MSK - Upper Limb 1

Question 1

What forms the anterior wall of the axilla?

Answer 1

Pectoralis major and minor muscles

Question 2

What forms the posterior wall of the axilla?

Answer 2

Subscapularis muscle

Question 3

What forms the medial wall of the axilla?

Answer 3

Thoracic wall and serratus anterior muscle

Question 4

What forms the lateral wall of the axilla?

Answer 4

Intertubercular sulcus of the humerus

Question 5

The axillary artery is the continuation of which artery?

Answer 5

Subclavian artery

Question 6

At what anatomical point does the axillary artery begin?

Answer 6

Lateral margin of the 1st rib

Question 7

The axillary artery continues beyond the axilla as which artery?

Answer 7

Brachial artery

Question 8

At what anatomical point does the brachial artery begin?

Answer 8

Lower margin of teres major

Question 9

Which ventral rami form the brachial plexus?

Answer 9

C5-T1

Question 10

What is Erb’s point?

Answer 10

The meeting point of six nerves 2-3cm above the clavicle

Question 11

Which nerve roots form the upper trunk of the brachial plexus?

Answer 11

C5 and C6

Question 12

Which nerve roots form the lower trunk of the brachial plexus?

Answer 12

C8 and T1

Question 13

What type of palsy can be caused by damage to the upper trunk of the brachial plexus?

Answer 13

Erb’s palsy

Question 14

What type of palsy can be caused by damage to the lower trunk of the brachial plexus?

Answer 14

Klumpke’s palsy

Question 15

What are the cords of the brachial plexus named for?

Answer 15

Their relation to the axillary artery

Question 16

What are the main branches of the lateral cord of the brachial plexus?

Answer 16

Lateral pectoral nerve
Lateral root of median nerve
Musculocutaneous nerve

Question 17

What are the main branches of the medial cord of the brachial plexus?

Answer 17

Medial pectoral nerve
Medial root of median nerve
Ulnar nerve
Medial cutaneous nerve of arm
Medial cutaneous nerve of forearm

Question 18

What are the main branches of the posterior cord of the brachial plexus?

Answer 18

Thoracodorsal nerve
Axillary nerve
Radial nerve
Upper subscapular nerve
Lower subscapular nerve

Question 19

Which vein arises at the lateral end of the dorsal venous arch?

Answer 19

Cephalic vein

Question 20

Which vein arises at the medial end of the dorsal venous arch?

Answer 20

Basilic vein

Question 21

Which vein shunts blood from the cephalic vein to the basilic vein?

Answer 21

Median cubital vein

Question 22

What are the five groups of lymph nodes found in the axilla (axillary lymph nodes)?

Answer 22

Anterior or pectoral group
Posterior or subscapular group
Apical group
Central group
Lateral group

Question 23

Which group of lymph nodes will be involved if the lymphatic spread of infection begins in the little finger?
(Axillary/Internal thoracic/Superficial inguinal)

Answer 23

Axillary

Question 24

Which group of lymph nodes will be involved if the lymphatic spread of infection begins in the scapular region?
(Axillary/Internal thoracic/Superficial inguinal)

Answer 24

Axillary

Question 25

Which group of lymph nodes will be involved if the lymphatic spread of infection begins in the medial part of the breast (close to the sternum)? (Axillary/Internal thoracic/Superficial inguinal)

Answer 25

Internal thoracic

Question 26

Which group of lymph nodes will be involved if the lymphatic spread of infection begins in the lateral part of the breast (close to axilla)? (Axillary/Internal thoracic/Superficial inguinal)

Answer 26

Axillary

Question 27

Infection around the umbilicus (infected tattoo) can spread to both axillary and superficial inguinal groups of both sides - why?

Answer 27

Above the umbilicus is drained by axillary group, below by superficial inguinal

Question 28

Which small joint do the entire pectoral girdle and upper limb articulate at?

Answer 28

Glenohumeral joint

Question 29

At which point does the conoid ligament attach to the clavicle?

Answer 29

Conoid tubercle

Question 30

Which part of the clavicle is weakest and commonly breaks during a fall?

Answer 30

Angle of the clavicle (change in the direction of bone)

Question 31

What type of joint is the acromioclavicular joint?

Answer 31

Synovial plane

Question 32

What type of joint is the sternoclavicular joint?

Answer 32

Synovial saddle

Question 33

Which muscle(s) are responsible for the elevation of the scapula?

