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Describes in multiple choice questions with answer sheet about upper limb anatomy.
Typology: Quizzes
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Section 1
Upper Limb Anatomy
With regard to the pectoral girdle: a) contains three joints, the sternoclavicular, the acromioclavicular and the glenohumeral b) serratus anterior, the rhomboids and subclavius attach the scapula to the axial skeleton c) pectoralis major and deltoid are the only muscular attachments between the clavicle and the upper limb d) teres major provides attachment between the axial skeleton and the girdle
Choose the odd muscle out as regards insertion/origin: a) supraspinatus b) subscapularis c) biceps d) teres minor e) deltoid
Which muscle does not insert in or next to the intertubecular groove of the upper humerus? a) pectoralis major b) pectoralis minor c) latissimus dorsi d) teres major
Identify the incorrect pairing for testing muscles: a) latissimus dorsi – abduct to 60° and adduct against resistance b) trapezius – shrug shoulders against resistance c) rhomboids – place hands on hips and draw elbows back and scapulae together d) serratus anterior – push with arms outstretched against a wall
Identify the incorrect innervation: a) subclavius – own nerve from the brachial plexus b) serratus anterior – long thoracic nerve c) clavicular head of pectoralis major – medial pectoral nerve d) latissimus dorsi – dorsal scapular nerve e) trapezius – accessory nerve
Which muscle does not extend from the posterior surface of the scapula to the greater tubercle of the humerus? a) teres major b) infraspinatus c) supraspinatus d) teres minor
With regard to action, which muscle is the odd one out? a) teres minor b) deltoid c) teres major d) subscapularis
Which statement is INCORRECT? a) the muscles of the rotator cuff are deemed to be such because all their tendons fuse with the lateral part of the shoulder capsule and are attached to the humerus near the joint b) the capsule of the shoulder joint is attached at the line of the anatomical head except inferiorly where it extends to the level of the surgical neck c) the subacromial bursa lies between the tendon of supraspinatus and the coraco-acromial ligament and communicates with the shoulder joint d) the long tendon of biceps lies intracapsular and is sheathed by synovial membrane that allows it to slide with movement
Stabilising factors of the shoulder joint include all but: a) a tight capsule b) tendons that fuse with the capsule c) glenohumeral and coracohumeral ligaments d) labrum e) splinting of the humeral head between the tendons of biceps and triceps
Regarding the brachial plexus, which is INCORRECT? a) it is derived from the anterior rami of C5-T1 after they have given off segmental supply to the prevertebral and scalene muscles b) the roots give off three branches including the long thoracic nerve to latissimus dorsi c) the trunks give off one branch d) the cords are divided into anterior and posterior divisions that supply the flexor and extensor compartments respectively and give off 13 branches e) the lateral cord supplies part of the median nerve
Regarding lymph nodes, the lateral side of the arm and forearm is drained initially to the: a) supratrochlear nodes b) posterior axillary nodes c) infraclavicular nodes d) central axillary nodes
Which of the following has some nerve supply from the radial nerve? a) long head of biceps b) coracobrachialis c) short head of biceps d) brachialis
As it emerges from the axilla, the median nerve lies where with regards to the brachial artery? a) lateral b) anterior c) medial d) posterior
The clavicle: a) ossifies at eight weeks b) has atypical synovial joints at both ends c) articulates with the first rib d) is more curved in females e) usually fractures between deltoid tubercle and coranoid tubercle
Regarding innervation of hand muscles: a) opponens pollicis may be supplied by ulnar nerve b) opponens digiti minimi may be supplied by median nerve c) two radial interossei are usually supplied by median nerve d) nail beds are supplied 3½ to 1½ by branches of radial and ulnar nerves e) adductor pollicis is supplied by muscular (recurrent) branch of median nerve
At the wrist / carpal tunnel: a) flexor retinaculum attaches to scaphoid and trapezoid laterally b) all superficial and deep flexors, except flexor pollicis longus, share a common flexor sheath c) the ulnar nerve lies medial to pisiform d) tendons of flexor digitorum remain attached until they reach the palm e) median nerve lies beneath flexor retinaculum between flexor digitorum superficialis and flexor pollicis longus
