USMLE Road Map - Upper Limb Flashcards Preview

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Flashcards in USMLE Road Map - Upper Limb Deck (100):
1

The pectoral girdle suspends the ...?

Humerus and the upper limb away from the axial skeleton to increase range of movement.

2

What is the only articulation between the axial skeleton and the upper limb?

The sternoclavicular joint.

3

The clavicle is commonly fractures at its weakest point ...?

Between the middle third and the lateral third.

4

The medial 2/3 of the clavicle may be elevated by the ...?

Sternocleidomastoid muscle.

5

The lateral third may be depressed by the ... or adducted by the ... .

Weight of the limb.
Pectoralis major.

6

Fracture of the clavicle - Which nerves may be lacerated?

The ventral rami of C8-T1 in the medial cord of the branchial plexus.

7

Shoulder trauma may cause a ... of the acromion at the acromioclavicular joint.

Subluxation.

8

The ... ligament prevents dislocation at the acromioclavicular joint.

Coracoclavicular ligament.

9

Common fracture sites of the upper limb:

1. Clavicle.
2. Surgical neck of the humerus.
3. Styloid process.
4. Scaphoid.

10

The scapula is laterally (upwardly) or medially (downwardly) rotated along the chest during ... and ... of the humerus at the glenohumeral joint.

Abduction and adduction.

11

In abduction, for every 2 degrees of abduction of the arm at the glenohumeral joint, there is ... degree of lateral or upward rotation of the scapula.

1 degree.

12

In 180 of full abduction, there is approx. ... degrees of abduction of the humerus at the glenohumeral joint, and approx. ... degrees of scapular rotation.

120, 60.

13

The tendons of the rotaror cuff muscles strengthen the articular capsule of the glenohumeral joint and include the ...?

1. Supraspinatus.
2. Infraspinatus.
3. Teres minor.
4. Subscapularis.
(SITS muscles)

14

Muscles that act at the pectoral (shoulder) girdle:

1. Levator scapulae.
2. Trapezius.
3. Pectoralis minor.
4. Lat dorsi.
5. Serratus anterior.
6. Rhomboid major/minor.

15

Muscles involved in elevation of the shoulder girdle:

1. Levator scapulae.
2. Trapezius.

16

Innervation of levator scapulae:

Dorsal scapular.

17

Innervation of trapezius:

Accessory.

18

Major segments of innervation - Levator scapulae:

C4-C5.

19

Muscles involved in depression of the shoulder girdle:

1. Pectoralis minor.
2. Trapezius.
3. Lat dorsi.

20

Pectoralis minor innervation:

Medial pectoral.

21

Lat dorsi innervation:

Thoracodorsal.

22

Major segments of innervation - Medial pectoral nerve:

C7-C8.

23

Major segments of innervation - Thoracodorsal nerve:

C6-C7-C8.

24

Muscles involved in protraction of the shoulder girdle:

1. Serratus anterior.
2. Pectoralis minor.

25

Innervation of serratus anterior:

Long thoracic (C5-C6-C7).

26

Muscles involved in retraction of the shoulder girdle:

1. Rhomboid major/minor.
2. Trapezius.

27

Innervation of rhomboid major/minor:

Dorsal scapular (C5).

28

Muscles involved in lateral rotation of scapula (in abduction):

1. Serratus anterior.
2. Trapezius.

29

Muscles involved in medial rotation of the scapula (in adduction):

1. Rhomboid minor/major.
2. Levator scapulae.

30

The tendons of muscles of the rotator cuff may become torn or inflamed. Which tendon is MC affected?

The tendon of the supraspinatus.

31

Patients with rotator cuff tears experience pain ...?

Anterior and superior to the glenohumeral joint during abduction.

32

The capsule of the glenohumeral joint is strengthened by several ligaments:

1. The glenohumeral bands strengthen the anterior aspect of the joint.
2. The coracohumeral ligament strengthen the superior aspect of the joint.

33

The coracoacromial ligament prevents ...?

Superior displacement of the head of the humerus.

