Upper limb mixed Flashcards by Mimi Fujino

Pectoralis Major:
(a) is quadrilateral in shape
(b) has a head that arises from the posterior surface of the clavicle
(c) inserts into the medial lip of the bicipital groove
(d) lies between biceps and the humeral shaft
(e) is supplied by all 5 segments of the brachial plexus

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Latissimus Dorsi:
(a) arises from the spinous processes of T2-L5
(b) spirals around the upper border of teres major
(c) arises from the iliac crest
(d) inserts into the lesser tuberosity
(e) externally rotates

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The sternoclavicular joint:
(a) communicates with the manubriosternal joint
(b) is mostly stabilised by the costoclavicular lig
(c) is the fulcrum of movements at the sternoclavicular joint
(d) contains 2 fibrocartilage discs
(e) is supplies by C8 and T1

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Teres major:
(a) arises from the medial border of the scapula
(b) forms the lower border of the quadrangular space
(c) forms the lateral border of the triangular space
(d) is supplied by the axillary nerve
(e) largely acts to extend the arm

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The axillary artery:
(a) arises from the vertebral artery
(b) is divided into 3 parts by teres major
(c) is clasped in its 3rd part by the cords of the brachial plexus
(d) has no branches in its 3rd part
(e) supplies the pectoral muscles via the superior thoracic a.

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With regard to the brachial plexus:
(a) the axillary n is derived from the lateral cord
(b) the radial nerve is derived from C7, 8 and T1
(c) the nerve to subclavius is the only branch from the trunks
(d) there are 7 divisions of the trunks
(e) the roots lie between the scalene muscles

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An injury to the middle trunk of the brachial plexus:
(a) would mean that C8 sensation is altered
(b) will manifest in the medial cord
(c) will affect the median nerve
(d) will affect the long thoracic nerve
(e) all of the above

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The rotator cuff is formed by all of the below except:
(a) subscapularis
(b) supraspinatus
(c) infraspinatus
(d) teres minor
(e) teres major

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The subacromial bursa:
(a) is strengthened anteriorly by the glenohumeral ligaments
(b) lies under the coracoacromial lig
(c) envelopes the distal end of the coracoid process
(d) if inflamed will be more tender when abducted
(e) all of the above

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With regards to the biceps brachii:
(a) the long head arises from the greater tuberosity
(b) the short head arises from the acromium
(c) supinates forearm
(d) supplied by median n
(e) its 2 heads merge in the upper arm

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The brachial artery:
(a) lies lateral to the basilic vein
(b) lies anterior to the cephalic vein
(c) is crossed posteriorly by the median n
(d) runs parallel but deep to the profunda a
(e) is the continuation of the subclavian a

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The triceps:
(a) is a misnomer because it has 2 heads
(b) supplied by radial n
(c) stabilises shoulder in adduction
(d) has its nerve compromised in humerus shaft #
(e) supplied by post. IO artery

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In the cubital fossa:
(a) the median n lies lateral to the brachial a
(b) the ulnar a is superficial to pronator teres
(c) the radial a originates from the brachial a
(d) the radial n lies medial to the biceps tendon
(e) the nerve to pronator teres is derived from the radial n
(f) med cutaneous n to forearm lies medial to basilic vein
(g) post IO n lies lateral to radial n

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The deepest structure in the mid forearm is:
(a) median n
(b) basilic v
(c) radial a
(d) F P L
(e) Ulnar n

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Palmaris Longus:
(a) is absent in 40 % people
(b) originally was an extensor of the MCP joints
(c) arises from the medial epicondyle
(d) inserts into the pisiform
(e) supplied by radial n

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F D P
(a) has its action enhanced by wrist extension
(b) is supplied entirely by ulnar n in 10% people
(c) partly inserts in to the flexor retinaculum
(d) assists pronator quadratus in powerful pronation
(e) all of the above

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Radial a:
(a) lies on the brachioradialis in the upper forearm
(b) in its middle third has the radial n medial to it
(c) forms both the anterior and posterior carpal arches
(d) passes between the tendons of APL and EPB
(e) all of the above

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Anatomical snuff box:
(a) has EPL on its ulnar side
(b) lies between EPL and APL
(c) has the trapezoid palpable at its base
(d) is most obvious with the thumb fully abducted
(e) contains the post IO artery

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The flexor retinaculum attaches to all the following except:
(a) scaphoid
(b) hamate
(c) trapezium
(d) pisiform
(e) captitate

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(a) abduction and lateral rotation
(b) adduction and medial rotation
(c) abduction and medial rotation
(d) adduction and lateral rotation
(e) lateral rotation

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Myotome of shoulder abduction?
(a) C5
(b) C5, C6
(c) C5, C6, C7
(d) C6, C7, C8
(e) C6, C7

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Which is false with respect to the lateral intermuscular septum:
(a) origin of medial head of triceps
(b) pierced by ant branch of profunda a
(c) pierced by radial n
(d) pierced by post branch of profunda a
(e) brachioradialis is anterior
(f) extends along lat suprachondylar line

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Which doesn’t pierce the clavipectoral fascia
(a) lymphatics
(b) cephalic vein
(c) lat pectoral n
(d) med pectoral n
(e) thoracoacromial a

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Serratus anterior
(a) Medially rotates shoulder
(b) Protracts scapula
(c) Is unipennate
(d) Arises from the upper 6 ribs
(e) Is supplied by the thoracodorsal a

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Which causes lateral rotation of the shoulder
(a) subscapularis
(b) teres minor
(c) teres major
(d) deltoid
(e) serratus anterior

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What stabilises the abducted shoulder?
(a) Capsule
(b) Long head triceps
(c) Glenohumeral joint
(d) Coracoacromial arch
(e) Glenohumeral ligament

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Which nerve does not pass through muscle described
(a) Radial n and brachioradialis
(b) Post IO n and supinator
(c) Musculocutaneous n and coracobrachialis
(d) Ulna n and FDS
(e) Median n and pronator teres

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In the cubital fossa which of the following is lateral to the radial a
(a) Brachial a
(b) Median n
(c) Biceps tendon
(d) Post IO n