Axillary artery: a) first part is separated from the cords by axillary sheath b) lies posterior lateral to vein – all three parts c) medial root of median nerve crosses behind ????? to join lateral root. d) leaves axillar through quadrangular space e) supplies the breast via thoracoacromial branch
All the following arise from the common extensor origin EXCEPT: a) extensor carpi radialis brevis b) extensor carpi radialis longus c) extensor digitorum d) extensor digitorum minimi e) extensor carpi ulnaris
Regarding triceps: a) lateral head arises from humerus below radial groove b) midshaft humerus fractures may paralyse triceps c) has an insertion into the elbow joint capsule d) aids in adduction of shoulder e) is pierced by ulnar nerve
Which of the following pairs do not match with regard to mode of ossification? a) ribs and cranium b) clavicle and humerus c) femur and 1st^ metatarsal d) patella and pisiform e) mandible and clavicle
Which joint is the odd one out with regard to degrees of freedom? a) 1 st^ carpometacarpal joint b) radiohumeral joint c) sternoclavicular joint d) acromioclavicular joint e) radiocarpal joint
Which of the statements regarding ligaments is FALSE? a) ligaments are relatively avascular b) final healing following sprains usually restores full strength c) torn ligaments may predispose to dislocation d) Sharpeg’s fibres penetrate the bone e) a healed sprain may be predisposed to reinjury
Regarding cartilage, which is FALSE? a) it is essentially avascular b) hyaline cartilage contains hyaluronic acid c) rib cartilage is elastic type d) TMJ is fibrous e) all contain mucopolysaccharides
Regarding types of joints, which pairing is CORRECT? a) diarthrosis – cranial suture b) synarthrosis – symphysis pubis c) amphiarthrosis – sternoclavicular joint d) cromphosis – intervertebral joints e) syndesmoses – tibiofibular joint
Types of muscles, which pairing is INCORRECT? a) unipennate – flexor pollicis longus b) bipennate – 4th^ lumbrical c) fusiform – supraspinatus d) bipennate – soleus e) multi-pennate – anterior deltoid
Regarding muscle strength, which is NOT a factor? a) resting length of muscle b) cross sectional area c) lever arm length d) the extent to which the muscle is contracted e) configuration of fibres, eg fusiform, c.f. bipennate
Regarding the autonomic nervous system, visceral pain is not referred to L3-5 and S1 because: a) there are no visceral afferents related to these lumbar splanchnic nerves b) there are no white rami communicans to these spinal nerves c) there are no sympathetic ganglia associated with theses spinal segments d) there is no sympathetic efferent supply to these spinal nerves e) there are no grey rami communicans associated with the autonomic ganglia of L3-S1 spinal nerves
Section 2
At the elbow joint: a) the tilt of the trochlear of the humerus is the main cause for the carrying angle of the elbow b) the capsule is not attached to the radius c) the annular ligament is attached to the head and neck of the radius d) the middle band is the strongest of the three bands that make up the ulnar collateral ligament e) the carrying angle is the angle between the extended ulna and the vertical
Regarding palmar spaces: a) the hypothenar space contains the long tendon of abductor digiti minimi b) the midpalmar space is deep to the common synovial sheath and flexor tendons c) the midpalmar space is not continuous with the three ulnar lumbrical canals d) the thenar space is open at the wrist e) prevent spread of infection
Which is NOT an origin of supinator a) radial tuberosity b) radial collateral ligament c) lateral epicondyle of humerus d) supinator crest of ulnar e) aponeurosis overlying supinator muscle
Regarding the nerves and vessels of the arm: a) the circumflex vessels and the axillary nerve enter the extensor compartment in the axilla through the triangular space b) the ulnar nerve pierces the lateral intermuscular septum in the lower third of the arm c) the median nerve crosses obliquely in front of the radial artery in the arm d) supratrochlear lymph nodes lie in the subcutaneous ????? just above the medial epicondyle e) the basilic vein is lateral to the cephalic vein
Brachial plexus: a) the five roots lie in front of scalenus anterior muscle b) the anterior division of the central trunk runs on as the medial cord c) the suprascapular nerve is the only branch from the trunks d) the radial nerve is a branch of the lateral cord e) the ulna nerve is a branch of the posterior cord
