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Perineurium

The connective tissue sheath surrounding nerve fascicles; it represents the smallest surgically identifiable unit and carries the vascular supply of the nerve.

Merkel Cells

Slowly adapting sensory receptors in the fingertips that test static innervation density via static two-point discrimination.

Double Crush Syndrome

Compression of a single nerve at two distinct anatomical locations (such as carpal tunnel and C6 radiculopathy), proposed to be caused by impaired axonal transport.

Durkan Compression Test - performed by applying direct manual pressure over the carpal tunnel

The most sensitive physical examination maneuver for carpal tunnel syndrome

Ligament of Struthers

A fibrous band extending from an abnormal supracondylar process of the humerus to the medial epicondyle, serving as a potential site of proximal median nerve entrapment.

Mannerfelt Syndrome

Rupture of the flexor pollicis longus (FPL) tendon over an osteophyte, typically secondary to STT osteoarthritis or rheumatoid arthritis.

Parsonage-Turner Syndrome

Also termed neuralgic amyotrophy; a condition presenting with a viral prodrome followed by acute severe shoulder pain and subsequent muscle weakness and atrophy.

Froment Sign

Compensatory IP joint hyperflexion of the thumb by the FPL during pinch, indicating weakness of the adductor pollicis muscle due to ulnar nerve palsy.

Arcade of Struthers

A thickening of the deep fascia in the distal medial arm that serves as a potential site of ulnar nerve entrapment proximal to the cubital tunnel.

Radial Tunnel Syndrome, at the arcade of Frohse.

Entrapment of the radial nerve causing isolated pain distal to the lateral epicondyle without motor or sensory deficits, most commonly occurring where?

Wartenberg Syndrome

Entrapment of the superficial branch of the radial nerve between the brachioradialis and extensor carpi radialis longus, leading to pain and paresthesias over the dorsal radial hand.

Spinoglenoid Notch Cyst

A cyst associated with a superior labral tear (SLAP lesion) that causes isolated weakness and atrophy of the infraspinatus muscle.

Elson Test

A physical exam maneuver evaluating central slip integrity where flexing the PIP joint over a table edge causes rigid DIP extension if the central slip is disrupted.

Lumbrical Plus Finger

Paradoxical extension of the PIP joint during active finger flexion, occurring when the FDP tendon is transected distal to the origin of the lumbrical muscle.

Quadriga Effect

An active flexion lag in uninjured adjacent digits caused by over-tightening or excessive shortening of a repaired FDP tendon.

Seymour Fracture

A pediatric transphyseal or juxta-epiphyseal fracture of the distal phalanx associated with entrapment of the proximal nail bed within the fracture site.

Moberg Advancement Flap

A palmar soft tissue advancement flap utilized to reconstruct distal transverse or palmar loss of the thumb.

Aeromonas hydrophila, fluoroquinolones or Bactrim.

A gram-negative bacterium responsible for infections secondary to medicinal leech therapy, typically treated or prevented using what? f

Hypothenar Hammer Syndrome

Ulnar artery thrombosis or aneurysm formation within Guyon's canal caused by repetitive impact or blunt trauma to the hypothenar eminence.

Herpetic Whitlow

A self-limiting viral infection of the digit caused by herpes simplex, characterized by painful clear or white vesicles.

Vickers Ligament

An abnormal tethering fibrous band stretching from the distal radius to the lunate, causing volar-ulnar physeal growth arrest in Madelung deformity.

Glomus Tumor

A benign vascular neoplasm classically characterized by the clinical triad of severe point tenderness, cold intolerance, and paroxysmal pain.

Meissner Corpuscles

Rapidly adapting sensory receptors in the fingertips that test innervation density via moving two-point discrimination.

Horner Sign in Brachial Plexus Injury

A clinical presentation consisting of ptosis, miosis, and anhydrosis indicating a pre-ganglionic avulsion of the C8 and T1 nerve roots.

Preganglionic Brachial Plexus Avulsion SNAP Finding

Preservation of normal sensory nerve action potentials (SNAPs) despite total clinical sensory and motor loss in an insensate limb, because the dorsal root ganglion remains intact distal to the avulsion.

Primary Functional Priority in Brachial Plexus Reconstruction

Surgical restoration of active elbow flexion.

Biceps Recovery Timeline in Erb Palsy

Failure of active biceps function to return by three to five months of age, serving as an indication for surgical exploration.

Rhomboid Muscle Dysfunction in Plexopathy

A clinical sign indicating a pre-ganglionic avulsion at the C5 level, due to the high anatomical origin of the dorsal scapular nerve off the C5 root.

Spinal nerves C5 - T1

Which nerves are involved in the brachial plexus?

C5 and C6

What nerves make up the superior trunk of the brachial plexus?

Dorsoscapular, Long Thoracic

What are the pre-plexus nerves discussed? (names only)

the C5 spinal nerve

Which nerve does the dorsoscapular nerve originate from?

Rhomboid Major and Minor, and Levator Scapulae muscles

What does the dorsoscapular nerve innervate?

Suprascapular and Subclavius Nerves

What two nerves branch off of the Superior trunk of the brachial plexus? (names only)

C5*, C6

Which spinal nerve is the main contributing nerve to the suprascapular nerve?

C4, C5, C6*

Which spinal nerve is the main contributing nerve to the Subclavius nerve?

What muscle(s) and/or joints do(es) the suprascapular nerve innervate?

Supraspinatus, Infraspinatus, Glenohumeral joint

Subclavius muscle, sternoclavicular joint

What muscles(s) and/or joints do(es) the subclavius nerve innervate?

