Notes on UE

Question 1

Function of the annular ligament?

Answer 1

Prevent displacement of the head o the radius from its socket; often violated in children.

Question 2

Smith’s fracture

Answer 2

smith’s fracture: distal fragment of radius deviates palmarword, displacing the lunate bone​.

Note: this is just reverse of colles’ fracture (distal fragment goes dorsally)

Question 3

What branch of the brachial artery accompanies the ulnar nerve in its path posterior to the medial epicondyle and provides blood supply to the ulna rnerve?

Answer 3

Superior ulnar collateral branch of brachial artery

Question 4

What artery arises form the profunda brachii and anastomoses with the radial recurrent branch of the radial artyer proximal to the elbow laterally?

Answer 4

Radial collateral artery (from profunda brachii artery)

Question 5

What nerve is injured at the surgical neck of the humerus?

Answer 5

Axillary nerve

Question 6

What nerve is injured at the medial epicondyle of the humerus?

Answer 6

Ulnar nerve

Question 7

What’s the main nerve injured in a supracondylar fracture of the humerus?

Answer 7

Median nerve

Question 8

What muscles are responsible for lateral rotation of the humerus? What nerve?

Answer 8

Deltoid

Teres minor

Infraspinatus

Deltoid & teres minor innervated by axillary nerve

Question 9

Colles fracture

Answer 9

Fracture of the distla end of the radius -> “dinner fork” deformity: proximal radius is displaced anteriorly, with teh distal bone fragment displaced posteriorly.

Scaphoid & lunate bones often fractured because of their direct articulation with the radius.

Question 10

What artery is in the supraspinous fossa and crosses the ligament that bridges the notch in teh superior border of teh scapula?

Answer 10

Suprascapular.

The supra scapular artery passes over the superior transverse scapular ligament; the suprascapular nerve passes under it. Then, they go to the supraspinatus muscle to supply it and then the infraspinatus.

Question 11

The subscapular artery is a branch of the third part of the axillary artery; it divides into __ and ___

Answer 11

Circumflex scapular

Thoracodorsal branches

Question 12

Describe the artery is the triangular space:

origin,

what muscle does it feed,

what does it anastomose with?

Answer 12

Circumflex scapular arery

• Origin: subscapular artery.
• Feeds the latissimus dorsi
• Anastmoses with teh suprascapular artery.

Question 13

Contents of the quadrangular space

Answer 13

• Axillary artery
• Posterior circumflexhumeral artery & vein

Question 14

In a fracture of the surgical neck of the humerus, the proximal fragment is abducted and the distal fragment is elevated & adducted.

What muscles are responsible for these?

Answer 14

• Supraspinatus muscle abducts proximal fragment
• Deltoid, biceps brachii, and coracobrachialis muscles elevate the distal fragment.
• Pec major, teres major, and lat dorsi adduct the distal fragment.

Question 15

Shrugging the shoulder tests trapezius function. What nerve innervates the traps?

Answer 15

Spinal accessory nerve

Question 16

Pushing against an immovable object tests and looking at the pt’s scapula what muscle and nerve?

Answer 16

Serrtaus anterior muscle and long thoracic nerve

Question 17

What spinal level is responsible for the brachioradialis reflex?

Answer 17

C6

Question 18

What spinal nerves are responsible for the biceps brachii reflex?

Answer 18

C5 does the motor

C6 does the sensory

Question 19

What nerve is responsible for the triceps reflex?

Answer 19

C7 (it’s the main contributor to the radial nerve)

85

Question 20

The ulna and the medial aprt of the distal humerus usually form what kind of joint?

Answer 20

Hinge/ginglymus joint (motion in one axis- flexion and extension)

Question 21

Abduction from 0 to 15 degrees involves what muscle, nerve, and spinal cord level?

What about 15 to 90 degrees?

Answer 21

0-15: supraspinatus muscle & suprascapular nerve (C5&6)

15-90: deltoid muscles & axillary nerves (mostly C7)

Question 22

What type of dislocation is much more common in children because their radial head isn’t fully developed?

Answer 22

Radius dislocated and slips out from the anular ligament, which holds it to articulate with the ulna & capitulum of the humerus.

Question 23

What is the flexor of the posterior freoarm?

Answer 23

Brachioradialis! Still innervated by radial nerve tho

Question 24

Waiter’s tip

Answer 24

Erb’s palsy due to upper trunk injury.

Question 25

What’s the major spinal cord level of the radial nerve?

Answer 25

C7

Question 26

Where is Erb’s point?

Answer 26

The union of the c5-c6 spinal nerves on teh brachial plexus

Question 27

Most commonly injured nerve in a shoulder dislocation

Answer 27

Axillary nerve

It wraps around the surgical neck of the humerus to innervate the teres minor and deltoid muscles.

Question 29

What nerves get damaged in erb’s palsy/upper brachial trunk injury, resulting in watier’s tip

Answer 29

Supra scapular, axillary, and musculocutaneous nerve.

Damage to suprascapular & axillary –> can’t abduct and laterlaly rotate

Damage to musculocutaneous –> can’t flex the forearm