Anatomy of upper limb Flashcards
Glenohumeral joint
Shoulder joint - synovial ball and socket joint
Articulation between scapula (glenoid fossa) and proximal humerus
Elbow joint
Synovial hinge joint allowing flexion and extension of forearm
Articulation of distal humerus with radius and ulna
Proximal and distal radio-ulnar joints
Synovial joints allowing pronation and supination of forearm and hand
Radiocarpal joint
Synovial (wrist) joint formed by articulation between distal radius and 2 of the carpal bones
5 movements of scapula
Retraction
Protraction
Elevation
Depression
Rotation (tilts glenoid fossa aiding movement of upper limb)
Movement of:
Radioulnar joints
Pronation (palm down)
Supination (palm up)
Articulation of clavicle
Sternum at medial end (sternoclavicular joint)
Acromion of scapula at lateral end (acromioclavicular joint)
Ridge of posterior scapula separating infraspinatus fossa from supraspinatus fossa
Spine of scapula
What comprises the pectoral girdle?
Clavicle, scapula and attached muscles
Groove in head of humerus named…
Anatomical neck
Deltoid attachment and movement
Attaches to humerus (deltoid tuberosity - anterolateral) and to lateral part of clavicle and spine of scapula
Powerful abductor after the first 20degrees of abduction
Radial groove of humerus
Marks path radial nerve follows and runs over the posterior part of the upper humeral shaft
The 2 large superficial muscles of the posterior pectoral girdle
Trapezius
Latissimus Dorsi
Where does latissimus Dorsi attach to the upper limb
Proximal end of the anterior humerus
3 smaller, deeper muscles that attach medial scapula to vertebral column
Levator scapulae
Rhombus minor
Rhombus major
Which is the only muscle associated with posterior pectoral girdle doesn’t attach vertebral column to scapula?
Latissimus dorsi - attaches at vertebral column and proximal end of humerus
Innervation of trapezius
Accessory nerve (XI)
Latissimus dorsi innervation
Thoracodorsal nerve (branch of brachial plexus)
7 movements possible at shoulder joint
Flexion
Extension
Abduction
Adduction
Medial rotation
Lateral rotation
Circumduction
6 muscles attaching scapula to humerus
Deltoid
(S)upraspinatus (rotator cuff)
(I)nfraspinatus (rotator cuff)
(T)eres Minor (rotator cuff)
(S)ubscapularis (rotator cuff)
Teres Major
Innervation of deltoid
Axillary nerve (branch of brachial plexus)
Teres Major attachment
Arises from posterior scapula attaching to anterior humerus
What 3 rotator cuffs originate from posterior clavicle surface and insert onto greater tubercle of humerus?
Supraspinatus
Infraspinatus
Teres Minor
Which rotator cuff originates from anterior surface of scapula and inserts onto lesser tubercle of humerus?
Subscapularis
Olecranon
Part of the ulna that cups the lower end of the humerus to create a hinge joint
Quadrilateral space borders and its relevance
Teres minor above, teres major below
Long head of triceps medially and surgical neck of humerus laterally
Axillary nerve travels through this space to enter the posterior scapula region
Although there is a poor fit of articular surfaces in the shoulder, stability is maintained by…
-Contraction of rotator cuff muscles holding head of humerus in the glenoid cavity
-Rotator cuff tendons fuse with capsule of shoulder joint
-Glenoid labrum - rim of fibrocartilage surrounding margin of glenoid fossa deepening the shallow fossa
What separates the posterior and anterior compartments of the arm?
