Anatomy- Block 1 Practice Exam 2005

3) The glenohumeral joint capsule attaches to the a. Anatomical neck of the humerus b. Greater tuberosity of the humerus c. Lesser tuberosity of the humerus d. Surgical neck of the humerus

a. Anatomical neck of the humerus

10) Fracture of the surgical neck of the humerus would most likely disrupt which of the following arteries? a. Anterior circumflex humeral b. Brachial c. Circumflex scapular d. Profunda brachii

a. Anterior circumflex humeral

12) A physician prescribes rehab as part of the rehabilitation of a shoulder injury. In one exercise, the patient holds the arm at 90° of flexion at the shoulder. The clinician pushes down on the arm as the patient attempts to increase the degree of flexion. Which of the following muscle is strengthened by this resistance exercise? a. Anterior deltoid b. Brachialis c. Pectoralis major d. Supraspinatus

a. Anterior deltoid

25) Which of the following statements describing the lunate bone is correct? a. It is a component of a carpometacarpal joint b. It can compress the median nerve if displaced anteriorly c. It lies in the distal row of the carpal bones d. It lies most medial of the carpal bones

b. It can compress the median nerve if displaced anteriorly

61) Rupture of which of the following ligaments will result in posterior lateral rotatory instability of the elbow? a. Annular ligament b. Lateral ulnar collateral ligament c. Radial (Lateral) collateral ligament d. Ulnar (Medial) collateral ligament

b. Lateral ulnar collateral ligament

11) A injury to the posterior cord of the brachial plexus will result, most likely, in weakness to which of the following muscles? a. Coracobrachialis b. Latissimus dorsi c. Pectoralis major d. Serratus anterior

b. Latissimus dorsi

20) A child is brought to the emergency room in extreme pain. The mother reports the onset immediately after she lifted him by his wrists into his stroller. Which of the following is the most likely cause of the child's pain? a. Separation of the head of the radius from its articulation with the trochlea of the humerus b. Separation of head of radius from its articulation with the ulna and capitulum of the humerus c. Separation of the ulna from its articulation with the trochlea of the radius d. Stretching of the radial nerve as it passes behind the medial epicondyle of the humerus

b. Separation of head of radius from its articulation with the ulna and capitulum of the humerus

44) The abductors of the arm are paralyzed resulting from a lesion of which of the following nerves? a. Axillary and musculocutaneous b. Suprascapular and axillary c. Suprascapular and dorsal scapular d. Thoracodorsal and upper subscapular

b. Suprascapular and axillary

2) All of the following muscles attach to the scapula EXCEPT: a. latissimus dorsi b. long head of biceps brachii c. serratus anterior d. short head of biceps brachii

a. latissimus dorsi

45) The muscles that form the floor of the cubital fossa are torn. Which of the following muscles has lost function? a. Brachialis and pronator teres b. Brachialis and supinator c. Brachioradialis and supinator d. Pronator teres and supinator

c. Brachioradialis and supinator

27) The ulnar nerve innervates which of the following muscles of the thumb? a. Abductor pollicis brevis b. Abductor pollicis longus c. Deep head of flexor pollicis brevis d. Opponens pollicis

c. Deep head of flexor pollicis brevis

15) A 42 year old mechanic has a hand dysfunction that is thought to result from selective involvement of the anterior interosseous nerve. The patient most likely has an inability to: a. Abduct the thumb b. Adduct the thumb c. Flex the interphalangeal joint of the thumb d. Flex the proximal interphalangeal joints of fingers 2 & 3

c. Flex the interphalangeal joint of the thumb

24) Which of the following muscles originates from the medial epicondyle? a. Brachioradialis b. Extensor carpi ulnaris c. Flexor carpi radialis d. Flexor pollicis longus

c. Flexor carpi radialis

28) In the upper extremity, a pulse may be palpated at all of the following locations EXCEPT: a. At the wrist at the radial side of the pisiform bone b. In the cubital fossa medial to the biceps tendon c. In the hand between the tendons of the extensor pollicis brevis and abductor pollicis longus d. In the wrist at the radial side of the tendon of flexor carpi radialis

c. In the hand between the tendons of the extensor pollicis brevis and abductor pollicis longus

