Karteikarten
Session 3: Forearm
Karten in diesem Stapel (53)
- 1Name the 4 muscles in the superficial layer of the anterior forearmPronator teres, Palmaris longus, flexor carpi radialis, flexor carpi ulnaris
- 2Pronator TeresFunction: pronates forearm.
Supplied by median nerve.
Arises from CFO (medial epicondyle humerus) and the distal part of the supracondylar ridge of the humerus.
Deep origin - medial aspect of the coronoid process of the ulna.
Origin: Inserts into the maximum convexity of the radius at the midpoint of the lateral aspect of the bone.
Nerve supply: median nerve passes between the two heads of the muscle, while the ulnar artery lies deep to both heads. The radial artery passes over its tendon of insertion. - 3Flexor carpii radialisFunction: wrist flexor, wrist abductor.
Supplied by median nerve.
Origin: arises from CFO and inserts into the bases of the second and third metacarpals.
Tendons: does not run in the carpal tunnel but in a separate compartment, lying in a groove in the trapezium.
It also assists in stabilising the wrist during powerful finger movements. - 4Palmaris longusFunction: wrist flexor, tenses the palmar fascia.
Nerve supply: median nerve.
Origin: arises from the CFO and inserts into the palmar aponeurosis.
Tendon: superficial tendon which is adherent to the flexor retinaculum.
Not always present. - 5Flexor carpii ulnarisFunction: wrist flexor, wrist adductor.
Nerve supply: ulnar nerve (lies posterior to the medial epicondyle, between its two heads).
Origin: arises from CFO and the medial margin of the olecranon process of the ulna. Aponeurosis that attaches to the upper two-thirds of the subcutaneous border of the ulna.
Tendon = attached to the pisiform, a sesamoid bone, with extensions to the hamate and the fifth metacarpal via the pisohamate and pisometacarpal ligaments respectively.
There is also an attachment to the anterior aspect of the flexor retinaculum. - 6Name the 1 intermediate muscle of the anterior forearmFlexor digitorum superficialis
- 7Flexor digitorum superficialisFunction: weak flexor elbow, strong flexor wrist and fingers.
Nerve supply: median nerve.
Origin: 2 heads - humero-ulnar head arises from the anterior aspect of the medial epicondyle via the CFO, the coronoid process of the ulna, and the ulnar collateral ligament of the elbow joint.
There is also an extended origin from the radius.
Tendons: 4 tendons run in a common sheath through the carpal tunnel.
Over the proximal phalanx, each tendon divides into two slips (the decussation), allow the tendon of FDP to pass through. The slips of each tendon then insert into radial and ulnar aspects of the base of the middle phalanx. - 8Name the 3 muscles that make up the deep layer of the anterior forearmFlexor digitorum profundus, flexor pollicis longus, pronator quadratus
- 9Flexor digitorum profundusFunction: mainly flexion of the distal interphalangeal joints, and flexion of the proximal interphalangeal joints, the metacarpophalangeal joints, and the wrist.
Nerve supply: median nerve (anterior interosseous branch) for radial 2 fingers, ulnar nerve for ulnar 2 fingers.
Origin: arises from ulna & adjacent interosseous membrane.
Tendons: run deep in carpal tunnel to each of the 4 fingers, inserting into the base of the terminal phalanges beyond the decussation of the FDS tendon. - 10Flexor pollicis longusFunction: strong thumb flexor.
Nerve supply: anterior interosseous branch of the median nerve.
Origin: arises from anterior surface of the distal radius proximal to pronator quadratus. It passes through the carpal tunnel to insert into the base of the distal phalanx of the thumb. - 11Pronator quadratusFunction: pronates forearm, square shaped.
Nerve supply: terminal motor branch of the anterior interosseous branch of the median nerve.
Origin: arises from anterior surfaces of the distal radius and ulna. It is a flat muscle whose fibres run from medial to lateral rather than proximal to distal. - 12Name the 6 superficial muscles of the posterior forearmAnconeus, brachioradialis, extensor carpi radialis longus, extensor carpi radialis brevis, extensor digitorum communis, extensor digiti minimi, extensor carpi ulnaris
- 13AnconeusFunction: elbow extensor, pulls the ulna posterolaterally in pronation.
Nerve supply: radial nerve (via its branch to the medial head of triceps)
Triangular muscle
Origin: arises from posterior aspect of the lateral epicondyle, inserts onto lateral aspect of the proximal ulna. - 14BrachioradialisFunction: flexes elbow midway between supination and pronation.
Nerve supply: radial nerve.
Origin: arises from upper 2/3 lateral supracondylar ridge of the humerus and inserts into radial styloid process. - 15Extensor carpi radialis longusFunction: radial extensor of wrist. When acting with ECU, wrist is neutrally extended. While acting with FCR, wrist is pulled into radial deviation.
Nerve supply: radial nerve.
