Anterior/Posterior Forearm and Joints of the Forearm, Wrist, Hand Flashcards
Organization
compartments
how are compartments seperated
fascia, bones and interosseous membrane
anterior compartment
flexors and pronators
posterior compartment
extensors and supinatiors
deep fascias
antebrachial fascia
interosseous membrane
antebrachial fascia
continuous w/ brachial fascia
covers over all muscles under the skin like a sleeve
different antebrachial fascia
extensor reticulum
palmar carpal ligament
flexor reticulum
extensor reticulum
holds down the extensor tendons
posterior
palmar carpal ligament
continuous of extensor retinaculum
palmar side (anterior)
holds down tendons
flexor reticulum
deeper
distal to PCL
not continuous w/ extensor retinaculum
creates carpal tunnel (roof)
runs in b/w hood of hamate and pisiform
interosseous membrane
thin, strong, fibrous membrane
holds the radius and ulna together
helps create anterior compartment
tendon (synovial) sheath
surround all tendons that pass underneath the extensor/flexor retinaculum
reduce friction
connect the forearm and the hand
where would infection most likely occur and spread
tendon (synovial) sheaths
infection can travel from the hand to the forearm easily
assists in the spread of infection
how many carpal bones are there
8
carpal bones
give flexibility to the wrist
convex posteriorly, concave anteriorly
allow the ability to grasp around spherical objects
acronym for carpal bones
Some Lovers Try Positions They Can’t Handle
proximal row of carpal bones lateral to medial
scaphoid
lunate
triquetrum
pisiform
distal row of carpal bones lateral to medial
trapezium
trapezoid
capitate
hamate
articulations
proximal carpals articulate w/ articular disc of radiocarpal joint
distal carpals articulate w/ metacarpals
metacarpals
forms the skeleton of the palm of the hand b/w the carpus and the phalanges
how many metacarpals are there
5 on each hand
parts of metacarpal
base
body
head
proximal articulation of metacarpal
bases articulate w/ carpal bones
distal articulation of metacarpals
heads articulate with the proximal phalanges
form knuckles
surfaces and landmarks of 1st metacarpal
(thumb)
thickest and shortest
surfaces and landmarks of 3rd metacarpal
distinguished by a styloid process on the lateral side of its base
how many phalanges are there
5 on each hand
parts of the phalanges
3 parts
base (proximal)
body (middle)
head (distal)
how many parts does the thumb have
2 phalanges
distal and proximal
articulations of phalanges
metacarpophalangeal joint
proximal interphalangeal joint
distal interphalangeal joint
thumb only has ___________ joint
interphalangeal
surfaces and landmarks of proximal phalanges
the largest part
S&L of middle phalanges
intermediate size
S&L of distal phalanges
smallest part
S&L of terminal phalanges
flattened and expanded at their distal ends
parts of the anterior compartment
superficial and deep groups
anterior compartment
innervated by median nerve (mostly)
what are the exceptions of innervation of anterior compartment
flexor carpi ulnaris
ulnar half of flexor digitorum profundus
innervated by ulnar nerve
superficial group of anterior compartment
“PFPF”
have common origins
run lateral to more medial
muscles in the anterior compartment
pronator teres
flexor carpi radialis
palmaris longus
flexor carpi ulnaris
flexor carpi digitorum superficialis
origin pronator teres
humeral head: medial epicondyle of humerus
ulnar head: coronoid process
insertion of pronator teres
lateral radius (distal to supinator insertion)
innervation of pronator teres
median nerve (C6-C7)
travels b/w ulnar and radial head of muscle
action of pronator teres
forearm pronation
weak elbow flexor
flexor carpi radialis origin
medial epicondyle of humerus
flexor carpi radialis insertion
base of 2nd metacarpal
flexor carpi radialis innervation
median nerve (C6-C7)
action of flexor carpi radialis
wrist flexion
ABD (radial deviation) of hand
palmaris longus origin
medial epicondyle of humerus
palmaris longus insertion
palmar aponeurosis
palmaris longus innervation
median nerve (C6-C7)
palmaris longus action
wrist flexion tightens palmar aponeurosis
weak elbow flexion
flexor carpi ulnaris origin
humeral head: medial epicondyle
ulnar head: olecranon
flexor carpi ulnaris insertion
pisiform
hook of hamate
base of 5th metacarpal
flexor carpi ulnaris innervation
ulnar nerve (C7-T1)
flexor carpi ulnaris action
wrist flexion
ADD of hand (ulnar deviation)
flexor digitorum superficialis
is intermediate
flexor digitorum superificialis origins
humeral head: medial epicondyle
ulnar head: coronoid process
flexor digitorum superificialis insertion
sides of middle phalanges of 2-5 digits
flexor digitorum superficialis innervation
median nerve (C8, T1)
flexor digitorum superficialis action
flexion of wrist
flexion of MCP joint
flexion of PIP joints of 2-5 digits
weak elbow flexor
what passes through the two heads of flexor digitorum superificialis
median and ulnar nerves
deep group of anterior compartment
