Brachial Plexus/Injuries(Writing/Mcq)
The roots of the entire brachial plexus are?
What are the lymph node groups in the axillary region? (5)
Lymph Node Groups:
1) pectoral
2)Lateral
3)Apical
4)Central
5)Posterior
Which vein is most commonly used for blood draws?
A) Cephalic vein
B) Basilic vein
C) Median cubital vein
D) Femoral vein
1. C
What is the primary function of the biceps brachii muscle?
A) Wrist flexion and finger extension
B) Elbow extension and wrist pronation
C) Shoulder abduction and hand grip strength
D) Elbow flexion, shoulder flexion, and forearm supination
D
All the extensors of the upper limb are innervated by which nerve?
A) Musculocutaneous nerve
B) Axillary nerve
C) Radial nerve
D) Ulnar nerve
C) RADIAL
What are the five nerves of the brachial plexus, roots, and functionality?Write it down!
Musculocutaneous nerve: roots C5-C7; flexion at both shoulder and elbow
Axillary nerve: roots C5-C6; helps w/ should rotation and enables arm abduction
Median nerve: roots C6-TI; movement in forearm and parts of hand
Radial Nerve:roots C5-TI; movements in the arm, elbow, forearm. and hand
Ulnar nerve:roots C8-Tl; fine motor control of fingers
What is the Clinical significance of Colle's fracture? (What is it, cause, what is it accompanied by, treatment)
Colle's Fracture: fracture of radial styloid process
Cause: falling on hand w extended arm
-- Displaces Posteriorly and process forces process into shaft (POSTERIORLY)
--Accompanied by avulsion of ulnar styloid process
--Treat: surgery to retrieve /reattach styloid process
1. What is a key symptom of a radial nerve injury proximal to the origin of the triceps?
A) Claw hand with loss of finger flexion
B) Inability to extend the elbow and wrist, leading to wrist drop
C) Thenar muscle atrophy and loss of thumb opposition
D) Loss of pronation and weakened grip strength
2. How does a radial nerve injury at the radial groove differ from an injury proximal to the triceps?
A) Triceps function is usually spared, but wrist drop still occurs
B) Elbow extension is completely lost along with wrist extension
C) Sensory loss is more severe, affecting the entire arm
D) The injury primarily affects thumb opposition and finger flexion
1. B
2. A
What is the primary function of the triceps brachii muscle?
A) Elbow flexion and forearm supination
B) Finger extension and wrist pronation
C) Wrist flexion and shoulder abduction
D) Elbow extension, shoulder extension, and adduction
T or F. The Flexor Digitorum Profundus is only innervated by the Ulnar Nerve.
F
List at least 8 additional nerves of the brachial plexus!
Which of the following statements is TRUE regarding Brachial Plexus Neuropraxia?
A) It is the most severe type of nerve injury involving complete nerve transection.
B) Older individuals commonly experience root compression due to head rotation.
C) Adolescents are more likely to experience nerve compression rather than traction injuries.
D) The condition does not cause any sensory disturbances, only motor deficits.
Additional nerves of brachial plexus:(DSSTMMUMLLL)
-Dorsal scapular
-suprascapular
-subclavius
-Lateralpectoral
-medial pectoral
-upper subscapular
-thoracodorsal
-lower subscapular
-medial brachial cutaneous
-medial antebrachial cutaneous
-long thoracic
1. B
Know the Clinical significance of the "anatomical snuffbox." (Borders, Contents, etc.)
- Radial artery enters the "snuffbox" and branches to produce dorsal arterial arch of the hand
• Principal artery of thumb → deep palmar arch
• Snuffbox borders - tendon of extensor pollicis longus; tendons of extensor pollicis brevis; and abductor pollicis longus
• Contents of snuffbox - radial artery and superficial radial nerve
1. What is a characteristic sign of an ulnar nerve injury at the wrist?
A) Hand of Benediction
B) Claw Hand due to hyperextension at MCP joints and flexion at IP joints
C) Ape Hand with thenar muscle atrophy
D) Wrist drop with loss of wrist extension
2. Which of the following is a symptom of ulnar nerve injury at the elbow?
A) Weak ulnar deviation of the wrist with hand abducted and extended
B) Loss of thumb opposition and thenar muscle atrophy
C) Complete paralysis of wrist flexors
D) Inability to pronate the forearm
1. B
2. A
What is the primary function of the levator scapulae muscle?
