Chapter: Upper Limb Anatomy; Topic: Shoulder Joint & Movements; Subtopic: Muscles of Abduction
Keyword Definitions:
Shoulder Abduction: Movement of arm away from body’s midline in coronal plane.
Supraspinatus: Initiates first 0–15° of abduction.
Deltoid Muscle: Principal abductor from 15–90°.
Trapezius: Helps upward rotation of scapula beyond 90°.
Serratus Anterior: Stabilizes scapula and aids overhead abduction.
1) Lead Question – 2016
Which of the following muscles carries out shoulder abduction from 15 to 90 degrees?
A) Supraspinatus
B) Trapezius
C) Deltoid
D) Serratus Anterior
Answer: C) Deltoid
Explanation: Shoulder abduction is initiated by supraspinatus for the first 15 degrees. From 15 to 90 degrees, the deltoid muscle—particularly its middle fibers—acts as the prime mover. Beyond 90 degrees, scapular rotation performed by trapezius and serratus anterior becomes essential. Therefore, among the provided options, deltoid is the correct muscle responsible for abduction from 15° to 90°. This division of abduction responsibility helps in clinical examination of rotator cuff integrity and nerve injuries such as axillary nerve palsy.
2) Supraspinatus initiates shoulder abduction up to–
A) 5°
B) 10°
C) 15°
D) 45°
Answer: C) 15°
Explanation: Supraspinatus is responsible for the first 15° of abduction before deltoid takes over. Thus, C is correct.
3) The deltoid muscle is supplied by–
A) Suprascapular nerve
B) Axillary nerve
C) Radial nerve
D) Median nerve
Answer: B) Axillary nerve
Explanation: The axillary nerve (C5–C6) innervates the deltoid and teres minor. Injury affects abduction. Thus, B is correct.
4) A patient with winged scapula has paralysis of–
A) Trapezius
B) Supraspinatus
C) Serratus anterior
D) Deltoid
Answer: C) Serratus anterior
Explanation: Winged scapula results from long thoracic nerve injury affecting serratus anterior. Thus, C is correct.
5) Upward rotation of the scapula during overhead abduction is mainly by–
A) Deltoid
B) Trapezius
C) Teres minor
D) Latissimus dorsi
Answer: B) Trapezius
Explanation: Trapezius rotates the scapula after 90° of abduction. Thus, B is correct.
6) Which muscle forms the rounded contour of the shoulder?
A) Deltoid
B) Supraspinatus
C) Subscapularis
D) Trapezius
Answer: A) Deltoid
Explanation: Deltoid gives shoulder its rounded shape. Thus, A is correct.
7) Axillary nerve injury leads to loss of sensation over–
A) Medial arm
B) Lateral shoulder
C) Forearm
D) Thumb
Answer: B) Lateral shoulder
Explanation: Axillary nerve supplies the superior lateral cutaneous nerve area. Thus, B is correct.
8) Teres minor assists in–
A) Abduction
B) Medial rotation
C) Lateral rotation
D) Flexion
Answer: C) Lateral rotation
Explanation: Teres minor, supplied by axillary nerve, laterally rotates the arm. Thus, C is correct.
9) Rotator cuff does NOT include–
A) Supraspinatus
B) Infraspinatus
C) Teres major
D) Subscapularis
Answer: C) Teres major
Explanation: Teres major is not part of rotator cuff whereas the other three are. Thus, C is correct.
10) Injury to suprascapular nerve affects which movements?
A) Abduction initiation & lateral rotation
B) Medial rotation only
C) Elbow flexion
D) Forearm pronation
Answer: A) Abduction initiation & lateral rotation
Explanation: Supraspinatus (abduction) and infraspinatus (lateral rotation) are supplied by suprascapular nerve. Thus, A is correct.
11) Deltoid paralysis leads to difficulty in raising the arm beyond–
A) 10°
B) 15°
C) 30°
D) 90°
Answer: B) 15°
Explanation: After the first 15°, deltoid is essential. Paralysis prevents further abduction. Thus, B is correct.
Chapter: Upper Limb Anatomy; Topic: Intrinsic Muscles of the Hand; Subtopic: Muscles Acting on the Thumb
Keyword Definitions:
Thenar Muscles: Intrinsic hand muscles responsible for fine thumb movements.
Dual Nerve Supply: A muscle receiving innervation from two different nerves.
Recurrent Median Nerve: Branch supplying most thenar muscles.
Deep Branch of Ulnar Nerve: Innervates some intrinsic hand muscles including part of FPB.
Pollicis Muscles: Muscles specifically acting on the thumb (pollex).
1) Lead Question – 2016
Which muscle acting on the thumb has dual nerve supply?
A) Flexor Pollicis Longus
B) Flexor Pollicis Brevis
C) Adductor Pollicis
D) Opponens Pollicis
Answer: B) Flexor Pollicis Brevis
Explanation: Flexor pollicis brevis (FPB) has two heads—superficial and deep. The superficial head is supplied by the recurrent branch of the median nerve, while the deep head is supplied by the deep branch of the ulnar nerve, making FPB the classic muscle with dual innervation. Flexor pollicis longus is entirely median-nerve supplied via the anterior interosseous nerve. Adductor pollicis receives only ulnar nerve supply. Opponens pollicis is solely median-innervated. Therefore, FPB is the correct answer, and its dual innervation is clinically important in thenar nerve injury assessment.
