Arm and Cubital Fossa: Learning Objectives and Review Questions

True/false

1. The surgical neck of the humerus is distal to the anatomical neck.
2. The anterior and posterior humeral circumflex arteries circle the anatomical neck of the humerus.
3. The glenohumeral joint capsule attaches, in part, along the margin of the surgical neck of the humerus.
4. The spiral groove is superior to the lateral head of the triceps and medial to the medial head of the triceps.
5. The long head of the triceps extends at the elbow and at the glenohumeral joint.
6. The teres major muscle shares a motor nerve with the subscapularis muscle.
7. The teres minor muscle medially rotates at the glenohumeral joint and the teres major muscle laterally rotates at the glenohumeral joint.
8. The inferior margin of the teres major contributes the superior border of the quadrangular space.
9. The inferior margin of the teres major contributes the superior border of the triangular interval.
10. The triangular interval marks the location of the spiral (radial) groove of the ulna.
11. The superior margin of the teres major muscle contributes the superior border of the triangular space.
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.
13. Properly installed door knobs turn in the direction of supination when the door opens toward you.
14. The deltoid muscle is synergistic to every movement available to the glenohumeral joint.
15. The brachialis muscle inserts on the coronoid process of the radius bone.
16. The biceps muscle inserts on the radial tuberosity of the ulna.
17. The lattisimus 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.
18. The brachioradalis muscle, a primary flexor at the elbow, is radial nerve innervated and extends the wrist.
19. The subscapularis muscle shares an nerve supply with the teres minor.
20. The subscapularis muscle inserts on the lesser tubercle of the humerus.
21. The musculocutaneous nerve enters the arm by passes through the coracobrachialis muscle and then resides on the anterior surface of the brachialis muscle.
22. The basilic vein is a single vein whereas the brachial vein is represented by two veins.
23. The medial cutaneous vein of the forearm is deep to the brachial fascia and superficial to the antebrachial fascia.
24. The radial nerve is accompanied by the radial artery as both structures are applied to the radial groove of the humerus.
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.
26. The radial collateral artery passes through the lateral intermuscular septum of the arm.
27. The superior ulnar collateral artery passes through the medial intermuscular septum of the arm.
28. The posterior ulnar artery passes through the heads of origin of the flexor carpi ulnaris muscle.
29. The interosseous recurrent artery anastomoses with the middle collateral artery.
30. The radial nerve and the median nerve are contents of the cubital fossa.
31. The median nerve is medial to the brachial artery within the cubital fossa.
32. The radial reccurrent artery and the radial collateral artery are contents of the cubital fossa.
33. The anterior boundary of the cubital fossa is partly formed by the bicipital aponeurosis.
34. The ulnar artery, but not the ulnar nerve, is a content of the cubital fossa.
35. The inferior ulnar collateral artery passes anterior to the medial epicondyle of the humerus and enters the cubital fossa.
36. The upper lateral cutaneous nerve of the arm is a lateral branch of the supraclavicular nerves.
37. The intercostobrachial cutaneous nerve shares cord level projections with high threshold receptors from the epicardium.
38. The posterior cutaneous nerve of the arm is a branch of the posterior cord of the brachial plexus.
39. The medial cutaneous nerve of the arm is a branch of the medial cord of the brachial plexus.
40. The posterior cutaneous nerve of the forearm is a branch of the musculocutaneous nerve.
41. The lower lateral cutaneous nerve of the arm is a branch of the posterior cord of the brachial plexus.
42. The medial cutaneous nerve of the forearm is a branch of the medial cord of the brachial plexus.
43. The lateral cutaneous nerve of the forearm is the terminal branch of the musculocutaneous nerve.
44. The medial 3.5 fingers of the palm receives cutaneous innervation from the median nerve.
45. The superfiical branch of the radial nerve innervates the dorsum of the index finger including the nail bed.
46. The nail bed of the ring finger receives ulnar nerve innervation on the lateral side and median nerve innervation on the medial side.
47. The articular surface of the head of the humerus is covered by hyaline cartilage.
48. The greater tubercle of the humerus receives the insertion of three medial rotators of the glenohumeral joint.
49. The spiral (radial) groove of the humerus divides the origin of the lateral and medial heads of the triceps muscle.
50. The medial epicondyle extends further distally than does the lateral epicondyle.
51. The capitulum articulates with the styloid process of the radius.
52. The olecranon fossa receives the styloid process of the ulna.
53. The coronoid fossa receives the coronoid process of the ulna.
54. The long head of the triceps takes origin from the supraglenoid tubercle of the scapula.
55. A lesion of the radial nerve at the spiral groove is expected to eliminate extension of the elbow.
56. Teres minor crosses anterior to the long head of the triceps whereas teres major crosses posterior to the long head of the triceps.
57. Teres minor and major are innervated by the lower and upper subscapular nerves.
58. The quadrangular space transmits the lower supscapular nerve to the posterior region of the arm.
59. The triangular interval overlies the deltoid tuberosity.
60. The triangular space provides a communication between the axilla and the supraspinous fossa.
61. The biceps muscle has two heads of origin and a single insertion onto the radial tuberosity of the radius.
62. The biceps, despite rigorous celebration for its flexion of the forearm, is a powerful supinator of the forearm.
63. The deltoid muscle inserts onto the medial lip of the intertubecular sulcus.
64. The brachialis muscle and the coracobrachialis muscle are both monoarticulate.
65. The coracobrachialis muscle adducts the arm and flexes the forearm.
66. The brachialis medially rotates the arm and rotates the scapula.
67. The brachioradialis, innervated by the radial nerve, flexes the forearm and extends the wrist.
68. The subscapularis muscle receives innervation from the upper and middle subscapular nerves.
69. The latissimus dorsi inserts lateral to the insertion of the teres major.
70. The basillic vein passes deep at the investing fascia of the arm whereas the cephapic vein passes deep at the clavipectoral fascia of the deltopectoral triangle.
71. At the mid-humeral level the musculocutaneous nerve lies posterior to brachiais and anterior to the biceps.
72. The radial nerve, the the spiral groove, is medial to the origin of the lateral head of the triceps.
73. Within the arm the median nerve crosses anterior to the brachial artery.
74. At the level of the medial supracondyler ridge the ulnar nerve passes distally through the medial intermuscular septum to enter the posterior compartment of the arm.
75. The radial recurrent artery anastotmoses most directly with the middle collateral artery.
76. The posterior ulnar recurrent artery anastomoses most directly with the superior ulnar collateral artery..
77. The interosseous recurrent artery anastomoses most directly with the the middle collateral artery.
78. The cubital fossa lies immediately inferior to a line between the humeral epicondyles.
79. The bicipital aponeurosis forms the anterior boundary of the cubital fossa and, thus, the median cubital vein is not a content of the cubital fossa.
80. The brachial artery, within the cubital fossa, lies lateral to the median n.

