NEET-PG MCQs - Upper Limb Anatomy

ANATOMY AIIMS, GROSS ANATOMY, EMBRYOLOGY, NEUROANATOMY, MICROANATOMY, APPLIED/ CLINICAL ANATOMY

NEET-PG MCQs - Upper Limb Anatomy

Question 1: Which of the following muscles is NOT a part of the rotator cuff muscles?

A) Infraspinatus

B) Teres minor

C) Subscapularis

D) Teres major

Answer: D) Teres major is not a part of the rotator cuff muscles.

Question 2: Which of the following nerves innervates the flexor carpi ulnaris muscle?

A) Median nerve

B) Ulnar nerve

C) Radial nerve

D) Musculocutaneous nerve

Answer: B) Ulnar nerve innervates the flexor carpi ulnaris muscle.

Question 3: Which of the following muscles is NOT involved in elbow flexion?

A) Biceps brachii

B) Brachialis

C) Brachioradialis

D) Triceps brachii

Answer: D) Triceps brachii is not involved in elbow flexion.

Question 4: The axillary nerve supplies which of the following muscles?

A) Deltoid and teres minor

B) Supraspinatus and infraspinatus

C) Subscapularis and teres major

D) Brachialis and brachioradialis

Answer: A) Deltoid and teres minor muscles are supplied by the axillary nerve.

Question 5: Which of the following nerves is responsible for supplying the extensor carpi radialis longus muscle?

A) Radial nerve

B) Median nerve

C) Ulnar nerve

D) Musculocutaneous nerve

Answer: A) Radial nerve supplies the extensor carpi radialis longus muscle.

Question 6: Which of the following bones is NOT part of the wrist joint?

A) Scaphoid

B) Lunate

C) Triquetrum

D) Humerus

Answer: D) Humerus is not part of the wrist joint.

Question 7: Which muscle is responsible for supination of the forearm?

A) Pronator teres

B) Supinator

C) Brachioradialis

D) Flexor carpi radialis

Answer: B) Supinator muscle is responsible for supination of the forearm.

Question 8: Which of the following muscles is NOT part of the intrinsic muscles of the hand?

A) Abductor pollicis brevis

B) Adductor pollicis

C) Flexor pollicis longus

D) Flexor digiti minimi brevis

Answer: C) Flexor pollicis longus muscle is not part of the intrinsic muscles of the hand.

Question 9: The radial nerve passes through which muscle?

A) Brachioradialis

B) Extensor carpi radialis longus

C) Supinator

D) Pronator teres

Answer: C) The radial nerve passes through the supinator muscle.

Question 10: The anterior interosseous nerve supplies which of the following muscles?

A) Flexor carpi ulnaris

B) Pronator teres

C) Flexor digitorum superficialis

D) Flexor pollicis longus

Answer: D) The anterior interosseous nerve supplies the flexor pollicis longus muscle.

Question 11: Which nerve is responsible for the sensation of the lateral aspect of the forearm?

A) Median nerve

B) Ulnar nerve

C) Radial nerve

D) Musculocutaneous nerve

Answer: D) The Musculocutaneous nerve is responsible for the sensation of the lateral aspect of the forearm.

Question 12: Which muscle is responsible for abduction of the arm at the shoulder joint?

A) Infraspinatus

B) Supraspinatus

C) Teres minor

D) Subscapularis

Answer: B) The supraspinatus muscle is responsible for abduction of the arm at the shoulder joint.

Question 13: Which nerve is responsible for the motor innervation of the triceps brachii muscle?

A) Radial nerve

B) Ulnar nerve

C) Musculocutaneous nerve

D) Median nerve

Answer: A) The radial nerve is responsible for the motor innervation of the triceps brachii muscle.

Question 14: The flexor carpi ulnaris muscle inserts on which of the following bones?

A) Scaphoid

B) Lunate

C) Triquetrum

D) Pisiform

Answer: D) The flexor carpi ulnaris muscle inserts on the pisiform bone.

Question 15: Which nerve is responsible for the motor innervation of the flexor carpi ulnaris muscle?

A) Ulnar nerve

B) Median nerve

C) Radial nerve

D) Musculocutaneous nerve

Answer: A) The ulnar nerve is responsible for the motor innervation of the flexor carpi ulnaris muscle.

Question 16: Which nerve is responsible for the sensory innervation of the medial aspect of the hand?

