PRACTICE EXAM ANSWERS - UPPER EXTREMITY AND BACK
I. Multiple Choice - Select
the One best answer to complete the statement or answer
the question. Fill in the blank space on the computer
answer sheet that corresponds to the letter of your choice.
Only one answer is acceptable.
1. __B__ Loss of flexion
of the forearm at the elbow would result from damage to the _________ nerve.
A. median
B. musculocutaneous
C. radial
D. ulnar
E. none of the above
2. __A__The levator
scapulae and the rhomboid muscles are innervated by branches of the
A. dorsal scapular nerve
B. suprascapular nerve
C. branches of the posterior
cord of the brachial plexus
D. accessory nerve
E. none of the above
3. __D__ Adduction
of the wrist results from the action of
A. flexor carpi ulnaris
B. flexor carpi radialis
C. extensor carpi ulnaris
D. both A and C
E. all of the above
4. __D__ Which of
the following cutaneous nerves is a DIRECT branch of a cord of the brachial
plexus
A. Posterior cutaneous nerve
of arm (Posterior brachial cutaneous)
B. Lateral cutaneous nerve
of arm (Lateral brachial cutaneous)
C. Lateral cutaneous nerve
of forearm (Lateral antebrachial cutaneous)
D. Medial cutaneous nerve
of forearm (Medial antebrachial cutaneous)
E. Posterior cutaneous nerve
of forearm (Posterior antebrachial cutaneous)
5. __C__ When the
arm is raised (abducted) from the side and lifted above the horizontal
plane, the order of muscular contractions is
A. Trapezius then deltoid
then serratus anterior
B. Deltoid then deltoid and
supraspinatus then serratus anterior
C. Supraspinatus then deltoid
and supraspinatus then serratus anterior
D. Deltoid then trapezius
and deltoid then serratus anterior
E. Serratus anterior then
deltoid then supraspinatus
6. __E__ The median
nerve supplies the following intrinsic hand muscles
A. palmar interosseus
B. adductor pollicis
C. medial two lumbricals
D. hypothenar muscles
E. none of the above
7. __D__ The axillary
artery can be arbitrarily divided into three parts by its relationship
to the
A. Trunks of the brachial
plexus
B. Pectoralis major
C. Latissimus dorsi tendon
D. Pectoralis minor
E. Lower border of teres
major
8. __D__ In which
direction is the humerus most likely to move initially in a dislocation
of the glenohumeral joint?
A. Anterior
B. Superior
C. Posterolateral
D. Inferior
E. Inferolateral
9. __C__ The Superficial
palmar arterial arch is derived MAINLY from the
A. deep branch of the ulnar
artery
B. radial artery
C. ulnar artery
D. arteria princeps pollicis
E. median artery
10. __C__ In which
area of the vertebral column does a curve develop in association with walking
upright?
A. cervical
B. thoracic
C. lumbar
D. sacral
E. cervical and thoracic
11. __E__ Contents
of the carpal tunnel DO NOT include the
A. flexor digitorum superficialis
B. flexor digitorum profundus
C. flexor pollicis longus
D. median nerve
E. ulnar artery
12. __E__ Cords of
the brachial plexus are named in relation to the
A. Subclavian artery
B. Pectoralis minor
C. Axillary vein
D. Trunks of the plexus
E. Axillary artery
13. __B__ A "shoulder
separation" involves rupture of which ligament?
A. coracoacromial
B. coracoclavicular
C. glenohumeral
D. coracohumeral
E. transverse humeral
14. __B__ The major
and most commonly occurring superficial vein on the
surface of the lateral antebrachium is the
A. Brachial vein
B. Cephalic vein
C. Basilic vein
D. Median cubital vein
E. Medial cubital vein
15. __B__ Which of
the following ligaments is ruptured in the condition
known as "pulled" elbow?
A. Radial collateral ligament
B. Annular ligament
C. Ulnar collateral ligament
D. Interosseus membrane
E. Oblique cord
16. __E__ The deep
back muscles (erector spinae) are innervated by
A. ventral rami of spinal
nerves
B. the accessory nerve
C. the dorsal scapular nerve
D. intercostal nerves
E. dorsal rami of spinal
nerves
17. __B__ The brachioradialis
muscles inserts
A. at the base of the second
metacarpal
B. at the styloid process
of the radius
C. at the styloid process
of the ulna
D. at the base of the fifth
metacarpal
18. __C__ The posterior
longitudinal ligament of the vertebral column is located
A. posterior to the spinous
processes
B. anterior to spinous processes
but posterior to the spinal cord
C. anterior to the spinal
cord but posterior to the bodies
D. anterior to the bodies
E. between adjacent pedicles
19. __E__ Sampling
of cerebrospinal fluid is usually done at vertebral
level
A. T6
B. T10
C. T12
D. L1
E. L4
20. __D__ Which muscle
takes origin from the outer surface of the upper eight
ribs and inserts upon the anterior surface of the medial
border of the scapula?