Essay

1. Discuss the posterior compartment of the arm. Include contents, compartments, relationships, boundaries, fascial specializations, vasculature, innervation, lymphatics, muscles and movements, and compensation in the case of nerve injury.
2. Discuss the anterior compartment of the arm. Include contents, compartments, relationships, boundaries, fascial specializations, vasculature, innervation, lymphatics, muscles and movements, and compensation in the case of nerve injury.
3. Discuss the short head of biceps muscle. Include fascial specializations, relationships, vasculature, innervation, lymphatics, movements, and compensation in the case of nerve injury.
4. Discuss the long head of the biceps muscle. Include fascial specializations, relationships, vasculature, innervation, lymphatics, movements, and compensation in the case of nerve injury.
5. Discuss the long head of the triceps muscle. Include fascial specializations, relationships, vasculature, innervation, lymphatics, movements, and compensation in the case of nerve injury.
6. Discuss the lateral head of the triceps muscle. Include fascial specializations, relationships, vasculature, innervation, lymphatics, movements, and compensation in the case of nerve injury.
7. Discuss the medial head of the triceps muscle. Include fascial specializations, relationships, vasculature, innervation, lymphatics, movements, and compensation in the case of nerve injury.
8. Discuss the brachialis muscle. Include fascial specializations, relationships, vasculature, innervation, lymphatics, movements, and compensation in the case of nerve injury.
9. Discuss the anconeus muscle. Include fascial specializations, relationships, vasculature, innervation, lymphatics, movements, and compensation in the case of nerve injury.
10. Discuss the brachioradialis muscle. Include fascial specializations, relationships, vasculature, innervation, lymphatics, movements, and compensation in the case of nerve injury.
11. Discuss the pronator teres muscle. Include fascial specializations, relationships, vasculature, innervation, lymphatics, movements, and compensation in the case of nerve injury.
12. Discuss the supinator muscle. Include fascial specializations, relationships, vasculature, innervation, lymphatics, movements, and compensation in the case of nerve injury.
13. Discuss the brachial artery and its branches. Include relationships, fascial specializations, and collateral circulation.
14. Discuss the profunda brachii artery and its branches. Include relationships, fascial specializations, and collateral circulation.
15. Discuss the musculocutaneous nerve in the arm. Include relationships, fascial specializations, movements, and compensation for nerve injury.
16. Discuss the radial nerve in the arm. Include relationships, fascial specializations, movements, and compensation for nerve injury.
17. Discuss the ulnar nerve in the arm. Include relationships, fascial specializations, movements, and compensation for nerve injury.
18. Discuss the median nerve in the arm. Include relationships, fascial specializations, movements, and compensation for nerve injury.
19. Discuss the boundaries and contents of the cubital fossa. Include fascial specializations, relationships, vasculature, innervation, and lymphatics.
20. Discuss the vascular and nervous injuries possible by a fracture at the surgical neck of the humerus.

