Upper Limb 2

Question 1

What are the 3 important muscles of the anterior arm?

What nerve supplies these muscles?

Answer 1

Biceps bracii
Coracobrachialis
Brachialis

Musculocutaneous nerve

Question 2

What is the origin and insertion of the biceps bracii?

Answer 2

Long head:

• Supraglenoid tubercle of the scapula
• Radial tuberosity

Short head:

• Coracoid process
• Radial tuberosity

Question 3

What 3 joints does the biceps bracii act on?

Answer 3

Shoulder
Elbow
Radio-ulnar joints

Question 4

What two muscles arise from the coracoid process?

Answer 4

Short head of the biceps bracii

Coracobrachialis

Question 5

What groove does the long head of the biceps bracii run in after arising from the supraglenoid tubercle?

Answer 5

Bicipital groove

Question 6

What is the action of the biceps bracii at each of its joints?

Answer 6

Flexes shoulder and elbow joint

Supination of the radio-ulnar joint

Question 7

Which segmental fibres mainly innervate biceps bracii?

Answer 7

C5 and C6

Question 8

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

Answer 8

Lateral cord

Question 9

What is the origin and insertion of the coracobrachialis?

Answer 9

Tip of the coracoid process

Medial margin of the humerus about its middle

Question 10

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

Answer 10

Flexion and adduction

Question 11

What is the nerve supply of the coracobrachialis?

Answer 11

Musculocutaneous nerve

Question 12

What is the origin and insertion of the brachialis?

Answer 12

Arises from the front of the distal half of the shaft of the humerus
Inserted into coronoid process of ulna

Question 13

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

Answer 13

Flexes elbow in all positions

Question 14

What nerve supplies the brachialis muscle?

Answer 14

Musculocutaneous nerve

Question 15

What muscle does the musculocutaneous nerve perforate to enter the arm?

Answer 15

Coracobracialis

Question 16

Between which two muscles does the musculocutaneous nerve descend between?

Answer 16

Biceps bracii

Brachialis

Question 17

After supplying the muscles of the arm what does the musculocutaneous nerve continue as?

Answer 17

Lateral cutaneous nerve of the forearm

Question 18

What is the segmental or root value of the musculocutaneous nerve?

Answer 18

C5-C7

Question 19

Injury to the musculocutaneous nerve from a weapon such as a knife would result in what?

Answer 19

Paralysis of biceps bracii, coracobrachialis and brachialis

Loss of sensation on the lateral aspect of forearm

Question 20

Where does the brachial artery start and end?

Answer 20

Direct continuation of the axillary artery which begins at the lower border of teres major muscle and ends in the cubital fossa close to the neck of the radius dividing into radial and ulnar arteries

Question 21

What is the deep artery of the arm called?

Which artery gives it off as a branch?

Answer 21

Profunda brachii

Main branch given off by the brachial artery in the arm

Question 22

Where is the best place to compress the brachial artery to control haemorrhage?

Answer 22

Middle of the arm/ middle third

Question 23

The median nerve arises in the axilla by two roots from the brachial plexus.

What are these?

Answer 23

One from medial cord and one from the lateral cord of the brachial plexus

Question 24

Describe the route of the median nerve in the arm once it is formed

Answer 24

Descends along the lateral side of axillary artery and upper part of brachial artery.

At the middle part of the arm the nerve crosses to the medial side of brachial artery and enters the cubital fossa.

Gives no branches in the axilla or the upper arm

Question 25

What does the median nerve supply?

Answer 25

Muscles in anterior compartment of forearm (apart from flexor carpi ulnaris and ulnar half of flexor digitorum profundus)

Question 26

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

Answer 26

Medial cord of the brachial plexus

Question 27

What is the route of the ulnar nerve in the arm once it arises?

Answer 27

Descends along the medial side of brachial artery and then it enters the posterior compartment of arm through the medial intermuscular septum runs along the medial head of triceps and to the back of the medial epicondyle

Question 28

What muscles does the ulnar nerve supply?

Answer 28

Flexor carpi ulnaris and ulnar half of flexor digitorum profundus Most intrinsic muscles of hand

Question 29

What are the 3 common sites of humerus where 3 nerves could be damaged due to fracture?

Answer 29

Radial nerve -> radial groove Ulnar nerve -> medial epicondyle Axillary nerve -> surgical neck

Question 30

What is the cubital fossa?

Answer 30

Triangular depression or a hollow in front of the elbow Corresponds to the popliteal fossa at the back of the knee

Question 31

What makes up the borders of the cubital fossa?

Answer 31

Base -> imagery line between two epicondyles Medial border -> pronator teres muscle Lateral border -> brachioradialis muscle

Question 32

List some of the contents of the cubital fossa

Answer 32

``` Bifurcation of the brachial artery Deep accompanying veins Biceps bracii tendon Median nerve Radial nerve dividing into superficial and deep branches ```

Question 33

What is usually the vein of choice for intravenous injections?

Answer 33

Median cubital vein

Question 34

What is the origin and insertion of the triceps?

Answer 34

Long head: - Infragenoid tubercle of the Scapula - Olecranon process of the ulna Lateral and medial heads: - Humerus - Olecranon process of the ulna

Question 35

What is the main action of the triceps on the elbow joint?

Answer 35

Extension

Question 36

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

Answer 36

Assists triceps in extending elbow joint; Stabilises elbow joint; Abducts ulna during pronation

Question 37

What is the action to triceps and anconeus muscle?

Answer 37

Radial nerve

Question 38

What does the radial nerve supply?

Answer 38

Extensor compartment of arm and forearm | Innervates all the extensor muscles of elbow and wrist joint

Question 39

What is the route of the radial nerve once it arises?

Answer 39

Enters the arm anterior to the long head of triceps and runs along with the profunda femoris artery (deep artery of the arm) a main branch of the brachial artery and curves around the midshaft region of the humerus in the radial groove

Question 40

What is the segmental (root value) of the radial nerve?

Answer 40

C5-T1

Question 41

What is the characteristic clinical sign of radial nerve injury?

Answer 41

Wrist drop

Question 42

What type of synovial joint is the elbow joint?

Answer 42

Synovial hinge

Question 43

The fibrous layer of the joint capsule of the elbow joint is thickened on the medial and lateral aspect of the joint to form strong bands called what? Is this the same with the anterior and posterior aspects? Why?

Answer 43

Collateral ligament Capsule is loose both on the anterior and posterior aspect of the joint to allow movement

Question 44

Which ligament holds the head of the radius?

Answer 44

Anular ligament

Question 45

What are the flexors of the elbow joint?

Answer 45

Brachialis Biceps bracii Brachioradialis

Question 46

What are the extensors of the elbow joint?

Answer 46

Triceps bracii | Anconeus

Question 47

Friction subcutaneous olecranon bursitis is also called what? Why?

Answer 47

Students elbow Students sitting at desk all day

Question 48

What type of synovial joint are the radio-ulnar joints?

Answer 48

Pivot type synovial joints

Question 49

What are the muscles involved in supination at the radio-ulnar joints?

Answer 49

Main - Supinator - Biceps bracii Other muscles assisting: - Extensor pollicis longus - Extensor carpi radialis longus

Question 50

What are the muscles involved in pronation at the radio-ulnar joints?

Answer 50

Main - Pronator teres - Pronator quadratus Other muscles assisting: - Flexor carpi radialis - Palmaris longus - Brachioradialis

Question 51

What is the most powerful supinator of the forearm?

Answer 51

Biceps bracii

Question 52

Which muscle is the most powerful pronator of the forearm?

Answer 52

Pronator teres