Flashcards
Forearm and Hand
Cards in this deck (98)
- 1Which bone can be felt at the base of hypothenar eminence medially? Which tendon terminates here?Pisiform bone
Flexor carpi ulnaris - 2Which muscle becomes prominent laterally along the forearm when the elbow is flexed against resistance?Brachioradialis
- 3Name the tendons on the front of the wrist from lateral to medial side.Flexor carpi radialis
Palamaris longus
Flexor carpi ulnaris - 4What does the proximal transverse crease mark?Wrist joint
- 5What does the distal transverse crease mark?Flexor retinaculum
- 6Where does the median nerve lie in the wrist?Along the lateral edge of palamaris longus
- 7Name the components of the anterior compartment of forearm.Eight muscles- 5 superficial (flexor carpi radialis, flexor carpi ulnaris, palmaris longus, pronator teres, flexor digitorum superficialis), 3 deep (flexor digitorum profundus, flexor pollicis longus and pronator quadratus)
2 arteries- radial and ulnar
3 nerves- median, ulnar, radial - 8What is the common flexor origin?All the superficial flexor muscles have a common origin from the front of the medial epicondyle of the humerus
- 9Where does the median nerve exits the cubital fossa?From between the two heads of pronator teres
- 10Pronator teres- Origin, insertion, nerve supple and actionOrigin-
Big head- Medial epicondyle of the humerus
Small head- Coronoid process of the ulna
Insertion-
Middle of the shaft of radius
Nerve Supply-
Median nerve
Action-
Pronator of the forearm - 11What muscle passes through a separate deep compartment of flexor retinaculum?Flexor carpi radialis
- 12Flexor carpi radialis- origin, insertion, nerve supple and actionOrigin-
Medial epicondyle of the humerus
Insertion-
Base of second and third metacarpal
Nerve Supply-
Median nerve
Action-
Flexes and abducts arm at wrist joint
- 13Which is the vestigeal muscle of the forearm?Palmaris longus
- 14Palmar aponeurosis is formed byPalmaris longus muscle
- 15Which tendon lies superficial to the flexor retinaculum?Palmaris longus
- 16Palmaris longus- origin, insertion, nerve supply and actionOrigin-
Medial epicondyle
Insertion-
Flexor retinaculum and palmar aponeurosis
Nerve supply-
Median nerve
Action-
Flexes wrist joint
- 17Flexor carpi ulnaris- origin, insertion, nerve supply, actionOrigin-
Humeral head- Medial epicondyle
Ulnar head- Medial aspect of olecranon process and posterior border of the ulna
Insertion- Pisiform bone; prolonged to the hook of the hamate and base of fifth metacarpal bone
Nerve supply-
Median nerve
Action-
Flexes middle phalynx, proximal phalynx and wrist joint
- 18How many heads does the flexor digitorum superficialis have? Name them2- humeroulnar and radial heads
- 19How are the two heads of flexor digitorum superficialis joined?Fibrous Arch
- 20Which vessel and nerve pass down the fibrous arch of flexor digitorum superficialis?Median nerve and ulnar artery
- 21Flexor digitorum superficialis- origin, insertion, nerve supply and actionOrigin-
Humeroulnar head- medial epicondyle and medial border of coronoid process of ulna
Radial head- Anterior oblique line of shaft of radius
Insertion-
divides into 4 tendons, each of which divide into two slip which are inserted on the side of the middle phalanx of 2nd to 5th digits
Nerve supply- Ulnar nerve
Action-
Flexes middle phalanx of fingers and proximal phalanx and wrist joint - 22Which is the most powerful and bulky muscle of the forearm?Flexor digitorum profundus
- 23Write a short note on Flexor Digitorum Profundus.1) It is the most powerful and bulky muscle of the forearm. It forms the elevation of the forearm at the posterior surface medial to the subcutaneous border of ulna.
2)Provides the main gripping power of the hand
3)Supplied by 2 nerves- hybrid muscle - 24Where are the anterior interosseous nerve and vessels located on interosseous membrane?On its anterior surface between flexor digitorum profundus and flexor pollicis longus
- 25What is the other name of ulnar bursa?Common flexor synovial sheath
- 26What does the ulnar bursa enclose? Where is it located?The common flexor synovial sheath encloses the tendons of flexor digitorum superficialis and flexor digitorum profundus.
