Re: Arm and Cubital Fossa: Learning Objectives and Review Questions - Part 1

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: : : Arm and Cubital Fossa: Learning Objectives and Review Questions : : True/False - 2011 : : 1. The surgical neck of the humerus is distal to the anatomical neck. : : T : Agree. : : 2. The anterior and posterior humeral circumflex arteries circle the anatomical neck of the humerus. : : F - surgical neck : Agree. : : 3. The glenohumeral joint capsule attaches, in part, along the margin of the surgical neck of the humerus. : : T - on the medial side, at most inferior aspect of capsular ligaments : Agree. : : 4. The spiral groove is related superiorily by the lateral head of the triceps and medially by the medial head of the triceps. : : T? - if the spiral groove also called the radial groove : Agree. Better wording - Superior to the spiral groove is the lateral head of the triceps and inferior to the spiral groove is the medial head of the triceps. You can make this prediction by knowing that the spiral groove runs from superior medial to inferior lateral. Trace the spiral groove by running you finger along the posterior arm. You quickly know that the lateral head is superior and that the medial head is inferior. : : 5. The long head of the triceps extends at the elbow and at the glenohumeral joint. : : T : Agree. : : 6. The teres major muscle shares a motor nerve with the subscapularis muscle. : : T : Agree. The lower subscapular nerve. : : 7. The teres minor muscle medially rotates at the glenohumeral joint and the teres major muscle laterally rotates at the glenohumeral joint. : : F - reverse that. Teres major medially rotates, teres minor laterally rotates the humerus. (Is lateral rotation the same thing as "external rotation"?) : Agree. Yes. : : 8. The inferior margin of the teres major contributes the superior border of the quadrangular space. : : F - to the inferior border. Teres minor contributes the superior border. : Agree. Doubly wrong. : : 9. The inferior margin of the teres major contributes the superior border of the triangular interval. : : T : Agree. : : 10. The triangular interval marks the location of the spiral (radial) groove of the ulna. : : F - spiral (radial?) groove of the humerus. : Agree. Fairly trite of me. : : 11. The superior margin of the teres major muscle contributes the superior border of the triangular space. : : F - teres minor is superior border, teres major is inferior border : Agree. : : 12. The long head of the biceps has a tendon of origin partly enveloped by a tendon sheath in the region of the bicipital groove. : : T - and does the anterior circumflex humeral artery run through this sheath or inferior to it? : Agree. Good question. My prediction based on patterns is inferior and deep. A shade of doubt. As usual, the sheath is an evacuated cavity. A little serous fluid and nothing else. A mesotendon will allow for vascular/neural supply. : : 13. Properly installed door knobs turn in the direction of supination when the door opens toward you. : : Depends on if you're turning them with your right or left hand, and whether it's a right or left-hung door and whether it's reverse or normal swing. In any case, the knob should spin so that a mark placed on the superior aspect moves away from the jamb. : Agree. Bottom line. Supination and flexion marks a properly installed door knob. I was not intending to not betray right-handed chauvinism. : : 14. The deltoid muscle acts synergistically with every movement available to the glenohumeral joint. : : T : Agree. Today's lecture omitted adduction but most inferior fibers are adductors depending on joint position. : : 15. The brachialis muscle inserts on the coronoid process of the radius bone. : : F - coronoid process and ulnar tuberosity of the ulna : Agree. : : 16. The biceps muscle inserts on the radial tuberosity of the ulna. : : F - radial tuberosity of the radius : Agree. : : 17. The latissimus dorsi muscle contributes to the posterior margin of the intertubercular sulcus and the pectoralis minor contributes to the anterior wall of an osseofibrous canal partly formed by the intertubercular sulcus. : : F - the latissimus dorsi inserts on the medial side of the sulcus and the pectoralis major (inserting on the lateral margin) partially forms the anterior surface of an osseofibrous canal incorporating the intertubercular sulcus as a posterior border : True. Nit picky; but the latissimus dorsi extends beyond the medial lip to line the floor. : : 18. The brachioradalis muscle, a flexor of the elbow, is radial nerve innervated and extends the wrist. : : F? - Netter appears to