The lateral and medial intermuscular septa
Insertion point of triceps brachii
All 3 heads converge via a common tendon onto the olecranon of the ulna
Long head of triceps origin
Infraglenoid tubercle of scapula
Lateral head of triceps origin
Posterior humerus proximal to radial groove
Medial head of triceps origin
Posterior humerus distal to radial groove
All 3 parts of triceps innervated by…
Radial nerve (major terminal branch of brachial plexus)
Axillary nerve motor fibres inervate…
Deltoid
Teres Minor
Axillary nerve sensory fibres innervate…
Patch of skin over upper lateral arm
Shaft of humerus expands distally to form 2 bony prominences called the…
Distal to this, the humerus bears further prominences…
Medial and lateral epicondyles
Trochlea (medially) and capitellum (laterally) which articulate with trochlear notch of ulna and head of radius respectively at elbow
6 anatomical boundaries of the axilla
Anterior wall - pectoralis major and minor
Posterior wall - subscapularis, teres major and latissimus dorsi
Lateral wall - Upper humerus
Medial wall - serratus anterior and chest wall
Apex - 1st rib, clavicle and scapula
Base - skin and fascia between chest wall and arm
Axillary lymph nodes and what do they drain?
5 groups of lymph nodes that drain upper limb, chest wall, breast, scapular region and abdominal region as far as umbilicus
What nodes receive lymph from all other lymph nodes in the axilla?
The apical nodes
Axillary artery is the continuation of the… which travels under the … into the axilla
Subclavian artery which travels under the clavicle into the axilla
Axillary artery continues into the arm to become the brachial artery as it crosses the…
Inferior border of teres major
Axillary vein formed by union of…
What does the axillary vein then flow into?
Deep veins of the arm with the basilic vein
Runs alongside the axillary artery back into the subclavian veins
What is contained within the axilla?
Fat
Lymph nodes
Axillary artery
Axillary vein
Brachial plexus
Brachial Plexus and its originating nerves
Complex network of nerves that provide motor and sensory innervation of the upper limb
Formed by spinal nerves C5-8 and T1
Trunks of the brachial plexus
C5 and C6 combine to form SUPERIOR TRUNK
C7 continues as MIDDLE TRUNK
C8 and T1 combine to form INFERIOR TRUNK
(all trunks located in neck)
Divisions of the brachial plexus
Each trunk divides into an anterior and posterior division under the clavicle
Cords of brachial plexus
LATERAL CORD - anterior divisions of superior and middle trunks
POSTERIOR CORD - posterior divisions of all trunks combine
MEDIAL CORD - continuation of anterior division of inferior trunk
5 branches of brachial plexus (located in axilla)
AXILLARY - branch from posterior cord
RADIAL - continuation of posterior cord
MUSCULOCUTANEOUS - branch from the lateral cord
ULNAR - branch from medial cord
MEDIAN - formed by branches from the lateral and medial cords
Axillary nerve
Innervates deltoid and teres minor
And small region of skin over upper lateral arm
Branch of posterior cord
Runs close to surgical neck of humerus (vulnerable to surgical neck fractures)
Radial nerve
Innervates triceps, and all muscles in posterior forearm (extensors of wrist and digits)
Continuation of posterior cord
Runs along radial groove of posterior humerus (vulnerable to mid-shaft fractures)
Musculocutaneous nerve (what does it innervate? where does it arise from?)
Innervates the 3 anterior arm muscles (BBC- Biceps, Brachialis, Coracobrachialis)
Continues as sensory nerve innervating region of skin over forearm
Arises from lateral cord
Median nerve (what does it innervate? where does it arise from?)
Innervates most muscles in anterior forearm (flexors for wrist and digits)
Innervates skin in lateral aspect of the palm (thumb and next 2 fingers
Formed by contributions from medial and lateral cords
Where is the median nerve most vulnerable?
As it crosses the anterior elbow at the cubital fossa
Ulnar nerve
Innervates most small muscles in hand (fine movement of digits)
Innervates skin over medial aspect of palm (pinky and one next to it)
Its a continuation of the lateral cord
Where is the ulnar nerve most vulnerable?