The ulnar bursa passes deep to the flexor retinaculum. It extends proximally into the forearm upwards for 5 cm and downwards into palm up to middle of shafts of metacarpal bones. It is continuous with the synovial sheath of the little finger. - 27What is the location of radial bursa?Superiorly it is coextensive with the ulnar bursa. Inferiorly it extends up to the distal phalanx of the thumb
- 28Radial sheath is also known asSynovial sheath of the tendon of flexor pollicis longus
- 29What is the digital synovial sheath?Digital synovial sheaths enclose the flexor tendons in the fingers and line the fibrous flexor sheaths.
- 30Flexor digitorum profundus- origin, insertion, nerve supply and actionOrigin-
Upper three-fourths of the anterior and medial surface of the shaft of ulna
Upper 3/4th of posterior border of ulna
Medial surface of coronoid process and olecranon process
adjoining part of the anterior surface of interosseous membrane
Insertion-
4 tendons for the medial 4 digits that pass deep to flexor retinaculum in ulnar bursa and digital synovial sheaths
Opposite to the proximal phalanx, then tendons perforate the tendons of flexor digitorum superficiali. Inserted on the base of distal phalanx
Nerve supply-
Medial half- ulnar nerve
Lateral half- anterior interosseous nerve
Actions-
Flexes distal phalanges, other joints of fingers and wrist
Chief gripping muscle - 31Flexor pollicis longus- origin, insertion, nerve supply and actionOrigin-
Upper 3/4th of the anterior surface of the shaft of radius
Adjoining part of the anterior surface of the interosseous membrane
Insertion-
The tendon passes deep to the flexor retinaculum and is inserted in the distal phalanx of the thumb
Nerve supply-
Anterior interosseous nerve
Actions-
Flexes the distal phalanx of the thumb - 32Pronator quadratus- origin, insertion, nerve supply and actionOrigin-
Oblique ridge on the lower 1/4th surface of the shaft of ulna and the area medial to it
Insertion-
superficial fibers- lower 1/4th of anterior surface and anterior border of radius
deep fibers- Triangular area above the ulnar notch
Nerve supply- Anterior interosseous nerve
Action-
Superficial fibers pronate the forearm
Deep fibers bind the lower end of radius and ulna - 33Radial artery arises fromBrachial artery in the cubital fossa
- 34Describe the course of the radial arteryThe radial artery is the smaller branch of the brachial artery in the cubital fossa. It goes downwards with a lateral convexity. It turns posteriorly and enters the anatomical snuffbox.
- 35What are the relations of the radial artery?Anteriorly-
upper part- brachioradialis
lower part- skin and fascia
Posteriorly- Pronator quadratus, flexor digitorum superficialis, flexor pollicis longus, biceps brachii (msc. attached to radius)
Medially-
Upper part- pronator teres
lower part: tendons of flexi carpi radialis
Laterally-Brachioradialis
radial nerve- middle 1/3 - 36Name the branches of the radial artery.1) Radial recurrent artery
2) Muscular branches
3) Palmaris carpal branches
4) Dorsal carpal branches
5) Superficial palmar branch - 37Differentiate between palmar carpal branch and dorsal carpal branch of the radial artery.Palmar carpal branch- arises near the lower border of pronator quadratus, medially deep to flexor tendons and anastomoses with the palmar carpal branch of ulnar artery- cruciform anastomoses
Dorsal carpal branch- Forms dorsal carpal arch with dorsal carpal branch of ulnar artery. - 38Which branch of radial artery passes through the thenar muscles?Superficial palmar branch
- 39Describe the course of ulnar artery.It runs obliquely from the cubital fossa and medially in the upper 1/3rd of the forearm; vertical in lower 2/3rd
- 40How is the ulnar artery present in relation to the flexor retinaculum?It passes superficial to the flexor retinaculum
- 41Describe the relations of ulnar artery.Anteriorly:
Upper half- muscles arising from common flexor origin and median nerve
Lower half- skin and fascia
Posteriorly- lies on brachialis and flexor digitorum profundus
Laterally- related to flexor digitorum
Medially- Related to ulnar nerve and flexor carpi ulnaris - 42Name the branches of the ulnar artery.1) The anterior and posterior ulnar recurrent artery
2)Common interosseous artery
3) Muscular branches
4) Palmar carpal branch
5) dorsal carpal branch - 43Draw a contemporary between the branches of recurrent branches of radial and ulnar artery.The radial recurrent artery and ulnar recurrent artery:
The radial recurrent artery arises below the elbow and anastomoses with the radial collateral artery in front of the lateral epicondyle. The Ulnar recurrent artery anastomoses around the elbow- the anterior ulnar recurrent with the inferior ulnar collateral in front of the medial epicondyle, the posterior ulnar recurrent with the superior ulnar collateral artery behind the medial epicondyle - 44Describe the common interosseous artery.Common interosseous artery is the branch of the ulnar artery which arises just below the radial tuberosity. It reaches the interosseous membrane from behind and divides into anterior and posterior interosseous arteries.
