Important University Questions of Upper Limb

Q.1: write short notes on Erb’s paralysis and Klumpke’s paralysis. 2.5+2.5

 Q.2: Name the climbing muscles. Give their origin, insertion, nerve supply and actions.1 +4

Q.3. Draw and label a diagram showing arterial anastomosis around elbow joint. 5 (2006 UHS)

Q.4: which nerve is present between the two heads of pronator teres? Describe the course and branches of radial artery in forearm. 1+2+2

Q5. Define complex joint. Give three example from upper limb.

Q.6: name the synovial joint of saddle variety in the hand. What are the various movements of that joint and the muscles responsible for it? 1+4

Q.7: compare and contrast the mid-palmar and thenar spaces of hand. 5 marks

MCQs UPPER LIMB

1. 1. The following structures pass posterior to the flexor retinaculum except which?

(a) Flexor digitorum superficialis tendons

(b) Median nerve

(c) Flexor pollicis longus tendon

(d) Ulnar nerve

(e) Anterior interosseous nerve

1. D.
2. The following tendons are inserted into the base of the proximal phalanx of the thumb except which?

(a) Extensor pollicis brevis

(b) Abductor pollicis longus

(c) Oblique head of adductor pollicis

(d) Flexor pollicis brevis

(e) First palmar interosseous

2. B.
3. The following muscles abduct the hand at the wrist joint except which?

(a) Flexor carpi radialis

(b) Abductor pollicis longus

(c) Extensor carpi radialis longus

(d) Extensor digiti minimi

(e) Extensor pollicis longus

3. D.
4. The following bones form the proximal row of carpal bones except which?

(a) Lunate

(b) Pisiform

(c) Scaphoid

(d) Triquetral

(e) Trapezium

4. E.

(a) Teres minor

(b) Supraspinatus

(c) Subscapularis

(d) Teres major

(e) Infraspinatus

 

5. D.
6. The quadrangular space is bounded by the following structures except which?

(a) Surgical neck of the humerus

(b) Long head of triceps

(c) Deltoid

(d) Teres major

(e) Teres minor

 

6. C
7. The radial nerve gives off the following branches in the posterior compartment of the arm except which?

(a) Lateral head of the triceps

(b) Lower lateral cutaneous nerve of the arm

(c) Medial head of the triceps

(d) Brachioradialis

(e) Anconeus

7. D.
8. All the following statements concerning the brachial plexus are correct except which?

(a) The roots C8 and T1 join to form the lower trunk.

(b) The cords are named according to their position relative to the first part of the axillary artery.

(c) The nerve that innervates the levator scapulae is a branch of the upper trunk.

(d) The roots, trunks, and divisions are not located in the axilla.

(e) No nerves originate as branches from the individual divisions of the brachial plexus.

 

8. B.
9. The anterior fascial compartment of the forearm contains the following arteries except which?

(a) Brachial

(b) Anterior interosseous

(c) Radial

(d) Ulnar

(e) Profunda

9. E.
10. The boundaries of the anatomic snuffbox include the following except which?

(a) Abductor pollicis brevis

(b) Extensor pollicis longus

(c) Extensor pollicis brevis

(d) Abductor pollicis longus

10. A.
11. The following structures are attached to the greater tuberosity of the humerus except which?

(a) Supraspinatus muscle

(b) Coracohumeral ligament

(c) Teres minor muscle

(d) Infraspinatus muscle

(e) Subscapularis muscle

11. E.
12. The following structures form the boundaries to the superior entrance into the axilla except which?

(a) Clavicle

(b) Coracoid process

(c) Upper border of the scapula

(d) Outer border of the first rib

 

12. B

 

 

13. The carpal tunnel contains the following important structures except which?

(a) Flexor pollicis longus tendon

(b) Flexor digitorum profundus tendons

(c) Median nerve

(d) Flexor carpi radialis tendon

(e) Flexor digitorum superficialis tendons

13. D.

 

Select the phrase that best completes each statement.

14. Hyperextension of the proximal phalanges of the little and ring fingers (i.e., claw hand) can result from damage to the ________ nerve.

(a) ulnar

(b) axillary

(c) radial

(d) median

(e) anterior interosseous

14. A.
15. Wrist drop can result from damage to the ________ nerve.

(a) median

(b) ulnar

(c) radial

(d) anterior interosseous

(e) axillary

 

15. C.
16. An inability to oppose the thumb to the little finger can result from damage to the ________ nerve.

(a) anterior interosseous

(b) posterior interosseous

(c) radial

(d) ulnar

(e) median

16. E.
17. The sensory innervation of the nail bed of the index finger is the

(a) median nerve.

(b) radial nerve.

(c) dorsal cutaneous branch of the ulnar nerve.