34

Muscles involved in flexion of the humerus:

1. Pectoralis minor.
2. Deltoid.
3. Biceps.
4. Coracobranchialis.

35

Innervation of the deltoid muscle:

Axillary (C5-C6).

36

Innervation of biceps and coracobranchialis:

Musculocutaneous (C5-C6-C7).

37

Muscles involved in extension of the humerus:

1. Deltoid.
2. Lat dorsi.
3. Teres major.

38

Innervation of teres major:

Lower subscapular (C6).

39

Muscles involved in abduction of humerus:

1. Deltoid.
2. Supraspinatus.

40

Innervation of supraspinatus:

Suprascapular (C5).

41

Muscles involved in adduction of humerus:

1. Pectoralis major.
2. Lat dorsi.
3. Teres major.

42

Muscles involved in lateral rotation of scapula in abduction:

1. Deltoid.
2. Infraspinatus.
3. Teres minor.

43

Innervation of infraspinatus:

Suprascapular (C5-C6).

44

Innervation of teres minor:

Axillary (C6).

45

Muscles involved in medial rotation of scapula in adduction:

1. Pectoralis major.
2. Lat dorsi.
3. Deltoid.
4. Teres major.
5. Subscapularis.

46

Innervation of subscapularis:

Upper and lower subscapular (C5-C6).

47

In a dislocation of the humerus at the glenohumeral joint, the head of the humerus is ...?

Commonly displaced inferiorly and then anteriorly and becomes positioned just inferior to the coracoid process.

48

A dislocation of the head of the humerus may stretch ...?

The axillary nerve or the radial nerve.

49

What may be injured in a fracture of the surgical neck of the humerus ...?

1. Axillary nerve.
2. The posterior circumflex humeral artery may be lacerated.

50

A fracture of the greater tubercle of the humerus may result in ...?

Avulsion of the greater tubercle and detachment of the rotator cuff muscles from the humerus.

51

In patients with fractures of the greater tubercle, the remaining rotator cuff muscle, the subscapularis, ...?

Medially rotates the humerus at the glenohumeral joint.

52

A transverse fracture of the humerus distal to the deltoid tuberosity may result in ...?

Abduction of the proximal fragment by the deltoid muscle.

53

In a midshaft (spiral) fracture of the humerus, what may be lesioned?

1. The radial nerve.
2. The profunda branchial artery may be lacerated.

54

In patients with a supracondylar fracture of the humerus, contractions of the triceps and the branchialis may ...?

Shorten the arm.

55

An intercondylar or supracondylar fracture of the distal end of the humerus may result in ...?

Lesion of the median nerve.

56

The 3 elbow joints:

1. The humeroradial.
2. The humeroulnar.
3. The proximal radioulnar.

57

Lateral epicondylitis (tennis elbow) is ...?

An inflammation of the common extensor tendon that results from forced extension and flexion of the forearm at the elbow.
--> Patients exhibit pain over the lateral epicondyle, which may radiate down the posterior aspect of the forearm.

58

Medial epicondylitis (golfer's elbow) is an ...?

Inflammation of the common flexor tendon that results from repetitive flexion and pronation of the forearm at the elbow.

59

In a fracture of the medial epicondyle of the humerus, which nerve may be lesioned?

The ulnar nerve.

60

The pectoral girdle consists of ...?

The clavicle and scapula.

61

The radiocarpal joint is formed by the ...?

Distal end of the radius and the scaphoid and the lunate.

62

The ulnocarpal joint is formed by the ...?

Distal end of the ulna, an articular disk, and the triquetrum.

63

The radiocarpal and ulnocarpal joints permit ...?

Flexion/Extension + Abduction/Adduction.

64

Muscles involved in the flexion of the ulna and radius:

1. Branchialis.
2. Biceps branchii.
3. Branchioradialis.

65

Innervation of branchioradialis:

Radial nerve (C5-C6).

66

Muscles involved in extension of ulna and radius:

Triceps branchii.

67

Innervation of triceps:

Radial nerve (C7-C8).

