Upper Limb Anatomy

Question 1

Supply of Brachial Plexus

Answer 1

C5-8 and T1

Question 2

Position of subclavian vessels in relation to scalene muscles

Answer 2

Artery posterior to scalene anterior, vein anterior to scalene anterior

Question 3

Supply of Brachial Cords

Answer 3

Lateral: Ant branches of upper and middle trunks
Medial: Ant Division of lower trunk
Posterior: Post division of all cords

Question 4

Cords forming medial nerve

Answer 4

Lateral + branch of medial

Question 5

Cords forming ulnar nerve

Answer 5

Medial

Question 6

Cords forming radial nerve

Answer 6

Posterior

Question 7

Klumpke’s Paralysis

Answer 7

C8/T1 Lesion

Claw hand, medial loss of sensation and Horner’s

Question 8

Ulnar Nerve Path

Answer 8

Descends on posteriomedial aspect of humerus. Passes between humeral and ulnar heads into anterior compartment. Passes into hand through Guyon’s canal.

Question 9

Muscles supplied by ulnar nerve

Answer 9

Flexor carpi ulnaris, Flexor digitorum profundus, Flexor digiti minimi, Abductor digiti minimi, Opponens digiti minimi, Adductor pollicus, 3/4th Lumbricals, palmaris Brevis

Question 10

Ulnar nerve sensory innervation

Answer 10

Fifth digit plus medial side of fourth (Palmar surface)

Question 11

Result of ulnar lesion at elbow

Answer 11

Claw hand, ulnar sensory deficit

Question 12

Result of ulnar lesion at wrist

Answer 12

Claw hand less prominent. Ulnar sensory deficit

Question 13

Median nerve Path

Answer 13

Courses along lateral, then medial surface of brachial artery, passes below flexor retinaculum in forearm.

Question 14

Median nerve branches in forearm

Answer 14

Anterior Interosseous, Palmar Cutaneous

Question 15

Median Nerve Muscle Supply

Answer 15

Pronator Teres, Flexor Carpi Radialis, Palmaris Longus, Flexor digitorum profundus, Flexor digitorum superficialis, Flexor pollicus longus, Lateral lumbricals, opponens Pollicus, Abductor Pollicus Brevis, Flexor pollicus brevis (LOAF)

Question 16

Median nerve Sensation

Answer 16

Thumb, index and middle finger. Lateral half of ring finger. (Palm supplied by palmar cutaneous branch)

Question 17

Upper arm median nerve injury

Answer 17

Loss of pronation, hand flexion, thumb abduction and sensation over median distribution

Question 18

Carpal tunnel injury

Answer 18

Loss of sensation over median distribution of hand (NOT palm, as palmar cutaneous leaves prior to canal)

Question 19

Anterior Interosseous Nerve

Answer 19

Branch of median nerve. Supplies flexor digitorum proufundus, flexor pollicus longus and pronator. Injury caused by tight forearm cast

Question 20

Radial nerve path

Answer 20

Passes medial to lateral in spiral groove of humerus. Passes anterior to lateral epicondyle. Terminates at superficial and deep branches

Question 21

Muscles supplied by radial nerve

Answer 21

Triceps, brachioradialis, extensor carpi radialis longus / brevis, Supinator, Extensor digitorum, Extensor digiti minimi, Extensor carpi ulnaris / radialis, Abductor pollicus longus, Extensor pollicus brevis / longus, Extensor indicis, (BEST)

Question 22

Musculocutaneous Nerve Origin

Answer 22

Branch of lateral cord

Question 23

Muscles of musculocutaneous nerve

Answer 23

Coracobrachialis, Biceps brachii, Brachialis (BBC)

Question 24

Musculocutaneous nerve injury

Answer 24

Weak elbow flexion / supination

Question 25

Erb's Palsy

Answer 25

C5/6 lesion resulting in pronation and medial rotation.