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In the upper limb which is correct?
(a) Receives supply from T4
(b) Supplied by C3 – T1
(c) Upper arm dermatomes are C4, 5, 8, T1
(d) Elbow flexion is C7, C8
(e) Thumb dermatome is C8

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Which is false regarding the carpal tunnel
(a) Median n and FPL are superficial
(b) FPL has its own sheath
(c) FDS and FDP tendons lie in the same sheath
(d) FCR tendon may pierce the flexor retinaculum
(e) FCU lies in canal of Guyon
8 flexor tendons share common sheath

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radial n
(a) runs with profunda brachii in the radial groove
(b) gives off the post IO n in the spiral groove
(c) is only C5, 6 7 and 8
(d) occupies the entire length of radial groove
(e) passes through the quadrilangular space
(f) it has no cutaneous branches in upper arm

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Of the quadrangular and triangular spaces which is false?
(a) Both share the same medial border
(b) Circumflex humeral a passes through quadrangular
(c) Long head of triceps borders both spaces
(d) Triangular space admits the radial n
(e) Teres minor does not form a border to either space

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Lumbricals:
(a) Oppose action of interossei
(b) Arise from FDS
(c) Are all supplied by ulnar n
(d) Form proprioceptive bridges between flexors and extensors
(e) Aid flexion of terminal phalanx

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Forearm muscles:
(a) Pronator teres is the most powerful pronator
(b) Palmaris longus is absent in 30% cases
(c) FPL is unipennate
(d) FCR runs over entire length of retinaculum
(e) Pronator quadtratus arises from lower radius

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Interossei
(a) Arise from flexor retinaculum
(b) Palmar abduct
(c) Palmar have 2 heads of origin
(d) Innervated by deep branch of ulnar n
(e) Combined dorsal and palmar abduct
(f) When act together dominant action is adduction

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Palmar interossei
(a) Have 2 heads
(b) Abduct the fingers
(c) Chiefly responsible for MCPJ flexion and DIPJ extension
(d) Arise from tendons of FDS
(e) Flex IPJ

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Mid palmar space:
(a) Extends into lumbrical canals distally
(b) Is continuous with common carpal space
(c) Extends proximally to the origin of FDS

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FDP
(a) Assists pronator quadratus in pronation
(b) Supplied 10% purely by median n
(c) Is the strongest muscle of the forearm
(d) Partly inserts into the flexor retinaculum
(e) Has its action enhanced by wrist flexion
(f) Origin = olecranon + ant surface radius

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Which is not a branch of the axillary artery: (>1 ANSWER)
(a) Thoracoacromial
(b) Sup thoracic
(c) Post CX humeral
(d) Dorsal scapular
(e) CX scapular
(f) Med thoracic
(g) Lateral thoracic

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The ulnar artery
(a) Has the ulna nerve lying laterally
(b) Supplies the deep palmar arch
(c) Has common interosseus as major branch

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Which of the following bones attach to both flexor and extensor retinaculum?
(a) Scaphoid
(b) Hamate
(c) Pisiform
(d) Trapezium
(e) Triquetral

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AC joint – which is false
(a) Is a complex joint with fibrocartilage intracapsular disc
(b) Coraco-acromial lig is not a stabilising factor
(c) All movements are passive
(d) Is innervated by the cervical plexus
(e) Synovial joint
(f) Supplied by supascapular n
(g) There is a thickening on top which constitutes the AC lig

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The deltoid
(a) Is supplied by the axillary n
(b) Has a multipennate arrangement for maximal range of movement
(c) Inserts into the bicipital groove

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Which muscle initiates shoulder abduction
(a) Multipennate centre of the deltoid
(b) Anterior and posterior fibres of deltoid
(c) Supraspinatus
(d) Teres minor

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Which muscle is supplied by the post IO n in the cubital fossa
(a) ECRL
(b) Anconeus
(c) ECRB
(d) ED
(e) Supinator

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regarding FDS
(a) it arises from the coronoid process and sublime tubercle
(b) the tendons to the II/V fingers travel superior to those of the III/IV fingers

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Regarding the anatomical snuff box which is incorrect
(a) Branches of the radial nerve can be palpated over the tendons
(b) The cephalic vein begins in the roof
(c) The bones palpable are the radial styloid, scaphoid, trapezium and the base of I metacarpal
(d) The tendons of APL and EPL form one boundary

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Injury to the wrist with impairment of thumb abduction is often associated with
(a) Inability to flex DIPJ of II
(b) Inability to flex PIPJ of II
(c) Inability to oppose thumb

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Lateral rotation of shoulder
(a) Supplied by C5
(b) Associated with adduction

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With respect to shoulder stability in abduction
(a) Is largely due to glenoid labrum
(b) Is mainly due to glenohumeral ligaments
(c) Is due mainly to musculotendinous cuff

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Which movement of the arm does not involve C6
(a) Pronation
(b) Supination
(c) Shoulder adduction
(d) Wrist flexion
(e) Wrist extension

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The scaphoid articulates with all of the following except:
(a) Trapezium
(b) Tripquetral
(c) Trapezoid
(d) Lunate
(e) Hamate

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Which muscles directly attach the pectoral girdle to the thorax
(a) Pec major
(b) Pec minor
(c) Subclavius

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Regarding the cutaneous nerve supply to the arm and forearm
(a) C3,4 supply pectoral and upper shoulder
(b) Branches of the brachial plexus supply arm and forearm
(c) C4,5,6 and T1 supply the majority of the arm

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Regarding the brachial plexus
(a) Serratus anterior is C6,7,8
(b) All branches originate from roots, divisions or cords
(c) Suprascapular nerve comes off posterior cord
(d) Dorsal scapular n comes off C5

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Regarding lymphatic drainage of the arm
(a) Superficial lymphatics follow volar aspect
(b) Superficial travel with the veins
(c) Deep travel with the veins
(d) Hand drains into apical LN in axilla

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Regarding digital nerves
(a) Common digital n lie superficial to superficial arch
(b) Palmar nerves only supply palmar surface
(c) Digital nerves are only sensory
(d) Digital nerve lies posterior to digital a

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The direct attachments of pectoral girdle to trunk is by following except:
(a) Subclavius
(b) Trapezius
(c) Rhomboids
(d) Levator scapulae
(e) Latissimus dorsi

