Arm And Anterior Forearm Flashcards

1
Q

Organization of upper limb

A

. Arm (brachium)
. Forearm (antebrachium)
. Wrist (carpus)
. Hand

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2
Q

Brachial fascia

A

Deep fascia of arm

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3
Q

Antebrachial fascia

A

Deep fascia of forearm

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4
Q

Medial and lateral intermuscular septa

A

Extensions of deep fascia that attach to medial and lat. suracondylar ridges of the humerus and shafts of radius and ulna

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5
Q

Retinacula

A

. Thickenings of antebrachial fascia that attach to distal radius and ulna and carpal bones
. Form osseofibrous tunnels for tendons of the forearm muscles
. Prevents bowstringing

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6
Q

Synovial tendon sheaths

A

. Thin walled, fibrous sacs lined w/ synovial membrane and lubricated by synovial fluid
. reduce friction and allow tendons to slide smoothly beneath retinacula

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7
Q

Compartments of arm and how they’re separated

A

. Ant. And post. Compartments separated by shaft of humerus and med. and lat. intermuscular septa

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8
Q

Forearm compartments and how they’re separated

A

. Ant. And post. Compartments separated by shafts of radius and ulna, interosseous membrane, and the med. and lat. intermuscular septa

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9
Q

Anterior compartments muscles

A

. Flexors and pronators

. Innervated by nerves derived from ant. Divisions (med/lat cords) or brachial plexus

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10
Q

Posterior compartment arm muscles

A

. Extensors and supinator

. Innervated by nerved derived from post. Division of brachial plexus

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11
Q

Dermatome distribution in arm

A

. Distributed along pre and postaxial borders of upper extremity in pattern that reflects limb’s origin in lateral body wall
. Single dermatome supplied by several peripheral nerves and individual named nerves carry fibers from several fiber segments

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12
Q

Autonomous area (zone)

A

. Region of skin supplied by single spinal nerve w/o any overlap

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13
Q

Myotome distribution

A
. Along proximodistal axis of extremity 
. C5-6 supply shoulder
. C6-7 supply elbow
. C7-8 supply wrist
. C8-T1: supply hand
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14
Q

Anconeus OIAN

A

O: lat. epicondyle of humerus
I: lat. surface of olecranon process of ulna
A: weakly extends forearm and stabilizes elbow joint
N: radial n.

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15
Q

Deep tendon reflex of biceps brachii mediated by —

A

C5 and C6 spinal levels

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16
Q

Triceps brachii reflex mediated by ___

A

C7

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17
Q

Anterior component of arm artery

A

Brachial artery

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18
Q

Posterior compartment of the arm arteries

A

Branches of profunda brachii a.

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19
Q

Pronator teres m OIAN

A

O: Medial epicondyle of humerus, coronoid process of ulna
I: Lateral radius at midshaft
A: Pronates forearm
N: Median n.

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20
Q

Flexor carpi radialis OIAN

A

O: Medial epicondyle of humerus
I: Base of Metacarpal II
A: Flexes and abducts wrist
N: Median n.

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21
Q

Palmaris longus m. OIAN

A

O: Medial epicondyle of humerus
I: Palmar aponeurosis
A: Weakly flexes wrist
N: Median n.

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22
Q

T/F palmaris longus is missing in over 10% population

A

T

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23
Q

Flexor carpi ulnaris OIAN

A

O: Humeral head—medial epicondyle of humerus
Ulnar head—medial olecranon process, posterior border of ulna
I: Pisiform bone, hook of hamate bone, and base of Metacarpal V
A: Flexes and adducts wrist
N: Ulnar n.

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24
Q

Flexor digitorum superficialis m. OIAN

A

O: Humeroulnar head: medial epicondyle, coronoid process of ulna, Radial Head: proximal ant. surface of radius
I: By 4 separate tendons to bases of middle phalanges of Digits II-V
A: Flexes PIP, MP, and wrist joints
N: Median n.

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25
Q

Muscles in anterior compartment superficial layer

A
. Pronator teres 
. Flexor carpi radialis 
. Palmaris longus 
. Flexor carpi ulnaris 
. Flexor digitorum superficialis
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26
Q

Deep layer muscles of ant. Compartment of the forearm

A

. Flexor digitorum profundus
. Flexor pollicis longus
. Pronator quadratus

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27
Q

Superficial anterior compartment of forearm vascular supply

A

Radial and ulnar aa.

28
Q

Vascular supply of anterior deep compartment of forearm

A

Anterior interosseous a.

29
Q

Flexor digitorum profundus m. OIAN

A
O: Upper three quarters of ulnar shaft and adjacent interosseous membrane
I: By 4 separate tendons to bases of distal phalanges of Digits II-V
A: Flexes DIP & PIP joints, MP joints, and wrist
N: Lateral half (Digits II-III): Median n.
Medial half (Digits IV-V): Ulnar n.
30
Q

Flexor pollicis longus OIAN

A
O: Anterior radial shaft and adjacent interosseous membrane
I: Base of distal phalanx of thumb
A: Flexes IP, MP, and carpometacarpal 
joints of thumb; assists wrist flexion
N: Median n.
31
Q

Pronator quadratus m. OIAN

A

O: Lower one fourth of ulnar shaft
I: Lower one fourth of radial shaft
A: Pronates forearm
N: Median n.

32
Q

Cubital fossa

A

Triangular hollow ant. To elbow

33
Q

Cubital fossa boundaries

A

. Sup by a line connecting the med. and lat. epicondyles, med. by the pronator teres m., and lat. by brachioradialis
. Brachialis and supinator mm. Form floor
. Deep fascia and bicipital aponeurosis form roof

34
Q

Contents fo cubital fossa lateral to medial

A
  1. Biceps brachii tendon
  2. Terminal brachial artery, proximal radial and ulnar arteries, venae comitantes.
  3. Median n.
35
Q

Median cubital vein location

A

Superficial fascia overlapping cubital fossa

36
Q

Musculocutaneous n.