Behind the medial epicondyle as its in a superficial position
Biceps brachii
Most superficial muscles in anterior arm
Long head - supraglenoid tubercle origin
Short head - apex of coracoid process of scapula
Insertion into deep fascia of forearm
Proximal attachments of biceps brachii
Long head - to the supraglenoid tubercle
Short head - to the coracoid process
2 muscle bellies of biceps brachii converge onto a common tendon attaching to…
The radial tuberosity on the radius
Bicep movement
Flexion of elbow
Flexion of shoulder joint
Supination of forearm when elbow is flexed
Brachialis attachments and movement
Proximally - Anterior aspect of lower shaft of humerus
Crosses elbow joint to attach:
Distally - Upon the ulna tuberosity
Flexor of elbow
Coracobrachialis attachments and movement
Proximally - coracoid process
Distally - medial aspect of mid-humerus
Acts upon shoulder joint as weak flexor
What is the Cubital fossa?
Triangular shaped region anterior to elbow joint
Contents of cubital fossa
Tendons of biceps brachii (can be palpated easily when elbow flexed)
Bicipital aponeurosis (extension of biceps tendon separating superficial veins from deeper structures)
Brachial artery (medial to biceps tendon and in the cubital fossa it bifurcates into radial and ulnar arteries)
Median nerve (medial to brachial artery travelling anteriorly)
Radial nerve (through lateral aspect of cubital fossa deep to brachioradialis)
Superficial veins (lie in subcutaneous tissue of cubital fossa and using for venepuncture - so mustn’t accidentally puncture brachial artery or median nerve
Origin and insertion of trapezius
Origin - skull, cervical and thoracic vertebrae
Insertion - Clavicle and scapula (spine and acromion)
Origin and insertion of latissimus dorsi
Origin - Lower thoracic vertebrae
Insertion - Humerus (upper anterior)
Origin and insertion of levator scapulae
Origin - Upper cervical vertebrae
Insertion - Medial scapula border
Origin and insertion of rhomboid minor
Origin - C7 and T1
Insertion - Medial scapula border
Origin and insertion of rhomboid major
Origin - Thoracic vertebrae
Insertion - Medial scapula border
How do rhomboid major and minor move the scapula?
Retracts
How does the trapezius move the scapula?
Upper part elevate
Middle part retracts
Lower part depresses
(rotates scapula)
Latissimus dorsi movement
Extends, adducts and medially rotates humerus
Deltoid action, origin from scapula, and insertion
Abduction beyond 20degrees
Spine and acromion (plus clavicle)
Deltoid tuberosity
Teres major action at shoulder joint, origin from scapula and insertion
Medial rotation and adduction
Posterior surface, inferior part of lateral border
Anterior humerus
Supraspinatus action at shoulder, origin from scapula and insertion
First 20degrees abduction
Supraspinous fossa
Greater tubercle - superior facet
Infraspinatus action at shoulder, origin from scapula and insertion
Lateral rotation
Infraspinous fossa
Greater tubercle - middle facet
Teres minor action at shoulder, origin from scapula and insertion
Lateral roation
Lateral scapula border
Greater tubercle - inferior facet
Subscapularis action at shoulder, origin form scapula and insertion
Medial rotation
Subscapular fossa
Lesser tubercle
What connects the radius and ulna?
