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. ____ 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. _____ 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. _____ 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. _____ 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. _____ 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. _____ 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. _____ 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. _____ 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. _____ 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. _____ 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. _____ 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. _____ 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. _____ A "shoulder separation" involves rupture of which ligament?

A. coracoacromial

B. coracoclavicular

C. glenohumeral

D. coracohumeral

E. transverse humeral

14. _____ 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. _____ 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. _____ 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. _____ 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. _____ 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. _____ Sampling of cerebrospinal fluid is usually done at vertebral level

A. T6

B. T10

C. T12

D. L1

E. L4

20. _____ 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. _____ 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. _____ 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. _____ The inferior angle of the scapula is located at vertebral level

A. T5

B. T6

C. T7

D. T8

E. T9

24. _____ Which muscle forms the anterior axillary fold?

A. Latissimus dorsi

B. Teres major

C. Subscapularis

D. Pectoralis minor

E. None of the above

25. _____ The axillary vein is located ________ to the axillary artery.

A. lateral

B. medial

C. superior

D. inferior

E. posterior

26. _____ Which direction does herniation of an intervertebral disc usually occur?

A. Anterior

B. Anterolateral

C. Posterior

D. Posteromedial

E. Posterolateral

27. _____ Which group of axillary lymph nodes DIRECTLY drains lymph from the breast?

A. Pectoral

B. Lateral

C. Infraclavicular (Deltopectoral)

D. Subscapular

E. Apical

28. _____ 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. _____ 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. _____ 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. _____ 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. _____ 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

II. 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. _____ Which spinal nerves supply the dermatomes of the hand

1. C6

2. C7

3. C8

4. T1

34. _____ 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. _____ Which of the following bones participates directly at the wrist joint

1. radius

2. hamate

3. scaphoid

4. pisiform

36. _____ 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. _____ 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. _____ 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. _____ 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. _____ 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. _____ 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. _____ 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. _____ Which of the following muscles inserts onto the radius?

1. Biceps brachii

2. Supinator

3. Pronator quadratus

4. Pronator teres

44. _____ 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. _____ 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. _____ 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. _____ 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. _____ Which muscles act to medially rotate the humerus?

1. latissimus dorsi

2. teres minor

3. subscapularis

4. infraspinatus

49. _____ 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. _____ Muscles which attach to the extensor expansion of THIRD digit include

1. lumbrical

2. dorsal interosseus

3. extensor digitorum

4. palmar interosseus

51. _____ 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. _____ 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. _____ 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. _____ 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. _____ 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. _____ 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. _____ 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. _____ Which of the following muscles are innervated by the Lower Subscapular nerve?

1. Teres minor

2. Teres major

3. Infraspinatus

4. Subscapularis

59. _____ 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. _____ 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. _____ 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. _____ 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. _____ 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. _____ 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. _____ 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. _____ 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

7. _____ 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. _____ 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. _____ 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. _____ 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._____ Latissimus dorsi 72._____ Infraspinatus (tuberosity) of humerus 73._____ Supraspinatus 74._____ Teres minor humerus 75._____ 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._____ Pronator teres (one head) 77._____ Pronator teres (other head) 78._____ Flexor carpi ulnaris (one head) 79._____ Flexor carpi ulnaris (other head) 80._____ Flexor digitorum superficialis (one head) 81._____ Flexor digitorum superficialis (other head) 82._____ Flexor pollicis longus 83._____ 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._____ Flexor pollicis longus 85._____ Extensor pollicis longus of thumb 86._____ Extensor pollicis brevis of thumb 87._____ Flexor pollicis brevis E. 2nd metacarpal 88._____ Extensor carpi radialis brevis 89._____ 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._____ At the digits, the flexor digitorum superficialis tendons split and insert onto the middle phalanx of digits 2-5.

91._____ 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._____ The lateral cutaneous nerve of the forearm (antebrachial cutaneous nerve) is typically the terminal branch of the Musculocutaneous nerve.

93._____ The interosseus membrane uniting the radius and ulna is an example of a synchondrosis type of joint.

94._____ Ligation of the axillary artery just proximal to the subscapular artery will not disrupt the blood supply to the upper extremity.

95._____ In the cubital fossa, the brachial artery lies lateral to the median nerve.

96._____ The axillary artery and vein are contained within the axillary sheath but not the posterior cord of the brachial plexus.

97._____ The superficial palmar arterial arch is located superficial to the palmar aponeurosis.

98._____ The superficial branch of the radial nerve courses in the forearm deep to the brachioradialis muscle.

99._____ The brachial plexus is formed of the anterior primary rami of spinal nerves not the posterior primary rami.

100._____ 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.