Arm Anatomy Flashcards
Proximal tip of the ulna
Olecranon
Proximal end of the radius
Radial head
Relationship of ulnar nerve with radius
Ulnar nerve runs posterior to the medial epicondyle
Relationship of radial nerve with radius
Radial nerve runs along the radial groove, can be entrapped in distal 1/3 of humeral shaft fracture
Portion of the radial head that is most susceptible to fracture due to paucity of subchondral bone content
Anterolateral portion of radius head
Muscles that insert in radial and ulnar tuberosities
Radial tuberosity: Biceps
Ulnar tuberosity: brachialis
Eponym to an injury caused by radial head subluxation, usually due to a strong pull on the hand by an adult
Nursemaid’s elbow
Borders of cubital tunnel
Roof: Arcuate (Osborne's) ligament Floor: medial collateral ligament Posterior: Medial head of triceps Anterior: Medial epicondyle Lateral: olecranon
Content of cubital tunnel
Ulnar nerve
A fibrous band running from an anomalous supracondylar process to medial epicondyles, can compress median nerve proximally
Ligament of Struthers
Structures that can be compressed by recurrent radial artery (leash of Henry)
Radial nerve (posterior interosseus nerve)
Components of the conjoined tendon
Coracobrachialis, short head of the biceps
Insertion of triceps brachii
Olecranon of ulna
Muscle that forms the border of quadrangular space, triangular space, and triangular interval
Long head of triceps brachii
Nerve that pierces corachobrachialis, then goes between biceps and brachialis
Musculocutaneous nerve
Nerve that starts medial in the proximal humerus, then spirals posteriorly and laterally around the humerus, and emerges between the brachioradialis and brachialis muscles in the distal lateral arm
Radial nerve
Nerve that runs along with brachial artery, initially lateral to it but crosses over to become more medial
Median nerve
Contents of the anterior compartment of the arm
Muscles: biceps brachii, coracobrachialis, brachialis
Nerves: Musculocutaneous, median nerve (Ms are constant), radial nerve (distally)
Vessel: brachial artery
Contents of the posterior compartment of the arm
Muscles: triceps trachii
Nerves: Radius (mid arm)
Ulnar nerve (distally)
Vessels: Radial recurrent arteries
Median nerve enters forearm under what structure?
Biceps aponeurosis (lacertus fibrosus)
Branch of brachial artery that runs with the radial nerve
Deep (profunda brachii) artery
Used as vascular pedicle in lateral arm flap
Posterior (middle) radial collateral - branch of deep artery of the brachial artery
Branches of the ulnar artery that run along the intermuscular septum
Anterior and posterior interosseous
Muscle of the arm that has a split innervation, hence can be used for internervous plane in ORIF of fractures
Brachialis (medial supplied by musculocutaneous and lateral supplied by radial nerve)
Tubercle on dorsal radius where EPL tendon runs around it
Lister’s tubercle
Proximal row bones of the hand
Scared lovers try positions
Scaphoid (located in the anatomic snuffbox)
Lunate
Triquetrum
Pisiform
Distal row bones of the hand
… that they cannot handle
Trapezium
Trapezoid
Capitate
Hamate
Most commonly fractured carpal bone
Scaphoid
Largest carpal bone
Capitate
First carpal bone to ossify
Capitate (ossification proceeds in a counter clockwise direction given an anatomic position starting with capitate)
Proximal ulnar fracture (usually with anterior angulation), + radial head anterior dislocation
Monteggia Fracture
Fracture of the arm commonly due to fall on outstretched hand, characterized by fracture of the distal 1/3 of the radial shaft and radioulnar dislocation
Galeazzi Fracture
Carpal bones without any muscle attachment, considered “intercalated segment”
Proximal row carpal bones (SLTP)
Broad term for ligaments that connect carpal bones within the same row
Interosseous ligament
Weak spot in the volar aspect of the hand where perilunate dislocations occur
Space of Poirier
Joint stabilized by the triangular fibrocartilage complex (TFCC)