The musculocutaneous nerve passes through which muscle? a) coracobrachialis b) short head of biceps c) brachialis d) medial head of triceps e) long head of biceps
What structure does NOT lie in the anatomical snuff box? a) cephalic vein b) radial artery c) radial styloid d) first metacarpal bone e) extensor pollicis longus
Latissimus dorsi: a) is an accessory muscle of inspiration and expiration b) is supplied by the dorsal scapular nerve c) forms the lower border of the medially axillary fold d) laterally rotates the humerus e) lies superficial to trapezius at its upper border
Regarding the shoulder joint, which is INCORRECT? a) full abduction requires medial rotation b) the long head of biceps is intracapsular c) the subacromial bursa is attached to the coracoacromial ligaments d) flexion involves pec major, deltoid, coracobrachialis and biceps e) supraspinatus initiates abduction
In the forearm: a) the median nerve passes between the two heads of pronator teres b) the ulnar nerve lies deep to flexor digitorum profundus c) superficial fibres of flexor digitorum superficialis gives rise to the tendons for index and middle fingers d) the radial artery is on the lateral side of the radial nerve e) the fibres of the interosseous membrane run obliquely down from ulna to radius
What structure does NOT pierce the clavipectoral fascia? a) cephalic vein b) lymphatics c) lateral thoracic artery d) lateral pectoral nerve e) thoracoacromial artery
Regarding the thumb: a) abductor pollicis longus originates from both radius and ulna b) opponens pollicis rotates the first metacarpal on the triquetral c) adductor pollicis inserts on to the radial sesamoid of the thumb, then the base of the proximal phalanx d) nerve supply is by the median nerve (C7, C8) e) adductor pollicis lies superficial to the thenar space
Which artery is the main supply of triceps? a) dorsal scapular artery b) brachial artery c) profunda brachii artery d) radial artery e) posterior circumflex humeral artery
Regarding the clavicle, which is false? a) the clavicle is longer and its curvatures more pronounced in the male b) the articulating sternal end is covered by fibrocartilage c) it is the first bone to ossify in the foetus d) it has four named ligaments attached to it e) fractures of the clavicle tend to occur between the costoclavicular and the coracoclavicular ligaments
Which is true of muscles of the pectoral girdle? a) “direct” muscles are inserted into the clavicle or scapula from the axial skeleton, eg pectoralis major b) “indirect” attachment to the axial skeleton is represented by serratus anterior c) the sternocostal fibres of pectoralis major from the 6th^ costal cartilage are inserted higher on the lateral lip of the intertubecular soleus than the fibres from the first cartilage d) biceps muscle gives no stability to the shoulder joint e) trapezius is the only muscle to be supplied by all five segments of the brachial plexus
The clavipectoral fascia is pierced by all but one of the following structures: a) lymphatic drainage from the infraclavicular nodes to apical axillary nodes b) cephalic vein c) lateral pectoral nerve d) thoracoacromial artery e) pectoralis minor
With respect to the axilla: a) the thoracodorsal nerve runs posterior to the mid axillary line on serratus anterior, which it supplies b) the axillary artery is divided into three parts by scalenus anterior c) the lateral wall is made up of latissimus dorsi tendon, subscapularis, teres major d) the lateral thoracic vein is connected by the thoracoepigastric vein to the superficial epigastric vein, therefore bypassing the IVC in its obstruction e) the axillary vein commences at the upper border of teres major as a continuation of the basilic vein
With respect to the brachial plexus: a) it consists of the entire anterior rami of C5 → T b) there are five roots, three trunks, five divisions and three cords c) there are two branches from the divisions d) there are a total of 13 branches from the cords e) there are two branches from the roots
With respect to the brachial plexus: a) the lateral cord lies in the axilla b) the median nerve is the largest branch of the whole plexus c) the roots lie within the posterior triangle of the neck d) the ulnar nerve is a branch of the lateral cord e) the musculocutaneous nerve is a branch of the medial cord
