Term
| The median nerve forms from branches of which cords of the brachial plexus? |
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Definition
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Term
| Where does the median nerve innervate (generally)? |
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Definition
| The forearm and hand (NO BRANCHES in the upper arm) |
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Term
| Name 4 muscles the median nerve innervates in the forearm |
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Definition
§ The most proximal is pronator teres (C6,C7) (teres means round in Latin)
§ The next is flexor carpi radialis (C6,C7)
§ Palmaris longus
§ Flexor digitorum superficialis (flexion of the metacarpal and proximal interphalangeal joints) |
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Term
| What is the anterior interosseous nerve a branch of and what muscles (3) does it innervate? |
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Definition
§ Flexor digitorum profundus (digits 2 and 3 only, distal interosseous joint)
§ Flexor pollicus longus (flexes distal thumb)
§ Pronator quadratous |
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Term
| Which 2 muscles of the hand/forearm are preferentially affected in inclusion body myositis? |
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Definition
| Flexor digitorum superficialis and profundus (finger flexors) |
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Term
| What muscles does the median nerve innervate in the hand? |
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Definition
o (LOAF):
§ Lumbricals 1st and 2nd (flex at the MJC and extend the proximal and distal interphalangeal joints, make an “L” with your hand)
§ Opponens pollicus (opposition of thumb)
§ Abductor pollicus brevis (thenar eminence)
§ Flexor pollici brevis- superficial head only, ulnar supplies the rest |
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Term
| Where does the median nerve provide sensory to the hand? |
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Definition
o 1st 3 digits (digital branches) and radial palm (palmar cutaneous branches) |
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Term
| What muscles does the ulnar nerve supply in the forearm? |
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Definition
o Flexor carpi ulnaris
o Flexor digitorum profundus (digits 4-5) |
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Term
| What motor parts of the hand does the ulnar nerve supply? |
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Definition
o Everything except LOAF (median innervated) |
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Term
| What are the 3 muscles of the hypothenar eminence and what nerve supplies it? |
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Definition
Ulnar nerve
§ Abductor digiti minimi
§ Flexor digiti minimi
§ Opponens digiti minimi |
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Term
| Which lumbricals does the ulnar nerve supply? |
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Definition
o Lumbricals 3rd and 4th
(Median does 1st and 2nd) |
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Term
| What are the 2 ulnar nerve supplied muscles of the thenar eminece? |
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Definition
§ Adductor pollicus
§ Flexor pollicus brevis (deep head only) |
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Term
| What parts of the hand does the ulnar nerve provide sensory to and via what branches? |
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Definition
· Palmar cutaneous (ulnar palm)
· Dorsal ulnar cutaneous (ulnar dorsal hand)
· Digital branches (digits 4 and 5) |
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Term
| What cords of the brachial plexus is the radial nerve part of? |
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Definition
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Term
What muscles does the radial nerve supply in the upper arm (4)?
At what location does the most common radial neuropathy occur? |
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Definition
o Triceps brachii
§ The most common radial neuropathy is at the spiral groove, but the branch for this is proximal to the spiral groove so the triceps are spared in lesions here
o Anconeus
o Brachioradialis (flexes elbow, along with biceps) (C6 muscle)
o Extensor carpi radialis longus (extends wrist) |
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Term
| What root and nerve supplies the brachioradialis muslce? |
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Definition
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Term
| Where does the radial nerve supply sensation to? |
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Definition
Basically the posterior arm, forearm, and the radial half of the back of the hand
· Arm
o Posterior brachial and antebrachial cutaneous
· Forearm
o Superficial radial (dorsal radial hand) |
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Term
| What cords of the brachial plexus is the median nerve from? |
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Definition
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Term
| What muscles does the musculocutaneous nerve supply? |
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Definition
· Only innervates 3 muscles and all are in the arm (all flex elbow and are C5-C6)
o Biceps brachii
o Corachobrachialis
o Brachialis |
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Term
| Where does the musculocutaneous nerve provide sensation to? |
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Definition
o Lateral antebrachial cutaneous (radial forearm) |
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Term
| What cords of the brachial plexus is the axillary nerve from? |
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Definition
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Term
| What is the most common site of damage to the axillary nerve? |
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Definition
o Most common damage to the nerve occurs in a fracture to the surgical neck of the humerus (travels posterior to it) |
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Term
| What muscles does the axillary nerve supply? |
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Definition
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Term
What nerve, cord, trunk, and roots supplies the Rhomboids?