Distal Radioulnar Joint
Components of triangular fibrocartilage complex
Central (articular disc)
Dorsal radioulnar
Palmar radioulnar
Ligament incised for carpal tunnel release
Transverse carpal ligament
Narrowest portion of the carpal tunnel
Hook of hamate
Borders of the carpal tunnel
Roof: transverse carpal ligament
Floor: Carpal bones, especially capitate and trapezoid
Medial: Pisiform, hamate
Lateral: Scaphoid, trapezium
Contents of the carpal tunnel
Median nerve
9 tendons: 4 FDS, 4 FDP, FPL
Borders of ulnar tunnel (Guyon canal)
Floor: Transverse carpal ligament, Roof: Volar carpal ligament
Medial: Pisiform
Lateral: Hook of hamate
Contents of ulnar tunnel
Ulnar nerve, ulnar artery
Most common cause of compression of structures within Guyon canal
ganglion cysts
Extensor compartments of distal portion of forearm
I: “pollicis” - extensor pollicis brevis and abductor pollicis longus
II: “carpi radialis”
extensor carpi radialis brevis and longus
III: extensor pollicis longus
IV: Extensor digitorum and extensor indicis
V: Extensor digiti minimi
VI: Extensor carpi ulnaris
Structures affected by de Quervain’s tenosynovitis
Abductor pollicis longus and extensor pollicis brevis (APL and EPB)
Muscle of the forearm used for tendon transfers, 10% are congenitally absent
Palmaris longus
Most powerful wrist flexor
Flexor carpi ulnaris
Superficial flexors of the wrist
Pronator teres, flexor carpi radialis, palmaris longus, flexor carpi ulnaris, flexor digitorum superficialis
Avulsion causes Jersey finger
Flexor digitorum profundus
Primary pronator of the forearm
Pronator quadratus
Deep flexors of the forearm
Flexor digitorum profundus, flexor pollicis longus, pronator quadratus
Innervation of all deep flexors of the forearm
Anterior interosseous artery of the ulnar artery
Superficial extensors of the wrist
Anconeus, extensor digitorum, extensor digiti minimi, extensor carpi ulnaris
Muscle that degenerates in tennis elbow
Extensor carpi radialis brevis
Deep extensors of the wrist
Abductor pollicis longus, extensor pollicis brevis, extensor pollicis longus, extensor indicis proprius
Test where both radial and ulnar arteries are occluded at the wrist, then release one artery to determine hand perfusion
Allen test
Test for de Quervain’s tenosynovitis
Finkelstein’s Test
Most common site of ganglion cyst
Dorsal wrist
Atrophy of the hypothenar eminence may suggest compression of which nerve
ulnar
Atrophy of the thenar eminence may suggest compression of which nerve
median
Number of phalanges of the thumb
2
Most commonly fractured metacarpal bone
5th metacarpals (boxer fracture) - usually a fall or punching mechanism
Eponym for jammed finger leading to extensor digitorum avulsion
Mallet finger
Branch of brachial artery that may be damaged with the radial nerve at midshaft fracture of the humerus
Deep brachial artery
Branch of radial artery that divides into two proper digital arteries for each side of the thumb
Princeps pollicis artery
Syndrome referring to retrograde flow in the vertebral artery due to ipsilateral subclavian artery stenosis
Subclavian steal syndrome
Artery used for percutaneous arterial catheterization if femoral artery is unavailable
Brachial artery (preferably the left, since it allows access to the descending aorta without crossing the right brachiocephalic trunk and left common carotid arteries)
Most commonly used artery and vein as access for chronic hemodialysis
Radial artery and cephalic vein, establishing an AV fistula between the 2 vessels
Vein that connects cephalic vein to the basilic vein over the cubital fossa
Median cubital vein
Classic finding in radial nerve injury
Wrist drop
Classic finding of median nerve injury at elbow
Benediction hand
Classic finding of ulnar nerve injury at elbow
Claw hand
Contracture of the forearm muscles commonly due to supracondylar fracture where brachial artery goes into spasm, thereby reducing blood flow
Volkmann ischemic contracture