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The following nerve passes through the quadrangular space
(a) Axillary
(b) Radial
(c) Thoracodorsal
(d) Suprascapular
(e) Infrascapular

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The only branch from the trunk of the brachial plexus is
(a) Dorsal scapular
(b) Nerve to subclavius
(c) Long thoracic
(d) Suprascapular
(e) Infrascapular

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The largest branch of the brachial plexus is
(a) Ulnar
(b) Axillary
(c) Radial
(d) Median
(e) Thoracodorsal

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With regards to pectoralis major
(a) Forms posterior axillary fold
(b) Sternocostal head assists in flexion of shoulder
(c) The clavicular fibres are chief adductors
(d) With the limb fixed in adduction, is accessory muscle of respiration
(e) Medial rotator and powerful adductor

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The unar n is located in the grooved surface of which of the following in the elbow joint
(a) Ant band of the medial collateral ligament
(b) Middle band of the medial collateral ligament
(c) Posterior band of the medial collateral ligament
(d) Radial collateral ligament
(e) Annular ligament

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Palmaris longus
(a) Arises from the lat epicondyle
(b) Inserts into the base of 2nd and 3rd metacarpals
(c) Is absent in 13%
(d) Is supplied by musculocutaneous n
(e) Is functionally useless

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The capsule of the elbow joint is not attached to
(a) Capitulum
(b) Trochlea
(c) Ulna
(d) Radius
(e) Annular ligament

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Bony points palpable in snuff-box are all except
(a) I metacarpal
(b) Trapezium
(c) Scaphoid
(d) Radial styloid
(e) Lunate

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The wrist joint
(a) Biaxial synovial joint
(b) Communicates with distal RUJ
(c) Supplied by branches of ulnar n
(d) Fibrocartilaginous disc transmits thrust from hand
(e) All of the above

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The carpal tunnel contains all except:
(a) Tendon of FDS
(b) Tendon of FDP
(c) Median n
(d) Palmaris longus tendon
(e) FPL tendon

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The earliest bone to ossify
(a) Radius
(b) Ulna
(c) Clavicle
(d) Humerus
(e) Mandible

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Muscles associated with the greater tuberosity of humerus
(a) Deltoid
(b) Latissimus dorsi
(c) Teres major
(d) Teres minor
(e) Subscapularis

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Number of ossification centres in scapula
(a) 4
(b) 5
(c) 6
(d) 7
(e) 8

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The nutrient artery to the humerus shaft mostly arises from
(a) Ulnar collateral a
(b) Profunda a
(c) Brachial a
(d) Post CX a
(e) None of the above

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The radial a in the forearm crosses all the following muscles except:
(a) FDS
(b) Biceps
(c) Supinator
(d) Pronator teres
(e) FDS

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Which do not lie beneath extensor retinaculum of wrist
(a) Brachioradialis
(b) APL
(c) Post IO n
(d) Extensor indicis
(e) ECU

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FCR
(a) Lateral to pronator teres
(b) Has a separate synovial sheath beneath flexor retinaculum
(c) Supplied by radial n
(d) Grooves scaphoid
(e) None of the above

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Which pass through the quandrangular space
(a) CX scapular a
(b) Nerve to the lateral head of triceps
(c) Radial n
(d) Profunda a
(e) Post humeral CX vessels

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The suprascapular n arises from where on brachial plexus
(a) Upper trunk
(b) Ventral roots C5,6
(c) Ventral division of upper trunk
(d) Dorsal division of upper trunk
(e) Lateral cord

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lymphatic drainage of the breast
(a) entirely to axillary nodes
(b) follows arterial supply
(c) follows superior epigastric vessels
(d) mainly through internal mammary nodes
(e) has significant drainage to opposite breast

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The groove on 1st rib is related to
(a) Subclavian v
(b) Scalenus pleuralis
(c) Subclavian artery
(d) Lower trunk of brachial plexus
(e) Dorsal cord of brachial plexus

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the dorsal scapular n
(a) major supply of levator scapulae
(b) dorsal to rhomboids
(c) fibres from C6
(d) receives fibres from cervical plexus
(e) accompanied by descending scapula vessels

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All but one is anterior to the brachial plexus in the neck
(a) Thoracic duct
(b) R recurrent laryngeal n
(c) Suprascapular a
(d) Scalenus medius
(e) Long thoracic n

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ECU
(a) Supplied by ulnar n
(b) Has no attachment to the ulna
(c) Superficial to extensor retinaculum
(d) Does not extend V finger

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which movements can take place at the IPJ
(a) abduction
(b) adduction
(c) flexion
(d) circumduction
(e) rotation

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Ossification of upper limb
(a) Ossification of clavicle is in cartilage
(b) Ossification of scapula from 1 centre
(c) Ossification of proximal row of carpals occurs before the distal row
(d) Distal radial epiphysis closes later than the proximal
(e) The radial head epiphysis closes at 15yo

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actions of latissimus dorsi
(a) flexion
(b) lateral rotation
(c) abduction
(d) all of the above
(e) none of the above

FCR
(a) Supplied by radial n
(b) Pierces flexor retinaculum
(c) Pronator
(d) Synergist with finger flexors
(e) Inserts to thumb

The number of branches of the median nerve in the upper arm
(a) 0
(b) 1
(c) 3
(d) 4
(e) 6

What supinates forearm
(a) Anconeus
(b) Biceps
(c) Brachialis
(d) ECU
(e) All of the above

The basilic vein
(a) Arises from the dorsum of hand
(b) Always superficial to deep fascia
(c) Unites with cephalic to form axillary
(d) All of the above
(e) None of the above

The roundness of the shoulder is due to
(a) Acromium
(b) Coracoid process
(c) Distal clavicle
(d) None of the above
(e) All of the above

C5 is mainly concerned with
(a) Pronation
(b) Wrist extension
(c) Elbow extension
(d) Medial rotation of shoulder
(e) None of the above

Branches of radial artery
(a) Comes nervi mediani
(b) Ant IO
(c) Post IO
(d) All of the above
(e) none of the above

what is true of the humerus
(a) the radial n is never in contact with bone
(b) APL origin = humerus
(c) Proximal epiphysis unites later than distal epiphysis
(d) Shorter than radius
(e) Contains transversely directed trabeculae

