Upper Limb

Question 1

List the sub-regions of the upper limb.

Answer 1

1 - Shoulder.

2 - Arm.

3 - Forearm.

4 - Wrist.

5 - Hand.

Question 2

List the joints of the upper limb.

Answer 2

1 - Sternoclavicular joint.

2 - Glenohumeral joint.

3 - Elbow joint.

4 - Wrist joints.

5 - Joints of the hand.

Question 3

What type of joint is the sternoclavicular joint?

Answer 3

A plane style synovial joint.

Question 4

Which bones are articulated in the pectoral girdle?

Answer 4

The clavicle and scapula.

Question 5

List the joints in the pectoral girdle.

Answer 5

1 - Sternoclavicular joint.

2 - Scapulothoracic joint.

3 - Acromioclavicular joint.

4 - Glenohumeral joint.

Question 6

What is the acromion and where is it?

Answer 6

A bony projection on the superior end of the scapula.

Question 7

Describe the shapes of both ends of the clavicle.

Answer 7

• The acromial end is flattened.

- The sternal end is triangular.

Question 8

In which rib levels does the scapula lie?

Answer 8

Between levels of the 2nd and 7th ribs.

Question 9

In which cavity does the scapula articulate with the humerus?

Answer 9

The glenoid fossa.

Question 10

Where does the clavicle extend from / to?

Answer 10

Extends from the manubrium of the sternum to the acromion of the scapula.

Question 11

What type of joint is the glenohumeral joint?

Answer 11

A ball and socket style synovial joint.

Question 12

What is the glenoid labrum and what is its function?

Answer 12

• A fibrocartilaginous rim evolved to deepen the glenoid fossa.
• It helps articulation with the disproportionately large head of the humerus.

Question 13

The tendon of which muscle blends with the glenoid labrum?

Answer 13

The long head of biceps brachii.

Question 14

List the types of synovial joint.

Answer 14

1 - Plane.

2 - Hinge.

3 - Ball and socket.

4 - Saddle.

5 - Pivot.

6 - Condyloid / ellipsoid.

Question 15

List 5 anatomical features of synovial joints.

Answer 15

1 - A synovial cavity (space between the bones of the joint).

2 - Articular surfaces covered with hyaline cartilage.

3 - Presence of an articular capsule made of a fibrous capsule and a synovial membrane.

4 - Presence of synovial fluid to form a thin film over articular surfaces,

5 - Presence of extra-capsular ligaments.

Question 16

How do the ligaments of the shoulder joint differ from most other ligaments?

Answer 16

In the shoulder joint, they are thickenings of the fibrous capsule of the joint.

Question 17

List the ligaments of the shoulder joint.

Answer 17

1 - Glenohumeral ligament.

2 - Coracohumeral ligament.

3 - Transverse humeral ligament.

4 - Coracoacromial ligament.

Question 18

Where does the stability of the shoulder joint come from?

Answer 18

Mainly from the rotator cuff muscles, which hold the head of the humerus in the glenoid cavity.

Question 19

List the rotator cuff muscles.

Answer 19

1 - Supraspinatus.

2 - Infraspinatus.

3 - Teres minor.

4 - Subscapularis.

Question 20

What are the sources of the articular arteries supplying the shoulder joint?

Answer 20

Branches of the anterior and posterior circumflex humeral arteries.

Question 21

From which arteries do the articular arteries supplying the shoulder joint arise?

From which artery do these arteries arise?

Answer 21

• The axillary and subscapular arteries.

- These arteries arise from the subclavian artery.

Question 22

What are bursae?

Answer 22

• Synovial filled sacs lined by synovial membrane.

- It provides a cushion between bones and tendons and/or muscles around a joint.

Question 23

What are the major bursae of the shoulder joint?

Answer 23

The subacromial and subscapular bursae.

Question 24

Describe the nerve supply to the shoulder joint.

Answer 24

Articular nerves are branches of the:

• Suprascapular nerve.
• Axillary nerve.

and

• Lateral pectoral nerve,

Question 25

What actions are brought about by the pectoralis muscles?

Answer 25

1 - Arm flexion.

2 - Arm adduction.

Question 26

Where does pectoralis minor lie in relation to pectoralis major?

Answer 26

Pectoralis minor is deep to pectoralis major.

Question 27

What are the two anatomical spaces of the upper limb?

Answer 27

• The axilla.

- The cubital fossa.

Question 28

Which structures form the anterior border of the axilla?

Answer 28

Pectoralis major and minor.

Question 29

Which structures form the medial border of the axilla?

Answer 29

• Serratus anterior.

- The thoracic wall.

Question 30

Which structures form the posterior border of the axilla?

Answer 30

• Subscapularis.
• Teres major.
• Latissimus dorsi.

Question 31

Which structures form the lateral border of the axilla?

Answer 31

The intertubercular sulcus of the humerus.

Question 32

Which bones converge at the apex of the scapula?

Answer 32

1 - Clavicle.

2 - Scapula.

3 - First rib.

Question 33

What is contained within the axilla?

Answer 33

1 - The axillary sheath.

2 - Axillary lymph nodes.

Question 34

What is the axillary sheath?

Answer 34

A fibrous sheath containing:

1 - Brachial plexus.

2 - Axillary artery.

3 - Axillary vein.

Question 35

What occupies the interval between pectoralis minor and subclavius?

Answer 35

Clavipectoral fascia.

Question 36

Where is the cubital / antecubital fossa?

Answer 36

On the anterior aspect of the interface between the arm and forearm.

Question 37

What forms the superficial boundary / roof of the cubital fossa?

Answer 37

• Deep fascia.

- The bicipital aponeurosis.

Question 38

What forms the deep boundary / floor of the cubital fossa?

Answer 38

• Brachialis.

- Supinator.

Question 39

What forms the superior boundary of the cubital fossa?

Answer 39

An imaginary line connecting the medial and lateral epicondyles of the humerus.

Question 40

What forms the medial boundary of the cubital fossa?

Answer 40

The pronator teres muscle.

Question 41

What forms the lateral boundary of the cubital fossa?

Answer 41

The brachioradialis muscle.

Question 42

List 3 points of clinical importance relating to the cubital fossa.

Answer 42

1 - During blood pressure measurements, the stethoscope is placed over the brachial artery in the cubital fossa.

2 - The cubital fossa is an area used to palpate for the brachial pulse.

3 - The cubital fossa is used for venous access.

Question 43

Which muscles are involved in abduction of the shoulder?

How are they involved in abduction?

Answer 43

• Supraspinatus up to 15 degrees.
• Deltoid from 15 degrees to 90 degrees.
• Trapezius and serratus anterior rotate the scapula such that the glenoid fossa faces upwards, making the humerus available for movements of up to 180 degrees.

Question 44

What is the coracoacromial arch?

Answer 44

A protective arch formed by the inferior aspect of the acromion and the coracoid process of the scapula with the coracoacromial ligament spanning between them.