Exam 3 review

​Exam 3 Review

Multiple Choice

What is the flow of lymph from the apex of the right lung?

• Pulmonary LN> R bronchopulmonaryLN > R Tacheobronchial LN > R Bronchiomediastinal LN

• Pulmonary LN> R bronchopulmonaryLN > L Tacheobronchial LN > L Bronchiomediastinal LN

• Pulmonary LN> R Tacheobronchial LN > R bronchopulmonaryLN > R Bronchiomediastinal LN

• Pulmonary LN> R Tacheobronchial LN > R Bronchiomediastinal LN > R bronchopulmonary LN

​Pulmonary LN>

R BronchopulmonaryLN >

R Tacheobronchial LN >

R Bronchiomediastinal LN

Multiple Choice

You are stabbed just forward of the axilla. sensation to the skin in the area is lost, which structure is mostly likely damaged?

• anterior branch of the anterior cutaneous branch

• Lateral branch of the anterior cutaneous branch

• anterior branch of the lateral cutaneous branch

• posterior branch of the lateral cutaneous branch

​Anterior br of the lateral cutaneous branch

Multiple Choice

A patient stabbed, what is the correct order of tissues the knife is passing through to the lung?

• External intercostal > Innermost intercostal > Endothoracic fascia > Visceral Pleura > Parietal Pleura

• External intercostal > Endothoracic fascia> Innermost intercostal > Visceral Pleura > Parietal Pleura

• External intercostal > Innermost intercostal > Endothoracic fascia > Parietal Pleura> Visceral Pleura

• Endothoracic fascia> External intercostal > Innermost intercostal > Visceral Pleura > Parietal Pleura

​External intercostal > Innermost intercostal > Endothoracic fascia >

Parietal Pleura>

Visceral Pleura

Multiple Choice

What intercostal muscles are most active during inspiration?

• innermost intercostal muscles

• external intercostal muscles

• internal intercostal muscles

• subcostal muscles

​External intercostal muscles = inspiration

​

internal intercostal muscles= expiration

​

innermost intercostal muscles= accessory muscles of respiration, help in FORCED expiration and FORCED inspiration ​

​

Multiple Choice

What provides motor innervation to the diaphragm?

• Phrenic n C3-5

• Phrenic n C3-4

• Musculophrenic n C3-5

• Musculophrenic n C4-5

​Phrenic N. C3-5

Multiple Choice

Patent presents with a rupture of the central slip, what deformity would you see?

• flexion of the DIP with hyperextensio of the PIP

• hyperflexion of the DIP

• flexion of the PIP and hyperextension at the DIP

• extension of the PIP and hyperflexion of the DIP

​flexion of the PIP, hyper extension of the DIP

Multiple Choice

Which of the following is NOT a branch of the internal thoracic a?

• Pericardiophrenic a

• Musculophrenic a

• Inferior Phrenic a

• Superior Epigastric a.

​Inferior Phrenic a

Multiple Choice

Which carpal bone interacts with the 4th and 5th metacarpals

• hamtate

• scaphoid

• lunate

• trapezium

​Hamate

Multiple Choice

The lingula is a component of what lung?

• Left lung

• Right Lung

• Both Lungs

• None of the above

​Left lung

Multiple Choice

Your patient is able to flex the PIP and MCPs of the lesser 4 digits, and the wrist. However, they have difficulty flexing the DIPs which of the following muscles is likely implicated?

• Flexor digitorum profundus

• flexor digitorum superficialis

• flexor carpi radialis

• flexor carpi ulnaris

​Flexor Digitorum Profundus

Multiple Choice

What structure is generally posterior at the level of the hilum?

• Pulmonary A

• Pulmonary V

• Bronchi

• Trachea

​Bronchi

Multiple Choice

Injury to the recurrent br of the median nerve would result all of the following EXCEPT?

• weakness of flexion of the MCPS and extension of IPs in the 1st and 2nd digit

• difficulty with opposition of the first digit

• difficulty with abduction of the first digit

• difficulty with flexion of the 5th digit

​difficulty w/ flexion of the 5th digit

​Recurrent or muscular br of the median nerve -

innervates:

​*Half of the Lumbricals (1&2)

​*Opponens pollicis

*​Abductor Pollicis brevis

*Flexor pollicis brevis (HALF) - superficial head

​

1/2 LOAF 1/2​

​

​

Multiple Choice

The bifurcation of the trachea occurs at what landmark?

• T5

• Rib 3

• Sternal notch

• Xiphoid

​T5 or Sternal angle

Multiple Choice

Tennis elbow is also known as _______ and is irritation/inflammation of the __________ ?

• medial epicondylitis

  common flexor tendon

• medial epicondylitis

  common extensor tendon

• lateral epicondylitis

  common flexor tendon

• lateral epicondylitis

  common extensor tendon

​Lateral=extensor tendon

Multiple Choice

A patient is stabbed just superior to the 7th rib and there appears to be significant bleeding. What vessel may have been injured?

• Costocervical trunk

• Anterior intercostal a

• Posterior intercostal a

• Collateral br of posterior intercostal a

​Collateral br of posterior intercostal a

Multiple Choice

The posterior compartment of the forearm is innervated by?

• Radial N.

