Clinical Anatomy of the Upper Limb

Question 1

Newborn baby abnormal resting position of right arm
Shoulder dystocia

Adduction and Internal rotation of shoulder and extension at the elbow joint.

Lack of flexion and supination at the elbow joint

State the part of the brachial plexus which has been damaged.

Answer 1

Superior Trunk

Upper Brachial Plexus Injury
Erb’s Palsy

Question 2

6-month old
Difficulty moving left arm
Hand kept in a claw like position

Answer 2

Inferior Trunk

Lower Brachial Plexus injury
Klumpke’s Palsy

Question 3

Abnormal Upper Limb
Arm is externally rotated and abducted

Answer 3

Inferior

Anterior dislocation of GH joint

Question 4

Anterior dislocation

Answer 4

More common

Abducted and Externally rotated

Question 5

Posterior dislocation

Answer 5

Less common

Adducted and Internally rotated

Question 6

Which nerve is most at risk during anterior dislocation of the GH joint ?

Answer 6

Axillary Nerve

Question 7

Left elbow bruised and swollen

Tenderness along lateral elbow line with pain on supination and pronation

Answer 7

Fracture of radial head

Characterised on X-ray bay dark circle around the bones

Question 8

Unopposed flexion of wrist

Unable to extend at forearm, wrist and fingers

Sensory loss over the posterior forearm and dorsum of hand.

Answer 8

Broken humerus
Wrist drop

Radial Nerve Damage

Question 9

Describe radial nerve injury in axilla/proximal humerus

Answer 9

Loss of entire nerve

Paralysis of all muscles it supplies and complete sensory loss

Question 10

Describe radial nerve injury in spiral grove

Answer 10

Extension at the elbow intact

Loss of extension at wrist and fingers

Sensory loss at the dorsal surface of the hand

Question 11

Describe radial nerve injury in the forearm

Answer 11

Damage to the superficial branch will cause sensory loss to the dorsal of the hand.

Damage to the deep branch will affect extension of the fingers

Question 12

Monteggia

Answer 12

Fracture of proximal ulnar and dislocation of the radial head at proximal radioulnar joint.

Question 13

Galeazzi

Answer 13

Fracture of the distal radius and dislocation of radial head at distal radioulnar joint.

Question 14

Dinner fork deformity

Answer 14

Colles Frature
Most common fracture in the forearm

Fracture of the distal radius with dorsal angulation
May also have fracture of ulnar styloid

Question 15

Tingling and numbness in lateral 3 digits

Answer 15

Median Nerve

Question 16

If carpal tunnel syndrome is left untreated what happens ?

Answer 16

Can result in weakness and wasting of the thenar eminence.

Question 17

Wrist pain
Particularly in the anatomical snuffbox area

Answer 17

Wrist splint then follow up with X-ray in 1-2 weeks.

Scaphoid Fracture