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Neuromuscular Diseases A Practical Guideline - part 3

Rami bụng của các dây thần kinh cổ tử cung trên (C1-4) hình thành các đám rối cổ tử cung. Đám rối này nằm gần các đốt sống trên bốn. Rami lưng của C1-4 phân bố các thần kinh cơ paraspinal và da ở mặt sau của cổ. Greater thuộc về lổ tai Greater chẩm Lesser chẩm thượng đòn | 89 Cervical plexus and cervical spinal nerves Genetic testing NCV EMG Laboratory Imaging Biopsy The ventral rami of the upper cervical nerves C1-4 form the cervical plexus. Anatomy The plexus lies close to the upper four vertebrae. The dorsal rami of C1-4 innervate the paraspinal muscles and the skin at the back of neck. Greater auricular Cutaneous nerves Greater occipital Lesser occipital Supraclavicular Transversus colli Transverse cutaneous nerve of the neck Intertransversarii cervicis C2-C7 Muscle branches Rectus capitis anterior C1-3 Rectus capitis lateralis C1 Rectus capitis longus C1-3 M. longus colli C2-6 Major motor nerve phrenic nerve Fibers from C2-C4 also contribute to the innervation of the sternocleidomastoid and trapezius muscles The ansa cervicalis connects with the hypoglossal nerve. Other communicating branches exist with caudal cranial nerves and autonomic fibers cervical vertebrae and joints and nerve roots spinal nerves C1 C2 and C3-8 . Complete cervical plexus injury Clinical picture Sensory loss in the upper cervical dermatomes. Clinical or radiological evidence of diaphragmatic paralysis. High cervical radiculopathies Less common affected by facet joint. C3 4 foramen most often involved. C2 3 site for Herpes Zoster with post-herpetic neuralgia possible. C2 dorsal ramus spinal nerve or greater occipital nerve irritation is better labeled occipital neuropathy . Cervical plexopathies Rarely affected in traction injuries and usually in conjunction with the upper trunk of the brachial plexus. Findings include sensory loss in the upper cervical This is trial version www.adultpdf.com 90 dermatomes and radiologic evidence of diaphragmatic paralysis phrenic nerve . Symptoms Cervicogenic headache controversial Although often cited the evidence for this condition is unconvincing. Lesser occipital nerve Damaged in the posterior triangle of the neck e.g. lymph node biopsy . Causes numbness behind the ear. Neck tongue syndrome Damage to the C2 ventral .