Term
| Where do the roots of spinal nerves lie? |
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Definition
| Exclusively within the spine. |
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Term
| Where do the rami of spinal nerves lie? |
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Definition
| Exclusively outside the spine. |
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Term
| Motor nerve fibers from lower motor neurons exit the spinal cord where? |
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Definition
| Via ONLY the anterior roots. |
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Term
| The cell bodies of lower motor neurons lie where? |
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Definition
| Within the anterior grey horns of the spinal cord segment. |
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Term
| Where do sensory nerve fibers enter the spinal cord? |
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Definition
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Term
| Where are the cell bodies of sensory neurons? |
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Definition
| Within the posterior root ganglia of the spinal nerves. |
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Term
| What kind of nerve fibers do the anterior and posterior rami of spinal nerves transmit? |
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Definition
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Term
| What is the lower end of the spinal cord called? |
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Definition
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Term
| At what vertebral level does the lower end of the spinal cord lie in an adult? |
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Definition
| The lower end of the spinal cord lies at the level of the lower border of the body of the first lumbar vertebra. |
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Term
| What is the cauda equina? What does it consist of? |
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Definition
| "Horse's tail" It consists of the spinal nerve roots that extend below the lower end of the spinal cord in the vertebral column. |
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Term
| Where is the cauda equina? |
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Definition
| Below the lower border of the spinal cord down to the lower border of the body of the second sacral vertebra. |
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Term
| What is the common location for doing a spinal tap? |
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Definition
| The space between the spinous process of the 4th and 5th lumbar vertebrae. |
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Term
| What is the landmark commonly used to locate the best place to perform a spinal tap? |
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Definition
| The highest point of the iliac crest lies at the level of the spinous process of the 4th lumbar vertebra (and a lumbar puncture would normally be done between the 4th and 5th lumbar vertebrae). |
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Term
| What structure underlies the point of the shoulder? |
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Definition
| The acromion of the scapula. |
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Term
| Describe a Grade I shoulder separation. |
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Definition
| An injury in which there are minor tears in the capsule of the acromioclavicular (AC) joint. |
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Term
| Describe a Grade II shoulder separation injury. |
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Definition
| There are minor tears in the capsule of the AC joint which results in the subluxation of the AC joint. |
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Term
| Describe a Grade III shoulder separation. |
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Definition
| Major tears in the capsule of the acromioclavicular (AC) joint and major tears of the coracoclavicular ligament; both types of tears result in the dislocation of the shsoulder. |
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Term
| What is the only type of shoulder separation injury in which there are major tears in the coracoclavicular ligament? |
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Definition
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Term
| In the shoulder joint, the head of the humerus articulates with what structures? |
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Definition
| The glenoid cavity of the scapula and the glenoid labrum. |
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Term
| The axillary nerve is the major nerve of the upper limb most at risk from what kind of injury? |
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Definition
| Anterior shoulder dislocations and fractures of the surgical neck of the humerus. |
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Term
| What innervates the trapezius? |
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Definition
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Term
| What are the actions of the trapezius? |
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Definition
| It is the prime mover for raising the shoulder and one of the two prime movers for lateral rotation of the scapula. |
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Term
| Which muscle is the prime mover for raising the shoulder and also helps to laterally rotate the scapula? |
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Definition
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Term
| What innervates serratus anterior? |
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Definition
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Term
| What does serratus anterior do? |
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Definition
| Prime mover for protraction of the shoulder and one of the two prime movers for lateral rotation of the scapula. |
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Term
| What two muscles are responsible for lateral rotation of the scapula? |
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Definition
| Trapezius and serratus anterior |
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Term
| What are the rotator cuff muscles? |
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Definition
| Supraspinatus, infraspinatus, subscapularis, and teres minor. |
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Term
| What does the supraspinatus muscle do? |
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Definition
| Initiates abduction of the arm at the shoulder joint from the anatomical position and is the prime mover of arm abductioin at the shoulder joint from 0 to 10 degrees. |
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Term
| What innervates the supraspinatus muscle? |
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Definition
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Term
| Which spinal cord levels provide all the nerve fibers that innervate the supraspinatus? |
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Definition
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Term
| The deltoid is innervated by what what nerve? |
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Definition
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Term
