Term
| Musculocutaneous Nerve Course, Innervation, and Clinical Manifestation of Injury |
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Definition
Arises from C5,6,7 and the lateral cord of the brachial plexus, Innervates anterior compartment of arm, becomes lateral cutaneous nerve and innervates the lateral forearm.
Damage then therefore affects flexion and supination of forearm, and numbness of the lateral forearm. |
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Term
| Axillary Nerve Course, Innervation, and Clinical Manifestation of Injury |
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Definition
Comes off posterior cord behind the axillary artery, anterior to the subscapularis muscle, through the quadrangular space
Gives off anterior, posterior, and articular terminal branches (I do not believe we need to know these however)
Innervates Teres Minor and Deltoid, and skin of Deltoid |
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Term
| Quadrangular Space Borders & Content |
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Definition
Borders
medial: long head of triceps
lateral: humeral shaft
superior: teres minor
inferior: teres major
Contains
Axillary Nerve |
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Term
| Triangular Space Borders & Content |
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Definition
Borders
inferior: teres major
lateral: long head of triceps
superior: lower border of teres minor
Contents
scapular circumflex artery |
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Term
| Triangular Interval (aka Triangular Space (Lower)) Borders & Content |
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Definition
Borders
superior: teres major
lateral: lateral head of the triceps or the humerus
medial: long head of the triceps
Contents
profunda brachii artery
radial nerve |
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Term
| Median Nerve Course, Innervation (11), and Clinical Manifestation of Injury |
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Definition
superficial volar forearm group
Pronator teres
Flexor carpi radialis
Palmaris longus
intermediate group
Flexor digitorum superficialis
deep group
Flexor digitorum profundus (lateral)
Flexor pollicis longus
Pronator quadratus
hand
1st and 2nd lumbricals
Opponens pollicis
Abductor pollicis brevis
Flexor pollicis brevis
Arises from Brachial plexus
C5-T1 roots
medial and lateral cords
Anterior compartment of arm
anterior compartment (anteromedial to humerus)
runs with brachial artery (lateral in upper arm / medial at elbow)
no branches in the arm
Forearm
enters the forearm between the pronator teres and biceps tendon
travels between flexor digitorum superficialis (FDS) and flexor digitorum profundus (FDP)
then emerges between the FDS and flexor pollicis longus (FPL)
Hand
the nerve then enters the hand via the carpal tunnel, along with the tendons of the FDS, FDP and FPL
Terminal branches
anterior interosseous branch (AIN)
innervates the deep volar compartment of forearm except the ulnar half of the FDP
palmar cutaneous branch
supplies sensory innervation to lateral palm
recurrent branch (to thenar compartment)
digital cutaneous branches
supply the radial 3 1/2 digits (palmar)
Clinical Conditions
Carpal Tunnel Syndrome
AIN Neuropathy
Pronator Syndrome |
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Term
| Radial Nerve Course, Innervation (13), and Clinical Manifestation of Injury |
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Definition
Radial nerve originates from the posterior cord of the brachial plexus (C5-T1)
behind axillary artery
Posterior wall axilla
courses on the posterior wall of the axilla (on subscapularis, latissimus dorsi, teres major)
3 Branches in axilla
posterior cutaneous nerve of the arm
branch to long head of triceps
branch to medial head of triceps
Runs through triangular interval
4 branches in spiral groove
branches in spiral groove
inferior lateral cutaneous nerve of the arm
posterior cutaneous nerve of the forearm
branch to lateral head of triceps
branch to medial head of triceps and anconeus
passes through the lateral intermuscular septa
runs between brachialis and brachioradialis
gives branches to supply: lateral brachialis, brachioradialis, ECRL, ECRB
Ends
superficial sensory branch
Deep branch/PIN
ECRB branch
Motor
radial nerve proper
triceps
anconeus
ECRL
ECRB
brachioradialis
Posterior Interosseous Nerve
Extensor Digotorum
Supinator
Extensor Digiti Minimi
Extensor Carpi Ulnaris
Abductor pollicis longus
Extensor Pollicis Longus
Extensor Pollicis Brevis
Extensor Indicis
Sensory
posterior cutaneous nerve arm
posterior cutaneous nerve - forearm
superficial branch radial nerve
dorsal digital branch
Neuropathies
PIN compression Syndrome
Radial Tunnel Syndrome |
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Term
| Ulnar Nerve Course, Innervation, and Clinical Manifestation of Injury |
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Definition
Ulnar nerve comes from the medial cord of the brachial plexus (C8-T1)
Runs just medial to biceps
Hooks around medial epicondyle
Runs through two heads of FCU then runs between FCU and FDP
Pass superficially over the flexor retinaculum of wrist
Clinical Manifestation
Claw Hand: Little and Ring finger are constantly flexed while others are extended, inability to form a round O shape with the index finger and thumb.
