@Q techno OO SPARK@Q techno OO SPARK{D) Abductor pollicis brevis and palmar interossei (E) Medial two and lateral two lumbricals Cline 48, A 31-year-old roofer walks in with teno- synovitis resulting from a deep penetrated wound in the palm by a big nail. Examina- indicates that he has an infection in the ulnar bursa, This infection most likely ted in necrosis of which of the following O DPS at) 2 2 tendons? (A) Tendon of the flexor carpi ulnaris (8) Tendon of the flexor pollicis longus (C) Tendon of the flexor digitorum profun- dus (D) Tendon of the flexor carpi radialis. (E) Tendon of the palmaris longus 19, An 18-year-old boy involved in an auto- mobile accident presents with arm that cannot abduct. His paralysis is caused by damage to which of the following nerves? {A) Suprascapular and axillary (8) Thoracodorsal and upper subscapular {C) Axillary and musculocutaneous (D) Radial and lower subscapular {E) Suprascapular and dorsal scapular 20. A 17-year-old boy with a stab wound received multiple injuries on the upper part of the arm and required surgery. If the bra- chial artery were ligated at its origin, which of the following arteries would supply blood to the profunda brachii artery? {A) Lateral thoracic {B) Subscapular (C) Posterior humeral circumflex (D) Superior ulnar collateral (E) Radial recurrent 21. A 23-year-old woman who receives a deep cut to her ring finger by a kitchen knife is unable to move the metacarpophalangeal joint. Which of the following pairs of nerves ‘was damaged? (A) Median and ulnar (B) Radial and median {C) Musculocutaneous and ulnar (D) Ulnar and radial (€) Radial and axillary 22, A27-year-old baseball player is hit on his forearm by a high-speed ball during the ‘World Series, and the muscles that form the TENTIAL Upper Limb 65 Noor of the cubital foss Which of the followi have lost their funct (A) Brachioradialis and supinator (8) Brachialis and supinator (C) Pronator teres and supinator (D) Supinator and pronator quadratus (E) Brachialis and pronator teres, appear to be torn 23. 23-year-old man complains of numb- ness on the medial side of the arm following astab wound in the axilla. On examination, he is diagnosed with an injury of his medial brachial cutaneous nerve. In which of the following structures are the cell bodies of the damaged nerve involved in numbness. located? (A) Sympathetic chain ganglion (B) Dorsal root ganglion (C) Anterior horn of the spinal cord (0) Lateral horn of the spinal cord {E) Posterior horn of the spinal cord 24, A38-year-old homebuilder was involved in an accident and is unable to supinate his forearm. Which of the following nerves are most likely damaged? (A) Suprascapular and axillary (8) Musculocutaneous and median {C) Axillary and radial {0) Radial and musculocutaneous (E) Median and ulnar 25, A 31-year-old patient complains of sen- sory loss over the anterior and posterior sur- faces of the medial third of the hand and the medial one and one-half fingers. He is diag- nosed by a physician as having “funny bone” symptoms. Which of the following nerves is injured? (A) Axillary (B) Radial (C) Median (D) Ulnar {E) Musculocutaneous 26. A patient with a deep stab wound in the middle of the forearm has impaired move- ment of the thumb, Examination indicates a lesion of the anterior interosseous nerve. Which of the following muscles is paralyzed? (A) Flexor pollicis longus and brevis (B) Flexor pollicis longus and opponens polliciset BO « BRS Gross Anatomy (pica era protrt and pone 0 (ay Be beaigtoram profundus and sup p> © fialis : 5 (ernst brevis and pronatr ss * 27. A 29-year-old patient comes in; he can- ferphalangeal (DIP) joint ole index finget. His physician determines that he has nerve damage from a suprs condylar fracture. Which of the following cnaitions is also a symptom of this nerve damage? (a) tnability to flex the DIP joint of the ring finger (8) Atrophy ofthe hypothenar eminence (C) Loss of sensation over the distal part of the second digit {D) Paralysis ofall the thumb muscles (€) Loss of supination riot flex the distal int 28, A27-year-old man with cubital tunnel syndrome complains of numbness and tin- ling in the ring and litte finger and back and sides of his hand because of damage to anerve in the tunnel at the elbow: Which of the following muscles is most likely to be paralyzed? (A) Flexor digitorum superficialis {8} Opponens pollicis (c) Two medial lumbricals (0) Pronator teres {E) Supinator 23, A secretary comes in to your office com- plaining of pain in her wrists from typing all day. You determine that she likely has carpal tunnel syndrome. Which of the following conditions would help you determine the diagnosis? {A) Inability to adduct the litte finger (8) Inability to flex the DIP joint of the ring finger (C) Flattened thenar eminence {D) Loss of skin sensation of the medial one and one-half fingers {E) Atrophied adductor pollicis muscle oe 30. Aman is unable to hold typing paper