with the ulnar nerve?

    <p>Abduction of digits 2 and 3</p> Signup and view all the answers

    What could be a consequence of an injury to the median nerve?

    <p>Loss of thumb opposition</p> Signup and view all the answers

    Which nerve directly arises from the medial secondary trunk?

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

    What is the primary motor function of the radial nerve?

    <p>Extension of the arm and wrist</p> Signup and view all the answers

    Cubital tunnel syndrome is associated with which nerve?

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

    Which part of the arm does the musculocutaneous nerve provide sensory innervation to?

    <p>Lateral aspect of the forearm</p> Signup and view all the answers

    What is the primary function of the long thoracic nerve?

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

    Which syndrome is characterized by symptoms that arise from damage to the sympathetic trunk?

    <p>Horner's syndrome</p> Signup and view all the answers

    What signifies a 'waiter tip' position in the context of an upper brachial plexus injury?

    <p>Flexion of the wrist due to deltoid weakness</p> Signup and view all the answers

    Which nerve is affected in Klumpke's palsy leading to hand and finger weakness?

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

    Why might an individual experience scapula alata?

    <p>Long thoracic nerve palsy</p> Signup and view all the answers

    What causes the weakness of hand muscles in Klumpke's palsy?

    <p>Damage to the C8-T1 nerves</p> Signup and view all the answers

    Which of the following is NOT a symptom of Horner's syndrome?

    <p>Winged scapula</p> Signup and view all the answers

    What anatomical landmark is associated with Erb's point?

    <p>Above the middle area of the clavicle</p> Signup and view all the answers

    What is the impact of damage to the T1 root of the brachial plexus?

    <p>Presence of Horner's syndrome</p> Signup and view all the answers

    Which nerve arises from the C5-C6 spinal roots and innervates the subclavius muscle?

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

    What characterizes claw hand in relation to the interosseous and lumbrical muscles?

    <p>Hyperextension of metacarpophalangeal joints and flexion of interphalangeal joints</p> Signup and view all the answers

    Which nerve injury is most commonly associated with the characteristics of claw hand?

    <p>Ulnar nerve injury</p> Signup and view all the answers

    What is a distinguishing feature of cubitus valgus?

    <p>It can cause hand paraesthesia and weakness in finger movements</p> Signup and view all the answers

    In the context of Guyon canal syndrome, what type of deficits occur?

    <p>Only motor deficits, without sensory loss</p> Signup and view all the answers

    What is the primary function of the musculocutaneous nerve?

    <p>To innervate the flexor muscles of the arm</p> Signup and view all the answers

    How does the median nerve contribution differ from the ulnar nerve in terms of finger innervation?

    <p>The median nerve affects the first three and a half fingers' movement</p> Signup and view all the answers

    What pathological sign can arise from the friction of the ulnar nerve within the cubital tunnel?

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

    What anatomical structure is primarily affected by median nerve compression?

    <p>Transverse carpal ligament</p> Signup and view all the answers

    Which statement best describes the function of interosseous muscles in relation to finger movement?

    <p>They facilitate abduction and adduction of the fingers</p> Signup and view all the answers

    Study Notes

    Overview of the Brachial Plexus

    • Brachial plexus innervates the upper limb and arises from five spinal roots: C5-T1, with minor contributions from C4 and T2.
    • Located between the anterior and middle scalene muscles.

    Trunks of the Brachial Plexus

    • Comprised of three trunks:
      • Superior trunk: C5-C6
      • Middle trunk: C7
      • Inferior trunk: C8-T1
    • Each trunk divides into anterior and posterior divisions, which contribute to the formation of three cords.

    Formation of Cords

    • Lateral cord: Created from anterior divisions of the superior and middle trunks.
    • Medial cord: Formed solely from the anterior division of the inferior trunk.
    • Posterior cord: Comprises the posterior divisions of all three trunks.

    Branches and Terminal Nerves

    • Main functions are mediated through terminal branches (peripheral nerves) originating from each cord.
    • Notable branches include:
      • Dorsal scapular nerve (C5): Innervates rhomboids and levator scapulae.
      • Long thoracic nerve (C5-C7): Innervates serratus anterior.

    Long Thoracic Nerve Palsy

    • Characterized by winged scapula due to weakness in the serratus anterior muscle, affecting shoulder movement.

