Upper Extremity Peripheral Nerve Review
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Questions and Answers

Which nerve is responsible for innervating the rhomboid major and minor muscles?

  • Long Thoracic Nerve
  • Nerve to the Subclavius
  • Dorsal Scapular Nerve (correct)
  • Suprascapular Nerve
  • What is a potential cause of long thoracic nerve damage?

  • Compression of the nerve by muscle spasm of the scalenes
  • Carrying heavy backpacks
  • Poorly fitted crutches
  • All of the above (correct)
  • Which of the following muscles is NOT innervated by a branch of the brachial plexus?

  • Levator scapulae
  • Serratus anterior
  • Trapezius (correct)
  • Subclavius
  • Which nerves arise from the roots of the brachial plexus?

    <p>Dorsal Scapular Nerve and Long Thoracic Nerve</p> Signup and view all the answers

    What is the functional classification of the long thoracic nerve?

    <p>Posterior Division Nerve</p> Signup and view all the answers

    Which nerve is associated with 'scapular winging' when damaged?

    <p>Long Thoracic Nerve</p> Signup and view all the answers

    Which of the following nerves arises from the upper trunk of the brachial plexus?

    <p>Nerve to the Subclavius</p> Signup and view all the answers

    What is the primary function of the nerve to the subclavius?

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

    Which nerve is most commonly injured due to a humeral fracture at the surgical neck?

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

    Which nerve is primarily responsible for innervating the deltoid muscle?

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

    What is the nerve that innervates the thumb and web space?

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

    Which nerve is most susceptible to injury in tennis players who frequently perform overhead smashes?

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

    Which of the following is NOT a symptom of Quadrangular Space Syndrome?

    <p>Loss of biceps reflex</p> Signup and view all the answers

    What is the primary reason why the term "terminal portions" is preferred over "terminal divisions" in the context of the Axillary Nerve?

    <p>To avoid confusion with the fact that the Axillary Nerve is a posterior division nerve</p> Signup and view all the answers

    Which two nerve roots contribute mainly to the formation of the Axillary Nerve?

    <p>C5 and C6</p> Signup and view all the answers

    What is the common name for the cutaneous distribution of the Axillary Nerve?

    <p>Regimental badge distribution</p> Signup and view all the answers

    Which muscle(s) is/are innervated by the deep radial nerve, but NOT the radial nerve?

    <p>Extensor carpi radialis brevis</p> Signup and view all the answers

    Which muscle in the antebrachium is innervated by a nerve originating from the brachial plexus?

    <p>Extensor indicis</p> Signup and view all the answers

    Which of the following nerves does NOT contribute to the innervation of the thumb muscles?

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

    Which nerve is responsible for the sensation of the posterior aspect of the forearm?

    <p>Posterior Antebrachial Cutaneous Nerve</p> Signup and view all the answers

    Which TWO muscles contribute to the deep head of the Flexor pollicis brevis?

    <p>Adductor pollicis</p> Signup and view all the answers

    What components are included in the muscular branches of the nerves in the brachial plexus?

    <p>GSE, GSA, GVA, and postganglionic GVE fibers</p> Signup and view all the answers

    Which of the following correctly describes the organization of the brachial plexus?

    <p>It comprises roots, trunks, divisions, and cords</p> Signup and view all the answers

    What is the path of re-assortment for the Ventral Primary Rami in the brachial plexus?

    <p>C5-T1 to roots, trunks, divisions, and then branches</p> Signup and view all the answers

    Which nerves are primarily involved in innervating the muscles of the upper extremity?

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

    What term describes the classification of fibers that provide input from muscular and vascular elements?

    <p>Both GVA and GSA</p> Signup and view all the answers

    Which structure in the brachial plexus is labeled in relation to the axillary artery?

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

    What is the spinal nerve root range from which the brachial plexus arises?

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

    What does 'segmental innervation' refer to in the context of peripheral nerve distribution?

    <p>Specific spinal nerves innervating individual muscles</p> Signup and view all the answers

    Which of the following muscles is NOT innervated by the median nerve?

    <p>Adductor pollicis</p> Signup and view all the answers

    Which branch of the median nerve is responsible for supplying the palm?

    <p>Palmar cutaneous branch</p> Signup and view all the answers

    What is the primary function of the postganglionic GVE sympathetic axons distributed by the median nerve?

