ANAT: Upper Limb (Forearm) Flashcards
what are A, B, C and D?
- A = lateral supracondylar ridge
- B = radial fossa (lateral)
- C = capitulum (lateral, articulates w/ head of radius)
- D = trochlea (medial, articulates w/ ulna)
what are E, F, G, H and I?
- E = medial supracondylar ridge
- F = coronoid fossa (medial)
- G = medial epicondyle
- H = olecranon fossa
- I = lateral epicondyle
what are A, B, C and D?
- A = coronoid process (articulates w/ coronoid fossa on humerus)
- B = trochlear notch (articulates w/ trochlea on humerus)
- C = olecranon process (articulates w/ olecranon fossa on humerus)
- D = radial notch of the ulna (PROXIMAL RADIOULNAR JOINT)
what are E, F, G and H?
- E = radial head (articulates w/ capitulum of humerus which is lateral to trochlea)
- F = radial tuberosity (distal insertion of biceps)
- G = ulnar tuberosity (insertion of brachialis)
- H = ulnar notch of the radius (forms DISTAL radioulnar joint)
what is I?
- I = styloid process (one radial, one ulnar)
- NB ulnar head is DISTAL
describe the articulations of the elbow joint
- CRazy TUlips
- capitulum of humerus goes with the head of the radius (lateral) - humeroradial
- trochlea of humerus goes with the trochlear notch of the ulna (medial) - humeroulnar joint
- (also the proximal radioulnar joint, but technically not part of the elbow as it allows for pronation and supination, not flexion and extension)
where are the bursae of the elbow?
- olecranon (subcutaneous) bursa
- bicipitoradial bursa (b/n biceps tendon and radial tuberosity)
- intratendinous bursa (in triceps brachii tendon)
- subtendinous bursa (b/n olecranon process and triceps brachii tendon)
which 2 ligaments support the elbow joint?
- radial collateral
- ulnar collateral
- help prevent medial/lateral dislocation
anatomical snuffbox borders
- medial: tendon of EPL
- lateral: tendon of abductor pollicis longus and EPB
- proximal: radial styloid process
- floor: scaphoid + trapezium
contents of anatomical snuffbox
- radial artery
- superficial branch of radial nerve
- cephalic vein
innervation of the elbow joint
- musculocutaneous nerve (sensory via lateral cutaneous nerve of forearm)
- radial nerve
- ulnar nerve
- median nerve
what is A?
- where is its origin?
- what are the 2 heads?
- what nerve runs through it?
- what movements is it responsible for?
- pronator teres (most superficial anterior layer)
- origin: medial supracondylar ridge
- has a superficial and deep head
- innervation: median nerve
- elbow flexion and pronation
what is B?
- where is its origin?
- where is its insertion?
- what is its innervation?
- what movements is it responsible for?
- flexor carpi radialis (most superficial anterior layer)
- origin: medial epicondyle
- insertion: base of 2nd and 3rd metacarpal
- innervation: median nerve
- movements: wrist flexion and lateral (radial) deviation of the wrist
what is C?
- where is its origin?
- where is its insertion?
- what is its innervation?
- what movement is it responsible for?
- palmaris longus (most superficial anterior layer)
- origin: medial epicondyle
- insertion: palmar aponeurosis
- innervation: median nerve
- movement: wrist flexion
what is D?
- where is its origin?
- where is its insertion?
- what is its innervation?
- what movements is it responsible for?
- flexor carpi ulnaris (most superficial anterior layer)
- origin: medial epicondyle
- insertion: base of 5th metacarpal
- innervation: ulnar nerve
- movement: wrist flexion and medial (ulnar) deviation of the wrist
what is this muscle?
- where are its origins?
- where are its insertions?
- what is its innervation?
- what movements is it responsible for?
