Practice Quiz - Superficial Limbs & Posterior Shoulder
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  1. In the process of escaping from T. rex in Jurassic Park the heroine punctures the skin on the medial side of her wrist on a spiny bush. A few days later, due to the toxin, an infection is seen spreading up the medial side of her arm along the large cutaneous vein extending from the dorsum of her hand to the medial side of her arm. The vein involved is the:
    basilic
    brachial
    cephalic
    median cubital
    ulnar
  2. The lateral antebrachial cutaneous nerve comes from the:
    Axillary nerve
    Medial cord nerve
    Musculocutaneous nerve
    Radial nerve
    Ulnar nerve
  3. In withdrawing a blood sample from the median cubital vein the needle passes slightly deep and medial; which nerve might possibly be injured?
    Dorsal ulnar cutaneous
    Lateral antebrachial cutaneous
    Medial antebrachial cutaneous
    Posterior antebrachial cutaneous
    Superficial radial
  4. The vein of choice for withdrawing blood is the:
    Basilic
    Cephalic
    Median antebrachial
    Median cubital

    A man is in an auto accident and sustains several injuries, among them are:
    1. Skin lacerations:
      • on the back of his head in the occipital area,
      • on his chest just above the nipple,
      • on the lateral side of his arm,
      • lateral forearm at midlength,
      • dorsal hand between his thumb and index finger.
    2. Abrasions and contusions (bruises) about his right shoulder
    3. A fractured right radius near its distal end

