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MRCS Sciences deck > Upper Limb > Flashcards

Upper Limb Flashcards

1
Q

In what relation does the axillary nerve lie to the axillary artery

A

Posterior

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2
Q

Which structures are found in the axillary sheath

A

A fibrous layer that covers the artery and the three cords of the brachial plexus

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3
Q

Through which anatomical area does the cephalic vein pass to enter the axilla?

A

Clavicopectoral triangle

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4
Q

Which peripheral branch of the brachial plexus is derived solely from the medial cord?

A

Ulnar nerve

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5
Q

What type of joint is the distal radioulnar joint?

A

Pivot joint

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6
Q

Which specific nerve branch provides motor innervation to the 1st lumbrical (index finger)

A

The palmar digital branch is a terminal division of the median nerve. It supplies the lateral two lumbricals, as well as cutaneous innervation to the palmar surface and fingertips of the lateral three and half digits

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7
Q

Which of the following nerves provides innervation to the sternoclavicular joint?

A

Nerve to the subclavius

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8
Q

Which structure primarily restricts the middle phalanx from dislocating posteriorly relative to the proximal phalanx?

A

Volar plate

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9
Q

What is the action of palmaris brevis?

A

Acts to improve grip and deepen the curvature of the hand

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10
Q

Carpal tunnel contents

A

The tendon of flexor pollicis longus
Four tendons of flexor digitorum profundus
Four tendons of flexor digitorum superficialis

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11
Q

A tear of which ligament would cause the shoulder to drop inferiorly?

A

Coracoclavicular ligament

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12
Q

Which node receives lymph from all axillary lymph node groups?

A

Apical

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13
Q

What type of synovial joint is the metacarpophalangeal joint?

A

Condyloid

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14
Q

What is the axillary inlet formed by

A

The axillary inlet is formed by lateral border of the first rib, superior border of scapula, and the posterior border of the clavicle.

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15
Q

Which of the following muscles is the main internal rotator at the glenohumeral joint?

A

Lat dors

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16
Q

The wrist joint is formed by an articulation between the radius and proximal carpal bones.

What type of synovial joint is it?

A

Ellipsoid joint

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17
Q

Trapezius fibres and function

A

The upper fibres of the trapezius elevate the scapula and rotates it during abduction of the arm. The middle fibres retract the scapula and the lower fibres pull the scapula inferiorly.

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18
Q

Where is the most likely point of fracture on the ulna?

A

The Shaft

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19
Q

What anatomical structure is damaged in a simple Bankart lesion?

A

Glenoid labrum

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20
Q

In lymphangitis, which group of axillary lymph nodes tends to be affected first?

A

Humeral

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21
Q

Which of the following movements occur at the acromioclavicular joint?

A

Axial rotation

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22
Q

Which bone is involved in a Bennett’s fracture?

A

The base of the first metacarpal is fractured, most often due to hyperabduction of the thumb

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23
Q

Which option arises directly from the roots of the brachial plexus?

A

Long thoracic nerve

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24
Q

How does the radial artery pass in relation to the adductor pollicis

A

The radial artery passes between the two heads of adductor pollicis.

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25
Q

What structure attaches to the clavicle at the trapezoid line?

A

Trapezoid ligament

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26
Q

Complete the sentence: The musculocutaneous nerve passes down the flexor compartment of the upper arm, in a plane between the _____________ and _____________ muscles

A

Biceps brachii and brachialis

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27
Q

At which landmark is the subclavian artery renamed the axillary artery?

A

Lateral border of the first rib

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28
Q

Which of the following arteries supply the sternoclavicular joint?

A

Internal thoracic artery

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29
Q

Where does the ulnar nerve lie in relation to the ulnar artery at the wrist?

A

Medial

30
Q

A 34 year old bodybuilder is using a large amount of anabolic steroids. Whilst curling in the gym, he suffers a sharp pain in his upper arm.

Examination reveals a positive Popeye’s sign.

Which tendon is most likely to have ruptured?

A

Long head of the biceps brachii

31
Q

Which fracture of the humerus is most likely to cause Volkmann’s ischaemic contracture?

A

Supracondylar fracture

32
Q

Which of the following muscle tendons passes through the axilla?

A

Coracobrachialis

33
Q

Positive arc sign

A

Supraspinatus tendinitis will typically demonstrate pain between 60-120 degrees abduction, due to impingement under the acromion.

34
Q

Long thoracic nerve nerve roots

A

C5, C6 and C7

35
Q

Supraspinatus arterial supply

A

Suprascapular artery

36
Q

Suprascapular nerve roots

A

C5 and C6

37
Q

Scaphoid blood supply

A

Dorsal palmar arch

38
Q

Major veins of the forearm and accompanying nerves

A

Basilic - Median cutaneous vein
Cephalic - Lateral cutaneous vein

39
Q

Which tendon runs within the glenohumeral capsule

A

Long head of the biceps

40
Q

The annular ligament encircles the head of which bone

A

Radius

41
Q

Most superficial tendon in the wrist

A

Flexor carpi radialis tendon

42
Q

Lymph nodes cheat sheet

A

Pectoral - Breast
Apical - Cephalic (CEFAP)
Cubital - Basilic (BACU)
Central - Bit of everything
Humeral - Majority of the upper limbs (Humeral - Humerus?)
Subscapular (posterior) – posterior thoracic wall and scapular region.