Division of ulnar n at wrist leads to sensory loss over:
(a) Thumb
(b) II and III fingers
(c) IV and V fingers
(d) All of the above
(e) None of the above

If the brachial artery is ligated
(a) No collaterals can be established
(b) Collaterals possible if ligation below level of sup ulnar collateral a
(c) Collaterals possible if ligation above the level of sup ulnar collateral a
(d) Immediate amputation is necessary
(e) Amputation of the fingers only will be necessary

radial n
(a) fibres from C6,7 and C8
(b) passes through quadrangular space
(c) does not supply ECU
(d) supplies supinator
(e) has no motor fibres in it
(f) passes in front of humerus from medial to lateral side
(g) supplies skin dorsum V finger
(h) sensory branches to nail beds II, III

musculocutaneous n
(a) supplies brachioradialis
(b) terminates as the post IO n
(c) arises from the lateral cord of the brachial plexus
(d) always supplies all of brachialis
(e) fibres from C6, C7 and C8

the nerve in closest relation to shoulder joint is
(a) radial
(b) median
(c) axillary
(d) musculocutaneous
(e) lateral pectoral

What lies medial to Lister’s tubercle
(a) ECU
(b) ECR
(c) EPL
(d) EPB
(e) ED

Nerve supply to palmaris brevis

(a) Palmar branch of median
(b) Recurrent branch of median
(c) Deep branch ulnar
(d) Superficial branch of ulnar
(e) None of the above

Almost exclusively supplied by median n
a. Adductor pollicus
b. APB
c. Opponens pollicus
d. FPB
e. None of the above

Following damage to the radial n on the spiral groove which of the following would show the earliest signs of recovery
a. Long head triceps
b. ED
c. ECRL
d. ECRB
e. Supinator

In abduction of arm
a. Clavicle remains fixed
b. Scapula moves dorsally on the chest wall
c. Scapula movement at first is more rapid than the humerus
d. Medial end of the clavicle moves downwards on the intraarticular disc
e. Medial rotation of humerus

The brachial a
a. Commences at upper border of teres major
b. Is in direct contact with the humerus
c. Has biceps tendon medial to it
d. Is readily compressible
e. Is accompanied throughout by basilic vein

The wrist
a. Has a synovial cavity continuous with distal RUJ
b. Has a synovial cavity continuous with mid carpal joint
c. Permits considerable flexion, extension, abduction and adduction but no rotation
d. Has articular surface of radius which faces distally, medially and dorsally
e. Has the flexor retinaculum anterior to it

Median n
a. Lateral to palmaris longus
b. Does not supply 1st dorsal interossei
c. Passes deep to both heads of pronator teres
d. Has constant and important exchange of fibres with musculocutaneous n
e. Supplies that portion of FDS which will move the II and III fingers

The 1st dorsal interossei
a. Adducts the index finger
b. Adducts the thumb
c. Is sometimes supplied by the median n
d. All of the above
e. None of the above

The female breast
a. Does not extend over serratus anterior
b. Has a separate duct for each lobe opening on to the nipple
c. Receives the great part of its blood supply from the internal mammary a
d. Drains lymph mainly to the infraclavicular LN
e. Collection of modified sebaceous glands

FDS
a. Essential for full finger flexion
b. Has tendons in one plane at the wrist
c. Supplied by both median and ulnar n
d. Communicates with the extensor apparatus by way of the lumbricals
e. Has the median n attached to its dorsal sheath.

If the ulnar n is cut at the elbow
a. Part of FDS is paralysed
b. There is loss of sensation on the back of the II finger
c. Flexion at the MCPJ of IV and V is lost if their IPJ are kept extended
d. Distal phalanges of all fingers are extended
e. Opposition of the thumb is usually lost

The cephalic vein (2 CORRECT)
a. Arises from the anatomical snuff box
b. Is deep to the lat cutaneous nerve of the forearm at the elbow
c. Terminates by joining the basilic vein
d. Is medial to the biceps in the arm
e. Has no valves
f. Pierces the clavipectoral fascia to join the subclavian v
g. Is associate with LNs
h. Is unsuitable for IV cannulation

A+G

The upper end of the humerus
a. Has subscapularis attaches to the greater tuberosity
b. Has teres major attached to the floor of the bicipital groove
c. Has 3 epiphyses which fuse separately with the chart
d. Has the capsular ligament of the shoulder joint attached to the whole of the anatomical neck
e. Is the growing end of the humerus

In the cubital fossa
a. The ulnar n is on the medial side
b. The radial n is on the lateral side
c. The median n is lateral to the brachial a
d. All the superficial veins are deep to the cutaneous nn
e. The brachial artery is lateral to the tendon of the biceps

The sternoclavicular joint
a. Is a fibrocartilaginous joint
b. Is strengthened by strong intra-capsular ligaments
c. Is the fulcrum of clavicular movement in abduction of the shoulder
d. Has a fibrocartilaginous disc
e. Allows very limited rotation

Subscapularis
a. Unipennate
b. Supplied by one branch of brachial plexus
c. Shares its nerve supply with teres minor
d. Covered by dense fascia
e. Arises from the whole of the subcostal surface of the scapula

. The ulnar collateral n

a. Branch of the ulnar n
b. Is a direct branch of the brachial plexus
c. Branch of radial n
d. Is cutaneous
e. Travels in spiral groove

Elbow joint
a. Does not communicate with prox RUJ
b. The trochlea articulates with the trochlear notch of the humerus
c. Capsule is attached to trochlear notch, annular ligament and the radius
d. Nerve supply from all cords of the brachial plexus
e. The radial collateral lig does not join fibres from the annular lig
f. In full flexion, the tip of the olecranon is in line with the humeral epicondyles
g. The ulnar collateral consists of 2 bands

The axilla
a. Has its floor composed of serratus anterior down to 4th rib
b. Communicates with the anterior triangle via its apex
c. Has the clavipectoral fascia as part of the anterior wall
d. Receives lymphatics from the arm only
e. Has teres minor as part of the posterior wall