A. Levator scapulae
B. Rhomboideus major
C. Rhomboideus minor
D. Serratus anterior
E. Semispinalis thoracis
21. __C__ Which of
the following conditions results when the neural folds
fail to fuse in development and the spinal cord is exposed
dorsally
A. Spina bifida cystica
B. Spina bifida cystica with
meningocele
C. Spina bifida cystica with
myeloschisis
D. Spina bifida cystica with
meningomyelocele
E. Spina bifida occulta
22. __D__ The thoracodorsal
nerve (middle subscapular nerve) arises from which
part of the brachial plexus?
A. Roots
B. Upper trunk
C. Lateral cord
D. Posterior cord
E. Medial cord
23. __C__ The inferior
angle of the scapula is located at vertebral level
A. T5
B. T6
C. T7
D. T8
E. T9
24. __E__ Which muscle
forms the anterior axillary fold?
A. Latissimus dorsi
B. Teres major
C. Subscapularis
D. Pectoralis minor
E. None of the above
25. __B__ The axillary
vein is located ________ to the axillary artery.
A. lateral
B. medial
C. superior
D. inferior
E. posterior
26. __E__ Which direction
does herniation of an intervertebral disc usually
occur?
A. Anterior
B. Anterolateral
C. Posterior
D. Posteromedial
E. Posterolateral
27. __A__ Which group
of axillary lymph nodes DIRECTLY drains lymph from
the breast?
A. Pectoral
B. Lateral
C. Infraclavicular (Deltopectoral)
D. Subscapular
E. Apical
28. __C__ What is
the arrangements of the Flexor digitorum superficialis
tendons as they pass deep to the flexor retinaculum?
A. 3 and 5 anterior to 2
and 4
B. 2 and 3 anterior to 4
and 5
C. 3 and 4 anterior to 2
and 5
D. 2 and 5 anterior to 3
and 4
E. all tendons in same coronal
plane
29. __E__ Damage to
which nerve results in a condition known as 'ape'
hand?
A. Radial
B. Ulnar
C. Posterior interosseus
D. Anterior interosseus
E. Median
30. __C__ Loss of
the ability to abduct and adduct the digits of the
hand would indicate a lesion of the
A. musculocutaneous nerve
B. radial nerve
C. ulnar nerve
D. median nerve
E. posterior cord of brachial
plexus
31. __C__ Which of
the following conditions can result from the presence
of a hemivertebra?
A. Kyphosis
B. Lordosis
C. Scoliosis
D. Exaggerated primary curvature
E. Exaggerated secondary
curvature
32. __B__ Within the
brachium, the brachial artery is crossed superficially
by the
A. ulnar nerve
B. median nerve
C. radial nerve
D. musculocutaneous nerve
E. axillary nerve
I. Multiple Completion. Under
the initial statement of each question are four (4)
statements that complete it or pertain to it.
Read ALL statements carefully
and then choose the appropriate answer.
CHOOSE;
A = 1, 2, and 3 are correct
B = 1 and 3 are correct
C = 2 and 4 are correct
D = only 4 is correct
E = all are correct
33. __A__ Which spinal
nerves supply the dermatomes of the hand
1. C6
2. C7
3. C8
4. T1
34. __A__ Which of
the following statements is true of the mid-palmar space?
1. It is located deep to
the palmar aponeurosis.
2. It is separated from the
hypothenar compartment by the medial fibrous septum.
3. It is located superficial
to the interosseus muscles.
4. It is not separated from
the thenar compartment.
35. __B__ Which of
the following bones participates directly at the wrist
joint
1. radius
2. hamate
3. scaphoid
4. pisiform
36. __B__ Which of
the following nerve(s) arise directly from the roots
of the brachial plexus?
1. Long thoracic
2. Nerve to Subclavius
3. Dorsal scapular
4. Suprascapular
37. __B__ Which of
the following are actions of the lumbrical muscles?
1. Flexion of metacarpophalangeal
joints
2. Extension of metacarpophalangeal
joints
3. Extension of interphalangeal
joints
4. Flexion of interphalangeal
joints
CHOOSE;
A = 1, 2, and 3 are correct
B = 1 and 3 are correct
C = 2 and 4 are correct
D = only 4 is correct
E = all are correct
38. __C__ Which of
the following structures course in the spiral groove
of the humerus?