A) Radial nerve

B) Ulnar nerve

C) Median nerve

D) Musculocutaneous nerve

Answer: B) The ulnar nerve is responsible for the sensory innervation of the medial aspect of the hand.

Question 17: The axillary nerve is responsible for the motor innervation of which muscle?

A) Supraspinatus

B) Infraspinatus

C) Teres minor

D) Subscapularis

Answer: C) The axillary nerve is responsible for the motor innervation of the Teres minor muscle.

Question 18: Which ligament stabilizes the acromioclavicular joint?

A) Coracoacromial ligament

B) Acromioclavicular ligament

C) Coracoclavicular ligament

D) Glenohumeral ligament

Answer: B) The acromioclavicular ligament stabilizes the acromioclavicular joint.

Question 19: Which nerve innervates the flexor carpi radialis muscle?

A) Radial nerve

B) Ulnar nerve

C) Median nerve

D) Musculocutaneous nerve

Answer: C) The median nerve innervates the flexor carpi radialis muscle.

Question 20: The ulnar nerve runs posterior to which bony landmark of the elbow joint?

A) Medial epicondyle

B) Lateral epicondyle

C) Olecranon process

D) Coronoid process

Answer: A) The ulnar nerve runs posterior to the medial epicondyle of the elbow joint.

Question 21: Which of the following is NOT a muscle of the rotator cuff?

A) Subscapularis

B) Supraspinatus

C) Teres major

D) Infraspinatus

Answer: C) Teres major is not a muscle of the rotator cuff.

Question 22: The radial nerve runs in the spiral groove of which bone?

A) Humerus

B) Ulna

C) Radius

D) Scapula

Answer: A) The radial nerve runs in the spiral groove of the humerus bone.

Question 23: Which nerve innervates the muscles of the thenar eminence?

A) Median nerve

B) Ulnar nerve

C) Radial nerve

D) Musculocutaneous nerve

Answer: A) The median nerve innervates the muscles of the thenar eminence.

Question 24: Which muscle forms the anterior border of the axilla?

A) Pectoralis minor

B) Serratus anterior

C) Teres major

D) Latissimus dorsi

Answer: A) Pectoralis minor forms the anterior border of the axilla.

Question 25: Which nerve is most commonly injured in a midshaft humeral fracture?

A) Median nerve

B) Ulnar nerve

C) Radial nerve

D) Axillary nerve

Answer: C) The radial nerve is most commonly injured in a midshaft humeral fracture.

Acromial Angle and its Significance

ANATOMY AIIMS, GROSS ANATOMY, EMBRYOLOGY, NEUROANATOMY, MICROANATOMY, APPLIED/ CLINICAL ANATOMY

Acromial Angle and its Significance

The acromial angle is the angle formed by the lateral border of the acromion and the horizontal plane. It is an important anatomical landmark in the study of shoulder anatomy and is used to diagnose various shoulder pathologies.

A larger acromial angle is associated with an increased risk of developing subacromial impingement syndrome, rotator cuff tears, and other shoulder disorders. It has been suggested that the shape of the acromion and the size of the acromial angle may contribute to the development of these conditions.

The normal range for the acromial angle is between 70-135 degrees, with an average of 90 degrees. However, there is some variation in the normal range depending on factors such as age, gender, and ethnicity.

The acromial angle can be measured using various imaging modalities such as X-ray, MRI, and ultrasound. It is also commonly assessed during a physical examination of the shoulder.

The acromial angle is an important anatomical landmark in the study of shoulder anatomy. It is the angle formed by the lateral border of the acromion and the horizontal plane. The acromion is a bony process that extends from the scapula (shoulder blade) and articulates with the clavicle (collarbone) to form the acromioclavicular joint. The acromion plays an important role in shoulder function as it serves as a site of attachment for several muscles and ligaments.

The acromial angle has been shown to be an important factor in the development of various shoulder pathologies. A larger acromial angle has been associated with an increased risk of developing subacromial impingement syndrome, rotator cuff tears, and other shoulder disorders. This is thought to be due to the fact that a larger acromial angle can cause compression of the subacromial space, which can lead to impingement of the rotator cuff tendons.

