Idea Transcript
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1. The distal attachment (insertion) of the triceps brachii muscle is:
A. B. C. D. E.
coronoid process of the ulna olecranon process of ulna styloid process of ulna radial notch of ulnar ulnar tuberosity
2. Most of the muscles that act on the shoulder girdle and upper limb joints are supplied by branches of the brachial plexus. Which of the following is not?
A. B. C. D. E.
trapezius teres minor latissimus dorsi rhomboid major levator scapulae
A. B. C. D. E.
depression of the scapula abduction of the arm extension of the arm flexion of the arm lateral rotation of the arm
4. The TRUE statement about the posterior compartment of the arm is:
A. B. C. D. E.
it receives its motor supply from the median nerve it contains the profunda brachii artery and radial nerve it contains a single elbow flexor its major artery is the brachial it contains the ulnar nerve in its distal part
5. The long head of the biceps brachii muscle arises from the:
A. B. C. D. E.
infraglenoid tubercle acromion process coracoid process clavicle supraglenoid tubercle
6. The major function of the muscles in the anterior compartment of the forearm is:
A. B. C. D. E.
abduction flexion adduction medial rotation lateral rotation
9. A structure found in the deltopectoral groove is the:
A. B. C. D. E.
cephalic vein basilic vein brachial vein radial vein musculocutaneous nerve
10. In the cubital fossa, the median cubital vein is frequently used for venipuncture. This vein is separated from underlying neurovascular structures by the:
A. B. C. D. E.
investing fascia of the brachialis muscle crural fascia bicipital aponeurosis anconeus muscle tendon of the biceps brachialis muscle
11. Which of these structures passes deep to the flexor retinaculum at the wrist?
A. B. C. D. E.
tendon of the palmaris longus ulnar artery median nerve palmar branch of the ulnar nerve radial artery
A. B. C. D.
neck clavicle nipple umbilicus
3. Increasing muscle mass and tone is the aim of many people who work out at the gym. This is done by contracting the muscle against resistance. If you want to increase the muscle mass of the latissimus dorsi muscle, which of the following actions would you be most likely to perform?
7. This is a radiographic image of the left shoulder. Which letter identifies the coracoid process?
8. This is a radiographic image of the wrist and hand. Which letter identifies the hook of the hamate?
12. If the dorsal rootlets of T4 are cut (dorsal rhizotomy) there will be a loss of sensation at the level of the:
Questions 13 and 14. A 52-year-old man was brought to the emergency room after being found in the park where he had apparently lain overnight after a fall. He complained of severe pain in the left arm. Physical examination suggested a broken humerus, which was confirmed radiologically. The patient was able to extend the forearm at the elbow, but supination appeared somewhat weak; the hand grasp was very weak when compared with the uninjured arm. Neurologic examination revealed an inability to extend the wrist ("wrist drop"). Since these findings pointed to apparent nerve damage, the patient was scheduled for a surgical reduction of the fracture.
13. The observations that extension at the elbow appeared normal, but supination of the forearm weak, warrants localization of the nerve to the:
A. B. C. D. E.
posterior division of the brachial plexus posterior cord of the brachial plexus in the axilla radial nerve at the distal third of the humerus radial nerve injury in the vicinity of the head of the radius radial nerve in the mid-forearm
14. In this patient, paralysis of the supinator muscle only slightly affects the ability to supinate due to the unimpaired action of the:
A. B. C. D. E.
pronator teres brachioradialis pronator quadratus biceps brachii triceps brachii
15. The thumb action that is totally affected by radial nerve trauma is:
A. B. C. D. E.
abduction adduction extension flexion opposition
16. The supraglenoid tubercle serves as an attachment for:
A. B. C. D. E.
the long head of the biceps long head of the triceps medial head of the triceps subscapularis short head of triceps
17. The extensor expansion of the fingers is formed by the tendon of the:
A. B. C. D. E.
extensor carpi radialis longus extensor pollicis longus extensor digitorum extensor pollicis brevis interossei
18. Which of the following muscles is innervated by the ulnar nerve?
A. B. C. D. E.
flexor pollicis longus extensor pollicis longus abductor pollicis brevis adductor pollicis opponens pollicis
