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WEEK 22:
Anatomy of nerve plexuses:
| Question | Answer |
|---|---|
| primary ramus | branch of spinal nerve |
| types of primary rami | ventral (anterior) and dorsal (posterior) |
| dorsal rami | pass posteriorly to supply strip of skin (dermatome) extending either side of midline of neck/ trunk where some fail to reach the skin eg C1, and extensor muscles of the vertebral column |
| ventral rami | larger than dorsal rami and clinically more important and can described in 5 groups |
| feature of all spinal nerves (except T2-T12) | their anterior rami branch rejoin forming nerve plexus occurring in cervical, brachial, lumbar, and sacral regions |
| within a plexus, nerve fibres regroup so that | branches may contain fibres from more than one spinal level (convergence), a given spinal level may contribute to more than one branch (divergence) |
| advantage of regrouping of nerve fibres | damage to one spinal segment usually does not lead to complete loss of function |
| groups of ventral (anterior) rami | Cervical plexus (C1-C5) supplies head & neck Brachial plexus (C5-T1) supplies upper limb Nerves of the trunk (T1-L1) supply trunk Lumbosacral plexus (L1-S3) supplies trunk & lower limb Coccygeal plexus(S4-S5, Co1) supplies pelvis & lower trunk |
| cutaneous (superficial) nerves and their spinal root value | Lesser occipital C2 (C3) Greater auricular C2, C3 Transverse cervical C2, C3 Supraclavicular C3, C4 |
| motor (deep) nerves and their spinal root value | Ansa cervicalis C1-C3 Phrenic C3-C5 Other muscular branches C1-C5 |
| lesser occipital nerve | C2 and maybe C3 found supplying in the skin of neck and scalp posteriosuperior auricle |
| greater auricular nerve | C2 and C3 found supplying skin over parotid gland, part of auricle, skin from angle of mandible to mastoid process |
| transverse cervical nerve | C2 and C3 found supplying skin of anterior cervical region |
| supraclavicular nerves | C3 and C4 supplying branches to skin of neck and over clavicle to skin of shoulder |
| ansa cervicallis | C1-C3 supplying the infrahyoid muscles except thyrohyoid |
| brachial plexus | formed by anterior rami of C5-T1 supplying the upper limb (sensory and motor) with components including roots, trunks, divisions, cord, and branches |
| Erb duchenne palsy | tractional lesion of upper trunk, C5+C6 roots avulsion |
| Erb duchenne palsy signs | signs of shoulder abduction, lateral rotation and flexion affected, elbow flexion paralyzed, limb hangs by side adducted and medially rotated (due to unopposed pectoralis major), and forearm extended and pronated due to deinnervation of biceps |
| Klumpke's palsy | damage to lower trunk (C8 + T1) leading to clawed hand |
| dorsal scapular nerve | rhomboid major and minor and levator scapulae where injury leads to winged scapula |
| long thoracic nerve supplies | serratus anterior and any damage leads to winged scapula |
| Suprascapular nerve supplies | Supraspinatus and infraspinatus muscle |
| Thoracodorsal nerve supplies | Latissimus dorsi muscle |
| Lateral and medial pectoral nerves supplies | Pectoralis major and minor |
| Upper and lower subscapular supplies | Subscapularis muscle and teres major |
| slide 29** | |
| dermatome | region of skin supplied by 1 spinal nerve |
| autonomic plexuses | |
| parasympathetic | vagus |
Created by:
kablooey
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