Several studies have investigated the relationship between acromial angle and shoulder pathology. A study by Bigliani et al. (1986) found that patients with rotator cuff tears had a significantly larger acromial angle compared to those without tears. Another study by Itoi et al. (1995) found that the tensile strength of the supraspinatus tendon (one of the rotator cuff tendons) was significantly decreased in specimens with a larger acromial angle.

The normal range for the acromial angle is between 70-135 degrees, with an average of 90 degrees. However, there is some variation in the normal range depending on factors such as age, gender, and ethnicity. The acromial angle can be measured using various imaging modalities such as X-ray, MRI, and ultrasound. It is also commonly assessed during a physical examination of the shoulder.

In clinical practice, the acromial angle is an important consideration in the management of shoulder pathologies. Conservative treatment options such as physical therapy and anti-inflammatory medications may be appropriate for patients with a smaller acromial angle, while surgical intervention may be necessary for those with a larger acromial angle.

References:

Bigliani LU, Morrison DS, April EW. The morphology of the acromion and its relationship to rotator cuff tears. Orthop Trans. 1986;10:228.

Itoi E, Berglund LJ, Grabowski JJ, Schultz FM, Growney ES, Morrey BF, An KN. Tensile properties of the supraspinatus tendon. J Orthop Res. 1995;13(4):578-584.

Magee DJ. Orthopedic physical assessment. Elsevier Health Sciences; 2014.

Significance	Description	Reference
Relationship to shoulder pathologies	A larger acromial angle is associated with an increased risk of developing subacromial impingement syndrome, rotator cuff tears, and other shoulder disorders.	Bigliani et al. (1986)
Tensile strength of rotator cuff tendons	The tensile strength of the supraspinatus tendon (one of the rotator cuff tendons) was significantly decreased in specimens with a larger acromial angle.	Itoi et al. (1995)
Normal range	The normal range for the acromial angle is between 70-135 degrees, with an average of 90 degrees.	Magee (2014)
Measurement	The acromial angle can be measured using various imaging modalities such as X-ray, MRI, and ultrasound. It is also commonly assessed during a physical examination of the shoulder.	Magee (2014)
Management of shoulder pathologies	Conservative treatment options may be appropriate for patients with a smaller acromial angle, while surgical intervention may be necessary for those with a larger acromial angle.	N/A

References:

Bigliani LU, Morrison DS, April EW. The morphology of the acromion and its relationship to rotator cuff tears. Orthop Trans. 1986;10:228.

Itoi E, Berglund LJ, Grabowski JJ, Schultz FM, Growney ES, Morrey BF, An KN. Tensile properties of the supraspinatus tendon. J Orthop Res. 1995;13(4):578-584.

Magee DJ. Orthopedic physical assessment. Elsevier Health Sciences; 2014.

Klumpke's Palsy / Klumpke's Paralysis

ANATOMY AIIMS, GROSS ANATOMY, EMBRYOLOGY, NEUROANATOMY, MICROANATOMY, APPLIED/ CLINICAL ANATOMY

Klumpke's Palsy / Klumpke's Paralysis

Klumpke's palsy is a type of brachial plexus injury that affects the lower nerves of the brachial plexus. The brachial plexus is a network of nerves that originates in the spinal cord and provides motor and sensory innervation to the shoulder, arm, and hand.

Klumpke's palsy is usually caused by a traumatic injury, such as a difficult childbirth, where the infant's arm is forcefully pulled during delivery. This can result in damage to the nerves that control movement and sensation in the hand and forearm.

The symptoms of Klumpke's palsy include weakness or paralysis of the muscles in the hand and forearm, as well as numbness or tingling in the affected area. In severe cases, there may be a loss of sensation in the hand and forearm.

Treatment for Klumpke's palsy typically involves physical therapy to help improve muscle strength and range of motion. In some cases, surgery may be necessary to repair or replace damaged nerves in the brachial plexus.

Klumpke's palsy is a type of brachial plexus injury that affects the lower nerves of the brachial plexus. The brachial plexus is a network of nerves that originates in the spinal cord and provides motor and sensory innervation to the shoulder, arm, and hand.

The lower nerves of the brachial plexus that are affected in Klumpke's palsy are the eighth cervical nerve and first thoracic nerve, also known as C8 and T1. These nerves exit the spinal cord and join together to form the lower trunk of the brachial plexus. The lower trunk then splits into two divisions, the anterior and posterior divisions, which further divide into the cords of the brachial plexus.