Anterior interosseous artery- deepest artery, accompanies anterior interosseous nerve. Descends on the interosseous membrane between flexor digitorum profundus and flexor pollicis longus. Enters extensor compartment through upper border of the membrane.
Posterior interosseous artery- gives interosseous recurrent artery, runs up and anastomoses with the middle collateral artery behind the lateral epicondyle. - 45Which branches of ulnar artery anastomose around wrist joint? Describe them.Palmar carpal and dorsal carpal branches
Palmar carpal branch forms the palmar carpal arch.
Dorsal carpal branch above the pisiform bone winds back to the tendons and forms the dorsal carpal arch. - 46Which is the main nerve of the forearm?Median nerve
- 47Which nerve supplies the thenar eminence muscles?Median nerve
- 48Which nerve is known as the laborer's nerve? Why?Median nerve
It controls coarse movements of the hand and supplies most long muscle of forearm. - 49Which is the medial most content of the cubital fossa?Median nerve
- 50Describe the course of the median nerve.1)Lies medial to the brachial artery. Enters the forearm through cubital fossa to lie between flexor digitorum superficialis and flexor digitorum profundus
2) In the wrist it lies deep and lateral to palmaris longus tendon.
3)Passes deep to flexor retinaculum to enter the palm. - 51What are the relations of the median nerve? (In cubital fossa, beginning of forearm, forearm, wrist)In cubital fossa-
medial to the brachial artery
behind bicipital aponeurosis
in front of brachialis
Enters the forearm by passing between the two heads of pronator teres . Crosses the ulnar artery and is separated from it by deep head of pronator teres.
Passes beneath the fibrous arch of flexor digitorum superficialis, runs on the surface of flexor digitorum profundus accompanied by median artery.
5 cm above the flexor retinaculum it becomes superficial and lies between the tendons of flexor carpi radialis and flexor digitorum superficialis, overlapped by tendon of palmaris longus.
Passes deep to flexor retinaculum - 52Name the branches of the median nerve.Muscular branches
Anterior interosseous branch
Palmar cutaneous branch
Articular branches
Vascular branches
Communicating branch - 53Which structures does the anterior interosseous nerve supply?Flexor digitorum profundus (lower part)
Flexor pollicis longus
Pronator quadratus
Distal radioulnar and wrist joints - 54Where does the palmar cutaneous branch of median nerve arise? What does it supply?It arises a little above flexor retinaculum, lies superficially and supplies the skin over thenar eminence and central part of the palm.
- 55What do the articular branches, vascular branches and communicating branch of median nerve supply/communicate with?Articular branches- elbow joint and proximal radioulnar joint
Vascular branches- radial and ulnar arteries
Communicating branch- Ulnar nerve - 56Which nerve is known as musician's nerve? Why?Ulnar nerve; controls fine movt. of fingers
- 57Describe the course of ulnar nerve?It lies behind the medial epicondyle and enters the forearm by passing between the two heads of flexor carpi ulnaris to lie along lateral border of flexor carpi ulnaris.
It courses superficial to flexor retinaculum to enter the palm - 58Explain the relations of ulnar nerve (elbow, forearm, wrist)Elbow- behind medial epicondyle
Forearm- runs on the medial part of flexor digitorum profundus muscle
Wrist- Lies between flexor carpi ulnaris and flexor digitorum profundus. Passes superficial to flexor retinaculum to enter the palm lateral to the pisiform bone - 59Name the branches of the ulnar nerve.Muscular branches
Palmar cutaneous branch
Dorsal cutaneous branch
Articular branch
Branches in palm - 60What does the palmar cutaneous branch of the ulnar nerve supply? Where does it arise?Skin over hypothenar eminence; middle of forearm
- 61Where does the dorsal cutaneous branch of ulnar nerve arise? What does it supply?Arises 7. cm above the wrist, winds backwards and supplies proximal parts of medial two and a half digits and the adjoining area of the dorsum of the hand.
- 62Give the course of the radial nerve.Divides into two terminal branches in cubital fossa below the lateral epicondyle.
- 63What are the branches of the radial nerve?Deep terminal branch/ posterior interosseous nerve
Superficial terminal branch (main cont.) - 64Give the course of the superficial terminal branch of the radial artery and the structures it supplies.It runs down the front of the forearm.
Upper 1/3rd of forearm- separated from radial artery
Middle 1/3rd- close to the radial artery
Lower 1/3rd- passes backwards under the tendon of brachiaradialis to the anatomical snuffbox.