2) Adductor pollicis is supplied by–
A) Median nerve
B) Ulnar nerve
C) Radial nerve
D) Musculocutaneous nerve
Answer: B) Ulnar nerve
Explanation: Adductor pollicis receives deep branch of ulnar nerve supply. Thus, B is correct.
3) Opponens pollicis is responsible for–
A) Thumb flexion
B) Thumb extension
C) Thumb opposition
D) Thumb adduction
Answer: C) Thumb opposition
Explanation: It brings thumb across palm for precision grip. Thus, C is correct.
4) Flexor pollicis longus is innervated by–
A) Radial nerve
B) Median nerve (AIN)
C) Ulnar nerve
D) Posterior interosseous nerve
Answer: B) Median nerve (AIN)
Explanation: The anterior interosseous nerve supplies FPL. Thus, B is correct.
5) In carpal tunnel syndrome, which thumb movement is most affected?
A) Adduction
B) Opposition
C) Extension
D) Abduction
Answer: B) Opposition
Explanation: Median nerve compression affects thenar muscles, especially opponens pollicis. Thus, B is correct.
6) Froment’s sign tests weakness of–
A) Opponens pollicis
B) Adductor pollicis
C) FPB superficial head
D) EPL
Answer: B) Adductor pollicis
Explanation: Froment’s sign indicates ulnar nerve palsy causing weak adductor pollicis. Thus, B is correct.
7) Median nerve injury leads to–
A) Loss of thumb adduction
B) Loss of thumb opposition
C) Weak extension of thumb
D) Clawing of little finger
Answer: B) Loss of thumb opposition
Explanation: Opponens pollicis is median-innervated; injury prevents opposition. Thus, B is correct.
8) Deep head of FPB is innervated by–
A) Median nerve
B) Ulnar nerve
C) Radial nerve
D) None
Answer: B) Ulnar nerve
Explanation: Dual innervation: superficial head (median), deep head (ulnar). Thus, B is correct.
9) Which muscle forms the anatomical snuffbox posterior boundary?
A) EPL
B) EPB
C) APL
D) FPB
Answer: A) EPL
Explanation: EPL tendon forms posterior border of the snuffbox. Thus, A is correct.
10) Injury to the radial nerve affects which thumb movement most?
A) Extension
B) Opposition
C) Flexion
D) Adduction
Answer: A) Extension
Explanation: Radial nerve supplies extensors like EPL and EPB. Thus, A is correct.
11) A thumb pinch with flexion of IP joint indicates weakness of–
A) Opponens pollicis
B) Adductor pollicis
C) FPL
D) APL
Answer: B) Adductor pollicis
Explanation: Compensation by FPL due to weak adductor pollicis is Froment’s sign. Thus, B is correct.
Chapter: Upper Limb Anatomy; Topic: Nerve Lesions of Hand; Subtopic: Ulnar Nerve Signs
Keyword Definitions:
Wartenberg’s Sign: Persistent abduction of little finger due to interossei weakness in ulnar nerve palsy.
Ulnar Nerve: Motor supply to interossei, medial lumbricals, adductor pollicis, and FPB deep head.
Intrinsic Plus Position: MCP flexion with IP extension produced by interossei & lumbricals.
Froment’s Sign: Flexion of thumb IP during pinch due to weak adductor pollicis.
Claw Hand: Hyperextension at MCP and flexion at IP joints due to ulnar nerve palsy.
1) Lead Question – 2016
What is Wartenberg's sign?
A) Inability to maintain intrinsic plus position
B) Inability to adduct small finger against the ring finger
C) Inability to grasp a book between the thumb and index finger
D) Inability to move the middle finger sideways
Answer: B) Inability to adduct small finger against the ring finger
Explanation: Wartenberg’s sign is characterized by persistent abduction of the little finger due to weakness of palmar interossei in ulnar nerve palsy. The patient is unable to adduct the little finger toward the ring finger. This occurs because the extensor digiti minimi is unopposed while the interossei cannot counteract it. This sign helps clinically differentiate ulnar nerve palsy from other nerve lesions. Therefore, the correct answer is B. It is commonly assessed during neurological evaluation of hand intrinsic muscle function.
2) Froment’s sign tests weakness of–
A) Opponens pollicis
B) Adductor pollicis
C) Abductor pollicis longus
D) EPL
Answer: B) Adductor pollicis
Explanation: Froment’s sign indicates ulnar nerve palsy causing weak adductor pollicis; patient flexes thumb IP to compensate. Thus, B is correct.
3) In ulnar nerve palsy, clawing is most pronounced in–
A) Index and middle fingers
B) Thumb
C) Ring and little fingers
D) All fingers equally
Answer: C) Ring and little fingers
Explanation: Medial lumbricals are ulnar-supplied; their loss leads to clawing of digits 4 and 5. Thus, C is correct.
4) A patient presents with difficulty crossing fingers. This suggests dysfunction of–
A) Lumbricals
B) Dorsal interossei
C) Thenar muscles
D) EPL
Answer: B) Dorsal interossei
Explanation: Dorsal interossei abduct fingers and help in crossing movements. Ulnar nerve injury weakens them. Thus, B is correct.