How do you test their strength? |
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Definition
C5-C6-> upper trunk -> Lateral cord
· Dorsal scapular nerve
§ Test these by having patient put their flexed arm behind their back and push backwards |
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Term
What nerve, cord, and roots supplies the Supraspinatous muscle?
What is its action? |
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Definition
C5-T1 -> Posterior Cord
Suprascapular nerve
§ First 15 degrees of abduction of arm (after that is deltoid) |
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Term
What nerve, cord, and roots supplies the Infraspinatous muscle?
How do you test this muscle? |
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Definition
C5-C6-> upper trunk -> Lateral cord
· Suprascapular
§ External rotation of the shoulder (test by stabilizing elbow and having patient rotate forearm posteriorly) |
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Term
What nerve, cord, and roots supplies the Lateral pectoral muscle?
What are the 2 actions of this muscle (clavicular head vs sternal head)? |
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Definition
C5-C6-> upper trunk -> Lateral cord
· Lateral pectoral
o Pectoralis major (C5-T1) – adducts arm
§ Clavicular head (C5-C7) (adducts arm forward)
§ Sternal head (Medial pectoral C8-T1) (adducts arm downward) |
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Term
What nerve, cord, and roots supplies the Subscapularis and Teres major muscle?
What is the action of the Teres Major? |
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Definition
C5-T1 -> Posterior Cord
· Subscapular nerve
o Teres major (C5-C7) Adducts the arm (along with the pectoralis major) |
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Term
What nerve, cord, and roots supplies the Subscapularis and Latissimus dorsi muscle?
What is the action of this muscle? |
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Definition
Posterior cord
· Thoracodorsal nerve
o Latissimus dorsi (C6-C7-C8) (adducts arm forward) |
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Term
| What muscles does the femoral nerve supply? |
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Definition
· Psoas
· Iliacus
· Sartorius
o Longest muscle in your body
· Pectineus
· Quadriceps (extension of knee)
o Vastus lateralis
o Vastus medialis
o Vastus intermedius
o Rectus femoris |
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Term
| What is the longest muscle in your body? |
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Definition
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Term
| Where does the femoral nerve supply sensation to and what are it's 3 sensory branches? |
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Definition
(anterior and medial thigh, and anteromedial lower leg)
· Intermediate cutaneous nerve of the thigh
· Medial cutaneous nerve of the thigh
· Saphenous |
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Term
| What muscles does the obturator nerve supply? |
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Definition
Motor (adducts thigh)
· Adductor longus
· Adductor brevis
· Adductor magnus (dual innervation, obturator and tibial innervation of sciatic nerve)
· Gracilis |
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Term
| Where does the obturator nerve supply sensation to? |
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Definition
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Term
| How do you distinguish between a sciatic and peroneal neuropathy? |
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Definition
| EMG of the short head of the biceps femoris (supplied by common peroneal nerve) |
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Term
| What is the only peroneal supplied muscle above the knee? What supplies this? |
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Definition
The Biceps Femoris
supplied by the common peroneal nerve |
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Term
| What muscles does the deep peroneal nerve supply? (6) |
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Definition
§ Tibialis anterior (dorsiflexion of the foot)
§ Extensor digitorum longus
§ Extensor hallucis longus
§ Perneous tertius
· Near here is where we do biopsies ..?
