Upper Limb - Most Important Questions for 1st Year MBBS Anatomy

(RGHUS University Pattern)

LONG ANSWER QUESTIONS (LAQs) - 10 Marks

• Describe the formation, parts, and branches of the brachial plexus. Add a note on its clinical correlations (Erb's palsy, Klumpke's palsy).
• Formation: Anterior rami of C5-C8 and T1; parts = roots → trunks → divisions → cords → branches (mnemonic: Robert Taylor Drinks Cold Beer)

• Describe the boundaries, contents, and clinical importance of the axilla.
• Walls: anterior (pectoralis major/minor), posterior (subscapularis, teres major, latissimus dorsi), medial (serratus anterior + ribs 1-4), lateral (intertubercular groove of humerus)
• Contents: axillary artery and its 3 parts, axillary vein, brachial plexus cords, 5 groups of lymph nodes, long thoracic nerve, thoracodorsal nerve

• Describe the shoulder joint - type, articular surfaces, ligaments, movements, muscles producing each movement, and dislocation.
• Type: Ball-and-socket synovial joint; most mobile but least stable
• Stabilized by: rotator cuff (SITS - Supraspinatus, Infraspinatus, Teres minor, Subscapularis)
• Most common dislocation: anteroinferior (Bankart lesion)

• Describe the boundaries and contents of the cubital fossa. What is the clinical importance of bicipital aponeurosis?
• Boundaries: medially pronator teres, laterally brachioradialis, base = line between epicondyles
• Contents (lateral to medial): Radial Nerve, Biceps tendon, Brachial Artery, Median Nerve (mnemonic: Really Be Nice To Me)

SHORT ANSWER QUESTIONS (SAQs) - 5 Marks

1. Enumerate the branches of the medial cord, lateral cord, and posterior cord of the brachial plexus.
2. Applied anatomy of the radial nerve - course and effects of injury at different levels (Saturday night palsy / wrist drop).
3. Applied anatomy of the ulnar nerve - injury at elbow vs. wrist (claw hand).
4. Applied anatomy of the median nerve - carpal tunnel syndrome, ape thumb deformity.
5. Long thoracic nerve - origin, course, injury (winged scapula).
6. Axillary nerve - course, injury (surgical neck fracture → loss of shoulder abduction).
7. Musculocutaneous nerve - course and distribution.
8. Horner's syndrome in relation to brachial plexus.

1. Rotator cuff - muscles, actions, and clinical significance (rotator cuff tears).
2. Muscles of the thenar eminence and their nerve supply.
3. Muscles of the hypothenar eminence.
4. Lumbricals and interossei - attachments, actions, innervation.
5. Biceps brachii - origin, insertion, actions, nerve supply.
6. Structures attached to the coracoid process.
7. Flexor retinaculum - attachments and structures passing deep/superficial to it.

1. Axillary artery - parts and branches (mnemonic: She Takes Lunch And Starts Producing Silk for 6 branches).
2. Anastomosis around the elbow joint.
3. Anastomosis around the scapula.
4. Radial artery - course, relations, pulse point.
5. Ulnar artery and superficial palmar arch.
6. Deep palmar arch - formation and branches.

1. Acromioclavicular joint and its ligaments.
2. Sternoclavicular joint - only joint connecting upper limb to axial skeleton.
3. Elbow joint - type, movements, carrying angle, pulled elbow (nursemaid's elbow).
4. Wrist joint (radiocarpal joint) - articular surfaces, movements, colles' fracture.
5. Shoulder joint dislocation - types and complications.
6. Scaphoid bone - blood supply, why fracture is clinically significant (avascular necrosis).

1. Structures piercing the clavipectoral fascia.
2. Quadrangular space - boundaries and contents (axillary nerve + posterior circumflex humeral artery).
3. Triangular space and triangular interval - contents.
4. Cubital fossa in detail.
5. Anatomical snuffbox - boundaries and contents (radial artery, scaphoid bone).
6. Carpal tunnel - boundaries and contents; carpal tunnel syndrome.

VERY SHORT ANSWER / VIVA QUESTIONS - 2-3 Marks

DIAGRAM QUESTIONS (Draw and Label)

1. Brachial plexus - full diagram with roots, trunks, divisions, cords, and terminal branches
2. Cubital fossa - boundaries and contents
3. Axilla - walls and contents
4. Rotator cuff muscles
5. Carpal tunnel - cross-section
6. Anatomical snuffbox
7. Anastomosis around scapula
8. Superficial and deep palmar arches

CLINICAL / APPLIED ANATOMY (High Yield)

HOT TIPS FOR RGHUS EXAMS

• Draw diagrams wherever asked - even in theory papers, a labeled diagram earns marks
• The brachial plexus is the single most asked LAQ - learn the complete diagram
• Applied anatomy (nerve injuries, clinical conditions) is always asked either as part of LAQ or separately
• Cubital fossa and axilla are very commonly asked 5-mark questions
• Memorize nerve levels (C5-T1) for each nerve/movement
• The rotator cuff (SITS muscles) is asked every year in some form