5) Ulnar nerve injury at the wrist spares which muscle?
A) Lumbrical 4
B) Interossei
C) Flexor digitorum profundus medial half
D) Adductor pollicis
Answer: C) Flexor digitorum profundus medial half
Explanation: FDP to ring/little fingers is supplied proximally; wrist injury spares it. Thus, C is correct.
6) The ‘ulnar paradox’ refers to–
A) Less clawing in proximal ulnar injury
B) More thumb involvement
C) Finger extension loss
D) Sensory sparing in digits
Answer: A) Less clawing in proximal ulnar injury
Explanation: Proximal injury weakens FDP, reducing clawing severity. Thus, A is correct.
7) Loss of adduction of fingers indicates paralysis of–
A) Palmar interossei
B) Dorsal interossei
C) Lumbricals 1&2
D) Thenar muscles
Answer: A) Palmar interossei
Explanation: Palmar interossei adduct fingers (PAD). Thus, A is correct.
8) Wartenberg’s sign is associated with lesions of–
A) Radial nerve
B) Ulnar nerve
C) Median nerve
D) Musculocutaneous nerve
Answer: B) Ulnar nerve
Explanation: Abduction of little finger is classic for ulnar palsy. Thus, B is correct.
9) A patient cannot perform intrinsic plus position. Likely muscle affected is–
A) Deltoid
B) Lumbricals
C) Brachioradialis
D) EPL
Answer: B) Lumbricals
Explanation: Lumbricals flex MCP and extend IP joints; their loss abolishes intrinsic plus. Thus, B is correct.
10) The deep branch of ulnar nerve supplies all except–
A) Interossei
B) Adductor pollicis
C) Lumbrical 1
D) FPB deep head
Answer: C) Lumbrical 1
Explanation: Lumbrical 1 is median-supplied; others are ulnar. Thus, C is correct.
11) Difficulty gripping paper between fingers occurs due to weakness of–
A) Palmar interossei
B) EPL
C) APL
D) FPL
Answer: A) Palmar interossei
Explanation: Paper grip test checks finger adduction; palmar interossei weakness indicates ulnar palsy. Thus, A is correct.
Chapter: Upper Limb Anatomy; Topic: Nerve Supply of Hand; Subtopic: Cutaneous Distribution of Ulnar Nerve
Keyword Definitions:
Ulnar Nerve: Major nerve of hand supplying medial digits and most intrinsic hand muscles.
Cutaneous Distribution: Area of skin supplied by a specific peripheral nerve.
Finger Tips Sensory Zones: Distal phalanx pads used to identify nerve territories.
Dorsal Branch of Ulnar Nerve: Supplies dorsomedial hand and little finger sensation.
Median Nerve Digital Supply: Supplies thumb, index, middle, and half of ring finger tips.
1) Lead Question – 2016
Sensory region of the ulnar nerve is?
A) Tip of little finger
B) Tip of index finger
C) 1st web space
D) Lateral upper aspect of arm
Answer: A) Tip of little finger
Explanation: The ulnar nerve supplies the medial 1½ digits, which includes the tip of the little finger and the medial half of the ring finger. The tip of the index finger is supplied by the median nerve; the first dorsal web space is supplied by the radial nerve; and the lateral aspect of the upper arm is innervated by the axillary nerve. Thus, the most accurate and classic sensory landmark for ulnar nerve integrity is the tip of the little finger, making option A correct.
2) The first dorsal web space is supplied by–
A) Median nerve
B) Radial nerve
C) Ulnar nerve
D) Musculocutaneous nerve
Answer: B) Radial nerve
Explanation: The radial nerve supplies dorsal thumb–index web space. Thus, B is correct.
3) Tip of the index finger is supplied by–
A) Radial nerve
B) Median nerve
C) Ulnar nerve
D) Axillary nerve
Answer: B) Median nerve
Explanation: Median nerve provides palmar digital branches to index fingertip. Thus, B is correct.
4) Sensation over medial 1½ fingers is due to–
A) Radial nerve
B) Median nerve
C) Ulnar nerve
D) Musculocutaneous nerve
Answer: C) Ulnar nerve
Explanation: Ulnar nerve supplies medial ring finger and little finger. Thus, C is correct.
5) Loss of sensation over dorsomedial hand suggests injury to–
A) Median nerve
B) Ulnar nerve
C) Radial nerve
D) Axillary nerve
Answer: B) Ulnar nerve
Explanation: Dorsal branch of ulnar nerve supplies medial dorsum. Thus, B is correct.
6) A patient with fracture of medial epicondyle may show sensory loss in–
A) Thumb
B) Middle finger
C) Little finger
D) First web space
Answer: C) Little finger
Explanation: Medial epicondyle injury affects ulnar nerve causing sensory loss in little finger. Thus, C is correct.
7) Which nerve supplies palmar aspect of ring finger (lateral half)?
A) Median nerve
B) Ulnar nerve
C) Radial nerve
D) Axillary nerve
Answer: A) Median nerve
Explanation: Median nerve supplies lateral half of ring finger. Thus, A is correct.
