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Anatomy · Upper limb · Lesson 03

Brachial plexus

The brachial plexus arises from the anterior rami of C5 to T1. From the roots emerge the trunks (upper, middle, lower); each splits into anterior and posterior divisions, regrouping as cords (lateral, posterior, medial) named for their position relative to the axillary artery.

Roots, trunks, divisions, cords, branches
Common injuries (Erb’s, Klumpke’s)
Exam tip Memorise the cords by their position on the axillary artery. Lateral cord supplies the lateral pectoral and musculocutaneous nerves.
2,190
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753
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261
Units
45
Modules
32,905
MCQs
5
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Pharmacology · Cardiovascular · Lesson 12

Beta-blockers

Beta-blockers act on beta-1 (cardiac), beta-2 (smooth muscle), and beta-3 (adipose) receptors. Cardioselective agents (bisoprolol, metoprolol) preferentially block beta-1. Non-selective agents (propranolol) block all subtypes.

Mechanism of action
Indications & contraindications
Exam tip Avoid in untreated phaeochromocytoma. Unopposed alpha-stimulation triggers a hypertensive crisis.
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Question 14 / 25 Cardiology
A 62-year-old man presents to ED with central crushing chest pain radiating to his left arm. ECG shows ST elevation in leads II, III and aVF. Which of the following coronary arteries is most likely occluded?
A Left anterior descending
B Left circumflex
C Right coronary artery
D Left main stem
E Diagonal branch
Why C is correct ST elevation in II, III and aVF localises the infarct to the inferior wall, supplied by the right coronary artery in 80–85% of patients (right-dominant circulation).
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02:14:38 Q 32 / 100
Mock blueprint — FRCEM SBA
Cardiovascular emergencies 14
Resuscitation & trauma 12
Paediatric emergencies 10
Toxicology & envenomation 8
Anatomy, physiology, pharmacology 10
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MRCEM Primary, MRCEM SBA or FRCEM SBA All modules and lessons, plus every exam and assessment Exam question bank and timed mocks
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Timed mock exams Per-unit assessments Unlimited timed mocks
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SLO1 - Exam · SBA Sample SBA · Live from the question bank
A 44-year-old man presents with a thunderclap headache that began during sexual intercourse 90 minutes ago. GCS is 15, BP 168/94 mmHg, HR 82, no focal neurology. Non-contrast CT head performed within two hours of symptom onset is reported as normal by the radiologist. What is the most appropriate next step in management?
Explanation
Worked answer

A normal CT head within six hours of thunderclap headache onset has a sensitivity approaching 98-99% for SAH when interpreted by an experienced radiologist (Perry et al., BMJ 2011; NICE Headache guideline NG12, 2021). However, a single negative CT does not exclude SAH. The Ottawa SAH Rule identifies high-risk features - including thunderclap onset and onset during exertion or sexual activity - that mandate further investigation regardless of CT result. Lumbar puncture (LP) performed at least 12 hours after headache onset remains the appropriate next step to detect xanthochromia by spectrophotometry, which distinguishes true SAH from a traumatic tap. CT angiography is not the immediate next step when LP has not yet been performed, as it would not exclude minor SAH without blood visible on CT.

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Overall score +6%
78%
across 412 questions
412 attempts Last 30 days
Performance by category Last 30 days
  • Cardiovascular
    84%
  • Resuscitation & trauma
    72%
  • Toxicology
    58%
  • Paediatric emergencies
    52%
  • Anatomy & physiology
    41%
Trend Last 10 sessions
78% latest score · up from 52% ten sessions ago
Suggested next
  • 41%
    Anatomy & physiology 23 unanswered questions in upper limb anatomy
  • 52%
    Paediatric emergencies Septic child, bronchiolitis, paediatric trauma
  • 58%
    Toxicology Paracetamol, TCAs, lithium, salicylate
OSCE library

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Dr Moussa Issa
From the founder
I sat the MRCEM and FRCEM. I built this for the doctors sitting them next. Lessons that teach the way doctors think. Questions that read like real ED handovers. OSCEs that mirror the actual stations. Pitched at the level the exam demands, written by people who have been on both sides of it.
Dr Moussa Issa Consultant in Emergency Medicine, PhD candidate, Lancaster University
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Yes. Every module maps directly to the current RCEM curriculum, with cross-references back to the official syllabus. We update content within four weeks of any RCEM blueprint change.

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The exam bank is timed, single-best-answer, RCEM-style for mock practice. The assessment bank sits at the end of each unit and is graded for progress tracking. Every plan unlocks one course: an SBA plan does not include the OSCE course of the same exam, which has its own plan.

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