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  • Question 1 - An injury to the brachial plexus can cause Erb's palsy. The following is...

    Correct

    • An injury to the brachial plexus can cause Erb's palsy. The following is expected to happen to a patient suffering from this condition, except for which one:

      Your Answer: Weakness of medial rotation of the arm

      Explanation:

      Erb’s palsy can be caused by a traumatic force downward on the upper arm and shoulder that damages the upper root of the brachial plexus.

      The patient will lose shoulder abduction (deltoid, supraspinatus), shoulder external rotation (infraspinatus), and elbow flexion as a result of this condition (biceps, brachialis).

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      15.8
      Seconds

  • Question 2 - Where on the body is the radial artery pulsation best palpated? ...

    Incorrect

    • Where on the body is the radial artery pulsation best palpated?

      Your Answer: At the wrist just lateral to the palmaris longus tendon

      Correct Answer: At the wrist just lateral to the flexor carpi radialis tendon

      Explanation:

      The radial artery lies lateral to the large tendon of the flexor carpi radialis muscle and anterior to the pronator quadratus at the distal end of the radius. The flexor carpi radialis muscle is used as a landmark in locating the pulse.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      20.1
      Seconds

  • Question 3 - A suicidal patient had lacerated his wrist, which resulted in an ulnar nerve...

    Correct

    • A suicidal patient had lacerated his wrist, which resulted in an ulnar nerve injury. Which of the following will confirm the presence of an ulnar nerve injury?

      Your Answer: Claw hand appearance

      Explanation:

      An ulnar injury may result in abnormal sensations in the little finger and ring finger, usually on the palm side, weakness, and loss of coordination of the fingers.

      A claw like deformity of the hand and wrist is present. Pain, numbness, decreased sensation, tingling, or burning sensation in the areas controlled by the nerve are also possible.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      22.2
      Seconds

  • Question 4 - The fracture of the medial epicondyle will cause damage to the ulnar nerve....

    Correct

    • The fracture of the medial epicondyle will cause damage to the ulnar nerve. Which of the following motions would be impaired by this type of injury?

      Your Answer: Adduction of the thumb

      Explanation:

      Fracture of the medial epicondyle is most likely to result in damage to the ulnar nerve.

      The three hypothenar muscles, two medial lumbricals, seven interossei, the adductor pollicis, and the deep head of the flexor pollicis brevis are all innervated by the deep branch of the ulnar nerve.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      41.4
      Seconds

  • Question 5 - A 30-year old male is brought to the emergency room after a terrible...

    Correct

    • A 30-year old male is brought to the emergency room after a terrible fall during a photoshoot. The patient reported falling on his right forearm. There is evident swelling and tenderness on the affected area, with notable weakness of the flexor pollicis longus muscle. Radiographic imaging showed a fracture on the midshaft of the right radius.

      Which of the following nerves is most likely injured in the case above?

      Your Answer: The anterior interosseous nerve

      Explanation:

      Flexor pollicis longus receives nervous supply from the anterior interosseous branch of median nerve, derived from spinal roots C7 and C8.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      27.1
      Seconds

  • Question 6 - A patent has weakness of humeral flexion and extension. A CT scan reveals...

    Correct

    • A patent has weakness of humeral flexion and extension. A CT scan reveals that he has suffered damage to the nerve that innervates pectoralis major.
      Pectoralis major receives its innervation from which of the following nerves? Select ONE answer only.

      Your Answer: Lateral and medial pectoral nerves

      Explanation:

      Pectoralis major is a thick, fan-shaped muscle situated in the chest. It makes up the bulk of the chest musculature in the male and lies underneath the breast in the female. It overlies the thinner pectoralis minor muscle.
      Superficial muscles of the chest and arm showing pectoralis major (from Gray’s Anatomy)
      Pectoralis major has two heads; the clavicular head and the sternocostal head. The clavicular head originates from the anterior border and medial half of the clavicle. The sternocostal head originates from the anterior surface of the sternum, the superior six costal cartilages and the aponeurosis of the external oblique muscle. It inserts into the lateral lip of the bicipital groove of the humerus.
      Pectoralis major receives dual innervation from the medial pectoral nerve and the lateral pectoral nerve.
      Its main actions are as follows:
      Flexes humerus (clavicular head)
      Extends humerus (sternocostal head)
      Adducts and medially rotates the humerus
      Draws scapula anteriorly and inferiorly

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      12.8
      Seconds

  • Question 7 - A 12-year old boy is taken to the emergency room after accidentally falling...