Interosseous membrane
Attachment of radius to humerus
Radial head articulates with capitellum of humerus
Attachment of ulna to humerus
Trochlea notch of ulna articulates with trochlea of humerus
Articulations of radius with ulna
Proximal and distal radioulnar joints (allowing pronation and supination)
Distal articulation of radius
With scaphoid and lunate of proximal carpus forming the radiocarpal joint (wrist joint)
Movement of the radiocarpal/wrist joint
Flexion, extension, abduction, adduction
Carpus composition
8 small bones roughly arranged into 2 rows of 4 bones (1 proximal, 1 distal)
Proximal row of carpal bones from lateral to medial comprises…
Scaphoid, lunate, triquetral and pisiform (pisiform not a true carpal bone)
Distal row of carpal bones from lateral to medial comprises…
Trapezium (base of thumb)
Trapezoid
Capitate (central and largest carpal bone)
Hamate
The hook of the hamate
Anterior bony process of the hamate bone that can be palpated
Boundaries of cubital fossa
Brachioradialis laterally
Pronator teres medially
Superiorly - line drawn between medial and lateral epicondyles of humerus
Contents of cubital fossa
Biceps tendon
Median nerve
Brachial artery (bifurcating in fossa into radial and ulnar arteries)
Superficial veins
Muscles of the anterior compartment of the forearm are divided into…
Superficial, middle and deep layers
8 muscles
Most act as flexors of wrist/fingers/thumb
Most innervated by median nerve
Superficial muscle layer of anterior forearm from lateral to medial comprises… (4)
Pronator teres
Flexor carpi radialis
Palmaris longus
Flexor carpi ulnaris
Superficial muscles of anterior forearm attach proximally to…
Medial epicondyle of humerus
Action of pronator teres
Pronator of proximal radioulnar joint
Action of flexor carpi radialis (FCR)
Flexes and abducts the wrist inserting onto radial side of wrist (hence name)
Palmaris longus
Small muscle belly but long, thin, easily recognised tendon when present (not present in 15%)
Inserts into fascia of palm of hand
Role of flexor carpi ulnaris (FCU)
Flexes and adducts the wrist
Inserts onto ulnar side of wrist (hence name)
Exception to rule as it’s innervated by ulnar nerve not median nerve
Muscles in the middle layer of the anterior forearm
Just 1 muscle: Flexor digitorum superficialis (FDS)
Role of flexor digitorum superficialis (FDS)
Flexor of the digits (can deduce it’s 4 tendons travel beyond wrist and to fingers)
2 muscles the median nerve travels between in the anterior forearm
FDS and FDP
Muscles in deep layer of anterior compartment of forearm
Flexor digitorum profundus
Flexor pollicis longus
Pronator quadratus
Flexor digitorum profundus (FDP) position and role
Lies deep to FDS and also gives rise to 4 tendons travelling into fingers
Flexor of the digits
Innervation of FDP
Lateral half of muscle innervated by median nerve (gives rise to tendons travelling to index and middle fingers)
Medial half of muscle innervated by ulnar nerve (gives rise to tendons travelling to ring and little fingers)
Flexor pollicis longus (FPL) role
Flexes thumb
Pronator quadratus role
Lies over distal end of radius and ulnar pronating the distal radioulnar joint
All anterior forearm muscles innervated by…
Except from…
Median nerve
FCU and medial half of FDP which are innervated by ulnar nerve
Carpal tunnel is a narrow passageway at the wrist. What are it’s boundaries?
Floor and sides - carpal bones
Roof - Flexor retinaculum (fibrous band) which attaches to the scaphoid and trapezium laterally and hook of hamate and pisiform meidally
Tendons of anterior forearm muscles that travel through carpal tunnel to insert onto digits
FDS (4 tendons, digits 2-5)
FDP (4 tendons, digits 2-5)
FPL (1 tendon, 1st digit / thumb)
Which nerve passes through the carpal tunnel?
Median nerve
Bifurcation of brachial artery in cubital fossa into…
Radial artery - travels along lateral aspect of forearm
Ulnar artery - travels along medial aspect of forearm
Radial and ulnar arteries anastomose in palm to form…
Palmar arches
There are superficial and deep veins in upper limb which all ultimately drain into…
Axillary vein
2 important superficial veins of upper limb
Cephalic vein - courses laterally in forearm
Basilic vein - courses medially
Where and what connects the basilic and cephalic veins?
The median cubital vein connects the 2 in the cubital fossa
How are metacarpals (distal to carpus) numbered?
