Upper Extremity

Question 1

Connects the appendicular and axial skeletons

Answer 1

Pectoral girdle

Question 2

What are the three joints of the shoulder?

Answer 2

Scapulothoracic joint
Acrominoclavicular joint
Glenohumeral joint

Question 3

Bone that transmits forces from the upper limb to the axial skeleton

Answer 3

Clavicle

Question 4

What are the two functions of the curvature of the clavicle?

Answer 4

1. Bony protection for brachial plexus
2. Curvature that increases the resilience of the clavicle allowing it to transmit shock from the upper limbs to the axial skeleton

Question 5

First long bone to ossify

Answer 5

Clavicle

Question 6

What nerve may be injured if someone fractures the distal ends of the humerus?

Answer 6

median nerve

Question 7

Where do wrist flexors attach?

Answer 7

Medial epicondyle of humerus

Question 8

Where do wrist extensors attach?

Answer 8

Lateral epicondyle of humerus

Question 9

Where does the ulna articulate with the carpal bones?

Answer 9

It doesn’t

Question 10

How many metacarpal bones are in one hand?

Answer 10

5

Question 11

How many phalanges are in one hand?

Answer 11

3 for each finger, 2 for the thumb. so 14 altogether

Question 12

Where are sesamoid bones often found in the hand?

Answer 12

Palmar side of metacarpal heads and also common on the thumb

Question 13

Muscles of the shoulder joint capsule (rotator cuff)

Answer 13

Subscapularis anteriorly
Supraspinatous superiorly
Infraspinatous and teres minor posteriorly

Question 14

What is the most frequently injured SITS muscle?

Answer 14

Supraspinatous. Due to how acromion impinges on it with overhead arm movement

Question 15

Which glenohumeral ligament is most important for anterior stability?

Answer 15

Inferior

Question 16

What structure bridges the gap between the greater and lesser tuberosities of the humerus? What runs through it?

Answer 16

Transverse Humeral Ligament.

Tendon of the long head of the biceps runs under it and is kept in place by it.

Question 17

What is the nerve supply of the shoulder?

Answer 17

Axillary and suprascapular nerves

Question 18

Muscles that produce shoulder flexion

Answer 18

Deltoid, pectoralis major, biceps, and coracobrachialis

“Cowboys bring pretty misses drinks”

Question 19

Muscles that produce shoulder extension

Answer 19

Deltoid, latissimus dorsi, and teres major

“Don’t let dogs trot merrily”

Question 20

Muscles that produce shoulder abduction

Answer 20

Deltoid, supraspinatus

“san diego will blow you away”

Question 21

Muscles that produce adduction in shoulder

Answer 21

Pec major, latissimus dorsi, teres minor and teres major
“terry may never leave PA”
Teres minor and major, lats, pec major

Question 22

Muscles of the shoulder that perform external rotation

Answer 22

Infraspinatous, teres minor, deltoid

Hitchhiking “Is Dumb for Minors”

Question 23

Internal rotation shoulder muscles

Answer 23

Subscapularis, latissimus doris, teres major, deltoid

Thumbs down “Ladies don’t take major shits”

Question 24

How do you test supraspinatous on PE?

Answer 24

Palpate above scapular spine as patient abducts against resistance

Question 25

Where is the subacromial bursa located?

Answer 25

Between acrominon process and rotator cuff tendon. Extends distally between deltoid muscle and humerus.

Question 26

What are the stabilizing features of the elbow?

Answer 26

Bony fit, capsule, collateral ligaments, and muscles attaching across the joint

Question 27

How is the elbow innervated?

Answer 27

Median nerve and ulnar nerve.

Question 28

What stabilizes the radio-ulnar joint?

Answer 28

Annular ligament

Question 29

The distal radius and ulna are firmly attached by the ______ of the distal radioulnar joint.

Answer 29

Articular disc "Triangular ligament"

Question 30

What is the pivot point for rotary movement of the radio-ulnar joint?

Answer 30

Ulnar styloid process attachment to radius

Question 31

In full supination, the bones are ________.

Answer 31

Parallel

Question 32

Which ligaments in the wrist joint strengthen the wrist?

Answer 32

Anterior and posterior ligaments

Question 33

What does the medial ligament of the wrist do?

Answer 33

Connects styloid process of ulna to the triquetrum

Question 34

What does the lateral ligament do?

Answer 34

Connects styloid process of raidus to the scaphoid

Question 35

What is the nerve supply of the wrist?

Answer 35

Anterior interosseous nerve (from median nerve) and deep branches of radial and ulnar nerves

Question 36

How is motion created in the radiocarpal joint?

Answer 36

No tendons or muscles are used: motion is determined purely by shape of the bones and ligaments.

Question 37

What type of joint is a carpometacarpal joint?

Answer 37

Synovial gliding joint. Little motion

Question 38

What ligaments prevent hyperextension in the metacarpophalangeal joints?

Answer 38

Palmar ligaments

Question 39

When the MCP joint is in flexion, the collateral ligaments are _____ (taut, lax)

Answer 39

taut

Question 40

What type of joint is an interphalangeal joint? (IP)

Answer 40

Synovial hinge joint | one in thumb, two in other digits

Question 41

In surgery, what area is important to get to the shoulder joint?

Answer 41

Deltopectoral groove

Question 42

What muscles cause flexion of the elbow?

Answer 42

Anterior compartment. Biceps brachii, brachialis, brachioradialis "Bring back big booty readheads'

Question 43

What muscles cause extension of the elbow?

Answer 43

Posterior compartment | Triceps brachii muscle

Question 44

What is the main innervation to the biceps?

Answer 44

Musculocutaneous nerve

Question 45

What is the main innervation to the flexors of the forearm?