8) Dorsal sensory branch of ulnar nerve arises at–
A) Wrist
B) Upper arm
C) Mid forearm
D) Shoulder
Answer: C) Mid forearm
Explanation: The dorsal branch splits in distal forearm to supply dorsal digits. Thus, C is correct.
9) Loss of sensation in first web space indicates lesion of–
A) Median nerve
B) Radial nerve
C) Ulnar nerve
D) Musculocutaneous nerve
Answer: B) Radial nerve
Explanation: Radial nerve provides sensory to dorsal thumb–index web space. Thus, B is correct.
10) Loss of palmar sensation over thumb indicates damage to–
A) Median nerve
B) Radial nerve
C) Ulnar nerve
D) Spinal accessory nerve
Answer: A) Median nerve
Explanation: Median nerve supplies palmar thumb sensation. Thus, A is correct.
11) Which nerve supplies lateral cutaneous sensation of arm?
A) Axillary nerve
B) Ulnar nerve
C) Radial nerve
D) Median nerve
Answer: A) Axillary nerve
Explanation: The superior lateral cutaneous nerve of arm is a branch of axillary nerve. Thus, A is correct.
Chapter: Upper Limb Anatomy; Topic: Cutaneous Nerve Supply of Hand; Subtopic: Digital Sensory Distribution
Keyword Definitions:
Digital Pulp: The highly sensitive fingertip area rich in sensory receptors, essential for fine touch.
Median Nerve: Supplies palmar aspect and fingertip pulps of thumb, index, middle, and lateral half of ring finger.
Radial Nerve: Supplies dorsum of hand but not pulps of digits (except a small dorsal part of thumb).
Ulnar Nerve: Supplies medial 1½ digits including little finger and medial ring finger.
Palmar Digital Branches: Terminal branches of median and ulnar nerves supplying fingertips.
1) Lead Question – 2016
Pulp of the index finger is supplied by:
A) Median nerve
B) Radial nerve
C) Ulnar nerve
D) Axillary nerve
Answer: A) Median nerve
Explanation: The palmar digital branches of the median nerve supply the pulps of the thumb, index, middle, and lateral half of the ring finger. The radial nerve supplies only the dorsal aspect of the hand and does not supply the fingertip pulp. The ulnar nerve supplies the medial 1½ digits (little finger and medial half of ring finger). The axillary nerve does not supply hand skin. Therefore, the pulp of the index finger is supplied exclusively by the median nerve, making option A correct.
2) Sensation of little finger pulp is supplied by–
A) Median nerve
B) Ulnar nerve
C) Radial nerve
D) Axillary nerve
Answer: B) Ulnar nerve
Explanation: Ulnar nerve supplies medial 1½ digits. Thus, B is correct.
3) The median nerve supplies pulp of all the following except–
A) Thumb
B) Index
C) Middle
D) Little finger
Answer: D) Little finger
Explanation: Little finger is supplied by ulnar nerve. Thus, D is correct.
4) A patient with carpal tunnel syndrome may develop sensory loss over–
A) Dorsal thumb
B) Pulp of index finger
C) Medial palm
D) Little finger
Answer: B) Pulp of index finger
Explanation: Median nerve compression affects index pulp sensation. Thus, B is correct.
5) The first dorsal web space is supplied by–
A) Ulnar nerve
B) Radial nerve
C) Median nerve
D) Axillary nerve
Answer: B) Radial nerve
Explanation: Radial nerve supplies dorsal web space. Thus, B is correct.
6) Sensory loss isolated to index fingertip suggests lesion at–
A) Axilla (radial nerve)
B) Wrist (median nerve)
C) Medial epicondyle
D) Elbow (ulnar nerve)
Answer: B) Wrist (median nerve)
Explanation: Median nerve compression at wrist affects digital pulps. Thus, B is correct.
7) Dorsal aspect of index finger is mainly supplied by–
A) Median nerve
B) Radial nerve
C) Ulnar nerve
D) Axillary nerve
Answer: B) Radial nerve
Explanation: Radial nerve supplies dorsum of lateral digits except pulps. Thus, B is correct.
8) Which nerve supplies palmar surface of thumb?
A) Median nerve
B) Radial nerve
C) Ulnar nerve
D) Musculocutaneous nerve
Answer: A) Median nerve
Explanation: Median nerve digital branches supply thumb pulp and palmar skin. Thus, A is correct.
9) Injury to ulnar nerve at the wrist results in sensory loss over–
A) Index pulp
B) Lateral palm
C) Little finger pulp
D) Dorsal thumb
Answer: C) Little finger pulp
Explanation: Ulnar nerve loss leads to sensory deficit in medial digits. Thus, C is correct.
10) A child with supracondylar humerus fracture has intact index pulp sensation. Which nerve is spared?
A) Median nerve
B) Radial nerve
C) Ulnar nerve
D) All three
Answer: A) Median nerve
Explanation: Index pulp is median-supplied; intact sensation indicates median nerve spared. Thus, A is correct.
11) Loss of lateral palm sensation indicates lesion of–
A) Ulnar nerve
B) Musculocutaneous nerve
C) Median nerve
D) Radial nerve
Answer: C) Median nerve
Explanation: Median nerve supplies lateral palmar skin. Thus, C is correct.