22) Which of the following statements concerning the teres major is TRUE? a. It divides the axillary artery into three parts b. It inserts into the humerus just distal to the infraspinatus insertion c. It is active in adduction of the glenohumeral joint d. It is innervated by the same nerve as the deltoid muscle

c. It is active in adduction of the glenohumeral joint

52) Which of the following muscles is most likely to originate from the glenoid of the scapula? a. Coracobrachialis b. Lateral head of triceps brachii c. Long head of biceps brachii d. Short head of biceps brachii

c. Long head of biceps brachii

9) Which of the following is considered the anterior wall of the axilla? a. Deltoid b. Latissimus dorsi c. Pectoralis major d. Serratus anterior

c. Pectoralis major

60) Again, referring to the injury in number 58, which artery may be damaged as a result of the injury? a. Brachial artery b. Posterior circumflex humeral artery c. Profunda brachii artery d. Radial artery

c. Profunda brachii artery

48) Occulsion of the radial artery just distal to its origin is most likely to cause which of the following conditions? a. A low blood pressure in the anterior interosseous artery b. A marked decrease in the blood flow in the princes pollicis artery c. A marked decrease in the blood flow in the superficial palmer arch d. Decreased pulsation in the artery passing superficial to the flexor retinaculum

b. A marked decrease in the blood flow in the princes pollicis artery

34) Reposition of the thumb (opposite motion of opposition) is accomplished by all of the following muscles EXCEPT the: a. Abductor pollicis longus b. Adductor pollicis c. Extensor pollicis brevis d. Extensor pollicis longus

b. Adductor pollicis

5) The "roof" of the shoulder is a term used to describe which anatomical structure? a. Acromioclavicular ligament b. Coracoacromial ligament c. Coracoclavicular ligament d. Coracohumeral ligament

b. Coracoacromial ligament

4) The sternoclavicular joint is reinforced by all of the following EXCEPT: a. Anterior sternoclavicular ligament b. Coracoclavicular ligament c. Costoclavicular ligament d. Interclavicular ligament

b. Coracoclavicular ligament

33) Laceration of the recurrent branch of the median nerve results in paralysis of all of the following muscles of the thumb EXCEPT: a. Abductor pollicis brevis b. Deep head of flexor pollicis brevis c. Oppones pollicis d. Superficial head of flexor pollicis brevis

b. Deep head of flexor pollicis brevis

55) Fracture of the hook of the hamate often requires surgical excision of the fractured segment. Which of the following muscles would be most affected by surgical lremoval of the hook of the hamate? a. Abductor digiti minimi b. Flexor digiti minimi c. Flexor pollicis brevis d. Opponens pollicis

b. Flexor digiti minimi

53) Which of the following muscles is NOT part of the common flexor tendon of the forearm? a. Flexor carpi radialis b. Flexor digitorum profundus c. Flexor digitorum superficialis d. Palmaris longus

b. Flexor digitorum profundus

64) Which of the following muscles has the same innervation as pronator quadratus? a. Flexor pollicis brevis b. Flexor pollicis longus c. Pronator teres d. Supinator

b. Flexor pollicis longus

50) Which of the following conditions is most likely to cause a loss of the axillary nerve function? a. Fracture to the anatomical neck of the humerus b. Inferior dislocation of the head of the humerus c. Injury to the lateral cord of the brachial plexus d. Knife wound to the teres major muscle

b. Inferior dislocation of the head of the humerus

56) A construction worker suffers a destructive injury to the structures related to the anatomical snuff box. Which of the following structures is most likely damaged? a. Abductor pollicis brevis tendon b. Extensor indicis tendon c. Radial artery d. Triquetral bone

