Upper Limb

Topics in this chapter

• Axilla And Quadrangular Space
• Brachial Plexus And Clinical Lesions
• Shoulder Joint And Rotator Cuff
• Arm, Forearm Nerves And Fractures
• Wrist And Carpal Anatomy
• Hand Nerve Syndromes And Deformities

Practice questions

1. Question 1Q-668040

   A 32-year-old male presents with a knife wound to the axilla. Examination reveals an inability to initiate abduction of the shoulder joint and loss of sensation over the lower half of the deltoid muscle (sergeant's patch). Which of the following cords of the brachial plexus and its terminal branch are most likely injured?

   1. A.Posterior cord, Axillary nerve
   2. B.Lateral cord, Musculocutaneous nerve
   3. C.Medial cord, Ulnar nerve
   4. D.Posterior cord, Radial nerve
   See the answer and solution
2. Question 2Q-4FAD57

   During a motorcycle accident, a 24-year-old man suffers a severe traction injury to his right upper limb caused by extreme downward displacement of the shoulder. He presents with the arm hanging loosely by the side, medially rotated, and pronated, assuming the 'waiter's tip' position. Which roots of the brachial plexus are primarily involved?

   1. A.C8 and T1
   2. B.C5 and C6
   3. C.C7 only
   4. D.C5, C6, C7, C8, and T1
   See the answer and solution
3. Question 3Q-841948

   A 45-year-old painter presents with pain and weakness when trying to abduct his right arm. Upon clinical testing, he is unable to initiate abduction for the first 15 degrees, though he can maintain abduction beyond that point if the arm is passively raised. Which muscle and nerve are primarily responsible for the initial 15 degrees of abduction?

   1. A.Deltoid muscle, Axillary nerve
   2. B.Supraspinatus muscle, Suprascapular nerve
   3. C.Infraspinatus muscle, Suprascapular nerve
   4. D.Serratus anterior muscle, Long thoracic nerve
   See the answer and solution
4. Question 4Q-92352C

   A patient sustained a mid-shaft fracture of the humerus. Examination reveals wrist drop, inability to extend the metacarpophalangeal joints, and sensory loss over the dorsolateral aspect of the hand. Which nerve is most likely injured?

   1. A.Ulnar nerve
   2. B.Median nerve
   3. C.Radial nerve
   4. D.Axillary nerve
   See the answer and solution
5. Question 5Q-6EACFB

   A 50-year-old woman presents with difficulty in making a fist with her right hand and an inability to flex the proximal and distal interphalangeal joints of the index and middle fingers. When she attempts to make a fist, the index and middle fingers remain extended ('hand of benediction'). Which nerve is injured?

   1. A.Ulnar nerve at the wrist
   2. B.Median nerve at the elbow/wrist
   3. C.Radial nerve in the spiral groove
   4. D.Anterior interosseous nerve
   See the answer and solution