Upper Limb

Question 1

Position of the breast

Answer 1

Midclavicular line, ribs 2-6

Nipple in 4th intercostal

Question 2

Blood supply of the breast

Answer 2

Internal thoracic - 1st part of subclavian
Lateral thoracic - 2nd part of the axillary
Thoraco-acromial - 2nd part of the axillary
Intercostal - internal thoracic.

Question 3

Origin of latissimus dorsi

Answer 3

Spines and supraspinous ligament T7 down to the sacrum, lumbar fascia, posterior third of iliac crest, last 4 ribs and inferior angle of scapula

Question 4

Insertion of latissimus dorsi

Answer 4

Floor of Bicipital groove

Question 5

Action of latissimus dorsi

Answer 5

Adducts, extends and medially rotates shoulder. Aids in inspiration and expiration

Question 6

Lat dorsi n.

Answer 6

Thoracodorsal nerve

Posterior cord

Question 7

Pec major o.

Answer 7

Medial half of clavicle, anterior and lateral manubrium, body of sternum, aponeurosis of ext. oblique, upper 7 costal cartilages

Question 8

Pec major i.

Answer 8

Anterior lamina and lateral lip of bicipital groove, manurial fibres to intermediate lamina, posterior lamina

Question 9

Pec major action.

Answer 9

Flexion, adduction, internal rotation

Question 10

Pec major n.

Answer 10

Lateral and medial pectoral nerves - supplied by all 5 segments of the brachial plexus.

Question 11

Deltoid o.

Answer 11

lateral third of the clavicle, acromion, spine of scapula as far as deltoid tubercle of scapula

Question 12

Deltoid i.

Answer 12

Deltoid tubercle of humerus

Question 13

Deltoid action

Answer 13

Abducts arm, anterior fibres flex and medially rotate. posterior fibres extend and laterally rotate.

Question 14

Deltoid nerve supply

Answer 14

Axillary (C5,6 - posterior cord)

Question 15

Teres major o.

Answer 15

Oval area on lower third lateral side of inferior angle of the scapula

Question 16

Teres major i.

Answer 16

Medial lip of bicipital groove

Question 17

Teres major a.

Answer 17

Medial rotation, adduction, stabilisation of shoulder

Question 18

Teres major nerve

Answer 18

Lower subscapular - posterior cord (C5,C6)

Question 19

Teres minor o.

Answer 19

Middle third lateral border of scapula

Question 20

Teres minor i.

Answer 20

Inferior facet of greater tuberosity and joint capsule

Question 21

Teres minor a.

Answer 21

Lateral rotation and stabilisation of shoulder

Question 22

Teres minor nerve

Answer 22

Axillary nerve (C5, 6 - posterior cord)

Question 23

Serratus anterior o.

Answer 23

Upper 8 ribs and intercostal

Question 24

Serratus anterior i.

Answer 24

Inner, medial border of scapula

Question 25

Serratus anterior action

Answer 25

Protracts and laterally rotates scapula

Question 26

Serratus anterior nerve

Answer 26

Long thoracic nerve (of Bell) - C5 to slips 1 and 2 - C6 to slips 3 and 4 - C7 to slips 5,6,7,8: crowded around lower tip of scapula (lateral rotation)

Question 27

Muscles of rotator cuff

Answer 27

Supraspinatus, subscapularis, infraspinatus, teres major

Question 28

Action of rotator cuff

Answer 28

Lateral rotation of the shoulder. Brace the head of the humerus against the glenoid

Question 29

Subscapularis o.

Answer 29

Medial ⅔ of sub scapular fossa

Question 30

Subscapularis i.

Answer 30

lesser tuberosity of humerus, half medial lip of bicipital groove and joint capsule

Question 31

Subscapularis action

Answer 31

Medial rotation and stabilisation of shoulder

Question 32

Subscapularis nerve

Answer 32

Upper and lower subscapular - posterior cord, C6,7

Question 33

Infraspinatus o.

Answer 33

medial ¾ infraspinous fossa and intermuscular septum

Question 34

Infraspinatus i.

Answer 34

Medial facet of greater tuberosity of humerus and joint capsule

Question 35

Infraspinatus action

Answer 35

Lateral rotation and stabilisation of the shoulder

Question 36

Infraspinatus nerve

Answer 36

Suprascapular nerve (C5,6 upper trunk)

Question 37

Supraspinatus o.

Answer 37

¾ supraspinous fossa and upper spine of scapula

Question 38

Supraspinatus i.

Answer 38

Superior facet of greater tuberosity of humerus and joint capsule

Question 39

Supraspinatus action

Answer 39

Abducts and stablises shoulder

Question 40

Supraspinatus nerve

Answer 40

Suprascapular (C5,6, upper trunk)

Question 41

Quadrangular space borders and contents

Answer 41

Teres major and subscapularis in POSTERIOR wall of axilla. Laterally bounded by humerus and medially by long head of triceps. Contents: - Axillary nerve - Posterior circumflex humeral artery and vein inferiorly.

Question 42

Triangular space

Answer 42

Between humerus and long head of triceps. | Contents: radial nerve and profunda brachii vessels.

Question 43

What pierces the clavipectoral fascia

Answer 43

``` Passing inwards - lymphatics from the infraclavicular nodes to the apical nodes. - Cephalic vein Passing outwards - Thoracoacromial vessels - Lateral pectoral nerve. ```

Question 44

Posterior wall of the axilla

Answer 44

Subscapularis, teres major, latissimus dorsi

Question 45

Medial wall of the axilla

Answer 45

Serratus anterior to 4th rib

Question 46

Anterior wall of the axill

Answer 46

Pec major and minor, clavipectoral fascia

Question 47

Lateral wall of the axilla

Answer 47

Intertubercular (bicipital groove) and biceps tendon

Question 48

Floor of axilla

Answer 48

Axillary fascia

Question 49

Contents of axilla

Answer 49

Neurovascular bundle from the neck, long head of biceps, coracobrachialis, long thoracic nerve.

Question 50

Nerve to remember during axillary dissection and why

Answer 50

Intercostalbrachial nerve. Sensory - supplies variable amount of skin on inner aspect of axilla and upper arm.

Question 51

Nerve of the flexor compartment of the arm

Answer 51

Musculocutaneous nerve