between his index and middle fingers. Which of the following nerves was likely injured? (A) Radial nerve (8) Median nerve (C) Ulnar nerve {D) Musculocutaneon (€) Axillary nerve 31. The victim of an automobit has a destructive injury of the proxi of carpal bones. Which of the following ones is most likely damaged? (A) Capitate (8) Hamate {¢) Trapezium (0) Triquetrum (E) Trapezoid 32. A patient has a torn rotator cuff of the Shoulder joint as the result of an aucomobile accident, Which of the following muscle ten- dons i intact and has normal function? (A) Supraspinatus {B) Subscapularis (¢) Teres major (0) Teres minor (E) Infraspinatus 33. A patient complains of having pain with repeated movements of his thumb (claudi- cation). His physician performs the Allen ‘test and finds an insufficiency of the radial artery. Which of the following conditions would be a result of the radial artery steno- sis? {A) A marked decrease in the blood flow in the superficial palmar arterial arch (B) Decreased pulsation in the artery pass- ing superficial to the flexor retinaculum, (C) Ischemia of the entire extensor muscles of the forearm {D) A marked decrease in the blood flow in the princeps pollicis artery (E) A low blood pressure in the anterior interosseous artery 34. A patient bleeding from the shoulder secondary to a knife wound is in fair condi- tion because there is vascular anastomosis around the shoulder. Which of the following, arteries is most likely a direct branch of the subclavian artery that is involved in the anastomosis? {A) Dorsal scapular artery (8) Thoracoacromial artery (C) Circumfex scapular artery {D) Transverse cervical artery (E) Suprascapular arteryination of a 35. During a breast exan 56-year-old woman, the physician found a palpable mass in her breast. Which of the following characteristics of breast cancer and its diagnosis is correct? (A) Elevated nipple (8) Polymastia {C) Shortening of the clavipectoral fascia (0) Dimpling of the overlying skin {E) Enlargement of the breast Citas » | O PSV (ets) 2 © 36. A patient with a stab wound receives « laceration of the musculocutaneous nerve. Which of the following conditions is most likely to have occurred? (A) Lack of sweating on the lateral side of the forearm (8) Inability to extend the forearm {¢) Paralysis of brachioradialis muscle {0) Loss of tactile sensation on the arm {E) Constriction of blood vessels on the hand 37. A20-year-old man fell from the parallel bar during the Olympic trial. A neurologic ‘examination reveals that he has a lesion of the lateral cord of the brachial plexus, Which of the following muscles is most likely weak- ened by this injury? {a) Subscapularis (8) Teres major {C) Latissimus dorsi {0) Teres minor (E) Pectoralis major 38, A 24-year-old carpenter suffers a crush injury of his entire little finger. Which of the following muscles is most likely to be spared? (B) Extensor digit {C) Palmar interossei {D) Dorsal interossei (E) Lumbricals 39. A7-year-old boy falls from a tree house and is brought to the emergency department ofa local hospital. On examination, he has weakness in rotating his arm laterally because of an injury of a nerve. Which of the following conditions is most likely to cause a loss of this nerve function? {A) Injury to the lateral cord of the brachial plexus [EMIT Upper tims o (8) Fracture of the anatomic neck of the humerus (C) Knife wound on the teres major muscle (D) Inferior dislocation of the head of the humerus. {E) A tumor in the triangular space in the shoulder region 40. A 49-year-old woman is diagnosed as having a large lump in her right breast Lymph from the cancerous breast drains primarily into which of the following, nodes? (A) Apical nodes {8) Anterior (pectoral) nodes {C) Parasternal (internal thoracic) nodes. {D) Supraclavicular nodes {E) Nodes of the anterior abdominal wall 41. A.17-year-old boy fell from his motorcy- cle and complains of numbness of the lat- eral part of the arm, Examination reveals that the axillary nerve is severed. Which of the following types of axons is most likely spared? {A) Postganglionic sympathetic axons {B) Somatic aflerent axons (C) Preganglionic sympathetic axons (0) General somatic efferent axons {E) General visceral afferent axons 42. A construction worker suffers a destruc- tive injury of the structures related to the anatomic snuffbox. Which of the following, structures would most likely be damaged? (A) Triquetral bone (8) Trapezoid bone {c) Extensor indicis tendon {0) Abductor pollicis brevis tendon (E) Radial artery 43, A rock climber falls on his shoulder, resulting in a chipping off of the lesser tubercle of the humerus. Which of the fol- lowing structures would most likely have structural and functional damage? (A) Supraspinatus muscle (8) Mfraspinatus muscle (¢) Subscapularis muscle (0) Teres minor muscle {E) Coracohumeral ligament 44. A 22-year-old female Macarena dancer fell from the stage and complains of elbow