A) Elevates the scapula and inclines the neck to the same side
B) Depresses the scapula and rotates the neck
C) Protracts the scapula and flexes the neck
D) Extends the arm and stabilizes the shoulder
A
1. What is the innervation of the pronator teres?
2. What is the innervation of Flexor Carpi ulnaris?
1. Innervation: Median n
2. Innervation: Ulnar nerve
1. Which of the following best describes a Brachial Plexus Rupture?
A) A mild nerve injury caused by temporary stretching without structural damage.
B) A forceful stretch leading to a partial or complete nerve tear.
C) A condition where scar tissue forms after a surgical nerve injury.
D) A complete separation of the nerve root from the spinal cord.
2. What is the primary cause of a Brachial Plexus Neuroma?
A) Excessive nerve traction due to a sudden downward force.
B) Compression of the nerve root from head rotation.
C) Nerve damage from surgical intervention leading to scar tissue formation.
D) A complete avulsion of the nerve root from the spinal cord.
3. Which statement about Brachial Plexus Avulsion is TRUE?
A) It is the least severe type of brachial plexus injury.
B) It occurs when the nerve root is completely separated from the spinal cord.
C) It can heal without medical intervention due to nerve regeneration.
D) It is commonly treated with simple physical therapy alone.
1. B
2. C
3. B
1. A patient is unable to lift their arm above 90 degrees. Which muscle and nerve are most likely affected?
A) Rhomboid minor – Dorsal scapular nerve
B) Serratus anterior – Long thoracic nerve
C) Deltoid – Axillary nerve
D) Trapezius – Spinal accessory nerve
2. How can you differentiate between a dorsal scapular nerve injury and a long thoracic nerve injury?
A) Both injuries cause complete loss of arm movement.
B) A dorsal scapular nerve injury prevents lifting the arm above 90 degrees.
C) A long thoracic nerve injury prevents lifting the arm above 90 degrees, while a dorsal scapular nerve injury does not.
D) Neither injury affects arm movement above 90 degrees.
1. B
2. C
1. Which nerve is most commonly damaged in a fracture of the distal end of the humerus?
A) Radial nerve
B) Ulnar nerve
C) Median nerve
D) Axillary nerve
2. A patient with wrist drop likely has a fracture at which location?
A) Distal end of the humerus
B) Middle of the humeral shaft
C) Medial epicondyle
D) Surgical neck of the humerus
3. A fracture of the medial epicondyle is most likely to damage which nerve?
A) Median nerve
B) Ulnar nerve
C) Radial nerve
D) Axillary nerve
4. A fracture of the surgical neck of the humerus is most likely to damage which nerve?
A) Axillary nerve
B) Radial nerve
C) Median nerve
D) Ulnar nerve
1. C
2. B
3. B
4. A
1. What is the primary function of the rhomboid major and minor muscles?
A) Elevate the scapula and rotate the neck
B) Steady the scapula and retract it medially upwards
C) Depress the scapula and assist in arm abduction
D) Extend and laterally rotate the shoulder
2. Which of the following correctly describes the functional roles of the different parts of the deltoid muscle?
A) The middle part abducts the arm, the anterior part extends and laterally rotates, and the posterior part flexes and medially rotates
B) The middle part abducts the arm, the anterior part flexes and medially rotates, and the posterior part extends and laterally rotates
C) The middle part flexes the arm, the anterior part extends and laterally rotates, and the posterior part abducts
D) The entire deltoid only performs abduction without any rotational or flexion/extension roles