1-5 from lateral (thumb) to medial (little finger)
Phalanges
3 phalanges each finger (digits 2-5) and 2 phalanges in the thumb (digit 1)
3 phalanges of fingers named proximal, middle and distal
2 phalanges of thumb named proximal and distal
Carpometacarpal joints (CMCJs)
Lie between distal row of carpal bones and proximal parts of metacarpals
Metacarpophalangeal joints (MCPJs)
Lie between distal parts (heads) of metacarpals and proximal phalanges
Interphalangeal joints (IPJs)
Lie between phalanges (fingers have a proximal interphalangeal joint (PIP) and distal interphalangeal joint (DIP))
3 types of grip brought about by hand
Power grip - hold/squeeze objects tightly
Hook grip - carrying objects with handles (bags)
Precision grip - hold objects between pads of thumb and index finger (pen)
4 movements of fingers
Flexion
Extension
Abduction
Adduction
5 movements of thumb
Flexion
Extension
Abduction
Adduction
Opposition
3 Primary flexors of wrist and their insertion
Flexor carpi radialis (inserts onto 2nd metacarpal)
Flexor carpis ulnaris (inserts onto 5th metacarpal)
Palmaris longus (inserts into palmar fascia)
3 primary flexors of digits
Flexor digitorum superficialis (FDS)
Flexor digitorum profundus (FDP)
Flexor pollicis longus (FPL)
(they travel through carpal tunnel)
Tendon of FDS
Splits into 2 slips which insert either side of middle phalanx of digits 2-5 (flexes MCP and PIP joints of 2-5)
Tendon of FDP
Passes through slit in FDS tendon inserting onto palmar aspect of distal phalanx (2-5)
Flexes DIP, PIP and MCP joints of digits 2-5
Tendon of FPL
Inserts onto distal phalanx of thumb flexing IP joint of thumb (only muscle that can do so)
Flexor tendon sheaths (of the upper limb)
Fibrous sheaths enclosing long flexor tendons which maintain position of flexor tendons in midline of each finger
Within fibrous sheaths, tendons enclosed in…
A synovial sheath reducing friction and allowing tendons to slide freely within their fibrous sheath during flexion/extension
4 groups and 1 single intrinsic muscles of hand
Thenar eminence (3 muscles)
Hypothenar eminence (3 muscles)
Lumbricals (4 muscles)
Interossei (7 muscles)
Remaining muscle is a muscle of the thumb called adductor pollicis
Intrinsic muscles of the hand are innervated by…
Ulnar and median nerves
Thenar eminence
Fleshy mass on palm of hand at base of thumb containing 3 muscles:
Flexor pollicis bravis (FPB) - flexes thumb
Abductor pollicis brevis (APB) - abducts thumb
Opponens pollicis (OP) - opposes the thumb
(all innervated by recurrent branch of median nerve)
Flexor Pollicis Bravis (FPB) movement, insertion and innervation
Flexion
Proximal phalanx
Recurrent branch of median nerve
Abductor pollicis brevis (APB) movement, insertion and innervation
Abduction
Proximal phalanx (lateral aspect)
Recurrent branch of median nerve
Opponens pollicis (OP) movement, insertion and innervation
Opposition
1st metacarpal
Recurrent branch of median nerve
Recurrent branch of median nerve leaves the median nerve…
after the carpal tunnel
Adductor pollicis also moves the thumb but isn’t considered in the thenar eminence because…
Lies deep in palm, not in thenar eminence
Innervated by ulnar nerve
Attached to 3rd metacarpal pulling thumb towards palm
Hypothenar eminence
Fleshy mass on medial side of palm containing 3 muscles which act on little finger:
Flexor digiti minimi (FDM) - flexes little finger
Abductor digiti minimi (ADM) - abducts little finger
Opponens digiti minimi (ODM) - opposes little finger
(all innervated by deep branch of ulnar nerve)
Flexor digiti minimi (FDM) movement, insertion and innervation
Flexion
Proximal phalanx of little finger
Deep branch of ulnar nerve
Abductor digiti minimi (ADM) movement, insertion and innervation
Abduction
Proximal phalanx
Deep branch of ulnar nerve
Opponens digiti minimi (ODM) movement, insertion and innervation)
Oppositon
5th metacarpal
Deep branch of ulnar nerve
Lumbricals
4 (1 for each finger)
Arise from tendons of FDP and insert onto dorsal aspects of digits 2-5
They flex MCP joints and simultaneously extend IP joints
Innervation of Lumbricals
Lateral 2 (2 and 3) innervated by median nerve
Medial 2 (4 and 5) innervated by ulnar nerve
Interossei
Muscles attached to and lie between metacarpals inserting onto dorsal aspects of digits 2-5
3 palmar interosseous muscles (1-3) (adduction and contribution to extension at IP joints)