- flexor digitorum superficialis (intermediate anterior layer)
- origins: distal humeral head, ulnar head, radial head
- insertions: base of middle phalanges (splits into Y shape to allow another tendon to pass thru)
- innervation: median nerve
- movements: wrist flexion, flexion of digits 2-5 @ PIP and MCP joints
what is A?
- what is its innervation?
- what movements is it responsible for?
- flexor pollicis longus (deep anterior layer)
- innervation: median nerve
- movements: thumb flexion @ IP and MCP joints
what is B?
- what is its origin?
- what is its insertion?
- what is its innervation?
- what movements is it responsible for?
- flexor digitorum profundus (deep anterior layer)
- origin: interosseous membrane (between radius and ulna) on the ulna
- insertion: base of distal phalanges 2-5
- innervation: median n. (lateral half) and ulnar n. (medial half)
- movements: flexion of wrist and flexion of digits @ MCP, PIPs and DIPs
what is this muscle and what is its innervation and function?
- pronator quadratus (deep anterior layer)
- median n.
- pronation
what is A?
- what is its origin?
- what is its insertion?
- what is its innervation?
- what movements is it responsible for?
- brachioradialis (superficial posterior layer)
- origin: lateral supracondylar ridge
- insertion: styloid process of radius
- innervation: radial nerve
- movement: elbow flexion
what is B?
- what is its origin?
- what is its insertion?
- what is its innervation?
- what movements is it responsible for?
- extensor carpi radialis longus (superficial posterior layer)
- origin: lateral epicondyle
- insertion: base of 2nd metacarpal
- innervation: radial nerve
- movements: wrist extension and radial (lateral) deviation of the wrist
what is C?
- what is its origin?
- what is its insertion?
- what is its innervation?
- what movements is it responsible for?
- extensor carpi radialis brevis (superficial posterior layer)
- origin: lateral epicondyle
- insertion: base of 3rd metacarpal
- innervation: radial nerve
- movements: wrist extension and radial (lateral) deviation
what is D?
- what is its origin?
- what is its insertion?
- what is its innervation?
- what movements is it responsible for?
- extensor carpi ulnaris (superficial posterior layer)
- origin: lateral epicondyle
- insertion: base of 5th metacarpal
- innervation: radial nerve (posterior interosseous nerve - deep branch)
- movement: wrist extension and ulnar deviation
what is E?
- what is its origin?
- what is its innervation?
- what is its function?
- anconeus (superficial posterior layer)
- origin: lateral epicondyle
- innervation: radial nerve
- function: ulnar stability during elbow movement
what is A?
- what is its origin?
- what is its insertion?
- what is its innervation?
- what movements is it responsible for?
- extensor digiti minimi (superficial posterior layer)
- origin: lateral epicondyle
- insertion: tip of 5th phalanx
- innervation: radial nerve (posterior interosseous n)
- movement: wrist extension + extension of 5th digit @ MCP, PIP and DIP joints
what is B?
- what is its origin?
- what is its insertions?
- what is its innervation?
- what movements is it responsible for?
- extensor digitorum (superficial posterior layer)
- origin: lateral epicondyle
- insertions: tip of phalanges 2-4 and tip of 5th metacarpal
- innervation: radial nerve (posterior interosseous n)
- movement: extension of digits 2-5 at MCP, PIP and DIP joints
what is A?
- what is its innervation?
- what movement is it responsible for?
- supinator (deep + superficial head - deep posterior layer)
- innervation: radial nerve (posterior interosseous nerve)
- movement: supination
what is B?
- what is its insertion?
- what is its innervation?
- what movement is it responsible for?
- abductor pollicis longus (deep posterior layer)
- insertion: base of 1st DISTAL phalanx
- innervation: radial nerve (posterior interosseous nerve)
- movement: thumb abduction
what is C?
- what is its insertion?
- what is its innervation?
- what movement is it responsible for?
- extensor pollicis brevis (deep posterior layer)
- insertion: base of 1st PROXIMAL phalanx
- innervation: radial nerve (posterior interosseous nerve)
- movement: thumb extension
what is D?
