Term
| Localization of Nerve Lesions, Name 3 types |
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Definition
| Paralysis, Anesthesia, Parasthesia |
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Term
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Definition
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Term
| Flaccid Paralysis due to loss of ...nerve |
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Definition
| Peripheral nerve (muscle becomes soft and can't contract). Cell bodies --> Lower motor neuron (ventral gray rami) |
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Term
| Spastic Paralysis due to damage of? |
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Definition
| Upper motor neuron lesion (brain). Muscle becomes hard and loses function |
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Term
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Definition
| numbness (complete sensory damage) |
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Term
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Definition
| tingling => partial sensory damage |
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Term
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Definition
| Dermatome: skin supplied by a specific spinal nerve |
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Term
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Definition
| The primary spinal nerve that contributes motor axons to that muscle constitutes the myotome of that muscle. |
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Term
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Definition
Axillary nerve --> deltoid muscle.
C5 = Primary Spinal nerve of axillary n.
C5 = MYOTOME of the deltoid muscle.
C5 lesion = C5 myotome muscles --> very weak (weak shoulder) |
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Term
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Definition
| Damage or injury to peripheral nerve. |
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Term
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Definition
| Metabolic prob, infection, trauma. |
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Term
| Damaged structure can be...? |
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Definition
I. Spinal cord
II. Spinal nerve root (dorsal or ventral) and/or spinal nerve (both d/v)
III. Rami (ventral/dorsal) |
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Term
| Complete lesion (cut nerve) --> ? |
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Definition
| flaccid paralysis & loss of sensation of region |
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Term
| Incomplete lesion (entrapment of nerve) --> ? |
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Definition
| Parasthesia & weak muscles |
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Term
| Radiculopathy is lesion to? |
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Definition
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Term
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Definition
| herniated intervertebral disc (nucleus pulposus)--> less sensation from dermatome & muscle weakness |
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Term
| I. SPINAL CORD lesions are usually caused by? |
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Definition
| Trauma (i.e. fracture of vertebrae --> nerve lesion --> inferior/distal spinal nerves can't function) |
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Term
| Give an example of a Spinal Cord lesion |
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Definition
| damage C5 --> all spinal nerves BELOW C5 can't function. C5 dermatome and myotome still FUNCTIONS! |
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Term
| Spinal segment vs. Vertebral Level |
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Definition
Spinal Segment = spinal cord region in which a SPECIFIC spinal nerve is attached. 31 segments = 31 PAIRS of spinal nerves. Spinal cord ends around L1/L2 in ADULT (recall embryology!)
Vertebral level = specific vertebra |
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Term
| Why are lower lumbar injuries unlikely to cause spinal cord damage? |
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Definition
| Spinal cord ends around L1/L2! |
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Term
| dorsal root of spinal nerve has what fiber? |
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Definition
| Somatic SENSORY (memorize how --> dorSal) |
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Term
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Definition
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Term
| Spinal nerve has what fibers? |
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Definition
| BOTH MOTOR and SENSORY [somatic] |
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Term
| II. Again, what is a radiculopathy? |
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Definition
| lesion of spinal ROOT! Thus either dorsal root (somatic sensory) OR ventral root (somatic motor) damage! |
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Term
| Give example of radiculopathy to C5 Dorsal root |
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Definition
| intervertebral disc herniation --> compression of C5 dorsal root --> loss of sensation and/or parasthesia from skin of C5 dermatome (posterior and lateral arm => axillary and radial nerves) |
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Term
| Would other portions of arm be affected by a radiculopathy of C5 dorsal root? Explain |
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Definition
| No, because the other regions of the arm are not derived from the C5 spinal nerve. |
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Term
| Give example of radiculopathy to C5 Ventral root (motor) |
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Definition
Axillary n => C5, C6.
Delotoid weak, but still partially functions b/c of C6
Note: See Chart 5 (pg 179) for more Radiculopathy |
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Term
| Lesions of BRACHIAL PLEXUS often result from...? |
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Definition
| Trauma. Important to LOCALIZE the lesion (what nerves involved, etc) |
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Term
| Lesion to branch of brachial plexus -->? |
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Definition
1) FLACCID Paralysis (lower motor neuron, in spinal cord, not brain which is a Spastic paralysis)
2) loss of sensation |
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Term
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Definition
Lesion of C5 and C6 roots (upper roots)
Motor/sensory deficits to:
1) Posterior and lateral ARM
2) Lateral Forearm
3) Radial side of hand
Muscles (scapula, shoulder, elbow and wrist) paralyzed |
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Term
| What are the muscles of Scapula, Shoulder, elbow, and wrist affected by Erb's palsy (C5, C6 spinal root lesion) |
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Definition
1) Subscapularis m (Upper/Lower Subscapular n.n.)