    Important Diagnostic Signs

    • Erb-Duchenne palsy: Occurs due to trauma at Erb's point, affecting C5-C6 innervated muscles, leading to a "waiter's tip" posture.
    • Klumpke’s palsy: Affects C8-T1, causes hand weakness and potential atrophy of hypothenar muscles.

    Horner's Syndrome

    • Results from damage to the T1 root, presenting symptoms like miosis and ptosis on the affected side.

    Important Nerves and Their Functions

    • Lateral pectoral nerve: Innervates pectoralis major.
    • Musculocutaneous nerve: Innervates coracobrachialis, biceps, and brachialis; becomes lateral cutaneous nerve of forearm.
    • Ulnar nerve: Governs finger movement, innervates flexors on the ulnar side.
    • Median nerve: Controls thumb flexion and some intrinsic hand muscles, critical for grip.
    • Axillary nerve: Involved in shoulder abduction and sensory supply to the skin covering the deltoid muscle.

    Common Injuries and Their Effects

    • Axillary nerve injury can lead to loss of shoulder abduction and sensory changes in the upper arm.
    • Ulnar nerve injuries may cause claw hand or cubital tunnel syndrome, affecting hand function.
    • Musculocutaneous nerve injuries are rare but can impact elbow flexion.

    Cubitus Valgus and Guyon Canal Syndrome

    • Cubitus valgus can result from elbow fractures, causing nerve compression.
    • Guyon canal syndrome involves ulnar nerve compression, leading to motor deficits without sensory loss.

    Additional Notes on Nerve Pathways

    • Median nerve travels underneath the flexor muscle layer to enter the carpal tunnel, important for its relationship to carpal tunnel syndrome.
    • The radial nerve is vital for extending the arm and hand and receives its origin from the posterior cord.

    Clinical Implications

    • Injury presentations depend on the level and structure affected within the brachial plexus, emphasizing the interconnectedness of arm function and potential complications from various accidents and surgeries.### Median Nerve
    • Responsible for motor function in the thenar eminence: controls abductor, short flexor, and opponens muscles of the thumb.
    • Palmar digital branches supply sensation to the fingertips of the index and middle fingers.
    • Common lesions occur due to various causes:
      • Compression when sleeping awkwardly (honeymoon palsy).
      • Humeral fractures and shoulder dislocation.
      • Puncture wounds and wrist injuries (cuts or carpal tunnel compression).
    • High lesion symptoms include:
      • "Preacher's hand" indicative of paralysis in flexors and pronators.
      • Loss of thumb opposition.
      • Reduced volume in the palm.
    • Low lesion outcome: carpal tunnel syndrome, often due to repetitive wrist movements, pregnancy, or underlying health conditions like diabetes.

    Radial Nerve

    • Innervates muscles in the extensor compartment of the arm and forearm; provides sensory input to the back of the hand.
    • Originates from the posterior secondary trunk near the armpit and travels along the radial sulcus, making it prone to injury from fractures.
    • The nerve runs between the brachialis and brachioradialis muscles, branching into:
      • Cutaneous nerves supplying the upper limb.
      • Posterior interosseous branch associated with multiple extensor muscles.
    • Lesion effects typically result in "wrist drop," characterized by impaired wrist and finger extension.

    Cutaneous Innervation in Upper Limbs

    • Different colors represent branches of the brachial plexus pertinent to sensory distribution:
      • Orange: supraclavicular branches
      • Grey: upper lateral cutaneous nerve
      • Ocher: medial cutaneous nerve of the arm
      • Red: lateral and posterior cutaneous nerves
      • Purple: medial cutaneous nerve of the forearm
      • Green: lateral cutaneous nerve of the forearm
      • Yellow: median nerve
      • Blue: ulnar nerve
    • Understanding the distinct sensory branches is crucial for diagnosing peripheral nerve injuries.

    Dermatomes of Upper Limbs

    • Dermatomal distribution differs from cutaneous innervation due to the merging of spinal nerves in the brachial plexus.
    • Each color in dermatomes aligns with spinal cord neuromeres, aiding in visualizing nerve damage locations.
    • Knowledge of motor and sensory distributions is vital for effective treatment of peripheral nerve lesions.

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    Description

    This quiz covers the anatomy and innervation of the upper limb, specifically focusing on the brachial plexus as detailed in the Vercelli L02 lesson. You will explore the formation of the plexus from spinal roots and its significance in upper limb function. Test your knowledge on the structures involved and their respective contributions.

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