Anterior forearm and wrist Flashcards

1
Q

what is the anterior compartment of the forearm responsible for

A

flexion of the wrist and digits and pronation

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2
Q

where is the common flexor origin

A

medial epicondyle of the humerus

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3
Q

what nerve supplies all but 2 muscles in the anterior compartment of the forearm

A

the median nerve

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4
Q

what 2 muscles does the median nerve not supply

A

flexor carpi ulnaris
ring/little finger side of flexor digitorum profundus

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5
Q

what nerve supplies flexor carpi ulnaris and ring/little finger side of flexor digitorum profundus

A

ulnar nerve

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6
Q

flexor carpi ulnaris lies ___ the ulnar nerve

A

above

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7
Q

ring and little finger side of flexor digitorum profundus lies ____ the ulnar nerve

A

directly below

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8
Q

what is the most superficial muscle in the forearm

A

palmaris longus

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9
Q

where does palmaris longus originate and insert

A

originates on medial epicondyle
inserts into and helps to tighten the palmar aponeurosis

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10
Q

how does the palmar aponeurosis aid grip

A

adheres to the skin of the palm above it and the muscles of the hand below it and so stops the skin sliding over the muscles

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11
Q

is palmaris longus necessary

A

no it is not an essential muscle and some individuals don’t have it or have unilateral presence of it

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12
Q

what nerve innervates palmaris longus

A

median nerve (C7,8)

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13
Q

function of palmaris longus

A

tighten aponeurosis
aids with wrist flexion

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14
Q

pronator teres has how many heads

A

2

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15
Q

what nerve passes between the 2 heads of pronator teres

A

median nerve

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16
Q

what does pronator teres do

A

pronation of forearm and assists in elbow flexion

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17
Q

if a muscle acts to move the radius during pronation where must it attach

A

radius

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18
Q

why would weak flexion of the elbow still be possible if the musculocutaneous nerve was damaged

A

the musculocutaneous nerve innervates brachialis - the main flexor of the elbowbut pronator teres also crosses the anterior aspect of the elbow and therefore assists in flexion - it is innervated by the median nerve therefore if damage occurs to one nerve the other will still work

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19
Q

what nerve innervates pronator teres

A

median nerve (C6,7)

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20
Q

what is the origin and insertion of pronator teres

A

medial epicondyle of humerus and coronoid process of ulna to the lateral surface of the radius

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21
Q

what is another word for wrist

A

carpus

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22
Q

what do flexor carpi ulnaris and radialis do

A

flex the wrist

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23
Q

flexor carpi ulnaris is on the ____ side of the forearm

A

medial (ulnar)

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24
Q

flexor carpi radialis is on the ____ side of the forearm

A

lateral (radial)

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25
Q

how is the wrist adducted (medial deviation)

A

if flexor carpi ulnaris and its counterpart in the extensor compartment of the forearm (extensor carpi ulnaris) both act on the wrist it will be adducted

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26
Q

how is the wrist abducted

A

if the flexor and extensors on the radial side both act on the wrist it will be abducted (lateral deviation)

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27
Q

what nerve innervates flexor carpi ulnaris

A

ulnar nerve (C7,8)

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28
Q

what nerve innervates flexor carpi radialis

A

median nerve (C6,7)

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29
Q

what is the function of flexor carpi ulnaris

A

flexion of wrist and adduction of wrist

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30
Q

what is the function of flexor carpi radialis

A

flexion of wrist and abduction of wrist

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31
Q

what is the origin and insertion of flexor carpi ulnaris

A

originates from medial epicondyle and inserts onto base pisiform, hamate and 5th metacarpal

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32
Q

what is the origin and insertion of flexor carpi radialis

A

originates from medial epicondyle and inserts onto base of 2nd metacarpal

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33
Q

what is the origin and insertion of flexor digitorum superficialis

A

originates on medial epicondyle of humerus and coronoid process of ulna and inserts on each side of middle phalange of digits 2-5 (not thumb)

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34
Q

what is the function of FDS

A

flexion of MCP and PIP joint and wrist

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35
Q

what is MCP

A

metacarpophalangeal

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36
Q

what is PIP

A

proximal interphalangeal

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37
Q

what nerve innervates FDS

A

median nerve (C7, C8, T1)

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38
Q

why can FDS not flex the DIP joint

A

it doesn’t cross the joint between the middle and distal phalanges

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39
Q

what is the origin and insertion of flexor digitorum profundus

A

ulna and interosseous membrane to distal phalanges digits 2-5 (palmar)

