Arm & Hand Flashcards
What does the lateral (radial) collateral ligament attach and what does it check?
-lateral epicondyle (of humerus) – annular ligament of the raduis -prevents excessive cubitus varus deviation
What does the medial (ulnar) collateral ligament attach and what does it check?
-medial epicondyle (of humerus) – coronoid process, olecranon process -prevents excessive cubitus valgus deviation
What kind of joint is the proximal radioulnar?
synovial pivot
What are the specific articulations of the proximal radioulnar joint?
head of the radius – radial notch of ulna
Describe the movement, and available movements, of the proximal radioulnar joint.
-head of the radius can move against the ulna (the head rotates within the ring formed by the annular ligament) -pronation; supination
This u-shaped ligament runs from the anterior surface of the radial notch around the head of the radius to the posterior surface of the radial notch, and holds the head of the radius in place.
annular ligament
What are the specific articulations of the distal radioulnar joint?
head of the ulna – ulnar notch of the radius
Describe the movement, and available movements, of the distal radioulnar joint.
-allows for movement of the radius around a relatively fixed ulna -pronation; supination
What kind of joint is the proximal radioulnar?
-synovial pivot
What are the ligaments of the distal radioulnar joint?
palmar and dorsal radioulnar ligaments: distal ulna – distal radius (dorsal and palmar surfaces)
What are the attachment points of coracobrachialis?
S/P: coracoid process I/D: middle, medial humerus
What are the actions of coracobrachialis?
-G-H flexion -G-H adduction
What are the attachment points of biceps brachii?
S/P (long head): supraglenoid tubercle (the biceps long head travels through the bicipital groove to its proximal attachment – the tendon has a sheath to protect it from the transverse humeral ligament which holds the tendon in place during contraction/movement) S/P (short head): coracoid process I/D: radial tuberosity, bicipital aponeurosis (fascia that runs from the biceps tendon and merges with the fascia of the anterior forearm)
What are the actions of biceps brachii
-G-H flexion -elbow flexion (prime mover for elbow flexion when in supination) -forearm supination (proxiomal and distal radioulnar joints)
What are the attachment points of brachialis?
S/P: anterior distal 1/2 of humerus I/D: ulnar tuberosity, coronoid process
What are the actions of brachialis?
elbow flexion (prime mover)
What are the attachment points of triceps brachii
S/P (long head): infraglenoid tubercle S/P (lateral head): posterior proximal humerus (superior to the radial groove) S/P (medial head): posterior distal humerus (inferior to the radial groove) I/D: olecranon process
What are the actions of triceps brachii?
-long head: G-H extension -all heads: elbow extension
What are the attachment points of anconeus?
S/P: lateral epicondyle (of humerus) I/D: olecranon process
What are the available movements of anconeus?
elbow extension (assists triceps – weak synergist)
What are the groups of bones in the hand?
-the carpal bones (8) -the metacarpals (5) -the phalanges (14)
What are the proximal carpal bones?
-scaphoid (sometimes called the navicular) (including its tubercle) (most commonly fractured carpal bone) -lunate (most commonly dislocated carpal) -triquetrum (pyramid-shaped) -pisiform (easily palpable; sesamoid bone)
What are the distal carpal bones?
-trapezium (including its tubercle) (think rhymes with thumb) -trapezoid -capitate -hamate (easily identified by the anterior projection called the hook of the hamate)
Where does the flexor retinaculum of the carpal tunnel attach?
-laterally to the tubercles of the scaphoid and trapezium -medially to the hook of the hamate and pisiform
What are the muscles of the proximal arm?
-coracobrachialis -biceps brachii -brachialis -triceps brachii -anconeus
What’s the most commonly fractured carpal bone?
scaphoid
What’s the most commonly dislocated carpal bone?
lunate
What kind of joint is the radiocarpal?
synovial condyloid
What kind of joint is the midcarpal?
synovial plane
What kind of joints are the intercarpals?
synovial plane
What kind of joint is the 1st carpometacarpal (CPC)?
synovial saddle
What kinds of joints are the 2nd-5th carpometacarpals (CPC)?
synovial plane
Palmar ligaments, a.k.a. ____ check ____
palmar plates; hyperextension
What kinds of joints are the metacarpophalangeals (MCP) and what are their available movements?
-synovial plane -flexion, extension, abduction, adduction (reference for abd and add of fingers is 3rd finger)
What kind of joints are the interphalangeal (IP) and what are their available movements?
-synovial hinge -flexion, extension
Where does the common flexor tendon (CFT) attach?
medial epicondyle
What are the muscles of the superficial layer of the anterior forearm?
-pronator teres -flexor carpi radialis (FCR) -palmaris longus -flexor carpi ulnaris (FCU)
What are the attachment points of Pronator Teres?