(d) superficial branch of the ulnar nerve.

(e) palmar cutaneous branch of the ulnar nerve.

17. A
18. The sensory innervation of the medial side of the palm is the

(a) radial nerve.

(b) palmar cutaneous branch of the ulnar nerve.

(c) dorsal cutaneous branch of the ulnar nerve.

(d) median nerve.

(e) superficial branch of the ulnar nerve.

18. B
19. The sensory innervation of the dorsal surface of the root of the thumb is the

(a) median nerve.

(b) radial nerve.

(c) superficial branch of the ulnar nerve.

(d) dorsal cutaneous branch of the ulnar nerve.

(e) posterior interosseous nerve.

19. B
20. The sensory innervation of the medial side of the palmar aspect of the ring finger is the

(a) radial nerve.

(b) posterior interosseous nerve.

(c) dorsal cutaneous branch of the ulnar nerve.

(d) median nerve.

(e) superficial branch of the ulnar nerve.

 

20. E
21. The musculocutaneous nerve originates from the ________ of the brachial plexus.

(a) posterior cord

(b) lateral cord

(c) both medial and lateral cords

(d) upper trunk

(e) medial cord

21. B
22. The suprascapular nerve originates from the ________ of the brachial plexus.

(a) medial cord

(b) lower trunk

(c) posterior cord

(d) lateral cord

(e) upper trunk

22. E
23. The median nerve originates from the ________ of the brachial plexus.

(a) medial and lateral cords

(b) medial cord

(c) posterior cord

(d) upper and lower trunk

(e) lateral cord

 

23. A
24. The thoracodorsal nerve originates from the ________ of the brachial plexus.

(a) lateral cord

(b) posterior cord

(c) medial cord

(d) medial and posterior cords

(e) lower trunk

24. B
25. The axillary nerve originates from the ________ of the brachial plexus.

(a) posterior cord

(b) middle trunk

(c) lateral cord

(d) lower trunk

(e) medial cord

25. A
26. The lymph from the upper lateral quadrant of the breast drains mainly into the

(a) lateral axillary nodes

(b) internal thoracic nodes

(c) posterior axillary nodes

(d) anterior axillary nodes

(e) deltopectoral group of nodes

26. D
27. The medial collateral ligament of the elbow joint is closely related to the

(a) brachial artery

(b) radial nerve

(c) ulnar nerve

(d) basilic vein

(e) ulnar artery

27. C

A patient was seen in the emergency department with a laceration of the skin over the middle phalanx of the right index finger. After carefully examining the patient, the physician decided to suture the wound under a digital nerve block.

28. The site of the anesthetic injection depended on the following statements except which?

(a) The skin of the right index finger over the middle phalanx is innervated anteriorly by two digital branches of the median nerve.

(b) The skin of the right index finger over the middle phalanx is innervated posteriorly by two digital branches of the superficial radial nerve.

(c) These nerves can easily be blocked by injecting small volumes of anesthetic solution around the base of the finger.

(d) The digital nerves to the fingers are difficult to inject because they are imbedded in tough deep fascia.

(e) Provided that the wound was clean and did not become infected, the healing process should take place without any complications and full return of skin sensation should occur.

 

28. D.

A 46-year-old man was involved in an automobile accident and sustained a tear of the capsule of the carpometacarpal joint of his right thumb. In view of his history of lung disease, it was decided to repair the laceration under a brachial plexus nerve block. The orthopedic surgeon decided to inject the anesthetic into the brachial plexus below the clavicle.

29. The injection procedure depended on the following statements except which?

(a) The brachial plexus lies in the axilla and is formed from the anterior rami of C5 through C8 and T1 spinal nerves.

(b) The axillary sheath is formed of deep fascia and surrounds the axillary artery and the brachial plexus.

(c) The arm is abducted to an angle greater than 90° so that the axillary artery could be palpated high up in the axilla.

(d) The anesthetic blocking needle is inserted into the sheath.

(e) The cords and branches of the brachial plexus, including the musculocutaneous nerve, lie within the sheath, and all the branches are blocked by the anesthetic using this approach.

 

Q.30: The following statements concerning this patient are correct except which?

(a) The deep fascia beneath the skin of the palm is thickened to form the palmar aponeurosis.

(b) The distal end of the aponeurosis gives rise to five slips to the five fingers.

(c) Each slip is attached to the base of the proximal phalanx and to the fibrous flexor sheath of each finger.

(d) Fibrous contraction of the slip to the ring finger resulted in permanent flexion of the metacarpophalangeal joint.

(e) The patient had Dupuytren’s contracture.

30. B. The distal end of the palmar aponeurosis gives rise to four slips, which pass to the four medial fingers.