4 dorsal interosseous muscles (1-4) (abduction and contribution to extension at IP joints)
Movement of palmar interossei muscles
Adduction of the fingers (and contribution to extension at IP joints)
Movement of the dorsal interossei muscles
Abduction of the fingers (and contribution to extension at IP joints)
1st palmar interosseous arises from…
And inserts onto…
Arises from medial side of 2nd metacarpal
Inserts onto medial aspect of 2nd proximal phalanx
2nd palmar interosseous arises from…
Inserts onto…
Arises from lateral side of 4th metacarpal
Inserts onto lateral aspect of 4th proximal phalanx
3rd palmar interosseous arises from…
Inserts onto…
Arises from lateral side of 5th metacarpal
Inserts onto lateral aspect of 5th proximal phalanx
1st dorsal interosseous arises from…
Inserts onto…
Arises from medial side of 1st metacarpal and lateral side of 2nd metacarpal
Inserts onto lateral aspect of 2nd proximal phalanx
2nd dorsal interosseous arises from…
Inserts onto…
Arises from medial side of 2nd metacarpal and lateral side of 3rd metacarpal
Inserts onto medial aspect of 3rd proximal phalanx
3rd dorsal interosseous arises from…
Inserts onto…
Arises from medial side of 3rd metacarpal and lateral side of 4th metacarpal
Inserts onto medial aspect of 3rd proximal phalanx
4th dorsal interosseous arises from…
Inserts onto…
Arises from medial side of 4th metacarpal and lateral side of 5th metacarpal
Inserts onto medial aspect of 4th proximal phalanx
Small muscles of the hand are only innervated by 2 nerves…
Median and Ulnar nerve
The radial nerve supplies no muscles in the hand
Structures that cross the wrist but superficial to flexor retinaculum (outside of the carpal tunnel)
Tendons of FCR, FCU and PL
Radial artery
Ulnar artery and ulnar nerve
Where is sensation tested for the median nerve?
Palmar surface of middle finger
Where is sensation tested for the ulnar nerve?
Medial border of hand
Where is sensation tested for radial nerve?
Dorsum of the hand, lateral aspect
What is a dermatome?
Region of skin innervated by a single spinal nerve
Testing dermatomes of C5 in the upper limb
Upper lateral arm
Testing dermatomes of C6 in upper limb
Thumb
Testing dermatomes of C7 in upper limb
Middle Finger
Testing dermatomes of C8 in upper limb
Medial border of hand
Testing dermatomes of T1 in upper limb
Medial border of arm
2 arteries supplying the hand
Radial and ulnar arteries
Palpating radial artery
Lateral aspect of wrist
Palpating ulnar artery
Medial aspect of wrist (may be partially covered by tendon of FCU making it harder to palpate than radial pulse)
Radial and ulnar arteries anastomose deep in palm to form 2 palmar arches…
Superficial palmar arch - formed largely by ulnar artery with small contribution from radial
Deep palmar arch - formed largely by radial with small contribution from ulnar
(arches give rise to metacarpal and digital arteries)
3 general statements about muscles of posterior forearm
Arranged in 2 layers - superficial and deep
Mostly extensors of wrist, digits, thumb
All innervated by radial nerve
6 superficial muscles of posterior forearm from lateral to medial
Brachioradialis
Extensor carpi radialis longus
Extensor carpi radialis brevis
Extensor digitorum
Extensor digiti minimi
Extensor carpi ulnaris
Common extensor origin
Lateral epicondyle of humerus
Brachioradialis
Lies on boundary between posterior and anterior compartments
Originates from humerus, proximal to lateral epicondyle
Inserts on distal radius
Acts as weak flexor of elbow (acts as anterior compartment muscle but innervated by radial nerve)
Extensor carpi radialis longus (ECRL) insertion and action
2nd metacarpal
Extend and abduct wrist
Extensor carpi radialis brevis (ECRB) insertion
3rd metacarpal
Extend and abduct wrist
Extensor digitorum (ED) insertion and action
Extends the digits via 4 long tendons that insert onto dorsal aspects of fingers
Tendons connected by fibrous bands making it difficult to fully extend the middle or ring fingers independently
Extensor digiti minimi (EDM) action and insertion
Extends little finger via insertion onto dorsum of little finger
Extensor carpi ulnaris (ECU) action and insertion
Extends and adducts wrist via insertion onto 5th metacarpal
Most medial of superficial muscles
Tendons of the posterior forearm travel under what through the wrist?