S/P: medial epicondyle of humerus, coronoid process of the ulna I/D: middle, lateral surface of the radius
What are the actions of Pronator Teres?
-pronation (radioulnar joints) -elbow flexion (weak)
What are the attachment points of Flexor Carpi Radialis?
S/P: medial epicondyle I/D: base of the 2nd metacarpal (a slip also runs to the base of the 3rd)
What are the actions of Flexor Carpi Radialis?
-radiocarpal joint flexion -radial deviation (abduction) (with ECRL/ECRB) -elbow flexion (weak) (weak synergist to biceps brachii and brachialis)
What are the attachment points of Palmaris Longus?
S/P: medial epicondyle I/D: palmar aponeurosis
What are the actions of Palmaris Longus?
-radiocarpal joint flexion -elbow flexion (weak)
What are the attachment points of Flexor Carpi Ulnaris?
S/P (humeral head): medial epicondyle S/P (ulnar head): olecranon and upper 1/2 of the posterior ulna I/D: pisiform, hook of hamate, base of the 5th metacarpal
What are the actions of Flexor Carpi Ulnaris?
-radiocarpal joint flexion -ulnar deviation (adduction) (with ECU) -elbow flexion (weak)
What’s the muscle of the intermediate layer of the forearm?
Flexor Digitorum Superficialis (FDS)
What are the attachment points of Flexor Digitorum Superficialis?
S/P (humeroulnar head): medial epicondyle, coronoid process of the ulna S/P (radial head): anterior/superior radius I/D: sides of the bases of the intermediate phalanges of the medial 4 digits
What are the actions of Flexor Digitorum Superficialis?
-2nd-5th CMC, MCP, PIP joint flexion -radiocarpal joint flexion -elbow flexion (weak)
What are the muscles of the deep layer of the forearm?
-Flexor Digitorum Profundus (FDP) -Flexor Pollicis Longus (FPL) -Pronator Quadratus
What are the attachment points of Flexor Digitorum Profundus?
S/P: proximal anterior surface of the ulna and interosseous membrane (tendons pierce the FDS) I/D: bases of the distal phalanges of the medial 4 digits
What are the actions of Flexor Digitorum Profundus?
-2nd-5th CMC, MCP, IP joint flexion -radiocarpal joint flexion
What are the attachment points of Flexor Pollicis Longus?
S/P: anterior middle surface of the radius and interosseous membrane (passes deep to the flexor retinaculum) I/D: base of the distal phalanx of the thumb
What are the actions of Flexor Pollicis Longus?
-IP joint flexion of the 1st digit -MCP, CMC joint flexion of the 1st digit
What are the attachment points of Pronator Quadratus?
Medial: distal anterior ulna Lateral: distal anterior radius
What are the actions of Pronator Quadratus?
pronation (radioulnar joints)
What are the muscles that pronate the forearm/hand?
Pronator Quadratus, Pronator Teres
What are the muscles that flex the hand?
FCR, FCU, Palmaris Longus
What are the muscles that flex the digits?
FDS, FDP, FPL
What are the tendons in the Carpal Tunnel?
-Flexor Digitorum Superficialis -Flexor Digitorum Profundus -Flexor Pollicis Longus
Pressure on what nerve causes Carpal Tunnel Syndrome?
median nerve
What are the muscles of the Superficial Layer of the posterior forearm?
-brachioradialis -extensor carpi radialis longus (ECRL) -extensor carpi radialis brevis (ECRB) -extensor digitorum (ED) -extensor digiti minimi -extensor carpi ulnaris (ECU)
What are the attachment points of Brachioradialis?
S/P: lateral supracondylar ridge of the humerus I/D: lateral distal radius
What are the actions of Brachioradialis?
elbow flexion (strongest when the forearm is in neutral)
What are the attachment points of Extensor Carpi Radialis Longus?
S/P: supracondylar ridge of the humerus (distal part) i/d: base of the 2nd metacarpal
What are the actions of Extensor Carpi Radialis Longus?
-radiocarpal extension -radial deviation (abduction) (with FCR and ECRB)
What are the attachment points of Extensor Carpi Radialis Brevis?
S/P: lateral epicondyle I/D: base of the 3rd metacarpal
What are the actions of Extensor Carpi Radialis Brevis?
-radiocarpal extension -radial deviation (abduction) (with FCR and ECRL)
What are the attachment points of Extensor Digitorum?
S/P: lateral epicondyle -distal phalanges of the medial 4 digits
What are the actions of Extensor Digitorum?
-2nd-5th MCP, IP extension -radiocarpal extension
What are the attachment points of Extensor Digiti Minimi?
S/P: lateral epicondyle I/D: extensor expansion of the 5th digit
What are the actions of Extensor Digiti Minimi?