Klumpke's palsy typically occurs when the lower trunk of the brachial plexus is stretched or torn. This can happen during childbirth when the infant's head and neck are pulled to one side, causing excessive stretching of the nerves in the lower trunk.

The symptoms of Klumpke's palsy include weakness or paralysis of the muscles in the hand and forearm, as well as numbness or tingling in the affected area. In severe cases, there may be a loss of sensation in the hand and forearm.

Treatment for Klumpke's palsy typically involves physical therapy to help improve muscle strength and range of motion. In some cases, surgery may be necessary to repair or replace damaged nerves in the brachial plexus.

Klumpke's palsy can cause various types of hand deformities depending on the severity of the nerve damage and the specific nerves affected. The most common hand deformities associated with Klumpke's palsy include:

Claw hand: This is a deformity where the fingers and wrist are flexed and the hand appears to be clawed. The muscles that control finger extension are weakened or paralyzed, while the muscles that control finger flexion are relatively stronger.

Loss of grip strength: Klumpke's palsy can weaken the muscles that control grip strength, making it difficult to grasp and hold objects.

Wrist drop: This is a deformity where the wrist is flexed and the hand hangs down. The muscles that control wrist extension are weakened or paralyzed, making it difficult to hold the wrist in a neutral position.

Sensory loss: Klumpke's palsy can also cause numbness or tingling in the hand and forearm due to damage to the sensory nerves.

Treatment for Klumpke's palsy typically involves physical therapy to help improve muscle strength and range of motion. In some cases, surgery may be necessary to repair or replace damaged nerves in the brachial plexus. Hand therapy can also be helpful in improving hand function and reducing the risk of long-term hand deformities.

Reference:

American Society for Surgery of the Hand. (n.d.). Klumpke's Palsy. https://www.assh.org/handcare/hand-arm-conditions/klumpkes-palsy

Horner's syndrome is a rare but possible complication of Klumpke's palsy. Horner's syndrome is a neurological disorder that affects the sympathetic nervous system and can result in a droopy eyelid, constricted pupil, and decreased sweating on one side of the face.

Horner's syndrome occurs when there is damage to the sympathetic nerves that originate in the neck and travel to the face. In Klumpke's palsy, the lower nerves of the brachial plexus (C8 and T1) are affected, and these nerves also give rise to the sympathetic nerves that supply the face.

If the nerve damage in Klumpke's palsy extends to the sympathetic nerves, it can lead to Horner's syndrome. The exact mechanism of how the nerve damage causes Horner's syndrome is not completely understood, but it is thought to involve interruption of the sympathetic nerve fibers that travel through the brachial plexus.

Horner's syndrome in Klumpke's palsy is typically temporary and resolves as the nerve damage heals. However, in some cases, Horner's syndrome can be permanent and may require additional treatment.

Horner's syndrome is a neurological disorder that affects the sympathetic nervous system and can cause several symptoms, which typically occur only on one side of the face. The symptoms of Horner's syndrome may include:

Ptosis: A drooping of the upper eyelid on the affected side of the face.

Miosis: Constriction of the pupil on the affected side of the face, causing it to appear smaller than the other pupil.

Anhidrosis: Decreased sweating on the affected side of the face, which may cause the skin to appear dry.

Facial flushing: In some cases, the skin on the affected side of the face may appear redder than the other side due to dilation of the blood vessels.

Eye redness: The affected eye may appear slightly redder than the other eye due to dilation of the blood vessels in the conjunctiva.

Horner's syndrome can be caused by various underlying medical conditions, including injury to the sympathetic nerve fibers, tumors, and neurological disorders. It is important to consult a doctor if you notice any of these symptoms, especially if they appear suddenly or are accompanied by other neurological symptoms.

Treatment for Horner's syndrome depends on the underlying cause and may include medications, surgery, or other interventions to address the underlying condition.

Reference:

National Organization for Rare Disorders. (2021). Horner Syndrome. https://rarediseases.org/rare-diseases/horner-syndrome/

Erb's Palsy / Erb's Paralysis

ANATOMY AIIMS, GROSS ANATOMY, EMBRYOLOGY, NEUROANATOMY, MICROANATOMY, APPLIED/ CLINICAL ANATOMY

Erb's Palsy / Erbs's Paralysis

Erb's paralysis, also known as Erb-Duchenne paralysis, is a condition that affects the brachial plexus, a network of nerves that controls movement and sensation in the shoulder, arm, and hand. The condition is named after Wilhelm Erb and Guillaume Duchenne, who described it in the late 19th century.