Answer 33

Upper trapezius and levator scapulae

Question 34

Which muscle(s) are responsible for the depression of the scapula?

Answer 34

Lower trapezius

Question 35

Which muscle(s) are responsible for the protraction (forward movement) of the scapula?

Answer 35

Serratus anterior

Question 36

Which muscle(s) are responsible for the retraction (backwards movement) of the scapula?

Answer 36

Middle trapezius and rhomboids

Question 37

Which muscle(s) are responsible for the lateral (upward) rotation of the scapula (elevating glenoid cavity)?

Answer 37

Upper and middle trapezius

Question 38

Which muscle(s) are responsible for the medial (downward) rotation of the scapula (depressing glenoid cavity)?

Answer 38

Levator scapulae, rhomboids and pectoralis minor (and gravity!)

Question 39

What is the rim of cartilage surrounding the glenoid cavity known as?

Answer 39

Glenoid labrum

Question 40

What is the function of the glenoid labrum?

Answer 40

Make the glenoid cavity deeper

Question 41

What is the name of the ligament which extends from the coracoid process of the scapula to the acromion?

Answer 41

Coracoacromial ligament

Question 42

What is the function of the coracoacromial arch?

Answer 42

Prevent displacement of the humeral head

Question 43

Which aspect of the glenohumeral joint capsule is strengthened by the glenohumeral ligaments?

Answer 43

Anterior

Question 44

Which aspect of the glenohumeral joint capsule is strengthened by the coracohumeral ligament?

Answer 44

Superior

Question 45

What makes up the coracoacromial arch?

Answer 45

Acromion, coracoid process of scapula and coracoacromial ligament

Question 46

Which part of the shoulder joint capsule is weakest as it is not protected by muscles or ligaments?

Answer 46

Inferior

Question 47

Which bursa communicates with the joint cavity?

Answer 47

Subscapular

Question 48

What is the role of the subacromial bursa?

Answer 48

Decreases friction and allows free motion fo the rotator cuff relative to the coracoacromial arch and the deltoid muscle

Question 49

What are the rotator cuff muscles?

Answer 49

Subscapularis Supraspinatus Infraspinatus Teres minor

Question 50

What movements of the glenohumeral joint are generated by the rotator cuff muscles?

Answer 50

Abduction, external rotation, internal rotation

Question 51

What is the most important role of the rotator cuff muscles?

Answer 51

Stability

Question 52

What are the actions of the anterior fibres of the deltoid muscle?

Answer 52

Flexion and internal rotation of the shoulder joint

Question 53

What is the action of the lateral fibres of the deltoid muscle?

Answer 53

Abduction

Question 54

What are the actions of the posterior fibres of the deltoid muscle?

Answer 54

Extension and external rotation

Question 55

What is the nerve supply to the deltoid muscle?

Answer 55

Axillary nerve

Question 56

What common injury traps and damages the axillary nerve?

Answer 56

Anterior dislocation of the head of the humerus

Question 57

Where would you test for loss of sensation to determine if a nerve injury had occurred?

Answer 57

Regimental badge patch area

Question 58

Where do the fibres of the pectoralis major muscle originate from?

Answer 58

Medial third of the clavicle, the sternum and the ribs

Question 59

What are the actions of the pectoralis major muscle?

Answer 59

Adduction and internal rotation of the humerus at the glenohumeral joint

Question 60

What is the name for the triangular space below the clavicle, between the deltoid and pectoralis major muscles?

Answer 60

Deltopectoral triangle

Question 61

Which vein is found in the deltopectoral triangle?

Answer 61

Cephalic vein

Question 62

What is the nerve supply of serratus anterior?

Answer 62

Long thoracic nerve

Question 63

What clinical sign is seen when the long thoracic nerve is damaged?

Answer 63

Winged scapula

Question 64

During which procedure is the long thoracic nerve commonly injured and why?

Answer 64

Mastectomy - the nerve runs superficially over the serratus anterior muscle

Question 65

What is the action of the superior fibres of the trapezius muscle on the scapula?

Answer 65

Elevation

Question 66

What is the action of the middle fibres of the trapezius muscle on the scapula?

Answer 66

Retraction

Question 67

What is the action of the inferior fibres of the trapezius muscle on the scapula?

Answer 67

Depression

Question 68

What is the innervation of the trapezius muscle?

Answer 68

Accessory nerve CNXI

Question 69

What are the actions of teres major on the shoulder joint?

Answer 69

Extension and medial rotation of the humerus