    Correct

    • A 12-year old boy is taken to the emergency room after accidentally falling off the monkey bars. Witnesses of the accident reported that, when the patient fell, he hit his right hand on a bar and a loud thump was heard. On examination, the hand is oedematous, tender and erythematous. On ultrasound, a rupture of the flexor carpi ulnaris is noted.

      Which of the following statements is true regarding the flexor carpi ulnaris?

      Your Answer: It acts to adduct the hand at the wrist joint

      Explanation:

      Flexor carpi ulnaris is a fusiform muscle located in the anterior compartment of the forearm. It belongs to the superficial flexors of the forearm, along with pronator teres, palmaris longus, flexor digitorum superficialis and flexor carpi radialis. Flexor carpi ulnaris is the most medial of the superficial flexors.

      Innervation of the flexor carpi ulnaris muscle is from the brachial plexus via the ulnar nerve (C7-T1).

      Flexor carpi ulnaris receives its arterial blood supply via three different routes. Proximally, a branch of the posterior ulnar recurrent artery supplies the muscle as it passes between the humeral and ulnar heads. Branches of the ulnar artery supply the middle and distal parts of the muscle, with an accessory supply also present distally via the inferior ulnar collateral artery.

      Due to its position and direction in the forearm, flexor carpi ulnaris can move the hand sideways as well as flexing it. Contracting with flexor carpi radialis and palmaris longus, flexor carpi ulnaris produces flexion of the hand at the wrist joint. However, when it contracts alongside the extensor carpi ulnaris muscle in the posterior compartment, their counteracting forces produce adduction of the hand at the wrist, otherwise known as ulnar deviation or ulnar flexion

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      32
      Seconds

  • Question 8 - A 20-year-old patient had sustained a supracondylar fracture due to falling from a...

    Correct

    • A 20-year-old patient had sustained a supracondylar fracture due to falling from a skateboard. The frequency of acute nerve injuries accompanying supracondylar humeral fractures ranges from 10 to 20%. The most common complication is injury to which nerve?

      Your Answer: Median nerve

      Explanation:

      According to various studies, the frequency of acute nerve damage associated with supracondylar humeral fractures in children ranges from 10% to 20%.

      Median nerve injury and anterior interosseous nerve injury are the most common consequences.

      Damage to this nerve indicated weakening or abnormal extension of the index finger’s distal interphalangeal joint and the thumb’s interphalangeal joint. The absence of sensibility is a distinguishing attribute.

      A surgical neck humerus fracture may cause injury to the axillary nerve. A midshaft humerus fracture might cause injury to the radial nerve. A medial epicondylar fracture might cause injury to the ulnar nerve.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      9.9
      Seconds

  • Question 9 - After a work-related accident, a 33-year old male is taken to the emergency...

    Correct

    • After a work-related accident, a 33-year old male is taken to the emergency room with difficulty in adduction and flexion of his left arm at the glenohumeral joint. The attending physician is suspects involvement of the coracobrachialis muscle.

      The nerve injured in the case above is?

      Your Answer: The musculocutaneous nerve

      Explanation:

      The coracobrachialis muscle is innervated by the musculocutaneous nerve (C5-C7) a branch of the lateral cord of the brachial plexus.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      18.1
      Seconds

  • Question 10 - Which of the following statements is true regarding the extensor pollicis longus? ...

    Incorrect

    • Which of the following statements is true regarding the extensor pollicis longus?

      Your Answer: Its tendons form the lateral border of the anatomical snuffbox

      Correct Answer: It is innervated by the posterior interosseous nerve

      Explanation:

      Extensor pollicis longus is part of the deep extensors of the forearm together with extensor pollicis brevis, abductor pollicis longus, extensor indicis and supinator muscles. It is located on the posterior aspect of forearm, extending from the middle third of the ulna, and adjacent interosseous membrane, to the distal phalanx of the thumb.

