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Upper Extremity: Muscles & Innervation ²

Roots   Root lesions Brachial plexus   Hereditary   Acquired Nerves Axillary Dorsal scapular Long thoracic Median   Anterior interosseus    Martin-Gruber Musculocutaneous Phrenic Radial   Posterior interosseus   Superficial radial Spinal accessory Suprascapular Ulnar Also see   Disease onset: Arms weak   Brachial plexus   Clinical maneuvers   Legs   Proximal arms weak   Thoracic outlet From: National Library of Medicine Mansur ibn Ilyas: Tashrih-i badan-i insan     1390

Root, Brachial plexus and Nerve components

• Flexor digitorum profundus: Anterior interosseus & Ulnar nerves
• Flexor pollicis brevis: Ulnar (Deep head) & Median (Superficial head)
• Adductor magnus: Obturator & Tibial portion of Sciatic

Frequency of nerve root lesions

• C7: Most common; 30% to 80%
• C6: 19% to 25%
• C8: 4% to 10%
• C5: 2% to 10%

Clinical Maneuvers

Spurling maneuver

• Maneuver
  • Movement: Neck extension, rotation & side-bending
  • Downward pressure on head
• Positive outcome: Pain or tingling radiating from shoulder to elbow
• Lesion
  • Cervical radiculopathy: Especially C5, Also other cervical levels
  • Sensitivity: Low; 30%
  • Specificity: High; 90%
• Similar activity
  • Hair washing in sink at hair salon