B6-004 Forearm and Hand Flashcards
boundaries of the cubital fossa [5]
-pronator teres
-line between medial and lateral epicondyles
-brachioradialis
-brachialis
-supinator
vein used for blood draws in lab
median cubital
biceps attaches to […] of radius
radial tuberoscity
the bicipital aponeurosis protects what two structures?
brachial artery
median nerve
at the cubital fossa, the brachial artery branches into […] and […]
ulnar a.
radial a.
at the cubital fossa, radial nerve will branch into
deep branch-supinator
superficial branch- dorsum of hand
nerve that runs behind the medial epicondyle
ulnar
the tendon of the flexor digitorum superficialis inserts onto the […]
middle phalynx
the flexor digitorum superficialis flexes the […] IP joint
proximal
what three muscles run through the flexor retinaculum?
flexor digitorum profundus
flexor pollicis longus
flexor digitorum superficialis
which compartment of the forearm contains flexors and pronators?
anterior
as the radial artery runs lateral to the wrist, it lies next to […] where you would take a radial pulse
flexor carpi radialis tendon
the ulnar artery branches into the […] which supplies the posterior compartment of the arm
posterior interosseus artery
the ulnar artery branches into the […] which supplies the anterior compartment of the arm
anterior interosseus artery
the flexor carpi radialis, flexor carpi ulnaris, and pronator teres all attach at the […] of the humerus
medial epicondyle
what branch of the radial nerve does sensory to the dorsum of the hand?
superficial
what branch of the radial nerve enters the supinator muscle?
deep branch
innervates the deep anterior compartment of the forearm
**flexor digitorum profundus, flexor pollicis longus, pronator quadratus
anterior interosseous branch of the median nerve
supplies sensation to the majority of the palm
palmar branch of the median nerve
why don’t you lose palmar sensation in carpal tunnel syndrome?
palmar branches of the median nerve lies anterior to the flexor retinaculum
where can the ulnar nerve become entrapped causing cubital tunnel?
flexor carpi ulnaris
supplies sensation to the dorsum of the medial hand
dorsal branch of ulnar nerve
the posterior compartment is generally attached to the […] epicondyle, except for […]
lateral epicondyle
extensor carpi radialis
where does extensor carpi radialis attach?
suprachondylar area
extensors and supinators lie in which compartment?
posterior
lateral epicondylitis is caused by repetitive use of […] muscles
extensor
pain over lateral epicondyle that radiates down posterior surface of the arm
lateral epicondylitis
pain is felt with opening doors or lifting a glass
lateral epicondylitis
medial epicondylitis is caused by repetitive use of the […] muscles
flexors
activity associated with medial epicondylitis
pitching
activity associated with lateral epicondylitis
tennis
pain over medial epicondyle that radiates down the anterior surface of the arm
medial epicondylitis
pain is felt when flexing the wrist or squeezing a ball
medial epicondylitis
avulsion of extensor digitorum tendon
mallet/baseball finger
individual cannot extend distal IP joint
mallet/baseball finger
pain and tenderness in proximal aspect of anterior forearm and abnormal sensation in the palm
pronator syndrome
cubital tunnel syndrome is the entrapment of ulnar nerve by [….]
flexor carpi ulnaris
pain and tenderness in the medial forearm and little finger, and abnormal palm sensation
cubital tunnel
proximal row of carpals (L to M)
scaphoid
lunate
triquetrum
pisiform
So Long To Pinky
distal row of carpals (M to L)
hamate
capitate
trapezoid
trapezium
Here Comes The Thumb
sesamoid bone that develops in the tendon of the flexor carpi ulnaris
pisiform
bones of the radio-carpal joint
scaphoid
lunate
triquetrum
radius
palmar aponeurosis helps with […]
grip
palmaris longus attaches distally to
palmar aponeurosis
if there was a puncture would to the 5th digit synovial sheath, where could the infection spread?
thumb, hand
even through carpal tunnel and up forearm
if there was a puncture wound to the 3rd digit synovial sheath, where could the infection spread?
nowhere, stays local
**2,3,4 have individual sheaths
caused by disparity in size of the flexor tendons vs the retinacular pulley system
trigger finger (stenosing flexor tenosynovitis)
progressive fibrosis of the palmar fascia
dupuytren’s contracture
muscles of the thenar eminence [4]
opponens pollicis
abductor pollicis brevis
flexor pollicis brevis
adductor pollicis
OAAF
the thenar eminence is innervated by [2]
recurrent branch of the median
**deep FPB and adductor pollicis are innervated by deep branch of ulnar
what muscles of the thenar eminence are innervated by the deep branch of the ulnar nerve?
flexor pollicis brevis
adductor pollicis
the muscles of the hypothenar eminence [3]
opponens digiti
abductor digiti minimi
flexor digit minimi
OAF
the hypothenar eminence is innervated by
deep branch of ulnar nerve
the 1st and 2nd lumbrical are innervated by
median
the 3rd and 4th lumbricals are innervated by
deep branch of ulnar
the palmar and dorsal interossei are innervated by
deep branch of ulnar
lumbricals are attached to the […]
flexor digitorum profundus
[…] interossei abduct
dorsal
**Dorsal ABduct (DAB)
[…] interossei adduct
palmar
*Palmar ADuct (PAD)
the ulnar a. terminates as […]
superficial palmar arch
the superficial palmar arch of the ulna artery extend to the […] crease of your hand
proximal
where should you do a finger stick?