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40
Q

what is the function of FDP

A

flexion of MCP PIP and DIP of digits 2-5 and wrist

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41
Q

what is the innervation of FDP

A

ring and little fingers is ulnar nerve (C8, T1)
index and middle fingers = median nerve (C8, T1 - anterior interosseous branch)

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42
Q

FDP is superficial/deep

A

deep

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43
Q

the tendons of FDP/FDS split to attach onto either side of phalange

A

FDS
tendons of FDP do not split - attach on palmar surface

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44
Q

FDP is innervated by ____ on the medial side

A

ulnar nerve

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45
Q

FDP is innervated by ____ on the lateral side

A

median nerve

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46
Q

what branch of the median nerve supplies FDP

A

anterior interosseous branch

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47
Q

what is the origin and insertion of flexor pollicis longus

A

radius and interosseous membrane to base of digital phalanx of thumb (palmar)

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48
Q

what is the function of FPL

A

flexion of MCP and IP of thumb and flexion of wrist

49
Q

what nerve innervates FPL

A

median nerve (C8, T1 - anterior interosseous branch)

50
Q

how many phalanges does the thumb have

A

2

51
Q

what is the origin and insertion of pronator quadratus

A

distal anterior ulna to distal anterior radius

52
Q

what is the function of pronator quadratus

A

pronation and help to stabilise distal radioulnar joint

53
Q

what is the innervation of pronator quadratus

A

median nerve (C8, T1 anterior interosseous branch)

54
Q

what are the fibres of the median nerve

A

C6 - T1

55
Q

what cords supply the median nerve

A

medial and lateral cords

56
Q

the median nerve is the major nerve of what

A

anterior compartment of the forearm and thumb side of hand

57
Q

describe the course of the median nerve in the arm and forearm

A

forms from components of medial and lateral cords and descends through the arm to pass through the cubital fossa then passes between the heads of pronator teres in the anterior compartment of forearm where it forms the anterior interosseous branch before passing through the carpal tunnel and into the palmar surface of hand

58
Q

what nerve passes through the carpal tunnel

A

median nerve

59
Q

what anatomical spaces does the median nerve pass through

A

cubital fossa
carpal tunnel

60
Q

median nerve passes through the 2 heads of

A

pronator teres

61
Q

does the median nerve give sensory innervation

A

yes, gives off sensory branches to supply sensory innervation to parts of the palm

62
Q

what muscles does the median nerve supply in the hand

A

muscles in the thenar eminence of the hand and to the lateral 2 lumbricals

63
Q

describe the course of the anterior interosseous branch

A

runs along interosseous membrane to supply deeper muscles of the anterior forearm

64
Q

what fibres form the ulnar nerve

A

(C7)-T1 fibres

65
Q

what cords give rise to the ulnar nerve

A

medial cord

66
Q

the ulnar nerve runs along the ___ side of the arm

A

medial

67
Q

describe the course of the ulnar nerve from the arm to the forearm

A

passes along a groove in the medial epicondyle of the humerus to reach the anterior compartment of the forearm

68
Q

the ulnar nerve runs along the ___ side of the _____ compartment forearm

A

medial side of the anterior compartment of the forearm

69
Q

what 2 muscles does the ulnar nerve run between the anterior compartment of the forearm

A

flexor carpi ulnaris and the medial side of flexor digitorum profundus

70
Q

what muscles in the anterior compartment of the forearm does the ulnar nerve supply

A

flexor carpi ulnaris and medial side flexor digitorum profundus

71
Q

the ulnar nerve passes close to what bone to reach the palmar surface of the hand

A

pisiform

72
Q

does the ulnar nerve pass through the carpal tunnel

A

no

73
Q

what does the ulnar nerve supply in the hand

A

many of the intrinsic muscles of the hand and also sensory innervation to the ring and little fingers

74
Q

where is the ulnar artery formed

A

at or near the cubital fossa as a terminal branch of the branchial artery

75
Q

the ulnar artery runs down the ____ compartment of the forearm

A

anterior

76
Q

the ulnar artery runs into the hand with

A

the ulnar nerve

77
Q

the ulnar artery is the major contributor to what

A

superficial palmar arch of the hand

78
Q

describe the course of the ulnar nerve

A

(C7) - T1 fibres
medial cord
medial side of arm
groove in medial epicondyle
medial side anterior compartment forearm between FCU and medial side of FDP
supplies these muscles then passes close to pisiform to reach palmar surface of hand