A. B. C. D. E.
radial median recurrent ulnar deep radial superficial radial
20. Which of the following muscles does NOT rotate the arm medially (or internally)?
A. B. C. D. E.
subscapularis supraspinatus latissimus dorsi pectoralis major anterior fibers of the deltoid
21. Damage to the coracobrachialis muscle and its nerve supply would weaken which motion of the arm and forearm?
A. B. C. D. E.
extension rotation flexion supination abduction
25. The uppermost part of the rotator cuff of the shoulder is the tendon of the:
A. B. C. D. E.
deltoid teres minor teres major subscapularis supraspinatus
26. Which of the following muscles is a lateral rotator of the arm?
A. B. C. D. E.
infraspinatus subscapularis latissimus dorsi teres major anterior fibers of the deltoid
27. Which of the following wrist bones is found in the proximal row?
A. B. C. D. E.
trapezium trapezoid capitate hamate scaphoid
28. Which of these muscles of the forearm has a double innervation?
A. B. C. D. E.
flexor digitorum profundus flexor digitorum superficialis pronator teres flexor pollicis longus pronator quadratus
29. The muscle that forms the bulk of the anterior axillary fold is the:
A. B. C. D. E.
latissimus dorsi pectoralis major subscapularis teres minor teres major
30. The infraglenoid tubercle serves as an attachment for the:
A. B. C. D. E.
long head of biceps long head of triceps medial head of triceps coracobrachialis subscapularis
19. If you slide a piece of paper between a patients fingers and asked the patient to hold onto the paper when you try to pull it from the fingers, and the patient is unable to perform this action, which nerve is suspected to be nonfunctional?
Match the lettered item on the diagram to the numbered structure: 22. trochlea
23. deltoid tuberosity
24. greater tuberosity
A. medial B. lateral C. posterior
31. The ulnar nerve is a branch of which cord of the brachial plexus?
32. Muscles of the hypothenar eminence are innervated by the:
A. B. C. D. E.
median nerve ulnar nerve radial nerve median and radial nerves median and ulnar nerves
33. Numbness to the skin on the lateral half of the palm of the hand would be caused by a lesion to which nerve?
A. B. C. D. E.
ulnar radial median superficial radial anterior interosseous
34. The nerve most likely to be injured in fractures of the medial epicondyle is the:
A. B. C. D. E.
radial axillary ulnar median musculocutaneous
35. Which nerve is probably damaged if a patient cannot abduct the arm beyond 25 degrees?
A. B. C. D. E.
axillary radial musculocutaneous median ulnar
37. The middle trunk of the brachial plexus is formed by anterior rami of which spinal cord segments?
A. B. C. D. E.
C7 C6 and C7 C6 C5 and C6 C7 and T1
38. Loss of pronation of the hand suggests a lesion of the:
A. B. C. D. E.
median nerve radial nerve ulnar nerve intercostobrachial nerve musculocutaneous nerve
A. B. C. D. E.
musculocutaneous ulnar radial median thoracodorsal
40. A physical sign known as "winged scapula" suggests the loss of function to which of the following muscles?
A. B. C. D. E.
rhomboid major levator scapulae latissimus dorsi serratus anterior trapezius
41. If a tumor grows into the quadrangular space of the axillary region, which structures would be in danger?
A. B. C. D. E.
anterior humeral circumflex artery and axillary nerve posterior humeral circumflex artery and radial nerve posterior humeral circumflex artery and axillary nerve radial nerve and profunda brachii artery profunda brachii artery and axillary nerve
42. The medial wall of the axilla is formed by which of the following muscles?
A. B. C. D. E.
teres major serratus anterior pectoralis major subscapularis pectoralis minor
43. A branch of the axillary artery is the:
A. B. C. D. E.
costocervical vertebral dorsal scapular suprascapular subscapular
44. At the front of the elbow, which of the following lies superficial to the bicipital aponeurosis?
A. B. C. D. E.
median cubital vein brachial artery median nerve ulnar nerve cephalic vein
45. The lateral boundary of the cubital fossa is formed by the:
A. B. C. D. E.
flexor carpi radialis muscle tendon of the biceps muscle brachialis muscle brachioradialis muscle pronator teres muscle
