ALS Lecture 6 - Cubital Fossa, Forearm and Wrist DONE Flashcards
location of cubital fossa
anterior to elbow joint
floor of cubital fossa
brachialis
roof of cubital fossa
skin, superficial fascia, aponeurosis of biceps brachii
lateral border of cubital fossa
brachioradialis
medial border of cubital fossa
pronator teres
superior border of cubital fossa
medial epicondyle, line between epicondyles
label all 4 diagrams of cubital fossa
done
on top of cubital fossa roof lies
median cubital vein
median cubital vein connects
cephalic and basilic veins
label the 2 diagrams of veins/nerves/arteries of cubital fossa
done
why is median cubital vein above cubital fossa important?
lot of venepuncture here
why is median cubital fossa good for venepuncture?
vessels and nerves in cubital fossa below are protected by bicipital aponeurosis
elbow fractures must be taken seriously as they can damage or compress
vessels/nerves in cubital fossa
compartments of forearm
anterior, posterior
anterior compartment of forearm contains
flexors of forearm
anterior compartment of forearm supplied by
median and ulnar nerves
label cadaver diagram of compartments of forearm
done
anterior compartment of forearm is split into 3 layers:
superficial, intermediate, deep
medial epicondyle known as
common flexor origin as flexors of forearm all start there
label the 2 diagrams of the superficial layer of the anterior flexor compartment
done
muscles in superficial layer of anterior flexor compartment
pronator teres, flexor carpi radialis, flexor carpi ulnaris, palmaris longus
flexor carpi radialis goes to
radial side carpals
flexor carpi ulnaris goes to
ulnar side carpals
palmaris longus
vestigial muscle, may be absent
muscles in intermediate layer of anterior flexor compartment
flexor digitorum superficialis
point of origin of flexor digitorum superficialis
2 points, medial epicondyle and radius
at the wrist, the flexor digitorum supeficialis
splits into tendons, pass under flexor retinaculum
posterior compartment of forearm contains
extensors
posterior compartment of forearm supplied by
radial nerve
muscles in deep layer of anterior flexor compartment
flexor digitorum profundus, flexor pollicis longus, pronator quadratus
flexor digitorum profundus
deep flexor of digit, tendons insert to base of distal phalanx of each finger
flexor pollicis longus
long flexor of thumb, tendon inserts into base of distal phalanx of thumb
pronator quadratus
pronates when contracts, pulls radius over ulna
pronator quadratus is responsible for
pronation
flexor pollicis longus is responsible for
flexion of thumb
flexor digitorum profundus is responsible for
flexion of digits
flexor digitorum superficialis is responsible for
flexion of digits
flexor digitorum superficialis attaches to
base of middle phalanx of each finger
flexor digitorum profundus attaches to
base of distal phalanx of each finger
flexor policis longus attaches to
base of distal phalanx of thumb
posterior compartment of forearm split into
superficial, deep
label the diagram of the intermediate layer of the anterior flexor compartment
done
label the 2 diagrams of the deep layer of the anterior flexor compartment
done
muscles in superficial layer of posterior extensor compartment
extensor carpi radialis, extensor carpi ulnaris, extensor digitorum, extensor digiti minimi
posterior compartment of forearm contains
extensors
lateral epicondyle is known as
common extensor origin
extensor carpi radialis
goes to radial side carpals
extensor carpi ulnaris
goes to ulnar side carpals
extensor digitorum and extensor digiti minimi
large muscle, tendons go to most digits and to some digits twice
label the diagram of the superficial layer of the posterior compartment of the forearm
done
muscles in deep layer of posterior extensor compartment
abductor pollicis longus, extensor pollicis brevis, extensor pollicis longus, extensor indicis
label the diagram of the deep layer of the posterior compartment of the forearm
done
muscles in posterior deep layer tend to originate from
posterior forearm bones
demonstrate and check wrist flexion
done
demonstrate and check wrist extension
done
demonstrate and check wrist abduction
done
wrist abduction is also known as
radial deviation
demonstrate and check wrist adduction
done
wrist adduction is also known as
ulnar deviation
label the pictures of wrist movements
done
pronators of the forearm
pronator teres, pronator quadratus
pronator teres
common flexor origin to radius, pulls radius over ulnar
pronator quadratus
distal end of radius and ulna (horizontal), pulls radius over ulna
supinators of the forearm
supinator, extensor indicis
supinator
common extensor origin to back of radius
label the diagram of the pronators
done
label the diagram of the supinators
done
label the diagrams of the wrist bones
done
name the wrist bones, in a circle starting at the bottom and going clockwise
lunate, scaphoid, trapezium, trapezoid, capitate, hamate, pisiform, triquetrum
ligament on lateral side of wrist
radial collateral ligament
ligament on medial side of wrist
ulnar collateral ligament
ligament separates radius and ulna
articular disc
main joint between wrist and forearm is between
scaphoid, lunate, triquetrum, radius
when we pronate our hand we bring our _____ over our _____
radius over ulna
label the diagrams of supination and pronation
done
label the tendons of the finger diagram
done
superficialis tendon is from
flexor digitorum superficialis
superficialis tendon lies ____ profundus tendon
above
profundus tendon is from
flexor digitorum profundus
superficialis tendon _____ as it comes into finger
splits
superficialis tendon inserts into
either side of base of middle phalanx
in between the split of the superficialis tendon passes the
profundus tendon
profundus tendon inserts into
base of distal phalanx
flexor digitorum profundus action
flexes distal phalanx at DIP joint
why can’t you just flex the end of your finger (distal phalanx), without flexing the rest?