1. Axillary nerve
2. Profunda brachii artery
3. Posterior humeral circumflex
artery
4. Radial nerve
39. __B__ Which of
the following statements is (are) true about the spinal
cord?
1. Tumors can spread by intervertebral
veins which drain veins from the spinal cord and internal
and external venous plexuses
2. The pia mater has lateral
extensions called denticulate ligaments which attach
directly to the inner wall of the vertebral canal
3. The spinal part of the
subarachnoid space extends inferiorly to vertebral
level S1.
4. The radicular arteries
are branches of the vertebral, intercostal and lumbar
arteries.
40. __B__ Which of
the following statements is true of the muscles of
the hand?
1. The palmar interossei
arise from the surface of metacarpals 1, 2, 4 and
5 but not from metacarpal 3.
2. The palmar interossei
abduct the fingers.
3. The first dorsal interosseus
muscle is pierced by the radial artery.
4. The lateral two palmar
interosseus muscles are innervated by the median nerve.
41. __D__ Which of
the following types of joints have an intervening
layer of fibrocartilage between the bones?
1. Synchondroses
2. Syndesmoses
3. Sutures
4. Symphyses
42. __C__ Which of
the following muscles does NOT rotate the head?
1. Obliquus capitis inferior
2. Obliquus capitis superior
3. Rectus capitis posterior
major
4. Rectus capitis posterior
minor
CHOOSE;
A = 1, 2, and 3 are correct
B = 1 and 3 are correct
C = 2 and 4 are correct
D = only 4 is correct
E = all are correct
43. __E__ Which of
the following muscles inserts onto the radius?
1. Biceps brachii
2. Supinator
3. Pronator quadratus
4. Pronator teres
44. __A__ Which of
the following statements is (are) true about the median
nerve?
1. It enters the forearm
by passing between the two heads of the pronator teres
muscle.
2. In the forearm it courses
deep to the flexor digitorum superficialis muscle.
3. It provides sensory innervation
for the lateral two-thirds of the palm and the lateral 3.5 digits.
4. It innervates the medial
half of the flexor digitorum superficialis muscle
while the ulnar nerve innervates the lateral half.
45. __A__ Which of
the following statements is (are) true about the branches
of the axillary artery?
1. The lateral thoracic artery
supplies blood to the breast.
2. The highest thoracic artery
supplies the first two intercostal spaces.
3. The thoracoacromial artery
sends branches to the pectoralis major and minor.
4. The subscapular artery
courses along the medial border of the scapula.
46. __B__ Which of
the following muscles is innervated by branches or
nerves derived from the lateral cord of the brachial plexus
1. Coracobrachialis
2. Pectoralis minoris
3. Pectoralis majoris
4. Brachioradialis
CHOOSE;
A = 1, 2, and 3 are correct
B = 1 and 3 are correct
C = 2 and 4 are correct
D = only 4 is correct
E = all are correct
47. __C__ Which of
the following statements is true about the synovial
sheaths in the hand and fingers?
1. The common synovial sheath
surround the flexor digitorum superficialis tendons
but not the flexor digitorum profundus tendons.
2. The common synovial sheath
is continuous with the digital sheath of the fifth digit.
3. The common synovial sheath
is rarely continuous with the sheath surrounding the
tendon of the Flexor pollicis longus.
4. Infections in synovial
sheaths of the digits 2, 3 and 4 tend to remain localized.
48. __B__ Which muscles
act to medially rotate the humerus?
1. latissimus dorsi
2. teres minor
3. subscapularis
4. infraspinatus
49. __E__ Branches
or terminal branches of the posterior cord of the brachial plexus supply
which of the following muscles?
1. teres major
2. subscapularis
3. deltoid
4. teres minor
50. __A__ Muscles
which attach to the extensor expansion of THIRD digit
include
1. lumbrical
2. dorsal interosseus
3. extensor digitorum
4. palmar interosseus
51. __A__ Which of
the following statements is (are) true about the spinal
cord?
1. The arachnoid is adherent
to the inner side of the dura mater.
2. The pia mater is closely
adherent to the spinal cord.
3. Spinal nerves C1-C7 exit
the spinal cord above the corresponding vertebrae.
4. The cauda equina is composed
of roots of the lower thoracic, lumbar and sacral
spinal nerves.
CHOOSE;
A = 1, 2, and 3 are correct
B = 1 and 3 are correct
C = 2 and 4 are correct
D = only 4 is correct
E = all are correct
52. __A__ Of the following
muscles, which would be completely paralyzed by severance
of the ulnar nerve at the medial epicondyle?