  5. After X-ray examination, you are called upon to suture his lacerations in the emergency room. Which laceration (from your observations in the gross anatomy lab) would you expect to be the most difficult to suture because of thick skin?
    back of his head in the occipital area
    chest, just above the nipple
    lateral side of arm
    lateral forearm
    dorsal side of hand
  6. While you are stitching up his hand, he notes that you did not have to give him an anesthetic since the area between his thumb and index finger on the dorsal side was already numb. Which nerve must have been injured (most likely by the fracture of his wrist) for this area to be numb?
    lateral antebrachial cutaneous
    medial antebrachial cutaneous
    median
    superficial radial
    superficial ulnar
  7. The injured nerve (from the skin of his hand) contains afferent nerve fibers that travel through which of the following parts of a spinal nerve?
    dorsal primary ramus
    dorsal root
    gray ramus communicans
    posterior cutaneous branch
    ventral root
  8. A sixteen-year-old boy receives a superficial cut on the thumb side of his forearm. The superficial vein most likely affected is the:
    Basilic
    Cephalic
    Median antebrachial
    Median cubital
    Radial
  9. A sixteen-year-old boy received a superficial cut on the ulnar side of his forearm. The superficial vein most likely affected is the:
    Basilic
    Cephalic
    Median antebrachial
    Median cubital
    Radial
  10. During insertion of an IV cannula in the median cubital vein, the patient suddenly lost feeling on the radial side of the forearm. What nerve was injured?
    Lateral antebrachial cutaneous
    Medial antebrachial cutaneous
    Musculocutaneous
    Posterior antebrachial cutaneous
    Superficial radial nerve
  11. After trying to throw a curve ball, a pitcher lost sensation from the tip of the little finger. This indicates injury to which nerve?
    Radial
    Median
    Ulnar
    Musculocutaneous
    Medial antebrachial cutaneous
  12. While having an IV needle inserted into the cephalic vein of the forearm, the patient suddenly screamed in pain and felt tingling in part of the skin of the forearm supplied by the nerve accompanying the vein. What nerve was injured?
    Posterior antebrachial cutaneous
    Lateral antebrachial cutaneous
    Medial antebrachial cutaneous
    Musculocutaneous
    Superficial radial
  13. Because of scarring of a patient's median cubital vein, the technician chooses to insert an infusion needle into her basilic vein at the level of the medial epicondyle. Despite the certainty that the needle does not pass through the deep (investing) fascia, there is still a chance that it might nick or impale which of the following?
    Brachial artery
    Lateral antebrachial cutaneous nerve
    Medial antebrachial cutaneous nerve
    Median nerve
    Radial nerve
  14. Following a car accident in which the patient received a deep laceration on the medial side of his right knee, the patient notices numbness along the medial side of his right leg and foot. He has no motor deficit. The nerve which appears to have been injured is the:
    femoral nerve
    saphenous nerve
    sural nerve
    superficial fibular nerve
    deep fibular nerve
  15. A 'saphenous vein cut-down' is a procedure used to locate the great saphenous vein at the ankle. To find this vein, the skin would be incised:
    anterior to the lateral epicondyle
    posterior to the medial epicondyle
    anterior to the medial malleolus
    posterior to the lateral malleolus
    over the base of the fifth metatarsal
  16. While doing a physical examination on a young boy, you noticed an enlarged superficial inguinal lymph node. The patient indicated that he has recently sustained an infected skin wound in the:
    anterior abdominal wall above the umbilicus.
    anterior chest wall.
    skin of the lower limb.
    upper back.
  17. A patient with a diabetic ulcer in the anterior midline of the ankle region experienced loss of cutaneous sensation on the dorsal surface of the foot. Which nerve was most likely damaged?
    Femoral
    Lateral sural cutaneous
    Saphenous
    Superficial fibular
    Sural
  18. A construction worker, who wears a heavy work belt all day on the job, notices a tingling sensation on the anterolateral surface of his thigh. This is most likely a condition called:
    compartment syndrome
    cryptorchidism
    hydrocoele
    meralgia parasthetica
    thrombophlebitis
  19. A saphenous cutdown is a surgical procedure that involves cutting through the skin to locate the greater saphenous vein in order to insert a catheter or cannula. You can find the vein as it passes ___________________ with the saphenous nerve.
    Anterior to the medial epicondyle
    Anterior to the medial malleolus
    Through the saphenous opening
    Tributaries to the posterior tibial vein
    Subcutaneous branches of the posterior tibial artery
  20. An elderly man complained of pain in his shoulder when he brought his forearm and hand behind his back while dressing. It was determined that the pain was caused by stretching of the lateral rotators of his arm during this motion. Which muscle was most likely involved?
    Infraspinatus
    Latissimus dorsi
    Subscapularis
    Supraspinatus
    Teres major
  21. A woman riding a mountain bike on a rough trail hits a rut and is thrown from the bike. Her upper arm hits a tree, fracturing the humerus just above the insertion of the teres major muscle. Later, during examination, it is noted that she cannot extend her forearm at the elbow or hand at the wrist. Which nerve must have been injured?
    Axillary
    Median
    Musculocutaneous
    Radial
    Ulnar
  22. A 50-year-old female patient has large varicose veins located primarily on the posterior aspect of her calf. These veins are most likely direct tributaries to the:
    great saphenous vein
    sural vein
    small saphenous vein
    femoral vein
    dorsal venous arch
  23. You are in the clinic when a patient presents with varicose saphenous veins in her lower limb. The attending physician asks where the venous valves are located that are defective and cause this condition. Having just studied a clinical case in that regard, you respond. "The valves in the:
    deep veins."
    perforating veins."
    superficial veins."
    venae commitantes."
  24. Subcutaneous venous varicosities were observed in the anteromedial thigh. The vein involved is likely to be the:
    Femoral
    Greater saphenous
    Lesser saphenous
    Popliteal
    Superficial external pudendal
  25. The distal part of the lesser saphenous vein was mobilized for grafting. Following the operation, the patient complained of numbness (loss of cutaneous sensation) on the distal lateral side of the leg and the lateral side of the foot. What nerve was damaged during the operation?
    Deep fibular (peroneal)
    Posterior femoral cutaneous
    Saphenous
    Superficial fibular (peroneal)
    Sural
  26. Varicosities in the subcutaneous veins of the medial thigh were observed at physical examination. The vein involved was most likely the:
    Femoral.
    Greater saphenous.
    Lesser saphenous.
    Popliteal.
    Pudendal.
  27. The lesser saphenous vein was mobilized for grafting. Following the surgery, the patient complained of a loss of cutaneous sensation at the distal posterolateral side of the leg, lateral side of the foot and small toe. What nerve was damaged during the operation?
    common fibular (peroneal)
    saphenous
    superficial fibular (peroneal)
    sural
    tibial
  28. Competency of venous valves in a patient with severe crural varicose veins was tested as follows: The superficial veins were emptied by elevating the limb and then they were compressed with a band just below the saphenous opening in the proximal thigh. When the patient quickly stood up, filling of the superficial veins took more than 30 seconds. The delayed filling of the superficial veins demonstrates that the valves of the:
    deep (central) veins are competent
    deep (central) veins are incompetent
    perforating veins are competent
    perforating veins are incompetent
    superificial veins are competent
  29. A needle biopsy of the sural nerve resulted in the formation of a hematoma. Which of the following veins closely adjacent to the nerve was accidently injured?
    accessory saphenous
    femoral
    greater saphenous
    lesser saphenous
    superficial external pudendal
  30. A cashier develops painful and tortuous varicose veins in her lower limb. Her doctor explains that prolonged standing at her job led to failure of the valves in the:
    deep femoral vein
    great saphenous vein
    lesser saphenous vein
    perforating veins
    popliteal vein
  31. Your patient complains of pain on her calf. Upon inspection, you find tortuous, dilated vessels lying subcutaneously on the posterior aspect of her leg. These vessels are most likely:
    Tributaries to the greater saphenous vein
    Tributaries to the lesser saphenous vein
    Perforating veins
    Through the iliotibial tract
    Through the popliteal fascia
  32. In old age, the supraspinatus tendon is sometimes ruptured where it blends with the capsule of the shoulder joint. Following this kind of injury one might expect
    difficulty in adducting the arm
    difficulty in flexing the arm
    difficulty in abducting the arm
    difficulty in extending the arm
    difficulty in medially rotating the arm

