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Questions and Answers
The posterior cutaneous nerve of the arm originates exclusively from spinal nerve T1.
The posterior cutaneous nerve of the arm originates exclusively from spinal nerve T1.
False (B)
The triceps brachii muscle is innervated by three distinct branches of the radial nerve.
The triceps brachii muscle is innervated by three distinct branches of the radial nerve.
False (B)
The radial nerve branches to the heads of the triceps brachii typically arise in the following sequence: medial, long, lateral, and medial.
The radial nerve branches to the heads of the triceps brachii typically arise in the following sequence: medial, long, lateral, and medial.
False (B)
The first branch of the radial nerve to the medial head of triceps is identified as the radial collateral nerve.
The first branch of the radial nerve to the medial head of triceps is identified as the radial collateral nerve.
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The second branch of the radial nerve to the medial head of triceps brachii ultimately provides innervation to the coracobrachialis muscle.
The second branch of the radial nerve to the medial head of triceps brachii ultimately provides innervation to the coracobrachialis muscle.
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The lower lateral cutaneous nerve of the arm, originating from C6, emerges after the radial nerve pierces the lateral intermuscular septum.
The lower lateral cutaneous nerve of the arm, originating from C6, emerges after the radial nerve pierces the lateral intermuscular septum.
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Avulsion of the brachial plexus roots, leading to complete plexus damage, is most commonly caused by car accidents involving forceful neck flexion.
Avulsion of the brachial plexus roots, leading to complete plexus damage, is most commonly caused by car accidents involving forceful neck flexion.
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In cases of complete brachial plexus root damage, the affected limb typically presents with hypermobility and heightened sensation.
In cases of complete brachial plexus root damage, the affected limb typically presents with hypermobility and heightened sensation.
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When assessing the musculocutaneous nerve, flexion of the elbow by the brachioradialis muscle is the definitive test to confirm its integrity.
When assessing the musculocutaneous nerve, flexion of the elbow by the brachioradialis muscle is the definitive test to confirm its integrity.
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The epidermis is composed of stratified cuboidal epithelium.
The epidermis is composed of stratified cuboidal epithelium.
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Sebaceous glands are responsible for producing sweat.
Sebaceous glands are responsible for producing sweat.
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Fat solvents can stiffen the horny layer of the skin.
Fat solvents can stiffen the horny layer of the skin.
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The dermis contains bundles of elastin fibers and blood vessels.
The dermis contains bundles of elastin fibers and blood vessels.
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Thick skin, like that on the sole of the foot, is characterized by a thick stratum corneum but a relatively thin dermis.
Thick skin, like that on the sole of the foot, is characterized by a thick stratum corneum but a relatively thin dermis.
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The 'claw hand' deformity arises from the unopposed action of the flexors and flexor digitorum profundus muscles.
The 'claw hand' deformity arises from the unopposed action of the flexors and flexor digitorum profundus muscles.
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To assess the small muscles innervated by the ulnar nerve, one should test for adduction of the index finger using the first dorsal interosseous.
To assess the small muscles innervated by the ulnar nerve, one should test for adduction of the index finger using the first dorsal interosseous.
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In a high ulnar nerve lesion, testing the flexion of the proximal interphalangeal joint of the little finger assesses the action of the ulnar half of flexor digitorum profundus.
In a high ulnar nerve lesion, testing the flexion of the proximal interphalangeal joint of the little finger assesses the action of the ulnar half of flexor digitorum profundus.
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Surgically exposing the ulnar nerve in the upper arm involves an incision along the lateral border of the biceps brachii.
Surgically exposing the ulnar nerve in the upper arm involves an incision along the lateral border of the biceps brachii.
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In lesions at or above the elbow affecting the median nerve, fingers tend to be more flexed due to the inaction of the ulnar portion of flexor digitorum profundus.
In lesions at or above the elbow affecting the median nerve, fingers tend to be more flexed due to the inaction of the ulnar portion of flexor digitorum profundus.
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For median nerve lesions at the wrist, assess abductor pollicis longus function instead of abductor pollicis brevis due to its more reliable nerve supply.
For median nerve lesions at the wrist, assess abductor pollicis longus function instead of abductor pollicis brevis due to its more reliable nerve supply.
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The median nerve in the upper arm is surgically approached via an incision along the lateral aspect of the biceps brachii, adjacent to the brachial artery.
The median nerve in the upper arm is surgically approached via an incision along the lateral aspect of the biceps brachii, adjacent to the brachial artery.
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To display the median nerve in the forearm during surgery, detach the ulnar head of flexor digitorum superficialis from the radius.
