Upper Limb Ultrasound

Question 1

Label the following structures

Answer 1

Question 2

What are the 3 components that form the contents of the cubital fossa?

Answer 2

1. tendon of biceps brachii
2. median nerve
3. brachial artery

Question 3

Label the contents of the cubital fossa

Answer 3

Question 4

Label the veins and nerves that travel past the cubital fossa

Answer 4

Question 5

Label the following pulse points

Answer 5

Question 6

What are the 3 main veins that are looked for on an upper limb ultrasound?

Answer 6

1. cephalic vein
2. basilic vein
3. median cubital vein

Question 7

Label the veins of the upper limb

Answer 7

Question 8

What are the key characteristics of an artery on an ultrasound?

Answer 8

1. pulsatile
2. thick wall
3. cannot be compressed

Question 9

What are the characteristics of a vein on an ultrasound?

Answer 9

1. easily compressible
2. non-pulsatile
3. thin walled

Question 10

Why do veins and arteries appear as different colours when using Doppler ultrasound?

Answer 10

The different colours represent the direction and speed of blood flow

Question 11

Label the radial artery

Answer 11

Question 12

How can you tell the difference between the radial artery and vein?

Answer 12

The radial artery is non-compressible

The vein can be easily compressed

Question 13

After a stabbing in the axilla, what would be the first priority?

Answer 13

Stopping the bleeding by applying firm pressure to the axilla

This compresses the axillary artery and vein onto the humerus

Question 14

Which veins in the cubital fossa are used to gain intravenous access?

Answer 14

1. cephalic vein
2. basilic vein
3. median cubital vein

Question 15

Which arteries are assessed in the antecubital fossa and the lateral wrist?

Answer 15

Antecubital fossa - brachial artery

Lateral wrist - radial artery

Question 16

If the radial pulse is still palpable after bleeding, what does this suggest about bloodflow in the arm?

Answer 16

The arm is still being perfused, despite the blood loss

Question 17

Upon examination, what brachial plexus injury is suggested by:

• weak grip
• extension and abduction of the thumb intact, but adduction and flexion weak
• adduction and abduction of fingers weak

Answer 17

Ulnar nerve damage:

• The interossei adduct and abduct the fingers and are damaged
• Adductor pollicis adducts the thumb

Median nerve damage:

• FPL and FPB flex the thumb and are damaged

The medial cord is a common point for the ulnar and median nerves so this is where the damage is likely to have occurred