46. Which artery accompanies the radial nerve to supply the posterior compartment of the arm?
A. B. C. D. E.
axillary brachial ulnar profunda brachii radial
47. The artery that may be palpated deep in the "anatomical snuff box" is the:
A. B. C. D. E.
superficial ulnar posterior interosseous cephalic radial deep ulnar
48. All of these arteries may contribute to the anastomoses around the scapula EXCEPT the:
A. B. C. D. E.
subscapular transverse cervical suprascapular intercostal lateral thoracic
49. When taking the blood pressure, the stethoscope is usually paced on which artery?
A. B. C. D. E.
ulnar profunda brachii axillary brachial radial
50. The superficial vein that runs up the ulnar side of the upper limb is the:
A. B. C. D. E.
radial median forearm axillary cephalic basilic
51. The deep palmar arterial arch is formed primarily by the:
A. B. C. D. E.
deep radial artery superficial radial artery ulnar artery anterior interosseous artery posterior interosseous artery
56. Which muscle is innervated by both the ulnar and median nerves?
A. B. C. D. E.
flexor digitorum superficialis pronator quadratus flexor digitorum profundus supinator none of the above
57. Which of the following muscles does NOT extend the wrist?
A. B. C. D. E.
extensor carpi radialis longus extensor carpi radialis brevis extensor carpi ulnaris extensor digitorum brachioradialis
58. Which of the following nerves sends branches to the muscles of the arm?
A. B. C. D. E.
median ulnar dorsal scapular musculocutaneous long thoracic
59. The filum terminale is a continuation of the:
A. B. C. D. E.
denticulate ligament coccygeal ligament dura mater arachnoid pia mater
60. Abduction of the thumb is when it is moved:
A. B. C. D. E.
laterally from the palm at right angles to the palmar surface along side the index finger straight across the palm none of the above
62. Which of the following statements is TRUE for the pectoralis major muscle?
A. B. C. D. E.
it arises from the humerus it inserts into the bony ribs it abducts the arm it is innervated by the median nerve there is no true statement
63. The nerve most likely to be traumatized with a fracture of the surgical neck of the humerus is the:
A. B. C. D. E.
median axillary radial ulnar profunda brachii
64. With an injury to the right upper trunk of the brachial plexus (Erb Duchenne paralysis), the patient's right upper extremity would be:
A. B. C. D. E.
abducted adducted medially rotated laterally rotated flexed
65. At the wrist, the long slender tendon of which muscle serves as a guide to the median nerve, which is deep and lateral to it:
A. B. C. D. E.
flexor carpi radialis flexor carpi ulnaris flexor digitorum superficialis palmaris longus flexor digitorum profundus
66. Which joint serves as the only bony attachment of the superior limb to the axial skeleton?
A. B. C. D. E.
glenohumeral acromioclavicular scapulothoracic sternoclavicular costoclavicular
67. The only rotator cuff muscle that does not contribute to rotation of the arm is the:
A. B. C. D.
teres minor infraspinatus supraspinatus subscapularis
68. The dermatome of the thumb is innervated by nervous elements arising from which spinal cord segment?
A. B. C. D. E.
C5 C6 C7 C8 T1
69. A large muscle that arises from two heads flexes and medially rotates the arm. It is innervated by nerves arising from different cords of the brachial plexus. This is the:
A. B. C. D. E.
latissimus dorsi trapezius deltoid subscapularis pectoralis major
70. Loss of opposition of the thumb is a symptom associated with lesion of which nerve?
A. B. C. D. E.
radial ulnar musculocutaneous median posterior interosseous
71. Which carpal bone articulates with the radius?
A. B. C. D. E.
trapezoid scaphoid hamate capitate trapezium
72. All of the following bony landmarks are visible on a skeleton when viewed directly from behind (posterior view), EXCEPT:
A. B. C. D. E.
medial epicondyle greater tubercle spiral groove lesser tubercle olecranon process
73. Inability to flex the distal phalanx of the middle finger indicates injury to which of these muscles?
A. B. C. D. E.
lumbrical dorsal interosseous flexor digitorum superficialis flexor digitorum profundus palmar interosseous
74. The anterior wall of the vertebral canal is formed by:
A. B. C. D. E.
ligamenta flava interspinal ligaments posterior longitudinal ligament anterior longitudinal ligament ligamentum nuchae
75. The muscle attached to the whole length of the scapular spine is the:
A. B. C. D. E.
trapezius serratus anterior rhomboideus major deltoid infraspinatus
A. B. C. D. E.
the tendon of the biceps brachii muscle the bicipital aponeurosis the tendon of the brachialis the brachioradialis muscle the medial epicondyle of the humerus
77. The subarachnoid space ends inferiorly in the adult at the level of:
A. B. C. D. E.
the coccyx S2 S5 promontory the lower border of L1
78. All of the following muscles attach to the medial border of the scapula, EXCEPT the:
A. B. C. D. E.
levator scapulae rhomboideus major teres major serratus anterior rhomboideus minor
