Anterior compartment of forearm Flashcards
What are the superficial muscles in the anterior compartment of forearm?
- Pronator teres
- Flexor carpi radialis
- Palmaris longus
- Flexor digitorum superficialis
- Flexor carpi ulnaris
What are the deep muscles in the anterior compartment of forearm?
- Flexor digitorum profundus
- Flexor pollicis longus
- Pronator quadratus
What is the origin of trapezius muscle?
External occipital protuberance and superior nuchal line of the back of the skull – ligamentum nuchae – spine processes of all thoracic vertebra T1 to T12
What is the insertion of deltoid?
Deltoid tuberosity
Actions of teres major
Adduction & medial rotation of the humerus
Origin of supraspinatus
Supraspinous fossa scapula
Where does the blood supply to the hand come from?
- Superficial palmar arterial arch
- Deep palmar arterial arch
Where do finger flexor tendons lie?
Ulna bursae
Where do thumb flexor tendons lie?
Radial bursae
Where is the nerve supply to all the Intrinsic muscles of the hand from?
From the ulnar nerve (C8,T1)
What are the thenar muscles supplies by?
Median nerve
Where are constant creases present?
Where skin and superficial fatty layer bound to deep fibrous tissue
What is skin of palm bound to and why?
To deep fascia and thick to permit grasping
How can you remember the attachments of the flexor retinaculum?
STOP
- Scaphoid
- Trapezium
- HOck of hamate
- Pisiform
What does the flexor retinaculum form?
The fibro-osseous carpal tunnel
What does the osseo-fascial carpal tunnel cover?
10 tendons and a nerve
Name the tendons and nerve that the osseo-fascial carpal tunnel cover
- FDS - 4
- FDP - 4
- FCR - 1
- FPL1
- Median nerve
- The radial and ulna bursae
What is the flexor retinaculum crossed superficially by?
- Ulnar nerve & artery (Guyon’s tunnel)
- Palmar cutaneous branch of ulnar nerve
- Palmar cutaneous branch of median nerve
- Tendon of palmaris longus
- Superficial palmar branch of Radial Artery
What does the flexor retinaculum give attachment to superficially?
Thenar and hypothenar muscles
What attaches the palmar aponeurosis to underlying skin?
Fibrous septa
What is palmar aponeurosis in relation to thenar and hypothenar muscles?
Thin layer of deep fascia over thenar and hypothenar muscles.
What is the palmar aponeurosis?
A strong centrally placed triangular thickening of deep fascia
What does the palmar aponeurosis cover/
- Superficial palmar arch artery
- Long flexor tendons
What does the proximally point of triangle blend with?
Flexor retinaculum & gives attachment to PL
What are the fibrous flexor sheaths in continuity with?
With slips from the palmar aponeurosis
What do fibrosseous tunnels attach to?
To the sides of the phalanges arching over the flexor tendon sheaths
Where do fibrosseous tunnels extend from and to?
From base of proximal phalanx to base of the distal phalanx (all fingers and thumb)
What are the fibrous flexor tunnels strengthened by?
By additional annular and cruciate fibres (pulleys)
Where are annular pulleys placed?
Anterior to 1st MCP (A1), middle third proximal phalanx (A2), proximal interphalangeal joint (A3) and middle third of middle phalanx (A4)
What are in between fibrous flexor sheaths?
The cruciate pulleys (C1, C2, C3)
What do the cruciate pulleys consist of?
Weaker crossing fibres
How many annular pulley are in the thumb?
Two
Where are the annular pulleys of the thumb?
A1 anterior to the MCPJ and A2 pulley proximal to
the interphalangeal joint
Where is the oblique pulley of the thumb?
Over middle third proximal phalanx.
What do fibrous flexor sheaths, palmar aponeurosis and flexor retinaculum prevent?
Prevent bow-stringing of the
flexor tendons and therefore increase the effectiveness of the grip
What are the three thenar muscles?
OAF
- Opponens pollicis
- Abductor pollicis brevis
- Flexor pollicis brevis
What is the most superficial thenar muscle?
Abductor Policis Brevis
What is the nerve supply of the thenar muscles?
The recurrent branch of the median nerve
What is the nerve supply of the hypothenar muscles?
Deep branch of ulnar nerve
What are the hypothenar muscles?
OAF
- Opponens digiti minimi
- Abductor digiti minimi
- Flexor digiti minimi