Thoracic Outlet Syndrome (C8 nerve)
Between top rib and clavicle
Can be an apical lung tumor
Tap other areas to see if entrapment is there
Cubital Tunnel Syndrome
May occur due to presence of bone spur
Worsened by flexion of the forearm
Most common site of compression is at the two heads of the FCU muscle
Symptoms: Numbness or Pain at the elbow, wrist, hand or fingers
Ulnar Tunnel Syndrome (Guyon Cannal)
Most commonly caused by a spur on the wrist
Tapping can be used to diagnose |
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Term
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Definition
Neuropathy of the Anterior Interosseous Nerve
Results in
motor deficits only
no sensory changes
Innervates
Half of FDP (index and middle finger only)
FPL
pronator quadratus
unable to make OK sign |
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Term
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Definition
A compressive neuropathy of the median nerve at the level of the elbow
Epidemiology
more common in women
common in 50s
has been associated with well-developed forearm muscles (e.g. weight lifters)
Symptoms include
paresthesias in thumb, index, middle finger and radial half of ring finger as seen in carpal tunnel syndrome
in pronator syndrome paresthesias often made worse with repetitive pronosupination
aching pain over proximal volar forearm
sensory disturbances over the distribution of palmar cutaneous branch of the median nerve (palm of hand) which arises 4 to 5 cm proximal to carpal tunnel
lack of night symptoms |
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Term
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Definition
Epidemiology
seen in cyclists, throwers, and tennis players or individuals that are exposed to repetitive motions and vibrations
commonly occurs in middle-aged women
Symptoms
numbness and tingling in radial 3-1/2 digits
clumsiness
pain and paresthesisas that awaken patient at night
self administered hand diagram
the most specific test (76%) for carpal tunnel syndrome
Treatment
Non-operative
night splints (good for patients with nocturnal symptoms only)
activity modification (avoid aggravating activity)
NSAIDs
steroid injections
Operative
open carpal tunnel release (surgery)
do only if rest/other treatments fail |
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Term
| How many tendons run through the carpal tunnel? Which tendons are they? |
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Definition
9 tendons run through the carpal tunnel
flexor digitorum profundus (four tendons)
flexor digitorum superficialis (four tendons)
flexor pollicis longus (one tendon) |
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Term
| Borders of the Cubital Fossa and What is found within it |
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Definition
Triangular Hollow Area
superior (proximal) boundary — an imaginary horizontal line connecting the medial epicondyle of the humerus to the lateral epicondyle of the humerus
medial (ulnar) boundary — lateral border of pronator teres muscle originating from the medial epicondyle of the humerus.
lateral (radial) boundary — medial border of brachioradialis muscle[2] originating from the lateral supraepicondylar ridge of the humerus.
Biceps Brachii muscle (mostly tendon)
Brachioradialis
Pronator Teres
Bicepital Aponeurosis
Basillic (medial) and Cephalic (lateral) Veins
Medial Cubital Vein
The Brachial Artery Splits into the Radial and Ulnar Arteries here along the medial border |
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Term
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Definition
The arcuate ligament runs overtop of the ulnar nerve as it passes through the canal made by the olecranon process and the medial epicondyle
The |
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Term
| Arcuate Ligament of Elbow |
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Definition
| Connects Humeral and Ulnar heads of FCU |
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Term
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Definition
| http://upload.wikimedia.org/wikipedia/commons/thumb/0/0e/Brachial_plexus_2.svg/750px-Brachial_plexus_2.svg.png |
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Term
| What are the sections of the brachial plexus from medial to lateral? |
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Definition
Roots
Trunks
Divisions
Cords
Branches |
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Term
| Triangle of Auscultation Borders |
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Definition
| Is bounded by the upper border of the latissimus dorsi muscle, the lateral border of the trapezius muscle, and the medial border of the scapula; its floor is formed by the rhom- boid major muscle. |
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Term
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Definition
| is caused by a chronic inflammation or irritation of the origin (tendon) of the extensor muscles of the forearm from the lat- eral epicondyle of the humerus as a result of unusual or repetitive strain. It is a painful condition and common in tennis players and violinists. |
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Term
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Definition
A painful condition caused by a small tear or an inflam- mation or irritation in the origin of the flexor muscles of the forearm from the medial epicondyle. It is similar to tennis elbow, which affects the other side of the elbow.
Treatment may include injection of glucocorticoids into the inflamed area or avoidance of repetitive bending (flexing) of the forearm in order to not compress the ulnar nerve. |
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Term
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Definition
| A paralysis of the arm caused by injury to the upper group of the arm's main nerves, specifically the severing of the upper trunk C5–C6 nerves. |
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