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  • Question 1 - During a radical mastectomy for advanced breast cancer, the surgeon injured the long...

    Incorrect

    • During a radical mastectomy for advanced breast cancer, the surgeon injured the long thoracic nerve. Which among the following muscles is likely to be affected?

      Your Answer: Subscapularis

      Correct Answer: Serratus anterior

      Explanation:

      The long thoracic nerve innervates the serratus anterior muscle which holds the scapula forward and balances the rhomboids and the trapezius muscles which retract the scapula. Injury to this nerve results in a ‘winged scapula’ with a posterior protrusion.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      19
      Seconds

  • Question 2 - A ‘claw hand’ is usually associated with injury to which of the following...

    Correct

    • A ‘claw hand’ is usually associated with injury to which of the following nerves?

      Your Answer: Ulnar nerve

      Explanation:

      A ‘claw hand’ is associated with injury to the ulnar nerve at the wrist affecting the interossei, lumbricals and hypothenar muscles of the hand. It is characterized by hypothenar eminence wasting, hyperextended metacarpophalangeal joints and flexed interphalangeal joints.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      8.8
      Seconds

  • Question 3 - The muscle which has an antagonistic action to the serratus anterior muscle and...

    Correct

    • The muscle which has an antagonistic action to the serratus anterior muscle and is one of the retractors of the scapula is the?

      Your Answer: Rhomboid major

      Explanation:

      Protraction is accomplished by the actions of the serratus anterior, pectoralis major, and pectoralis minor muscles. Retraction is accomplished by the actions of the trapezius, rhomboids, and latissimus dorsi muscles.

      The rhomboid major arises from the second, third, fourth and fifth thoracic vertebrae. It is inserted into a narrow tendinous arch attached to the root of the spine of the scapula and the inferior angle. By its insertion in the inferior angle of the scapula, it acts on this angle and produces a slight rotation of the scapula on the side of the chest. It also retracts the scapula by working with the trapezius muscle.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      3.2
      Seconds

  • Question 4 - A man had an injury to his right brachial plexus. After examination by...

    Correct

    • A man had an injury to his right brachial plexus. After examination by the doctor they found that the diaphragm and the scapula were unaffected however the patient could not abduct his arm. When helped with abducting his arm to 45 degrees he was able to continue the movement. This means that he was unable to initiate abduction. Where is the likely site of injury?

      Your Answer: Suprascapular nerve

      Explanation:

      The loss of ability to initiate abduction means paralysis of the supraspinatus muscle. This muscle is supplied by the supraclavicular nerve.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      7.6
      Seconds

  • Question 5 - A gymnast was admitted to hospital for investigation of a weakness in the...

    Correct

    • A gymnast was admitted to hospital for investigation of a weakness in the extension and adduction of his arm. He had a previous penetrating wound in the area of the posterior axillary fold. Which of these muscles is the likely cause?

      Your Answer: Latissimus dorsi

      Explanation:

      All the criteria of this case points towards the latissimus dorsi. This muscle is greatly involved in extension, adduction and medial rotation of the arm and forms the posterior axillary fold which in this case was injured.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      8.7
      Seconds

  • Question 6 - Which muscle would be affected most following injury to the transverse cervical artery?...

    Correct

    • Which muscle would be affected most following injury to the transverse cervical artery?

      Your Answer: Trapezius

      Explanation:

      The latissimus dorsi receives blood from the thoracodorsal artery, the supraspinatus receives its blood from the suprascapular artery, the levator scapulae and the rhomboids are supplied by the dorsal scapular artery and the transverse cervical artery supplies blood to the trapezius.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      14.5
      Seconds

  • Question 7 - An old man fell and fractured a carpal bone articulating with the pisiform...

    Correct

    • An old man fell and fractured a carpal bone articulating with the pisiform bone. Which bone was most likely fractured?

      Your Answer: Triquetral

      Explanation:

      The pisiform bone has an oval facet for articulation with the triquetral bone. The pisiform bone is a sesamoid bone, and is anterior to the other carpal bones.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      6.4
      Seconds

  • Question 8 - When you rest your elbows on a desk, what bony landmark of the...

    Incorrect

    • When you rest your elbows on a desk, what bony landmark of the upper limb are you resting on?

      Your Answer: Coronoid process of the ulna

      Correct Answer: Olecranon process of the ulna

      Explanation:

      At the upper and back part of the ulna, there exists a curved eminence which is the olecranon process. This process lodges in the olecranon fossa of the humerus. It’s posterior surface is subcutaneous and this triangular area is what you rest your elbow upon.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      9.6
      Seconds

  • Question 9 - Regarding abduction of the digits of the hand, which of the following is...

    Correct

    • Regarding abduction of the digits of the hand, which of the following is correct?