To display the median nerve in the forearm during surgery, detach the ulnar head of flexor digitorum superficialis from the radius.
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In carpal tunnel release surgery, the flexor retinaculum is incised longitudinally on the radial side of the median nerve to avoid damaging the muscular branch.
In carpal tunnel release surgery, the flexor retinaculum is incised longitudinally on the radial side of the median nerve to avoid damaging the muscular branch.
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Red marrow is primarily found in the cancellous ends of limb bones in young adults.
Red marrow is primarily found in the cancellous ends of limb bones in young adults.
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The periosteum's blood vessels are essential for nourishing the bone underneath it.
The periosteum's blood vessels are essential for nourishing the bone underneath it.
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Sharpey's fibers weaken the connection between the periosteum and the bone, especially at tendon and ligament attachment points.
Sharpey's fibers weaken the connection between the periosteum and the bone, especially at tendon and ligament attachment points.
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The periosteum plays a vital role in bone repair but loses its bone-producing ability after growth is complete.
The periosteum plays a vital role in bone repair but loses its bone-producing ability after growth is complete.
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Intramembranous ossification involves the formation of bone within an existing cartilage structure.
Intramembranous ossification involves the formation of bone within an existing cartilage structure.
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The clavicle, like the bones of the skull vault and face, develops through intramembranous ossification.
The clavicle, like the bones of the skull vault and face, develops through intramembranous ossification.
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Bone growth, excluding the thickening of existing bones, primarily occurs via endochondral ossification.
Bone growth, excluding the thickening of existing bones, primarily occurs via endochondral ossification.
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Study Notes
Introduction to Regional Anatomy
- Body composed of four basic tissues: epithelium, connective tissue, muscle, and nerve.
- Different tissue types adapt to various organ functions.
- Details of cell types and intercellular substances covered in histology texts.
Skin
- Skin consists of epidermis (epithelium) and dermis (connective tissue).
- Epidermis is stratified squamous keratinizing epithelium.
- Skin appendages (sebaceous glands, sweat glands, nails, hair) are specialized epidermis derivatives.
- Dermis is mainly collagen fibers, elastic tissue, blood vessels, lymphatics, and nerve fibers in ground substance.
- Thick skin (e.g., sole) has a thick stratum corneum and relatively thin dermis.
- Thin skin (e.g., forearm) has a thin stratum corneum and relatively thick dermis.
Bone
- Periosteum: Outer fibrous layer covering bones, containing blood vessels crucial for bone nourishment. Osteogenic layer contains osteoblasts for new bone formation during growth and fracture repair.
- Periosteum anchored to bone by Sharpey's fibers.
- Bone development: Intramembranous (skull vault, face, clavicle) and endochondral (long bones) ossification.
- Intramembranous ossification involves direct bone formation in fibrous tissue, with no cartilage precursor.
- Red bone marrow found in cancellous ends of limb bones, ribs, sternum, vertebrae, skull bones. Scant lymphatic drainage to regional lymph nodes.
- Blood vessels run in Volkmann's canals in compact bone.
Nerves and Muscles in the Upper Limb
- Brachial Plexus: Damage rare; most common causes motorbike accidents. Complete damage results in limb immobility and anaesthesia.
- Musculocutaneous Nerve: Rarely injured; test biceps for elbow flexion. Brachioradialis (radial nerve) may simulate biceps action.
- Median Nerve: Easily exposed by incision along medial biceps border and forearm; compression relief involves longitudinally incising the flexor retinaculum.
- Ulnar Nerve: Exposure is along biceps medial border, adjacent to brachial artery. Test for abduction of index finger, ulnar half of flexor digitorum profundus action.
- Triceps: Supplied by 4 radial nerve branches to long, medial, lateral, and medial heads. Ulnar collateral nerve to medial head, runs behind ulnar nerve. Second branch continues deep to triceps to supply anconeus.
- Injuries : A key muscle test is necessary to assess major limb nerve integrity, e.g., biceps for musculocutaneous nerve. Nerve injuries and surgical procedures are summarized.
Scapula
- Scapula's form, costal concavity, and three/four ridges for fibrous septa attachment.
- Supraspinatus, infraspinatus, teres major, and teres minor origin locations.
- Infraspinatus covers the infraspinous fossa, and teres minor is dorsal.
Humerus
- Humerus carries articular surface for elbow joint and projected medial and lateral epicondyles.
- Anterior and posterior appearances differ significantly.
- Articular surface coated with hyaline cartilage and shows conjoined capitulum and trochlea.
- Capitulum is a spherical section for articulation with radius head and a projected ridge from the non-articular bone.
- Trochlea extends to posterior surface.
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