- what is its insertion?
- what is its innervation?
- what movement is it responsible for?
- extensor pollicis longus (deep posterior layer)
- insertion: base of 1st DISTAL phalanx
- innervation: radial nerve (posterior interosseous nerve)
- movement: thumb extension
what is E?
- what is its insertion?
- what is its innervation?
- what movement is it responsible for?
- extensor indicis (deep posterior layer)
- insertion: distal 2nd phalanx
- innervation: radial nerve (posterior interosseous nerve)
- movement: index finger extension
what are A, B and C?
- A = carpometacarpal joints
- B = midcarpal joints (plane/gliding joint)
- C = radiocarpal joints
during pronation, what is the fulcrum/pivot point?
- articular disc (cartilage): triangular in shape
- attaches to radius and ulnar styloid
what are A, B, C and D?
- A = scaphoid
- B = lunate
- C = triquetrium
- D = pisiform
(Straight Line To Pinky - from lateral to medial)
what are E, F, G and H?
- E = trapezium
- F = trapezoid
- G = capitate
- H = hamate
- Here Comes The Thumb (from medial to lateral)
what are A, B and C?
- A = radial collateral ligament (from radius to carpals)
- B = palmar radiocarpal ligament
- C = palmar ulnar carpal ligament
what are D, E and F?
- D AND F = ulnar collateral ligament (from ulna to carpals)
- E = dorsal radiocarpal ligament
what are A, B and C?
- A = flexor digitorum superficialis tendons
- B = flexor carpi radialis tendon
- C = tendon sheath to allow gliding and prevent friction
what are D and E?
- D = flexor digitorum profundus tendons
- E = flexor pollicis longus tendon
borders of the cubital fossa
- superior: imaginary line b/n medial and lateral epicondyles
- lateral: brachioradialis
- medial: pronator teres
- roof: skin
- floor: brachialis + supinator
contents of the cubital fossa
- radial nerve
- median nerve
- biceps tendon
- brachial artery
- median cubital vein
what are A, B, C and D?
- A = brachioradialis
- B = basilic vein
- C = cephalic vein
- D = median antebrachial vein
what are E, F, G, H?
- E = supinator
- F = superficial branch of radial nerve
- G = deep branch of radial nerve
- H = biceps tendon (attaches to radial tuberosity)
what are I, J, K, L and M?
- I = brachial artery
- J = radial artery
- K = ulnar artery
- L = median nerve
- M = ulnar nerve
what is A?
- what is its origin?
- what is its insertion?
- what is its innervation?
- what movements is it responsible for?
- abductor digiti minimi (palmar)
- origin: pisiform carpal
- insertion: base of proximal 5th phalanx
- innervation: ulnar nerve
- movement: abduction of 5th finger
what is B?
- what is its origin?
- what is its insertion?
- what is its innervation?
- what movements is it responsible for?
- flexor digiti minimi (palmar)
- origin: hamate carpal
- insertion: 5th metacarpophalangeal joint
- innervation: ulnar nerve
- movement: flexion of 5th finger
what is C?
- what is its origin?
- what is its insertions?
- what is its innervation?
- what movements is it responsible for?
- flexor pollicis brevis (palmar)
- origin: trapezium carpal
- insertion: base of proximal 1st phalanx
- innervation: median nerve
- movement: thumb flexion @ MCP joint
what is D?
- what is its innervation?
- what movements is it responsible for?
- abductor pollicis brevis (palmar)
- innervation: median nerve
- movement: thumb abduction
what are A, B and C?
- what is their function and innervation?
- A = opponens digiti minimi (palmar): opposition of 5th finger (ulnar n.)
- B = adductor pollicis (palmar): adduction of thumb (ulnar n.)
- C = opponens pollicis (palmar): thumb opposition (median n.)
what are these muscles?
