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Upper limb Flashcards

1
Q

Which structure does cephalic vein pierce

A

Clavipectoral fascia

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1
Q

How many dorsal interrossei are there

A

4
2 heads at base

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2
Q

How many palmar interrossei are there

A

3

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3
Q

Which nerve supplies nailed of index finger

A

Median

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4
Q

Ulnar nerve related to artery at wrist

A

Artery is radial

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5
Q

If axillary artery is ligated which artery would have a reversal of flow

A

Circumflex scapular

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6
Q

Which strcuture is most likely to be damaged with laceration to lateral side of extensor retinaculum

A

Superficial radial nerve

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7
Q

Branches of radial nerve

A

Lateral cutaneous of arm
Posterior cutaneous of arm
Posterior cutaneous of forearm
Superficial sensory to hand
PIN- continuation of deep

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8
Q

Which muscles does the PIN innervate

A

ECU
ED
EDM
APL
EPL
EPB
EI

So only doesn’t innervate ECR brevis and longus, radiobrachialis and aconeus - all innervated by deep radial

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9
Q

Branches of ulnar nerve

A

Muscular- branches in forearm
Palmar cutaneous- medial half of palm
Dorsal- dorsal half and muscles in hand

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10
Q

Branches of median nerve

A

AIN- nerves of forearm
Palmar cutaneous- sensory in hand
Recurrent- thenar muscles
Palmar digital branch – innervates the palmar surface and fingertips of the lateral three and half digits. Also innervates the lateral two lumbrical muscles.

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11
Q

Median nerve in relation to brachial artery throughout upper limb

A

Lateral in arm
Crosses over anterior to medial just before ACF
Medial at ACF

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12
Q

Where can the PIN get trapped and what effect does this cause

A

Arcade of Frohse which is a superficial part of the supinator muscle which overlies the posterior interosseous nerve.
This nerve is entirely muscular

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13
Q

Which muscles does AIN innervate

A

FPL
Flexor pollicis longus
PQ
Lateral FDP

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14
Q

Sensory innervation of arm

A

Lateral arm- radial branch
Posterior arm- radial branch
Medial arm and forearm- medial antecubital
Lateral forearm- lateral antecubital- branch of musco

Hand
Palmar
Median- 3.5
Ulnar- medial 1.5

Dorsal
Radial up until finger tips lateral 3.5
Ulnar medially 1.5

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15
Q

If little finger infected where it the most proximal it can spread to

A

Flexor retinaculum as tendon sheath extends to this

Other finger tendon sheath stop at base of digit

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16
Q

Nerve at risk with humeral surgical neck fracture

A

Axillary nerve

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17
Q

What does the posterior cord of brachial plexus give rise to

A

Radial
Axillary
Upper subscapular- subscapularis
Lower subscapular - teres major
Thoracodorsal

ULNAR

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18
Q

Nerves arising from medial cord of brachial plexus

A

Ulnar
Median
Medial pectoral nerve (C8, T1)
Medial brachial cutaneous nerve (T1)
Medial antebrachial cutaneous nerve (C8, T1)

