😀 EASY

Welcome to another MedGuide quiz. This is part one of the Upper Limb Disorder series of presentations, focusing on the shoulder and brachial plexus clinical anatomy and imaging. Good luck!

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Approach to the Upper Limb Disorder Patient - Part I

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Question 1
Which of the following is true of the clavicle?
A
The lateral 2/3rds are angled anteriorly in situ
B
There is an articular disc in the acromioclavicular joint
C
There is no articular disc in the sternoclavicular joint
D
The medullary cavity of the clavicle is a site of stem cell harvest
E
It is the first fetal bone to ossify
Question 2
A paramedic is assessing a posterior stab wound.  He sees the entry wound immediately inferior to the inferior angle of the scapula.  Which of the following structures is unlikely to be pierced by a directly transverse incision at this angle?
A
Lung
B
Parietal pleura
C
Heart
D
Rib 7
E
Scapula
Question 3
On post-mortem the examiner notes an aberrant finding of anatomy in the subject's scapula.  A nerve has pierced the upper portion of the supraspinous fossa.  Which nerve most likely is the culprit?
A
Upper subscapular
B
Supraclavicular
C
Lower subscapular
D
Thoracodorsal
E
Long thoracic
Question 4
A patient presents with tenderness over the proximal, anterior humeral diaphysis, exacerbated with flexion of the elbow and supination of the forearm.

Which is the best matched differential?
A
Biceps tendon rupture
B
Coracobrachialis avulsion
C
Calcific tendinosis
D
Adhesive capsulitis
E
Biceps tendonitis
Question 5
The capituloradial angle is used for assessing which fracture type?
A
Galaezzi
B
Nightstick
C
Monteggia fracture
D
Smith
E
Colles
Question 6
The middiaphysis of the humerus has an anterolateral tuberosity for the attachment of a muscle.  What is the innervation of this muscle?
A
Axillary
B
Median
C
Musculocutaneous
D
Radial
E
Ulnar
Question 7
Which of the following are not an attachment of the flexor retinaculum
A
Scaphoid
B
Triquetrium
C
Trapezium
D
Pisiform
E
Hamate
Question 8
A patient suffers a fall and subsequent glenohumeral joint anterior dislocation which is reduced with Kocher's manoeuvre in the field.  On plain radiography, an indentation is seen in the posterior humeral head.  What is this lesion called?
A
Hill-Sachs
B
Heberden
C
Bouchard
D
Galeazzi
E
Mountbatton
Question 9
During surgery to clear the first portion of axillary nodes (anterior, posterior and lateral), a nerve was damaged in the procedure and subsequently the patient has found it difficult to raise themselves, via the arms, from a chair.

Which nerve is most likely affected?
A
Long thoracic nerve
B
Medial pectoral nerve
C
Lateral pectoral nerve
D
Thoracodorsal nerve
E
Medial antebrachial cutaneous nerve
Question 10
A soldier presents to the Royal Army Medical Corps after a game of contact rugby.  On parade the following morning, he found he was unable to salute.  His lieutenant sent him straight to the Doctor for this outrage.  Physical exam is notable for contusion to the tip of the shoulder (most-superior C5 dermatome region) and a lean toward the affected shoulder in order to swing the arm laterally to allow abduction to occur.
Which structure is most likely affected?  
A
Spine of the scapula
B
Sternoclavicular ligaments
C
Conoid ligaments
D
Supraspinous tendon
E
Teres major tendon
Question 11
A poly trauma patient has suffered bilateral clavicular fractures and has a collar on his neck.
If you were to assess the eleventh cranial nerve, what other actions could you ask him to perform?
A
90º Flexion of the glenohumeral joint
B
50º adduction of the glenohumeral joint
C
40º internal rotation of the glenohumeral joint
D
180º abduction of the glenohumeral joint
E
60º external rotation of the glenohumeral joint
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