Erb's paralysis is typically caused by a traumatic injury to the brachial plexus during childbirth, but it can also result from a fall or other types of trauma. The injury often occurs when the infant's head and neck are pulled to one side during a difficult delivery. The most common symptoms of Erb's paralysis are weakness or paralysis of the shoulder and upper arm, numbness or tingling in the affected area, and a lack of reflexes in the affected arm.

Treatment for Erb's paralysis usually involves physical therapy and, in some cases, surgery. Physical therapy can help improve muscle strength and range of motion, and may include exercises and stretches to help retrain the muscles of the affected arm. In more severe cases, surgery may be necessary to repair or replace damaged nerves.

While the majority of infants with Erb's paralysis will eventually recover some or all of their movement and sensation in the affected arm, some may experience long-term weakness or disability. It is important for parents and caregivers of infants with Erb's paralysis to seek medical attention as soon as possible in order to ensure the best possible outcome.

Erb's paralysis is caused by an injury to the brachial plexus, a network of nerves that originates in the spinal cord and provides motor and sensory innervation to the shoulder, arm, and hand. The brachial plexus is formed by the joining of the nerve roots of the spinal cord that arise from the lower cervical and upper thoracic segments.

The injury to the brachial plexus that causes Erb's paralysis is typically a result of excessive stretching or tearing of the nerve fibers that comprise the plexus. During childbirth, the baby's head and neck may be pulled to one side, causing stretching or tearing of the nerves in the brachial plexus.

The most commonly affected nerves in Erb's paralysis are the fifth and sixth cervical nerves, which form the upper trunk of the brachial plexus. These nerves control movement and sensation in the shoulder and upper arm.

The injury to the brachial plexus in Erb's paralysis can cause a range of symptoms, including weakness or paralysis of the shoulder and upper arm, numbness or tingling in the affected area, and a lack of reflexes in the affected arm.

The severity of the injury to the brachial plexus will determine the extent of the symptoms and the potential for recovery. Mild injuries may result in temporary weakness or discomfort, while more severe injuries may cause long-term disability.

Treatment for Erb's paralysis typically involves physical therapy to help improve muscle strength and range of motion. In some cases, surgery may be necessary to repair or replace damaged nerves in the brachial plexus.

In Erb's paralysis, the position of the affected upper limb may vary depending on the severity and extent of nerve damage. Generally, the affected arm will be adducted (pulled towards the body), internally rotated (turned inwards towards the body), and extended at the elbow, with the forearm pronated (turned downwards) and the wrist flexed (bent downwards). This position is also known as the "waiter's tip" position, as it resembles a waiter holding a tray.

The "waiter's tip" position is a result of the loss of innervation to the muscles that control shoulder abduction, external rotation, and elbow flexion. The affected arm is unable to move away from the body or rotate outwards, resulting in the adducted and internally rotated position. Additionally, the loss of innervation to the muscles that control forearm supination (turning upwards) and wrist extension results in the pronated and flexed position of the forearm and wrist.

The "waiter's tip" position is a common clinical finding in infants with Erb's paralysis, and can be used to help diagnose the condition. However, it is important to note that not all cases of Erb's paralysis will present with this specific positioning, and the extent of nerve damage and resulting symptoms may vary.

References:

American Academy of Orthopaedic Surgeons. (2021). Erb's Palsy (Brachial Plexus Birth Palsy). https://orthoinfo.aaos.org/en/diseases--conditions/erbs-palsy-brachial-plexus-birth-palsy/

Terzis, J.K., & Kokkalis, Z.T. (2017). Nerve Surgery. Thieme Medical Publishers.