c. Radial artery

58) Fracture of the shaft of the humerus would most likely result in damage to which nerve? a. Axillary nerve b. Musculocutaneous nerve c. Radial nerve d. Ulnar nerve

c. Radial nerve

63) All of the following can be found in the cubital fossa EXCEPT a. Biceps brachii tendon b. Median nerve c. Radial nerve d. Terminal portion of brachial artery

c. Radial nerve

57) A rock climber falls on his shoulder, resulting in the chipping off of the lesser tubercle of the humerus. Which of the following structures would most likely have structural and functional damage? a. Coracohumeral ligament b. Infraspinatus muscle c. Subscapularis muscle d. Supraspinatus muscle

c. Subscapularis muscle

62) A patient reports to you complaining of shoulder pain and weakness. Evaluation reveals a significant decrease in strength during external rotation of the humerus. Which of the following nerves is most likely damaged (or entrapped)? a. Dorsal scapular nerve b. Lower sub scapular nerve c. Suprascapular nerve d. Thoracodorsal nerve

c. Suprascapular nerve

21) A 50 year old woman is diagnosed with an apical lung cancer that invades the inferior trunk of the brachial plexus. Which of the following muscle actions is most likely to show the greatest weakness after damage of this trunk? a. Arm abduction b. Elbow flexion c. Thumb and finger adduction d. Thumb extension

c. Thumb and finger adduction

42) The defect known as winged scapula is caused by damage to a nerve that arises from which of the following structures of the brachial plexus? a. Lower trunk b. Posterior cord c. Roots d. Upper trunk

c. roots

54) Which of the following muscles originates from the distal 1/3 of the lateral supracondylar ridge? a. Brachialis b. Brachioradialis c. Extensor carpi radialis brevis d. Extensor carpi radialis longus

d. Extensor carpi radialis longus

23) Which of the following statements describing the pectoralis minor is correct a. It attaches to the acromion process of the scapula b. It is an adductor and medial rotator of the humerus c. It is innervated by the thoracodorsal nerve d. It aids in stabilization of the scapula

d. It aids in stabilization of the scapula

17) Because the thumb is important for hand function, if it is severed because of trauma or disease, the great toe often is transplanted to replace it. The surgeon performing this procedure must understand muscle attachments to establish function of the transplanted digit. Which of the following inserts onto the first metacarpal bone? a. Abductor pollicis brevis b. First palmar interosseous c. Flexor pollicis brevis d. Opponens pollicis

d. Opponens pollicis

43) Which of the following muscles is able to do the following: 1) flex the metacarpophalangeal joint and extend the interphalangeal joint of the ring finger, and 2) adduct the ring finger? a. Flexor digitorum profundus b. Lumbrical c. Dorsal interosseous d. Palmar interosseous

d. Palmar interosseous

70) The middle collateral artery anastomoses with which of the following arteries? a. Posterior recurrent artery b. Radial collateral artery c. Radial recurrent artery d. Recurrent interosseous artery

d. Recurrent interosseous artery

8) A patient complains of anterior shoulder pain while doing overhead activity. There is no history of trauma. Your exam reveals only pain with passive elevation of the humerus past 90°. You suspect which of the following problems? a. AC joint sprain b. Anterior instability of the glenohumeral joint c. SC joint sprain d. Subacromial impingement syndrome

d. Subacromial impingement syndrome

51) Which of the following muscles does NOT have an attachment (origin or insertion) on the medial border of the scapula? a. Rhomboid major b. Rhomboid minor c. Serratus anterior d. Teres minor

d. Teres minor

6) A patient presents to you with complaints of shoulder instability when their arm is in 90° of abduction and maximal external rotation. Which ligament is most likely compromised? a. Coracohumeral ligament b. Inferior glenohumeral ligament c. Middle glenohumeral ligament d. Superior glenohumeral ligament

b. Inferior glenohumeral ligament

A) Deep Branch of Ulnar Nerve B) Median Nerve C) Median and Deep Branch of Ulnar Nerves D) Posterior interosseous Nerve For each muscle, select the most appropriate innervation. 38) Abductor pollicis longus muscle 39) Lumbrical muscles (all of them) 40) Dorsal interosseous muscles (all of them) 41) Adductor pollicis muscle

