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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
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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
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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
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C5 C6 C7 C8 T1
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Spinal Cord Segments C5, C6, C7 Muscles Innervated Serratus
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Spinal Cord Segment C5 (C4 is variable) Muscles Innervated Levator Rhomboids
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Spinal Cord Segments C5, C6 Muscles Innervated SC
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Spinal Cord Segments C4, C5, C6 Muscles Innervated SS IS
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Innervates volar aspect of U.E. Spinal Cord Segments C5 C6 C7 C8 T1
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Innervates the dorsal aspect of the U.E. Spinal Cord Segments C5 C6 C7 C8 T1
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Spinal Cord Segments C5, C6, C7 Muscles Innervated Pec. Maj.
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Gives rise to 2 nerves Spinal Cord Segments C5 C6 C7
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Gives rise to 5 nerves Spinal Cord Segments C5 C6 C7 C8 T1
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Gives rise to 5 nerves Spinal Cord Segments C8 T1
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Spinal Cord Segments C8, T1 Muscles Innervated Pec. Maj. Pec. Min.
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Spinal Cord Segments C5, C6 Muscles Innervated Subscapularis
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Spinal Cord Segments C6, C7, C8 Muscles Innervated Lat. D.
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Spinal Cord Segments C5, C6 Muscles Innervated T. Maj. Subscapularis
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Spinal Cord Segments C8 T1
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Spinal Cord Segments C8 T1
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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
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Spinal Cord Segments C5, C6 Muscles Innervated T. Min. Deltoid
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Spinal Cord Segments C5, C6, C7, C8, T1 Muscles Innervated Triceps, Anconeous, BR, Brachialis, ECRL
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Spinal Cord Segments C5, C6, C7 Muscles Innervated BB, CB, Brachialis
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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).
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Due to traction Traumatic injuries Contusion Disruption of blood supply Laceration
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Fracture Dislocation Compression Sites Low lesion Ant. Interosseous lesion Lesion proximal to elbow
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Wasting of the thenar eminence and unable to oppose the thumb
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Fractures Lacerations Low Lesions High Lesions
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Cubital tunnel Guyon’s canal Midpalm
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Wasting of hypothenar muscles, interossei, and two medial lumbricals
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Fractures Dislocations Posterior Interosseous Lesions Mid-humeral Lesion High Lesion Sensory Loss
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Anatomy of the Radial Nerve Deltoid tuberosity Radial Groove (Spiral Groove)
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Wrist, thumb, and finger extensors weakness
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Brachial plexopathies require thorough understanding of anatomy Specialized sensory and motor testing can help localize the pathology
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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
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