Chapter: Upper Limb Anatomy; Topic: Peripheral Nerve Injuries; Subtopic: Radial Nerve Lesions (Low Lesions)
Keyword Definitions:
Radial Nerve: Nerve supplying extensors of arm, forearm, wrist, fingers, and thumb.
Spiral Groove Injury: Radial nerve lesion occurring at radial groove of humerus.
Low Radial Nerve Palsy: Lesion distal to triceps branches, sparing elbow extension.
Wrist Drop: Inability to extend wrist due to extensor muscle paralysis.
Digital Extensors: Radial-innervated muscles allowing finger and thumb extension.
1) Lead Question – 2016
Low radial nerve (just after spiral groove) palsy does not produce?
A) Loss of wrist extension
B) Loss of elbow extension
C) Loss of finger extension
D) Loss of thumb extension
Answer: B) Loss of elbow extension
Explanation: A low radial nerve palsy—occurring just after the spiral groove—spares the branches to triceps because these branches arise proximally. Therefore, elbow extension remains intact. However, wrist extensors, finger extensors, and thumb extensors receive their innervation distal to this level and are therefore affected, resulting in wrist drop, inability to extend fingers, and loss of thumb extension. Hence, the only function preserved is elbow extension, making option B the correct choice.
2) Wrist drop is a classic feature of–
A) Median nerve injury
B) Ulnar nerve injury
C) Radial nerve injury
D) Axillary nerve injury
Answer: C) Radial nerve injury
Explanation: Radial nerve supplies wrist extensors; its palsy causes wrist drop. Thus, C is correct.
3) Sensation over the anatomical snuffbox is supplied by–
A) Median nerve
B) Ulnar nerve
C) Radial nerve
D) Axillary nerve
Answer: C) Radial nerve
Explanation: The superficial branch of radial nerve supplies snuffbox region. Thus, C is correct.
4) A fracture of mid-shaft humerus commonly injures–
A) Axillary nerve
B) Radial nerve
C) Median nerve
D) Musculocutaneous nerve
Answer: B) Radial nerve
Explanation: The radial nerve lies in spiral groove of humerus and is commonly injured by mid-shaft fractures. Thus, B is correct.
5) Radial nerve injury at axilla leads to loss of–
A) Elbow extension
B) Wrist extension
C) Finger extension
D) All of the above
Answer: D) All of the above
Explanation: High lesion affects triceps and all extensor muscles. Thus, D is correct.
6) Posterior interosseous nerve palsy presents with–
A) Wrist drop
B) Finger drop with preserved wrist extension
C) Thumb opposition loss
D) Clawing
Answer: B) Finger drop with preserved wrist extension
Explanation: PIN supplies finger extensors; wrist extensors remain functional via ECRL. Thus, B is correct.
7) Loss of brachioradialis reflex suggests injury to–
A) C8
B) T1
C) C6
D) C5
Answer: C) C6
Explanation: C6 root supplies brachioradialis via radial nerve. Thus, C is correct.
8) Inability to extend the thumb indicates involvement of–
A) AIN
B) Ulnar nerve
C) Radial nerve
D) Musculocutaneous nerve
Answer: C) Radial nerve
Explanation: EPL and EPB are radial-innervated. Thus, C is correct.
9) Sensory loss in dorsum of hand over lateral three fingers suggests lesion of–
A) Median nerve
B) Ulnar nerve
C) Radial nerve
D) Axillary nerve
Answer: C) Radial nerve
Explanation: Superficial radial nerve supplies dorsolateral hand. Thus, C is correct.
10) In low radial nerve palsy, which nerve branch remains functional?
A) Posterior interosseous nerve
B) Branches to triceps
C) Superficial radial nerve
D) All branches lost
Answer: B) Branches to triceps
Explanation: Triceps branches arise proximal to spiral groove and are spared. Thus, B is correct.
11) Patient with wrist drop but preserved elbow extension has lesion likely at–
A) Axilla
B) Spiral groove
C) Lateral epicondyle
D) Wrist
Answer: B) Spiral groove
Explanation: Classic finding of low radial palsy: wrist drop with normal elbow extension. Thus, B is correct.
Chapter: Upper Limb Anatomy; Topic: Scapular Musculature; Subtopic: Fossae of Scapula & Their Muscles
Keyword Definitions:
Infraspinous Fossa: Large depression below the spine of the scapula housing the infraspinatus muscle.
Infraspinatus: A rotator cuff muscle responsible for lateral rotation of the arm.
Supraspinous Fossa: Upper scapular depression containing supraspinatus muscle.
Subscapular Fossa: Anterior scapular surface containing subscapularis muscle.
Teres Major: Muscle located inferiorly, not in the infraspinous fossa.
1) Lead Question – 2016
Infraspinous fossa of scapula contains which of the following muscles?
A) Subscapularis
B) Infraspinatus
C) Teres major
D) Supraspinatus
Answer: B) Infraspinatus
Explanation: The infraspinous fossa is the large posterior surface of the scapula located below the spine. It exclusively contains the infraspinatus muscle, one of the rotator cuff muscles responsible for lateral rotation of the shoulder. The supraspinatus muscle lies above the spine in the supraspinous fossa. Subscapularis occupies the anterior subscapular fossa, and teres major lies inferior to the infraspinous fossa, not within it. Therefore, the correct answer is B. Understanding scapular fossae and their associated muscles is essential for interpreting shoulder injuries and muscle actions.
