Tutorial 2: Upper Limb, Dry Lab

Question 1

Look at diagram of humerus (pg 29)

Answer 1

…

Question 2

What are the muscle compartments of the arm?

Answer 2

Anterior (flexor), posterior (extensor)

Question 3

What are the muscles of the anterior compartment of the arm?

Answer 3

Biceps brachii
Coracobrachialis
Brachialis

Question 4

What do the two heads of the biceps brachii arising from the scapula meet and what do they from?

Answer 4

Distal 3rd of the upper arm

Form a short tendon which inserts into the tuberosity of the radius

Question 5

What joints does the biceps brachii act on?

Answer 5

Shoulder
Elbow
Radio-ulnar joints

Question 6

What are the 2 heads of the biceps brachii?

Answer 6

Long head

Short head

Question 7

Where does the short head of the biceps arise from?

Answer 7

The coracoid process of the scapula

Question 8

Where does the long head of the biceps arise from and where does it later run?

Answer 8

The supraglenoid tubercle

Runs in the bicipital groove

Question 9

What bone is the supraglenoid tubercle found on?

Answer 9

Scapula

Question 10

Which bony process on the radius is the tendon of the biceps attached to distally?

Answer 10

Radial tuberosity

Question 11

What is the action of the biceps on the shoulder joint?

Answer 11

Flexion

Question 12

What is the action of the biceps on the elbow joint?

Answer 12

Flexion

Question 13

What is the action of the biceps on the radio-ulnar joint?

Answer 13

Supination

Question 14

What is the nerve supply to the biceps muscle?

Answer 14

Musculocutaneous muscle

Question 15

Which segmental fibres mainly innervate the biceps muscle?

Answer 15

C6 (+C5)

Question 16

From which cords of the brachial plexus is the musculocutaneous nerve a branch of?

Answer 16

Lateral cord (C5, C6, C7 spinal roots)

Question 17

What is the action of the coracobrachialis muscle on the shoulder joint?

Answer 17

Flexion

Question 18

What is the nerve supply to the coracobrachialis muscle?

Answer 18

Musculocutaneous nerve

Question 19

What are the insertions for the coracobrachialis muscle?

Answer 19

Proximal - coracoid process

Distal - medial margin of the humerus at about it’s middle

Question 20

What are the insertions for the brachialis muscle?

Answer 20

Proximal - anteriorly from the distal half of the humerus

Distal - coronoid process of the ulna

Question 21

What is the action of the brachialis muscle on the elbow joint?

Answer 21

Flexion

Question 22

What nerve supplies the brachialis muscle?

Answer 22

Musculocutaneous nerve

Question 23

What path does the musculocutaneous nerve follow?

Answer 23

It arises from the lateral cord of the brachial plexus
Enters the arm by perforating the coracobrachialis muscle and descends between the biceps and brachialis. After supplying the muscles of the arm it continues as the lateral cutaneous nerve of the forearm

Question 24

What muscle compartment is supplied by the musculocutaneous nerve?

Answer 24

Anterior compartment of the arm

Question 25

What are the segmental root values of the musculocutaneous nerve?

Answer 25

C5, C6, C7

Question 26

What does the musculocutaneous nerve become in the forearm?

Answer 26

Lateral cutaneous nerve - supplies the lateral aspect of the forearm

Question 27

Does the musculocutaneous nerve supply any of the muscles in the forearm or hand?

Answer 27

No

Question 28

How could the musculocutaeous nerve be damaged?

Answer 28

Stab to the axilla

Question 29

What would be the effect of the musculocutaneous nerve being severed?

Answer 29

Paralysis of the biceps, coracobrachialis and brachialis muscles Loss of sensation on the lateral aspect of the forearm

Question 30

What does the axillary artery become?

Answer 30

The brachial artery

Question 31

Where does the brachial run to and from where?

Answer 31

The brachial artery runs from the lower border of the teres major to the cubital fossa

Question 32

What does the brachial artery divide into?

Answer 32

The radial and ulnar arteries

Question 33

What is the profunda brachii?

Answer 33

The deep artery of the arm | A branch of the brachial artery

Question 34

What is the progression of the arteries from the aorta to the forearm?

