Re: Axilla and Brachial Plexus: Learning Objectives and Review Questions - Part I

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: Sorry, another issue. For #12, why isn't this false? I have abduction from 90-160 being cranial nerve XI, and from 160-180 being long thoracic nerve. : For #17, isn't the median nerve innervating flexor carpi radialis, and therefore responsible for radial deviation, the counter to ulnar deviation? Why would the wrist be adducted here? : : : : 1. The dorsal scapular nerve arises from the posterior cord of the brachial plexus. : : : False – anterior root : : FALSE was the intended answer. Ventral ramus of C5. : : : 2. A lesion of the upper root of the brachial plexus would weaken protraction of the scapula. : : : True – Long thoracic Nerve (C5, C6 & C7) to Serratus Anterior (protractor) would be affected as would lateral pectoral nerve to the pectoralis muscles, also protractors. : : TRUE was the intended answer. : : : 3. The long thoracic nerve is derived from the lower 3 roots of the brachial plexus. : : : False – upper 3 roots : : TRUE was the intended answer. : : : 4. A lesion of the long thoracic nerve would severely weaken protraction of the scapula. : : : True – see answer 3 : : TRUE was the intended answer. Read about winging of the scapula : : : 5. A lesion of the long thoracic nerve would affect complete abduction of the arm. : : : False – Deltoid is chief abductor, supplied by Axillary nerve : : TRUE was the intended answer. Serratus anterior mediates upward rotation of the scapula. : : : 6. A lesion of the middle subscapular would weaken lateral rotation of the arm. : : : False – no such thing as middle subscapular : : FALSE was the intended answer. The middle subscapular nerve innervates the latissimus dorsi; a medial rotator of the arm. : : : 7. A lesion of the lower subscapular nerve would weaken medial rotation. : : : True – supplies subscapularis and teres major, both medial rotators : : TRUE was the intended answer. : : : 8. A complete lesion of the posterior cord and its branches would cause uncompensated loss of medial rotation. : : : False – lateral pectoral nerve off anterior cord would still provide innervations to pectoralis muscles, which are medial rotators : : FALSE was the intended answer. Also be aware of the short head of the biceps. : : : 9. A complete loss of the posterior cord and its branches would cause uncompensated loss of arm abduction from approximately 15 - 90 degrees. : : : True – loss of Axillary nerve means loss of deltoid, which is responsible for approximately 15 – 90 degrees : : TRUE was the intended answer. : : : 10. Entrapment of the suprascapular nerve at the superior transverse scapular notch could cause uncompensated loss of arm abduction from 0 - 15 degrees and compensated loss of medial rotation of the arm. : : : False – the first portion of the statement is true, loss of Suprascapular nerve would cause loss of function of supraspinatus, which is responsible for 0 – 15 degrees of abduction. However, this would not cause an uncompensated loss of medial rotation. The pectoralis muscle could still contribute to medial rotation. : : FALSE was the intended answer. There is no weakness in medial rotation. Infraspinatus is a lateral rotator. : : : 11. A lesion of the lower subscapular nerve would cause weakened (compensated) arm adduction. : : : True – lower subscapular innervates teres major, which is an adductor. The loss would be compensated by latissimus dorsi, an adductor innervated by thoracodorsal nerve : : TRUE was the intended answer. What if the middle subscapular nerve was lesioned as well? : : : 12. A lesion of the axillary nerve would weaken every possible movement at the glenohumeral joint with the exception of abduction from 0 - 15 degrees. : : : True – loss of Axillary means loss of deltoid, which is involved in almost all movements at glenhumeral joint. However, Suprascapular nerve would still innervate supraspinatus for 0 – 15 degrees of abduction. : : TRUE was the intended answer. : : : 13. A total lesion of the median nerve would cause ape hand. : : : True – median nerve innervates