Revision of the Upper Limb Anatomy

Question 1

What are the three bones of the shoulder?

Answer 1

Scapula, clavicle and humerus

Question 2

What are the three joints of the shoulder?

Answer 2

Sternoclavicular, acromioclavicular and glenohumeral

Question 3

What is the blood supply to the upper arm?

Answer 3

Subclavian artery becomes the axillary as it passes by the armpit, and then the brachial after the inferior border of teres major.

Question 4

What are the nerve roots of the brachial plexus?

Answer 4

C5-T1

Question 5

What are the 5 terminal nerves of the brachial plexus?

Answer 5

Musculocutaneous, axillary, radial, median and ulnar

Question 6

What are the three nerves of the anterior cord of the brachial plexus?

Answer 6

Musculocutaneous, median and ulnar

Question 7

What are the two nerves of the posterior cord of the brachial plexus?

Answer 7

Axillary and radial

Question 8

What nerve is likely to be damaged if there is an anterior dislocation of the shoulder?

Answer 8

Axillary nerve as it runs underneath the glenohumeral joint

Question 9

If there is axillary nerve damage what are the clinical findings?

Answer 9

Weakness in abduction of the arm due to deltoid paralysis and loss of sensation over the regimental badge

Question 10

Where does lymph from the upper limb mainly drain?

Answer 10

Into humeral and central nodes

Question 11

Where does the lymph from the lateral breast drain?

Answer 11

Axillary nodes

Question 12

Where does the lymph from the medial breast drain?

Answer 12

Into parasternal nodes

Question 13

What is meant by scapula-humeral rhythm?

Answer 13

The scapula and humerus move in a 1:2 ratio. When the arm is abducted 180 degrees, 60 degrees is done by rotation of the scapula whilst 120 is done by rotation of the humerus at the shoulder joint

Question 14

What is the function of serratus anterior?

Answer 14

To keep the scapula onto the ribcage

Question 15

What is the nerve supply to serratus anterior?

Answer 15

Long thoracic nerve

Question 16

What happens if there is damage to the long thoracic nerve?

Answer 16

Winging of the scapula due to lack of innervation to serratus anterior muscle which usually keeps scapula to ribcage

Question 17

What causes winging of the scapula?

Answer 17

Long thoracic nerve injury (dysfunction of serratus anterior)

Question 18

What nerve may be injured in breast cancer surgery (axillary node clearance)?

Answer 18

Thoracodorsal nerve (to latissimus dorsi) OR long thoracic nerve (serratus anterior)

Question 19

What is the nerve supply to latissimus dorsi?

Answer 19

Thoracodorsal

Question 20

How may the spinal accessory nerve become damaged?

Answer 20

Tumour around the jugular foramen

Question 21

What are the signs of damage to the spinal accessory nerve?

Answer 21

Weak shoulder abduction, atrophy of trapezius and shoulder falls

Question 22

What are the joints at the elbow?

Answer 22

Humeroulnar, humeroradial and proximal radioulnar joints

Question 23

What structures run in the spiral groove of the posterior compartment of the upper arm?

Answer 23

Radial nerve and deep artery of the arm

Question 24

What structures run in the anterior compartment of the upper arm?

Answer 24

Median and musculocutaneous nerves with the brachial artery

Question 25

What nerve is at risk of injury in a mid-shaft humeral fracture?

Answer 25

Radial nerve –> wrist drop

Question 26

What nerve is at risk of injury in a supracondylar fracture just above the elbow?

Answer 26

Median nerve –> hand of benediction

Question 27

What nerve is at risk of injury in a medial epicondyle fracture?

Answer 27

Ulnar nerve –> ulnar claw

Question 28

Which is the stabilising bone of the forearm?

Answer 28

Ulna is most stabilising as the ulna claws over the bone

Question 29

What is the function of the muscles in the anterior compartment of the forearm?

Answer 29

Flexors and pronators

Question 30

What is the nerve supply to the muscles in the anterior compartment of the forearm?

Answer 30

Median and ulnar nerves

Question 31

What is the blood supply to the muscles in the anterior compartment of the forearm?

Answer 31

Radial and ulnar arteries

Question 32

What is the function of the muscles in the posterior compartment of the forearm?

Answer 32

Extensors and supinators

Question 33

What is the nerve supply to the muscles in the posterior compartment of the forearm?

Answer 33

Radial nerve

Question 34

What is the blood supply to the muscles in the posterior compartment of the forearm?

Answer 34

Posterior interosseous artery (from ulnar artery in the anterior compartment)

Question 35

What are the joints of the hand?

Answer 35

Distal radioulnar, radiocarapl, inter carpal, carpometacarpal, metacarpaphalangeal and interphalangeal (distal and proximal)

Question 36

Does the ulna bone articulate with the carpal bones?

Answer 36

No

Question 37

Which bones does the radius articulate with?

Answer 37

Scaphoid and lunate

Question 38

What is a Colle’s fracture?

Answer 38

Fracture of the distal radius only within 2cm of the distal fracture

Question 39

What muscle group will atrophy in the hand if the median nerve is compressed?

Answer 39

Thenar (thumb) muscles

Question 40

What protects the long flexor and extensor tendons from rubbing on the bones?

Answer 40

Tendon sheath

Question 41

Where do the radial and ulnar arteries anastamose?

Answer 41

In the superficial and deep palmar arches