  33. During a strenuous game of tennis a 55 year old woman complained of severe shoulder pain that forced her to quit the game. During physical examination it was found that she could not initiate abduction of her arm, but if her arm was elevated to 45 degrees from the vertical (at her side) position, she had no trouble fully abducting it. Injury to which muscle was responsible?
    deltoid
    infraspinatus
    supraspinatus
    teres major
    trapezius

  34. A man is in an auto accident and sustains several injuries, among them are:
    1. Skin lacerations:
      • on the back of his head in the occipital area,
      • on his chest just above the nipple,
      • on the lateral side of his arm,
      • lateral forearm at midlength,
      • dorsal hand between his thumb and index finger.
    2. Abrasions and contusions (bruises) about his right shoulder
    3. A fractured right radius near its distal end

    Later, while undergoing physical therapy because of his shoulder injury, he comments that it is very painful when his forearm is brought across his chest (medial or internal rotation of the humerus). You deduce that the pain is due to stretching of the lateral (external) rotators of the shoulder. Which muscle was most likely the source of his pain?
    infraspinatus
    latissimus dorsi
    rhomboideus major
    supraspinatus
    teres major
  35. An elderly patient complains of shoulder pain and has difficulty abducting his arm. Arthroscopy is done in which a dye is injected into the shoulder joint and an X-ray taken. The radiologist notes that the dye has leaked from the shoulder joint into the subacromial bursa. What tendon would need to be ruptured for this to occur?
    deltoid
    infraspinatus
    latissimus dorsi
    supraspinatus
    teres minor
  36. A person riding a mountain bike on a rustic trail hits a rut, the fork of the bike breaks and the person is thrown into a tree, severely fracturing the upper end of his humerus. During the repair the surgeon ties off the artery traveling through the quadrangular space to stop the hemorrhage. Which artery did he ligate?
    dorsal scapular
    posterior circumflex humeral
    scapular circumflex
    subscapular
    suprascapular
  37. After initial examination, a patient is sent to radiology. Radiographs reveal that the portion of the scapula forming the tip or point of the shoulder has been fractured. This bone is the
    acromion
    angle
    coracoid
    glenoid
    spine
  38. Several deficits in muscle function of the right upper limb were noted, including inability to abduct the arm. This was caused by denervation of which muscle?
    deltoid
    infraspinatus
    latissimus dorsi
    teres minor
    trapezius
  39. The rotator cuff is composed of all of the following muscles except:
    infraspinatus
    subscapularis
    supraspinatus
    teres major
    teres minor
  40. Following a gunshot wound to the shoulder, a patient is unable to abduct the arm between 0 and 15 degrees, with reduced lateral rotation of the humerus. What nerve is probably injured?
    Accessory (CN XI)
    Axillary
    Median
    Suprascapular
    Ulnar
    A scaffold falls on the right shoulder of a construction worker lacerating the side of his neck and suprascapular area, severing C5 spinal nerve just lateral to the vertebral column. Subsequent to the injury, the patient could not elevate the tip of his shoulder or retract it and had difficulty fully abducting his arm. Given this scenario answer the following questions.

  41. Due to the bleeding, the surgeon ligated (tied off) the suprascapular artery as it crossed the top of the scapula. There was no concern however, as she knew that direct collateral branches of which artery would supply the normal distribution of the suprascapular artery.
    anterior circumflex humeral
    posterior circumflex humeral
    scapular circumflex
    subscapular
    thoracodorsal
  42. The patient was unable to retract his scapula because of paralysis of the trapezius and
    infraspinatus
    levator scapulae
    rhomboids
    serratus posterior superior
    supraspinatus
  43. Would there be loss of cutaneous sensation over the shoulder due to loss of the nerves supplying the C5 dermatome?
    Yes
    No
  44. When the C5 spinal nerve was severed were any preganglionic sympathetic fibers cut?
    Yes
    No
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