Upper limb 1

Question 1

What is the axilla?

Answer 1

pyramidal space below the shoulder joint

Question 2

Function of axilla

Answer 2

passageway for vessels and nerves going to and from the upper limb

Question 3

Anterior wall of axilla

Answer 3

pec major and pec minor (+subclavius)

Question 4

Posterior wall of axilla

Answer 4

teres major + subscapularis

Question 5

Medial wall of axilla

Answer 5

serratus anterior and thoracic wall

Question 6

Lateral wall of axilla

Answer 6

intertubercular groove of humerus

Question 7

The axillary artery is the continuation of which artery?

Answer 7

subclavian

Question 8

at what anatomical point does the axillary artery start?

Answer 8

lateral border of 1st rib

Question 9

Axillary artery continues beyond the axilla as which vessel?

Answer 9

brachial

Question 10

At what anatomical point does the axillary artery become the brachial artery?

Answer 10

distal to inferior border of teres major

Question 11

When may compression of axillary artery be necessary?

Answer 11

profuse bleeding due to severe injury of upper limb

Question 12

What forms the brachial plexus?

Answer 12

ventral rami of C5-T1

Question 13

major branches of brachial plexus

Answer 13

radial, ulnar, musculocutaneous, median, axillary

Question 14

Which nerves roots form upper trunk?

Answer 14

C5+6

Question 15

Erb’s point and clinical relevance

Answer 15

union of C5+C6

injury at birth or fall on shoulders (hyperextension) - paralyse arm muscles –> waiter’s tip

Question 16

Waiters tip position

Answer 16

erb’s palsy

medially rotated with wrist flexed

Question 17

Which group of muscles affected in erb’s palsy?

Answer 17

BBC muscles - musculocutaneous nerve

brachioradialis and deltoid - axillary nerve

Question 18

Roots of lower trunk of brachial plexus

Answer 18

C8+T1

Question 19

Klumpke’s palsy

Answer 19

intrinsic muscles of hand and ulnar flexors of wrist and fingers - claw hand
lower trunk affected

Question 20

Cause of klumpke’s palsy

Answer 20

undue abduction of arm

Question 21

How are the cords of the brachial plexus named?

Answer 21

relation to axillary artery

Question 22

Brachial plexus nerves and their cords

Answer 22

musculocutaneous - lateral cord
axillary, radial - posterior cord
median - lateral and medial cord
ulnar - medial cord

Question 23

Where do the cephalic and basilic veins arise?

Answer 23

cephalic - lateral end of dorsal venous arch

basilic - medial end of dorsal venous arch

Question 24

What is the median cubital vein?

Answer 24

large communicating vein shunting blood from cephalic to basilic vein

Question 25

Dermatome

Answer 25

area of skin supplied by one spinal segment

Question 26

Where do all upper limb lymphatic vessels drain?

Answer 26

axillary LN

Question 27

5 distinct axillary LN groups

Answer 27

``` pectoral subscapular apical central lateral ```

Question 28

Why can infected umbilicus spread to axillary and superficial inguinal LN?

Answer 28

cephalic to umbilicus - axillary caudal to umbilicus - inguinal watershed region

Question 29

Pectoral girdle

Answer 29

connects upper limb to axial skeleton

Question 30

Upper limb and pectoral girdle articulating point

Answer 30

acromioclavicular joint

Question 31

Clavicle break

Answer 31

middle and lateral 1/3 junction

Question 32

AC joint

Answer 32

synovial plane

Question 33

Sternoclavicular joint

Answer 33

synovial saddle

Question 34

Movement of shoulder joint involves what?

Answer 34

AC, SC and shoulder joint

Question 35

scapula-humeral rhythm

Answer 35

beyond 30 degrees for every 3 degrees of abduction 2 occurs at shoulder and 1 at scapula-thoracic 2:1

Question 36

Elevation of scapula

Answer 36

levetor scapulae trapezius rhomboids serratus anterior

Question 37

Depression of scapula

Answer 37

lower trapezius and serratus anterior

Question 38

protraction of scapula

Answer 38

serratus anterior | pec major and minor

Question 39

Retraction of scapula

Answer 39

middle fibres of trapezius and rhomboids

Question 40

Lateral rotation of scapula

Answer 40

superior and inferior trapezius | inferior serratus anterior

Question 41

medial rotation of scapula

Answer 41

rhomboids, pec major, gravity, levator scapulae

Question 42

Shoulder - joint type and what each part is

Answer 42

synovial ball and socket | ball is humeral head and socket is glenoid cavity

Question 43

Rim of cartilage around glenoid cavity

Answer 43

glenoid labrum

Question 44

Glenoid labrum function

Answer 44

insertion for structures | deepens socket and increases SA

Question 45

Glenohumeral ligament strengthens...

Answer 45

anterior aspect of joint

Question 46

Coracohumeral ligament strengthens...

Answer 46

superior aspect of joint capsule

Question 47

Coraco-acromial arch parts

Answer 47

acromion coracoid process coracoacromial ligament

Question 48

function of coraco-acromial arch

Answer 48

prevents displacement of humeral head

Question 49

What part of shoulder joint is weakest and why?

Answer 49

inferior part | not protected by any muscles or ligaments

Question 50

Which shoulder bursa communicates with joint cavity?

Answer 50

subscapular

Question 51

subacromial bursa function

Answer 51

facilitate movement of supraspinous tendon and deltoid over joint capsule

Question 52

subacromial bursa injury

Answer 52

dislocation of glenohumeral joint

Question 53

4 rotator cuff muscles

Answer 53

teres minor subscapularis supraspinatous infraspinatous

Question 54

Glenohumeral joint movements - rotator cuff

Answer 54

abduction, external and internal rotation

Question 55

Rotator cuff main function

Answer 55

stability

Question 56

Deltoid attachments

Answer 56

lateral spine of scapula across acromion lateral third of clavicle

Question 57

Anterior fibres of deltoid

Answer 57

flex and medially rotates

Question 58

Middle fibres of deltoid

Answer 58

abduction

Question 59

Posterior fibres of deltoid

Answer 59

extend and laterally rotate

Question 60

Nerve supply to deltoid

Answer 60

Axillary - C5/6

Question 61

Common injury trapping axillary nerve

Answer 61

surgical neck of humerus fracture

Question 62

Loss of sensation - axillary nerve

Answer 62

regimental badge area - lateral arm

Question 63

Origin of pec major fibres

Answer 63

medial third of clavicle, sternum and rubs

Question 64

Pec major - shoulder

Answer 64

flex, adduct and internally rotate humerus

Question 65

Deltopectoral triangle

Answer 65

space below clavicle - between deltoid and pec major | subclavian vein

Question 66

nerve supply of serratus anterior

Answer 66

long thoracic nerve - C5-7

Question 67

Injury to long thoracic nerve and when this could happen

Answer 67

winged scapula | surgery for breast cancer

Question 68

Superior fibres of trapezius - scapula

Answer 68

elevates

Question 69

Medial fibres of trapezius - scapula

Answer 69

retracts

Question 70

Inferior fibres of trapezius - scapula

Answer 70

depress

Question 71

Trapezius innervation

Answer 71

CN 11 - spinal accessory nerve

Question 72

Teres major on shoulder joint

Answer 72

adduct and medially rotate

Question 73

Lattisimus dorsi on shoulder

Answer 73

extends, adducts and medially rotate

Question 74

Lateral or external rotation of shoulder

Answer 74

teres minor and infraspinatus