B1W3: Hand and Forearm Flashcards

1
Q

The three elbow joint articulations

A

Humeroulnar

Humeroradial

Proximal radioulnar

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2
Q

Humeroulnar articulation

A

hinge with coronoid process and trochlea/olecranon fossa and olecranon; flexion/extension (ulna=pinkie side)

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3
Q

Humeroradial articulation

A

modified hinge with capitulum and head; flexion/extension and supination/pronation (radius=thumb side)

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4
Q

Proximal Radioulnar Joint

A

pivot between radius and ulna; supination and pronation

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5
Q

Anular ligament

A

Round ligament that wraps around head of radius, allows for rotation

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6
Q

Nursemaid’s Elbow

A

if radius is dislocated, annular ligament would be broken; radial head in children isn’t that big yet, so radius can actually be pulled out of anular ligament and displaced

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7
Q

Radial collateral ligament

A

holds radius in place and works with ulnar collateral

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8
Q

Ulnar collateral ligament

A

holds ulna in place and works with radial collateral

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9
Q

The three ligaments of the elbow joint

A

Anular ligament
Radial collateral ligament
Ulnar collateral ligament (baseball players tear this one)

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10
Q

Components of long bones

A

Epiphysis: end of long bone
Metaphysis: where epiphysis, diaphysis meet; growth center
Diaphysis: shaft

Head of radius is proximal while head of ulna is distant

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11
Q

Proximal/distal radioulnar joints

A

How pronation/supination occurs; radius moves around the stationary ulna

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12
Q

Distal radioulnar joint

A

Pivot/synovial joint responsible for supination/pronation

Separated from joint space by articular disc (i.e. triangular fibrocartilage complex)

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13
Q

Articulations of the wrist (3)

A

Midcarpal joint: full extension

Radiocarpal joint: majority of movement

Articular disc: helps elaborate articular surface of radius so bones can slide on top of each other without articulating the ulna directly

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14
Q

Wrist bones

A

PROXIMAL ROW (palmar, thumb to pinkie): scaphoid lunate triquetrum pistiform

DISTAL ROW: trapezium, trapezoid, capitate, hamate

Scaphoid/lunate make direct connections to the radius, so a fall on the hand will break the scaphoid bone

No bones made articulation directly with ulna

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15
Q

Carpometacarpal joint (CMC)

A

Thumb=saddle joint (great range of motion, only other saddle joint is sternum)

digits=plane

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16
Q

Metacarpophalangeal (MCP or MP)

A

Thumb=hinge (only goes to front and back)

Digits=condyloid (can spread fingers apart, and use as hinge); flexion/extension/abduction/adduction

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17
Q

Proximal Interphalangeal (PIP) joint

A

Hinge

No thumb
flexion/extension only

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18
Q

Distal Interphalangeal (DIP) joint

A

Hinge

No thumb

flexion/extension only

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19
Q

Ligaments of fingers

A

Collateral ligaments: two per each MC/IP joint capsule; stabilizes and guards against too much lateral deviation

Palmar ligaments/plates: thicken joint capsule and aid in centering tendons and guard against hyperextension

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20
Q

Elbow movements

A

Flexion: biceps brachii, brachialis

Extension: triceps brachii

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21
Q

Forearm movements

A

Protonation: pronator teres and pronator quadranis

Supination: biceps brachii, supinator

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22
Q

Wrist movements

A

Flexion: “oh no he didn’t”
Extension: “as if”
Adduction: deviating medially
Abduction: deviating laterally