flexor digitorum profundus passes over other phalanges
to test just the profundus tendon
hold rest of finger still, get pt to flex end
flexor digitorum superficialis action
flexes middle phalanx at PIP joint
to test just the superficialis tendon we
pull other digits back to stretch profundus, then flex digit being tested at PIP joint
extensor digitorum location
superficial layer of posterior compartment (extensor) of forearm
extensor digitorum sends a tendon to
4 fingers
tendons of extensor digitorum pass over the
back of wrist, under extensor retinaculum
extensor digitorum tendons splits to insert in 2 places…
base of middle phalanx, either side of base of distal phalanx
extensor digitorum controls 2 joints, the
proximal and distal interphalangeal
test extensor appartus of fingers by
push down on finger and ask pt to extend it
look at diagram of extensor digitorum tendons
done
where is the carpal tunnel between?
base of thumb and little finger
_____ lies over carpal bones, forming carpal tunnel
aponeurosis
through the carpal tunnel passes
tendons and nerves of hand
median nerve supplies sensation to
palm, base of thumb
tinging in palm, weakness in thumb
carpal tunnel syndrome
carpal tunnel syndrome can be due to
swelling making carpal tunnel tight
to help carpal tunnel syndrome we can
cutting aponeurosis
label the diagrams of the carpal tunnel
done
anatomical snuff box location
base of thumb (dorsal side, towards index finger)
scaphoid fractures often occur
falling on outstretched hand
scaphoid fractures are important as
blood supply to scaphoid may be impaired so will necrose
pressing on anatomical snuff box will cause _____ in the event of ______
pain, scaphoid fracture
head of the radius is held against humerus and ulna by the
annular ligament
in children, radial head can easily be pulled out of annular ligament because
annular ligament and radius not properly formed
label the diagram of scaphoid fracture
done
label the diagrams of the elbow
done
vessels of flexor (anterior) compartment
brachial artery, radial and ulnar arteries
brachial artery course and splits
enters cubital fossa, splits into radial and ulnar arteries as it leaves
ulnar artery stays close to
ulnar nerve
median nerve continues down
middle of forearm, under flexor retinaculum to middle of wrist and hand
radial artery passes down
radial wrist
injuries to the ____ side of the wrist are more ____
ulnar, serious
injuries to the ulnar side of the wrist are more serious because
ulnar nerve and artery run so close so if artery is cut nerve very likely to be damaged
label diagrams of forearm vessels/nerves
done
nerves that innervate the flexor (anterior) compartment of the forearm
median, ulnar
nerve that innervates the extensor (posterior) compartment of the forearm
radial
median nerve supplies
pronator teres, flexor carpi radialis, palmaris longus, flexor digitorum superficialis, flexor pollicis longus, pronator quadratus and half of flexor digitorum profundus
median nerve supplies all of the flexor muscles of the forearm except
flexor carpi ulnaris, half of flexor digitorum profundus
ulnar nerve supplies
flexor carpi ulnaris, half of flexor digitorum profundus
nerve that innervates the extensor (posterior) compartment
radial
radial nerve innervates
all of posterior muscles of the forearm
if we see a pin on the posterior aspect of the forearm, it is innervated by the
radial nerve