38) D) Posterior interosseous Nerve 39) C) Median and Deep Branch of Ulnar Nerves 40) A) Deep Branch of Ulnar Nerve 41) A) Deep Branch of Ulnar Nerve

A) Infraspinatus Muscle B) Subscapularis Muscle C) Supraspinatus Muscle D) Teres Minor Muscle For each description, select the appropriate rotator cuff muscle. 35) A primary medial (internal) rotator of the arm 36) Initiates humeral abduction 37) Innervated by the axillary nerve

35. B) Subscapularis Muscle 36. C) Supraspinatus Muscle 37. D) Teres Minor Muscle

18) A 34 year old police officer is injured by a bullet that fractures his right clavicle and enters the posterior triangle of the neck. Examination reveals diminished function of the forearm and hand, but the arm and shoulder are unaffected. He is diagnosed with injury to the medial cord of the brachial plexus. The medial cord contains fibers from which of the following divisions of the brachial plexus? a. Anterior division of inferior trunk only b. Anterior divisions of middle and inferior trunks c. Anterior divisions of superior and middle trunks d. Posterior divisions of middle and inferior trunks

a. Anterior division of inferior trunk only

59) With the same injury as mentioned above (# 58) the patient would have a loss of sensation, most likely, where? a. Area of anatomical snuff-box b. Lateral aspect of arm c. Medial aspect of arm d. Medial one and one-half fingers

a. Area of anatomical snuff-box

66) A gymnast sprains her ankle and is placed on crutches for two weeks. She reports to you for rehabilitation after the two week period. During your initial screening the patient exhibits weakness with shoulder abduction and external rotation. After further investigation you discover that this started after she was placed on crutches. She also reports that she leans on her crutches with her weight through the axilla. What nerve is most likely injured? a. Axillary b. Musculocutaneous c. Radial d. Suprascapular

a. Axillary

14) Any muscle that attaches to the humerus may be damaged by a fracture of that bone. Which of the following muscles lacks an attachment to the humerus? a. Biceps brachii b. Brachialis c. Coracobrachialis d. Extensor carpi radialis longus

a. Biceps brachii

1) The costal tubercle is a feature of which bone? a. Clavicle b. First rib c. Humerus d. Scapula

a. Clavicle

7) All of the following are static stabilizers of the glenohumeral joint EXCEPT: a. Coracoacromial ligament b. Coracohumeral ligament c. Inferior glenohumeral ligament d. Superior glenohumeral ligament

a. Coracoacromial ligament

30) With the upper limb adducted, hanging by the side holding a heavy suitcase, support at the glenohumeral joint to prevent downward displacement is provided by all of the following EXCEPT: a. Coracoacuromial ligament b. Coracohumeral ligament c. Short head of the biceps brachii muscle d. Supraspinatus muscle

a. Coracoacuromial ligament

49) A 24 year old carpenter suffers a crush injury to his entire little finger, which of the following muscles is most likely to be spared? a. Dorsal interossei b. Extensor digitorum c. Flexor digitorum profundus d. Palmar interossei

a. Dorsal interossei

65) During pronation of the forearm, which of the following structures aids in carrying the hand into the pronated position? a. Dorsal radiocarpal ligament b. Palmar radiocarpal ligament c. Radial collateral ligament of the wrist d. Ulnar collateral ligament of the wrist

a. Dorsal radiocarpal ligament

47) In a patient with carpal tunnel syndrome, which of the following conditions most likely occurs? a. Flattened (atrophied) thenar eminence b. Inability to adduct the middle finger c. Inability to flex the distal interphalangeal joint of the ring finger d. Loss of skin sensation to the medial one and one-half fingers

