[Review test] Upper limb

Question 1

Answer 1

• 1. C.
• 2. E.
     * four branches of thoracoacromial
     
     • pectoral
     • clavicular
     • acromial
     • deltoid
• 3. D
     * the long thoracic nerve arises from the roots of the BP (C5-C7)

Question 2

A 16 year old patient has weakness flexing the metacarpophalyngeal joint of the ring finger and is unable to adduct the same finger. Which of the ff muscles is most likelly paralyzed?

• A. Flexor digitorum profundus
• B. Extensor digitorum
• C. Lumbrical
• D. Dosral interosseus
• E. Palmar interosseus

Answer 2

E. Palmar interosseus

• Dorsal interosseus : abduct

Question 3

Answer 3

• 5 C
  
  • The pectoralis minor muscle inserts on the coracoid process
  • innervated by the medial and lateral pectoral nerves form medial and lateral cords
• 6 D
  
  • arises from the lateral cutaneous branch of the 2nd intercostal nerve
• 7 A
  
  • Radial nerve injury = wrist drop

Question 4

Answer 4

• 8 D
• 9 C
• 10 E
  
  • Components of the cubital fossa (medial to lateral)
    
    • Median nerve
    • brachial artery
    • biceps brachii tendon
    • radial nerve

Question 5

Answer 5

• 11 D
• 12 C
  
  • Muscles attached to the middle digit
    
    • Extensor digitorum
    • FDP
    • Dorsal interosseus
    • lumbricals

Question 6

Answer 6

• 13 D
• 14 C
• 15 D
  
  • Structures entering the palm superficial to the flexor retinaculum
    
    • ulnar nerve
    • ulnar artery
    • palmaris longus tendom
    • palmar cutaneous branch of the median nerve

Question 7

Answer 7

• 16 C
  
  • other intrincsic muscles of the thumb inserts in the on the proximal phalanges
    
    • APB
    • FPB
    • Adductor pollicis
• 17 C
  
  • The median nerves innervates
    
    • 2 LATERAL lumbricals, oppones pollicis,, Abductor pollicis Brevis
  • Ulnar nerve
    
    • All interossei, ADDuctor pollicis and 2 MEDIAL lumbricals

Question 8

Answer 8

• 18 C
  
  • Ulnar bursa = tendons of both the flexor digitorum superficialis and profundus muscles
  • Radial bursa = tendon of Flexor pollicis longus
• 19 A
  
  • Abductors: Deltoid and supraspinatus muscles

Question 9

Answer 9

• 20 C
• 21 D

Question 10

A 27 year old baseball player is hit in his forearm by a high speed ball during the world series that form the floor of the cubital fossa appear to be torn. WHich of the ff group of muscles Have lost their fucnctions

• A. Brachioradialis and supinator
• B. Brachialis and Supinator
• C. Pronator teres and supinator
• D. Supinator and pornator quadratus
• E. Brachialis and pronator terer

Answer 10

B

• Lateral boundary is the brachioradialis
• Medial boundary is the pronator teres

Question 11

Answer 11

• 23 B
• 24 D
  
  • Supinator and the biceps brachii supinates the arm
• 25 D

Question 12

A Patient with a deep stab wound in the middle of the forearm has impaired movement of the thumb. Examination indicates a lesion of the anterior interosseus nerve. Which of the ff muscles is paralysed?

• A. Flexor pollicis longus and brevis
• B. FPL and OP
• C. FDP and Pronator quadratus
• D, FDP and Superficialis
• E. Flexor pollicis previs and pronator quadratus

Answer 12

C

• supplies the FDL, pronator quadratus and half of the FDP

Question 13

Answer 13

• 27 C
  
  • the FDP flexes the DIP joints of the index and middle fingers and is innervated by the median nerve
• 28 C
  
  • The ulnar nerve innervates the two medial lumbricals
• 29 C
  
  • The carpal tunner consists of
    
    • Median nerve
    • FPL
    • FDP
      FDS

Question 14

A man is unable to hold a typing paper between his index and middle fingers. Which of the followinf nerve was likely injured?

• A. Radial nerve
• B. Median Nerve
• C. Ulnar nerve
• D. Musculocutaneous nerve
• E. Axillary nerve

Answer 14

C

Question 15

Answer 15

• 31 D
• 32 C

Question 16

Answer 16

• 33 D
• 34 A
  
  • The suprascapular and transverse cervical artery are branches of the thyrocervical trunk
  • Thoracoarcomial artery is a short trunk from the 1st or 2nd part of the axillary artery and has branches
    
    • pectoral
    • clavicular
    • acromial
    • deltoid

Question 17

Answer 17

• 35 D
• 36 A
  
  • the musculocutaneous nerve contains sympathtetic postganglionic fibers that supply the sweat glands and blood vessels

Question 18

Answer 18

• 37 E
• 38 D

Question 19

A 7 year old boy fall from the a tree house and is brought to the emergency department of a local hospital, On examiantion, he has weakness in rotating his arm laterally because of an injury of a nerve. Which of the ff conditions is most likely to cause a loss this nerve function?

