1. Peripheral Nerves- The Mystery of the Braids Neuroanatomy: A Clinician’s Review: CHRMC Neuroanatomy: A Clinician’s Review: CHRMC Spring 2007 Bernadette Gillick, MS, PT Bernadette Gillick, MS, PT

9. Brachial Plexus “Simplified” Dorsal Scapular Nerve Suprascapular Nerve Nerve to Subclavius Lateral Pectoral Nerve Axillary Nerve Radial Nerve Thoracodorsal Nerve Subscapular Nerve Medial Pectoral Nerve Medial Cutaneous Nerve- Arm and Forearm Musculocutaneous Nerve Median Nerve Ulnar Nerve

17. Nerves acting on the Thumb

18. Radial- Abductor Pollicis Longus

19. Ulnar- Adductor Pollicis

20. Median- Flexor Pollicis Longus and Brevis (sup head)

21. Lumbar Plexus “Simplified” Iliohypogastric Nerve Ilioinguinal Nerve Genitofemoral Nerve Lateral Femoral Cutaneous Nerve Femoral Nerve Obturator Nerve Saphenous Nerve Superior Gluteal Nerve Inferior Gluteal Nerve Sciatic Nerve Common Peroneal Nerve Superficial Peroneal Nerve Deep Peroneal Nerve Tibial Nerve Sural Nerve Posterior Femoral Cutaneous Pudendal Nerve

30. Dermatomes and Myotomes Dermatome- sensory region of skin innervated by a nerve root Myotome- muscles innervated by a single nerve root

31. 28 Total Dermatomes Two aspects - absent, impaired, normal –Pin Prick (why?) –Light Touch (why?) Proprioception- absent, impaired, normal –Same one joint on each extremity –Index finger and Great Toe

32. Common Dermatomal Levels Remember – Sensation on Chest and Back skips from C4 to T2 as the upper extremities are represented. C4 also dips low on the anterior or ventral neck.

33. Common Dermatomal Levels C5- Shoulder C6- Lateral Arm and Digits 1&2 C7- Middle Digit C8- Digits 4 & 5

34. Common Dermatomal Levels Nipples- T4 Umbilicus- T10

35. Common Dermatomal Levels L4- Anteromedial Shin L5- Anterolateral Shin, dorsum of foot to big toe

36. Common Dermatomal Levels S1- 5 th toe, lateral foot, sole and calf S2, S3, S4 innervate the perineal area in a “saddle-like” distribution

39. ASIA, 2006

42. Common Dermatomal Levels Face- Trigeminal nerve Head- C2 via the greater and lesser occipital nerves

43. Multiple Segments Innervating BicepsECRLTriceps ASIA, 2006

44. Myotomes Helpful to have memorized at least one muscle that gets major innervation from each nerve root

52. Neuro Exam Do you use components of these in your own exams?

53. Blumenfeld, 2002

56. The beginning is the most important part of the work. - Plato Thank you for working with me these past four weeks! - Bernadette Gillick