Chapter 4: Upper Limb (continued)

Question 1

Another name for median nerve damage caused by an injury at the elbow?

Where is the injury found to cause damage of the median nerve?

Answer 1

supracondylar fracture of the humerus

Question 2

Do lesions of median nerve at the wrist present with hand of benediction?

Answer 2

no they don’t

Question 3

What are some locations that can lead to ulnar nerve injury?

Answer 3

elbow (medial epicondyle), wrist (lacerations), or fracture of hook of hamate, clavicle fracture

Question 4

What are some symptoms caused by fracture of the surgical neck of the humerus or inferior dislocation of the shoulder damaging the axillary nerve?

Answer 4

• loss of abduction of the arm to the horizon
• sensory loss over the deltoid muscle

Question 5

What is the major typical symptom of injury to the long thoracic nerve?

Answer 5

“winged scapula”

Question 6

An injury to the suprascapular nerve would cause what symptoms?

Answer 6

• loss of shoulder abduction between 0 and 15 degrees (supraspinatus muscle)
• weakness of lateral roation of shoulder (infraspinatus muscle)

Question 7

What nerve roots carry the axillary nerve?

Answer 7

C5, C6

Question 8

What nerve roots carry the musculocutaneous nerves?

Answer 8

C5, C6, C7

Question 9

What nerve roots carry the radial nerve?

Answer 9

C5, C6, C7, C8, T1

Question 10

What nerve roots carry the median nerve?

Answer 10

C5, C6, C7, C8, T1

Question 11

What nerve roots carry the ulnar nerve?

Answer 11

C8, T1

Question 12

Where is altered sensation found when there is damage to the axillary nerve?

Answer 12

lateral arm

Question 13

Where is the altered sensation felt in one who has damage to the musculocutaneous nerve?

Answer 13

lateral forearm

Question 14

Where is the altered sensation felt in one with radial nerve damage?

Answer 14

dorsum of hand over first dorsal interosseous and anatomic snuffbox

Question 15

Where is the altered sensation felt in one with damage to the median nerve?

Answer 15

lateral 3 1/2 digits; lateral palm

Question 16

Where is altered sensation found in one with ulnar nerve damage?

Answer 16

medial 1 1/2 digits; medial palm

Question 17

Where is motor weakness found in those with axillary nerve damage?

Answer 17

abduction of shoulder

Question 18

Where is motor weakness found in one with musculocutaneous nerve damage?

Answer 18

flexion of forearm

supination

Question 19

Where is motor weakness found in those with radial nerve damage?

Answer 19

wrist extension

metacarpo-phalangeal extension

supination

Question 20

Where is motor weakness found in those with median nerve damage?

Answer 20

wrist flexion

finger flexion

pronation

thumb opposition

Question 21

Where is motor weakness found in those with ulnar nerve damage?

Answer 21

wrist flexion

finger spreading

finger extension

thumb adduction

Question 22

Common sign of a radial nerve lesion?

Answer 22

wrist drop

Question 23

Common sign of a median nerve lesion?

Answer 23

ape hand

hand of benediction

ulnar deviation at wrist

Question 24

What is a common sign of lesion at ulnar nerve?

Answer 24

claw hand

radial deviation at wrist

Question 25

What are the causes of lesions at the axillary nerve?

Answer 25

• surgical fracture of the humerus
• dislocated humerus

Question 26

What are causes of lesions at musculocutaneous nerve?

Answer 26

rarely lesioned

Question 27

What are causes of lesions at radial nerve?

Answer 27

• saturday night palsy
• midshaft fracture of humerus
• subluxation of radius
• dislocated humerus

Question 28

What are causes of lesions of the median nerve?

Answer 28

• carpal tunnel compression
• supracondylar fracture of humerus
• pronator teres syndrome

Question 29

What are the causes of ulnar nerve lesions?

Answer 29

• fracture of medial epicondyle of humerus
• fracture of hook of hamate
• fracture of clavicle

Wrist lacerations?

Question 30

The subclavian artery is a branch of what arteries on the right and left side of the body?

Answer 30

branch of brachiocephalic trunk on the right and aortic arch on the left

Question 31

What locations on the body does the axillary artery run from?

Answer 31

from the 1st rib to the posterior edge of the teres major muscle

Question 32

What are the 3 major branches of the axillary artery?

Answer 32

lateral thoracic artery

subscapular artery

posterior humeral circumflex artery

Question 33

What does the lateral thoracic artery supply?

Answer 33

supplies mammary gland; runs with long thoracic nerve

Question 34

Where is the posterior humeral circumflex artery located? What nerve does it run with?

Answer 34

at surgical neck with axillary nerve

Question 35

The brachial artery runs with what nerve?

Answer 35

radial nerve

Question 36

Deep palmer arch is supplied by what artery?

Answer 36

radial

Question 37

Superficial palmer arch is supplied by what artery?

Answer 37

ulnar

Question 38

Examples of collateral circulation at the shoulder?

Answer 38

subscapular branch of axillary a and suprascapular branch of subclavian artery

Question 39

What is the tunnel in carpal tunnel bounded by?

Answer 39

anteriorly by the flexor retinaculum and posteriorly by the proximal row of carpal bones (lunate)

Question 40

What does the carpal tunnel transmit? What structures?

Answer 40

9 tendons and the radial and ulnar bursae

(4 tendons of the flexor digitorum superficialis, 4 tendons of the flexor digitorum profundus, and the tendon flexor pollicis longus) and the median nerve

Question 41

Are there any blood vessels that go through the carpal tunnel?

Answer 41

no

Question 42

What are the rotator cuff muscles?

Answer 42

supraspinatus, infraspinatus, teres minor, and subscapularis (SITS)

Question 43

What tendon is commonly affected in rotator cuff injury?

Answer 43

supraspinatus

Question 44

Humeral surgical neck fracture could cause damage to what structures?

Answer 44

lacerate the posterior humeral circumflex artery and the axillary nerve

Question 45

What does a midshaft humeral fracture lead to? (What structures may be damaged?)

Answer 45

radial nerve and profunda brachii artery (brachial artery) injury

Question 46

What is the most frequently fractured of the carpal bones?

Answer 46

scaphoid bone

Question 47

How is avascular necrosis of scaphoid caused?

Answer 47

separation of the proximal portion scaphoid from its blood supply (which enters the bone at the distal head)

Question 48

What is the most commonly dislocated carpal bone?

Answer 48

lunate

Question 49

A fall on the outstretched hand may fracture the hamate which may cause damage to which nerve?

Answer 49

ulnar nerve as it passes into the hand