68

Muscles involved in rotation of the radius over ulna?

1. Pronator teres.
2. Pronator quadratus.

69

Innervation of pronator teres:

Median (C6-C7).

70

Innervation of pronator quadratus:

Median (ant. interosseous) - C8-T1.

71

Muscles involved in supination (radius returns to anatomic position):

1. Supinator.
2. Biceps branchii.

72

Innervation of supinator:

Radial (deep br.) - C6-C7-C8.

73

Colles' fracture:

Distal radius - May result in avulsion of the styloid process from the shaft of the radius.

74

In patients with a fracture of the distal radius, the forearm and hand may exhibit a ...?

"Dinner fork" deformity as a result of the posterior displacement of the distal part of the radius.

75

The 8 carpal bones are loosely arranged into 2 rows. The proximal row contains from lateral to medial:

1. Scaphoid.
2. Lunate.
3. Triquetrum.
4. Pisiform.

76

The pisiform is ... to the triquetrum.

ANTERIOR

77

The pisiform is a ... bone that is ...?

Sesamoid bone that is embedded in the tendon of the flexor carpi ulnaris.

78

The distal row of carpal bones contains, from lateral to medial:

1. Trapezium.
2. Trapezoid.
3. Capitate.
4. Hamate.

79

Muscles involved in flexion of the hand:

1. Flexor carpi ulnaris.
2. Flexor carpi radialis.

80

Innervation of flexor carpi ulnaris:

Ulnar (C8).

81

Innervation of flexor carpi radialis:

Median (C6-C7).

82

Muscles involved in extension of hand:

1. Extensor carpi ulnaris.
2. Extensor carpi radialis longus.
3. Extensor carpi radialis brevis.

83

Innervation of the muscles involved in extension of the hand:

Radial (C6-C7-C8).

84

Muscles involved in abduction (radial deviation) of the hand:

1. Extensor carpi radialis longus/brevis.
2. Flexor carpi radialis.

85

Muscles involved in adduction (ulnar deviation) of hand:

1. Flexor carpi ulnaris.
2. Extensor carpi ulnaris.

86

Which carpal bone is the MC dislocated?

The lunate.

87

The lunate is typically dislocated ... into the carpal tunnel.

ANTERIORLY.

88

Dislocation of the lunate may cause ...?

Carpal tunnel syndrome.

89

The flexor retinaculum completes the carpal tunnel anteriorly. It attaches medially to the ... and laterally to the ... .

Medially --> Pisiform and hamate.
Laterally --> Tubercles of the scaphoid and trapezium.

90

The capral tunnel contains:

The median nerve and 9 tendons that arise from 3 flexor muscles:
1. Flexor digitorum profundus.
2. Flexor digitorum superficialis.
3. Flexor pollicis longus.

91

The canal of Guyon is situated between ...?

The pisiform and the hook of the hamate superficial to the carpal tunnel.

92

Which anatomic structures cross the wrist and pass into the hand after transversing the canal of Guyon?

1. The ulnar nerve.
2. The ulnar artery.
3. The ulnar vein.

93

Which anatomic structures form the anatomic snuffbox?

1. The tendons of the 2 extensor muscles of the thumb.
2. The abductor pollicis longus.

94

Which muscles form the lateral border of the anatomic snuffbox?

1. Extensor pollicis brevis.
2. Abductor pollicis longus.

95

Which muscle forms the medial border of the anatomic snuffbox?

The extensor pollicis longus.

96

The scaphoid and the trapezium bones are in the ... of the snuffbox.

FLOOR.

97

Which artery and which nerve passes through the snuffbox?

The radial artery and the superficial branch of the radial nerve --> Innervates the skin over the snuffbox.

98

MC fractured carpal bone?

The scaphoid.

99

Patients with a scaphoid fracture may exhibit pain and tenderness localized over the ...?

Anatomic snuffbox.

100

Scaphoid fracture - The proximal part of the scaphoid may undergo ...?

Avascular necrosis because the blood supply to the bone supplies the DISTAL part first and then the PROXIMAL part.