thumb : : TRUE was the intended answer. What is the key muscle? : : : 14. A total lesion of the ulnar nerve would cause claw hand. : : : True – ulnar nerve innervates 5th finger : : TRUE was the intended answer. Why is there clawing of the radial two fingers? : : : 15. A total lesion of the radial nerve would cause wrist drop. : : : True – radial nerve innervates extensors, wrist drop is result of extensor paralysis : : TRUE was the intended answer. : : : 16. A lesion of the radial nerve at the spiral groove would cause loss of extension at the elbow. : : : True – radial groove on humerus bone, lesion here would impair extension at elbow via triceps : : FALSE was the intended answer. Radial nerve branches to the triceps are proximal to the spiral groove. : : : 17. A lesion of the radial nerve at the spiral groove would cause the wrist to be flexed and adducted. : : : ? : : TRUE was the intended answer. : : : 18. A lesion of the ulnar nerve at the ulnar groove would cause the wrist to be extended and abducted. : : : ? : : TRUE was the intended answer. : : : 19. A lesion of the ulnar nerve within the anterior compartment of the arm would cause the wrist to be extended and abducted. : : : True to extension – don’t know about abduction : : TRUE was the intended answer. : : : 20. The ulnar nerve enters the anterior arm by passing through the heads of origin of the flexor carpi ulnaris. : : : True : : TRUE was the intended answer. : : : : This site has been visited 32596 times since July 10, 2007 : : : : Axilla and Brachial Plexus: Learning Objectives and Review Questions - 2008 : : : : True/False : : : : 1. The dorsal scapular nerve arises from the posterior cord of the brachial plexus. : : : : 2. A lesion of the upper root of the brachial plexus would weaken protraction of the scapula. : : : : 3. The long thoracic nerve is derived from the lower 3 roots of the brachial plexus. : : : : 4. A lesion of the long thoracic nerve would severely weaken protraction of the scapula. : : : : 5. A lesion of the long thoracic nerve would affect complete abduction of the arm. : : : : 6. A lesion of the middle subscapular would weaken lateral rotation of the arm. : : : : 7. A lesion of the lower subscapular nerve would weaken medial rotation. : : : : 8. A complete lesion of the posterior cord and its branches would cause uncompensated loss of medial rotation. : : : : 9. A complete loss of the posterior cord and its branches would cause uncompensated loss of arm abduction from approximately 15 - 90 degrees. : : : : 10. Entrapment of the suprascapular nerve at the superior transverse scapular notch could cause uncompensated loss of arm abduction from 0 - 15 degrees and compensated loss of medial rotation of the arm. : : : : 11. A lesion of the lower subscapular nerve would cause weakened (compensated) arm adduction. : : : : 12. A lesion of the axillary nerve would weaken every possible movement at the glenohumeral joint with the exception of abduction from 0 - 15 degrees. : : : : 13. A total lesion of the median nerve would cause ape hand. : : : : 14. A total lesion of the ulnar nerve would cause claw hand. : : : : 15. A total lesion of the radial nerve would cause wrist drop. : : : : 16. A lesion of the radial nerve at the spiral groove would cause loss of extension at the elbow. : : : : 17. A lesion of the radial nerve at the spiral groove would cause the wrist to be flexed and adducted. : : : : 18. A lesion of the ulnar nerve at the ulnar groove would cause the wrist to be extended and abducted. : : : : 19. A lesion of the ulnar nerve within the anterior compartment of the arm would cause the wrist to be extended and abducted. : : : : 20. The ulnar nerve enters the anterior arm by passing through the heads of origin of the flexor carpi ulnaris. : : : : Short Answer and Definitions : : : : 1. Coracoid Process : : : : 2. Quadrangular Space : : : : 3. Triangular Space : : : : 4. Deltopectoral Groove : : : : 5. Bicipital Groove/Intertubercular Sulcus : : : : 6. Clavipectoral Fascia : : : : 7. Suspensory Ligament of the Axilla : : : : 8. Winging of the scapula : : : : 9. Serratus anterior and upward