Regarding finger flexion
a. FDS inserts into base of distal phalanx
b. FDP enters the fibrous sheath superficial to the FDS tendon
c. When palmar & dorsal interossei contract together flexion of the MCPJ results
d. The lumbricals are attached to the extensor expansions and to the prox phalanges
e. In the flexor sheath, the tendons of FDP and FDS are invested by separate synovial sheaths

Median n
a. Supplies pronator teres
b. Supplies EPL
c. Supplies all of FDP
d. Supplies biceps brachii
e. Passes under pronater teres

Regarding carpal bones
a. The capitate is the 2nd largest carpal
b. The lunate is least likely to be dislocated
c. The scaphoid is unlikely to develop avascular necrosis
d. The trapezium has its own synovial joint
e. The head of the hamate makes contact with superficial branch of the ulnar n

Concerning blood supply of the hand
a. The radial artery crosses the anatomical snuff box over the trapezoid
b. The superficial palmar arch is a direct continuation of the radial artery
c. The superficial palmar arch is usually a complete arch
d. The superficial palmar arch supplies the thumb
e. The radial artery gives off the radialis indicis artery and the princeps pollicis artery

The medial cord of the brachial plexus
a. Has no contribution from C7
b. Has the median nerve as its largest branch
c. Lies posterior to the first part of axillary artery
d. Gives the upper subscapular n (C5,6)
e. Is formed by the anterior division of the middle and lower trunk

Regarding tendons across the wrist
a. FCU passes deep to the flexor retinaculum
b. ECRB inserts into the base of the 3rd metacarpal
c. FDP tendons insert into the base of the prox phalanx
d. ECRL passes through carpal tunnel
e. FCR lies superficial to flexor retinaculum

Regarding the cubital fossa
a. It is diamond shaped
b. Contains the ulnar n
c. Radial nerve exits between the 2 heads of supinator
d. Brachial artery is lateral to biceps tendon
e. Brachialis is not a part of the floor

Regarding the stability of the shoulder
a. The weakest aspect is anteriorly
b. The coracoid is not an important contributor
c. Scapular rotation does not contribute significantly to upper limb mobility
d. Posterior dislocation is more common than anterior
e. There is a 4:1 disparity between the glenoid and the humeral head

Movements of the thumb include
a. Radial abduction by APB and EPB
b. Opposition of opponens pollicis
c. Palmar abduction by APL
d. Adduction by FPL
e. Opposition is not important in the power grip

Carpal tunnel syndrome is associated with
a. Impaired sensation over the little and ring fingers
b. Sensory loss over the thenar eminence
c. Weakness of FPL
d. Ulnar n compression in the canal of Guyon
e. Normal flexion of the terminal phalanx of the thumb

With regard to the deep spaces of the hand the following are correct except
a. The thenar space always contains the 1st lumbrical
b. The thenar space is overlaid by the flexor tendons to the II finger
c. Infection in the midpalmar space can involve the ulnar 3 lumbricals
d. The hypothenar space encloses only the hypothenar muscles
e. The thenar space contains the common flexor sheaths

The following muscles are supplied by the median n except
a. FDS
b. FCR
c. FCU
d. FPL
e. Palmaris longus

Regarding the shoulder joint
a. The humeral head is twice the area of the glenoid cavity
b. The short head of biceps is intracapsular
c. It often communicates anteriorly with subscapularis bursa
d. It is reinforced by important glenohumeral ligaments
e. It is only supplied by the axillary n

The upper brachial plexus supplies
a. The medial rotators of the shoulder
b. The adductors of the shoulder
c. The extensors of the elbow
d. The small muscles of the hand
e. Sensation of the lateral side of arm and forearm

Regarding the elbow joint
a. The posterior band of the ulnar collateral lig is the strongest
b. The radial collateral ligament consists of 3 bands
c. Capsule is attached to the radius and ulna
d. The annular ligament has no attachment to the radius
e. It is supplied by the radial and ulnar n only

In regard to the vascular supply of the forearm
a. The post IO a ends in the dorsal carpal anastomosis
b. The radial a crosses the radial n distally
c. The ulnar a supplies the nutrient aa to both radius and ulna
d. The common IO a is a branch of the radial a
e. Both ant and post carpal arches lie at the level of the wrist joint

Regarding the carpal tunnel
a. FPL has its own synovial sheath
b. The flexor retinaculum is attached to the scaphoid, trapezium, hamate and triquetrum
c. the median n lies medial to FDS
d. median n compression causes paraesthesia of the thenar eminence
e. palmaris longus runs lateral to the median n

The radial a
a. Is lateral to the biceps tendon in the cubital fossa
b. Can be palpated in the floor of the anatomical snuff box
c. Disappears beneath the tendons of APL and EPB
d. Is rarely thrombosed during cannulation
e. In the middle one third of its course has the radial n medial to it

regarding the cubital fossa (2 CORRECT)
a. the contents are biceps tendon, brachial a, median n and ulnar n
b. the brachial a divides at the level of the radial neck
c. the roof is formed by the superficial fascia of the forearm
d. the roof is formed by the deep fascia of the forearm reinforced on the lateral side by the bicipital aponeurosis
e. the bicipital aponeurosis lies on the lateral side
f. the floor is formed by the biceps muscle
g. the floor is formed by pronator teres
h. is the triangular area between pronator teres, brachioradialis and a line joining the humeral epicondyles

B+H

In the brachial plexus
a. The roots forming the plexus originate from the posterior rami of C5-T1
b. The roots lie between the scalenus medius and scalenus posterior muscles
c. The trunks lie in the upper part of the posterior triangle
d. The division are formed behind the clavicle
e. The cords are formed after the outer border of the 1st rib

with regard to the median nerve
a. it crosses posterior to the brachial artery to lie medial in the cubital fossa
b. its palmar cutaneous branch arises proximal to the carpal tunnel
c. it divides into lateral and medial branches distal to the carpal tunnel
d. it is the sole nerve supply to the flexors of the forearm

Concerning the wrist joint
a. The distal radius is not part of the joint
b. The joint capsule is thicker posteriorly
c. The triquetral bone forms part of the wrist joint
d. It usually communicates with the distal RUJ
e. It usually communicates with the midcarpal joint