Radial deviation: moving thumb side
Ulnar deviation: moving pinkie side

23
Q

Thumb movements: adduction/abduction

A

Occurs at CMC

Thumb coming straight up=abduction

Thumb coming down=adduction

Perpendicular to plane of palm

24
Q

Thumb movements: flexion/extension

A

Occurs at CMC/MP joint

Flexion=bringing thumb into palm
In coronal plane, parallel to plane of palm

25
Thumb movements: opposition
At CMC joint | Thumb opposes little fingers
26
MCP Movements
Done by ulnar nerve Abduction=spreading fingers out Adduction=bringing fingers back together
27
Musculature of hand generalities
Flexor/pronators=medial epicondyle, in anterior compartment; always radial nerve Extensors/supinators=lateral epicondyle, in dorsal compartment Hand intrinsics: originate and insert in wrist and hand; no dorsal muscles and only do fine movement
28
Superficial layer of extensor muscles, lateral to medial on dorsal side of hand
``` Extensor carpi radialis longus Extensor carpi radialis brevis Extensor digitorum Extensor digiti minimi Extensor carpi ulnaris ```
29
Trifurcation of extensor digitorum tendon
Central slip and two lateral bands that attach to distal phalanes if you tear one, can't flex fingers!
30
Extensor hood
Elaboration of this muscle on the dorsum of each proximal phalanx; includes central and lateral components; non contractile, extends IPs when ED contracts and is pulled proximally (can't extend DIP and flex PIP at same time!) the interossei and lumbrical attach
31
Deep layer extensor muscles
Supinator Abductor pollics longus Extensor pollicis longus Extensor policis brevis
32
What are the outcropping muscles?
Make anatomical snuff box Abductor pollicis longus, extensor pollicis longus, extensor pollicis brevis
33
Anatomical snuff box
Dorsal side of hand near thumb Contains radial nerve, cephalic vein, radial artery and scaphoid bone
34
Superficial layer flexor muscles of hand (lateral to medial when palm side up)
Pronator teres Flexor carpi radialis Palmaris longus Flexor carpi ulnaris
35
Intermediate layer of flexor muscles of hand
Flexor digitorum superficialis --major flexor of wrist/fingers, 4 tendons, no movement of thumb
36
Deep layer flexor muscles of hand
Flexor digitorum profundus (tendon passes thru Camper's chiasm) Flexor pollicis longus Pronator quadratu
37
Flexor sheath
Membrane portion=promotes tendon gliding, allows for good grip Retinacular portion=forms pulleys which stabilize tendon; cruciate tendons that cross anular ones and go all the way around finers
38
Carpal tunnel
Flexor renticulum goes over it Contains medial nerve, which is compressed during carpel tunnel syndrome 9 tendons go through (flexor policis longus, flexor digitorum profundus, flexor digtorium superficialis)
39
Hand intrinsics: thenar
Base of thumb group Abductor pollicis brevis Flexor pollicis brevis (2) Opponens pollicis Adductor pollicis (2 heads, oblique and transverse)
40
Hand intrinsics: hypothenar
Base of little finger Abductor digiti minimi Flexor digiti minimi Opponens digiti minimi Palmaris brevis
41
Interossei
3 palmar adductors, unipennate (PAD); ulnar nerve 4 dorsal abductors, bipenate (DAB); ulnar nerve Flex MCPs and extend IPs through extensor hood (flexing fingers at 90 degrees) Metacarpals to proximal phalanx and extensor hood
42
Lumbricals
Arise from FDP tendons and go into extensor hood; flex MCPs and extend IPs through extensor hood Index and middle arise from 1 head Ring and small arise from two heads
43
What happens if you lose intrinsic hand muscles?
Get a claw-shaped hand (i.e. lose the interosseous and lumbrical muscles)
44
Arteries of hand
Radial artery=goes to snuffbox Ulnar artery=goes into hand Other structures: superficial and deep palmar arches, princeps pollicis, radials indicis, common palmar digital and proper palmar digital
45
Alan's test
See what vasculature in hand is like Squeeze wrist, watch hand turn white, let go and see where the color returns
46
Venous system of hand
Superfical veins: cephaalic, basilic, and median cubital (where you take blood) Deep veins: perforating eins and Venae Comitantes; usually paired Once basilic vein joins the venae comitantes of the axillary artery, becomes axillary vein
47
Nursemaid's Elbow
Captiulum to radial head=annular ligament | If radius dislocated, annular ligament breaks or in kids slides up
48
Dorsum of wrist and hand
6 dorsal compartments; fibro-osseous tunnels with synovial sheaths Extensor retinaculum secures tendons and prevents bowstring effect Juncturae tendinum allows synergistic function of extensor tendons
49
Innervations of forearm/hand
Extensor/supinator: radial nerve; sensation to dorsal hand Flexor/pronator: median nerve except FCU and 1/2 FDB (both ulnar); sensation to prehensile area, goes through carpal tunnel Hand intrinsics: ulnar except med loaf--2 lateral lumbricals, opponons polilics, abductor policis brevis, superfical head of flexor pollicis breavis
50
Ulnar nerve and hand intrinsics
Innervates 4th and 5th fingers, half of middle finger passes through Guyon's canal MED loaf=lumbricals 1 and 2, flexor policis brevis, abductor policis brevis
51
Collateral ligaments
Medial and lateral; fibrous layer of the IP and MC against excessive lateral deviation
52
Palmar ligaments
Volar thickening of joint capsule which aid incentering the long flexortendons and guard against hyperextension
53
Medial nerve
flexor/pronator except for FCU/ 1/2 FDP MED LOAF carpal tunnel syndrome when compressed, can't move thumb, lose strength