Upper Limb Practice MCQs

Munib AbbasMunib Abbas April 27, 2020
1: Regarding clavicle all are ture, EXCEPT: :





... Answer is "It is an example of short bone"
The clavicle is a sigmoid-shaped long bone with a convex surface along its medial end when observed from cephalad position.
2: The most common site of fracture of clavicle is: :





... Answer is "Junction of medial two-thirds and lateral third"
The most common type of fracture occurs when a person falls horizontally on the shoulder or with an outstretched hand. A direct hit to the collarbone can also cause a break. In most cases, the direct hit occurs from the lateral side towards the medial side of the bone.
3: These muscles are attached to medial two third of clavicle: :





... Answer is "Deltoid"
The deltoid muscle is shaped like the Greek letter delta (Δ). It can be divided into an anterior, middle and posterior part. Attachments: Originate from the lateral third of the clavicle, the acromion and the spine of the scapula. It attaches to the deltoid tuberosity on the lateral aspect of the humerus.
4: The onferior surface of clavicle gives attachment to all of the following except: :





... Answer is "Pectoralis major"
It is large and fan shaped, and is composed of a sternal head and a clavicular head: Attachments: The distal attachment of both heads is into the intertubercular sulcus of the humerus. Clavicular head - originates from the anterior surface of the medial clavicle.
5:A 29 year old man comes in with a stab wound, cannot raise his arm above horizontal and exhibits a condition known as "winged scapula". Which of the following structures of the bracial plexus would most likely be damaged: :





... Answer is "Root"
Winged scapula is caused by paralysis of serratus anterior muscle that results in damage to long thoracic nerve which arise from root of bracial plexus.
6:A 18-year old patient has a weakness flexing the metacarpophalangeal joint of the ring finger and is unable to adduct the same finger. Which of the following muscles is likely paralyzed: :





... Answer is "Palmar interosseous"
The dorsal and palmar interosseous and lumbricals can flex the metacarpophalangeal joints and extend the interphalangeal joints. Palmar interosseous muscles adduct the fingers, while dorsal interosseous abduct the finger.
7: The glenoid cavity articulates with the head of humerus by a: :





... Answer is "Ball and socket"
The glenoid cavity or glenoid fossa of scapula is a part of the shoulder. It is a shallow, pyriform articular surface, which is located on the lateral angle of the scapula. This cavity forms the glenohumeral joint along with the humerus. This type of joint is classified as a synovial, ball and socket joint.
8: One of the following is not attached to the medial border of scapula: :





... Answer is "Teres minor"
The teres minor originates at the lateral border and adjacent posterior surface of the scapula. It inserts at the greater tubercle of the humerus. The tendon of this muscle passes across, and is united with, the posterior part of the capsule of the shoulder-joint.
9: All of the following parts of scapula can be felt except: :





... Answer is "Upper border"
In its lower two-thirds, i.e. where it forms the medial boundary of the infraspinous fossa, this border can easily be felt through the skin, but its upper third is more deeply placed and cannot be palpated in the normal subject. The superior border, thin and sharp, is the shortest of the three borders.
10: The surgical neck of humerus is related to: :





... Answer is "Axillary nerve"
The axillary nerve derives from the posterior cord of the brachial plexus with the radial nerve, and lies in close proximity to the surgical neck of the humerus.
11: The back of medial epicondyle is related to: :





... Answer is "Ulnar nerve"
The ulnar nerve and its branches innervate the following muscles in the forearm and hand: An articular branch that passes to the elbow joint while the ulnar nerve is passing between the olecranon and medial epicondyle of the humerus.
12: A 23 year old man walks in with a shoulder and arm injury after falling during horse-back riding. Examination indicates that she cannot adduct her arm because of paralysis of which of the following: :





... Answer is "Lattismus dorsi"
Lattismus dorsi adduct the arm, supraspinatus abduct the arm. Infraspinatus and teres minor rotate the arm laterally while the serratus anterior rotates the glenoid cavity of scapula.
13: A 32 year old woman walks in with a stab wound to the most medial side of proximal portion of cubital fossa. Which of the following structures would most likely be damaged: :





... Answer is "Median nerve"
Cubital fossa content from medial to lateral are: Median nerve,Bracial artery, Bicep bracii tendon and radial nerve. The radial recurrent artery ascent medial to radial nerve (The mnemonic to simplify the contents is present in the blog)
14: A 14 year old boy has a fracture of the shaft of the humerus. Which of the following nerve is most likely to be damaged :





... Answer is "Radial nerve"
The radial nerve is damaged runs in radial groove on the back of shaft of the humerus with profunda brachii artery
15: In an attempt to obtain blood sample from a patient's median cubital vein, a regestered nerse inadvertently procures arterial blood. Which of the following artery is ruptured :