- what is their innervation
- lumbricals (palmar)
- arise from FDP tendons - begin anteriorly and then insert around the back of the fingers to become extensors
- innervation: median nerve (2-3) and ulnar nerve (4-5)
- movement: MCP flexion of digits 2-5 and extension @ the IP joints
what are these muscles and what is their function?
- left: palmar interossei (adduction - PAD)
- right: dorsal interossei (abduction - DAB)
label all components
- A = radial artery
- B = ulnar artery
- C = posterior interosseous vessel
- D = anterior interosseous vessel
- E = radial/deep palmar arch
- F = superficial palmar arch (from ulna)
main cause of pain in anatomical snuffbox
- scaphoid fracture, usually caused by FOOSH > avascular necrosis
what 3 muscles make up the thenar eminence and what nerve innervates them
- flexor pollicis brevis, abductor pollicis brevis, opponens pollicis
- lateral - on the palmar surface of the thumb
- innervated by median nerve
monteggia and galeazzi fractures
- monteggia (A for proximal): proximal ulnar shaft fracture leading to anterior dislocation of radial head, usually from posterior force on ulna
- galeazzi (Z for distal): fracture of distal third of radius > causes ulna to dislocate at the distal radioulnar joint, usually from trauma to distal end of radius.
- “mugger”: MU = Monteggia Ulna and GR = galeazzi = radius
colles and smith’s fractures
- colles: posterior displacement of distal radius, from FOOSH > can cause median nerve damage
- smith’s: ANTERIOR displacement of distal radius > from falling on flexed wrist (opposite of FOOSH)
describe the general innervation of the forearm
- anterior compartment: median nerve
- posterior compartment: radial nerve
- hand: ulnar (medially), radial and median nerve
2 types of epicondylitis
- medial: golfer’s elbow (pronation and wrist flexion): flexor carpi ulnaris and pronator teres
- lateral: tennis elbow (supination and wrist extension) - extensor carpi radialis
student’s elbow
- olecranon bursitis
- presentation: pain, swelling, redness
what 4 muscles make up the hypothenar eminence and what nerve are they innervated by
- abductor digiti minimi
- flexor digiti minimi brevis
- opponens digiti minimi
- palmaris brevis
- medial - on the palmar surface of the pinky finger
- innervated by ulnar nerve
what is carpal tunnel syndrome
- impingement of the median nerve which can cause numbness and tingling
- can cause thenar atrophy
- positive tinel and phalen’s signs
describe the proximal and distal radioulnar joints
- proximal: radial notch of ulna articulates with radial head
- distal: ulnar notch of radius articulates with ulnar head (has a weak capsule to allow for pronation and supination)
- both are pivot joints which allow for pronation and supination
contents of the carpal tunnel
- median nerve
- 1x FPL tendon, 4x FDP tendon, 4x FDS tendon
guyon’s canal
- passageway in the anteromedial portion of the wrist for the ulnar n. and a.
flowchart of anterior forearm muscles
flowchart of posterior forearm muscles
flowchart of hand muscles
an injury to which carpal bone is most likely to result in median nerve compression and hence carpal tunnel syndrome?
- lunate
which carpal doesn’t participate in the wrist joint?
- pisiform
does radial or ulnar deviation have more ROM? why?
- ulnar
- b/c radial styloid gets in the way and prevents radial deviation
what type of joint is the MCP joint?
- hinge
describe the sensory innervation of the hand
- DORSAL: medial 1.5 digits (ulnar), lateral 3.5 digits (RADIAL) EXCEPT FINGERTIPS (MEDIAN)
- PALMAR: medial 1.5 digits (ulnar), lateral 3.5 digits (median)
which nerve innervates palmaris brevis?
- ulnar n.
sign of benediction vs claw hand
- benediction: normal flexion of 4-5 digits but can’t flex 1-3 (median nerve damage)
- claw: hyperextension of MCP joints 4-5 and normal 1-3 (ulnar nerve damage)
does the radial or ulnar a. contribute more to the superficial palmar arch?
- ulnar