In regard to median n distribution in the hand
a. The muscular branch to the thumb is given off prior to passing below the flexor retinaculum
b. Lateral branch supplies the nail bed of the thumb
c. Medial branch supplies the skin over the thenar eminence
d. The 1st lumbrical is supplied by the ulnar n
e. Digital nerves lie deep to the digital arteries

The axillary artery
a. Becomes the brachial artery at the upper border of teres major
b. Gives rise to the thoracoacromial artery as its largest branch
c. Lies medial to the axillary vein
d. Gives rise to the superior thoracic artery which supplies lattisimus dorsi
e. Is the continuation of the 3rd part of the subclavian artery

In relation to the movements of the thumb
a. APB is inserted into the ulnar side of the base of the prox phalanx
b. Thenar eminence supplied by muscular (remnant) branch of the median n
c. Adduction is by adductor pollicis brevis and longus
d. Opponens pollicis rotates the 1st metatarsal on the triquetral
e. Opponens pollicis inserts to the base of the prox phalanx

Elbow joint capsule attachments include
a. Medial and lateral epicondyles
b. Radial head
c. Common flexor origin
d. Annular ligament
e. All of the above

In the cubital fossa
a. The brachial a is medial to median n
b. The radial nerve gives off a branch to the biceps
c. Brachialis provides the medial boundary
d. The radial nerve splits into its 2 terminal branches
e. Pronator teres provides the floor

Thumb adduction is effected by adductor pollicis and
a. FCR
b. FPB
c. EPL
d. FPL
e. EPB

Regarding the shoulder joint
a. full abduction of the humerus is possible only with medial rotation
b. glenohumeral ligaments provide significant stability to the joint
c. the capsule is attached circumferentially to the surgical neck of the humerus
d. nerve supply comes from the axillary, musculocutaneous and suprascapular nn
e. the subacromial bursa extends laterally when the arm is abducted

Regarding the brachial plexus
a. The divisions lie in the axilla
b. The solitary branch from the trunk is the dorsal scapular n
c. The axillary n supplies the skin of the axilla
d. The radial nerve is the largest branch of the plexus
e. The cords embrace the first part of the axillary a

Regarding the muscles in the hand
a. Palmar abduction of the thumb is produced by APL
b. All lumbricals are supplied by the ulnar n
c. All 4 dorsal interossei arise by 2 heads
d. Lumbrical muscles arise from the superficialis tendons
e. 1st and 2nd interossei are supplied by the median n

Nerve supply to the wrist is from the following except
a. Ant IO n
b. Post IO n
c. Dorsal branch of ulnar
d. Deep branches of the ulnar
e. Median n

The deep muscles of the anterior compartment of the forearm
a. Receive supply from the ant IO branch of median n
b. Are supplied by a branch of the radial a
c. Receive fibres from C7,C8 only
d. All have tendons which run through the flexor tunnel
e. Are involved with supination of the forearm

In the upper limb
a. The cephalic vein pierces the clavipectoral fascia to enter the axillary vein
b. The axillary vein starts at the lower border of teres minor
c. Venous drainage of the hand is predominantly the deep veins of the forearm
d. The basilic vein begins in the roof of the anatomical snuff box
e. The median cubital vein lies deep to the bicipital aponeurosis

Biceps
a. Is supplied by the radial n
b. Is a weak abductor of the shoulder
c. Has a short head attaching to the coracoid process
d. The 2 heads merge above the deltoid tuberosity
e. Inserts into the tuberosity of the ulna

hich of the following nerves is in direct contact with the medial epicondyle of the humerus
a. Ulnar
b. Median
c. Radial
d. Musculocutaneous
e. Medial cutaneous nerve of the forearm

A lesion of the medial cord of the brachial plexus would cause
a. Weakness of adduction of the thumb
b. Weakness of wrist extension
c. Weakness of elbow extension
d. Numbness of the lateral aspect of the forearm
e. Numbness in most of the axilla

Which of the following is least important in the stability of the shoulder
a. Long head of biceps
b. Short head of biceps
c. Deltoid
d. Supraspinatus tendon
e. Subscapularis tendon

With respect to the cubital fossa
a. The brachial artery is lateral to the biceps tendon
b. The radial nerve is the most medial nerve
c. The median basilic vein lies under the bicipital aponeurosis
d. The medial cutaneous nerve of the forearm is lateral to the median cephalic vein
e. Median nerve lies medial to the brachial artery

With respect to the carpus
a. The intercarpal joints share one continuous synovial space
b. The intercarpal synovial space is usually continuous with the wrist joint
c. The proximal row = scaphoid, lunate and trapezium
d. The scaphoid is the only carpal which articulates with radius
e. In pronation-supination the carpus move with the ulna

he scaphoid
a. Articulates with the base of the 2nd metacarpal
b. Articulates with the hamate
c. Has a poor supply to its distal half
d. Has a palpable tubercle
e. Has a groove for FPL

At the flexor aspect of the wrist
a. The median nerve lies between palmaris longus and FDP
b. The median nerve lies between FDP and FCR
c. The ulnar nerve lies between palmaris longus and FCR
d. Radial nerve passes under the tendon of brachioradialis
e. Radial artery crosses the insertion of pronator teres

The extensor retinaculum of the wrist
a. Is not attached to the radius
b. Is attached to the pisiform and the triquetral
c. Divides the extensor tunnel into 5 compartments
d. The most medial compartment transmits EDM
e. The most lateral compartment transmits EPL

The ulnar n
a. Runs anteriorly to the brachial artery
b. Passes between the heads of pronator teres
c. Lies on FDS
d. Is a direct continuation of the lateral cord
e. Lies in contact with the sublime tubercle

hich one of these tendons shares a synovial sheath with another tendon
a. Extensor indicis
b. APL
c. FCR
d. FPL
e. ECRL

The midpalmar space
a. Always contains the 1st lumbrical
b. Is floored by the 2nd and 3rd metacarpal spaces
c. Usually contains the flexor tendons to the II finger
d. Communicates with the ulnar 3 lumbrical canals
e. Is not limited proximally