It is distributed to :
-lateral half of dorsum of hand
-proximal parts of dorsal surface of thumb, index finger and lateral half of middle finger - 65What is palmar aponeurosis?Deep fascia of palm
- 66What makes the skin of the palm firm?Its attachment to palmar aponeurosis.
- 67Name the subcutaneous muscle on the palm. What is its function?Palmaris brevis, helps in improving grip by steadying skin on ulnar side.
- 68What structures are formed by deep fascia of the wrist and hand?Wrist- flexor retinaculum
Palm- Palmar aponeurosis
Fingers- fibrous flexor sheaths - 69What is the flexor retinaculum?It is a fibrous band on the wrist which bridges the anterior concavity of the carpal to form the carpal tunnel.
- 70Give the attachments of flexor retinaculum.Medially-
Pisiform bone and hook of hamate
Superficial slip- pisiform bone
Laterally-
Tubercle of scaphoid and crest of trapezium
Deep slip- attached to medial lip of groove on trapezium - 71What passes within the lateral deep slip of flexor retinaculum?Tendon of flexor carpi radialis
- 72What passes deep to medial superficial lip of flexor retinaculum?Ulnar vessels and nerves
- 73What is the other name of medial superficial lip of flexor retinaculum?Volar carpal ligament
- 74Give the relations of flexor retinaculum.Superficial relations-
1)Palmar cutaneous branch of median nerve
2)Palmar cutaneous branch of ulnar nerve
3)Tendon of palmaris longus
4)Ulnar vessels
5)Ulnar nerve
Deep relations-
1)Median nerve
2)4 tendons of flexor digitorum superficialis
3)4 tendons of flexor digitorum profundus
4)Ulnar bursa
5) Radial bursa
6) Tendon of n n Flexor carpi radialis - 75What structures are covered by palmar aponeurosis?Superficial palmar arch, long flexor tendons, terminal part of median nerve and superficial branch of ulnar nerve
- 76Describe the features of palmar aponeurosis.1) It is triangular in shape
Apex- proximal, blends with flexor retinaculum and is continuous with the tendons of palmaris longus.
Base- distal
2)Divides into superficial and deep strata. The superficial is attached to the dermis. Deep strata divides into 4 flips opp the heads of the metacarpals of medial four digits. One slip divides into two parts continuous with the fibrous flexor sheaths.
3)Extensions pass to deep transverse metacarpal ligament, capsule of metacarpophalangeal joints and sides of base of proximal phalanx. - 77Describe the structure of fibrous flexor sheath of the fingers.It is thick and arched.
Attaches to the sides of yu hthe phalanges and across the base of the distal phalanx. Proximally it is continuous with the palmar aponeurosis.
A blind osseofascial tunnel is formed enclosing the long flexor tendons in the digital synovial sheath. - 78What is Dupuytren's contracture?Cause- Inflammation of ulnar side of palmar aponeurosis. Thickening and contraction of the aponeurosis.
Proximal and later middle phalanx of become flexed. Ring finger is most commonly involved. - 79Name the intrinsic muscles of the hand.Total- 20 muscles
1) a. Thenar muscles- Abductor pollicis brevis, flexor pollicis brevis, opponens pollicis
b. Adductor of thumb- Adductor pollicis
2)Hypothenar muscles- Palmaris brevis, abductor digiti minimi, flexor digiti minimi, opponens digiti minimi
3)Four Lumbricals
4) Four palmar interossei
5) Four dorsal interossei - 80Abductor pollicis brevis- origin, insertion, nerve supply and actionOrigin- tubercle of scaphoid, crest of trapezium, flexor retinaculum
Insertion- Base of proximal phalanx of thumb
Nerve supply- Median nerve
Action- Abduction of thumb - 81Flexor pollicis brevis- origin, insertion, nerve supply and actionOrigin- Flexor retinaculum, crest of trapezium, capitate bone
Insertion- Base of proximal phalanx of thumb
Nerve supply-Median nerve
Action- Flexes metacarpophalangeal joint of thumb - 82Opponens pollicis- origin, insertion, action and nerve supplyOrigin- Flexor retinaculum, crest of trapezium
Insertion- Lateral half of shaft of the metacarpal bone of thumb
Nerve supply- Median nerve
Action- Pulls thumb medially and forward across palm - 83Adductor pollicis -origin, insertion, nerve supply and actionOrigin-
oblique head- Bases of 2nd and 3rd metacarpals
transverse head- shaft of 3rd metacarpal
Insertion- Base of proximal phalanx of the thumb(medial aspect)
Nerve supply- Deep branch of ulnar nerve
Action- Adduction of thumb - 84Palmaris brevis- origin, insertion, nerve supply and actionOrigin- flexor retinaculum
