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eMRCS questions > Upper limb > Flashcards

Upper limb Flashcards

1
Q

Which structure does cephalic vein pierce

A

Clavipectoral fascia

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1
Q

How many dorsal interrossei are there

A

4
2 heads at base

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2
Q

How many palmar interrossei are there

A

3

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3
Q

Which nerve supplies nailed of index finger

A

Median

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4
Q

Ulnar nerve related to artery at wrist

A

Artery is radial

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5
Q

If axillary artery is ligated which artery would have a reversal of flow

A

Circumflex scapular

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6
Q

Which strcuture is most likely to be damaged with laceration to lateral side of extensor retinaculum

A

Superficial radial nerve

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7
Q

Branches of radial nerve

A

Lateral cutaneous of arm
Posterior cutaneous of arm
Posterior cutaneous of forearm
Superficial sensory to hand
PIN- continuation of deep

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8
Q

Which muscles does the PIN innervate

A

ECU
ED
EDM
APL
EPL
EPB
EI

So only doesn’t innervate ECR brevis and longus, radiobrachialis and aconeus - all innervated by deep radial

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9
Q

Branches of ulnar nerve

A

Muscular- branches in forearm
Palmar cutaneous- medial half of palm
Dorsal- dorsal half and muscles in hand

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10
Q

Branches of median nerve

A

AIN- nerves of forearm
Palmar cutaneous- sensory in hand
Recurrent- thenar muscles
Palmar digital branch – innervates the palmar surface and fingertips of the lateral three and half digits. Also innervates the lateral two lumbrical muscles.

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11
Q

Median nerve in relation to brachial artery throughout upper limb

A

Lateral in arm
Crosses over anterior to medial just before ACF
Medial at ACF

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12
Q

Where can the PIN get trapped and what effect does this cause

A

Arcade of Frohse which is a superficial part of the supinator muscle which overlies the posterior interosseous nerve.
This nerve is entirely muscular

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13
Q

Which muscles does AIN innervate

A

FPL
Flexor pollicis longus
PQ
Lateral FDP

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14
Q

Sensory innervation of arm

A

Lateral arm- radial branch
Posterior arm- radial branch
Medial arm and forearm- medial antecubital
Lateral forearm- lateral antecubital- branch of musco

Hand
Palmar
Median- 3.5
Ulnar- medial 1.5

Dorsal
Radial up until finger tips lateral 3.5
Ulnar medially 1.5

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15
Q

If little finger infected where it the most proximal it can spread to

A

Flexor retinaculum as tendon sheath extends to this

Other finger tendon sheath stop at base of digit

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16
Q

Nerve at risk with humeral surgical neck fracture

A

Axillary nerve

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17
Q

What does the posterior cord of brachial plexus give rise to

A

Radial
Axillary
Upper subscapular- subscapularis
Lower subscapular - teres major
Thoracodorsal

ULNAR

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18
Q

Nerves arising from medial cord of brachial plexus

A

Ulnar
Median
Medial pectoral nerve (C8, T1)
Medial brachial cutaneous nerve (T1)
Medial antebrachial cutaneous nerve (C8, T1)

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19
Q

Nerves arising from lateral cord of brachial plexus

A

Muscocutaneous
Median
Lateral pectoral (C5, C6, C7

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20
Q

What separates cephalic vein and brachial artery in ACF

A

Bicep aponeurosis

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21
Q

Which muscles flexes IP vs MCP joint of thumb

A

FPL- IP

FPB- MCP

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22
Q

What is the Gantzer muscle and its innervation

A

Accessory of FPL
So AIN

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23
Q

What attaches periosteum to bone

A

Sharpey Fibres

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24
Q

Which finger does the palmar interossei not attach to

A

Middle

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25
Q

Venous drainage of upper limb

A

Basillic medially- joins Brachial to form Axillary
Cephalic joins axillary

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26
Q

Course of median nerve relative to brachial artery

A

Lateral, anterior, medial

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27
Q

Which upper limb muscle dose not insert onto radius

A

Brachialis

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28
Q

Which muscle is attached to anterior aspect of fibrous capsule

A

Brachialis

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29
Q

Which structure lies closest to hamate in carpal tunnel

A

Median nerve

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30
Q

Laceration, loss of pincer movement of thumb and index finger, no loss of sensation

A

AIN

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31
Q

Which nerve is damaged in a Crutch palsy and what symptoms

A

Radial
Wrist drop

Saturday night palsy

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32
Q

Surgical Treatment of hyperhidrosis of hands and arms

A

Divide sympathetic ganglia at T2,3

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33
Q

Nerve damaged with surgical neck of humerus fracture

A

Axillary

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34
Q

An MRI scan shows a small cuff of tendon still attached to the radial tuberosity consistent with a recent tear. Which of the following muscles has been injured?

A

Bicep brachii

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35
Q

What separates ulnar artery and median nerve

A

Pronator teres
Ulnar lies deep

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36
Q

Where does the shoulder joint insert

A

The fibrous capsule attaches to the anatomical neck superiorly and the surgical neck inferiorly

37
Q

What are the defects in the fibrous capsule of shoulder

A

Two defects in the fibrous capsule; superiorly for the tendon of biceps. Anteriorly there is a defect beneath the subscapularis tendon.