a. Flattened (atrophied) thenar eminence

26) A patient is referred to you for treatment after an accident in which his hand went through a glass window. A piece of glass penetrated the palmar aspect of the 2 digit. The patient is unable to flex the distal interphalangeal joint of the 2 finger but can flex the proximal interphalangeal joint. You suspect disruption of which tendon? a. Flexor digitorum profundus b. Flexor digitorum superficialis c. First lumbrical d. Palmar interossei

a. Flexor digitorum profundus

31) All of the following statements concerning the scaphoid bone are true EXCEPT a. It articulates maximally with the radius in ulnar deviation b. It is the most susceptible of the carpal bones to fracture c. It participates in the mid carpal joint d. It lies in the anatomical snuff box

a. It articulates maximally with the radius in ulnar deviation

67) Based on your answer above, this gymnast would experience sensation deficits in which area? a. Lateral arm b. Lateral forearm c. Medial arm d. Web space between thumb and index finger

a. Lateral arm

16) A 50 year old administrative assistant complains of persistent bilateral tingling and pain mainly over the lateral fingers. The pain is worse over the finger tips and sometimes radiates proximally into the forearm. It even awakes him at night. His work load as a typist has recently increased significantly. After evaluation you would suspect compression of which nerve? a. Median nerve in carpal tunnel b. Median nerve passing through pronator teres c. Ulnar nerve in cubital tunnel d. Ulnar nerve in tunnel of Guyon

a. Median nerve in carpal tunnel

68) A patient presents to you complaining of lateral elbow pain. You notice that he has an excessive carrying angle (> 15°). He also reports he is the star pitcher for his high school baseball team and he also plays center field when not pitching. You rule out any type of musculotendonis problem or instability. The most likely problem with his lateral elbow is what? a. Osteochondral defect of capitulum b. Osteochondral defect of trochlea c. Ulnar collateral ligament sprain d. Ulnar nerve subluxation

a. Osteochondral defect of capitulum

13) A 19 year old soldier in peak physical condition can do 40 one-handed chin-ups without resting. While on night maneuvers, she falls against the stump of a dead tree limb and injures a nerve in one arm. The next day, she cannot do chin-ups with the affected extremity. Which of the following nerves has most likely been injured? a. Dorsal scapular b. Lateral pectoral c. Long thoracic d. Thoracodorsal

d. Thoracodorsal

46) Damage to the ulnar nerve at the elbow most likely results in paralysis of which of the following muscles? a. Flexor digitorum superficialis b. Opponens pollicis c. Pronator teres d. Two medial lumbricals

d. Two medial lumbricals

32) All of the following structures pass deep to the flexor retinaculum EXCEPT the: a. Flexor digitorum superficialis b. Flexor pollicis longus tendon c. Median nerve d. Ulnar artery

d. Ulnar artery

29) Following complete severance of the musculocutaneous nerve, some weak flexion of the elbow is possible through contraction of muscles not innervated by that nerve. All of the following muscles also flex the elbow EXCEPT: a. Brachioradialis b. Flexor carpi radialis c. Flexor carpi ulnaris d. Ulnar head of pronator teres

d. Ulnar head of pronator trees????

19) A bicycle rider has weak abduction and adduction of her fingers but has no difficulty in flexing them. She has decreased sensation over the palmar surface of fingers 4 & 5. These deficits most likely result from compression of which of the following nerves? a. Median nerve in carpal tunnel b. Radial nerve at supinator c. Ulnar nerve at medial epicondyle d. Ulnar nerve at tunnel of Guyon

d. Ulnar nerve at tunnel of Guyon

69) The third dorsal interosseous muscle inserts into the dorsal digital expansion of what? a. Radial side of the second digit b. Radial side of the third digit c. Ulnar side of the fourth digit d. Ulnar side of the third digit

d. Ulnar side of the third digit