Grays Anatomy Review
- Upper Limb Exam
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Latest Updated
2026/2027
,1 A 45-year-old woman is being examined as a candidate for cosmetic breast surgery. The
surgeon notes that both of her breasts sag considerably. Which structure(s) has most
likely become stretched to result in this condition?
A. Scarpa's fascia
B.Pectoralis major muscle
C. Pectoralis minor muscle
D.Suspensory (Cooper's) ligaments
E.Serratus anterior muscle
D. The suspensory ligaments of the breast, also known as Cooper's ligaments, are fibrous
bands that run from the dermis of the skin to the deep layer of superficial fascia and are
primary supports for the breasts against gravity. Ptosis of the breast is usually due to the
stretching of these ligaments and can be repaired with plastic surgery. Scarpa's fascia is
the deep membranous layer of superficial fascia of the anterior abdominal wall. The
pectoralis major and pectoralis minor are muscles that move the upper limb and lie deep
to the breast but do not provide any direct support structure to the breast. The serratus
anterior muscle is involved in the movements of the scapula.
,2 A 27-year-old man was admitted to the emergency department after an automobile
collision in which he suffered a fracture of the lateral border of the scapula. Six weeks
after the accident, physical examination reveals weakness in medial rotation and
adduction of the humerus. Which nerve was most likely injured?
A. Lower subscapular
B.Axillary
C. Radial
D.Spinal accessory
E. Ulnar
A. The lower subscapular nerve arises from the cervical spinal nerves 5 and 6. It innervates
the subscapularis and teres major muscles. The subscapularis and teres major muscles are
both responsible for adducting and medially rotating the arm. A lesion of this nerve would
result in weakness in these motions. The axillary nerve also arises from cervical spinal
nerves 5 and 6 and innervates the deltoid and teres minor muscles. The deltoid muscle
is large and covers the entire surface of the shoulder, and contributes to arm
movement in any plane. The teres minor muscle is a lateral rotator and a member of
the rotator cuff
group of muscles. The radial nerve arises from the posterior cord of the brachial plexus.
It is the largest branch, and it innervates the triceps brachii and anconeus muscles in the
arm. The spinal accessory nerve is cranial nerve XI, and innervates the trapezius muscle,
which elevates and depresses the scapula. The ulnar nerve arises from the medial cord
of the brachial plexus and runs down the medial aspect of the arm. It innervates muscles
of the forearm and hand.
, 3 A 48-year-old female court stenographer is admitted to the orthopedic clinic with
symptoms of carpal tunnel syndrome, with which she has suffered with for almost a year.
Which muscles most typically become weakened in this condition?
A. Dorsal interossei
B.Lumbricals III and IV
C. Thenar
D.Palmar interossei
E. Hypothenar
C. The thenar muscles (and lumbricals I and II) are innervated by the median nerve, which
runs through the carpal tunnel. The carpal tunnel is formed anteriorly by the flexor
retinaculum and posteriorly by the carpal bones. Carpal tunnel syndrome is caused by a
compression of the median nerve, due to reduced space in the carpal tunnel. The carpal
tunnel contains the tendons of flexor pollicis longus, flexor digitorum profundus, and
flexor digitorum superficialis muscles and their synovial sheaths. The dorsal interossei,
lumbricals III and IV , palmar interossei, and hypothenar muscles are all innervated by the
ulnar nerve. GAS 798, 808; N 452; McM 159
- Upper Limb Exam
Questions Verified and
Provided with A+
Graded Answers |
Latest Updated
2026/2027
,1 A 45-year-old woman is being examined as a candidate for cosmetic breast surgery. The
surgeon notes that both of her breasts sag considerably. Which structure(s) has most
likely become stretched to result in this condition?
A. Scarpa's fascia
B.Pectoralis major muscle
C. Pectoralis minor muscle
D.Suspensory (Cooper's) ligaments
E.Serratus anterior muscle
D. The suspensory ligaments of the breast, also known as Cooper's ligaments, are fibrous
bands that run from the dermis of the skin to the deep layer of superficial fascia and are
primary supports for the breasts against gravity. Ptosis of the breast is usually due to the
stretching of these ligaments and can be repaired with plastic surgery. Scarpa's fascia is
the deep membranous layer of superficial fascia of the anterior abdominal wall. The
pectoralis major and pectoralis minor are muscles that move the upper limb and lie deep
to the breast but do not provide any direct support structure to the breast. The serratus
anterior muscle is involved in the movements of the scapula.
,2 A 27-year-old man was admitted to the emergency department after an automobile
collision in which he suffered a fracture of the lateral border of the scapula. Six weeks
after the accident, physical examination reveals weakness in medial rotation and
adduction of the humerus. Which nerve was most likely injured?
A. Lower subscapular
B.Axillary
C. Radial
D.Spinal accessory
E. Ulnar
A. The lower subscapular nerve arises from the cervical spinal nerves 5 and 6. It innervates
the subscapularis and teres major muscles. The subscapularis and teres major muscles are
both responsible for adducting and medially rotating the arm. A lesion of this nerve would
result in weakness in these motions. The axillary nerve also arises from cervical spinal
nerves 5 and 6 and innervates the deltoid and teres minor muscles. The deltoid muscle
is large and covers the entire surface of the shoulder, and contributes to arm
movement in any plane. The teres minor muscle is a lateral rotator and a member of
the rotator cuff
group of muscles. The radial nerve arises from the posterior cord of the brachial plexus.
It is the largest branch, and it innervates the triceps brachii and anconeus muscles in the
arm. The spinal accessory nerve is cranial nerve XI, and innervates the trapezius muscle,
which elevates and depresses the scapula. The ulnar nerve arises from the medial cord
of the brachial plexus and runs down the medial aspect of the arm. It innervates muscles
of the forearm and hand.
, 3 A 48-year-old female court stenographer is admitted to the orthopedic clinic with
symptoms of carpal tunnel syndrome, with which she has suffered with for almost a year.
Which muscles most typically become weakened in this condition?
A. Dorsal interossei
B.Lumbricals III and IV
C. Thenar
D.Palmar interossei
E. Hypothenar
C. The thenar muscles (and lumbricals I and II) are innervated by the median nerve, which
runs through the carpal tunnel. The carpal tunnel is formed anteriorly by the flexor
retinaculum and posteriorly by the carpal bones. Carpal tunnel syndrome is caused by a
compression of the median nerve, due to reduced space in the carpal tunnel. The carpal
tunnel contains the tendons of flexor pollicis longus, flexor digitorum profundus, and
flexor digitorum superficialis muscles and their synovial sheaths. The dorsal interossei,
lumbricals III and IV , palmar interossei, and hypothenar muscles are all innervated by the
ulnar nerve. GAS 798, 808; N 452; McM 159