5th digit extension
What are the attachment points of Extensor Carpi Ulnaris?
S/P: lateral epicondyle I/D: base of the 5th metacarpal
What are the actions of Extensor Carpi Ulnaris?
-radiocarpal extension -ulnar deviation (with FCU)
What are the muscles of the deep layer of the posterior forearm?
-supinator -extensor indicis -abductor pollicis longus -extensor pollicis brevis -extensor pollicis longus
What are the attachment points of Supinator?
S/P (superficial layer): lateral epicondyle S/P (deep layer): supinator fossa/crest of ulna I/D: anterior/lateral/posterior parts of proximal radius
What are the actions of Supinator?
supination (radioulnar joints)
What are the attachment points of Extensor Indicis?
S/P: posterior mid-distal forearm (posterior mid-distal ulnar surface and interosseous membrane) I/D: extensor expansion of the 2nd digit
What are the actions of Extensor Indicis?
extends 2nd digit
What are the attachment points of Abductor Pollicis Longus?
S/P: posterior mid-distal forearm (posterior surface of the ulna, radius, and interosseous membrane) I/D: base of the 1st metacarpal
What are the actions of Abductor Pollicis Longus?
1st CMC abduction
What are the attachment points of Extensor Pollicis Brevis?
S/P: posterio mid-distal forearm (posterior mid-distal radial surface and interosseous membrane) I/D: base of the proximal phalanx of the thumb
What are the actions of Extensor Pollicis Brevis?
-1st MCP extension -1st CMC extension
What are the attachment points of Extensor Pollicis Longus?
S/P: posterior mid-distal forearm (posterior ulnar surface and interosseous membrane (superior to the extensor indicis) I/D: base of the distal phlanx of the thumb
What are the actions of Extensor Pollicis Longus?
-1st IP extension -1st MCP extension
What are the borders and floor of the anatomical snuff box?
-anterior border: abductor pollicis longus and extensor pollisic brevis -posterior border: extensor pollicis longus -floor: scaphoid
What are the two-headed muscles of the forearm?
-Flexor Carpi Ulnaris (humeral head and ulnar head) -Flexor Digitorum Superficialis (humeroulnar head and radial head)
What are the borders of the Cubital Fossa?
-superiorly: a line drawn between the medial and lateral epicondyles -medially: pronator teres -laterally: brachioradialis
What are the floor and roof of the Cubital Fossa?
-floor: brachialis, supinator -roof: fascia, bicipital aponeurosis
What are the contents of the Cubital Fossa?
-biceps tendon -brachial artery -brachial vein -median nerve
What are the available movements of the carpometacarpal joints?
-flexion: movement that takes thumb medially along the coronal plane towards the other fingers -extension: movement that takes the thumb laterally along the coronal plane away from the other fingers -abduction: movement that takes the thumb along the sagittal plane away from the palm -adduction: movement that takes the thumb along the sagittal plane towards the palm -circumduction -opposition: movement by which the 1st digit pad (thumb) is brought to another digit pad
What are the ligaments of the midcarpal joint?
dorsal and palmar intercarpal ligaments
What are the ligaments of the radiocarpal joint?
palmar and dorsal radiocarpal ligaments attach distal radius - carpal bones on the palmar and dorsal surfaces
What are the ligaments of the intercarpal joints?
interosseous intercarpal ligaments
What are the ligaments of the carpometacarpal joints (2-5)?
dorsal, palmar, interosseous ligaments
What are the ligaments of the intermetacarpal joints?
-interosseous ligaments -between the heads of the medial 4 metacarpals is the deep transverse metacarpal ligament
What are the ligaments of the metacarpophalangeal joints?
-medial and lateral collateral ligaments -palmar ligaments (palmar plates) - they check hyperextension
What are the ligaments of the interphalangeal joints?
medial and lateral collateral ligaments
What passes under the extensor retinaculum of the wrist?
extensor tendons at the wrist pass under (with each tendon is a sheath for protection)
What are the thenar muscles?
-opponens pollicis -abductor pollicis brevis -flexor pollicis brevis
What are the hypothenar muscles?
-opponens digiti minimi -abductor digiti minimi -flexor digiti minimi brevis -palmaris brevis
What are the deep muscles of the hand?
-adductor pollicis -lumbricals -dorsal interossei (4 muscles) -palmar interossei (3 muscles)
The intrinsic muscles of hand can be remembered using the mnemonic, “ A OF A OF A”, which stands for:
Abductor pollicis brevis, Opponens pollicis, Flexor pollicis brevis (the three thenarmuscles), Adductor pollicis, and the three hypothenar muscles, Opponens digiti minimi, Flexor digiti minimi, Abductor digiti minimi.