• Median N

• Musculocutaneous N

• Ulnar N

​Radial N

​Deep radial Br. - superficial layer, as it passes between the supinator

Superficial radial br- cutaneous mostly

Posterior interosseous n - innervates the DEEP layer -- changes its name after the supinator​

Multiple Choice

Compression of the posterior interosseous will lead to weakness in all of the following muscles EXCEPT

• Supinator

• Anconeus

• Abductor pollicis longus

• Extensor digitorum

​Anconeus- Radial n C6-8

Multiple Choice

What are the contents of the carpal tunnel?

• Median Nerve

  Tendons of : FDP, FDS, FPL

• Median Nerve

  Tendons of: ED, ECU, ECRL

• Median Nerve

  Tendons of FCU, FCR, FDP

• Median Nerve

  Tednons of

  FDS, FDP, FCU

​carpal Tunnel

​Contains 10 structures total

​

Median Nerve

Tendons of flexor digitorum profundus (4) ​

Tendons of flexor digitorum superficialis (4)

Flexor Poll. Longus ​

Multiple Choice

Fracture of the pisiform is most likely to result in weakness of what action?

• Abduction of 5th digit

• Flexion of 5th digit

• Opposition of 5th digit

• Adduction of 1st digit

​Abduction of 5th digit

pisiform is the PA for abductor digiti minimi​

Multiple Choice

A pt presents with pain and numbness in the 5th digit and half of the 4th digit. You suspect compression of the _____ , in this space_____?

• median nerve

  carpal tunnel

• ulnar nerve

  guyons canal

• radial n

  anatomic snuffbox

• ulnar nerve

  cubital tunnel

​Guyons Canal, Ulnar Nerve

​Know the spaces, the structures in them and the presentation if a problem occurs

Multiple Choice

A patient present with weakened internal rotation of the humerus. Which of the following muscles may be injured?

• Supraspinatus

• Infraspinatus

• Teres Minor

• Subscapularis

​Subscapularis

Multiple Choice

Pt has a crush injury to the proximal forearm, has bruising on the medial aspect of the proximal forearm. They have weakness in the pinky finger mechanics, the 3/4 lumbricals, and flexor carpi ulnaris. They have loss of sensation to the 5th and half of the 4th digit. What nerve was most likely injured?

• radial n

• median n

• ulnar n

• musculocutaneous

​Ulnar N

​It runs along the medial aspect of the arm, (hint: bruising on med aspect of forearm)

innervates the muscles listed, and provides cutaneous sensation to the 5th and 1/2 the 4th digit ​

​BONUS ???: what are the sites of entrapment for the Ulnar N?

Multiple Choice

Which of the following is NOT a borders of the anatomic snuffbox?

• Tendon of the FPL

• Tendon EPL

• Tendon of the APL

• Tendon of the EPB

​Tendon of the FPL

​Pain in the snuffbox = ??

Multiple Choice

Which of the following muscles flexes the elbow?

• coracobrachialis

• anconeous

• brachioradialis

• triceps brachii

​ Muscle Chart

​

Brachioradialis ​- b/c of attachments on the humerus and the radius

​

Multiple Choice

A patient present with signs of significant ischemia in the distal most portion of the thumb. What vessel may be occluded?

• Radialis Indicis

• Common palmar digital a

• Dorsal digital a

• Princeps pollicis

​Princeps pollicis

Multiple Choice

A blood clot in the superior ulnar collateral artery is not as concerning because of its anastamoses to what artery?

• anterior ulnar recurrent artery

• posterior ulnar recurrent artery

• common interosseous artery

• interosseous recurrent artery

​Superior ulnar collateral = posterior ulnar recurrent

​SIMR

PAIR

PAPA​

Multiple Choice

Which muscle is innervated by branches of both the median & ulnar n?

• Flexor digitorum profundus

• Flexor carpi ulnaris

• Flexor digitorum superficialis

• Flexor pollicis longus

​Flexor digitorum profundus

Multiple Choice

A superficial cut to the lateral aspect of the hand, just at the base of the thumb results in non-pulsatile blood flow. What structure was likely injured?

• basilic vein

• ulnar artery

• cephalic vein

• raidal artery

​Cephalic vein

​superficial

non pulsatile blood flow

​ (not an artery)

Multiple Choice

A midshaft fracture of the ulna would impact which of the following muscles?

• ECRL

• ED

• EPL

• EPB

​EPL

Multiple Choice

A pt presents with loss of sensation to the medal aspect of the forearm. You suspect injury to what nerve? Which originates from?

• lateral antebrachial cutaneous n from the musculocutanous n

• medial antebrachial curaneous n. from the musculocutaneous n.

• medial antebrachial cutaneous n, from the medial cord of the brachial plexus

• medial antebrachial cutaneous n. from the ulnar artery

​Medial cutaneous n of the forearm, from the medial cord of the brachial plexus

Multiple Choice

2 weeks post carpal tunnel release surgery a patient presents with profound weakness of the thumb. Exam reveals loss of thumb opposition but sensation of the hand remains intact. What nerve was most likely injured?

• First common digital branch of median nerve

• Recurrent branch of the median nerve

• Deep branch of ulnar nerve

• Anterior interosseous nerve

​Recurrent branch of the median nerve

Poll

Do you want tutoring on Thursday December 1st, the evening after the last CI exam??

• Yes, I will be there

• No, I will need a brain break

​NO TUTORING on Thanksgiving

take a much needed break!!​

​QUESTIONS?

good luck!​

​youre almost done with semester one!!