Muscles of Upper Limb and their Innervation/Nerve Supply

ANATOMY AIIMS, GROSS ANATOMY, EMBRYOLOGY, NEUROANATOMY, MICROANATOMY, APPLIED/ CLINICAL ANATOMY

Muscles of Upper Limb and their Innervation/Nerve Supply
 

Muscle	Nerve Supply	References
Deltoid	Axillary nerve (C5-C6)	Gray's Anatomy, 41st Edition, Chapter 47
Supraspinatus	Suprascapular nerve (C4-C6)	Gray's Anatomy, 41st Edition, Chapter 47
Infraspinatus	Suprascapular nerve (C4-C6)	Gray's Anatomy, 41st Edition, Chapter 47
Teres minor	Axillary nerve (C5-C6)	Gray's Anatomy, 41st Edition, Chapter 47
Subscapularis	Upper and lower subscapular nerves (C5-C6)	Gray's Anatomy, 41st Edition, Chapter 47
Pectoralis major	Lateral and medial pectoral nerves (C5-T1)	Gray's Anatomy, 41st Edition, Chapter 46
Latissimus dorsi	Thoracodorsal nerve (C6-C8)	Gray's Anatomy, 41st Edition, Chapter 46
Teres major	Lower subscapular nerve (C5-C6)	Gray's Anatomy, 41st Edition, Chapter 46
Biceps brachii	Musculocutaneous nerve (C5-C6)	Gray's Anatomy, 41st Edition, Chapter 47
Brachialis	Musculocutaneous nerve (C5-C6); Radial Nerve	Gray's Anatomy, 41st Edition, Chapter 47
Brachioradialis	Radial nerve (C5-C6)	Gray's Anatomy, 41st Edition, Chapter 47
Triceps brachii	Radial nerve (C6-C8)	Gray's Anatomy, 41st Edition, Chapter 47
Anconeus	Radial nerve (C7-C8)	Gray's Anatomy, 41st Edition, Chapter 47
Pronator teres	Median nerve (C6-C7)	Gray's Anatomy, 41st Edition, Chapter 47
Flexor carpi radialis	Median nerve (C6-C7)	Gray's Anatomy, 41st Edition, Chapter 47
Palmaris longus	Median nerve (C7-T1)	Gray's Anatomy, 41st Edition, Chapter 47
Flexor carpi ulnaris	Ulnar nerve (C7-T1)	Gray's Anatomy, 41st Edition, Chapter 47
Flexor digitorum superficialis	Median nerve (C7-C8)	Gray's Anatomy, 41st Edition, Chapter 47
Flexor digitorum profundus	Median nerve (C8-T1) (index and middle fingers), Ulnar nerve (C8-T1) (ring and little fingers)	Gray's Anatomy, 41st Edition, Chapter 47
Pronator quadratus	Median nerve (C8-T1)	Gray's Anatomy, 41st Edition, Chapter 47
Extensor carpi radialis longus	Radial nerve (C6-C7)	Gray's Anatomy, 41st Edition, Chapter 47
Extensor carpi radialis brevis	Radial nerve (C6-C7)	Gray's Anatomy, 41st Edition, Chapter 47
Extensor carpi ulnaris	Radial nerve (C7-C8)	Gray's Anatomy, 41st Edition, Chapter

Muscles of Hand and their Innervation-

Muscle	Nerve Supply	References
Abductor pollicis brevis	Median nerve (C8-T1)	Gray's Anatomy, 41st Edition, Chapter 48
Flexor pollicis brevis	Median nerve (C8-T1)	Gray's Anatomy, 41st Edition, Chapter 48
Opponens pollicis	Median nerve (C8-T1)	Gray's Anatomy, 41st Edition, Chapter 48
Adductor pollicis	Ulnar nerve (C8-T1)	Gray's Anatomy, 41st Edition, Chapter 48
Flexor digiti minimi brevis	Ulnar nerve (C8-T1)	Gray's Anatomy, 41st Edition, Chapter 48
Abductor digiti minimi	Ulnar nerve (C8-T1)	Gray's Anatomy, 41st Edition, Chapter 48
Opponens digiti minimi	Ulnar nerve (C8-T1)	Gray's Anatomy, 41st Edition, Chapter 48
Lumbricals (1-4)	Median nerve (C8-T1) (1st and 2nd), Ulnar nerve (C8-T1) (3rd and 4th)	Gray's Anatomy, 41st Edition, Chapter 48
Dorsal interossei (1-4)	Ulnar nerve (C8-T1)	Gray's Anatomy, 41st Edition, Chapter 48
Palmar interossei (1-3)	Ulnar nerve (C8-T1)	Gray's Anatomy, 41st Edition, Chapter 48
Adductor pollicis	Ulnar nerve (C8-T1)	Gray's Anatomy, 41st Edition, Chapter 48