      Your Answer: All of the adductors of the digits take at least part of their attachments from metacarpal bones

      Explanation:

      Lying on the palmer surfaces of the metacarpal bones are four palmar interossei which are smaller than the dorsal interossei. Arising from the entire length of the metacarpal bone of one finger, is a palmar interosseous, which is inserted into the side of the base of the first phalanx and the aponeurotic expansion of the extensor digitorum communis tendon to the same finger. All the interossei are innervated by the eighth cervical nerve, through the deep palmar branch of the ulnar nerve. The palmar interossei adducts the fingers to an imaginary line drawn longitudinally through the centre of the middle finger.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      10.4
      Seconds

  • Question 10 - During a street fight a boy sustained a laceration below the elbow. It...

    Incorrect

    • During a street fight a boy sustained a laceration below the elbow. It was a deep cut that led to profuse bleeding from an artery situated on the supinator muscle immediately below the elbow. The vessel most likely to have been injured is?

      Your Answer: Anterior ulnar recurrent artery

      Correct Answer: Radial recurrent artery

      Explanation:

      The radial recurrent artery is situated on the supinator muscle then passing between the brachialis and the brachioradialis muscles. It originates from the radial artery and ends by anastomosing with the terminal part of the Profunda brachii.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      30.5
      Seconds

  • Question 11 - What is the arterial sequence for an analgesic to reach the latissimus dorsi...

    Incorrect

    • What is the arterial sequence for an analgesic to reach the latissimus dorsi muscle assuming that your starting point is at the subclavian vein?

      Your Answer: Subclavian – axillary – thyrocervical trunk – suprascapular

      Correct Answer: Subclavian – axillary – subscapular – thoracodorsal

      Explanation:

      Assuming our starting point is the subclavian artery, the analgesic continues in the same vessel into the axillary artery, as it passes into the axilla. The axillary artery at the lower border of the subscapularis gives rise to the subcapsular artery which is considered the largest branch of the axillary artery. This circumflex scapular branch distributes a serratus branch before entering the substance of the muscle as the thoracodorsal artery.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      2.4
      Seconds

  • Question 12 - An old man presented with atrophy of the thenar eminence despite the sensation...

    Correct

    • An old man presented with atrophy of the thenar eminence despite the sensation over it still being intact. What is the injured nerve in this case?

      Your Answer: Median nerve

      Explanation:

      Atrophy of the thenar muscles means injury to the motor supply of these muscles. The nerve that sends innervation to it is the median nerve. But the median nerve does not provide sensory innervation to the overlying skin so sensation is spared.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      3.4
      Seconds

  • Question 13 - A chef, whilst preparing food, cut her thumb with a knife. She transected...

    Correct

    • A chef, whilst preparing food, cut her thumb with a knife. She transected the arteria princeps pollicis. This artery is a branch of the?

      Your Answer: Radial artery

      Explanation:

      The radial artery branches into the arteria princeps pollicis as it turns medially into the deep part of the hand. The arteria princeps pollicis is distributed to the skin and subcutaneous tissue of the thumb.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      5.2
      Seconds

  • Question 14 - The rotator cuff surrounds the shoulder joint and consists of the supraspinatus, infraspinatus,...

    Correct

    • The rotator cuff surrounds the shoulder joint and consists of the supraspinatus, infraspinatus, subscapularis and which one other muscle?

      Your Answer: Teres minor

      Explanation:

      The correct answer is the teres minor muscle. These group of muscles play an important role in protecting the shoulder joint and keeping the head of the humerus in the glenoid fossa of the scapula. This fossa is somehow shallow and needs support to allow for the full mobility that the shoulder joint has.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      8
      Seconds

  • Question 15 - The muscle that forms the posterior wall of the axilla along with the...

    Incorrect

    • The muscle that forms the posterior wall of the axilla along with the scapula, subscapularis muscle and teres major muscle is the?

      Your Answer: Supraspinatus

      Correct Answer: Latissimus dorsi

      Explanation:

      The latissimus dorsi forms the posterior wall of the axilla along with the scapula. It is responsible for extension, adduction, transverse extension also known as horizontal abduction, flexion from an extended position, and (medial) internal rotation of the shoulder joint. It also has a synergistic role in extension and lateral flexion of the lumbar spine.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      39.1
      Seconds

  • Question 16 - Which best describes the suprascapular nerve? ...

    Incorrect

    • Which best describes the suprascapular nerve?

      Your Answer: It courses superior to the suprascapular ligament enroute to the supraspinatus muscle

      Correct Answer: It contains nerve fibres from C5 and C6 spinal cord segments

      Explanation:

      The suprascapular nerve arises from the cervical spinal nerves 5 and 6 after coming together to form common trunk. This nerve supplies the supraspinatus and infraspinatus muscles giving off branches to the shoulder joint.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      63.7
      Seconds

  • Question 17 - A lad involved in a road traffic accident is rushed to casualty where...