1. flexor carpi ulnaris
2. adductor pollicis
3. medial (third and fourth)
lumbricals
4. flexor pollicis longus
53. __A__ In the anatomical
position
1. Abduction of digits 2,4
and 5 is movement away from digit 3.
2. Extension of the thumb
is a lateral movement away from the other digits with
the thumbnail retaining its right angle to the other
digits.
3. Opposition of the thumb
is a movement in which the thumb contacts the tips
of any of the other digits.
4. Abduction of the thumb
is movement posteriorly so that the thumb points posteriorly.
54. __B__ The cubital
fossa is bounded by the following:
1. laterally the brachioradialis
2. medially the supinator
3. the roof is formed by
the bicipital aponeurosis
4. the floor is formed by
the brachialis muscle and the pronator teres
55. __C__ Which of
the following is (are) true about the vertebral column:
1. Flexion-extension movements
occur between the thoracic vertebrae but not rotational
movements.
2. Rotational movements occur
between the thoracic vertebrae but not flexion-extension
movements.
3. Rotational movements occur
between lumbar vertebrae but not flexion-extension
movements.
4. Flexion extension movements
occur between lumbar vertebrae but not rotational
movements.
56. __D__ Which of
the following muscles extend(s) from the transverse
process of one vertebrae to the transverse process of the
vertebra above?
1. Splenius
2. Semispinalis
3. Spinalis
4. Longissimus
CHOOSE;
A = 1, 2, and 3 are correct
B = 1 and 3 are correct
C = 2 and 4 are correct
D = only 4 is correct
E = all are correct
57. __B__ Which of
the following muscles take(s) origin from the lateral
epicondyle of the humerus?
1. Extensor carpi radialis
brevis
2. Brachioradialis
3. Extensor carpi ulnaris
4. Extensor carpi radialis
longus
58. __C__ Which of
the following muscles are innervated by the Lower
Subscapular nerve?
1. Teres minor
2. Teres major
3. Infraspinatus
4. Subscapularis
59. __A__ Which of
the following forms a part of the borders of the quadrilateral
space?
1. Long head of triceps
2. Teres major
3. Teres minor
4. Lateral head of triceps
60. __B__ Branches
derived from which arteries contribute to the anastomoses
on the medial side of the elbow joint?
1. Brachial artery
2. Posterior interosseus
artery
3. Ulnar artery
4. Profunda brachii artery
61. __B__ Damage to
which of the following structures can result in claw
hand?
1. Lower trunk of brachial
plexus
2. C5 root of brachial plexus
3. Ulnar nerve
4. Lateral cord of brachial
plexus
62. __B__ Which of
the following statements is true of the brachial plexus?
1. The medial cord is formed
only from the anterior division of the lower trunk
2. The upper trunk is formed
only from the root of C5
3. Two named nerves arise
from the upper trunk
4. A named nerve arises directly
from the roots of C6, C7 and C8
CHOOSE;
A = 1, 2, and 3 are correct
B = 1 and 3 are correct
C = 2 and 4 are correct
D = only 4 is correct
E = all are correct
63. __D__ Superficial
lymphatics from the lateral half of the upper extremity
drain DIRECTLY to which of the following groups of axillary
lymph nodes?
1. Pectoral group of nodes
2. Subscapular group of nodes
3. Lateral group of nodes
4. Infraclavicular (Deltopectoral)
nodes
64. __E__ Which of
the following are branches of the radial artery?
1. Dorsalis pollicis artery
2. Arteria princeps pollicis
3. Dorsalis indicis artery
4. Arteria radialis indicis
65. __B__ At the wrist
the median nerve is
1. Medial to the flexor carpi
radialis tendon
2. Medial to the ulnar nerve
3. Lateral to the flexor
digitorum superficialis tendons
4. Lateral to the radial
artery
66. __C__ Which of
the following statements is true of the muscles of
the back
1. The trapezius muscles
takes origin from the ligamentum nuchae, spines of
the seventh cervical vertebra and spines of all the
thoracic vertebrae but not the occipital bone.
2. The latissimus dorsi takes
origin from the iliac crest, the lumbar fascia, the
spines of the lower six thoracic vertebra, the lower
four ribs and the inferior angle of the scapula.
3. The levator scapulae takes
origin from the transverse processes of all of the
cervical vertebrae.
4. The rhomboideus major
takes origin from the second to fifth thoracic vertebrae.
CHOOSE;
A = 1, 2, and 3 are correct
B = 1 and 3 are correct
C = 2 and 4 are correct
D = only 4 is correct
E = all are correct
67. __D__ Which of
the following statements is true of the muscles of
the posterior compartment of the arm?