flexor digitorum profundus
flexor pollicis longus
pronator quadratus
flexor digitorum profundus origin
ulna (2/3s of flexor surface)
interosseous membrane
flexor digitorum profundus insertion
distal phalanges of 2-5 digits (palmar surface)
flexor digitorum profundus innervation
median nerve (C8,T1)
ulnar half by ulnar nerve (C8,T1)
flexor digitorum profundus action
flexion of wrist, MCP, PIP, DIP of 2-5 digits
flexor pollicis longus origin
radius (mid anterior surface)
adjacent interosseous membrane
flexor pollicis longus insertion
distal phalanx of thumb (palmar surface)
flexor pollicis longus innervation
median nerve (C7,C8)
flexor pollicis longus action
wrist flexion
ABD of hand (radial deviation)
flexion of carpometacarpal of thumb
MCP and IP flexion
pronator quadratus origin
distal quarter of ulna (anterior surface)
pronator quadratus insertion
distal quarter of radius (anterior surface)
pronator quadratus innervation
median nerve (C7-C8)
pronator quadratus action
hand pronation
distal radioulnar joint stabilization
posterior compartment is innervated by…
radial nerve or its branches
parts of the posterior compartments
superficial muscles
deeps muscles
superficial muscle group
all arise from a common extensor tendon attached to the posterior surface of the lateral epicondyle of the humerus and adjacent fascia
muscles in the superior muscle group of the posterior compartment
brachioradialis
extensor carpi radialis longus
extensor carpi radialis brevis
extensor digitorum
extensor digiti minimi
extensor carpi ulnaris
brachioradialis origin
lateral supracondylar ridge of distal humerus
lateral intermuscular septum
brachioradialis insertion
styloid process of the radius
brachioradialis innervation
radial nerve (C5-C7)
brachioradialis action
elbow flexion
what happens to the brachioradialis in forearm neutral
in greatest position/greatest flexor/ greatest advantage
extensor carpi radialis longus origin
lateral supracondylar ridge of distal humerus
lateral intermuscular septum
extensor carpi radialis longus insertion
base of 2nd metacarpal
extensor carpi radialis longus innervation
radial nerve (C6-C7)
extensor carpi radialis longus action
wrist extension and ABD (radial deviation)
weak elbow flexion
where is the extensor carpi radialis longus
parallels brachioradialis on lateral forearm
extensor carpi radialis brevis origin
lateral epicondyle of humerus
extensor carpi radialis brevis insertion
base of 3rd metacarpals
extensor carpi radialis brevis innervation
radial nerve (C7-C8)
extensor carpi radialis brevis action
wrist extension and ABD (radial deviation)
weak eblow flexion
where is the extensor carpi radialis brevis
lies deep to the extensor carpi radialis longus
shorter than the extensor carpi radialis longus
where is the extensor digitorum
lies medial to extensor carpi radialis brevis
extensor digitorum origin
lateral epicondyle of humerus
extensor digitorum insertion
dorsal digital expansions of 2-5 digits
extensor digitorum innervation
radial nerve (C7-C8)
extensor digitorum action
wrist extension
extension/ABD of MCP, PIP and DIP of 2-5 digits
where is extensor digiti minimi
detached portion of extensor digitorum
extensor digiti minimi origin
lateral epicondyle of humerus
extensor digiti minimi insertion
dorsal digital expansion of 5th digit
extensor digiti minimi innervation
radial nerve (C7-C8)
extensor digiti minimi action
wrist extension
ADD of hand (ulnar deviation)
extension and ABD of MCP, PIP, DIP of 5th digit
where is extensor carpi ulnaris
most medial of superficial posterior muscles
extensor carpi ulnaris origin
lateral epicondyle of humerus
ulnar head (dorsal surface)
extensor carpi ulnaris insertion
base of 5th metacarpal
extensor carpi ulnaris innervation
radial nerve (C7-C8)
extensor carpi ulnaris action
wrist extension
ADD of hand (ulnar deviation)
deep group of posterior compartment
anatomical snuffbox
supinator
abductor pollicis longus
extensor pollicis brevis
extensor pollicis longus
extensor idicis
where is the supinator muscle
deep muscle at posterior aspect of elbow
supinator origin
olecranon
lateral epicondyle of humerus
radial collateral ligament
anular ligament
supinator insertion
radius
b/q the radial tuberosity and insertion of pronator teres
supinator innervation
radial nerve (C6-C7)
deep branch of the radial nerve will pierce through the muscle
supinator action
radioulnar joint supination
where is the abductor pollicis longus
lateral and parallel to extensor pollicis longus
abductor pollicis longus origin
radius and ulna
dorsal surfaces
interosseous membrane
abductor pollicis longus insertion
base of 1st metacarpal
abductor pollicis longus innervation
posterior interosseous nerve
from deep branch of radial nerve (C7-C8)
abductor pollicis longus action
ABD of hand at the radiocarpal joint
carpometacarpal joint of thumb ABD
where is the extensor pollicis brevis
part of pair of deep muscles overlain by extensor carpi ulnaris
extensor pollicis brevis origin
posterior surface of radius