43
Q

Which of the following structures separates the ulnar artery from the median nerve

A

Pronator teres

44
Q

What are the borders of the cubical fossa

A

Laterally the brachioradialis
Medially the pronator teres
Superiorly the medial epicondyle (Imaginary line)

45
Q

Where does the biceps tendon attach itself

A

radial tuberosity (immediately distal to the radial neck).

46
Q

Extensor compartments and known pathology

A

Compartment 1 tendon inflammation results in deQ Tenosynovitis
Compartment 2 contains Lister’s tubercle – a bony prominence of the distal aspect of the radius.
Compartment 3 forms the medial border of the anatomical snuffbox

47
Q

How does the hook of the hamate relate to the hypothenar muscles

A

The ulnar canal is approximately 4cm in length. It extends from the proximal aspect of the pisiform bone to the origin of the hypothenar muscles at the hook of hamate.

48
Q

What are the borders of the Ulnar canal

A
  • Medial (ulnar) – pisiform, flexor carpi ulnaris tendon, abductor digiti minimi muscle.
  • Lateral (radial) – hook of hamate.
  • Roof – palmar carpal ligament.
  • Floor – flexor retinaculum, pisohamate ligament, and hypothenar muscles.
49
Q

Median nerve hugs

A

Median nerve passes through the heads of the pronator teres and the flex dig sup

50
Q

Why is brachioradialis called a paradoxical muscle

A

The brachioradialis is a paradoxical muscle. Its origin and innervation are characteristic of an extensor muscle, but it is actually a flexor at the elbow.

It is supplied by the radial nerve

51
Q

What is special about the anconeus muscle

A

Fibres are blended with the triceps muscle and hence are indistinguishable

52
Q

Brachial plexus nerves and innervations

A

Musculocutaneous nerve: C5, C6, C7
Median nerve: C6 – T1
Ulnar : C8 – T1
Axillary: C5 – C6
Radial: C5 – T1

53
Q

What nerve supplies the glenohumeral joint

A

Axillary nerve

54
Q

Where does the common interosseous artery arise from

A

The ulnar artery and then it splits into ant and post interosseous

55
Q

Where does the basilic vein enter the arm

A

At the border of the teres major, the vein moves deep into the arm. Here, it combines with the brachial veins from the deep venous system to form the axillary vein.

56
Q

Where is the supraspinatus tendonitis painful arc

A

60-90 degrees

57
Q

Which artery passes between the two heads of adductor pollicis.

A

The radial artery passes between the two heads of adductor pollicis.

58
Q

What forms the roof of the cubital tunnel

A

(known as the cubital tunnel retinculum or the arcuate ligament of Osbourne).

59
Q

Which of the following nerves is at MOST risk during axillary clearance?

A

Long thoracic nerve

60
Q

Where does the axillary nerve lie in relation to the artery

A

The axillary nerve is located posteriorly to the axillary artery

61
Q

Which of the following arteries supply the sternoclavicular joint?

A

Internal thoracic artery

62
Q

All of the peripheral nerves listed below arise from the brachial plexus. Which option arises directly from the roots of the brachial plexus?

A

Long thoracic nerve

63
Q

Where does the axillary artery become the brachial artery

A

inferior border of the Teres Major

64
Q

In forearm damage, which tendon is the most susceptible to damage?

A

Flexor carpi radialis

65
Q

What are the muscles supplied by the radial nerve

A

BEST
Brachioradialis
Extensors
Supinator
Triceps

66
Q

A 32 year old lady complains of carpal tunnel syndrome. The carpal tunnel is explored surgically. Which of the following structures will lie in closest proximity to the hamate bone within the carpal tunnel?

A

Tendons of the flexor digitorum profundus

67
Q

What to do with a scaphoid fracture of the proximal pole

A

It is generally accepted that proximal pole fractures of the scaphoid should be surgically fixed as non union rates of up to 34% can be seen when cast immobilization alone is attempted.

68
Q

A 23 year old man is injured during a game of rugby. He suffers a fracture of the distal third of his clavicle, it is a compound fracture and there is evidence of arterial haemorrhage. Which of the following vessels is most likely to be encountered first during subsequent surgical exploration?

A

The thoracoacromial artery arises from the second part of the axillary artery. It is a short, wide trunk, which pierces the clavipectoral fascia, and ends, deep to pectoralis major by dividing into four branches.

69
Q

What is the articulation of the radial head superiorly

A

A useful revision aid : ‘Capital Radio’ is the articulation of the radial head superiorly.

70
Q

FACT

A

The middle finger has no attachment of the palmar interosseous.

MRCS Sciences deck (16 decks)

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