79. Which nerve-artery pair do not run together?
A. B. C. D. E.
radial nerve, profundus brachii artery axillary nerve, posterior humeral circumflex artery ulnar nerve, superior ulnar collateral artery median nerve, posterior interosseous artery anterior interosseous nerve, anterior interosseous artery
80. Following a cervical injury, a patient is unable to abduct the arm above the horizontal plane. This would be a result of an injury to the:
A. B. C. D. E.
spinal accessory nerve long thoracic nerve axillary nerve all of the above none of the above
A. B. C. D. E.
radial nerve axillary nerve ulnar nerve median nerve medial brachial cutaneous nerve
A. B. C. D. E.
lower subscapular nerve axillary nerve thoracodorsal nerve long thoracic nerve suprascapular nerve
A. B. C. D. E.
hamate, pisiform, trapezium, scaphoid hamate, capitate, trapezoid, scaphoid lunate, hamate, capitate, scaphoid lunate, pisiform, trapezoid, hamate trapezium, trapezoid, capitate, hamate
36. Identify the nerve of the brachial plexus that supplies the muscles of the posterior compartment of the arm.
39. After a time, when a motor nerve to a muscle is sectioned, the muscles will atrophy (get smaller). If you notice that the thenar muscles are atrophied, which nerve would you suppose has been injured?
55. The clavicle is one of the most fractured bones. In the diagram, the clavicle has been fractured at about the junction of the middle and distal thirds. Notice that the proximal end has been pulled upward. Which of the following muscles is responsible for this? A. B. C. D. E.
anterior deltoid fibers trapezius subclavius sternocleidomastoid pectoralis major
76. You are to perform a venipuncture of the median cubital vein. Which of the following structures is most suitably located to afford protection against your inadvertently entering the brachial artery rather than the veins?
Bones can fracture or be displaced from their normal anatomical position at any of several locations. Each of these injuries may traumatize a nerve passing close to the bone in question at that location. Match the nerve most likely to be injured with the problem: 81.Fracture of the medial epicondyle of the humerus 82. Fracture of the surgical neck of the humerus 83. Mid-shaft humeral fracture 84. Anterior dislocation of the lunate Match the following muscles with their appropriate innervation. 85. supraspinatus muscle 86. latissimus dorsi muscle 87. teres minor muscle 88. serratus anterior muscle
89. The four chief bony attachments of the flexor retinaculum are:
90. Select the correct match to the structure at the end of the arrow A. B. C. D.
tendon of the extensor digitorum muscle flexor digitorum superficialis muscle lumbrical muscle vincula longus
This is an anterior view of the left elbow. Match the lettered items with the following: 91. trochlea 92. insertion of brachialis muscle 93. insertion of biceps brachii muscle 94. capitulum 95. common origin of flexor muscles of hand
96. Match the lettered items with the numbered statements. 96. With a lesion of this nerve elbow flexion is severely weakened 97. One indication of a lesion of this nerve: the patient is unable to hold a piece of paper tightly between the fingers 98. All postaxial musculature of the upper extremity would be denervated by a lesion at this site 99. This nerve may be damaged by a deep cut over the anterolateral chest wall 100. This nerve is traumatized in Carpal Tunnel Syndrome
101. drains into subclavian vein 102. innervates muscles of the hand 103. drains into the brachial vein 104. biceps brachii muscle
Questions 105 - 107 refer to the diagrams. The diagrams on the right show an area of anesthesia occurring after a cut (shown by the red arrow and dotted line) in the lower left figure). Nerve regeneration over a period of 4 (left column) to 93 (right column) weeks indicates a reduced area of anesthesia as shown. Assume only nerves are cut and not any tendons. 105. The injured nerve is the: A. B. C. D. E.
radial median musculocutaneous ulnar median recurrent
106. Motor changes that would acccompany this lesion would include all of these EXCEPT: A. B. C. D. E.
adduction of the fifth finger abduction of the fifth finger adduction of the fourth finger abduction of the thumb adduction of the thumb
107. In most patients, accompanying initial motor changes would include some weakness in thumb A. B. C. D. E.
abduction adduction opposition extension flexion
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