Upper extremity anatomy

Question 1

Innervation of supraspinatus

Answer 1

suprascapular nerve

Question 2

Innervation of infraspinatous

Answer 2

suprascapular nerve

Question 3

Innervation of deltoid

Answer 3

axillary nerve

Question 4

Innervation of serratus anterior

Answer 4

long thoracic

Question 5

innervation of teres minor

Answer 5

axillary nerve

Question 6

Which muscles make up the rotator cuff

Answer 6

Supraspinatour
Infraspinatous
Teres minor
Subscapularis

Question 7

What do the empty/full can tests assess for?

Answer 7

Impingment of rotator cuffs with acromium process

Question 8

What deficits will someone with carpal tunnel syndrome have?

Answer 8

loss of motor to thumb
loss of flexion/extension of lateral lumbricals
loss of sensation to lateral fingers and thenar eminense

Question 9

What bone is palpable in the snuff box?

Answer 9

Scaphoid

Question 10

What supplies blood to the scaphoid?

Answer 10

radial artery (in retrograde manner)

Question 11

Complications of scaphoid fracture?

Answer 11

Avascular necrosis and non-union

Question 12

Dislocation of lunate may lead to what?

Answer 12

Acute carpal tunnel syndrome (lunate is attached to radius so other bones move back and lunate moves forward)

Question 13

What attaches to the lateral epicondyle of the humerus?

Answer 13

Wrist extensors

Question 14

What attaches to the medial epicondyle of the humerus?

Answer 14

Wrist flexors

Question 15

Tennis elbow refers to waht?

Answer 15

Lateral epicondylitis

Question 16

What is nursemaids elbow?

Answer 16

Radial head subluxation - annular ligament slips over head of radius, may occur when arm is extended and yanked

Question 17

in general which nerve supplies the muscles of the anterior forearm ?

Answer 17

median nerve

Exceptions: the flexor carpi ulnaris and ulnar half of flexor digitorum profundus are innervated by the ulnar nerve.

Question 18

in general which nerve supplies the muscles of the posterior forearm?

Answer 18

Radial

Question 19

Which nerve supplies the muscles of the posterior upper arm?

Answer 19

radial

Question 20

which nerve supplies the muscles of the anterior upper arm?

Answer 20

musculocutaneous

Question 21

most common pediatric fracture?

Answer 21

supracondylar fracture - risk of brachial artery and median nerve injury

Question 22

causes of injury to axillary nerve?

Answer 22

fractured surgical neck of humerus

anterior dislocation of humerous

Question 23

presntation of axillary nerve injury?

Answer 23

flattened deltoid
loss of arm abduction
loss of sensation over deltoid muscle and lateral arm

Question 24

cause of injury to radial nerve?

Answer 24

crutches, sleeping with arm over chair
Midshaft fracture
Repetitive pronation/supination

Question 25

Presentation of radial nerve injury

Answer 25

wrist drop decreased grip strength loss of sensaion over posterior arm/forearm and dorsal hand

Question 26

causes of injury to median nerve

Answer 26

Supracondylar fracture of humerus or carpal tunnel syndrome/wrist laceration

Question 27

Presentation of injury to medial nerve

Answer 27

Loss of wrist flexion, flexion of lateral ingers, thumb flexion and lumbricals of lateral fingers Loss of sensation over thenar eminance and dorsal and palmas aspects of lateral three fingers

Question 28

Causes of injury to ulnar nerve

Answer 28

fracture of medial epicondyle of humerus Fractured hook of hamate

Question 29

Presentation of ulnar nerve injury

Answer 29

ulnar claw radial deviation of wrist loss of wrist flexion, flexion of medial fingers and abducation/adducation of fingers loss of sensation over medial 1 1/2 fingers including hypothenar eminance

Question 30

How would you injury the reccurent branch of the median nerve?

Answer 30

Superficial laceration of the palm

Question 31

How will a laceration of the reccurent branch of the median nerve present?

Answer 31

``` ape hand (loss of thenar muscle group) NO loss of sensation ```

Question 32

Which nerve roots are damaged in Erbs palsy?

Answer 32

C5, C6 roots (upper trunk)

Question 33

Causes of erbs palsy?

Answer 33

Lateral traction on neck during delivery of baby In adults -trauma

Question 34

how does erbs palsy present?

Answer 34

arm internally rotated, adducted, pronated, elbow extended "waiters tip"

Question 35

Which roots are damaged in klumpe palsy?

Answer 35

C8-T1 (lower roots)

Question 36

Causes of klumpe palsy?

Answer 36

Infants - upward force on arm during delivery | Adults- trauma such as grabbing a tree branch while falling

Question 37

Which muscles are affected in klumpe palsy?

Answer 37

Intrinsic muscles of the hand

Question 38

Presentation of klumpe palsy?

Answer 38

Complete claw hand (all the lumbricals are damaged)

Question 39

What is thoracic outlet syndrome?

Answer 39

Compression of the lower trunk and subclavian vessels, most commonly within the scalene triangle Caused by cervical ribs or pancoast tumour Presents the same as klumpe but may has have ischemia, pain, etc.

Question 40

Cause of winged scapula?

Answer 40

Damage to long thoracic nerve of bell (innervates serratus anterior)

Question 41

Presentation of winged scapula?

Answer 41

inability to anchor scapula to thoracic cage -cannot abduct arm above horizatal position

Question 42

What runs through guyons canal?

Answer 42

Ulnar nerve and ulnar artery

Question 43

Who commonly gets injury to guyons canal?

Answer 43

Cyclists

Question 44

How does injury to guyons canal present?

Answer 44

Loss of abducation/adduction of the fingers Motor loss to little finger side (medial lumbrical/hypothenar) sensory loss to medial fingers

Question 45

What is the motor supply to the muscles of the hand?

Answer 45

Ulnar nerve supplies everything except loaf: Lumbricals (lateral) Opponens pollicis Abductor policies brevis Flexor policies brevis