Origin: arise from distal 1/3 of the lateral supracondylar ridge.
Tendons: insert into bases of 2nd and 3rd metacarpals. - 16Extensor carpi radialis brevisFunction: radial extensor of wrist. With ECU= wrist is neutrally extended. With FCR = wrist is pulled into radial deviation.
Nerve supply: posterior interosseous branch radial nerve.
Origin: CEO.
Tendons: insert into bases of 2nd and 3rd metacarpals. - 17Extensor digitorum communisFunction: main extensor finger joints, wrist extension also.
Nerve supply: posterior interosseous nerve.
Origin: arises from CEO, inserts via 4 tendons which spread out onto the dorsum of the hand, passing to the index, middle, ring, and little fingers.
Tendons: run in a common compartment deep to the extensor retinaculum. As each tendon crosses the metacarpophalangeal joint, it forms a dorsal expansion which covers the proximal phalanx. This expansion is reinforced by the tendons of the corresponding interosseus and lumbrical muscles. Over the proximal interphalangeal joint, the tendon divides into three slips. The middle slip attaches to the base of the middle phalanx, while the outer two slips pass distally and reunite to attach to the base of the distal phalanx. - 18Extensor digiti minimiFunction: extends joints of little fingers.
Nerve supply: posterior interosseous nerve
Origin: arises from CEO, inserts into medial aspect of the dorsal expansion of the little finger. It supplements the extensor action of the EDC tendon to the little finger, which only joins EDM just proximal to the metacarpal head. - 19Extensor carpi ulnarisFunction: extends (with ECRL and ECRB) adducts (with FCU) hand at the wrist.
Nerve supply: posterior interosseous nerve.
Origin: arises from CEO, with an additional proximal attachment to the subcutaneous border of the ulna. It inserts into the base of the fifth metacarpal. - 20Name the 5 deep muscles of the posterior forearmSupinator, abductor pollicis longus, extensor pollicis brevis, extensor pollicis longus, extensor indicis
- 21SupinatorFunction: supinates radius (weaker than biceps brachii).
Nerve supply: posterior interosseous nerve runs dorsally between its oblique and transverse fibres.
Origin: supinator crest of the ulna and the area just distal to the radial notch. More oblique superficial fibres originate from the posterior aspect of the lateral epicondyle, as well as from the lateral and anular ligaments of the elbow. It inserts into the lateral aspect of the proximal shaft of the radius. - 22Abductor pollicis longusFunction: abducts and extends thumb metacarpal at carpometacarpal joint & abducts the hand at the wrist.
Origin: proximal part of the dorsum of the ulna, the interosseous membrane, and the dorsum of the mid-portion of the radius. It inserts into the lateral aspect of the base of the thumb metacarpal. - 23Extensor pollicis brevisFunction: extends thumb at metacarpophalangeal (MCP) and carpometacarpal (CMC) joints.
Origin: dorsum of the radius distal to AbPL, with an additional origin from the adjacent part of the interosseous membrane. It inserts into the base of the proximal phalanx of the thumb. - 24Extensor pollicis longusFunction: extends metacarpo- phalangeal and interphalangeal (IP) joints of thumb. Weak extensor of the wrist.
Origin: dorsum of ulna distal to AbPL, with an additional origin from the adjacent part of the interosseous membrane. Its long tendon winds around the dorsal (Lister’s) tubercle of the radius, changing its direction to reach the thumb. EPL inserts into the dorsum of the base of the terminal phalanx of the thumb. - 25Extensor indicisOrigin: posterior aspect of the ulna, distal to the thumb extensors, and from the interosseous membrane.
Tendon: runs in the same compartment as the EDC deep to the extensor retinaculum and crosses the EDC tendon to the index finger to lie on its medial (ulnar) side. It inserts into the dorsal expansion of the index finger. - 26What muscles make up the anatomical snuffbox?Extensor pollicis longus, extensor pollicis bravis, abductor pollicis longus.
- 27—1 = extensor pollicis longus.
2= extensor pollicis bravis.
3 = abductor pollicis longus.
D = first dorsal interosseous muscle
A = radial artery
T = trapzium
S = scaphoid - 28—1 = pronator teres
2 = flexor carpi radial
3 = palmaris longus
4 = flexor carpi ulnaris
5 = flexor digitorum superficialis
6 = pronator quadratus
7 = flexor pollicis longus
8 = flexor digitorum profundus
- 29—1 = abductor pollicis longus & extensor pollicis brevis
2 = extensor carpi radialis longus & brevis
3 = extensor pollicis longus
4 = 4 tendons of extensor digitorum communis, extensor indicis.
5 = extensor digiti minimi
6 = extensor carpi ulnaris
- 30Brachial arteryDivides into the radial and ulnar arteries. These run down the forearm and form the deep and superficial palmar arches in the hand respectively.
- 31Median nerveEnters the palm in the carpal tunnel deep to the flexor retinaculum.