... Answer is "Bracial artery"
The median cubital vein lies superficial to the bicipital aponeurosis and thu seperates it from the bracial artery, which can be punctured during IV injection and blood transfusion.
16:A man was struck by a bullet in the arm and his median nerve has been damaged. Which of the following symptoms is likely to be produced by this nerve damage? :





... Answer is "Ape hand"
The injury to median nerve produces ape hand (i.e. a hand with thumb permenantly extended).
17: The deltopectoral groove contains :





... Answer is "Cephalic vein"
The deltopectoral groove is an indentation in the muscular structure between the deltoid muscle and pectoralis major. It is the location through which the cephalic vein passes and where the coracoid process is most easily palpable.
18: Axilla contain all of the following except :





... Answer is "Trunk of bracial plexus"
The trunks of the brachial plexus pass between the anterior and middle scalene muscles. The ventral rami of C5 and C6 unite to form the upper trunk. The suprascapular nerve and the nerve to the subclavius arise from the upper trunk.
19: The bicipital groove of humerus contains :





... Answer is "Long head of bicep"
The bicipital groove lodges the long tendon of the biceps brachii between the tendon of the pectoralis major on the lateral lip and the tendon of the teres major on the medial lip. It also transmits a branch of the anterior humeral circumflex artery to the shoulder joint.
20: Muscle/s taking origin from clavicle is/are: :





... Answer is "Pectoralis major"
The pectoralis major consists of two heads. One of the heads is called the clavicular head, which originates on the inside part of the clavicle (collarbone). The other head is called the sternal head, and it originates from three different areas, which include: Outside border of the sternum (breast plate).
21: One of the following is a branch of second part of axillary artery: :





... Answer is "Lateral thoracic artery"
The second branch of the second part of the axillary artery is the lateral thoracic artery. It provides blood to the lateral portions of the chest wall and the mammary gland. The third part lies distal to the lower border of the pectoralis minor muscle, anterior to the subscapularis muscle and teres major muscle
22:Thoracoacromial artery is a branch of: :





... Answer is "Lateral thoracic artery"
The thoracoacromial artery (acromiothoracic artery; thoracic axis) is a short trunk that arises from the second part of the axillary artery, its origin being generally overlapped by the upper edge of the pectoralis minor.
23: Breast is supplied by: :





... Answer is "All of the above"
Arterial supply to the medial aspect of the breast is via the internal thoracic artery (also known as internal mammary artery) - a branch of the subclavian artery. The lateral part of the breast receives blood from four vessels: Lateral thoracic and thoracoacromial branches - originate from the axillary artery.
24: The female breast: :





... Answer is "Has cooper's ligament that suspends the breast"
Cooper's ligaments (also known as the suspensory ligaments of Cooper and the fibrocollagenous septa) are connective tissue in the breast that help maintain structural integrity.
25: The bracial plexus has: :





... Answer is "6 divisions"
The brachial plexus is divided into five roots, three trunks, six divisions (three anterior and three posterior), three cords, and five branches.
26:A young patient presents with an inability to draw the scapula forward and downward because of paralysis of pectoralis minor. Which of the following would be most likely cause of his condition :





... Answer is "Fracture of coracoid process"
Pectoralis minor inserts on the coracoid process, originates from the 2nd-5th ribs and is innervated by median and lateral pectoral nerves that arise from medial and lateral cords of bracial plexus. It depresses the shoulder and forms the anterior wall of axilla
27:A young patient has a lesion of the upper trunk of bracial plexus i.e ERB PARALYSIS. Which of the following is the most likely diagnosis :





... Answer is "Arm tending to lie in medial rotation"
The lesion of the upper trunk of bracial plexus resuts in a condition called "waiter's tip hand",in which the arm tend to lie in medial rotation because of paralysis of lateral rotators and abductors of arm.
28: A gun shot patient requires surgery in which his thoracoacromial trunk need to be ligated. Which of the following arterial branches would maintain normal blood flow? :





... Answer is "Superior thoracic artery"
The superior thoracic artery is a direct branch of axillary artery.The thoracoacromial trunk has four branches: Pectoral,Clavicular,Acromial and Deltoid
29:A 16 year old boy fell from a motorcycle and his radial nerve severely damaged because of a fracture of the midshaft of the humerus.Which of the following conditions would most likely result from this accident :





... Answer is "Loss of wrist extension leading to wrist drop"
Injury to radial nerve result in loss of wrist extension, leading to wrist drop
30: A woman 20 years of age comes with a complain of not being able to flex her proximal interphalangeal joints. Which of the following muscle appear to be paralyzed on further examination of her fingers :





... Answer is "Flexor digitorum superficialis"
The flexor digitorum superficialis muscle flexes the proximal interphalangeal joints.
31: The usual number of branches of medial cord of bracial plexus :





... Answer is "5"

32: The usual number of branches of lateral cord of bracial plexus :





... Answer is "3"

33: The earliest bone to ossify in the body :





... Answer is "Clavicle"
The clavicle is the first bone to ossify in the developing embryo and the last to complete epiphyseal union
34: The deep pectoral fascia :