interosseous membrane
extensor pollicis brevis insertion
base of distal phalanx of thumb
extensor pollicis brevis innervation
radial nerve (C7-C8)
extensor pollicis brevis action
ABD at radiocarpal joint (radial deviation of hand)
thumb extension (carpometacarpal and MCP joints)
where is the extensor pollicis longus
part of a pair of deep muscles overlain by extensor carpi ulnaris
extensor pollicis longus origin
posterior surface of ulna
interosseous membrane
extensor pollicis longus insertion
base of distal phalanx of thumb
extensor pollicis longus innervation
radial nerve (C7-C8)
extensor pollicis longus action
wrist extension
ABD of hand (radial deviation)
thumb carpometacarpal joint extension
MCP and IP joint of thumb extension
where is extensor idicis
tiny muscle arising close to wrist
extensor idicis origin
posterior surface of ulna
interosseous membrane
extensor idicis insertion
posterior digital expansion of 2nd digit
extensor idicis innervation
posterior interosseous nerve
deep nerve of radial branch (C7-C8)
extensor idicis action
wrist extension
MCP, PIP and DIP of 2nd digit expansion
arteries
ulnar artery
radial artery
ulnar artery
anterior recurrent
posterior recurrent
common interosseous
dorsal carpal arch
palmar carpal arch
common interosseous artery
anterior interosseous
posterior interosseous
goes into recurrent interosseous
radial artery
radial recurrent
dorsal carpal arch
palmar carpal arch
veins
superficial
deep
superficial veins
cephalic and basilic
deep veins
radial and ulnar
nerves
medial antebrachial
lateral antebrachial
median (anterior interosseous)
ulnar
radial
lateral antebrachial nerve
off musculocutaneous nerve
innervates lateral skin of the forearm
median nerve
anterior interosseous
contributions from lateral and medial cords
supplies everything in the anterior compartment besides few exceptions
exceptions to median nerve innervation
flexor carpi ulnaris
ulnar half of flexor digititorum profundus (digits 4-5)
ulnar nerve
terminal branch of medial cord of brachial plexus
runs behind medial epicondyle
runs b/w two heads of flexor carpi ulnaris
radial nerve
superficial (sensory supply)
deep branch (motor supply)
posterior compartment of the arm and the forearm
runs anteriorly to lateral epicondyle
deep branch of radial nerve
posterior interosseous (superficial branch)
pierces the supinator
spaces of forearm
flexor retinaculum
extensor retinaculum
anatomical snuffbox
structures passing through the flexor retinaculum
superficial structures
deep structures
superficial structures
palmaris longus tendon
ulnar artery
ulnar nerve
flexor carpi ulnaris tendon
deep structures
carpal tunnel
compartment of flexor carpi radialis tendon
carpal tunnel
flexor digitorum superficialis tendons
flexor digitorum profundus tendons
flexor pollicis longus tendons
median nerve
compartment of flexor carpi radialis tendon
flexor carpus radialis tendon
compartments under extensor retinaculum
abductor pollicis longus
abductor pollicis brevis
extensor pollicis longus
extensor digitorum
extensor indicis
extensor digiti minimi
extensor carpi ulnaris
anatomical snuffbox boundaries
lateral and medial
lateral border of anatomical snuffbox
abductor pollicis longus tendon
extensor pollicis brevis
medial border of anatomical snuffbox
extensor pollicis longus tendon
contents of anatomical snuffbox
radial artery (deep)
cephalic vein
lateral antebrachial cutaneous nerve
superficial branch of radial nerve
joints of the forearm
proximal radioulnar joint
distal radioulnar joint
proximal radioulnar joint
pivot type of synovial joint
anular ligament
allows for pronation and supination of the forearm
distal radioulnar joint
pivot type of synovial joint
radius moves around the fixed distal end of the ulna
radius crosses over the ulnar during pronation
what type of joint is the wrist joint
condyloid type of synovial joint
articulations of the wrist joint
radius and the articular disc of the distal radioulnar joint
proximal row of carpal bones
ligaments of wrist joint
palmar radiocarpal
dorsal radiocarpal
ulnar collateral
radial collateral
movements at the wrist joint
flexion/extension
ABD/ADD (radial/ulnar deviation)
circumduction
joints of the hand
intercarpal
carpometacarpal
intermetacarpal
metacarpophalangeal
interphalangeal
intercarpal joint
plane type of synovial joint
interconnecting the carpal bones
gliding movements possible
flexion and extension of hand (initiated with midcarpal joint)
carpometacarpal joint
plane type of synovial joint
except for CMC of thumb
CMC of thumb
saddle type of joint
allows for flexion/extension, ABD/ADD, circumduction
intermetacarpal joint
plane type of joints
adjacent metacarpals articulate w/ each other
occur b/w the radial and ulnar aspects of the bases of the metacarpals
metacarpophalangeal joint
condyloid joint
allows for flexion/extension, ABD/ADD
medial and lateral collateral ligaments
deep transverse metacarpal ligaments
interphalangeal joint
hinge type of joint
permits flexion/extension only