      Extensor digitorum is innervated by posterior interosseous nerve which is a continuation of a deep branch of radial nerve (root value C7 and C8).

      Extensor pollicis brevis receives its blood supply from the posterior interosseous artery and perforating branches of the anterior interosseous artery.

      The main action of extensor pollicis longus is extension of the thumb at the metacarpophalangeal and interphalangeal joints. Extension at the metacarpophalangeal joint occurs in synergy with extensor pollicis brevis muscle. When the thumb reaches the full extension or abduction, extensor pollicis longus can also assist in adduction of the thumb.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      19.7
      Seconds

  • Question 11 - Injury to which nerve can lead to weakness or paralysis of the brachialis...

    Incorrect

    • Injury to which nerve can lead to weakness or paralysis of the brachialis muscle?

      Your Answer: The radial nerve

      Correct Answer: The musculocutaneous nerve

      Explanation:

      The brachialis muscle is a prime flexor of the forearm at the elbow joint. It is fusiform in shape and located in the anterior (flexor) compartment of the arm, deep to the biceps brachii. The brachialis is a broad muscle, with its broadest part located in the middle rather than at either of its extremities. It is sometimes divided into two parts, and may fuse with the fibres of the biceps brachii, coracobrachialis, or pronator teres muscles. It also functions to form part of the floor of the cubital fossa.

      The brachialis is primarily supplied by the musculocutaneous nerve (C5, C6). In addition, a small lateral portion of the muscle is innervated by the radial nerve (C7).

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      7.6
      Seconds

  • Question 12 - Following a road traffic collision, a patient sustains damage to the long thoracic...

    Correct

    • Following a road traffic collision, a patient sustains damage to the long thoracic nerve. Which of the following clinical findings would you most expect to see on examination:

      Your Answer: Winged scapula deformity

      Explanation:

      Damage to the long thoracic nerve results in weakness/paralysis of the serratus anterior muscle. Loss of function of this muscle causes the medial border, and particularly the inferior angle, of the scapula to elevate away from the thoracic wall, resulting in the characteristic ‘winging’ of the scapula. This deformity becomes more pronounced if the patient presses the upper limb against a wall. Furthermore, normal elevation of the arm is no longer possible.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      5.6
      Seconds

  • Question 13 - A 24-year-old waiter cuts his hand on a dropped plate that smashed and...

    Correct

    • A 24-year-old waiter cuts his hand on a dropped plate that smashed and damages the nerve that innervates opponens digiti minimi.
      The opponens digiti minimi muscle is innervated by which of the following nerves? Select ONE answer only.

      Your Answer: The deep branch of the ulnar nerve

      Explanation:

      Opponens digiti minimi is a triangular-shaped muscle in the hand that forms part of the hypothenar eminence. It originates from the hook of the hamate bone and the flexor retinaculum and inserts into the medial border of the 5thmetacarpal.
      Opponens digiti minimi is innervated by the deep branch of the ulnar nerve and receives its blood supply from the ulnar artery.
      Opponens digiti minimi draws the fifth metacarpal bone anteriorly and rotates it, bringing the fifth digiti into opposition with the thumb.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      15.1
      Seconds

  • Question 14 - Which of the following accurately describes the extensor pollicis brevis muscle? ...

    Incorrect

    • Which of the following accurately describes the extensor pollicis brevis muscle?

      Your Answer: It extends the distal phalanx of the thumb at the metacarpophalangeal joint

      Correct Answer: It lies on the medial side of abductor pollicis longus

      Explanation:

      Extensor pollicis brevis is a short and slender muscle located in the posterior compartment of the forearm, extending from the posterior surface of radius to the proximal phalanx of thumb. It is one of the deep extensors of the forearm, together with supinator, abductor pollicis longus, extensor pollicis longus and extensor indicis muscles.

      Extensor pollicis brevis is a deep extensor of the thumb that lies deep to extensor digitorum muscle. It sits directly medial to abductor pollicis longus and posterolateral to extensor pollicis longus muscle. Just above the wrist, extensor pollicis brevis obliquely crosses the tendons of extensor carpi radialis brevis and extensor carpi radialis longus muscles.

      Extensor pollicis brevis is innervated by posterior interosseous nerve which is a continuation of a deep branch of radial nerve (root value C7 and C8).