79
Q

the ulnar artery forms what artery in the anterior forearm

A

common interosseous artery

80
Q

the common interosseous artery divides to form what

A

anterior and posterior interosseous arteries that lie either side of the interosseous membrane in the forearm

81
Q

where do the anterior and posterior interosseous arteries supply

A

supply muscles of both the anterior and posterior compartments of the forearm

82
Q

describe the veins of the anterior compartment of the forearm

A

veins run with the arteries (radial, ulnar, interosseous) and eventually drain into the brachial veins in the arm

83
Q

describe the wrist joint

A

articulation between the radius ulna and carpal bones

84
Q

what kind of joint is the wrist

A

synovial condyloid joint

85
Q

what movements can be done at the wrist

A

flexion
extension
abduction
adduction
circumduction

86
Q

can you rotate the wrist

A

no

87
Q

how is the wrist “rotated”

A

pronation and supination of the forearm

88
Q

the carpal bones are named in

A

rows - proximal and distal row

89
Q

what are the bones of the proximal row

A

scaphoid
lunate
triquetral (pisiform)

90
Q

what are the bones of the distal row

A

trapezium
trapezoid
capitate
hamate

91
Q

what is seen on hamate

A

hook-shaped protuberance that acts as an attachment point for flexor retinaculum

92
Q

what attaches onto hamate

A

flexor retinaculum

93
Q

what is the function of capitate

A

‘keystone’ that forces generated by movement pass through

94
Q

what shape is lunate

A

half moon when seen from lateral side

95
Q

what kind of joints are between the carpal bones of the wrist

A

synovial plane joints

96
Q

what kind of movement occurs between the bones of the wrist

A

carpals move slightly to accommodate movements of the hand but stay together to prevent damage to structures that pass through the carpal tunnel

97
Q

what is the rhyme to remember bones of the wrist

A

lateral to medial
proximal row (some lovers try positions)
distal row (that they cannot handle)

98
Q

what holds the wrist together

A

many small ligaments between the carpal bones and by medial (ulnar) and lateral (radial) collateral ligaments

99
Q

what forms the roof of the carpal tunnel

A

strengthened area of flexor retinaculum

100
Q

the majority of the articulation at the wrist is between what

A

base of radius and proximal row of carpal bones

101
Q

the distal end of the ulna is much ____ than the distal end of the radius

A

smaller

102
Q

the distal end of the ulna is associated with what

A

an articular disc to increase the congruency of the joint on the medial side

103
Q

what is retinaculum

A

connective tissue that forms bands on the anterior and posterior surfaces of the wrist

104
Q

the carpal tunnel allows the passage of structures across the ___ surface of the wrist joint

A

anterior

105
Q

what is the medial attachment of the flexor retinaculum

A

pisiform, hook of hamate

106
Q

what is the lateral attachment of flexor retinaculum

A

tubercle of scaphoid and ridge on trapezium

107
Q

the strong roof formed by flexor retinaculum helps to do what

A

keep the long flexor tendons close to the carpal bones

108
Q

what forms the floor of the carpal tunnel

A

carpal bones

109
Q

where does the tendon of flexor carpi radialis pass through

A

small space created by flexor retinaculum passing towards trapezium bone

110
Q

the flexor retinaculum also acts as an attachment site for

A

small intrinsic muscles of the hand found in the thenar and hypothenar eminences

111
Q

what sides are the thenar and hypothenar eminences

A

thenar - thumb
hypothenar - little finger side

112
Q

what structures pass through the carpal tunnel

A
  • tendons of flexor digitorum superficialis
  • tendons of flexor digitorum profundus
  • tendon of flexor pollicis longus
  • tendon of flexor carpi radialis
  • median nerve
113
Q

will carpal tunnel syndrome affect the blood supply to the hand

A

no but will affect nerve supply

114
Q

what structures pass through the carpal tunnel

A

median nerve and
tendons of FDS, FDP, FCR, FPL

115
Q

do the radial artery and nerve and ulnar artery and nerve pass through carpal tunnel

A

no

116
Q

how do the ulnar nerve and artery reach the hand

A

pass over the carpal tunnel to reach palmar surface of hand

117
Q

how does the radial nerve reach the hand

A

supplies the posterior compartment of the forearm and ends as a superficial sensory branch that passes over the roof of the anatomical snuffbox and into the hand

118
Q

how does the radial artery reach the hand

A

passes along the lateral side of the anterior compartment of the forearm and through the floor of the anatomical snuffbox before entering hand