Extensor retinaculum
5 muscles of deep posterior forearm from lateral to medial
Supinator
Abductor pollicis longus
Extensor pollicis brevis
Extensor pollicis longus
Extensor indicis
Extensor Pollicis Brevis (EPB) action and insertion
Extends the MCP joint of the thumb by inserting onto the proximal phalanx of the thumb
Extensor pollicis longus (EPL) action and insertion
Extends the interphalangeal joint of the thumb by inserting onto distal phalanx
Extensor Indicis (EI) insertion and action
Inserts onto dorsum of index finger allowing independent extension of this digit
All posterior forearm muscles are extensors except for…(3)
Brachioradialis
Supinator
Abductor Pollicis Longus
Name of the superficial veins of the dorsum of the hand. What do these veins drain into?
Dorsal venous network
Drain into cephalic vein laterally and basilic vein medially
What are the extensor expansions?
Fibrous structures overlying dorsal aspect of the digits
Attaches to base of proximal phalanx giving rise to a central slip and 2 marginal slips
Central slip inserts on middle phalanx
Marginal slips converge on distal phalanx
Tendons of what muscles insert into dorsal aspect of extensor expansion?
Extensor Digitorum
Extensor Indicis
Extensor Digiti Minimi
Tendons of what muscles insert into the sides of the proximal parts of the extensor expansion?
Lumbricals
Insterossei
(via this attachment, they contribute to extension of IP joints in fingers)
What is the Anatomical Snuffbox (ASB)?
Triangular-shaped depression at lateral aspect of wrist seen when thumb is extended
Boundaries:
Tendon of EPL medially
Tendons of EPB and APL laterally
Superficial branch of radial nerve runs over ASB to supply skin over lateral aspect of dorsum of hand
Posterior compartment of forearm blood supply
Ulnar artery
A superficial branch of radial nerve innervates the skin over…
Lateral aspect of dorsum including skin over ASB and over dorsum of lateral 3.5 digits as far as DIP joint
The Shoulder Joint
Synovial ball and socket formed by articulation of glenoid fossa of scapula and head of humerus
The Elbow Joint
Synovial hinge joint formed by articulation between trochlea of humerus and trochlear notch of ulna, and capitellum of humerus and radial head
The Proximal and Distal Radioulnar Joints
Synovial, pivot-type joints between radius and ulna
Radius rotates around the ulna
Anular ligament of radius attaches to ulna holding radial head in place
Wrist Joint and Carpus
Condyloid synovial joint formed by articulation of distal radius with scaphoid and lunate
Joints of the Hand are all…
Synovial
First carpometacarpal (CMC) joint lies between…
Trapezium and 1st metacarpal
Saddle joint
Metacarpophalangeal Joints are…
Condyloid Joints
Interphalangeal Joints are…
Hinge joints