Answer 45

median nerve

Question 46

What muscles cause pronation at the radioulnar joint?

Answer 46

Pronator teres, pronator quatratus Anterior compartment "pronate to pants quickly"

Question 47

What muscles cause supination at the radioulnar joint?

Answer 47

Biceps brachii, supinator | Don't question my "super biceps"

Question 48

What are the superficial muscles of the anterior forearm?

Answer 48

Brachioradialis, flexor carpi radialis, palmaris longus, flxor carpi ulnaris.

Question 49

Excessive use of extensors can cause what?

Answer 49

Tennis elbow (lateral epicondylitiis)

Question 50

Excessive use of flexors can cause what?

Answer 50

Golfer's elbow (medial epicondylitis)

Question 51

Where does the flexor digitorum superficialis attach?

Answer 51

base of middle phalanx

Question 52

Where does the flexor digitorum profundus attach?

Answer 52

Base of distal phalanx

Question 53

What is the name given to the mass of muscles at the base of the thumb that help it perform various movements?

Answer 53

thenar compartment

Question 54

What is the most common bone fractured in the wrist?

Answer 54

Scaphoid

Question 55

What muscles act on the MP joints, aiding in flexion, extension, ad/abduction of the digits?

Answer 55

Interosseus and lumbrical muscles of the central compartment (intrinsic)

Question 56

What is the name given to the mass of muscles at the base of the 5th digit that helps it perform various movements? What nerve damage can cause atrophy to this area?

Answer 56

Hypothenar compartment | Ulnar nerve damage

Question 57

Where do the roots of the brachial plexus enter?

Answer 57

Base of the neck between the scalenes (anterior and medius)

Question 58

Where are the roots of the brachial plexus located?

Answer 58

Scalene triangle of the neck

Question 59

What nerve innvervates hte serratus anterior muscle?

Answer 59

Long thoracic nerve

Question 60

The posterior cord of the brachial plexus gives you which nerves?

Answer 60

Radial and axillary

Question 61

The lateral cord of the brachial plexus gives you which nerves?

Answer 61

musculocutaneous, contributes nerve fibers to median nerve

Question 62

The medial cord of the brachial plexus gives you which nerves?

Answer 62

ulnar, medial antebrachial cutaneous nerve, contributes fibers to the median nerve

Question 63

The cords of the brachial plexus become arranged around what?

Answer 63

The axillary artery

Question 64

What nerve innervates the web space on dorsum between the thumb and the forefinger?

Answer 64

Radial

Question 65

What nerve innervates the tip of the forefinger?

Answer 65

median

Question 66

What nerve innervates the tip of the pinky?

Answer 66

ulnar

Question 67

Which nerve divides into a superficial branch and a deep branch at the elbow? When the deep branch passes through the supinator muscle, what is its new name?

Answer 67

Radial nerve | Posterior interosseous nerve

Question 68

Which nerve enters the deep surface of the deltoid?

Answer 68

Axillary

Question 69

Which nerve branches in anterior compartment into each muscle and then changes its name to lateral cutaneous nerve of the forearm?

Answer 69

Musculocutaneous nerve

Question 70

Which nerve starts at the front of the shoulder joint and then enters the hand superficially to the carpal tunnel, between pisiform and hamate bones, deep to Guyon's canal and enters the hydrothenar compartment?

Answer 70

Ulnar nerve

Question 71

Digital nerves include branches from what?

Answer 71

Median, radial, and ulnar nerves

Question 72

What condition is characterized by partial occlusion of the subclavian artery so with decreased vascular resistance in the arm (vasodilation from exercise), blood is directed into the arm and away from the brain causing syncope?

Answer 72

Subclavian steal syndrome

Question 73

Radial and ulnar collateral arteries branch from which artery?

Answer 73

Brachial artery

Question 74

How are superficial veins drained in the arm?

Answer 74

Dorsal venous plexus (digital veins) Cephalic vein (joins axillary vein) Basilic vein (joints brachial plexus) Median cubital vein (connects cephalic and basilic veins in cubital fossa)

Question 75

How are deep veins drained in the arm?

Answer 75

They follow arteries. "Comcomittant veins" Brachial vein is actually several veins that wind around brachial artery. Joined by basilic vein and enters axilla to become axillary vein, then joins cephalic vein at first rib and is subclavian vein.

Question 76

Superficial lymph vessels follow the course of _______. Deep lymph vessels follow the course of ________.

Answer 76

Superficial veins | Arteries

Question 77

Where do lymph nodes and vessels along the axillary and subclavian veins converge?

Answer 77

Base of the neck

Question 78

Lymph vessels from the right upper limb drain where? Lymph vessels from the left upper limb drain where?

Answer 78

Right: veins on right side of neck Left: thoracic duct

Question 79

Specialized, thickened bands of deep investing fascia that guide and restrain tendons crossing the wrist

Answer 79

Retinacula

Question 80

Tubular bursa that envelops a tendon, wherever a tendon is subject to friction. Subject to inflammation and swelling.

Answer 80

Tendon sheath

Question 81

When you jam a finger, you get a hyper______ of a PIP joint.

Answer 81

flexion

Question 82

Area between proximal palmar crease and insertion oft he flexor superficialis at the midpportion of the middle phalanx. Where both flexor tendons of the fingers run through a tight fibrous tunnel

Answer 82

No man's land

Question 83

Hyperflexion of the PIP joint and hyperextension of the DIP. Rupture of central slip. More common in rheumatoid arthritis

Answer 83

Boutinnere deformity

Question 84

Evulsion of the distal extensor tendon off the distal phalanx

Answer 84

Mallet finger