1.B
2.B
1. Which carpal bone is the most frequently fractured?
A) Lunate
B) Scaphoid
C) Capitate
D) Triquetrum
2. Which carpal bone is the most commonly dislocated?
A) Hamate
B) Scaphoid
C) Lunate
D) Trapezium
1. B
2. C
1. Which of the following is a common sign of an Upper Brachial Plexus (C5-C6) injury?
A) Weakness in wrist flexion and finger movement
B) Difficulty abducting the arm and flexing the elbow
C) Loss of sensation in the lower limb
D) Impaired hip and knee movement
2. A patient with a Lower Brachial Plexus (C8-T1) injury is most likely to experience:
A) Weakness in shoulder and elbow movement
B) Difficulty with fine motor control in the hand
C) Loss of sensation in the upper back
D) Inability to extend the knee
3. Which of the following best differentiates an Upper Brachial Plexus (C5-C6) injury from a Lower Brachial Plexus (C8-T1) injury?
A) Upper plexus injuries primarily affect hand function, while lower plexus injuries impair shoulder movement.
B) Lower plexus injuries cause difficulty with elbow flexion, while upper plexus injuries spare the elbow.
C) Upper plexus injuries limit shoulder and elbow motion, while lower plexus injuries affect hand and wrist function.
D) Both injuries present with the same muscle weakness but differ in
1. B
2. B
3. C
What happens when the radial nerve is injured at all injury points?
WRIST DROP
1. What causes the "Hand of Benediction" deformity?
A) Ulnar nerve injury at the wrist
B) Median nerve injury above the elbow
C) Radial nerve injury at the forearm
D) Axillary nerve injury at the shoulder
2. Why does "Ape Hand" develop in a median nerve injury at the wrist?
A) Loss of the adductor pollicis muscle function
B) Atrophy of the thenar muscles due to prolonged nerve damage
C) Complete paralysis of all hand muscles
D) Weakness in wrist extension
3. Which lumbricals and fingers are primarily affected in the "Hand of Benediction" deformity due to a median nerve injury?
A) 3rd and 4th lumbricals; ring and little fingers (4th and 5th)
B) 1st and 2nd lumbricals; index and middle fingers (2nd and 3rd)
C) All four lumbricals; all fingers equally
D) 1st and 2nd lumbricals; thumb and pinky (1st and 5th)
1. B
2. B
3. B
1. What is the primary function of the subscapularis muscle?
A) Lateral rotation and abduction of the arm
B) Adduction and medial rotation of the arm
C) Extension and lateral rotation of the arm
D) Flexion and stabilization of the scapula
2. Which rotator cuff muscle is responsible for lateral rotation of the arm?
A) Supraspinatus
B) Subscapularis
C) Infraspinatus
D) Coracobrachialis
3. What is the primary function of the supraspinatus muscle?
A) Medial rotation of the arm
B) Lateral rotation of the arm
C) Abduction of the arm
D) Extension of the arm
4. Which rotator cuff muscle shares the same function as the infraspinatus?
A) Supraspinatus
B) Subscapularis
C) Teres minor
D) Pectoralis major
5. Which of the following muscles is NOT part of the rotator cuff?
A) Supraspinatus
B) Teres major
C) Infraspinatus
D) Teres minor
1. B
2. C
3. C
4. C
5. B
1. What nerve is compressed in Carpal Tunnel Syndrome?
A) Ulnar nerve
B) Radial nerve
C) Median nerve
D) Musculocutaneous nerve
2. Which of the following structures does NOT pass through the carpal tunnel?
A) Flexor digitorum profundus
B) Flexor pollicis longus
C) Ulnar nerve
D) Flexor digitorum superficialis
3. What is the clinical treatment for severe carpal tunnel syndrome?
A) Immobilization with a cast
B) Cutting the flexor retinaculum to relieve pressure
C) Physical therapy only
D) Complete removal of the carpal bones
1. C
2. C
3. B