38
Q

Where does scaphoid receive majority of its blood

A

Dorsal carpal branch of radial artery

39
Q

What articulates with radial head

A

Capitulum
Capital Radio

40
Q

What articulates with olecranon

A

Trochlear

41
Q

Where do the rotator cuffs insert

A

Greater tuberosity of humerus

Apart from subscapularis- lesser

Teres major -not RC but inserts into intertubercular sulcus

42
Q

Anatomical relations of shoulder jointW

A

Anteriorly
Brachial plexus
Axillary artery and vein

Posterior Suprascapular nerve
Suprascapular vessels

Inferior
Axillary nerve
Circumflex humeral vessels

43
Q

Which part of shoulder capsule is related to axillary nerve

A

The inferior extension of the capsule is closely related to the axillary nerve at the surgical neck and this nerve is at risk in anteroinferior dislocations

44
Q

Radial nerve relation to humerus at supracondylar area

A

Anterolateral

45
Q

Where does Pin leave antecubital fossa

A

Between 2 heads of supinator

46
Q

Where does cephalic vein form

A

Anatomical snuff box

47
Q

Which nerve does basilica vein follow in forearm

A

Medial cutaneous

48
Q

Which nerve does cephalic vein follow in forearm

A

Lateral cutaneous

49
Q

Where does brachial artery bifurcate

A

Opposite neck of radius
Beneath bicipital aponeurosis

50
Q

Largest branch of brachial artery

A

Ulnar

51
Q

Branches of radial artery

A

Recurrent radial- arrises from lateral aspect and anastomoses with radial collateral of brachial profunda

52
Q

Guyon canal borders and content

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.

Contains ulnar nerve and artery

53
Q

Which bone articulates with scaphoid on lateral aspect

A

Trapezium

54
Q

Anatomical location of the base of the breast

A

2-6th rib vertically
Lateral border of sternum and MAL

55
Q

Course of radial artery

A

Under BR
Emerge on medial aspect
Floor of anatomical snuff
Piece between 2 heads of 1st interosseous

56
Q

5 superficial upper limb muscles

A

FCU, PL, PT, FCR

FDS- intermediate

57
Q

3 deep muscles of upper limb

A

FPD, FPL, PQ

58
Q

Pec minor attachments

A

3-5th rib to coracoid

59
Q

Arterial and nerve supply of rhomboids

A

Dorsal scapula

60
Q

Border of axilla

A

Ant- pec major and minor
Post- teres major, lat doors, subscapularis
Medial- serrates anterior and thoracic wall
Lateral- intertubecular sulcus

61
Q

Level of nodes relative to pec minor

A

1- lateral
2- behind
3- medial

62
Q

Muscles median nerve passes between to enter wrist

A

FDS and FPL

63
Q

What encloses axillary vessles and brachial plexus

A

Axillary sheath

64
Q

Brachial artery branches

A

Profunda brachii (P)
Nutrient artery of the humerus (N)
Superior ulnar collateral artery (S)
Middle ulnar collateral artery (M)
Inferior ulnar collateral artery (I)

65
Q

Nerves arrises from brachial plexus roots

A

Long thoracic
Nerve to subclavius
Dorsal scapula

66
Q

Nerves arising from trunks of brachial plexus

A

Suprascpaular

67
Q

Dorsal guttering

A

Wasting of dorsal interossei

68
Q

How does palmar cutaneous nerve of median enter hand

A

Superficial to flexor retinaculum

69
Q

Annular ligament Goes around

A

Encircles head of radius

70
Q

Ligaments of elbow

A

Radial collateral - lateral epicondyle blends in with annular

Ulnar collateral - medial epicondyle to coronoid and olecranon of ulnar

Annular

71
Q

Where does ulnar nerve enter forearm

A

Between 2 heads of FCU in cubital tunnel

72
Q

Borders of cubital tunnel

A

Medial wall – medial epicondyle of the humerus.

Lateral wall – olecranon of the ulna
.
Floor – elbow joint capsule and medial collateral ligament of the elbow.

Roof – cubital tunnel retinaculum or the arcuate ligament of Osbourne

73
Q

Test for AIN

A

Flex at IPJ of thumb

74
Q

Nerve supply of teres minor

A

Axillary

75
Q

Involvement of which nerve root might result in Horners

A

T1

76
Q

Hand of benediction

A

High median nerve damage
Tries to make a fist
Unable to flex DIP or PIPJ due to paralysis of both FDS and lateral FDP

77
Q

Patient weak extender of shoulder which nerve affected

A

Thoracodorsal

78
Q

Borders of cubital fossa

A

Proximal- line connecting medial and lateral epicondyles

Medial- pronator teres

lateral- brachioradialis

Roof- bicipital aponeurosis

Floor- brachial and supinator

79
Q

Brachial artery relative to bicep brachial

A

Medial

Medial to tendon in fossa too

Lateral to median

80
Q

Brachial artery, biceps tendon, , median nerve order in fossa

A

Lateral to medial

Biceps
Brachial
Median

81
Q

Global wasting of hand muscles nerve root damage

A

T1

or C8

As effects both ulnar and median

82
Q

Where does median cross brachial

A

In mid arm

From lateral to medial

83
Q

Intercostalbrachial nerve root and supply

A

T2

Sensation of medial arm and axilla

84
Q

Nervous supply of breast

A

Anterior branches of 1-6th intercostal medially

Lateral 2-7th intercostal

85
Q

Breast coverage of pec major and serrates anterior

A

2/3 of breast covers pec
1/3 covers serrates

86
Q

Where does axillary form and end

A

The axillary artery commences from the subclavian artery at the outer border of the first rib and terminates when it becomes the brachial artery at the outer border of the teres major muscle.

87
Q

Where does basilica vein pierce deep fascia

A

Halfway between elbow and axilla

88
Q

Where does rotters node lie

A

Between pec minor and major

89
Q
A

eMRCS questions (45 decks)

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