Anatomy Upper Limb

Question 1

Winged scapula

Answer 1

long thoracic nerve, serratus anterior muscle

Question 2

Axillary nerve damage by which fracture and causes what

Answer 2

fracture of surgical neck of humerus (risk of posterior circumflex artery damage too)
Causes paralysis of deltoid and teres minor –> can’t abduct limb

Question 3

What structure runs through the intertubercular groove of the humerus

Answer 3

tendon of long head of biceps brachii

Question 4

Rotator cuff muscles

Answer 4

supraspinatous, infraspinatous, teres major (attach to greater tuberosity)
Subscapularis (attaches to lesser tuberosity)

Question 5

Mid shaft of humerus fracture causes what injury

Answer 5

radial nerve and profunda brachii artery injury (found in radial/spiral groove)
Radial nerve innervates extensor muscles of wrist –> wrist drop with sensory loss of 3 fingers
+ impaired elbow extension (innervates triceps)

Question 6

Relation between ulnar nerve and elbow

Answer 6

ulnar nerve passes in groove posterior to the medial epicondyle

Question 7

Supracondylar fracture consequences

Answer 7

• brachial artery injury –> Volkman’s ischemic contracture: Uncontrolled hand flexion
• ulnar and radial nerve
• anterior interosseous nerve (branch of median) –> weakness of flexor pollicis longus, can’t make okay sign/pinch

Question 8

Bones of wrist joint

Answer 8

distal radius, scaphoid, lunate

Question 9

Colle’s fracture

Answer 9

fracture of the distal radius, structures distal to the fracture (wrist and hand) are displaced posteriorly, ‘dinner fork deformity’.

Question 10

Smith’s fracture

Answer 10

falling onto the back of the hand, opposite of Colles’ fracture, as the distal fragment is displaced anteriorly

Question 11

Monteggia’s fracture

Answer 11

proximal shaft of ulna is fractured, head of radius dislocates (ulna and radius connected by interosseous membrane)

Question 12

Galeazzi’s fracture

Answer 12

distal radius fracture, distal ulna dislocates

Question 13

Scaphoid fracture risk

Answer 13

Avascular necrosis (retrograde blood supply) 
Missed diagnosis are likely to develop osteoarthritis of the wrist later

Question 14

Boxer’s fracture

Answer 14

5th metacarpal neck fracture, clenched fist striking hard object

Question 15

Bennett’s fracture

Answer 15

Fracture of 1st metacarpal base, due to hyperabduction of thumb

Question 16

Pectoralis major innervation and function

Answer 16

Lateral and medial pectoral nerves

Adduction and medial rotation of arm

Question 17

Pectoralis minor innervation and function

Answer 17

Medial pectoral nerves

Stabilizes scapula

Question 18

Accessory nerve injury cause and effect

Answer 18

Medical procedure (cervical LN biopsy, cannulation of internal jugular vein)
Trapezius weakness, can’t shrug his shoulders, asymmetrical neckline

Question 19

Latissimus dorsi innervation

Answer 19

Thoracodorsal nerve

Question 20

Latissimus dorsi innervation

Answer 20

Thoracodorsal nerve

Question 21

Anterior compartment muscles of arm and innervation and blood supply

Answer 21

BBC: Biceps brachii, coracobrachialis, brachialis
Innervated by musculocutaneous nerve
Brachial artery

Question 22

Bicep tendon reflex which spinal cord

Answer 22

C6

Question 23

Popeye sign

Answer 23

Long head of biceps rupture

Sign appears when flexing the elbow

Question 24

Posterior compartment of upper arm

Answer 24

Triceps brachii
Innervated by radial nerve
Blood supply: profunda brachii artery

Question 25

Triceps tendon reflex spinal cord

Answer 25

C7

Question 26

Muscles of anterior compartment of forearm

Answer 26

“Flexor muscles” -> flexion of wrist and fingers
Superficial: flexor carpi ulnaris, flexor carpi radialis, pronator teres, palmaris longus
Intermediate: flexor digitorum superficialis
Deep: flexor digitorum profundus, flexor pollicis longus, pronator quadratus

Question 27

Anterior compartment of forearm blood supply

Answer 27

Radial artery and ulnar artery

Question 28

Anterior compartment of forearm innervation

Answer 28

All muscles are innervated by median nerve (and anterior interosseous nerve: flexor pollicis longus, pronator quadratus)
EXCEPT: flexor carpi ulnaris + medial half of flexor digitorum profundus —> ulnar nerve

Question 29

Anterior compartment of forearm attachment on elbow

Answer 29

Medial epicondyle

Question 30

Posterior compartment of forearm

Answer 30

“Extensor muscles”:
Superficial: extension of wrist and fingers (mainly without thumb)
Deep: extension of thumb and index finger, supination of forearm
all extensors EXCEPT brachioradialis: elbow flexion

Question 31

Posterior compartment of forearm innervation

Answer 31

Radial nerve

Question 32

Posterior compartment of forearm attachment on elbow

Answer 32

Lateral epicondyle

Question 33

Tennis elbos

Answer 33

Lateral epicondylitis due to repeated use of superficial extensor muscles of forearm

Question 34

thenar muscles innervation

Answer 34

median nerve

opponens pollicis, abductor pollicis brevis, flexor pollicis brevis

Question 35

hypothenar muscles innervation

Answer 35

ulnar nerve

opponens digiti minimi, abductor digiti minimi, flexor digiti minimi brevis

Question 36

carpals proximal and distal rows

Answer 36

proximal row: scaphoid, lunate, triquetrum, pisiform

distal row: trapezium, trapezoid, capitate, hamate