| What does the deltoid muscle do? |
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Definition
| It is the prime mover of abduction of the arm at the shoulder joint from the ten degree abduction position. |
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Term
| Which spinal cord levels provide all the nerve fibers that innervate the deltoid? |
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Definition
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Term
| Abduction of the arm at the shoulder joint is controlled mainly by what nerve fibers? Why? |
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Definition
| C5 nerve fibers, because supraspinatus and deltoid (the only muscles involved in abducting the arm at the shoulder joint) each receive more innervation from C5 than C6 nerve fibers. |
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Term
| Abduction of the arm 180 degrees from the anatomical position is dependent on the coordinated actions of what four muscles? |
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Definition
| Supraspinatou, deltoid, trapezius, and serratus anterior |
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Term
| What are the chief adductors and internal rotators of the arm at the shoulder joint? |
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Definition
| Pectoralis major, teres major, and latissimus dorsi. |
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Term
| What forms the brachial plexus? |
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Definition
| The anterior rami of spinal nerves C5, C6, C7, C8, and T1. |
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Term
| Describe the structure of the brachial plexus. |
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Definition
| The C5 and C6 roots unite to form the upper trunk, the C7 root extends to become the middle trunk, and the C8 and T1 roots unite to form the lower trunk of the brachial plexus. |
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Term
| What are the 5 major nerves of the upper limb? |
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Definition
| Musculocutaneous, ulnar, median, axillary, and radial nerves. (MUMAR) |
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Term
| What is the origin of the musculocutaneous nerve? |
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Definition
| It arises from the lateral cord of the brachial plexus. |
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Term
| What is the origin of the ulnar nerve? |
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Definition
| The medial cord of the brachial plexus. |
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Term
| What is the origin of the median nerve? |
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Definition
| Both the medial and lateral cords. |
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Term
| What is the origin of the axillary and radial nerves? |
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Definition
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Term
| What group of lymph nodes in the axilla is the first to filter lymph from the lateral half of the breast? |
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Definition
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Term
| Where can the anterior group of axillary lymph nodes be palpated? |
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Definition
| On the posterior surface of the anterior axillary fold. |
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Term
| Why is the so called sentinal lymph node important? |
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Definition
| This lymph node serves as the first guard against the lymphogenous spread of a breast tumor from the microscopic region in which the tumor initially arises (it is presumed that the lymph drained from every microscopic region within the breast is first filtered almost exclusively by one lymph node). |
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Term
| What nerve is most at risk from a fracture injury of the midshaft of the humerus? |
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Definition
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Term
| What nerve is most at risk from a fracture of the medial epicondyle of the humerus. |
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Definition
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Term
| What is a Colles' fracture? |
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Definition
| A fracture at the distal end of the radius in which the distal fragment is both posteriorly displaced and posteriorly angulated. |
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Term
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Definition
| An upward pull on the arm momentarily subluxes the head of the radius from the capitulum of the humerus. The subluxation may produce a transverse tear in the annular ligament of the proximal radioulnar joint and result in the upper torn part of the annular ligament slipping over the head of the radius. The head of the radius moves upward into its normal position as the force of hte pull diminishes, thereby pinching the upper part of the annular ligament between the capitulum of the humerus and the head of the radius. |
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Term
| Biceps brachii and brachialis are both innervated by what nerve? Which spinal cord levels provide all the nerve fibers that innervate these muscles? |
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Definition
| Musculocutaneous nerve; C5 and C6 provide most of the nerve fibers that innervate the muscles. |
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Term
| Which muscles are the major flexors of the forearm at the elbow joint? |
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Definition
| Biceps brachii and brachialis. |
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Term
| What is the major supinator of the forearm? |
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Definition
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Term
| The biceps brachii tendon reflex test assesses reflex activity in what spinal cord segments? |
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Definition
| C5 and C6 because biceps brachii is innervated by nerve fibers that enter and exit the spinal cord chiefly via the C5 and C6 spinal nerves. |
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Term
| Flexion of the forearm at the elbow joint is controlled mainly by what nerve fibers? |
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Definition
| C6 nerve fibers, because biceps brachii and brachialis each receive more innervation from C6 than from C5. |
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Term
| What nerve innervates the triceps? What spinal cord segments provide most of the nerve fibers that innervate the triceps? |
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Definition
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Term
| Extension of the forearm at the elbow joint is controlled mainly by what nerve fibers? |
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Definition
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Term
|
Definition
| Severe injury to the C5 and C6 nerve roots. |
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Term
| What muscles are affected by Erb's palsy? |
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Definition
