A: Spot exam Qs

Question 1

When is the thoracodorsal nerve at risk of injury?

Answer 1

Injury to axilla, mastectomy, surgical removal of lymph nodes.

Question 2

Where is the most common site to fracture clavicle?

Answer 2

Middle third

Question 3

What ligament is attached to coracoid process?

Answer 3

Coracoclavicular ligament.

Question 4

When is pectoralis major used for normal breathing?

Answer 4

If patient is asthmatic so needs extra muscles to breathe quietly.

Question 5

What are the consequences of loss of function in serratus anterior?

Answer 5

• Winging of scapula (cannot hold medial border of scapula against thoracic wall)
• Difficulty raising arm above head (rotating scapula upwards)
• Difficulty reaching forward (protraction of scapula).

Question 6

What are the muscles that depress the scapula?

Answer 6

pectoralis minor, trapezius.

Question 7

List the muscles that elevate the scapula

Answer 7

Trapezius, levator scapulae, rhomboid minor, rhomboid major

Question 8

Which muscles rotate scapula upwards?

Answer 8

Lower serratus anterior, trapezius.

Question 9

How can you test the functioning of the accessory nerve in a patient?

Answer 9

Ask them to shrug their shoulder against resistance.

Question 10

When is the long thoracic nerve at risk of injury?

Answer 10

Injury to thoracic wall (e.g. knife wound), mastectomy.

Question 11

What is the main ligament which stabilises the acromioclavicular (AC) joint i.e. prevents dislocation?

Answer 11

Coracoclavicular ligament.

Question 12

What is this?

Answer 12

Xiphoid process of sternum

Question 13

What is this?

Answer 13

Xiphoid process of sternum

Question 14

Label

Answer 14

1= Suprascapular artery + nerve
2 = Thoracodorsal artery + nerve
3 = Subscapularis muscle
4 = Teres major muscle
5 = Axillary nerve and posterior circumflex humeral artery
6 = Biceps brachii tendon
7 = Subscapularis tendon
8 = Supraspinatus tendon

Question 15

Label

Answer 15

1 = Common flexor tendon
2 = Pronator teres muscle
3 = Flexor carpi radialis muscle
4 = Palmaris longus muscle
5 = Flexor carpi ulnaris muscle
6 = Flexor digitorium superficialis muscle
7 = Flexor pollici longus muscle and tendon
8 = bicipital aponeurosis

Question 16

Label

Answer 16

1 = Trapezius
2 = Deltoid
3 = Cephalic vein
4 = Flexor carpi radialis tendon
5 = Palmaris longus tendon
6 = Basilic vein
7 = Extensor carpi radialis brevis muscle
8 = Extensor carpi ulnaris muscle

Question 17

What muscles insert into the bicipital groove?

Answer 17

Pectoralis major, latissimus dorsi, teres major,

Question 18

Where is the midpalmar space located?

Answer 18

Space between the fibrous septum attaching the palmar aponeurosis to the 3rd and 5th metacarpal bones.

Question 19

At what location does the subclavian vein end?

Answer 19

Behind sternoclavicular joint

Question 20

A patient is bleeding severely from the UL. Where can you apply pressure to control the bleeding? Explain.

Answer 20

Press over 1st rib, in the inferior part of posterior triangle of the neck to occlude the subclavian artery.

Question 21

An attempt is made to catheterize the subclavian vein of a patient by
entering the vein below the clavicle. What nerve lies immediately deep to the vein and is at risk of injury? What would be the consequences to the patient of injury?

Answer 21

Phrenic - breathing difficulty

Question 22

Name the nerves and vessels that lie posterior and anterior to the anterior scalene muscle.

Answer 22

Anterior: Subclavian vein + Phrenic nerve (lies immediately posterior to the vein)
Posterior: Roots of brachial plexus

Question 23

What is the axillary sheath?

Answer 23

A covering of connective tissue which forms a sleeve enclosing the
axillary artery, vein and cords of brachial plexus.

Question 24

Where is median nerve vulnerable to injury?

Answer 24

Wrist - laceration
Carpal tunnel
Cubital fossa

Question 25

Identify this muscle

Answer 25

First dorsal interosseous muscle

Question 26

Identify this vessel. Name its main source of blood and branches from this vessel

Answer 26

Deep palmar arch
Radial artery
Palmar metacarpal arteries