Slide 1

Slide 2 Roots C5 C6 C7 C8 T1 Trunks Upper 5,6 Middle 7 Lower 8,1 Divisions Anterior primarily flexors Posterior primarily extensors Cords Lateral C5,6,7 Posterior C5,6,7,8 Medial C8,T1 Slide 3 Slide 4 1 st cervical nerve exits ABOVE C1 vertebra 2 nd through 7 th nerves exit above corresponding vertebrae 8 th cervical nerve exits BELOW C7 vertebra Note: There are 7 cervical vertebrae There are 8 cervical nerves Slide 5 Slide 6 Defined: The defined segmental portion of the skin innervated by the sensory component of each spinal nerve. Sensory testing helps localize the level of the nerve root lesion Note: Territories of dermatomes do overlap Slide 7 Slide 8 Slide 9 Slide 10 C5 C6 C7 C8 T1 Slide 11 Spinal Cord Segments C5, C6, C7 Muscles Innervated Serratus Slide 12 Spinal Cord Segment C5 (C4 is variable) Muscles Innervated Levator Rhomboids Slide 13 Spinal Cord Segments C5, C6 Muscles Innervated SC Slide 14 Spinal Cord Segments C4, C5, C6 Muscles Innervated SS IS Slide 15 Innervates volar aspect of U.E. Spinal Cord Segments C5 C6 C7 C8 T1 Slide 16 Innervates the dorsal aspect of the U.E. Spinal Cord Segments C5 C6 C7 C8 T1 Slide 17 Spinal Cord Segments C5, C6, C7 Muscles Innervated Pec. Maj. Slide 18 Gives rise to 2 nerves Spinal Cord Segments C5 C6 C7 Slide 19 Gives rise to 5 nerves Spinal Cord Segments C5 C6 C7 C8 T1 Slide 20 Gives rise to 5 nerves Spinal Cord Segments C8 T1 Slide 21 Spinal Cord Segments C8, T1 Muscles Innervated Pec. Maj. Pec. Min. Slide 22 Spinal Cord Segments C5, C6 Muscles Innervated Subscapularis Slide 23 Spinal Cord Segments C6, C7, C8 Muscles Innervated Lat. D. Slide 24 Spinal Cord Segments C5, C6 Muscles Innervated T. Maj. Subscapularis Slide 25 Spinal Cord Segments C8 T1 Slide 26 Spinal Cord Segments C8 T1 Slide 27 Spinal Cord Segments C8, T1 Muscles Innervated FCU, FDP (4,5), PB, ADM, ODM, FDM, ADD POL, FPB (deep head), Lum (4,5) DI, PI Slide 28 Spinal Cord Segments C5, C6 Muscles Innervated T. Min. Deltoid Slide 29 Spinal Cord Segments C5, C6, C7, C8, T1 Muscles Innervated Triceps, Anconeous, BR, Brachialis, ECRL Slide 30 Spinal Cord Segments C5, C6, C7 Muscles Innervated BB, CB, Brachialis Slide 31 Spinal Cord Segments C5, C6, C7, C8, T1 Muscles Innervated PT, FCR, PL, FDS, FDP (2,3), FPL, FPB, APB, OP, PQ, LUM (2,3). Slide 32 Slide 33 Due to traction Traumatic injuries Contusion Disruption of blood supply Laceration Slide 34 Fracture Dislocation Compression Sites Low lesion Ant. Interosseous lesion Lesion proximal to elbow Slide 35 Slide 36 Wasting of the thenar eminence and unable to oppose the thumb Slide 37 Fractures Lacerations Low Lesions High Lesions Slide 38 Cubital tunnel Guyons canal Midpalm Slide 39 Wasting of hypothenar muscles, interossei, and two medial lumbricals Slide 40 Fractures Dislocations Posterior Interosseous Lesions Mid-humeral Lesion High Lesion Sensory Loss Slide 41 Anatomy of the Radial Nerve Deltoid tuberosity Radial Groove (Spiral Groove) Slide 42 Wrist, thumb, and finger extensors weakness Slide 43 Brachial plexopathies require thorough understanding of anatomy Specialized sensory and motor testing can help localize the pathology Slide 44 Hoppenfeld, S., (2000). Physical examination of the spine and extremities. In S. Hoppenfeld (Ed.), Physical examination of the cervical spine and temporomandibular joint (p.105-132). Norwalk, CT: Appleton and Lange