    Correct

    • A lad involved in a road traffic accident is rushed to casualty where physical examination reveals that he has limited extension of his right humerus. Which of the following nerves is most likely to have been injured?

      Your Answer: Thoracodorsal nerve

      Explanation:

      Extension of the humerus is a function of the latissimus dorsi. This muscle is supplied by the thoracodorsal nerve which is a branch of the posterior cord of the plexus whose fibres are derived from cranial nerves V, VI and VII.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      15.7
      Seconds

  • Question 18 - A 40 year old man sustained a fracture to the surgical neck of...

    Correct

    • A 40 year old man sustained a fracture to the surgical neck of his left humerus. Which of the following arteries is suspected to be injured in this case?

      Your Answer: Posterior humeral circumflex

      Explanation:

      The posterior humeral circumflex artery arises from the axillary artery and runs with the axillary nerve through the quadrangular space which is bounded laterally by the surgical neck of the humerus. After winding around the surgical neck of the humerus, it is distributed to the deltoid muscle and the shoulder joint. Thus fractures in the surgical neck of the humerus could result in an injury to this artery.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      9.4
      Seconds

  • Question 19 - A 38 year-old man falls on an outstretched hand. X-rays indicate an anterior...

    Correct

    • A 38 year-old man falls on an outstretched hand. X-rays indicate an anterior dislocation of one of the carpal bones. Which carpal bone is most commonly dislocated?

      Your Answer: Lunate

      Explanation:

      The scaphoid bone is the most commonly fractured carpal bone and has an increased risk of avascular necrosis.

      The lunate is the most commonly dislocated carpal bone. The displaced bone may compress the median nerve in the carpal tunnel.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      10.7
      Seconds

  • Question 20 - The annular ligament in the forearm: ...

    Correct

    • The annular ligament in the forearm:

      Your Answer: Encircles the head of the radius

      Explanation:

      The annular ligament forms about four-fifths of the osseofibrous ring and is attached to the anterior and posterior margins of the radial notch. It is a strong band of fibres which encircles the head of the radius retaining it in contact with the radial notch of the ulna. When it comes to its upper border, it blends with the anterior and posterior ligament of the elbow.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      6.1
      Seconds

  • Question 21 - Which muscle originates from the common flexor tendon of the forearm? ...

    Correct

    • Which muscle originates from the common flexor tendon of the forearm?

      Your Answer: Flexor digitorum superficialis

      Explanation:

      The medial epicondyle of the humerus is the site of origin of this group of muscles of the forearm. It originates from the medial epicondyle of the humerus by a common tendon. Fibres from the deep fascia of the forearm, near the elbow and septa, pass from this fascia between the muscles. These muscles include the pronator teres, palmaris longus, flexor carpi radialis, flexor carpi ulnaris and flexor digitorum superficialis.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      11.3
      Seconds

  • Question 22 - A young man came to the emergency room after an accident. The anterior...

    Correct

    • A young man came to the emergency room after an accident. The anterior surface of his wrist was lacerated with loss of sensation over the thumb side of his palm. Which nerves have been damaged?

      Your Answer: Median

      Explanation:

      The median nerve provides cutaneous innervation to the skin of the palmar radial three and a half fingers. Also the site of injury indicates that the medial nerve may have been injured as it passes into the hand by crossing over the anterior wrist.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      7.6
      Seconds

  • Question 23 - A young boy fell from a tree, sustaining an injury to the elbow...

    Incorrect

    • A young boy fell from a tree, sustaining an injury to the elbow area and damaging the nerve behind the medial epicondyle of the humerus. What is the most likely result from that injury?

      Your Answer: Extension of the metacarpophalangeal joints of digits 4 and 5

      Correct Answer: Flexion in the distal interphalangeal joint of digit 5

      Explanation:

      The nerve injured in this situation is the ulnar nerve. It passes posterior to the medial epicondyle of the humerus before going between the two heads of the flexor carpi ulnaris muscle. This nerve supplies the muscles and skin of forearm and hand. At the level of medial epicondyle, the injury will led to paralysis in flexor carpi ulnaris and the ulnar half of the flexor digitorum profundus as well as the palmar interossei and hypothenar muscles in the hand. The correct answer will be that the boy will suffer from inability to flex the distal interphalangeal joint of digit 5

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      14.5
      Seconds

  • Question 24 - A man came to the hospital complaining of a sensation of pins and...

    Correct

    • A man came to the hospital complaining of a sensation of pins and needles in the dorsum of the thumb and digits 1 and 2. On further examination they found that he had weakness in wrist dorsiflexion and finger extension. Which nerve do you think is injured in this case?