      Extensor pollicis brevis receives its blood supply by posterior interosseous artery and perforating branches from the anterior interosseous artery, which are the branches of common interosseous artery. The common interosseous artery arises immediately below the tuberosity of radius from the ulnar artery.

      Together with extensor pollicis longus, extensor pollicis brevis is in charge of extension of the thumb in the first metacarpophalangeal joint. It also extends the thumb in the carpometacarpal joint of the thumb. This movement is important in the anatomy of the grip, as it enables letting go of an object. As it crosses the wrist, extensor pollicis brevis also participates in the extension and abduction of this joint.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      19.7
      Seconds

  • Question 15 - A 35 year old man presents with a deep laceration to the proximal...

    Incorrect

    • A 35 year old man presents with a deep laceration to the proximal part of the forearm. On further assessment, the patient is unable to flex the metacarpophalangeal joints and interphalangeal joints of the index, middle finger and the thumb.

      The ring and little fingers are intact but there is weakness at the proximal interphalangeal joint.

      There is also loss of sensation over the lateral palm and the palmar surface of the lateral three and a half fingers.

      Which of these nerve(s) has most likely been affected?

      Your Answer: Median and ulnar nerve

      Correct Answer: Median nerve

      Explanation:

      A median nerve injury affecting the extrinsic and intrinsic muscles of the hand will present with:

      Loss of sensation to the lateral palm and the lateral three and a half fingers.

      Weakness of flexion at the metacarpophalangeal joints of the index and middle finger. This is because of paralysis of the lateral two lumbricals.

      Weakness of flexion of the proximal interphalangeal joints of all four fingers due to paralysis of the flexor digitorum superficialis

      Weakness of flexion at the distal interphalangeal joints of the index and middle finger following paralysis of the lateral half of the flexor digitorum profundus.
      Weakness of thumb flexion, abduction and opposition due to paralysis of the flexor pollicis longus and thenar muscles

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      44.9
      Seconds

  • Question 16 - Which of the following statements is correct about the extensor digitorum muscle? ...

    Incorrect

    • Which of the following statements is correct about the extensor digitorum muscle?

      Your Answer: It assists with abduction of the wrist joint

      Correct Answer: It extends the medial four digits at the metacarpophalangeal joints

      Explanation:

      Extensor digitorum is a long muscle located in the posterior compartment of the forearm. Together with the extensor carpi ulnaris and extensor digiti minimi, extensor carpi radialis longus and brevis as well as the brachioradialis, it belongs to the group of superficial extensors of the forearm. These muscles can be easily palpated in the lateral aspect of the posterior forearm, especially during the extension of hand when they are contracted.

      Extensor digitorum runs from the lateral epicondyle of humerus to the medial four phalanges of the hand. In this way, it generates the pull for the extension of the four medial fingers in their metacarpophalangeal and both interphalangeal joints. Extensor digitorum also participates in the extension of the wrist.

      Extensor digitorum is innervated by posterior interosseous nerve which is a continuation of a deep branch of radial nerve (root value C7 and C8).

      Extensor digitorum is vascularized by the branches of three different arteries: (1) posterior interosseous artery, (2) radial recurrent artery, and (3) anterior interosseous artery. Anterior and posterior interosseous arteries are the branches of the common interosseous artery that arises from the ulnar artery. The radial recurrent artery is a branch of the radial artery.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      19.2
      Seconds

  • Question 17 - A man suffered from a back injury due to a fall from a...

    Incorrect

    • A man suffered from a back injury due to a fall from a ladder. Significant bruising was found to be overlying his latissimus dorsi muscle.

      Which of the following statements regarding the latissimus dorsi muscle is considered correct?

      Your Answer: It is the most superficial back muscle

      Correct Answer: It raises the body towards the arm during climbing

      Explanation:

      The latissimus dorsi muscle is a broad, flat muscle that occupies the majority of the lower posterior thorax. The muscle’s primary function is of the upper extremity but is also considered to be a respiratory accessory muscle.

      Latissimus dorsi is a climbing muscle. With the arms fixed above the head, it can raise the trunk upwards, together with the help of pectoralis major.