2) Rhomboids m. (Dorsal Scapular n.)
3) Extensor Carpi Radialis Longus/Brevis m.m. (Both via Radial n.)
4) Supinator (Radial)
5) Brachioradialis (Radial n)
6) Deltoid (Axillary n)
7) Teres Minor (Axillary n)
8) Biceps (Musculocutaneous n)
9) Brachialis (Musculocutaneous n)
10) Supraspinatous m (suprascapular n)
11) Infraspinatous m (suprascapular n)
Will revisit them later on! |
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Term
| What are the only muscles left over that work on the shoulder for an Erb's Palsy patient? |
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Definition
| Pectoralis major/minor m.m., latissimus dorsi, and teres major |
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Term
| What position is the wrist of an Erb's palsy patient? Explain |
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Definition
| In a FLEXED position. Why? --> C5 and C6 innervated Extensor carpi radialis longus/brevis m.m. |
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Term
| What are the "Lower Roots" of the Brachial Plexus? |
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Definition
C8, T1
(Lesions here are less common) |
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Term
| C8 and T1 lesions lead to ? palsy? |
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Definition
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Term
| Discuss C8 and T1 dermatome |
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Definition
Sensory innervation from:
Medial Hand
Medial Forearm
Medial Side of Arm |
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Term
| Discuss C8 and T1 myotome |
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Definition
Motor innervation to:
All intrinsic muscles of digits |
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Term
Chart 1- Brachial Plexus Lesions cards follow. Describe (1) Motor and (2) Sensory Deficit for each nerve lesion
Term will have Nerve (spinal segment) and where the nerve branches from (=> means "came from" like in orgo) |
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Definition
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Term
| Long Thoracic N. (C5,6, 7 ventral rami) |
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Definition
1. Motor --> Serratus Anterior m. --> Winged Scapula
2. No Sensory |
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Term
| Suprascapular n. (C5,C6) => Superior TRUNK |
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Definition
1) Motor --> Supra/infraspinatus m.m.
Supraspinatus deficit = can't start abduction
Infraspinatus deficit = can't externally rotate shoulder
2) No Sensory |
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Term
| Axillary n. (C5) => Posterior Chord |
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Definition
1) Motor Deficit -> Deltoid, hard to abduct to shoulder level.
2) Sensory Deficit -> point of shoulder |
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Term
| Musculocutaneous n. (C5, C6, C7) => Lateral Cord |
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Definition
1) Motor deficit -> Biceps, Brachialis, Weak ELBOW flexion
2) Radial (lateral) forearm |
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Term
| Radial n. (C5,6,7,8) => Posterior cord |
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Definition
1) Motor deficit -> Extensor muscles, drop wrist
2) Sensory deficit: Back of hand on radial (lateral) side |
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Term
Median n. at Elbow (Pronator Teres Syndrome)
Median n = C6,7,8,T1 |
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Definition
1) Motor deficits to:
a) Wrist flexors
b) Digit flexors
c) Thenar muscles - Ape Thumb (can't oppose thumb)
Result: Hand of Benediction (gun hand)
2) Sensory deficits: Palmar surface on Radial side |
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Term
Median n. at Wrist (Carpal Tunnel Syndrome)
Median n = C6,7,8,T1 |
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Definition
1) Motor deficit: Thenar muscles (Ape thumb-can't oppose thumb)
2) Sensory deficits: Palmar surface on Radial side
Recall: Median nerve covers the ANTERIOR compartment of forearm and most of hand (palmar). |
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Term
| Ulnar n. (C8,T1) at ELBOW causes which syndrome? |
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Definition
| Cubital Tunnel Syndrome (Banging Funny Bone) |
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Term
| Cubital Tunnel Syndrome (ulnar n. at elbow) |
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Definition
1) Motor deficits:
a) Weak ADDUCTION of wrist
b) Abduct/Adduct fingers
c) HyperABducted thumb
d) "Clawing" of 3rd and 4th fingers
2) Sensory deficit: ulnar side of hand (palm and dorsal surfaces) |
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Term
| Ulnar nerve passes which tunnel in Hand? |
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Definition
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Term
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Definition
1) Motor deficits:
a) Abduct and Adduct fingers
b) HyperABducted thumb
c) "Clawing" of 3rd and 4th fingers
2) NO SENSORY DEFICIT! |
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