The blood supply to the breast involves all but one of the following: a) lateral thoracic artery b) long thoracic artery c) internal thoracic artery d) posterior intercostal artery e) thoracoacromial artery
Which muscle takes origin (in part) from both the medial and lateral intermuscular septa? a) biceps b) brachioradialis c) extensor carpi radialis longus d) supinator e) triceps
The carpus: a) there are five extensor tunnel compartments b) the extensor expansion attaches to the anterolateral border of the radius above the styloid process, and distally to the pisiform and trapezoid bones c) the radiocarpal joint is an uniaxial synovial joint d) there are no muscular attachments to the extensor surface of the carpus e) the bones palpable in the anatomical snuff box are the radial styloid, triquetral, scaphoid and base of first metacarpal
Which is true? a) the flexor synovial sheath is only continuous from wrist to distal phalanx in the thumb b) the medial cutaneous nerve is the smallest nerve branch of the brachial plexus c) the capitate bone within the carpus is the last of these to ossify d) the pisiform bone is the first bone of the carpus to ossify e) superficial lymphatics lie with arteries, deep lymphatics with veins
Section 4
Upper Limb
Which is true? a) epidermis derives from mesoderma b) the sweat glands, sebaceous glands are mesodermal in origin c) the colour of the skin is determined by the number of melanocytes in the skin d) the dermis has a mesodermal origin
Regarding sweat glands, which is true? a) the main nerve supply is via cholinergic sympathetic fibres b) the main nerve supply is via adrenergic sympathetic nerves c) the sweat glands derive from the mesoderm d) the normal tubular sweat glands undergo cyclical changes with the menstrual cycle e) the highest number of sweat glands are found on the soles and palms
Regarding cartilage, which is true? a) they have a rich blood supply b) the intervertebral discs are hyaline cartilages c) the hyaline and fibrocartilages never calcify d) the elastic cartilage never calcifies e) the commonest cartilage type is elastic cartilage
Regarding muscles, which is true? a) the cardiac muscle is more powerful than the other two muscle types b) the skeletal muscle fibre is spindle shaped c) the smooth muscles do not have actin and myosin d) the skeletal muscle contraction causes peristalsis in the GI tract and ureter e) the cardiac muscle is short, branched, mononuclear and a striated muscle
Regarding periosteum, which is TRUE? a) it is an avascular fibrous tissue b) it is osteogenic c) it covers the articular surfaces of long bones d) it covers the inner surface of the medullary cavity e) it receives its blood supply from overlying muscle
An example of secondary cartilaginous joint include: a) hip joint b) manubrio-sternal joint c) costochondral joint d) epiphysis joint e) wrist joint
An example of a fibrous joint include: a) structures of the vault of the skull b) the vertebral columns c) pubic symphysis d) hip joint e) manubrio-sternal joint
Which of the following peripheral fibres have pain and temperature fibres? a) α neurone b) β neurone c) γ neurone d) δ neurone e) group B fibres
Pectoralis major: a) is innervated laterally by the lateral pectoral nerve b) inserts into the medial lip of the intertubercular sulcus c) receives its arterial supply via the thoracoacromial artery d) can act as an accessory muscle of inspiration e) acts with latissimus dorsi and teres minor to adduct the arm
Regarding the brachial plexus: a) the suprascapular nerve arises from the anterior C5, 6 division b) ulnar nerve often carries fibres from C c) the radial nerve leaves the axilla via the quadrangular space d) the radial artery lies anterior to the medial and lateral roots of the median nerve e) the long thoracic nerve arises from the C5 nerve root only
The subacromial bursa: a) communicates with the shoulder joint b) does not extend beyond the lateral aspect of the acromion c) innervated in part by the dorsal scapular nerve d) attached superiorly to the conoid trapezoid and conoid ligaments e) attached inferiorly to the tendon of supraspinatus
The subclavius muscle: a) arises from the costochondral junction of the second rib b) passes in the subclavian groove on the inferior aspect of the clavicle to attach to the acromion c) is enclosed by the upper attachment of the clavipectoral fascia d) is supplied by C7 and C e) assists shoulder adduction
Pectoralis minor: a) inserts into the lateral tip of the intertubecular groove of the humerus b) is a rectangular muscle c) is a guide for the underlying subclavian artery d) is superior to the suspensory ligament of the axilla e) is supplied by the subclavian nerve