Short Answer and Definitions

1. Coracoid Process
2. Quadrangular Space
3. Triangular Space
4. Bicipital Groove/Intertubercular Sulcus
5. Transverse humeral ligament
6. Anterior and posterior humeral circumflex arteries
7. Shoulder anastomosis (Thoracoacromial trunk + deltoid and acromial branches + ant/post humeral circumflex aa + ascending branch profunda brachii artery)
8. Greater tubercle of humerus
9. Lesser tubercle of humerus
10. Ulnar groove of humerus
11. medial humeral epicondyle
12. lateral humeral condyle
13. olecranon fossa
14. spiral (radial) groove
15. lateral intermuscular septum
16. medial intermuscular septum
17. radial tuberosity
18. coronoid process

True/False

1. The intercostobrachial nerve is segmental and, thus, not derived from a plexus.
2. Structures passing through the quandrangular space are immediately related to the anatomical neck of the humerus.
3. The spiral (radial) groove is located on the anterior surface of the humerus.
4. Three fossae of the distal humerus contribute to stability of the extended elbow.
5. Teres minor, a medial rotator of the forearm, is innervated by the lower subscapular nerve.
6. The long head of the triceps contributes to the borders of two named spaces and a named interval.
7. The long head of the triceps is biarticulate.
8. The spiral groove separates the origins of the lateral and medial heads of the triceps.
9. Teres major shares an insertion with the pectoralis major at the lateral lip of the intertubercular sulcus.
10. The triangular interval is immediately related to the circumflex scapular artery.
11. Both heads of the biceps are biarticulate whereas the brachialis and the coracobrachialis are monoarticulate.
12. The bicipital aponeurosis provides protection for the ulnar nerve within the cubital fossa.
13. A lesion of the musculocutaneous nerve within the axilla results in uncompensated loss of flexion at the elbow.
14. The brachialis may receive innervation from the radial nerve.
15. A lesion of the axillary nerve within the axilla results in weakness of all shoulder movements with a pronounced weakenss in abduction.
16. Lesions of the upper, middle, and lower subscapular nerves results in complete loss of medial rotation of the arm.
17. Coracobrachialis assists the biceps in flexing the forearm.
18. Brachialis assists the long head of the triceps in adducting the arm.
19. Brachioradialis flexes the elbow, supinates from pronation, pronates from supination, and is, thus, critical to the execution of a straight pool stroke.
20. The brachial fascia gives rise to the anterior and posterior intermuscular septae.
21. The radial nerve penetrates the medial intermuscular septum to then enter the cubital fossa.
22. The ulnar nerve penetrates the lateral intermuscular septum to enter the posterior compartment of the arm.
23. The profunda brachial artery gives rise to the radial and middle collateral arteries.
24. The middle collateral artery passes within the long head of the triceps.
25. The brachial artery terminates within the cubital fossa
26. The radial recurrent artery passes along the medial border of the brachioradialis.
27. The posterior interosseous recurrent artery passes within the anconeus muscle.
28. The posterior ulnar recurrent artery passes between the humeral and ulnar heads of origin of the flexor carpi radialis.
29. The superior ulnar collateral artery penetrates the medial intermuscular septum to then pass anterior to the elbow.
30. The radial and median nerves, but not the ulnar nerve, are contents of the cubital fossa.
31. Within the cubital fossa the median nerve is medial to the brachial artery.
32. The pectoralis major crosses the transverse humeral ligament prior to inserting on the lateral lip of the intertubercular sulcus (bicipital groove).
33. The brachialis acts only at the elbow. It is a monoarticular muscle.
34. The radial collateral artery, within the cubital fossa, is between the ulnar head of pronator teres and the medial border of the brachialis.
35. The radial collateral artery travels through the medial head of the triceps and forms an anastomosis with the interosseus recurrent artery.
36. The posterior ulnar recurrent artery passes between the heads of origin of the flexor carpi ulnaris.
37. The brachial artery crosses the median nerve on the anterior side of the median nerve. (hint: what is the relation of the medial cord to the axillary artery)
38. Within the cubital fossa the median nerve lies medial to the brachial artery.
39. The median cubital vein crosses the posterior (deep) surface of the bicipital aponeurosis.
40. Generally, it is within the cubital fossa that the radial artery terminates into superficial and deep branches.
41. The radial recurrent artery is, in part, within the cubital fossa.
42. The ulnar head of the pronator teres takes origin from the coronoid process.
43. The biceps tendon inserts on the tuberosity of the ulna.
44. The brachialis inserts on the radial tuberosity.
45. Fexion and supination at the elbow are syngergistic actions of the biceps.
46. The superior ulnar collateral artery passes posterior the medial epicondyle of the humerus.
47. The musculocutaneous nerve pierces the short head of the biceps upon entering the arm.
48. The lateral antebrachial cutaneous nerve can be found in the cubital fossa.
49. The radial nerve passes posterior to the superior free edge of the teres major to enter into the triangular interval.
50. The inferior ulnar collateral artery converges with the unlar nerve at the anterior region of the lateral humeral epicondyle.
51. The coracobrachialis and the short head of the biceps are both biarticulate and have a common site of origin.