0702 - Elbow, Wrist, hand Flashcards
What surface anatomy can be palpated at the Elbow?
Lateral epicondyle, Medial Epicondyle, olecranon, radial head.
What surface anatomy can be palpated at the Wrist?
Radial styloid
Lister’s tubercle
Ulna styloid
What 3 joints make up the elbow joint?
Ulno-humeral (hinge)
Radio-humeral (pronation)
Proximal radio-ulnar.
Not a simple hinge joint.
Where are the radial and ulnar heads? Radial tuberosity?
Radial head at proximal end, ulnar head at distal end (DON”T CONFUSE THEM)
Radial tuberosity at proximal end. Otherwise long, narrow shaft with ligaments in between.
What are the Digital bones?
Standard for fingers - Metacarpal, proximal, middle, distal phalanges.
Thumb - metacarpal and proximal and distal phalanges.
What are the Carpal bones?
8, divided into 2 rows.
Proximal row - Scaphoid, lunate, triquetrum, and pisiform (anterior to others with others, contained in a tendon).
Distal row - Trapezium, Trapezoid, Capitate, Hamate.
Why is the scaphoid important?
Central to wrist joint, critical for function. But limited, retrograde blood supply.
Fractures are difficult to diagnose and easily missed, but can develop avascular necrosis and arthritis if untreated.
Put patient in plaster if you don’t see a fracture and review in 2 weeks.
What are the ligaments of the elbow joint?
Medial, lateral, annular - They are tight, restrained, and complex (key message)
Most are attached to ulna, but blend into annular ligament, and attach into lateral side of ulna.
Medial - simple - attach from humerus to lateral. 3 bands - Anterior (strong), posterior (weaker), oblique (weakest).
What are the Ligaments of the forearm and wrist?
Interosseous membrane. Holds them in position.
Wrist has HEAPS. But 2 important - Scapholunate and triangular fibrocartilage (hold distal radius and ulna together).
What are the Ligaments of the fingers?
Co-lateral ligament on each side of each finger joint - names as radial or ulnar co-lateral ligament. As well as ligament for each to prevent hyperextension of ligament - volar plate (on palmar aspect).
What are the groups of muscles at the Elbow?
Are divided based on origin - common extensor or common flexor.
Common extensor - muscles arise from lateral epicondyle (tennis elbow)
Common flexor - muscles arise from medial epicondyle (golfer’s elbow)
What are the flexor muscles of the Forearm?
5 superficial muscles, 3 deep.
Superficial cross elbow (generally), Deep dont cross elbow.
Superficial - Pronator Teres, Flexor Carpi Radialis, Flexor digitorum superficialis, palmaris longus, flexor carpi ulnaris
Deep - Flexor digitorum profundus, flexor pollicis longus, pronator quadratus.
How many muscles are on the extensor (dorsal) forearm?
On back of forearm, 12 muscles.
First 2 - Anconeus And Supinator
Then 3 3’s
3 pass on radial border - brachioradialis, and extensor carpi radialis longus and brevis
3 from common extensor origin - Extensor digitorum communis, extensor digiti minimi, extensor carpi ulnaris
3 emerge between others - Abductor pollicis longus, extensor pollicis longus and brevis.
1 distally to forefinger - Extensor Indicis Proprius
How do the tendons of the fingers/forearm inter-relate?
Each finger has superficialis and profundus tendon - superficialis flexes PIP, profundus DIP. Profundus is a single muscle dividing into 4 tendons. Superficial is 4 independent muscles. If you hold back the other fingers and they can still flex it, then they’re using superficialis.
What is the Carpal tunnel?
Structure at volar aspect of wrist that contains 9 tendons + 1 nerve. The 4 profundus, the 4 superficialis of the fingers, and flexor pollicis longus. Also contains median nerve.
Pathology - if tendons thicken up for some reason, nerve gets impinged.