What structure pierces the flexor retinaculum? a) ulnar nerve b) flexor carpi radialis tendon c) palmar branch of median nerve d) flexor pollicis longus tendon e) ulnar artery
The lumbrical muscles: a) arise from the four superficial tendons b) are all bicipital muscles c) pass along the ulnar side of the metacarpophalangeal joint d) flex the metacarpophalangeal joint e) attach directly to the first phalanx
The following are true about flexor carpi radialis EXCEPT: a) it arises from the common flexor origin at the humerus b) it has its own compartment in the flexor retinaculum c) the radial artery lies laterally to it at the wrist d) flexor pollicis longus lies medially e) it is supplied by the median nerve f) it inserts into the base of the 2nd^ and 3rd^ metacarpals
Which is the smallest branch of the medial cord of the brachial plexus? a) medial pectoral nerve b) medial root of the median nerve c) medial cutaneous nerve of the arm d) medial cutaneous nerve of the forearm e) ulnar nerve
The nerve supply of serratus anterior is: a) axillary nerve b) C c) dorsal scapular nerve d) thoracodorsal nerve e) long thoracic nerve
Which muscle arises from both the radius and ulna: a) extensor pollicis longus b) extensor pollicis brevis c) abductor pollicis longus d) extensor indicis e) extensor digitorum
Which lymphatics do not drain the breast? a) subscapular nodes b) infraclavicular nodes c) lateral axillary nodes d) parasternal nodes e) pectoral nodes
Section 5
General Principles
Regarding tissues: a) cartilage is very vascular b) ligaments do not stretch c) deep fascia is not sensitive d) cardiac muscle is nonstriated e) periosteum is not sensitive
An example of a unipennate muscle is: a) sartorius b) flexor pollicis longus c) rectus femoris d) deltoid e) tibialis anterior
An example of a secondary cartilaginous joint is: a) distal tibiofibular joint b) costochondral joint c) sagittal suture d) sternal angle joint e) knee joint
Which vessel is not an end-artery? a) renal artery b) retinal artery c) pulmonary artery d) intercostal artery e) splenic artery
A group C nerve fibre: a) is up to 20 nm in diameter b) is myelinated c) has motor function d) is fusimotor to muscle spindles e) is post-ganglionic autonomic
Regarding cartilage, which is INCORRECT? a) it is essentially avascular b) hyaline cartilage contains hyaluronic acid c) rib cartilage is elastic type d) TMJ is fibrous e) all contain mucopolysaccharides
At birth: a) the transverse diameter of the thorax is thrice the AP diameter b) the liver is relatively twice as big as that of the adult c) the suprarenal gland is twice as big as the kidney d) the spinal cord extends to L e) the rib cage is more vertically inclined than in the adult
In the foetal skull: a) the vertical height of the orbit is equal to the combined vertical heights of the maxilla and the mandible b) the mandible is ossified at birth c) the anterior fontanelle is closed at the end of the first year d) the volume of the vault is equal to that of the face e) the bones of the face and the vault ossify at six years
Regarding the sympathetic nervous system: a) every spinal nerve receives a white ramus communicans b) efferent post ganglionic fibres are myelinated c) afferent sympathetic fibres synapse in the sympathetic trunk d) preganglionic cell bodies lie within the lateral horn cells of the T1-L2 spinal segments e) each cervical ganglion gives off one ramus communicans
Which of the following nerve roots is correctly associated with the corresponding muscle action? a) L5 – plantar flexion of the foot b) L2 – knee extension c) C5 – abduction of the shoulder d) C8 – abduction of the thumb e) S1 – extension of the great toe
In the skin: a) apocrine sweat glands are confined to the axillae, breasts and urogenital region b) dark skinned races possess greater numbers of melanocytes c) sebaceous glands are abundant on the palms and soles d) melanocytes predominate in the dermis e) eccrine glands develop under the influence of the sex hormones
Regarding bone: a) cancellous and compact bone show marked microscopic differences b) the clavicle ossifies in membrane c) the bones of the skull and face ossify in cartilage d) the epiphyseal plates of growing bones are composed of fibrocartilage e) sesamoid bones are only associated with flexor tendons
The metacarpophalangeal joints are: a) planar b) ellipsoid c) hinge d) saddle e) ball in socket