2) Supraspinatus originates from–
A) Infraspinous fossa
B) Supraspinous fossa
C) Subscapular fossa
D) Glenoid cavity
Answer: B) Supraspinous fossa
Explanation: Supraspinatus arises from supraspinous fossa and initiates abduction. Thus, B is correct.
3) Subscapularis muscle lies on which surface?
A) Anterior scapula
B) Posterior scapula above spine
C) Posterior scapula below spine
D) Lateral border
Answer: A) Anterior scapula
Explanation: Subscapularis occupies the subscapular fossa on anterior surface. Thus, A is correct.
4) The infraspinatus muscle is responsible for–
A) Medial rotation
B) Lateral rotation
C) Abduction
D) Adduction
Answer: B) Lateral rotation
Explanation: Infraspinatus is a major lateral rotator of the humerus. Thus, B is correct.
5) Which nerve supplies the infraspinatus?
A) Axillary nerve
B) Suprascapular nerve
C) Thoracodorsal nerve
D) Spinal accessory nerve
Answer: B) Suprascapular nerve
Explanation: Suprascapular nerve supplies both supraspinatus and infraspinatus. Thus, B is correct.
6) A patient with suprascapular nerve lesion will have weakened–
A) Lateral rotation
B) Medial rotation
C) Finger flexion
D) Elbow extension
Answer: A) Lateral rotation
Explanation: Loss of infraspinatus affects lateral rotation. Thus, A is correct.
7) Teres minor lies–
A) Above infraspinatus
B) Below infraspinatus
C) Anterior to subscapularis
D) Within supraspinous fossa
Answer: B) Below infraspinatus
Explanation: Teres minor is inferior to infraspinatus on posterior scapula. Thus, B is correct.
8) Which muscle inserts on the lesser tubercle?
A) Infraspinatus
B) Supraspinatus
C) Subscapularis
D) Teres minor
Answer: C) Subscapularis
Explanation: Subscapularis uniquely inserts on lesser tubercle. Thus, C is correct.
9) Suprascapular nerve passes through–
A) Quadrangular space
B) Suprascapular notch
C) Triangular space
D) Guyon’s canal
Answer: B) Suprascapular notch
Explanation: The nerve passes under the superior transverse ligament. Thus, B is correct.
10) In rotator cuff tears, which muscle is most commonly affected?
A) Subscapularis
B) Supraspinatus
C) Infraspinatus
D) Teres major
Answer: B) Supraspinatus
Explanation: Supraspinatus tendon is most vulnerable to impingement. Thus, B is correct.
11) A patient with difficulty initiating abduction likely has injury to–
A) Infraspinatus
B) Latissimus dorsi
C) Supraspinatus
D) Deltoid
Answer: C) Supraspinatus
Explanation: Supraspinatus initiates first 15° of abduction. Thus, C is correct.
Chapter: Upper Limb Anatomy; Topic: Wrist Anatomy; Subtopic: Structures Passing Deep to Flexor Retinaculum
Keyword Definitions:
Flexor Retinaculum: Strong fibrous band forming the roof of the carpal tunnel.
Carpal Tunnel: Passageway containing median nerve and flexor tendons.
Median Nerve: Only nerve passing deep to the flexor retinaculum.
Ulnar Canal (Guyon’s Canal): Tunnel where ulnar nerve and artery pass superficial to flexor retinaculum.
Flexor Tendons: FDS, FDP, and FPL pass deep to the flexor retinaculum.
1) Lead Question – 2016
Structure passing deep to flexor retinaculum at the wrist:
A) Ulnar nerve
B) Median nerve
C) Radial nerve
D) Ulnar artery
Answer: B) Median nerve
Explanation: The flexor retinaculum forms the roof of the carpal tunnel, and the median nerve is the only nerve that passes deep to it. The flexor tendons—FDS, FDP, and FPL—also pass deep to the retinaculum. The ulnar nerve and ulnar artery pass superficial to the flexor retinaculum through Guyon’s canal. The radial nerve does not enter the carpal tunnel. Therefore, the correct answer is B. Injury or compression of the median nerve deep to the flexor retinaculum commonly causes carpal tunnel syndrome.
2) Which structure passes superficial to the flexor retinaculum?
A) Median nerve
B) Ulnar nerve
C) FPL tendon
D) FDP tendon
Answer: B) Ulnar nerve
Explanation: The ulnar nerve travels through Guyon’s canal superficial to the flexor retinaculum. Thus, B is correct.
3) Carpal tunnel syndrome affects which nerve?
A) Radial nerve
B) Median nerve
C) Ulnar nerve
D) Musculocutaneous nerve
Answer: B) Median nerve
Explanation: Median nerve compression causes carpal tunnel syndrome. Thus, B is correct.
4) Which tendon passes through the carpal tunnel?
A) EPL
B) ECRB
C) FDS
D) APL
Answer: C) FDS
Explanation: Flexor digitorum superficialis passes deep to flexor retinaculum. Thus, C is correct.
5) Guyon’s canal contains–
A) Median nerve
B) Ulnar nerve and artery
C) Radial artery only
D) Ulnar nerve only
Answer: B) Ulnar nerve and artery
Explanation: Both structures run superficial to the flexor retinaculum. Hence, B is correct.
