Anatomy Upper limb and Breast Book

Question 1

Sections of axillary artery

Answer 1

First part- first rib until medial border of pec minor
Second- deep to pec minor
Third- lateral border of pec minor to inferior border of trees major

Question 2

Branches of axillary artery

Answer 2

1st part- superior thoracic
2nd part -thoracoacromical and lateral thoracic
3rd part- sub scapular, anterior and posterior circumflex

Question 3

Function of rhomboids

Answer 3

Retraction of scapula

Question 4

Muscles causing elevation of scapula

Answer 4

Levator scapulae

Question 5

Muscles causing adduction of humerus

Answer 5

Pec major
Lat dorsi
Subscapular
Teres major

Question 6

Muscles causing medial rotation of humerus

Answer 6

Pec major
Lat dorsi
Subscapularis
Teres major

Question 7

Muscles causing lateral rotation of humerus

Answer 7

Infrascapularis
Teres minor

Question 8

Coracoid position relative to clavicle

Answer 8

Immediately above junction of middle and lateral third

Question 9

Mx of elbow fractures

Answer 9

Above elbow back slab until surgery

Question 10

Important radiological features for elbow fractures

Answer 10

Anterior humeral line
Posterior fat pad

Question 11

Where does avascular necrosis occur in scaphoid fractures

Answer 11

Proximal pole

Question 12

Bennet fracture

Answer 12

Fracture of base of 1st metacarpal
Can have subluxation or dislocation

Question 13

Types of nerve injury

Answer 13

Neuropraxia- transient functional loss -local segmental demyelination
Axonotmesis- An axonotmesis injury involves damage to the axon and its myelin sheath. However, the endoneurium, perineurium, and epineurium remain intact.
Neurotmesis- complete disconnection, loss is complete

Question 14

Fromet sign

Answer 14

Flexion of IPJ of thumb to resist removal of piece of paper

Abductor pollicis weakness due to ulnar nerve damage

Question 15

Common other fractures associated with Colles

Answer 15

Scaphoid on OOSH
Ulnar styloid

Question 16

What passes through quadrangular space

Answer 16

Axillary nerve
Posterior circumflex nerve

Question 17

Borders of quadrangular space

Answer 17

Superior – inferior margin of teres minor.
Lateral – surgical neck of the humerus.
Medial – long head of triceps brachii.
Inferior – superior aspect of teres major

Question 18

Blood supply of breast

Answer 18

Lateral thoracic (form lateral mammary) and throacoacromial branches of axillary artery
Internal mammary (internal thoracic)
Lateral perforating branches of intercostal

Question 19

How much do axillary lymph nodes make up of breast drainage

Answer 19

75%

Question 20

Borders of anatomical snuffbox

Answer 20

APL and EPB radically
EPL ulnarlly

Question 21

Relation of ulnar artery and nerve at flexor retinaculum

Answer 21

Nerve lies medial

Question 22

Which muscles does the ulnar artery lie in between in distal forearm

Answer 22

FDS and FCU

Question 23

What crosses ulnar artery in proximal forearm

Answer 23

Median nerve superficially after ulnar artery just forms

Question 24

Levels of metastatic axillary node spread of breast cancer

Answer 24

I- below Pec minor
II- behind
III- above pec minor

Question 25

Formation of brachial plexus

Answer 25

C5-T1 Form upper, middle and lower trunks These split into anterior and posterior divisions Anterior- anterior of upper and middle Medial- anterior of lower Posterior- posterior of all 3

Question 26

Nerves in brachial plexus not formed at cords and where they are formed

Answer 26

Dorsal scapular - C5 Suprascapular - upper trunk Nerve to subclavius- upper trunk Long thoracic -C5,6,7

Question 27

Suprascapular fossa and content

Answer 27

Formed by supra scapular ligament Nerve travels in Vessels travel above ligament

Question 28

Spinoglenoid notch

Answer 28

Spinoglenoid notch is a connection between the infraspinatus fossa and the supraspinatus fossa Ligament runs over Suprascapular nerve and vessels run deep to it

Question 29

Contents of quadrangular space, triangular space and interval

Answer 29

QS- posterior circumflex artery, axillary nerve TS- scapular circumflex artery TI- deep branch of branchial, radial

Question 30

What compromises the thenar eminence and nerve supply

Answer 30

Abductor Opponens Flexor pollicis Recurrent branch of median

Question 31

What compromises the hypothenar eminence and nerve supply

Answer 31

Abductor Flexor Opponens digiti minimi Deep branch of ulnar

Question 32

Contents of carpal tunnel

Answer 32

Median nerve FDP FDS FPL

Question 33

If there is axillary artery blockage what happens to blood supply of upper limb

Answer 33

Scapular anastomosis Involves branches of distal subclavian and proximal axillary Blood supply can come from thyrocevical trunk, suprascapular and deep transverse cervical from subclavian Subscapular, posterior circumflex, thoracoacromial from axillary Not superior thoracic

Question 34

Brachial plexus is surrounded by fascia originating from what

Answer 34

Prevertebral fascia

Question 35

What actions are most affected by olecranon fractures

Answer 35

Extension of arm Pushing to stand for example

Question 36

Extension compartments of wrist

Answer 36

1st- EPB, APL 2nd- ECRL, ECRB 3rd- EPL 4th- ED, EI 5th- EDM 6th- ECU

Question 37

Course of radial artery in forearm and wrist

Answer 37

Starts at level of radial neck Lying on bicep tendon Passes under brachioradialis Enters wrist between first 2 dorsal interosseous

Question 38

When does radial nerve vs artery pierce deep fascia

Answer 38

Nerve pierces 7cm proximal to artery

Question 39

Which humeral fractures cause nerve damage

Answer 39

Mid shaft- radial Distal - median Medial epicondylar- ulnar

Question 40

Which of the superficial flexor muscles of forearm does not attach to the common flexor attachment

Answer 40

FDP Which arrises at proximal ulnar

Question 41

Which muscles are innervated by the anterior interroseous nerve

Answer 41

FPL Lateral FDP PQ The deep muscles

Question 42

Which muscles are innervated by the posterior interroseous nerve

Answer 42

Superficial Extensor digitorum Extensor digiti minimi Extensor carpi ulnaris Deep EI Abductor pollicis longus EPB EPL