Block 3: GL 24 Gray's Review (Overview of Upper Limb)

Question 1

Describe the course of the radial nerve in the lower arm

Answer 1

the radial nerve (deep branch) winds laterally around the radius and continues as the deep and superficial branches of the radial nerve

Question 2

Describe the deep and superficial branches of the radial nerve

Answer 2

deep: continues as the posterior interosseous
innervates muscles in the posterior compartment of forearm

superficial:
cutaneous innervation of dorsal hand and fingers

Question 3

Where does the radial nerve divide into its branches?

Answer 3

the cubital fossa

Question 4

Musculocutaneous nerve supplies what muscles?

Answer 4

biceps brachii, brachialis, coracobrachialis

Question 5

Tenosynovitis

what is it?
how can it be harmful>

Answer 5

due to an infection of the synovial sheaths of the digits

may spread through the synovial sheath of the flexor pollicis longus tendon, aka radial bursa

Question 6

Annular Ligament

Answer 6

fibrous band encircling the head of the radius

Question 7

Musculocutaneous N. Motor Function

Answer 7

supplies the anterior compartment of the arm, which is the flexor muscles

Question 8

Tenosynivitis

what is it
how is it serious?

Answer 8

due to an infection of the synovial sheaths of the digits

it may spread through the synovial sheath of the flexor pollicis longus tendon which is aka the radial bursa

Question 9

Annular Ligament
what is it?
f(x)

Answer 9

fibrous band encircling the head of the radius

f(x): prevents the displacement of the head of the radius from its socket

Question 10

Which carpal bone is most likely to be dislocated during a Smith fracture ?

Answer 10

lunate bone

Question 11

Smith Fracture

Answer 11

fracture where the distal shaft of the radius deviates palmarward (in a volar direction)

sometimes called a reverse calles fracture

Question 12

What is the result of a fracture of the surgical neck of the humerus

Answer 12

it often injuries the axillary nerve, which innervates the deltoid and teres minor muscle

axillary nerve also provides sensation of the “sargeant’s patch” over the shoulder

Question 13

Colles’ Fracture

Answer 13

a fracture of the distal end of the radius where the proximal portion of the arm is displaced anteriorly, w/ the distal bone being displaced posteriorly

Question 14

After the 3rd part of the artery, what is the only collateral blood supply

Answer 14

posterior circumflex humeral and the ascending branch of the profunda brachii

Question 15

Describe the course of the suprascapular artery

Answer 15

the suprascapular artery passes over the superiortransverse ligament

Question 16

Describe the course of the suprascapular nerve

Answer 16

the suprascapular nerve passes under the superior transverse scapular ligament

Question 17

F(x) of the superior transverse scapular ligament

Answer 17

bridges the suprascapular notch in the upper border of the scapula

Question 18

What artery passes through the triangular space of the axilla?

Answer 18

circumflex scapular artery, after arising from the subscapular artery

Question 19

F(x) of pectoralis major

Answer 19

adduction and flexion of the humerus

Question 20

Function of the pectoralis minor

Answer 20

stabilizes the scapula/shoulder joint by drawing it anteroinferiorly

Question 21

Describe the common extensor tendon

origin
clinical significance

Answer 21

origin: from the lateral epicondyle

inflammation of this tendon can lead to lateral epicondylitis, aka tennis elbow

Question 22

Bicep Tendon Reflex

Answer 22

testing spinal cord level C6

Question 23

Triceps Tendon Reflex

Answer 23

testing spinal cored level C7

Question 24

Ginglymus Joint

Answer 24

hinge joint

allows motion in 1 axis (flexion/extension)

Question 25

Which carpal bones are usually fractured or dislocated in a Colles’ fracture?

Answer 25

fracture: scaphoid
dislocated: lunate

Question 26

Explain the usual mechanism of arm dislocation in children

Answer 26

the radius is dislocated and slips out from the annular ligament, which holds it in place

In adults, the annular ligament has a good “grip” at the radial neck, but in children this hasn’t developed yet so dislocation is more likely to happen

Question 27

What nerve is most likely to be affected by a midshaft humeral injury? Why?

Answer 27

radial n. b/c the nerve winds around the shaft of the humerus in the radial groove

Question 28

Compartment Syndrome

Answer 28

characterized by increasing pressure within a confined space by a fascial compartment, leading to the limb to appear swollen, pale and cool

Question 29

Motor and Sensory parts of the biceps tendon reflex

Answer 29

the motor part is carried out by C5, the sensory (afferent) part is carried out by C6

Question 30

Brachioradialis Tendon Reflex

Answer 30

performed by tapping the tendon of the brachioradialis muscle

the reflex innervates spinal nerves C5, C6, and C7; the major contribution is from C6

Question 31

A fracture of the midshaft humerus affects the radial nerve how?

Answer 31

you’d have deficits along the posterior forearm

Question 32

What is significant about a fracture of the humerus at the surgical neck?

Answer 32

axillary N is most likely to be damaged b/c it leaves the brachial plexus, travels through the quadrangular space and wraps around the head of the humerus

posterior circumflex humeral artery is damaged

Question 33

Where does the median nerve travel?

Answer 33

supracondylar humeral region

Question 34

What would be affected by an injury to the anatomical snuffbox?

Answer 34

superficial radial nerve and the radial artery