6) A patient with carpal tunnel syndrome will show weakness of–
A) Interossei
B) Thenar muscles
C) Forearm extensors
D) Triceps
Answer: B) Thenar muscles
Explanation: Median nerve supplies thenar muscles affected in CTS. Thus, B is correct.
7) The flexor retinaculum attaches to–
A) Scaphoid and trapezium
B) Lunate and capitate
C) Pisiform and hook of hamate
D) Both A and C
Answer: D) Both A and C
Explanation: The flexor retinaculum spans from scaphoid/trapezium to pisiform/hamate. Thus, D is correct.
8) Median nerve injury at carpal tunnel causes loss of–
A) Wrist flexion
B) Finger flexion
C) Thumb opposition
D) Thumb adduction
Answer: C) Thumb opposition
Explanation: Opponens pollicis is median-supplied. Thus, C is correct.
9) Flexor pollicis longus tendon lies–
A) Superficial to flexor retinaculum
B) Deep to flexor retinaculum
C) In Guyon’s canal
D) In radial tunnel
Answer: B) Deep to flexor retinaculum
Explanation: FPL passes through the carpal tunnel. Thus, B is correct.
10) Superficial radial nerve supplies sensation to–
A) Thumb pulp
B) Dorsal thumb
C) Little finger
D) Palmar index
Answer: B) Dorsal thumb
Explanation: Radial nerve supplies dorsolateral hand. Thus, B is correct.
11) Compression of structures superficial to flexor retinaculum leads to–
A) Carpal tunnel syndrome
B) Guyon’s canal syndrome
C) Pronator syndrome
D) Radial tunnel syndrome
Answer: B) Guyon’s canal syndrome
Explanation: Ulnar nerve compression superficial to retinaculum leads to this syndrome. Thus, B is correct.
Chapter: Upper Limb Anatomy; Topic: Shoulder Joint Ligaments; Subtopic: Coracoacromial Arch & Stability
Keyword Definitions:
Coracoacromial Ligament: A strong triangular ligament spanning between coracoid process and acromion, forming the coracoacromial arch.
Coracoacromial Arch: Superior protective roof over the shoulder joint preventing upward displacement of humeral head.
Humeral Head Displacement: Abnormal superior or inferior movement of humeral head due to ligament or muscle dysfunction.
Shoulder Stability Structures: Rotator cuff muscles, capsule, labrum, and ligaments that prevent dislocation.
Upward Migration of Humerus: Superior movement resisted mainly by coracoacromial arch.
1) Lead Question – 2016
Coracoacromial ligament resists which movements?
A) Upward displacement of humeral head
B) Abduction of shoulder
C) Inferior displacement of humerus
D) External rotation
Answer: A) Upward displacement of humeral head
Explanation: The coracoacromial ligament forms the superior boundary of the shoulder joint along with the coracoacromial arch. Its primary function is to resist upward displacement of the humeral head, especially when strong forces are transmitted through the rotator cuff. The ligament prevents superior migration of the humerus and thus acts as a protective stabilizing structure. It has no direct role in resisting abduction, inferior displacement, or external rotation. Therefore, the correct answer is A. This ligament becomes important in conditions like rotator cuff tears where superior humeral migration may occur.
2) Which ligament forms the coracoacromial arch?
A) Coracoclavicular ligament
B) Coracoacromial ligament
C) Glenohumeral ligament
D) Transverse humeral ligament
Answer: B) Coracoacromial ligament
Explanation: The coracoacromial arch is created by the coracoacromial ligament spanning between coracoid and acromion. Thus, B is correct.
3) The structure preventing inferior dislocation of humeral head is–
A) Deltoid
B) Superior glenohumeral ligament
C) Coracoacromial ligament
D) Long head of triceps
Answer: B) Superior glenohumeral ligament
Explanation: SGHL stabilizes against inferior translation in adducted arm. Thus, B is correct.
4) A patient with massive rotator cuff tear may show–
A) Upward migration of humeral head
B) Inferior laxity
C) Frozen shoulder
D) No change in humeral head position
Answer: A) Upward migration of humeral head
Explanation: Loss of cuff tension permits upward displacement resisted only by coracoacromial arch. Thus, A is correct.
5) The coracoclavicular ligament stabilizes–
A) AC joint
B) Glenohumeral joint
C) Sternoclavicular joint
D) Scapulothoracic articulation
Answer: A) AC joint
Explanation: CC ligament (conoid & trapezoid) anchors clavicle to coracoid, stabilizing AC joint. Thus, A is correct.
6) Which muscle helps resist upward humeral displacement?
A) Latissimus dorsi
B) Supraspinatus
C) Pectoralis minor
D) Trapezius
Answer: B) Supraspinatus
Explanation: Supraspinatus compresses humeral head and prevents superior migration. Thus, B is correct.
7) Injury to which nerve may weaken shoulder abduction initiation?
A) Axillary nerve
B) Suprascapular nerve
C) Radial nerve
D) Ulnar nerve
Answer: B) Suprascapular nerve
Explanation: Suprascapular nerve supplies supraspinatus which initiates abduction. Thus, B is correct.