Question 26

Origin of Subclavian

Answer 26

Right: Brachiocephalic Left: Aorta

Question 27

Branches of Subclavian

Answer 27

Internal Thoracic, Vertebral, Thyrocervical trunk, Costocervical trunk, Doorsal Scapular Artery

Question 28

End of subclavian artery

Answer 28

Border of first rib

Question 29

Branches of thyrocervical trunk

Answer 29

Inferior thyroid, Supra-scapular, Transverse cervical

Question 30

Borders of axillary artery

Answer 30

Start: First rib End: Lower border trees minor

Question 31

Brachial Artery Path

Answer 31

Begins lower border trees minor | Passes medial to biceps tendon

Question 32

Profunda Brachii Supply

Answer 32

Deltoid and triceps

Question 33

Profunda Brachii Path

Answer 33

Follows radial nerve along humeral groove to reach lateral epicondyle

Question 34

Deltoid Muscle

Answer 34

``` Origin: Lateral clavical, acromion and scapula Insertion: Deltoid tuberosity of humerus Innervation: Axilary nerve Artery: Ant + Post. Humeral Circumflex Action: Shoulder abduction ```

Question 35

Brachioradialis

Answer 35

``` Origin: Lateral humerus Insertion: Distal radius Innervation: Radial Artery: Radial recurrent Action: Elbow flexion ```

Question 36

Biceps

Answer 36

Origin: Coracoid process of scapula / Supraglenoid tubercle Insertion: Radial tuberosity / Bicipital aponeurosis Innervation: Musculocutaneous nerve Artery: Brachial Action: Elbow flexion / Supination / Shoulder Abduction

Question 37

Triceps

Answer 37

Origin: Infra gelnoid tubercle / above/ below radial sulcus Insertion: Olecranon of ulna Innervation: Radial Artery: Deep brachial Action: Extends elbow / extends should / adducts arm

Question 38

Supinator

Answer 38

``` Origin: Lateral humeral epicndule / ulna Insertion: Lateral radial shaft Innervation: Radial Artery: Radial Action: Supination ```

Question 39

Pronator Teres

Answer 39

``` Origin: Humeral / Ulnar Head Insertion: Middle / Lateral Radius Innervation: Median Artery: Ulnar Action: Pronation ```

Question 40

Palmaris Longus

Answer 40

``` Origin: Medial Epicondyle Insertion: Palmar Aponeurosis Innervation: Median Artery: Ulnar Action: Wrist flexion ```

Question 41

Coracobrachialis

Answer 41

``` Origin: Coracoid process of scapula Insertion: medial humerus Innervation: Musculocutaneous Artery: Brachial Action: Adduction ```

Question 42

Infraspinatus

Answer 42

``` Origin: Infraspinatous fossa of scapula Insertion: Humeral greater tubercle Innervation: Suprascapular nerve Artery: Supra and circumflex scapular nerve Action: Lateral rotation of shoulder ```

Question 43

Latissimus Dorsi

Answer 43

Origin: Spinous process of T7 to L5, Iliac crest Insertion: Intertubercular groove of humerus Innervation: Thoracodorsal Artery: Subscabular Action: Adducts, extends and internally rotates shoulder

Question 44

Pectoralis Minor

Answer 44

``` Origin: Ribs 3-5 Insertion: Coracoid process of scapula Innervation: Medial Pectoral Artery: Thoracoacromial trunk Action: Stablises scapula ```

Question 45

Pectoralis Major

Answer 45

``` Origin: Clavicular and sternocostal head Insertion: Bicipital groove of humerus Innervation: Lateral and medial pectoral nerve (brachial plexus) Artery: Thoracoacromial trunk Action: Flexes and extends humerus ```

Question 46

Subscapularis

Answer 46

``` Origin: Subscapular fossa Insertion: Humeral lesser tubercle Innervation: Upper/Lower Subscapular nerve Artery: Subscapular Action: Shoulder internal rotation ```

Question 47

Supraspinatous

Answer 47

``` Origin: Supraspinatous Fossa Insertion: Humeral greater tubercle Innervation: Suprascapular Artery: Suprascapular Action: Abduction ```

Question 48

Teres Major

Answer 48

``` Origin: Inferior scapular Insertion: Intertubecular Sulcus Innervation: Subscapular nerve Artery: Subscapular Action: Internal rotation ```

Question 49

Teres Minor

Answer 49

``` Origin: Lateral scapular Insertion: Greater tubercle Innervation: Axillary Artery: Posterior circumflex humeral Action: External rotation ```

Question 50

Anconeus

Answer 50

``` Origin: Lateral Epicondyle Insertion: Olecranon of ulna Innervation: Radial Artery: Brachial Action: Assists with extension of elbow ```