Long flexors of the fingers and thumb also run through this narrow space. - 32Ulnar nervePosterior to medial epicondyle
Passes between the heads of flexor carpi ulnaris, and divides into superficial and deep palmar branches in the hand. - 33Name the 6 Clinical ApplicationsCarpal tunnel syndrome, rupture of the extensor pollicis longus tendon, De Quervain's synovitis, mallet finger, fracture of the scaphoid, tennis and golfers elbow.
- 34Carpal Tunnel SyndromeNerve entrapment syndrome caused by compression of the median nerve within the carpal tunnel.
Symptoms: pain and paraesthesia (tingling sensation) in the distribution of the median nerve, weakness of the muscles of the thenar eminence.
Treatment: night splints to prevent wrist flexion, steroid injections and ultimately surgery to divide the flexor retinaculum. - 35Rupture of the extensor pollicis longus tendonFractures of the distal radius = rupture of the tendon of extensor pollicis longus because of its association with the dorsal (Lister’s) tubercle.
Patients are unable to extend the interphalangeal joint of the thumb. - 36De Quervain's synovitisThickening of the synovial tendon sheaths of two tendons to the thumb, abductor pollicis longus and extensor pollicis brevis. Symptoms: pain, tenderness, and swelling over the radial side of the wrist, and difficulty gripping. Some consider this to be an overuse injury with repetitive movements of the thumb being a contributing factor.
Treatment: surgery may provide relief in severe cases, but there is a risk of injury to the sensory branches of the radial nerve. - 37Mallet fingerInability to extend distal interphalangeal (DIP) joint of the finger = injury to the insertion of the extensor digitorum communis tendon at the base of the distal phalanx.
This is a common sports injury, sustained when there is forced hyperflexion of the DIP joint.
Treatment: splinting the DIP joint in slight hyperextension. If this fails, surgery may be required to repair the ruptured tendon. - 38Fracture of the scaphoidA fracture at the waist of the scaphoid is a common fracture caused by a fall onto the outstretched hand.
Avascular necrosis (death of bone tissue) of the proximal fragment is a common complication, as the blood supply to the scaphoid goes from distal to proximal.
As the scaphoid is palpable on the floor of the anatomical snuffbox, patients presenting to the Accident Department with snuff box tenderness must be treated as a fracture. - 39Tennis and golfers elbowSymptoms: pain and tenderness over the common extensor origin, caused by overuse leading to a degenerative tear. Resisted wrist extension aggravates the pain.
Treatment: rest and/or steroid injections is effective in the majority of cases. Golfer’s elbow is a similar inflammatory condition affecting the medial epicondyle, where the forearm flexors attach. - 40—1 = hypothenar muscles
2 = ulnar artery
3 = ulnar nerve
4 = flexor carpi radialis
5 = flexor digitorum superficialis
6 = thenar muscles
7 = radial artery
8 = abductor pollicis longus
9 = radial nerve
10 = brachioradialis
11 = flexor carpi radialis
- 41—1 = medial epicondyle humerus
2 = bicipital aponeurosis
- 42—1 = flexor carpi radialis
2 = CFO
3 = pronator teres
4 = bifurcation of brachial artery
- 43—1 = flexor carpi ulnaris
2 = palmaris longus
3 = flexor carpi radialis
4 = radial artery
- 44—1 = flexor digitorum profundus
2 = flexor pollicis longus
- 45—1 = pronator quadratus
2 = flexor digitorum profundus
3 =flexor pollicis longus
4 = interosseous membrane
- 46—1 = brachioradialis
2 = extensor carpi radialis longus
3 = extensor carpi radialis brevis
- 47—1 = extensor carpi radialis longus
2 = extensor carpi radialis brevis
- 48—Extensor digitorum communis
- 49—1 = extensor digiti minimi
2 = tendons of the extensor digitorum communis
- 50—extensor carpi ulnaris
- 51—1 = extensor indicis
2 = extensor digiti minimi
3 = extensor digiti communi
4 = extensor indicis
5 = edc tendon to index finger
- 52—1 = extensor pollicis longus
2 = extensor pollicis brevis
3 = abductor pollicis longus
4 = extensor retinaculum
- 53—1 = palmar cutaneous branch of median nerve
2 = palmaris longus tendon
3 = ulnar artery
4 = ulnar nerve
5 = tendon of flexor carpi radialis
6 = tendon of flexor pollicis longus
7 = tendons flexor digitorum superficialis
8 = tendons flexor digitorum profundus
t = thenar eminence
T = trapezium
Td = trapezoid
C = capitate
H = hamate
h = hypothenar eminence
FR = flexor retinaculum
M = median nerve
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- Medicine (FAB) Karteikarten am Session 3: Forearm, erstellt von Elisha Bagg am 13/10/2018.
- Erstellt von
- Elisha Bagg
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