§ Extensor digitorum Brevis
§ Extensor hallucis brevis |
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Term
| Name two main branches of the sciatic nerve |
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Definition
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Term
| Where does the deep vs superficial peroneal nerve provide sensation to? |
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Definition
o Deep (1st web space between big toe and second toe)
o Superficial (anterolateral leg and dorsum of foot) |
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Term
| What muscles does the sciatic nerve innervate? (5 main ones) |
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Definition
· Hamstrings:
o Semitendinosus – medial hamstring
o Semimembranosus- medial hamstring
o Biceps femoris-long head – part of the lateral hamstring
o Adductor magnus
· Gastrocnemius- medial and lateral
· Popliteus
· Soleus
· Tibialis posterior
· Flexor digitorum longus
· Flexor hallucis longus (toe flexor) |
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Term
| Where does the sciatic nerve supply sensation to? |
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Definition
· Sural
· Plantars
· medial and lateral (posterior/lateral lower leg and plantar foot) |
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Term
| What's special about the gluteal nerves? |
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Definition
| They are L5, S1 non-sciatic muscles |
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Term
| What is the main root that supplies the superior gluteal nerve, what action does it do, and what muscle(s) does it innervate? |
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Definition
· Superior gluteal (>L5) (abduct thigh)
o Gluteus medius
o Gluteus minimus
o Tensor fascia lata |
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Term
| What is the main root that supplies the inferior gluteal nerve, what action does it do, and what muscle(s) does it innervate? |
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Definition
· Inferior gluteal (>S1)
o Gluteus maximus (Abduct and extend thigh) |
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Term
| Describe the connective tissue surrounding nerves |
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Definition
o Endoneurium inside the fascicle
o Perineurium surrounds the fascicles
o Epineurium is around the entire nerve |
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Term
| What cell myelinates peripheral nerves? How does it do this? |
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Definition
· Schwann cell myelinates peripheral nerves by wrapping around the axon in layers wrapping it in layers of the schwann cell membrane |
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Term
| What makes up a motor unit? |
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Definition
o A motor axon and all the muscle fibers that it innervates |
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Term
| What causes a nerve to depolarize? |
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Definition
| Influx of calcium through voltage gated calcium channels |
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Term
| What is the muscle cell membrane called? |
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Definition
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Term
| Where are acetylcholine receptors on a muscle cell membrane? |
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Definition
| At the crests of the folds |
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Term
| Where are voltage gated sodium channels on a muscle cell membrane? |
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Definition
| At the base of the folds, open in response to acetylcholine binding the receptors in the crests once a certain threshold is reached |
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Term
| Describe the connective tissue around a muscle fiber |
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Definition
o Endomysium inside the fascicle
o Perimysium around the fascicle (atrophy of this in dermatomyositis)
o Epimysium surrounds the entire muscle |
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Term
Describe the following components of a sarcomere:
- between ___ lines
- A band
- H band
- M line
- I band |
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Definition
o Sarcomere (myofibrillar myopathies usually affect this)
§ Between Z lines
§ A band: thin and thick filaments
· Has H band in the center, and in the center of that is the M line
§ I band: thin filaments only |
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Term
| Name the thick filament of a myofibril |
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Definition
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Term
| Name the thin filaments of a myofibril (3) |
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Definition
actin
troponin
tropomyosin |
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Term
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Definition
o A continuation/invagination of the sarcolemma that is associated with the sarcoplasmic reticulum |
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Term
| Describe the steps of excitation contraction coupling and what 2 steps require energy |
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Definition
o T tubule excitation causes the sarcoplasmic reticulum to release calcium through the ryanodine receptor channel. This calcium binds troponin which releases the binding site on tropomyosin -> the myosin head binds tropomysin -> ATP is released (requires energy) -> this forms a cross bridge which leads to muscle contraction
o Relaxation
§ Calcium is released and returns to sarcoplasmic reticulum, (requires ATP) |
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Term
| How can women get X linked recessive diseases? |
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Definition
a. Lyonization- inactivation of one of the X chromosomes in women. If this happens to the good X chromosome, X-linked recessive diseases can manifest in women. |
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Term
| What does reflexes diminished/absent out of proportion to degree of weakness or sensory loss suggest? |
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Definition
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Term
| Most CMT is ___ inheritance |
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Definition
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Term
| What is the most common type of CMT? What gene is affected and how? |
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Definition
CMT1a
PMP22 gene duplication
causes demyelination |
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Term
| What kind of neuropathy does CMT2 cause |
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Definition
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Term
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Definition
| CMT3, congentical or early onset with poor initial myelination |
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Term
| What causes HNPP (hereditary neuropathy with predisposition to pressure palsy) and what is a characteristic finding on teased fiber preparation? |
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Definition
PMP22 gene deletion
See a tomacula
[image] |
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