Deck 5: Anatomy and Physiology of Upper Limb and Shoulder

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Question
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
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Question
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
Question
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
Question
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
Question
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
Question
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
Question
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
Question
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
Question
Median n

A)Supplies pronator teres
B)Supplies EPL
C)Supplies all of FDP
D)Supplies biceps brachii
E)Passes under pronater teres
Question
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
Question
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
Question
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
Question
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
Question
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
Question
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
Question
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
Question
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
Question
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
Question
The following muscles are supplied by the median n except

A)FDS
B)FCR
C)FCU
D)FPL
E)Palmaris longus
Question
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
Question
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
Question
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
Question
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
Question
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
Question
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
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Deck 5: Anatomy and Physiology of Upper Limb and Shoulder
1
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
Is the growing end of the humerus
2
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 radial n is on the lateral side
3
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
Has a fibrocartilaginous disc
4
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
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5
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
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6
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
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7
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
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8
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
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9
Median n

A)Supplies pronator teres
B)Supplies EPL
C)Supplies all of FDP
D)Supplies biceps brachii
E)Passes under pronater teres
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10
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
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11
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
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12
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
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13
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
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14
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
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15
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
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16
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
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17
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
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18
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
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19
The following muscles are supplied by the median n except

A)FDS
B)FCR
C)FCU
D)FPL
E)Palmaris longus
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20
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
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21
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
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22
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
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23
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
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24
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
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25
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
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