| All muscles whose sole/major innervation is provided by C5 and C6 nerve fibers. Supraspinatus, deltoid, biceps brachii, brachialis, and supinator are affected. |
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Term
| Explain why Erb's palsy may cause the entire upper limb to hang in a deadened fashion beside the trunk of the body? |
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Definition
| Because paralysis of supraspinatous and deltoid results in an inability to abduct the arm at the shoulder joint. |
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Term
| What is the result of paralysis of biceps brachii and brachialis? |
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Definition
| Profoundly weakened flexion; paralysis of biceps brachii and supinator results in an inability to supinate the forearm, the forearm is more pronated than usual. |
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Term
| What three carpals articulate with the distal end of the radius and the articular disc? |
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Definition
| Scaphoid, lunate, and triquetrum. |
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Term
| The anterior muscles of the forearm collectively do what? |
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Definition
| 1) Pronate the forearm 2) Flex, abduct, and adduct the hand at the wrist and midcarpal joints 3) Flex the thumb and fingers at their metacarpophalangeal and interphalangeal joints. |
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Term
| What nerve innervates most of the anterior forearm muscles? |
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Definition
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Term
| What muscles in the anterior forearm are NOT innervated by the median nerve? |
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Definition
| The muscle that can adduct the hand and the medial half of the one muscle that flexes the ring and little fingers at their DIP joints. These one and a half muscles are innervated by the ulnar nerve. |
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Term
| The posterior muscles of the forearm do what? |
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Definition
| 1) Supinate the forearm 2) Extend, abduct, and adduct the hand at the wrist and midcarpal joints 3) Abduct the thumb 4) Extend the thumb and fingers at their metacarpophalangeal and interphalangeal joints. |
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Term
| What nerve innervates all the posterior forearm muscles? |
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Definition
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Term
| What nerve fibers provide most of the control of flexion of the thumb and fingers at their interphalangeal joints? |
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Definition
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Term
|
Definition
| When severe injury to the radial nerve in the axilla or arm significantly weakens or paralyses the posterior forearm muscles which extend the hand at the wrist and midcarpal joints. |
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Term
| What is the most commonly fractured carpal? |
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Definition
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|
Term
| Tenderness upon direct or indirect pressure on what structure is highly suggestive of a fractured scaphoid? |
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Definition
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|
Term
| What is the most commonly dislocated carpal? |
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Definition
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Term
| Where are the first and second lumbricals? What nerve innervates them? |
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Definition
| The index and middle fingers; median nerve. |
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Term
| Where are the third and fourth lumbricals? What nerve innervates them? |
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Definition
| The ring and little fingers respectively; they are innervated by the deep branch of the ulnar nerve. |
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Term
| What is the result if a lumbrical is paralyzed? |
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Definition
| Hyperextension of the finger at its metacarpophalangeal joint and full flexion at its interphalangeal joints. |
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Term
| What muscle abducts the fingers? |
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Definition
|
|
Term
| What muscle adducts the fingers? |
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Definition
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|
Term
| What nerve innervates the dorsal and palmar interossei? |
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Definition
| Deep branch of the ulnar nerve |
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Term
| What are the functions of the thenar eminence? |
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Definition
| It can abduct, flex, and oppose the thumb. |
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Term
| What nerve innervates the thenar eminence? What occurs if the thenar muscles are paralyzed? |
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Definition
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Term
| What are the functions of the hypothenar eminence? What nerve innervates this muscle? |
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Definition
| Flex, abduct, and oppose the little finger; deep branch of the ulnar nerve. |
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|
Term
| What spinal nerve provides most of the nerve fibers that control abduction and adduction of the fingers at their metacarpophalangeal joints? |
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Definition
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|
Term
| If the patient cannot touch their thumb to the base of the little finger, what muscle and nerve are affected? |
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Definition
| Opponens pollicis; median nerve. |
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Term
| Asking the patient to clench a piece of paper tightly between the middle and ring fingers as the clinician attempts to dislodge it is a test of what nerve's functioning? |
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Definition
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Term
| Asking the patient to clench a piece of paper tightly between the middle and ring fingers as the clinician attempts to dislodge it is a test of what muscles' functioning? |
|
Definition
| Palmar and dorsal interossei |
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Term
| Clawhand is a result of what? |
|
Definition
| The paralysis of the intrinsic hand muscles innervated by the deep branch of the ulnar nerve. |
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|
Term
| Klumpke's palsy is a result of what? |
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Definition
| Motor deficits that result from severe injury of the C8 and T1 roots or lower trunk of the brachial plexus. |
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Term
| Most severe lower brachial plexus injuries produce what? |
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Definition
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