Blue Boxes 1: Arm and Cubital Fossa/Forearm/Hand

Question 1

What does the biceps reflex test?

Answer 1

Musculocutaneous nerve and the C5 and C6 spinal cord segments

Question 2

What is biceps tendinitis?

Answer 2

Inflammation of the tendon of the long head of the biceps that moves back and forth withing the bicipital groove inside its synovial sheath

Question 3

Where is the common place for the biceps tendon to tear?

Answer 3

From its attachment to the supraglenoid tubercle of the scapula

Question 4

What is the clinical term for stopping bleeding through manual or surgical control of blood flow?

Answer 4

hemosatsis

Question 5

Where is the best place to compress the brachial artery to control hemorrhage?

Answer 5

Medial to the humerus near the middle of the arm

Question 6

How long can muscles and nerves tolerate ischemia?

Answer 6

Up to 6 hours

Question 7

What is ischemic compartment syndrome?

Answer 7

When scar tissue replaces necrotic tissue and causes the involved muscles to shorten permanently

Question 8

A midhumeral fracture may injure what nerve?

Answer 8

Radial going through the radial groove

Question 9

Will a lesion of the radial nerve in the redial groove paralyze the triceps?

Answer 9

No because of the high origin of the nerves to two of its three heads, only medial head is affected

Question 10

A musculocutaneous nerve injury results in the paralysis of what muscles?

Answer 10

coracobrachialis, biceps, and brachialis

Question 11

What is the cutaneous innervation of the musculocutaneous nerve

Answer 11

the lateral antebrachial cutaneous nerve

Question 12

What is the characteristic clinical sign of radial nerve injury?

Answer 12

wrist drop

Question 13

What vein is most commonlyy selected for venus punctures?

Answer 13

Median cubital

Question 14

What provides some protection during venus blood draws in the cubital fossa region?

Answer 14

bicipital aponeurosis

It separates the median cubital vein from the underlying brachial artery and median nerve

Question 15

Where is tennis elbow pain felt?

Answer 15

Over the lateral epicondyle, they often feel pain when they open a door or lift a glass
Tennis elbow is a problem with tendons

Question 16

What tendon usually causes the pain in tennis elbow?

Answer 16

ECRB

Question 17

What is mallet finger?

Answer 17

The extensor tendon is torn off the distal ip joint

Question 18

Why is a fracture of the olecranon common?

Answer 18

Because the olecranon is subcutaneous and protrusive

Question 19

Why is pinning usually required to repair a fractured olecranon?

Answer 19

The fractured olecranon is pulled away by the active and tonic contraction of the triceps.

Question 20

Where on the hand are synovial cysts usually found?

Answer 20

Dorsum of the wrist

The distal attachment of ECRB tendon to the base of the 3rd metacarpal

Question 21

Where is the common place to measure pulse rate?

Answer 21

Where the radial artery lies on the anterior surface of the distal end of the radius, lateral to the tendon of the FCR

Question 22

Why shouldn’t you use the pulp of the thumb when measuring the radial pulse rate?

Answer 22

Because the thumb has its own pulse

Question 23

When a superficial vessel is pulsating near the wrist, it is probably a superficial what?

Answer 23

Radial artery

Question 24

Is FDP affected when the median nerve is severed in the elbow?

Answer 24

Only the lateral head of FDP would be affected, the medial part is innervated by the ulnar

Question 25

What lesion produces the hand of benediction?

Answer 25

Median nerve lesion

Question 26

When the anterior interosseous nerve is injured, what is affected?

Answer 26

The thenar muscles are unaffected, by partial paralysis of the flexor digitorumm profundus and flexor pollicis longus occurs

Question 27

Anterior interosseous syndrome is characterized by what hand position?

Answer 27

Abnormal “pinch” sign rather than a normal “ok” sign

Can’t flex the distal IP joint of first finger (FDP) and the IP of the thumb (FPL)

Question 28

What nerve is compressed in pronator syndrome?

Answer 28

The median nerve is compressed between the heads of the pronator teres.
Often caused by activities that require consistent pronation

Question 29

Communication between median and ulnar nerves is uncommon. What clinical challenge does it provide?

Answer 29

Even if there is a complete lesion of one nerve, some muscles may not be paralyzed

Question 30

Where are the common places for the ulnar nerve to become entraped?

Answer 30

Posterior to the medial epicondyle of the hmerus
In the cubital tunnel between the humeral and ulnar heads of the FCU
In the hand
In Guyon’s Canal

Question 31

What nerve is responsible for the “funny bone”

Answer 31

ulnar

Question 32

What clinical hand sign is the result of a distal lesion of the ulnar nerve?

Answer 32

Claw hand

Question 33

What is cubital tunnel syndrome?

Answer 33

compresson of the ulnar nerve between the two heads of FCU

Question 34

Does loss of sensation occur in a deep branch of the radial nerve lesion?

Answer 34

No, the deep radial nerve is entirely muscular

Question 35

How do you test the integrity of the deep branch of the radial nerve?

Answer 35

Ask the person to extend the MP joints while the examiner provides resistance. If the nerve is intact the long extensor tendons should appear prominently on the dorsum of the hand.