All the following concerning FDS are true except
a. Arises from the common flexor origin
b. Forms the upper limit of the space of Parona
c. The middle and ring finger tendon are more superficial than the index and middle finger
d. Tendons inserts into the base of the distal phalanx
e. The median nerve is on its deep surface

The long head of the biceps
a. Separates the radial nerve from the humerus
b. Arises from the infraglenoid tubercle
c. Is supplied by the median n
d. A bursa separates its tendon from the radial tuberosity
e. Is intracapsular in the shoulder joint

the extensor expansions of the fingers
a. form the posterior part of the capsule of the MCPJ
b. central slip passes to the terminal phalanx
c. retinacular ligaments are attached near the base of the proximal phalanx
d. the lumbricals attach more proximal than the interossei
e. the extensor expansion is broadest over the middle phalanx

Compression of structures in the carpal tunnel usually results in
a. Weakness of forearm flexors
b. Weakness of flexion of the terminal phalanx of the thumb
c. Weakness of the interossei mm
d. Unaffected sensation on the palmar surface of the little finger
e. Weakness of all the lumbrical muscles

Regarding the innervation of the hand
a. Palmar branch of the medial nerve passes under the flexor retinaculum
b. The ulnar 1 ½ fingers are supplied by the deep branch of the ulna nerve
c. The deep branch of the ulna nerve supplies the interossei mm
d. The common palmar digital nerve lies superficial to the palmar arch
e. Carpal tunnel syndrome results in the loss of flexion of the IPJ of thumb

With regard to the anatomical snuff box
a. The basilic vein originates in it
b. The EPL tendon forms its ulnar border
c. The radial artery makes up part of its roof
d. The APB tendon forms its radial border
e. Scaphoid and triquetrum are palpable in its floor

The annular ligament of the radius
a. Is covered by synovium
b. Is attached to the head of the radius
c. Is attached to the margins of the radial notch
d. Clasps the head, neck and shaft of the radius
e. Is extracapsular to the elbow joint

Rotator cuff muscles include
a. Subclavius
b. Teres minor
c. Pectoralis major
d. Teres major
e. Deltoid

Regarding the synovial flexor sheaths in the hand and wrist, which is false
a. They surround flexor tendons in the carpal tunnel
b. The superficial and deep flexors are invested with a common synovial sheath
c. The common flexor sheaths can communicate with FPL sheath in some people
d. For the II, III and IV fingers a separate synovial sheath lies the fibrous sheath over the phalanges
e. The sheath is the origin of the lumbricals

The axillary nerve
a. Supplies the rotator cuff
b. Is a branch of the medial cord of the brachial plexus
c. Exits the axilla through the quadrangular space
d. Is accompanied by the profunda brachii artery
e. Is derived from C7,C8

The ulna nerve
a. Has C8, T1 fibres only
b. Is sensory to the medial aspect of the forearm and hand
c. Supplies the ulnar part of FDP
d. Traverses the carpal tunnel lateral to the tendon of FCU
e. Accompanies the brachial artery in the cubital fossa

The axillary artery
a. Arrives at the lateral border of scalenus anterior
b. Is divided into 3 parts by its relationship to pectoralis major
c. Becomes the brachial artery at the inferior border of teres minor
d. Has 3 branches from its 3rd part
e. Is clasped by the trunks of the brachial plexus at its 2nd part

The following structures are relevant to the cubital fossa except
a. Brachialis
b. Pronator quadratus
c. Radial artery
d. Median nerve
e. Supinator

FCR tendon
a. Gives a slip of insertion into the scaphoid
b. Contains a sesamoid bone
c. Lies medial to the median nerve at the wrist
d. Lives in the groove of the hamate at the wrist
e. Has fleshy fibres on its radial side until immediately proximal to the carpal tunnel

The radius
a. Articulates with the trochlea of the humerus in a synovial ball and socket joint
b. Has Lister’s tubercle on its posterior aspect
c. Provides insertion of the brachioradialis at the tip of the styloid process
d. Articulates predominantly with the triquetral and the lunate
e. Provides insertion for brachialis muscle a the radial tubercle

In the upper limb
a. The upper trunk of the brachial plexus is prone to injury by forceful depression of the shoulder and results in Erb’s palsy
b. Median nerve compression in the axilla may result in ‘Saturday night palsy’
c. The unla nerve is commonly injured in fractures of the surgical neck of humerus
d. Musculocutaneous nerve is prone to injury in fractures of the lower 1/3 of the humerus
e. The radial nerve is most commonly injured in supracondylar fractures

Rotation of the scapula is primarily produced by
a. Rhomboids
b. Teres major
c. trapezius
d. Latissimus dorsi
e. Levator scapulae

In the hand
a. The tendon of extensor indicis is usually split into 2
b. The skin over the thenar eminence is supplied by the muscular recurrent branch of the median nerve after it supplies the thenar muscles
c. The ulnar nerve supplies palmaris brevis
d. Adductor pollicis lies deep to the other 2 muscles of the thenar eminence
e. The digital arteries lie on the palmar side of the nerve

At the wrist
a. The scaphoid and the trapezoid form the floor of the anatomical snuff box
b. FPL is surrounded by the common synovial sheath
c. The ulna articulates with the triquetral except in extreme radial adduction
d. All carpal bones form part of the wrist joint
e. No active rotation takes place

regarding the elbow joint
a. the radial collateral ligament is triangular and consists of 3 bands
b. the capsule is not attached to the radius
c. the annular ligament is attached to the margins of the radial notch of the ulna and the neck of the radius
d. the carrying angle is 1800
e. the trochlea forms a portion of a sphere

Muscles of the flexor compartment of the forearm include
a. Pronator teres
b. Anconeus
c. Brachioradialis
d. Supinator
e. Adductor Pollicis Longus

Injury to the ulnar nerve will cause paralysis of all of the following except
a. Medial half FDP
b. FDMB
c. APB
d. FCU
e. Adductor pollicis

Which of the following structures passes posterior to the flexor retinaculum at wrist
a. Palmar cutaneous branch of the ulnar n
b. Palmaris longus tendon
c. FPL tendon
d. Ulnar artery
e. Palmar cutaneous branch of median n