the side of digit. that’s where proper palmar digital arteries lie
the radial artery goes […] to the thumb
posterior
what artery runs in the anatomical snuff box?
radial
**radial goes behind the thumb
the radial a. terminates as
deep palmar arch
princeps pollici and radial indicis are branches of the […] artery
radial
ulnar artery + superficial branch from radial gives you
superficial palmar arch
radial a. + deep branch of ulnar a. gives you
deep palmar arch
provides motor innervation to the intrinsic muscles of hand
deep branch of ulnar
cutaneous sensation to the medial hand on both palmar and dorsal side, half of digit 4 and all of digit 5
ulnar n.
cutaneous sensation to the anterior lateral hand and to digits 1-4.5 and nail beds
median
cutaneous sensation to lateral-dorsal aspect of:
-hand
-thumb
-proximal portion of digits 1-4.5
superficial branch of radial nerve
what muscles are involved in extension of thumb [3]
extensor pollicis brevis
extensor pollicis longus
abductor pollicis longus
what muscles are involved in flexion of thumb [2]
flexor pollicis brevis
flexor pollicis longus
what muscles are involved in abduction of thumb [2]
abductor pollicis longus
abductor pollicis brevis
what muscle is involved in adduction of thumb
adductor pollicis
what muscle is involved in opposition of thumb
opponens pollicis
lumbricals and interossei insert into
extensor “hood” (dorsal)
**comes off extensor digitorum
lumbricals and interossei […] the MCP and […] the DIP/PIPs
flex MCP
extend DIP/PIP
mallet finger rips the […]
extensor hood
**comes off extensor digitorum
disruption of the terminal slip of the extensor tendon at the DIP joint
mallet finger
mallet finger is caused by […] of the finger
hyperflexion
rupture of the flexor digitorum profundus at the attachment on distal phalanx
jersey finger
jersey finger is caused by […] of the finger
hyperextension
muscles going through carpal tunnel
flexor digitorum superficialis
flexor digitorum profundus
flexor pollicis longus
long standing carpal tunnel will result in atrophy of the […]
thenar eminence
guyon’s canal is made up of […] and […] bones
hamate and pisiform
what neurovascular structures pass through Guyon’s canal?
ulnar a.
ulnar n.
Guyon’s canal only affects the […] portion of the hand
anterior
**palmar and dorsum spared
provides sensory to fifth digit and half of 4th
superficial terminal branch of ulnar n.
boundaries of anatomical snuffbox [3]
extensor pollicis longus
extensor pollicis brevis
abductor pollicis longus
contents of anatomical snuffbox [5]
radial styloid
scaphoid
trapezium
base of first metacarpal
radial artery
you can check for point tenderness of scaphoid fracture by pressing on the
anatomical snuffbox
inflammation of abductor pollicis longus and extensor pollicis brevis cause […]
De Quervain Tenosynovitis
pain with thumb extension (grabbing groceries, carrying child carseat)
De Quervain Tenosynovitis
how to test for De Quervain Tenosynovitis?
pain illicited when pressing the thumb down and flexing
most common fracture of carpals
scaphoid
why is the scaphoid at risk of necrosis when fractured?
it gets a retrograde blood supply from the radial a.
point tenderness in the anatomical snuffbox suggests a fracture in
scaphoid
can cause loss of thumb opposition
carpal tunnel
weakness or inability to flex or oppose the thumb indicates damage to
median
decreased strength during extension of the thumb indicates damage to
radial nerve
atrophy of dorsal interosseus muscles indicates damage to
ulnar nerve
loss of sensation to the skin covering the medial aspect of hand indicates damage to the
ulnar nerve
the ulnar artery originates in the
cubital fossa
the ulnar artery branches from the
brachial
what artery is highly subject to compression in anterior compartment syndrome of the forearm?
ulnar
the posterior interosseus v. continues into the deep branch of the radial v. and enters the […] compartment
posterior
nerve that is just medial to the brachial artery
median
the synovial sheaths of digits […] do not communicate with other synovial sheaths
2-4
provides supination and flexion of the forearm
biceps brachii
label A-F
a. capitulum of humerus
b. radial tuberoscity
C. trochlea of humerus
D. olecranon
E. medial epicondyle
F. head of radius
site of origin for the common flexor tendons and pronator teres
medial epicondyle
where triceps brachii attach distally
olecranon
damage to the […] nerve will result in loss of wrist extension
radial
weakness in pronation may be caused by damage to the
median or anterior interosseus
sensory loss over the ventral aspect of the thumb would result from damage to the […] nerve
median
inability to oppose thumb results from damage to the […] nerve
median
inability to abduct fingers results from damage to the
ulnar
artery that supplies the posterior compartment of the forearm
posterior interosseus
brachial artery branches into [..] and […] at cubital fossa
radial and ulnar
the radial and ulnar arteries are located in the […] compartment and terminate in the hand
anterior
the deep artery of the arm is located in the […] compartment and travels with […]
posterior
radial nerve
loss of sensation over medial hand and entire 5th digit is due to damage in
ulnar nerve
loss of finger abduction and adduction is due to damage in the
ulnar nerve
weakness of flexion in the distal IP joint of the index would be due to damage to the
lateral part of flexor digitorum profundus
lateral part of flexor digitorum profundus is innervated by
anterior interosseus
weakness of pronation results from damage to the
median nerve
weakness of wrist abduction results from damage to [2 nerves]
radial nerve- ECRL or ECRB
or median nerve- FCR
weakness of wrist […] is caused by damage to the radial nerve
extension