Lachmans TEST REVIEW (PERSONAL Upper Limb) (Part 1)

Question 1

What are the ligaments anchoring the clavicle medially?

Answer 1

Costoclavicular Ligament

Anterior and Posterior Sternoclavicular Ligaments

Articular Disk (attached to clavicle above and 1st costal cartilage below)

Question 2

What structures anchor the clavicle laterally?

Answer 2

Acromioclavicular (AC) Joint (clavicle to scapula)

Coracoclavicular Ligament (includes conoid and trapezoid ligaments)

AC Ligament helps protect AC joint integrity

Question 3

What is the function of the AC and Coracoclavicular ligaments?

Answer 3

Prevent the acromion from being driven under the clavicle, maintaining AC joint integrity.

Question 4

What does dislocation of the AC joint cause?

Answer 4

Shoulder separation

Question 5

What muscle causes upward tilt of the medial fragment in clavicular fracture?

Answer 5

Sternocleidomastoid (SCM)

Question 6

What causes the lateral fragment of a fractured clavicle to displace downward?

Answer 6

Weight of the arm

Action of the deltoid muscle

Question 7

How do pectoralis major and latissimus dorsi affect a fractured clavicle?

Answer 7

Adduct the arm and decrease the distance between the acromion and midline.

Question 8

Why does the arm medially rotate after clavicular fracture?

Answer 8

Medial rotators (pec major, subscapularis, teres major, lats) are stronger than lateral rotators (infraspinatus, teres minor)

Question 9

What is the role of the subclavius muscle in clavicular fracture?

Answer 9

Connects the clavicle to the 1st rib and protects subclavian vessels and the brachial plexus from bony fragments.

Question 10

Which dermatomes are involved in sensory innervation of the opponens pollicis and abductor pollicis brevis?

Answer 10

C8–T1 via the median nerve

Question 11

What is the function of the opponens pollicis?

Answer 11

Advances the thumb across the palm in an arc and rotates it so that the palmar surfaces of the thumb and little finger touch (thumb opposition)

Question 12

What is the function of the abductor pollicis brevis?

Answer 12

Pulls the thumb away from the palm in a plane at right angles to the palm

Question 13

Where do the brachial plexus and subclavian artery pass through in the neck?

Answer 13

Scalene Triangle

Question 14

What are the boundaries of the scalene triangle?

Answer 14

Anterior: Anterior scalene

Posterior: Middle scalene

Inferior: 1st rib

Question 15

What happens when the size of the scalene triangle decreases?

Answer 15

Compression of the brachial plexus and subclavian artery

Question 16

Where does the subclavian vein pass in relation to the scalene triangle?

Answer 16

Anterior to the anterior scalene (i.e., not inside the scalene triangle)

Question 17

Which structures are the most inferior in the scalene triangle?

Answer 17

The inferior trunk of the brachial plexus and the subclavian artery

Question 18

What does the subclavian artery supply?

Answer 18

Cerebral hemispheres

Anterior thorax (breast and anterior abdominal wall)

Fingers

Vertebral column

Thyroid gland

Question 19

Where does the right subclavian artery arise from?

Answer 19

Brachiocephalic trunk behind the sternoclavicular joint, arches upward and laterally, above the clavicle

Question 20

Where does the left subclavian artery arise from and how is it different?

Answer 20

Arises directly from the arch of the aorta

Ascends through the superior mediastinum into the supraclavicular fossa

It is longer and more commonly affected (>70%)

Question 21

Through what structures does the vertebral artery course?

Answer 21

Transverse foramina of C1–C6

Dura of spinal canal

Foramen magnum, then joins the opposite vertebral artery to form the basilar artery

Question 22

What is the largest branch of the artery?

Answer 22

AICA OR PCS.

Question 23

What are the sources of arterial anastomoses for the vertebral artery?

Answer 23

Contralateral vertebral artery

Ipsilateral occipital artery

Ipsilateral external carotid artery

Thyrocervical and costocervical trunks

Ipsilateral internal thoracic artery

Question 24

Where can the ulnar artery pulse be palpated?

Answer 24

Superficial to the flexor retinaculum, radial to the pisiform

Lies lateral to the tendon of flexor carpi ulnaris (pisiform is a sesamoid bone in this tendon)

Question 25

Where is the radial artery pulse best felt?

Answer 25

Lateral side of the distal forearm, lateral to the tendon of flexor carpi radialis

Question 26

What does the absence of both radial and ulnar pulses suggest?

Answer 26

Occlusion of the brachial artery proximal to its bifurcation

Question 27

Where does the brachial artery begin and what are its major branches around the elbow?

Answer 27

continuation of the axillary artery (after it passes the inferior border of teres major) Gives rise to superior and inferior ulnar collateral arteries

Question 28

With which arteries do the ulnar collaterals anastomose?

Answer 28

Superior & inferior ulnar collateral arteries anastomose with the anterior & posterior ulnar recurrent arteries (from ulnar a.)

Question 29

What artery accompanies the radial nerve and branches off the brachial artery?

Answer 29

Profunda brachii (deep brachial) artery

Question 30

What are the branches of the profunda brachii and their anastomoses?

Answer 30

Radial collateral artery → anastomoses with radial recurrent artery (from radial a.) Middle collateral artery → anastomoses with interosseous recurrent artery (from ulnar a.)

Question 31

From where is the median nerve derived?

Answer 31

Lateral and medial cords of the brachial plexus

Question 32

Which forearm muscles are not innervated by the median nerve?

Answer 32

Flexor carpi ulnaris Medial half of flexor digitorum profundus (ulnar half)