ANATOMY LECOM EXAM 1 CLINICAL
UE, LE, AND BACK QUESTIONS AND
ANSWERS
what are the unequivocal dermatomes? - Correct Answers -C6-thumb
C7-middle finger
C8- fifth digit
T1- medial forearm and distal arm
Listers tubercle is a pulley for what muscle? - Correct Answers -extensor pollicis longus
what is at risk with supracondylar fracture of humerus? - Correct Answers -median
nerve
what is at risk with fracture of medial epicondyle? - Correct Answers -ulnar nerve
what is at risk for Colles fracture? - Correct Answers -dinner fork deformity; median
nerve
transverse fracture of distal radius with dorsal displacement of hand; x-rays reveal
dorsal angulation of distal radius metaphysis; radial and ulnar styloids come to lie
parallel to each other (normally radial is distal to ulnar)
what is at risk for lunate dislocation? - Correct Answers -median nerve
what is Dupuytren's contracture? - Correct Answers -thickening and shortening of
longitudinal bundles of palmar aponeurosis; draws 4th and 5th digits into palm, become
useless
what is the most commonly fractured bone in the body? - Correct Answers -clavicle at
middle 1/3; can danger the suprascapular VAN, supraclavicular nerves, brachial plexus
and subclavian vein
what happens in a complete shoulder separation? - Correct Answers -rupture of AC and
coracoclavicular ligaments;
what is the most commonly injured rotator cuff muscle? - Correct Answers -
supraspinatus; can be torn by trying to lift too much or catching a falling object
,tested by drop arm test: asking patient to slowly adduct their arm from abduction at 90
degrees
most shoulder dislocations occur where? - Correct Answers -anteriorly or anterior
inferior due to ligaments and tendons support
often tears joint capsule (anterior band of GH ligament) and detaches labrum; can result
in compression fx of humeral head; may injure axillary or radial nerve or compress
axillary artery
posterior dislocation: rare; can compress posterior circumflex artery
rupture of tendon of long head biceps brachii - Correct Answers -with chronic
inflammation, intrascapular portion of tendon can erode and rupture
what is golfer's wrist? - Correct Answers -pain/tenderness in palm or wrist caused by
hairline fracture of hook of hamate
FOOSH Injury - Correct Answers -youth: displacement of distal radial epiphysis
adolescent: clavicular fracture
elderly: Colles' fracture; distal radius fx about 1 inch proximal to the radiocarpal joint
carpal bones affected: scaphoid (most commonly fractured); susceptible to avascular
necrosis
lunate: most commonly dislocated; can impinge carpal tunnel and median nerve
can injure the "million dollar nerve" - recurrent branch of median nerve resulting in
paralysis of thenar muscles
what is the terrible triad? - Correct Answers -injury to elbow characterized by
dislocation, fracture of radial head and avulsion of the coronoid process
what is Tommy John surgery? - Correct Answers -reconstruction of torn ulnar collateral
ligament; carries serious risk of injury to the ulnar nerve by the medial epicondyle
what is "nursemaid's elbow"? - Correct Answers -subluxation/dislocation of radial head
due to sudden "yank" of the arm of a young child (extension and pronation) and can tear
annular ligament resulting in partial or complete dislocation
how are pulses rated? - Correct Answers -0 = absent
1 = weak, but detectable (CHF, stenosis)
2 = normal, easily palpable **
3 = increased pulse (nervousness, exertion, stimulants)
4 = bounding pulse (cocaine, aneurysm)
, what are the collateral anastomoses around the scapula, elbow, hand? - Correct
Answers -ligation of axillary artery between thyrocervical trunk and subscapular artery
will maintain blood flow to UE via scapular collateral network
ligation of brachial artery between subscapular and profunda brachii arteries will result
in greatly impaired flow to forearm and hand
ligation of brachial artery distal to inferior ulnar collateral will maintain blood flow to hand
through collateral channels of elbow
what are the important arterial sites to compress to stop bleeding? - Correct Answers -
axillary: anterior to teres major, against proximal humerus
brachial: against distal humerus
ulnar: lateral (and proximal) to pisiform
radial: between two tendons of brachioradialis and FCR; "snuffbox", 1st dorsal digital
space
what is the Allen test? - Correct Answers -tests integrity of communication between
ulnar and radial arteries in the hand
patient makes a tight fist, radial and ulnar arteries are compressed at the wrist with your
fingers. Patient opens hand; ulnar compression is removed and if circulation is intact,
normal color will return in few seconds. If pale remains, ulnar circulation is damaged
what happens if the axillary vein is lacerated? - Correct Answers -cephalic vein must be
preserved as it becomes the only vein returning blood from UE
avascular necrosis of scaphoid - Correct Answers -non-union proximal and distal
fragments after transverse fracture along the middle 1/3 "waist"; distal portion includes
the nutrient artery entrance site. "waist" fracture can damage this artery and leave
proximal fragment without blood supply
what is lymphedema? - Correct Answers -accumulation of lymph in interstitial
space/tissue which cannot be drained resulting in swelling; commonly occurs after
breast/axilla surgery which disrupts lymph flow to axillary
cutaneous nerves vs. dermatomes - Correct Answers -sensory loss in dermatomal
pattern: radiculopathy
sensory loss in territory of peripheral nerve: distal injury (entrapment, trauma)
what is the sympathetic innervation to UE? - Correct Answers -T2-7
what nerve roots control the movements of the shoulder? - Correct Answers -abduction:
C5-6
adduction: C5-T1
