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  • Question 1 - A 22 year old male has been stabbed and is brought to the...

    Incorrect

    • A 22 year old male has been stabbed and is brought to the ED with a stab wound to his upper limb. On examination, the patient is unable to flex the distal interphalangeal joints of the ring and little finger. However, the proximal interphalangeal joint is intact. The most likely affected nerve is which of the following, and at which level is this occurring?

      Your Answer: Median nerve at wrist

      Correct Answer: Ulnar nerve at elbow

      Explanation:

      The medial half of the flexor digitorum profundus is innervated by the ulnar nerve. Paralysis of this muscle results in loss of flexion at the distal interphalangeal joint of the ring and little finger.
      Flexion at the proximal interphalangeal joint is preserved as this is a function of the flexor digitorum superficialis which is innervated by the median nerve.
      The ulnar nerve is not correct as ulnar nerve injury at the wrist would not affect the long flexors, and the injury must have been more proximal.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      40.1
      Seconds

  • Question 2 - A 20-year-old patient had sustained a supracondylar fracture due to falling from a...

    Incorrect

    • 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: Ulnar nerve

      Correct 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
      19
      Seconds

  • Question 3 - A 33-year-old heavily muscled man presents with left-sided chest pain. After taking part...

    Incorrect

    • 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: The clavicular head originates from the lateral half of the clavicle

      Correct 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
      87.7
      Seconds

  • Question 4 - A patient sustains an injury to the proximal median nerve after falling through...

    Incorrect

    • A patient sustains an injury to the proximal median nerve after falling through a glass door. Which of the following muscles would you not expect to be affected:

      Your Answer: Flexor digitorum profundus

      Correct Answer: Flexor carpi ulnaris

      Explanation:

      All of the muscles in the anterior forearm are innervated by the median nerve, except for the flexor carpi ulnaris and the medial half of the flexor digitorum profundus which are innervated by the ulnar nerve.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      214.3
      Seconds

  • Question 5 - During bedside rounds, an 82-year old female in the Medicine Ward complains of...

    Incorrect

    • During bedside rounds, an 82-year old female in the Medicine Ward complains of pain and tingling of all fingers of the right hand. The attending physician is considering carpal tunnel syndrome.

      Which of the following is expected to undergo atrophy in carpal tunnel syndrome?

      Your Answer: The wrist flexors

      Correct Answer: The thenar eminence

      Explanation:

      Carpal tunnel syndrome (CTS) is an entrapment neuropathy caused by compression of the median nerve as it travels through the wrist’s carpal tunnel. It is the most common nerve entrapment neuropathy, accounting for 90% of all neuropathies. Early symptoms of carpal tunnel syndrome include pain, numbness, and paraesthesia’s. These symptoms typically present, with some variability, in the thumb, index finger, middle finger, and the radial half (thumb side) of the ring finger. Pain also can radiate up the affected arm. With further progression, hand weakness, decreased fine motor coordination, clumsiness, and thenar atrophy can occur.

      The muscles innervated by the median nerve can be remembered using the mnemonic ‘LOAF’:
      L– lateral two lumbricals
      O– Opponens pollicis
      A– Abductor pollicis
      F– Flexor pollicis brevis

      In the early presentation of the disease, symptoms most often present at night when lying down and are relieved during the day. With further progression of the disease, symptoms will also be present during the day, especially with certain repetitive activities, such as when drawing, typing, or playing video games. In more advanced disease, symptoms can be constant.

      Typical occupations of patients with carpal tunnel syndrome include those who use computers for extended periods of time, those who use equipment that has vibration such as construction workers, and any other occupation requiring frequent, repetitive movement.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      40.6
      Seconds

  • Question 6 - Most of the lymph from vessels that drain the breast is collected in...

    Correct

    • Most of the lymph from vessels that drain the breast is collected in which of the following lymph nodes?

      Your Answer: Axillary nodes

      Explanation:

      Lymph is the fluid that flows through the lymphatic system.

      Axillary lymph nodes are near the breasts. They are often the first location to which breast cancer spreads if it moves beyond the breast tissue. They receive approximately 75% of lymph drainage from the breast via lymphatic vessels, laterally and superiorly.

      The lymph usually first drains to the anterior axillary nodes, and from here, through the central axillary, apical, and supraclavicular nodes in sequence.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      18.7
      Seconds

  • Question 7 - 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
      32.9
      Seconds

  • Question 8 - A patient suffered from a chest injury while working out in the gym....

    Incorrect

    • 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 flexes the humerus

      Correct 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
      35.1
      Seconds

  • Question 9 - A 25-year-old man suffers from a shoulder injury that damaged the nerve that...

    Incorrect

    • A 25-year-old man suffers from a shoulder injury that damaged the nerve that innervates the infraspinatus muscle.

      Which of the following nerves may most likely be affected?

      Your Answer: The thoracodorsal nerve

      Correct Answer: The suprascapular nerve

      Explanation:

      The suprascapular nerve (C5-C6) innervates the infraspinatus. It originates at the superior trunk of the brachial plexus. It runs laterally across the lateral cervical region to supply the infraspinatus and also the supraspinatus.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      33.3
      Seconds

  • Question 10 - Regarding the abductor pollicis longus, which of the following statements is true? ...

    Incorrect

    • Regarding the abductor pollicis longus, which of the following statements is true?

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

      Correct Answer: It extends the thumb at the carpometacarpal joint

      Explanation:

      Abductor pollicis longus is a muscle found in the posterior compartment of the forearm. It is one of the five deep extensors in the forearm, along with the supinator, extensor pollicis brevis, extensor pollicis longus and extensor indicis.

      Abductor pollicis longus is innervated by the posterior interosseous nerve (C7, C8), which is a continuation of the deep branch of the radial nerve. The radial nerve is a branch of the posterior cord of the brachial plexus.

      Blood supply to the abductor pollicis longus muscle comes from the interosseous branches of the ulnar artery.

      Acting alone or with abductor pollicis brevis, abductor pollicis longus pulls the thumb away from the palm. More specifically, it produces (mid-) extension and abduction of the thumb at the first metacarpophalangeal joint. This action is seen in activities such as bowling and shovelling.

      Working together with the long and short extensors of the thumb, the muscle also helps to fully extend the thumb at the metacarpophalangeal joint. This action is important for loosening the hand grip, for example, when letting go of objects previously being held. Abductor pollicis longus also helps to abduct the hand (radial deviation) at the radiocarpal joint.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      53.7
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Anatomy (2/10) 20%
Upper Limb (2/10) 20%
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