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Where do the brachial plexus orginate?
from ventral primary rami of C5-T1
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How many roots does the brachial plexus have?
5
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The five roots combine to form how many trunks?
3
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The three trunks split to form what kind of divisions?
anterior and posterior
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The divisions combine to form how many cords?
3
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Where are the cords of the brachial plexus found?
surrounding the axillary a.
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The three cords give rise to how many terminal branches?
5
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What are terminal branches?
nerves which supply motor and sensory innervation to the upper extremity
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What are the names of the 3 trunks of the brachial plexus?
- upper (superior) trunk
- middle trunk
- lower (inferior) trunk
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The three trunks each split to form the:
6 divisions
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How is the upper trunk formed?
by union of C5-6
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How is the middle trunk formed?
continuation of C7
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How is the lower trunk formed?
union of C8-T1
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Name the three cords of the brachial plexus:
- lateral cord
- medial cord
- posterior cord
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What spinal nerves are represented by the lateral cord?
C5-C7
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How is the lateral cord formed?
union of anterior divisions of upper and middle trunks
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What spinal nerves are represented by the medial cord?
C8-T1
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How is the medial cord formed?
continuation of anteior division of lower trunk
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What spinal nerves are represented by the posterior cord?
C5-T1
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How is the posterior cord formed?
union of posterior divisions of all three trunks
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What are the names of the terminal branches of the brachial plexus?
- musculocutaneous n.
- ulnar n.
- axillary n.
- radial n.
- median n.
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What are the branches of the lateral cord?
- lateral pectoral n.
- musculocutaneous n.
- lateral root of median n.
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What spinal nerves are represented by the lateral pectoal n.?
C5-C7
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What spinal nerves are rpresented by the musculocutaneous n.?
C5-C7
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What are the branches of hte medial cord?
- medial pectoral n.
- medial brachial cutaneous
- medial antebrachial cutaneous
- ulnar n.
- medial root of median n.
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What spinal nerves are represented by the medial pectoral n.?
C8-T1
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What spinal nerves are represented by the medial brachial cutaneous?
C8-T1
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What spinal nerves are represented by the medial antebrachial cutaneous?
C8-T1
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What spinal nerves are represented by the ulnar n?
C8-T1
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What are the branches of the posterior cord?
- uppersubscapular n.
- thoracodorsal n.
- lower subscapular n.
- axillary n.
- radial n.
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What spinal nerves are represented by the upper subscapular n?
C5-C6
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What spinal nerves are represented by the thoracodorsal n.?
C6-C8
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What spinal nerves are represented by the lower subscapular n.?
C5-C6
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What spinal nerves are represented by the axillary n.?
C5-C6
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What spinal nerves are represented by the radial n?
C5-T1
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How is the median n. formed?
the two roots of the median nerve combine to form the median nerve
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What part of the brachial plexus is affected by Erb's Palsy (Erb-Duchenne paralysis)?
upper part of plexus, C5-6
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What causes Erb's Palsy?
- excessive separation of neck and shoulder
- severe stretching of an infant's neck during delivery
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What happens to the nerves with Erb's Palsy?
dorsal and ventral nerve roots are pulled out of spinal cord from C5-6
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What muscles would be paralyzed with Erb's Palsy?
- deltoid, supraspinatus, infraspinatus, teres minor and subscapularis
- -flexors of elbow are weak
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What are the symptoms of Erb's Palsy?
- adduction and medial rotation of arm, extension of elbow, flexion of hand, loss of sensation in C5-6 dermatomes supplied by dorsal and ventral primary rami
- -skin of back and lateral surface of upper extremity
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What part of the brachial plexus is affected by Klumpke's (Klumpke-Dejerine paralysis)?
lower part of plexus, C8-T1
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What part of the body is affected by Klumpke's?
distal part of upper extremity (forearm and hand)
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What is the cause of Klumpke's?
- upper extremity suddenly pulled upward
- grasp something to break a fall
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What is affected by Klumpke's?
muscles and skin innervated by the ulnar nerve
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What impairments would occur with Klumpke's?
- wrist flexion and movements of may of the intrinsic muscles of the hand
- reduced sensation along medial side of arm,forearm, and hand
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What happens if Klumpke's occurs at birth?
affected upper extremity will not grow to same size or length of the unaffected extremity
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When you think Klumpke's, think....
damaged ulnar N
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What is the thoracic outlet?
space located between first 2 pairs of ribs
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What is another name for thoracic outlet syndrome?
cervical rib syndrome
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What is thoracic outlet syndrome?
chronic injury to brachial plexus in lower part of neck, often also involving injury to subclavian artery
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What part of the brachial plexus is affected by thoracic outlet syndrome?
lower trunk at, or close to level where it crosses the first rib
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What are the symptoms of thoracic outlet syndrome?
pain in fingers, hand, forearm, arm and shoulder, along with paresthesia perceived in the dermatomes of C8-T1
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When you think thoracic outlet syndrome, think:
compressed inferior trunk, --ulnar N
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Cervical rib:
transverse process of C7 grows and wraps around, kinda like a rib. Lies next to apex of axilla
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