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WorksheetsBrachial/Lumbar/Sacral Plex
Total questions: 16
Worksheet time: 10mins
30-year-old Duke Athie limps into the orthopaedic long bone clinic for review of his complicated tibial fracture. From reading his notes you see that he had a motorcycle accident ten years ago in which he broke both legs and injured his neck. You introduce yourself, but when you offer to shake his hand he grimaces and awkwardly shrugs the right side of his chest in response. You notice that his right arm is held unnaturally; it is turned inward at the shoulder, tucked into his side, fully extended at the elbow and his fingers are pointing out behind him.
At which level do you suspect his brachial plexus may have been compromised?
C8-T1
C7-T8
C4-T5
C6-C7
C5-C6
You are observing Dr Gasser anaesthetise a patient prior to open rotator cuff repair surgery. She intends to perform a regional nerve block affecting the brachial plexus and asks you about the relevant anatomy.
Between which two muscles do the roots of the brachial plexus emerge?
Anterior and middle scalene
Pectoralis minor and major
Sternocleidomastoid and anterior scalene
Middle and posterior scalene
Anterior and posterior scalene
Which of the following brachial plexus nerve roots continues alone as a trunk?
C5
C8
C7
T1
C6
A competitive motorcyclist is involved in a 'high-side' dismount whereby he is thrown up and over his motorbike, landing hard on his shoulder with his neck flexed toward the contralateral side. He sustains a comminuted open clavicular fracture in addition to an upper rib and proximal humerus fractures.
Which syndrome is he at risk of developing following complete brachial plexus injury (i.e. avulsion of the nerve roots)?
Horner's Syndrome
Holmes-Adie Syndrome
Thoracic Outlet Syndrome
Subclavian Steal Syndrome
Pickwickian Syndrome
Billy is a ten-year-old who has fallen from a tree. He’s been a fairly lucky ten-year-old, as a primary survey in the emergency department has revealed no issues with his airway, cervical spine, breathing, circulatory system or neurological status. On examination of his limbs, however, he appears to have unfortunately developed a rare deformity whereby the right wrist and metacarpophalangeal joints are held in extension, the interphalangeal joints are flexed, and he has abnormal sensation over the ulnar border of the hand.
Which roots of the brachial plexus do you suspect have been injured?
C7-C8
C6-C7
C5-C6
C8-T1
C4-C5
Mr Vintner is involved in an implausible accident with a sharp piece of glass, which penetrates through pectoralis major and narrowly avoids both pectoralis minor and the axillary artery. It does, however, completely transect his musculocutaneous nerve. He is left virtually unable to flex his right arm and struggles to supinate, to the extent that he can no longer use a corkscrew and has to import wine in screw-top bottles only.
Which of the following structures is NOT innervated by the musculocutaneous nerve or its branches?
Biceps Brachii
Supinator
Skin (sensation) on the Radial aspect of the forearm
Brachialis
Coracobrachialis
As part of your revision of the pathology of carpal tunnel syndrome, you thought it might be a helpful exercise to follow the path of the implicated nerve from the wrist all the way up to the spinal cord.
This particular nerve in question is derived from which two cords of the brachial plexus?
Posterior and Lateral
Medial and Lateral
Medial and Posterior
Median and Lateral
Posterior and Anterior
Mr Bloggs has dislocated his shoulder in an ill-advised attempt to jump over a cow. You remember hearing of a medicolegal case in which a doctor was sued for failing to document axillary nerve sensation prior to reducing such a dislocation, and thus being unable to demonstrate that he had not caused the axonotmesis when it was later discovered. You find that Mr Bloggs, fortunately, has intact sensation in the distribution of the axillary nerve.
From which cord of the brachial plexus does the axillary nerve arise?
Upper
Posterior
Medial
Lateral
Lower
Which of the following muscles does NOT derive its motor innervation from the posterior cord of the brachial plexus?
Latissimus Dorsi
Subscapularis
Triceps
Deltoid
Serratus Anterior
Mr Unlucky has never been the superstitious type, frequently crossing paths with black cats and breaking mirrors for fun. Earlier this morning, however, he ducked underneath a ladder in the street and unfortunately received a direct blow to the middle portion of his clavicle from a paint tin from the sky.
Which part of the brachial plexus most commonly lies deep to the clavicle?
Divisions
Nerves
Cords
Roots
Trunks
Which nerve roots form the lumbar plexus?
L1-L5
L1-L4
L2-L4
L2-L5
L2-L5
Which two nerves have motor functions in the lower limb?
lioinguinal and iliohypogastric
Femoral and Iliohypogastric
Femoral and obturator
Genitofemoral and obturator
Femoral and Genitofemoral
Damage to the L2-L4 spinal roots will NOT affect which of these nerves
Iliohypogastric
Lateral cutaneous nerve of thigh
Femoral
Obturator
Inguinal
Which nerve roots form the sacral plexus?
L1-L4
L2-S1
L4-S4
L5-S4
L1-S4
Which nerve of the sacral plexus innervates the external urethral sphincter?
Superior gluteal
Sciatic
Inferior gluteal
Pudendal
Iliohypogastric
Damage to which of these nerve roots would prevent the function of gluteus maximus?
L4-L5
L5-S2
S1-S3
S2-S4
L2-S1