A

. Innervates all muscles in ant. Compartment of arm
. Pierces coracobrachialis then courses inf. In plane btw biceps brachii and brachialis
. Emerges sup. To elbow to becomes lat. antebrachial cutaneous n.

37
Q

Median n. What muscles it innervates

A

. Innervates all muscles in ant. Compartment of forearm except flexor carpi ulnaris and med. portion of flexor digitorum profundus

38
Q

Median n. Pathway

A

. Passes med. to biceps tendon and deep to bicipital aponeurosis then enters forearm btw heads of pronator teres
. Passes through hiatus in flexor digitorum superficialis and descends in plane btw sup. And deep muscle groups
. Crosses wrist med. to tendon of flexor carpi radialis
. Passes deep to flexor retinaculum

39
Q

Where is median n. Likely to be compressed in injury?

A

. Btw heads of pronator teres (pronator syndrome)

. As it passes deep to flexor retinaculum (carpal tunnel syndrome)

40
Q

Ulnar n.

A

. Supplies 1.5 muscles in forearm
. Pierces med. intermuscular septum to course in post. Brachial compartment deep to triceps
. Enters cubital tunnel post. To med. epicondyle
. Courses btw heads of flexor carpi ulnaris to enter the ant. Compartment of forearm and descends deep to flexor carpi ulnaris
. Crosses wrist superficial to flexor retinaculum and just lat. to pisiform bone where it’s secured by CT (guyon’s canal)

41
Q

Cyclist’s palsy

A

. Compression at wrist causing pain and numbness of med. 1.5 digits and weakness of intrinsic hand muscles

42
Q

What can injure ulnar n.?

A

Blows to elbow/fractures of med. epicondyle

. Subject to compression when it passes through cubital tunnel

43
Q

Radial n.

A

. Innervates all muscles of post. Compartment of arm
. Supplies sensory to lat. and post. Aspects of arm
. Courses in spinal radial groove btw med. and lat. heads of triceps
. Pierces lat. intermuscular septum above elbow to course in furrow btw. Brachialis and brachioradialis

44
Q

Medial brachial cutaneous n.

A

Supplies sensory to ant. And med. arm

45
Q

Intercostobrachial n.

A

. T2
. Lat. cutaneous branch of 2nd intercostal n.
. Supplies sensory to med. and post. Arm

46
Q

Axillary n.

A

Supplies sensory to lat. and post. Aspects of arm

47
Q

Lateral antebrachial cutaneous n.

A

. Direct continuation of musculocutaneous n.

. Supplies sensory to ant. And post. Aspects of lateral forearm

48
Q

Medial antebrachial cutaneous nerve

A

. Supplies sensory to ant. And post. Aspects of med. forearm

49
Q

Brachial artery

A

. Blood supply to upper extremity
. Continuation of axillary a. Distal to inf. Border of teres major
. Terminates in cubital fossa by bifurcation into radial and ulnar aa.

50
Q

Branches of brachial a.

A

. Collateral branches to elbow anastomoses and unarmed muscular branches
. Profunda brachii (deep brachial) a. Arises high in arm and courses w/ radial n. In spiral groove

51
Q

Radial a.

A

. Lat. terminal branch of brachial a.

. Descends in lat. forearm deep to brachioradialis m. And becomes superficial just prox. To wrist

52
Q

Radial a. Branches

A

. Numerous muscular and collateral branches

. Branches to wrist and hand

53
Q

Ulnar a.

A

. Med. terminal branch of brachial a.

. Courses inferomedially btw superficial and deep muscle groups and becomes superficial just prox. To wrist

54
Q

Ulnar a. Branches

A

. Common interosseous a.: sometimes absent, short branch that divides immediately into ant. And post. Interosseous
. Ant. Interosseous a.: descends on ant. Surface of interosseous membrane and supplies deep flexor muscles of forearm
. Post. Interosseous a.: passes sup. To interosseous membrane and descends on post. Surface supplying post. Forearm muscles

55
Q

Collateral circulation

A

Branches of 4 major arteries of arm and forearm (brachial, profunda brachii, radial, and ulnar) form circular network of anastomoses around elbow joint

56
Q

Semilunar valves

A

. Prevent blood from flowing retrograde

57
Q

Arterial pump

A

Arterial pulsation propel blood towards heart in vein

58
Q

Muscular pump

A

Dense brachial and antebrachial fasciae direct force of muscular contractions inward propelling blood towards heart

59
Q

How do superficial veins communicate w/ deep veins?

A

Perforating branches that have valves that direct blood flow from superficial to deep

60
Q

T/F SUperficial veins are constant, but superficial venous channels are highly variable

A

F, opposite

61
Q

Cephalic vein

A

. Lat. aspect of forearm and arm

. Pierces clavipectoral fascia w/in deltopectoral triangle and empties into axillary v.

62
Q

Basilic v.

A

. Med. aspect of forearm and arm

. Pierces brachial fascia in lower arm and unites w/ venae comitantes of brachial a. To form axillary v.

63
Q

Median cubital v.

A

. Short, horizontal venous channel connecting cephalic and basilic vv. At cubital fossa
. Blood flow usually from cephalic v. To basilic v.

64
Q

Axillary lymph nodes

A

Majority of lymph from upper extremity drained to these

65
Q

Lymph vessels accompanying cephalic c. Drain into ____

A

Deltopectoral nodes