All of the following are true of EPL except
a. It inserts at the base of the proximal phalanx of the thumb
b. It forms the ulnar side of the anatomical snuff box
c. Its nerve supply is from the radial nerve
d. Its origin is from the posterior surface of the ulna and adjacent IO membrane
e. Its tendon passes beneath the extensor retinaculum of the wrist

In abduction of the arm
a. The clavicle remains fixed
b. The scapula moves dorsally on the chest wall
c. Scapular movement is at first more rapid than movement of the humerus
d. The medial end of the clavicle moves downward on the intra-articular disc
e. Medial rotation of the humerus occurs

Part of the rotator cuff of the shoulder is supplied by
a. A nerve formed from the root of C5,6,7
b. A branch of the upper trunk of the brachial plexus
c. A branch of the lateral cord of the brachial plexus
d. A nerve which passes through the triangular space
e. A branch of the medial cord of the brachial plexus

The stability of the shoulder is related to all of the following except
a. Glenoid labrum
b. Acromium process
c. Rotator cuff
d. Long head of the biceps
e. Deltoid

The lunate articulates with all of the following except
a. Scaphoid
b. Triquetral
c. Capitate
d. Radius
e. Hamate

Loss of sensation in the thumb and lateral forearm is consistent with an isolated injury to
a. Lateral cutaneous nerve of the forearm
b. Median nerve
c. Lateral cutaneous nerve of the arm
d. C6 root
e. C7 root

The skin of the tip of the index finger is supplied by
a. The radial nerve only
b. The median nerve only
c. The ulnar nerve only
d. The radial and median nerves
e. The radial and ulnar nerves

Following a laceration to the anterior surface of the wrist, a patient is unable to flex the PIPJ of his III finger when the other fingers are held in extension. Which tendon is divided
a. Palmaris longus
b. Flexor indicis
c. FDP
d. FDS
e. None of the above

Paralysis of which nerve results in the inability to initiate abduction of the arm
a. The axillary nerve
b. The suprascapular nerve
c. The subscapular nerve
d. The dorsal scapular nerve
e. The thoracodorsal nerve

The axilla
a. Communicates with the anterior triangle of the neck
b. Contains lymph nodes draining the upper limb and lateral chest wall
c. Has an anterior wall made up by the serratus anterior muscle
d. Has an apex bounded by the humerus, clavicle and scapula
e. Has no medial wall

The brachial artery
a. Crosses anterior to the median nerve in the arm
b. Gives off the nutrient artery to the humerus
c. Lies deep to the biceps
d. Has the ulnar nerve on its medial side
e. Gives muscular branch to the triceps

The elbow joint
a. Is supplied exclusively by the radial n
b. Permits flexion – extension and pronation – supination
c. Has a capsule which attaches in part to the radius
d. Communicates with the superior RUJ
e. None of the above

The main stabilising factor of the sternoclavicular joint
a. The AC ligament
b. The costoclavicular ligament
c. The interclavicular ligament
d. The sternoclavicular ligament
e. The coracoclavicular ligament

With respect to the thenar muscles
a. APB inserts into the base of the distal phalanx of the thumb
b. All arise from the flexor retinaculum
c. FPB is usually supplied by a branch of the ulnar nerve
d. APB has no role in the opposition of the thumb
e. Opponens pollicis is the most superficial muscle of the group

The musculocutaneous nerve
a. Supplies brachioradialis
b. Terminates as the posterior IO n
c. Supplies all of brachialis
d. Fibres from C5,6,7 and 8
e. Arises from the lateral cord of the brachial plexus

In the antecubital fossa
a. The ulnar nerve is on medial side
b. The median nerve is lateral to the brachial artery
c. The radial nerve is on the lateral side
d. All superficial veins are deep to the cutaneous nerve
e. The brachial artery is lateral to the biceps tendon

With respect to the flexor retinaculum
a. It attaches to the scaphoid, hamate, pisiform and trapezium
b. The tendon of palmaris longus passes deep to it
c. The median nerve passes superficial to it
d. The ulnar artery passes deep to it
e. It is pierced by the tendon of FCU

The clavicle
a. Is convex anteriorly throughout its entire length
b. Articulates laterally with the coracoid via the coracoclavicular ligament
c. Is crossed in its middle 1/3 by the subclavian vein
d. Forms part of the apex of the axilla
e. Has as its only inferior musculature attachment the muscle pectoralis major

On the palmar aspect of the wrist
a. The median nerve lies between FCR and palmaris longus
b. The ulnar nerve passes deep to the medial aspect of the flexor retinaculum
c. The flexor tendons lie together in a complete synovial sheath
d. The radial artery may be palpated over the flexor retinaculum
e. FCR may be distinguished by the presence of musculature fibres

In carpal tunnel syndrome which is unaffected by compression of the median n
a. The medial branch of the median nerve
b. Opponens pollicis
c. The lateral branch of the median nerve
d. Palmar branch of the median nerve
e. APB

Regarding the median nerve , all are true except
a. It is formed by the union of 2 roots from the medial and lateral cords
b. In the arm it passes anterior to the brachial artery
c. It passes deep to the flexor retinaculum
d. It does not supply the part of FDP to III finger
e. Typically chronic compression results in wasting of the thenar eminence

Regarding the extensor retinaculum of the wrist
a. It includes attachment to the ulna
b. It overlies 6 fibrous compartments
c. Tension of he retinaculum is reduced with pronation
d. It has the palmaris longus fused with it
e. Is pierced by ECRL

Which of the following is a branch of the posterior cord of the brachial plexus
a. Dorsal scapular n
b. Long thoracic n
c. Musculocutaneous n
d. Ulnar n
e. Thoracodorsal n

In the hand the deep palmar arch
a. Is normally incomplete
b. Is formed by the superficial branch of the ulnar artery
c. Crosses the palm 1cm distal to the superficial arch
d. Gives off 3 metacarpal arteries
e. Does not anastomose with the anterior carpal arch

Regarding the interossei of the hand
a. They insert into the middle phalanges
b. The palmar interossei have 2 heads of origin
c. They are solely innervated by T1
d. There are 3 dorsal muscles
e. The palmar abduct

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Upper limb mixed Flashcards

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