1. The lateral head of the
triceps takes origin from the infraglenoid tubercle
of the scapula.
2. The long head of the triceps
takes origin from the posterior surface of the humerus
above the spiral groove.
3. The lateral head of the
triceps receives some of its innervation via the axillary
nerve.
4. The medial head of the
triceps takes origin from the posterior surface of
the humerus below the spiral groove.
68. __A__ Which of
the following statements is true of the muscles of
the forearm?
1. The extensor pollicis
brevis takes origin from the radius
2. The supinator takes origin
from the lateral epicondyle of the humerus.
3. The extensor indicis and
extensor digiti minimi each insert upon the extensor
expansions of the corresponding digits.
4. The extensor pollicis
brevis and extensor indicis form the borders of the
"anatomical snuffbox".
69. __E__ Which of
the following is true of the hand?
1. The abductor and flexor
digiti minimi both insert on the proximal phalanx
of the fifth finger.
2. The adductor pollicis
is not a muscle of the thenar eminence.
3. The recurrent branch of
the median nerve is motor to all the thenar muscles.
4. The deep branch of the
ulnar nerve courses deep (posterior) to the long flexor
tendons to the digits but superficial (anterior) to
the interosseus muscles.
70. __A__ The radial
nerve
1. has a deep branch that
passes posteriorly through the supinator.
2. innervates extensor indicis
muscle
3. is formed from the posterior
cord of the brachial plexus
4. innervates the dorsal
interossei.
III. Matching Questions (one
point each)
Match the muscle with its
insertion
| 71. __A__ Latissimus
dorsi
72. __C__ Infraspinatus
(tuberosity) of humerus
73. __C__ Supraspinatus
74. __C__ Teres minor
humerus
75. __B__ Subscapularis |
A. Bicipital groove
B. Lesser tubercle
C. Greater tubercle
(tuberosity) of
D. Shaft of humerus
E. Anatomical neck of
humerus |
Match the muscle with its
origin(s)
| 76. __C__ Pronator
teres (one head)
77. __B__ Pronator
teres (other head)
78. __C__ Flexor carpi
ulnaris (one head)
79. __B__ Flexor carpi
ulnaris (other head)
80. __C__ Flexor digitorum
superficialis (one head)
81. __A__ Flexor digitorum
superficialis (other head)
82. __A__ Flexor pollicis
longus
83. __D__ Extensor
digiti minimi |
A. Radius
B. Ulna
C. Medial epicondyle
of humerus
D. Lateral epicondyle
of humerus |
Match the muscle with a
bone upon which it inserts
| 84. __C__ Flexor
pollicis longus
85. __C__ Extensor
pollicis longus of thumb
86. __B__ Extensor
pollicis brevis of thumb
87. __B__ Flexor pollicis
brevis E. 2nd metacarpal
88. __D__ Extensor
carpi radialis brevis
89. __C__ Extensor
carpi radialis longus |
A. First metacarpal
B. Proximal phalanx
C. Distal phalanx
D. 3rd metacarpal |
IV. True/False. For each
question fill in the blank space on the computer answer
sheet. Fill in the space for an "A" on the answer sheet
for all TRUE statements. Fill in the space for a "B" on the answer
sheet for all false statements.
90. __A__ At the digits,
the flexor digitorum superficialis tendons split and
insert onto the middle phalanx of digits 2-5.
91. __B__ The blood
supply to the posterior compartment of the forearm
is derived from the posterior interosseus artery which is typically
a branch of the radial artery.
92. __A__ The lateral
cutaneous nerve of the forearm (antebrachial cutaneous
nerve) is typically the terminal branch of the Musculocutaneous
nerve.
93. __B__ The interosseus
membrane uniting the radius and ulna is an example
of a synchondrosis type of joint.
94. __A__ Ligation
of the axillary artery just proximal to the subscapular
artery will not disrupt the blood supply to the upper extremity.
95. __A__ In the cubital
fossa, the brachial artery lies lateral to the median
nerve.
96. __B__ The axillary
artery and vein are contained within the axillary
sheath but not the posterior cord of the brachial plexus.
97. __B__ The superficial
palmar arterial arch is located superficial to the
palmar aponeurosis.
98. __A__ The superficial
branch of the radial nerve courses in the forearm
deep to the brachioradialis muscle.
99. __A__ The brachial
plexus is formed of the anterior primary rami of spinal
nerves not the posterior primary rami.
100. __B__ In the
distal half of the brachium, the ulnar nerve courses
into the posterior compartment of the arm and then passes anterior
to the medial epicondyle of the humerus to enter the forearm.
|