Insertion-Skin of the palm
Nerve supply- Superficial branch of the ulnar nerve
Action-Improves grip by wrinkling skin - 85Abductor digiti minimi- origin, insertion, nerve supply, actionOrigin- Pisiform bone
Insertion-Base of proximal phalanx of little finger
Nerve supply- Deep branch of Ulnar nerve
Action- abducts the little finger - 86Flexor digiti minimi- origin, insertion, action and nerve supplyOrigin-Flexor retinaculum
Insertion- Base of proximal phalanx of little finger
Nerve supply- Deep branch of ulnar nerve
Action- Flexes the little finger - 87Opponens digiti minimi- origin, insertion, nerve supply, actionOrigin- Flexor retinaculum
Insertion- Medial border of the 5th metacarpal bone
Nerve supply- Deep branch of ulnar nerve
Action- Pulls the little finger(cupping motion) - 88Lumbricals- Origin, insertion, nerve supply and actionOrigin-
1- Lateral side of tendon of flexor digitorum profundus of 2nd digit
2- Lateral side of same tendon of 3rd digit
3- Adjacent sides of same tendon of 3rd and 4th digit
4- Adjacent side of same tendon of 4th and 5th digit
Insertion- Via extensor, expansion into dorsum of distal phalanx
Nerve supply- Lateral 2- median nerve
medial 2- ulnar nerve
action- Flex the metacarpophalangeal joints, extend interphalangeal joints of 2nd to 5th digits - 89Palmar interossei- origin, insertion, nerve supply and actionOrigin-
1- Medial side of base of 1st metacarpal
2-Medial border of shaft of 2nd metacarpal
3-Lateral border of shaft of 4th metacarpal
4th- lateral border of shaft of 5th metacarpal
Insertion-
1- Medial side of base of proximal phalanx of first digit
2, 3, 4- Via extensor expansion into dorsum of the bases of distal phalanges of 2nd, 4th and 5th digits
Nerve supply- Deep branch of ulnar nerve
Action- Adduct fingers towards 3rd digit. Flex metacarpophalangeal joints and extend interphalangeal joints - 90Dorsal interossei- origin, insertion, nerve supply, actionOrigin- adjacent sides of the shafts of the two metacarpals they are in between
Insertion-Via extensor expansion into the dorsum of the distal phalanges of 2nd, 3rd, 3rd and 4th digits
Nerve supply-Deep branch of ulnar nerve
Action- Abduct fingers from center of third digit. Flex metacarpophalangeal joints and extend interphalangeal joints] - 91How is the superficial palmar arch formed?It is formed by anastomosis between the superficial palmar branch of the ulnar and radial artery.
- 92Describe the relations of the superficial palmar arch.Lies deep to palmaris brevis and palmar aponeurosis. Crosses palm over flexor digiti minimi,flexor tendons, lumbricals and digital branch of median nerve
- 93What are the branches of the superficial palmar arch?Three common digital and one proper digital branches supplying 3 and a half digits. Lateral three are joined by palmar metacarpal arteries from deep palmar arch.
- 94Give the course of the radial artery in the hand.Runs obliquely downward and backward deep to the tendons of abductor pollicis lungus, extensor pollicis brevis and extensor pollicis longus, superficial to the lateral ligament of wrist and through the anatomical snuffbox. Then passes forward to reach first interosseous space and into the palm.
- 95Give the relations of radial artery.1) It leaves forearm by winding backward round the wrist.
2)It passes through the anatomical snuffbox where it lies deep to tendons of abductor pollicis longus, extensor pollicis longus and extensor pollicis brevis. It is superficial to the lateral ligament of the wrist joint.
3) Reaches the proximal end of the first interosseous space and between the two heads of first dorsal interosseous muscle to reach the palm.
4) In the palm it runs medially. It lies deep to oblique head f the adductor pollicis and then passes between the two heads of this muscle to form deep palmar arch. - 96Which is the main nerve of the hand?Ulnar nerve
- 97Give the course of the ulnar nerve.The ulnar nerve lies superficial to the flexor retinaculum, covered by the slip of volar carpal ligament. It divides into a superficial and deep branch.
Superficial branch-cutaneous
Deep branch- through muscles of hypothenar eminence, ends in adductor pollicis. - 98—
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- MBBS Anatomy Flashcards on Forearm and Hand, created by La La Land on 06/04/2021.
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