Osteology Viva Questions on the Upper Limb, with Answers

Upper limb osteology vivas follow a pattern: identify, side, position, then a few features and one clinical point per bone. These are the questions that come up again and again, with the short answers an examiner expects. Say them aloud with the bone in your hand.

Clavicle

Why is the clavicle said to have no medullary cavity?
It ossifies in membrane, the first bone to start ossifying (around the fifth to sixth week), and it has no medullary cavity.

Where does it fracture most often, and why does the lateral fragment drop?
At the junction of the middle and lateral thirds. The lateral fragment is pulled down by the weight of the limb; the medial fragment is pulled up by sternocleidomastoid.

Name the ligament attached to the conoid tubercle and the trapezoid line.
The coracoclavicular ligament, in two parts: conoid and trapezoid.

Scapula

Which nerves pass through the suprascapular notch and under the ligament?
The suprascapular nerve passes under the superior transverse scapular ligament; the suprascapular artery passes above it.

What attaches to the supraglenoid and infraglenoid tubercles?
Long head of biceps above, long head of triceps below.

Winging of the scapula: which muscle and which nerve?
Serratus anterior, supplied by the long thoracic nerve (C5, C6, C7).

Humerus

Name the nerves related to the humerus and where each can be injured.
Axillary nerve at the surgical neck; radial nerve in the radial (spiral) groove; ulnar nerve behind the medial epicondyle; median nerve at the supracondylar region.

What attaches to the greater and lesser tubercles?
Greater tubercle: supraspinatus, infraspinatus and teres minor, from above downwards. Lesser tubercle: subscapularis.

What is the deltoid tuberosity and what lies just behind it?
The rough V-shaped area on the lateral surface of the shaft for deltoid; the radial groove with the radial nerve and profunda brachii vessels runs behind and below it.

What articulates with the capitulum and the trochlea?
The head of the radius with the capitulum; the trochlear notch of the ulna with the trochlea.

Why does a fracture of the surgical neck cause loss of sensation over the shoulder?
The axillary nerve is damaged; its upper lateral cutaneous branch supplies the skin over the lower half of the deltoid, the regimental badge area.

Radius

What is the radial tuberosity for?
Insertion of biceps brachii.

What is the dorsal tubercle (Lister's tubercle)?
A ridge on the back of the lower end; the tendon of extensor pollicis longus hooks around its medial side.

What is a Colles fracture?
A fracture of the lower end of the radius about 2 cm above the wrist, with backward displacement of the distal fragment, giving the dinner-fork deformity. It usually follows a fall on the outstretched hand.

Ulna

Which bone carries the trochlear and radial notches?
The ulna: the trochlear notch for the trochlea of the humerus and the radial notch for the head of the radius.

What is the subcutaneous border of the ulna and why does it matter?
The posterior border, which can be felt along its whole length from the olecranon to the styloid process; it is used as a landmark and separates the flexor and extensor compartments.

Why does the ulna not take part in the wrist joint?
The articular disc of the inferior radio-ulnar joint lies between the head of the ulna and the carpus.

Hand

Name the carpal bones in order.
Proximal row from lateral to medial: scaphoid, lunate, triquetral, pisiform. Distal row: trapezium, trapezoid, capitate, hamate.

Which carpal bone is most often fractured, and what is the danger?
The scaphoid, across its waist; the blood supply enters mainly at the distal end, so the proximal fragment may undergo avascular necrosis. Tenderness is felt in the anatomical snuffbox.

Which carpal bone is most often dislocated?
The lunate, usually anteriorly, where it can press on the median nerve in the carpal tunnel.

What attaches to the hook of the hamate and the pisiform?
The flexor retinaculum, and flexor carpi ulnaris to the pisiform (which is a sesamoid bone in its tendon).

Which joint allows opposition of the thumb?
The first carpometacarpal joint, a saddle joint between the trapezium and the first metacarpal.

General

Which end of the humerus is the growing end?
The upper end. The epiphysis at the upper end fuses last, around 18 to 20 years; most growth in length takes place there.

What is the carrying angle?
The angle between the long axis of the arm and the forearm when the elbow is extended and supinated, because the medial edge of the trochlea projects lower than the lateral. It is greater in women.

Name the bones you can feel at the wrist.
The styloid processes of the radius and ulna, the head of the ulna, the pisiform, the hook of the hamate (deep), and the scaphoid tubercle.

Prepare with the bones in your hand

Go through this list with the bones from your set in front of you and point to every structure you name. A unilateral bone set has every upper limb bone; a bilateral set lets you compare both sides. The XBONZ Anatomy Lab has a larger bank of viva questions, spotters and timed mock exams, with the muscles and nerves shown on the 3D skeleton.

This is a revision aid. Check it against your course textbook and what your department teaches.