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19
Q

Nerves arising from lateral cord of brachial plexus

A

Muscocutaneous
Median
Lateral pectoral (C5, C6, C7

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20
Q

What separates cephalic vein and brachial artery in ACF

A

Bicep aponeurosis

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21
Q

Which muscles flexes IP vs MCP joint of thumb

A

FPL- IP

FPB- MCP

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22
Q

What is the Gantzer muscle and its innervation

A

Accessory of FPL
So AIN

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23
Q

What attaches periosteum to bone

A

Sharpey Fibres

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24
Which finger does the palmar interossei not attach to
Middle
25
Venous drainage of upper limb
Basillic medially- joins Brachial to form Axillary Cephalic joins axillary
26
Course of median nerve relative to brachial artery
Lateral, anterior, medial
27
Which upper limb muscle dose not insert onto radius
Brachialis
28
Which muscle is attached to anterior aspect of fibrous capsule
Brachialis
29
Which structure lies closest to hamate in carpal tunnel
Median nerve
30
Laceration, loss of pincer movement of thumb and index finger, no loss of sensation
AIN
31
Which nerve is damaged in a Crutch palsy and what symptoms
Radial Wrist drop Saturday night palsy
32
Surgical Treatment of hyperhidrosis of hands and arms
Divide sympathetic ganglia at T2,3
33
Nerve damaged with surgical neck of humerus fracture
Axillary
34
An MRI scan shows a small cuff of tendon still attached to the radial tuberosity consistent with a recent tear. Which of the following muscles has been injured?
Bicep brachii
35
What separates ulnar artery and median nerve
Pronator teres Ulnar lies deep
36
Where does the shoulder joint insert
The fibrous capsule attaches to the anatomical neck superiorly and the surgical neck inferiorly
37
What are the defects in the fibrous capsule of shoulder
Two defects in the fibrous capsule; superiorly for the tendon of biceps. Anteriorly there is a defect beneath the subscapularis tendon.
38
Where does scaphoid receive majority of its blood
Dorsal carpal branch of radial artery
39
What articulates with radial head
Capitulum Capital Radio
40
What articulates with olecranon
Trochlear
41
Where do the rotator cuffs insert
Greater tuberosity of humerus Apart from subscapularis- lesser Teres major -not RC but inserts into intertubercular sulcus
42
Anatomical relations of shoulder jointW
Anteriorly Brachial plexus Axillary artery and vein Posterior Suprascapular nerve Suprascapular vessels Inferior Axillary nerve Circumflex humeral vessels
43
Which part of shoulder capsule is related to axillary nerve
The inferior extension of the capsule is closely related to the axillary nerve at the surgical neck and this nerve is at risk in anteroinferior dislocations
44
Radial nerve relation to humerus at supracondylar area
Anterolateral
45
Where does Pin leave antecubital fossa
Between 2 heads of supinator
46
Where does cephalic vein form
Anatomical snuff box
47
Which nerve does basilica vein follow in forearm
Medial cutaneous
48
Which nerve does cephalic vein follow in forearm
Lateral cutaneous
49
Where does brachial artery bifurcate
Opposite neck of radius Beneath bicipital aponeurosis
50
Largest branch of brachial artery
Ulnar
51
Branches of radial artery
Recurrent radial- arrises from lateral aspect and anastomoses with radial collateral of brachial profunda
52
Guyon canal borders and content
Medial (ulnar) – pisiform, flexor carpi ulnaris tendon, abductor digiti minimi muscle. Lateral (radial) – hook of hamate. Roof – palmar carpal ligament. Floor – flexor retinaculum, pisohamate ligament, and hypothenar muscles. Contains ulnar nerve and artery
53
Which bone articulates with scaphoid on lateral aspect
Trapezium
54
Anatomical location of the base of the breast
2-6th rib vertically Lateral border of sternum and MAL
55
Course of radial artery
Under BR Emerge on medial aspect Floor of anatomical snuff Piece between 2 heads of 1st interosseous
56
5 superficial upper limb muscles
FCU, PL, PT, FCR FDS- intermediate
57
3 deep muscles of upper limb
FPD, FPL, PQ
58
Pec minor attachments
3-5th rib to coracoid
59
Arterial and nerve supply of rhomboids
Dorsal scapula
60
Border of axilla
Ant- pec major and minor Post- teres major, lat doors, subscapularis Medial- serrates anterior and thoracic wall Lateral- intertubecular sulcus
61
Level of nodes relative to pec minor
1- lateral 2- behind 3- medial
62
Muscles median nerve passes between to enter wrist
FDS and FPL
63
What encloses axillary vessles and brachial plexus
Axillary sheath
64
Brachial artery branches
Profunda brachii (P) Nutrient artery of the humerus (N) Superior ulnar collateral artery (S) Middle ulnar collateral artery (M) Inferior ulnar collateral artery (I)
65
Nerves arrises from brachial plexus roots
Long thoracic Nerve to subclavius Dorsal scapula
66
Nerves arising from trunks of brachial plexus
Suprascpaular
67
Dorsal guttering
Wasting of dorsal interossei
68
How does palmar cutaneous nerve of median enter hand
Superficial to flexor retinaculum
69
Annular ligament Goes around
Encircles head of radius
70
Ligaments of elbow
Radial collateral - lateral epicondyle blends in with annular Ulnar collateral - medial epicondyle to coronoid and olecranon of ulnar Annular
71
Where does ulnar nerve enter forearm
Between 2 heads of FCU in cubital tunnel
72
Borders of cubital tunnel
Medial wall – medial epicondyle of the humerus. Lateral wall – olecranon of the ulna . Floor – elbow joint capsule and medial collateral ligament of the elbow. Roof – cubital tunnel retinaculum or the arcuate ligament of Osbourne
73
Test for AIN
Flex at IPJ of thumb
74
Nerve supply of teres minor
Axillary
75
Involvement of which nerve root might result in Horners
T1
76
Hand of benediction
High median nerve damage Tries to make a fist Unable to flex DIP or PIPJ due to paralysis of both FDS and lateral FDP
77
Patient weak extender of shoulder which nerve affected
Thoracodorsal
78
Borders of cubital fossa
Proximal- line connecting medial and lateral epicondyles Medial- pronator teres lateral- brachioradialis Roof- bicipital aponeurosis Floor- brachial and supinator
79
Brachial artery relative to bicep brachial
Medial Medial to tendon in fossa too Lateral to median
80
Brachial artery, biceps tendon, , median nerve order in fossa
Lateral to medial Biceps Brachial Median
81
Global wasting of hand muscles nerve root damage
T1 or C8 As effects both ulnar and median
82
Where does median cross brachial
In mid arm From lateral to medial
83
Intercostalbrachial nerve root and supply
T2 Sensation of medial arm and axilla
84
Nervous supply of breast
Anterior branches of 1-6th intercostal medially Lateral 2-7th intercostal
85
Breast coverage of pec major and serrates anterior
2/3 of breast covers pec 1/3 covers serrates
86
Where does axillary form and end
The axillary artery commences from the subclavian artery at the outer border of the first rib and terminates when it becomes the brachial artery at the outer border of the teres major muscle.
87
Where does basilica vein pierce deep fascia
Halfway between elbow and axilla
88
Where does rotters node lie
Between pec minor and major
89

eMRCS questions (45 decks)

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