      Your Answer: Radial

      Explanation:

      The radial nerve can be injured in multiple sites along its course in the upper limb, and each site has its own presentation. The major complaint is wrist drop which if high above the elbow, can cause numbness of the forearm and hand. It can last for several days or weeks. The most common site of compression for the radial nerve is at the proximal forearm in the area of the supinator muscles.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      4.9
      Seconds

  • Question 25 - An X ray of a 60 year old male brought to the accident...

    Correct

    • An X ray of a 60 year old male brought to the accident and emergency following a fall down stairs shows a fractured olecranon process of the right ulna with the line of fracture passing through the superior surface, disrupting a muscle. Which among the following muscles was most likely injured?

      Your Answer: Triceps brachii

      Explanation:

      The superior surface of the olecranon process forms an attachment for the insertion of the triceps brachii on the posterior aspect. It also has a minor transverse groove for the attachment of part of the posterior ligament of the elbow on the anterior aspect.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      8.2
      Seconds

  • Question 26 - The muscle that depresses the glenoid fossa directly is the: ...

    Incorrect

    • The muscle that depresses the glenoid fossa directly is the:

      Your Answer: Supraspinatus

      Correct Answer: Pectoralis minor

      Explanation:

      Situated at the upper part of the thorax beneath the pectoralis major, is a thin pectoralis minor, triangular muscle. It originates from the third, fourth and fifth ribs, near the cartilage and from the aponeurosis which covers the intercostals. These fibres move upwards and laterally to join and form a flat tendon. This is inserted into the medial border and upper surface of the coracoid process of the scapula. Through this medial anterior thoracic nerve, fibres from the pectoralis minor are received from the eighth cervical and first thoracic nerves. This pectoralis minor pushes down on the point of the shoulder (glenoid fossa), drawing the scapula downward and medially towards the thorax which throws the inferior angle backwards.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      17.9
      Seconds

  • Question 27 - When a young boy falls on his outstretched hand, he fractures one of...

    Incorrect

    • When a young boy falls on his outstretched hand, he fractures one of the bones at his wrist joint. The doctors told his parents that the fractured bone has special importance as it is that bone that articulates with the distal end of the radius. Which one of the following is it?

      Your Answer: Trapezium

      Correct Answer: Scaphoid

      Explanation:

      It is the scaphoid bone that articulates with the radius at this level. It is located at the radial side of the wrist and is considered the largest bone in the proximal row of carpal bones. It articulates with the radius via its superior surface. This bone also articulates with trapezium and trapezoid bones via the inferior surface, capitate and lunate medially.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      13.7
      Seconds

  • Question 28 - A swimmer was struggling to finish his training following an injury to his...

    Correct

    • A swimmer was struggling to finish his training following an injury to his right arm. On further examination it was found that any movements involving adduction, medial rotation and extension of her arm were particularly weak. Which nerve in this case was damaged?

      Your Answer: Thoracodorsal

      Explanation:

      Weakness on these particular movements indicate that there is a problem with the latissimus dorsi muscle. This muscle is very important particularly in swimming movements and is supplied by the thoracodorsal nerve.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      3.9
      Seconds

  • Question 29 - Following an accident, a man was unable to extend the wrist and metacarpophalangeal...

    Correct

    • Following an accident, a man was unable to extend the wrist and metacarpophalangeal joints, despite sensation being intact. Which nerve was likely damaged?

      Your Answer: Posterior interosseous nerve

      Explanation:

      The posterior interosseous nerve which causes, what is known as the posterior interosseous nerve syndrome. The nerve is compressed before it bifurcates to form the medial and lateral branches. The compression is beyond the origin of the branches to the radial wrist extensors and the radial sensory nerve. The result of such a case is paralysis of the digital extensors and the extensor carpi ulnaris, resulting in dorsoradial deviation of the wrist.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      16.2
      Seconds

  • Question 30 - An old man was diagnosed with squamous cell carcinoma with axillary lymph node...

    Correct

    • An old man was diagnosed with squamous cell carcinoma with axillary lymph node metastasis. The doctor said he will excise the tumour and remove all axillary lymph nodes lateral to the edge of the pectoralis minor muscle. One of the following axillary lymph nodes won't be removed by this procedure. Which is it?

      Your Answer: Apical

      Explanation:

      The apical lymph node group won’t be removed which include 20 to 30 lymph nodes.

      Axillary lymph nodes are grouped according to location. The lateral group, the anterior to pectoral group, the posterior or subscapular group, the central group, and the medial or apical group. The lateral, pectoral, and subscapular groups are found lateral to the pectoralis minor muscle. The central group is situated directly under that muscle. Thus, if all lymph nodes lateral to the medial edge of the pectoralis minor muscle are removed, all the above four groups will be removed. The apical group won’t be removed which is situated medial to the medial edge of the pectoralis minor muscle.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      5.1
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Anatomy (21/30) 70%
Upper Limb (21/30) 70%
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