have it inserting on the distal styloid of the radius. I'm thinking without crossing at least one of the metacarpals, it can't act at the wrist. It is innervated by the radial nerve. : Agree. Nice question, huh? : : 19. The subscapularis muscle shares an nerve supply with the teres minor. : : F? - teres minor is supplied by axillary nerve, subscapularis is upper/lower subscapular nerve. It shares innervation from the same nerve roots though - C5/C6. : Agree. They share cord levels but not peripheral nerves. Plexuses; what fun. : : 20. The subscapularis muscle inserts on the lesser tubercle of the humerus. : : T : Agree. : : 21. The musculocutaneous nerve enters the arm by passes through the coracobrachialis muscle and then resides on the anterior surface of the brachialis muscle. : : T : Agree. : : 22. The basilic vein is a single vein whereas the brachial vein is represented by two veins. : : T - brachial vein is vena commitantes : Agree. : : 23. The medial cutaneous vein of the forearm is deep to the brachial fascia and superficial to the antebrachial fascia. : : ?? - I could not find a medial cutaneous vein of the forearm. I found a median antebrachial vein that drains into the basilic vein below the cubital fossa. It doesn't go near the brachial fascia. I also found a median cubital vein, but that one appears to be superficial to the bicipetal aponeurosis. Does the bicipetal aponeurosis constitute part of the brachial fascia? In either case, both veins are superficial to both the brachial and antebrachial fascia. : True. The medial antebrachial cutaneous nerve is deep to brachial fascia and becomes superficial to antebrachial fascia. It must. : : 24. The radial nerve is accompanied by the radial artery as both structures are applied to the radial groove of the humerus. : : F - by the profunda brachii artery. : Agree. : : 25. The posterior interosseous artery passes into the posterior compartment of the arm by passing superior to the posterior free edge of the interosseous membrane and inferior to the oblique cord. : : T : False. Posterior compartment of the forearm. Sorry for the trick. : : 26. The radial collateral artery passes through the lateral intermuscular septum of the arm. : : T : Agree. : : 27. The superior ulnar collateral artery passes through the medial intermuscular septum of the arm. : : F? - it remains anterior to it? : True. The superior goes posterior. There is a natural inclination for Humans to not pair superior with posterior. The superior ulnar collateral artery forms and anastomosis with the posterior ulnar recurrent artery. : : 28. The posterior ulnar artery passes through the heads of origin of the flexor carpi ulnaris muscle. : : T? : Agree. As does the ulnar nerve. Entrapment. : : 29. The interosseous recurrent artery has an anastomosis with the middle collateral artery. : : T : Agree. : : 30. The radial nerve and the median nerve are contents of the cubital fossa. : : T : Agree. : : 31. The median nerve is medial to the brachial artery within the cubital fossa. : : T : Agree. : : 32. The radial recurrent artery and the radial collateral artery are contents of the cubital fossa. : : F? - the superior boundary of the cubital fossa is a line drawn through the epicondyles of the humerus. Netter shows the radial recurrent and the radial collateral anastemosing on the anterior/lateral surface of the capitulum right around there, so I'm guessing one is incorporated in the fossa and one is not? Or, actually, since they anastemose on the lateral surface of the capitulum, are they lateral to the cubital fossa? : True. They are medial to brachioradialis. Put them both in the cubital fossa. Some authors exclude them but it is a matter of definition and maybe careless omission. : : 33. The anterior boundary of the cubital fossa is partly formed by the bicipital aponeurosis. : : T : Agree. : : 34. The ulnar artery, but not the ulnar nerve, is a content of the cubital fossa. : : T - ulnar nerve is too far medial : Agree. The ulnar nerve is too far posterior. : : 35. The inferior ulnar collateral artery passes anterior to the medial epicondyle of the humerus and enters the cubital fossa. : : T - it does pass anterior to the medial epicondyle of the humerus, but does it come far enough lateral to be included in the fossa, if the medial boundary of the fossa is pronator teres? : Agree. The inferior ulnar artery is applied to the lateral margin of pronator teres and the anterior/medial margin of brachialis. Definition. Let's include it. : Cautionary note. Please inform me if any of my answers contradict Anna's lecture

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