Answer 34

``` (Brachiocephalic trunk (L)) Subclavian artery Axillary artery Brachial artery Radial and Ulnar arteries ```

Question 35

Which cords of the brachial plexus does the medial nerve in the arm arise from?

Answer 35

Arises from 2 roots: one from the medial cord and one from the lateral cord

Question 36

What pathway does the median nerve follow?

Answer 36

It descends along the lateral side of the axillary artery and the upper part of the brachial artery. At the middle part of the arm the nerve crosses to the medial side of the brachial artery and enters the cubital fossa. It gives no branches in either the axilla or in the upper arm

Question 37

What cords of the brachial plexus does the ulnar nerve arise from?

Answer 37

Medial cord

Question 38

What path does the ulnar nerve follow?

Answer 38

It descends along the medial side of the brachial artery and enters the posterior compartment of the arm through the medial inter muscular septum and runs along the medial head of the triceps and to the back of the medial epichondyle

Question 39

Do the median or ulnar nerves supply any muscles in the arm?

Answer 39

No

Question 40

What nerve is most likely to be affected by a fracture to the surgical neck of the humerus?

Answer 40

Axillary nerve

Question 41

What nerve is most likely to be affected by a fracture to the radial groove of the humerus?

Answer 41

Radial nerve

Question 42

What nerve is most likely to be affected by a fracture to the medial epichondyle of the humerus?

Answer 42

ulnar nerve

Question 43

What is the cubital fossa?

Answer 43

The triangular depression in the front of the elbow

Question 44

What pulse can be felt medially to the tendon of the biceps in the cubital fossa?

Answer 44

Brachial pulse

Question 45

What are the borders of the cubital fossa?

Answer 45

Base - imaginary line between the 2 epichodyles Medial border - pronator teres muscle Lateral border - brachioradialis muscle

Question 46

What are the contents of the cubital fossa?

Answer 46

Radial nerve Biceps tendon Brachial artery Median nerve

Question 47

What muscle occupies the posterior compartment of the arm?

Answer 47

Triceps brachii

Question 48

What are the connections for the triceps brachii?

Answer 48

Long head - scapula | 2 shorter heads - lateral and medial from the humerus

Question 49

Where is the common tendon of the triceps inserted?

Answer 49

Olecranon process of the ulna

Question 50

What bone are the olecranon and coronoid processed located on?

Answer 50

Ulna

Question 51

Which head of the triceps has it's proximal attachment from the infraglenoid tubercle of the scapula?

Answer 51

Long head

Question 52

What is the main function of the triceps on the elbow?

Answer 52

Extension

Question 53

What is the action of the anconeus muscle?

Answer 53

Extension of the elbow

Question 54

What nerve supplies the triceps and anconeus muscles?

Answer 54

Radial nerve

Question 55

What cord of the brachial plexus is the radial nerve a part of?

Answer 55

Posterior cord

Question 56

What does the radial nerve provide motor innervation for?

Answer 56

Extensor muscles of the wrist and elbow

Question 57

What path does the radial nerve follow?

Answer 57

Enters the arm anterior to the long head of the triceps and runs along with the profunda femoris artery and curves around the mid shaft region of the humerus in the RADIAL GROOVE

Question 58

What are the segmental root values of the radial nerve?

Answer 58

C5-T1

Question 59

What is a characteristic clinical sign of radial nerve injury?

Answer 59

Wrist drop

Question 60

What type of joint is the elbow?

Answer 60

Synovial hinge joint

Question 61

What movements occur at the elbow?

Answer 61

Flexion, Extension

Question 62

What ligaments are there in the elbow?

Answer 62

Ulnar collateral ligament Radial collateral ligament Anular ligament

Question 63

What muscles flex the elbow joint?

Answer 63

Brachialis, coracobrachialis, biceps brachii

Question 64

What muscles extend the elbow joint?

Answer 64

Triceps brachii, anconeus

Question 65

What type of joints are the proximal and distal radio-ulnar joints?

Answer 65

Pivot-type synovial joints

Question 66

What muscles are involved in the supination of the radio-ulnar joint?

Answer 66

Supinator | Biceps brachii

Question 67

What muscles are involved in the pronation of the radio-ulnar joint?

Answer 67

Pronator quadratus | Pronator teres