    <p>Control sweat gland activity</p> Signup and view all the answers

    Which group of muscles is primarily affected by pronator teres syndrome?

    <p>Superficial forearm muscles</p> Signup and view all the answers

    What characterizes the distribution of the median nerve to the hand?

    <p>It branches into the palmar and digital cutaneous branches.</p> Signup and view all the answers

    Which muscle is innervated by the anterior interosseous branch of the median nerve?

    <p>Flexor pollicis longus</p> Signup and view all the answers

    In carpal tunnel syndrome, which branch of the median nerve remains unaffected?

    <p>Palmar cutaneous branch</p> Signup and view all the answers

    Which condition can cause symptoms in both the palmar cutaneous and common proper digital branches of the median nerve?

    <p>Pronator teres syndrome</p> Signup and view all the answers

    Which muscles are primarily innervated by the suprascapular nerve?

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

    From which portion of the brachial plexus do the infraclavicular branches derive?

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

    Which nerve innervates the upper and lower fibers of the pectoralis major?

    <p>Lateral Pectoral Nerve</p> Signup and view all the answers

    Which nerve is primarily responsible for the internal rotation of the shoulder?

    <p>Upper Subscapular Nerve</p> Signup and view all the answers

    The musculocutaneous nerve is a terminal branch of which part of the brachial plexus?

    <p>Lateral Cord</p> Signup and view all the answers

    Which of the following muscles is NOT innervated by the musculocutaneous nerve?

    <p>Teres Major</p> Signup and view all the answers

    What sensory function is associated with the suprascapular nerve?

    <p>Sensation from the acromioclavicular joint</p> Signup and view all the answers

    Which nerve is responsible for innervating the latissimus dorsi muscle?

    <p>Thoracodorsal Nerve</p> Signup and view all the answers

    Study Notes

    Upper Extremity Peripheral Nerve Review

    • This review is a reference for the neuroanatomy of the upper extremity
    • Key areas of focus include:
      • Brachial plexus components (roots, trunks, divisions, cords, and branches)
      • Names of terminal nerves and their branches
      • Nerves innervating extremity muscles
      • Spinal nerve distribution to individual muscles (segmental innervation)
      • Indicator muscles and reflexes for individual spinal nerve roots (MSR levels)
    • Muscle actions are not covered; refer to other anatomy resources for those
    • All muscular branches of nerves include somatic components (GSE, GSA, high/low threshold), vascular components (GVA, high/low threshold), and postganglionic GVE sympathetic fibers to muscles
    • All cutaneous branches include somatic components (GSA, high/low threshold) vascular components (GVA, high/low threshold), and postganglionic sympathetic fibers to vascular elements

    The Brachial Plexus

    • Arises from the Ventral Primary Rami (VPR) of spinal nerve roots C5-T1
    • VPR reorganize into:
      • Roots (C5-T1)
      • Trunks (upper-C5, C6; middle-C7; lower-C8,T1)
      • Divisions (anterior and posterior from each trunk)
      • Cords (lateral, medial, posterior)
      • Terminal branches/nerves (musculocutaneous, axillary, radial, median, ulnar)
    • Several nerves branch off the roots, trunks, and cords prior to terminal nerves
    • The terminal nerves then have additional branches

    Additional Details

    • Nerves arising from roots include dorsal scapular, long thoracic nerves. These innervate rhomboid muscles, serratus anterior (long thoracic nerve). Significant weakness can be indicated by scapular winging.
    • Nerves arising from trunks include (nerve to subclavius, suprascapular - innervates supraspinatus and infraspinatus).
    • Infraclavicular branches derive from cords and include (lateral pectoral, medial pectoral, upper/lower subscapular, thoracodorsal which innervates latissimus dorsi).
    • Details on various nerves also include cutaneous and muscular innervation, important clinical implications.
    • Multiple illustrations of brachial plexus, nerves and their branches

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    Description

    This review provides a comprehensive reference for the neuroanatomy of the upper extremity, focusing on the brachial plexus, terminal nerves, and muscle innervation. It also covers spinal nerve distribution and reflex indicators without delving into muscle actions. For deeper anatomical insights beyond the scope of this review, supplementary resources are recommended.

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