rotation of the scapula : : : : 10. Anterior and posterior axillary folds : : : : 11. Clavipectoral fascia : : : : 12. Axillary lymph nodes : : : : 13. Intertubercular groove : : : : 14. Transverse humeral ligament : : : : 15. Axillary Sheath : : : : 16. Cephalic vein : : : : 17. Parts 1, 2, and 3 of the axillary artery : : : : 18. Thoracoacromial trunk : : : : 19. Circumflex scapular artery : : : : 20. Anterior and posterior humeral circumflex arteries : : : : 21. Shoulder anastomosis (Thoracoacromial trunk + deltoid and acromial branches + ant/post humeral circumflex aa + ascending branch profunda brachii artery) : : : : 22. Subscapular artery and ligation of the axillary artery : : : : 23. Ventral ramus of spinal nerve : : : : 24. Dorsal ramus of spinal nerve : : : : 25. Roots of the brachial plexus : : : : 26. Trunks of the brachial plexus : : : : 27. Posterior cord of brachial plexus (6 pts) : : : : 28. Medial antebrachial cutaneous nerve : : : : 29. Middle subscapular nerve : : : : 30. Lower subscapular nerve : : : : Essay : : : : 1. Discuss the anatomy of the axilla. Include contents, relationships, boundaries, fascial specializations, vascularization, innervation, lymphatics, muscles and movements, and compensation in the case of nerve injury. : : : : 2. Discuss the brachial plexus. Include parts, boundaries, relationships, fascial specializations, vascularization, muscles and movements, and compensation in the case of nerve injury. : : : : 3. Discuss the subscapularis muscle. Include fascial specializations, relationships, vascularization, innervation, lymphatics, movements, and compensation in the case of nerve injury. : : : : 4. Discuss the pectoralis minor muscle. Include fascial specializations, relationships, vascularization, innervation, lymphatics, movements, and compensation in the case of nerve injury. : : : : 5. Discuss the coracobrachialis muscle. Include fascial specializations, relationships, vascularization, innervation, lymphatics, movements, and compensation in the case of nerve injury. : : : : 6. Discuss the short head of biceps muscle. Include fascial specializations, relationships, vascularization, innervation, lymphatics, movements, and compensation in the case of nerve injury. : : : : 7. Discuss the pectoralis major muscle. Include fascial specializations, relationships, vascularization, innervation, lymphatics, movements, and compensation in the case of nerve injury. : : : : 8. Discuss the latissimus dorsi muscle. Include fascial specializations, relationships, vascularization, innervation, lymphatics, movements, and compensation in the case of nerve injury. : : : : 9. Discuss the serratus anterior muscle. Include fascial specializations, relationships, vascularization, innervation, lymphatics, movements, and compensation in the case of nerve injury. : : : : 10. Discuss the teres major muscle. Include fascial specializations, relationships, vascularization, innervation, lymphatics, movements, and compensation in the case of nerve injury. : : : : 11. Discuss the branching of the axilary artery. Include relationships, fascial specializations, relationships, lymphatics, movements, and collateral circulation in the case of injury. : : : : 12. Discuss the contents of the axillary sheath, provide relations within the sheath. : : : : 13. Discuss the path of the posterior cord of the brachial plexus and its branches in the axilla, shoulder, and proximal upper extremity. : : : : 14. Discuss the vascular and nervous injuries possible by a fracture at the surgical neck of the humerus. : : : : 15. Discuss the symptoms resulting from injuries to the upper brachial plexus. : : : : 16. Discuss the symptoms resulting from injuries to the lower brachial plexus. : : : : 17. Discuss "ape hand" and median nerve injury. : : : : 18. Discuss "claw hand" and ulnar nerve injury. : : : : 19. Discuss the actions of the serratus anterior muscle and winging of the scapula. : : : : 20. Discuss the loss of action and sensation after a fracture of the surgical neck of the humerus or a downward dislocation of the shoulder.

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