C5, C6, and C7

What spinal nerves contribute to the Long Thoracic Nerve?

Serratus Anterior muscle

What muscle(s) do(es) the Long Thoracic nerve innervate?

The anterior division of the Middle Trunk and the continuation of the Superior Trunk

What divisions contribute to the Lateral Cord of the brachial plexus?

Lateral Pectoral Nerve

What nerve branches off from the Lateral Cord of the brachial plexus? (name only)

Pectoralis major muscle (some minor)

What muscle(s) do(es) the lateral pectoral nerve innervate?

C5, C6*, C7

Which spinal nerves contribute to the lateral pectoral nerve?

C5, C6, C7

Which spinal nerves contribute to the Musculocutaneous nerve?

the Lateral Cord

Which cord(s) contribute to the musculocutaneous nerve?

the Superior Trunk and the anterior division of the Middle Trunk

Which trunk(s) contribute to the musculocutaneous nerve?

ANTERIOR ARM: brachialis, biceps brachii, coracobrachialis

What muscle(s) and/or joint(s) does the Musculocutaneous nerve innervate?

Radial Forearm Skin

What area of the skin does the musculocutaneous nerve contribute to?

Upper subscapular, Thoracodorsal, Lower subscapular nerves.

What branch(es) come(s) off from the Posterior Cord of the brachial plexus? (names only)

the Radial Nerve and the Axillary Nerve

What does the Posterior Cord turn into? (names only)

Superior subscapularis muscle

What muscle does the upper subscapular nerve innervate?

Latissimus Dorsi muscle

What muscle does the Thoracodorsal nerve innervate?

C5*, C6

What spinal nerves contribute to the upper subscapular nerve?

C6, C7*, C8

What spinal nerves contribute to the thoracodorsal nerve?

C5, C6*, C7

What spinal nerves contribute to the lower subscapular nerve?

the posterior division of the superior trunk and the posterior division of the inferior trunk

What trunks make up the posterior chord of the brachial plexus?

Inferior subscapularis muscle and teres major muscle

What muscle does the lower subscapular nerve innervate?

Teres Minor muscle, Deltoid muscle, Glenohumeral Joint

What muscle(s) and/or joint(s) do(es) the Axillary nerve innervate?

The lateral arm skin, skin over the deltoid

What skin does the sensory portion of the axillary nerve innervate?

C5, C6

What spinal nerves contribute to the axillary nerve?

C5 - T1

What spinal neves contribute to the radial nerve?

ALL DORSAL FOREARM MUSCLES. Brachioradialis, Extensor carpi radialis longis, Extensor carpi radialis brevis, Extensor digitorum, Extensor carpi ulnaris, Supinator, Extensor pollicis longis, Extensor indices, Extensor digiti minimi, Abductor Pollicis longis, Pronator Quadratus

What muscle(s) and/or joint(s) do(es) the Radial nerve innervate?

The web between the thumb and the index finger, dorsally

What portion of the skin is specific to the sensory innervation by the radial nerve?

C6, C7, C8, T1

What spinal nerves contribute to the median nerve?

THENAR group: Flexor Pollicus Brevis, Abductor Pollicus Brevis, Opponens Pollicus; Anterior Forearm: Pronator Teres, Flexor Carpi Radialis, Palmaris Longis, NOT Flexor Carpi Ulnaris, NOT 1/2 of flexor digitorum profundus, 1/2 of lumbricals

What muscle(s) and/or joint(s) do(es) the median nerve innervate?

Palmar Skin, from the thumb to the lateral 1/2 of the ring finger.

What portion of the skin does the sensory portion of the median nerve innervate?

Lateral Cord and the Medial Cord

What cords contribute to the median nerve?

Superior, Middle and Inferior Trunks

What trunks contribute to the median nerve?

The Posterior Cord

What cord(s) contributes to the radial nerve?

The Posterior Cord

What cord(s) contribues to the axillary nerve?

Superior trunk, Middle Trunk, Inferior Trunk

What trunk(s) contribute to the radial nerve?

The Superior trunk

What trunk(s) contribute to the axillary nerve?

none

What nerves branch off of the inferior trunk of the brachial plexus?

Medial Pectoral, Medial Brachial Cutaneous, and Medial Antebrachial Cutaneous nerves

What nerves branch off of the medial cord of the brachial plexus? (names only)

Pectoralis Minor muscle, some of pectoralis major

What muscle does the medial pectoral nerve innervate? (name only)

C8, T1

What spinal nerves contribute to the medial pectoral nerve?

C8, T1

What spinal nerves contribute to the medial brachial cutaneous nerve?

The skin on the medial arm

What does the medial brachial cutaneous nerve innervate?

The skin on the medial forearm

What does the medial antebrachial cutaneous nerve innervate?

C8, T1 (sometimes C7)

What spinal nerves contribute to the Ulnar nerve?

The medial cord

What cord(s) contribute to the Ulnar nerve?

All 3 posterior divisions of the trunks

What divisions contribute to the posterior cord?

HYPOTHENAR group: abductor digiti minimi, flexor digiti minimi, opponens digiti minimi; the flexor carpi ulnaris, 1/2 of the flexor digitorum profundus, the interosseus muscles (dorsal and palmar), 1/2 of lumbricals

What muscle(s) and/or joint(s) do(es) the ulnar nerve innervate?

the skin on the medial hand

What area of the skin does the sensory portion of the ulnar nerve innervate?