8) The transverse humeral ligament stabilizes–
A) Biceps long head tendon
B) Subscapularis tendon
C) AC joint capsule
D) Axillary artery
Answer: A) Biceps long head tendon
Explanation: It holds biceps tendon in the bicipital groove. Thus, A is correct.
9) A painful arc between 60–120 degrees of abduction usually indicates–
A) AC joint arthritis
B) Subacromial impingement
C) GH dislocation
D) Rotator cuff rupture
Answer: B) Subacromial impingement
Explanation: Compression of supraspinatus tendon under coracoacromial arch causes this painful arc. Thus, B is correct.
10) The ligament preventing anterior humeral head displacement is–
A) Coracoacromial
B) Middle glenohumeral ligament
C) Coracoclavicular
D) Interclavicular
Answer: B) Middle glenohumeral ligament
Explanation: MGHL resists anterior translation especially in mid-range motion. Thus, B is correct.
11) Coracoid process provides attachment for all except–
A) Coracoacromial ligament
B) Coracoclavicular ligament
C) Short head of biceps
D) Deltoid
Answer: D) Deltoid
Explanation: Deltoid originates from clavicle, acromion, and spine of scapula, not coracoid. Thus, D is correct.
Chapter: Upper Limb Anatomy; Topic: Shoulder Joint Ligaments; Subtopic: Coracohumeral Ligament Attachments
Keyword Definitions:
Coracohumeral Ligament: Strong ligament extending from the coracoid process to the humerus, providing superior stability.
Greater Tuberosity: Lateral prominence of humerus where supraspinatus, infraspinatus, and teres minor insert.
Lesser Tuberosity: Medial prominence where subscapularis inserts.
Bicipital Groove: Groove between tuberosities holding long head of biceps tendon.
Shoulder Stabilizing Ligaments: Ligaments supporting humeral head stability including coracohumeral ligament.
1) Lead Question – 2016
Coracohumeral ligament inserts on?
A) Greater tuberosity
B) Lesser and greater tuberosities
C) Anatomical neck of humerus
D) Bicipital groove
Answer: B) Lesser and greater tuberosities
Explanation: The coracohumeral ligament originates from the lateral border of the coracoid process and splits into two bands. One band inserts onto the lesser tuberosity and blends with the subscapularis tendon, while the other band inserts onto the greater tuberosity alongside the supraspinatus tendon. This arrangement provides superior reinforcement to the shoulder joint capsule and checks inferior translation of the humeral head. Because the ligament attaches to both tuberosities, the correct answer is B. It does not attach to the anatomical neck or the bicipital groove.
2) The coracohumeral ligament primarily prevents–
A) Posterior dislocation
B) Inferior displacement of humeral head
C) Upward migration of humerus
D) External rotation
Answer: B) Inferior displacement of humeral head
Explanation: It acts as a superior stabilizer resisting inferior pull. Thus, B is correct.
3) Which ligament forms the coracoacromial arch?
A) Coracohumeral
B) Coracoacromial
C) Glenohumeral
D) Costoclavicular
Answer: B) Coracoacromial
Explanation: Coracoacromial ligament forms the protective arch. Thus, B is correct.
4) A patient with inferior shoulder instability likely has damage to–
A) SGHL
B) Coracohumeral ligament
C) Transverse humeral ligament
D) AC ligament
Answer: B) Coracohumeral ligament
Explanation: Coracohumeral ligament stabilizes against inferior translation. Thus, B is correct.
5) The transverse humeral ligament stabilizes–
A) Long head of biceps tendon
B) Subscapularis tendon
C) AC joint capsule
D) Labrum
Answer: A) Long head of biceps tendon
Explanation: It converts the bicipital groove into a canal. Thus, A is correct.
6) Glenohumeral ligaments are best seen in which position?
A) Neutral
B) External rotation
C) Internal rotation
D) Flexion
Answer: B) External rotation
Explanation: External rotation tensions GH ligaments making them visible. Thus, B is correct.
7) Injury to suprascapular nerve affects which movement most?
A) Internal rotation
B) Initial abduction
C) Extension
D) Adduction
Answer: B) Initial abduction
Explanation: Supraspinatus initiates abduction. Thus, B is correct.
8) Which muscle inserts on the greater tuberosity?
A) Subscapularis
B) Supraspinatus
C) Teres major
D) Latissimus dorsi
Answer: B) Supraspinatus
Explanation: Supraspinatus, infraspinatus, and teres minor insert there. Thus, B is correct.
9) Coracoid process gives attachment to all except–
A) Short head of biceps
B) Coracobrachialis
C) Pectoralis minor
D) Deltoid
Answer: D) Deltoid
Explanation: Deltoid attaches to clavicle, acromion, and scapular spine. Thus, D is correct.
10) A patient with upward migration of humeral head likely has–
A) Massive rotator cuff tear
B) Axillary nerve injury
C) Clavicle fracture
D) Glenoid labrum tear
Answer: A) Massive rotator cuff tear
Explanation: Loss of cuff support permits superior displacement. Thus, A is correct.
11) The lesser tuberosity receives insertion of–
A) Infraspinatus
B) Supraspinatus
C) Subscapularis
D) Teres minor
Answer: C) Subscapularis
Explanation: Subscapularis inserts solely on the lesser tuberosity. Thus, C is correct.