... Answer is "Seperated the pectoral major from the breast"

35: The anterior wall of axilla is formed by all of the following except: :





... Answer is "Teres major"
Anterior wall: Made up of the pectoralis major and minor, forming the anterior axillary fold. Posterior wall: Made up of the subscapularis, latissimus dorsi, and teres major muscles, forming the posterior axillary fold. Medial wall: Formed by the thoracic cage and the serratus anterior
36: In Erb's paralysis, the deformity is called :





... Answer is "Waiter's tip position"
The classical sign of erb's palsy is called Waiter's tip deformity. This is due to loss of the lateral rotators of the shoulder, arm flexors, and hand extensor muscles.
36: In Klempke's paralysis, the deformity is called :





... Answer is "Claw hand"
Klumpke's paralysis is a form of paralysis involving the muscles of the forearm and hand, resulting from a brachial plexus injury in which the eighth cervical (C8) and first thoracic (T1) nerves are injured either before or after they have joined to form the lower trunk
38: Paralysis of serratus anterior muscle causes :





... Answer is "Winging of scapula"
Medial winging is more common, being caused by serratus anterior paralysis. This is typically due to damage (i.e. lesions) of the long thoracic nerve. This nerve supplies the serratus anterior, which is located on the side of the thorax and acts to pull the scapula forward
39: Suprascapular nerve is a branch from :





... Answer is "Upper trunk"
The suprascapular nerve is a nerve that branches from the upper trunk of the brachial plexus. It is responsible for the innervation of two of the muscles that originate from the scapula, namely the supraspinatus and infraspinatus muscles
40: The root value of long thoracic nerve is :





... Answer is "C5,6,7"
The long thoracic nerve (external respiratory nerve of Bell; posterior thoracic nerve) supplies the serratus anterior muscle. This nerve characteristically arises from the anterior rami of three spinal nerve roots: the fifth, sixth, and seventh cervical nerves (C5-C7)
41: A patient with middle finger crushed visited ER. Which of the following muscles is most likely to retain function :





... Answer is "Palmar interosseous in not attached to the middle finger while all others are"
The long thoracic nerve (external respiratory nerve of Bell; posterior thoracic nerve) supplies the serratus anterior muscle. This nerve characteristically arises from the anterior rami of three spinal nerve roots: the fifth, sixth, and seventh cervical nerves (C5-C7)
42: A 14 years old boy fells on his outstretched hand and has a fracture of the scaphoid bone.The fracture is most likely accompained by a rupture of which of the following arteries :





... Answer is "Radial artery"
The scaphoid bone forms the floor of anatomical snuffbox, through which the radial artery passes to enter the palm. The radial artery divide into princeps pollicis artery and deep palmar
43: A patient with fracture of base of first metacarpal bone experiences an impaired thumb movement. Which of the following intrinsic muscles in most likely to be injured? :





... Answer is "Opponens pollicis"
The opponens pollicis inserts on first metacarpal. All other intrinsic muscles of thumb inserts on the proximal phalanges
44: A 31 year old patient complains of sensory loss over the anterior and posterior surface of medial third of hand and medial one and one half of fingers. He is diagnosed with have "funny bone" symptoms. Which of the following nerves is injured :





... Answer is "Ulnar nerve"
The ulnar nerve supplies sensory fibers to the skin over the palmar and dorsal surfaces of median third of hand and medial one and one half of fingers.
45: A patient came to ER with a complain of not being able to supinate the forearm. Which of the following nerves are most likely damaged :





... Answer is "Musculocutaneous and radial"
The supinator and biceps brachii muscles, which are innervated by the radial and musculocutaneous nerves respectively, produce supination of the forearm.
46: The trapezius muscle is supplied by the





... Answer is "Spinal accessory nerve"
The nerve conveying motor innervation to trapezius is the spinal accessory nerve, which is the 11th cranial nerve.
47: One of the following is not a rotator cuff muscle





... Answer is "Teres major"
The rotator cuff includes muscles such as the supraspinatus muscle, the infraspinatus muscle, the teres minor muscle and the subscapularis muscle. The upper arm consists of the deltoids, biceps, as well as the triceps.
48: Paralysis of deltoid muscle causes





... Answer is " Loss of abduction of arm from 15 degrees to 90 degree"
.
49: Lesion of axillary nerve causes causes





... Answer is " Flat shoulder"
Axillary nerve palsy is a neurological condition in which the axillary (also called circumflex) nerve has been damaged by shoulder dislocation. It can cause weak deltoid and sensory loss below the shoulder. Since this is a problem with just one nerve, it is a type of Peripheral neuropathy called mononeuropathy.
50: Muscles that rotate the scapula downward are attached to





... Answer is "Dorsal lip of medial border of scapula "
.
51: Muscles that rotate the scapula upward are attached to





... Answer is "a and c"
.





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