• A. Injury to the lateral cord of the brachial plexus
• B. fracture of the anatomic neck of the humerus
• C. Knife wound on the teres major muscle
• D. inferior dislocation of the head of the hunerus
• E. Tumoir in the triangular space in the should region

Answer 19

D

Inferior dislocation may damage the axillary arteries which supplies the deltoid and teres minor

It arises from the posterior cord, and runs through the quadrangular space

Question 20

Answer 20

• 40 B
• 41 C
  
  • No preganglionic sympathetic GVE

Question 21

Answer 21

• 42 E
• 43 C
  
  • The subscapularis inserts into the lesser tubercle
  • The supraspinatus, infraspinatus, and teres minor inserts on the greater tubercle

Question 22

A 22 year old female macarena dancer fell from the stage and complains of elbow pain and inability to supinate her forearm. Which of the following nerves are mist likely injured from this accident

• A. Median and Ulnar
• B. Axilalry and Radial
• C. Radial and Musculocutaneous
• D. Ulnar and Axillary
• E Musculocutaneous and median nerves

Answer 22

C

• Supinator is innervated by radial
• Biceps brachii is innervated by the musculocutaneous

Question 23

Answer 23

• 45 E
• 46 D
• 47 B

Question 24

A 21 year old man injures his riht arm in an automobile accident. Xray reveals a fracture of the medial epicondyle

Answer 24

• 48 E
• 49 D
  
  • Ulnar nerve: Adductor pollicic
  • Radial nerve: Abductor pollicis longus and extensor pollicis brevis
  • Median nerve: Abductor pollicis brevis amd opponens pollicis
• 50 E

Question 25

A 10 year old biy falls off his bike has difficulty in moving his shoulder, and is brought to an emergency department. His Xray and angiogram reveal fracture of the surgical neck of his humerus and bleeding from the point of fracture

Answer 25

* 51 B * 52 C

Question 26

A 10 year old biy falls off his bike has difficulty in moving his shoulder, and is brought to an emergency department. His Xray and angiogram reveal fracture of the surgical neck of his humerus and bleeding from the point of fracture

Answer 26

* 53 D * 54 C * 55 B

Question 27

Answer 27

* 56 A * 57 B

Question 28

A 17 year old biy is injured in an automobile accident. He has a fracture of the shaft of the humerus

Answer 28

* 58 B * 59 D * 60 D

Question 29

A 17 year old boy is injured in an automobile accident. He has a fracture of the shaft of the humerus

Answer 29

* 61 C * 62 D

Question 30

Answer 30

* 63 D * The scapular notch transmits the suprascapular nerve below the the superior transverse ligamaent, whereas the suprascapular artery and vein run over the ligament * The suprascapular nerve supplies the supraspinatus and infraspinatus muscles * 64 D * fracture of the surgical neck of the humerus occurs commonly and damages the axillary nerve and the posterior humeral circumflex artery

Question 31

65. Destruction of this area would most likely cause weakness in supination and flexion of the forearm 66. Destruction of this area would most likely cause weakness of pornation of the forearm and flexion of the wrist joints 67. A lesion of the radial nerve would most likely cause paralysis of the muscles that are attached to this area

Answer 31

* 65 B * the **radial tuberosity** is the site for tendinous attachment of the biceps. brachii muscle, which supinates and flexes the forearm. * 66 E * The **medial epicondyle** is the site of origin for the common flexor tendon and pronator teres. * The common flexors includes * flexor carpi radialis and ulnaris * palmaris longus * 67 D * The **olecranon** is the site for insertion of the triceps brachii, which is innervated by the radial nerve.

Question 32

68. Destruction of the structure indicated by the letter E most likely causes weakness of which of the following muscle? A. Flexor carpi radialis B. Palmaris longus C. Flexor carpi ulnaris D. Brachioradialis E. Flexor digitorum superficialis

Answer 32

C The hook of hamate and the pisiform provide insertion for the flexor carpi ulnaris

Question 33

If the floor of the anatomic snuffbox and origin of the abductor pollicis brevis are famaged, which of the Following bones is most likely to be involved?

Answer 33

B The scaphoid forms the floor of the anatomic snuffbox and provides a site for the origin of the abductor pollicis brevis

Question 34

70. The patient is unable to abduct her middle finger because of paralysis of this structure 71. A lesion of the median nerve causes paralysis of this structure 72. The patient is unable to adduct her little finger because of paralysis of this structure 73. Atrophy of this structure impairs extension of both the metacarpophalangeal and interphalangeal joints

Answer 34

* 70 D * this is the **second dorsal interosseus** muscle which abducts the middle finger * 71 A * This is the **flexor pollicis longus**, which is innervated by the median nerve * 72 G * This is the **third palmar interosseous** muscle, which adducts the little finger * 73 E * **Extensor digitorum** extends both the metacarpophalangeal and interphalangeal joints