      Functionally, the latissimus dorsi muscle belongs to the muscles of the scapular motion. This muscle is able to pull the inferior angle of the scapula in various directions, producing movements on the shoulder joint (internal rotation, adduction and extension of the arm). It is innervated by the thoracodorsal nerve (C6 – C8) from the posterior cord of the brachial plexus, which enters the muscle on its deep surface.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      34.1
      Seconds

  • Question 18 - A 33-year-old heavily muscled man presents with left-sided chest pain. After taking part...

    Correct

    • A 33-year-old heavily muscled man presents with left-sided chest pain. After taking part in a powerlifting competition, he felt a painful snap at the front of his shoulder and chest. There is also the presence of bruising and swelling over the left side of his chest. A ruptured pectoralis major muscle was suspected upon examining the injured area.

      Which of the following statements regarding the surface markings of the pectoralis major muscle is considered correct?

      Your Answer: It inserts into the lateral lip of the bicipital groove of the humerus

      Explanation:

      The pectoralis major is the superior most and largest muscle of the anterior chest wall. It is a thick, fan-shaped muscle that lies underneath the breast tissue and forms the anterior wall of the axilla.

      Its origin lies anterior surface of the medial half of the clavicle, the anterior surface of the sternum, the first 7 costal cartilages, the sternal end of the sixth rib, and the aponeurosis of the external oblique of the anterior abdominal wall.
      The insertion of the pectoralis major is at the lateral lip of the intertubercular sulcus of the humerus. There are 2 heads of the pectoralis major, the clavicular and the sternocostal, which reference their area of origin.
      The function of the pectoralis major is 3-fold and dependent on which heads of muscles are involved:
      – Flexion, adduction and medial rotation of the arm at the glenohumeral joint
      – Clavicular head causes flexion of the extended arm
      – Sternoclavicular head causes extension of the flexed arm

      Arterial supply of the pectoralis major, the pectoral artery, arises from the second branch of the axillary artery, the thoracoacromial trunk.

      The 2 heads of the pectoralis major have different nervous supplies. The clavicular head derives its nerve supply from the lateral pectoral nerve. The medial pectoral nerve innervates the sternocostal head. The lateral pectoral nerve arises directly from the lateral cord of the brachial plexus, and the medial pectoral nerve arises from the medial cord.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      27.1
      Seconds

  • Question 19 - A patient presents with pain in the wrist and a tingling in the...

    Incorrect

    • A patient presents with pain in the wrist and a tingling in the hand. On examination Tinel's test is positive and you diagnose carpal tunnel syndrome. Regarding the carpal tunnel, which of the following statements is INCORRECT:

      Your Answer: The median nerve lies anterior to the tendons in the carpal tunnel.

      Correct Answer: The tendons of the flexor digitorum profundus, flexor digitorum superficialis and flexor pollicis longus lie within a single synovial sheath.

      Explanation:

      Free movement of the tendons in the carpal tunnel is facilitated by synovial sheaths, which surround the tendons. All of the tendons of the flexor digitorum profundus (FDP) and flexor digitorum superficialis (FDS) are contained within a single synovial sheath with a separate sheath enclosing the tendon of the flexor pollicis longus (FPL).

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      56.2
      Seconds

  • Question 20 - A patient suffered from a chest injury while working out in the gym....

    Correct

    • A patient suffered from a chest injury while working out in the gym. As a consequence of his injury, his pectoralis minor muscle was damaged.

      Which of the following statements regarding the pectoralis minor muscle is considered correct?

      Your Answer: It stabilises the scapula

      Explanation:

      The pectoralis minor, in comparison to the pectoralis major, is much thinner and triangular in shape and resides below the major. It originates from the margins of the third to fifth ribs adjacent to the costochondral junction. The fibres consequently pass upward and laterally to insert into the medial border and superior surface of the coracoid process. It is crucial in the stabilization of the scapula by pulling it downward and anteriorly against the thoracic wall.

      Arterial supply to the pectoralis minor also derives from the pectoral branch of the thoracoacromial trunk. Nerve supply of the pectoralis minor is a function of the lateral pectoral nerve and the medial pectoral nerve.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      17.6
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Anatomy (12/20) 60%
Upper Limb (12/20) 60%
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