flexion: C5-6
UE, LE, AND BACK QUESTIONS AND
ANSWERS
what are the unequivocal dermatomes? - Correct Answers -C6-thumb
C7-middle finger
C8- fifth digit
T1- medial forearm and distal arm
Listers tubercle is a pulley for what muscle? - Correct Answers -extensor pollicis longus
what is at risk with supracondylar fracture of humerus? - Correct Answers -median
nerve
what is at risk with fracture of medial epicondyle? - Correct Answers -ulnar nerve
what is at risk for Colles fracture? - Correct Answers -dinner fork deformity; median
nerve
transverse fracture of distal radius with dorsal displacement of hand; x-rays reveal
dorsal angulation of distal radius metaphysis; radial and ulnar styloids come to lie
parallel to each other (normally radial is distal to ulnar)
what is at risk for lunate dislocation? - Correct Answers -median nerve
what is Dupuytren's contracture? - Correct Answers -thickening and shortening of
longitudinal bundles of palmar aponeurosis; draws 4th and 5th digits into palm, become
useless
what is the most commonly fractured bone in the body? - Correct Answers -clavicle at
middle 1/3; can danger the suprascapular VAN, supraclavicular nerves, brachial plexus
and subclavian vein
what happens in a complete shoulder separation? - Correct Answers -rupture of AC and
coracoclavicular ligaments;
what is the most commonly injured rotator cuff muscle? - Correct Answers -
supraspinatus; can be torn by trying to lift too much or catching a falling object
,tested by drop arm test: asking patient to slowly adduct their arm from abduction at 90
degrees
most shoulder dislocations occur where? - Correct Answers -anteriorly or anterior
inferior due to ligaments and tendons support
often tears joint capsule (anterior band of GH ligament) and detaches labrum; can result
in compression fx of humeral head; may injure axillary or radial nerve or compress
axillary artery
posterior dislocation: rare; can compress posterior circumflex artery
rupture of tendon of long head biceps brachii - Correct Answers -with chronic
inflammation, intrascapular portion of tendon can erode and rupture
what is golfer's wrist? - Correct Answers -pain/tenderness in palm or wrist caused by
hairline fracture of hook of hamate
FOOSH Injury - Correct Answers -youth: displacement of distal radial epiphysis
adolescent: clavicular fracture
elderly: Colles' fracture; distal radius fx about 1 inch proximal to the radiocarpal joint
carpal bones affected: scaphoid (most commonly fractured); susceptible to avascular
necrosis
lunate: most commonly dislocated; can impinge carpal tunnel and median nerve
can injure the "million dollar nerve" - recurrent branch of median nerve resulting in
paralysis of thenar muscles
what is the terrible triad? - Correct Answers -injury to elbow characterized by
dislocation, fracture of radial head and avulsion of the coronoid process
what is Tommy John surgery? - Correct Answers -reconstruction of torn ulnar collateral
ligament; carries serious risk of injury to the ulnar nerve by the medial epicondyle
what is "nursemaid's elbow"? - Correct Answers -subluxation/dislocation of radial head
due to sudden "yank" of the arm of a young child (extension and pronation) and can tear
annular ligament resulting in partial or complete dislocation
how are pulses rated? - Correct Answers -0 = absent
1 = weak, but detectable (CHF, stenosis)
2 = normal, easily palpable **
3 = increased pulse (nervousness, exertion, stimulants)
4 = bounding pulse (cocaine, aneurysm)
, what are the collateral anastomoses around the scapula, elbow, hand? - Correct
Answers -ligation of axillary artery between thyrocervical trunk and subscapular artery
will maintain blood flow to UE via scapular collateral network
ligation of brachial artery between subscapular and profunda brachii arteries will result
in greatly impaired flow to forearm and hand
ligation of brachial artery distal to inferior ulnar collateral will maintain blood flow to hand
through collateral channels of elbow
what are the important arterial sites to compress to stop bleeding? - Correct Answers -
axillary: anterior to teres major, against proximal humerus
brachial: against distal humerus
ulnar: lateral (and proximal) to pisiform
radial: between two tendons of brachioradialis and FCR; "snuffbox", 1st dorsal digital
space
what is the Allen test? - Correct Answers -tests integrity of communication between
ulnar and radial arteries in the hand
patient makes a tight fist, radial and ulnar arteries are compressed at the wrist with your
fingers. Patient opens hand; ulnar compression is removed and if circulation is intact,
normal color will return in few seconds. If pale remains, ulnar circulation is damaged
what happens if the axillary vein is lacerated? - Correct Answers -cephalic vein must be
preserved as it becomes the only vein returning blood from UE
avascular necrosis of scaphoid - Correct Answers -non-union proximal and distal
fragments after transverse fracture along the middle 1/3 "waist"; distal portion includes
the nutrient artery entrance site. "waist" fracture can damage this artery and leave
proximal fragment without blood supply
what is lymphedema? - Correct Answers -accumulation of lymph in interstitial
space/tissue which cannot be drained resulting in swelling; commonly occurs after
breast/axilla surgery which disrupts lymph flow to axillary
cutaneous nerves vs. dermatomes - Correct Answers -sensory loss in dermatomal
pattern: radiculopathy
sensory loss in territory of peripheral nerve: distal injury (entrapment, trauma)
what is the sympathetic innervation to UE? - Correct Answers -T2-7
what nerve roots control the movements of the shoulder? - Correct Answers -abduction:
C5-6
adduction: C5-T1
flexion: C5-6
