Bones And Joints Of The Forearm And Cubital Fossa Flashcards
2 bones of the forearm
Radius
Ulna
What connects the radius and ulna
Interosseous membrane
Ulna and humerus articulation
Trochlea notch of ulna with trochlea of humerus
Radius and humerus articulation
Radial head with the capitellum of the humerus
What movements occur at the elbow joint
Flexion
Extension
Radius and ulna articulations
Proximal and distal radioulnar joints
Movements of proximal and distal radioulnar joints
Pronation and supination of the forearm and hand
Radius pivots around the ulna
Wrist joint
Radiocarpal joint
Radius articulates with 2 small bones of the wrist (carpal bones)
Movements at the wrist joint
Flexion
Extension
Abduction
Adduction
Which muscles move the proximal and distal radioulnar joints
Muscles of anterior arm and anterior and posterior forearm
Which muscles move the wrist joint
Muscles of anterior and posterior forearm
Olecranon
Posteriorly, proximal ulna forms a bulky process
Fits into Olecranon fossa on posterior distal humerus to allow full extension
Where is the olecranon fossa
Posterior distal humerus
Coronoid process
Anterior protrusion on proximal end of ulna
Fits into coronoid fossa on anterior distal humerus when elbow fully flexed
Where is the coronoid fossa located
Anterior distal humerus
Radial tuberosity
Roughened lump near proximal end of radius
Distal to head and neck
Where biceps brachii tendon inserts onto radius
Styloid process
Distal protrusion of the radius and ulna
Often implicated in fractures
What type of joint is the elbow joint
Synovial hinge joint
What reinforces the joint capsule of the elbow
Medial (ulnar) and lateral (radial) collateral ligaments
What maintains stability of the elbow joint
Medial and lateral Collateral ligaments
The coronoid process and olecranon of the ulna pinch the trochlea of the humerus
What type of joint are the proximal and distal radioulnar joints
Synovial, pivot type joints
Annular ligament
Ligament of the radius which wraps around the radial neck, attaches to the ulna and holds the radial head in place
The radial head rotates within it to produce pronation and supination
How many bones comprise the carpus
8 small bones
How are the bones of the carpus arranged
2 rows of 4 bones
Which 2 carpal bones does the distal radius articulate with
Scaphoid and lunate
Which bones comprise the proximal row of carpal bones from lateral to medial
Scaphoid
Lunate
Triquetrum
Pisiform
Pisiform
Not a true carpal bone
A small bone that develops in the tendon of flexor carpi ulnaris
Meaning of scaphoid
Boat-shaped
Meaning of lunate
Moon-shaped
Meaning of triquetrum
Three-cornered
Meaning of pisiform
Pea-shaped
Which bones form the distal row of the carpal bones from lateral to medial
Trapezium
Trapezoid
Capitate
Hamate
Trapezium
Base of the thumb
Capitate
Located centrally
Largest carpal bone
Hamate
Bears a bony process anteriorly (hook)
Meaning of capitate
Head
Meaning of hamate
Hook
What type of joint is the radiocarpal joint
Condyloid synovial joint
What type of joint are the intercarpal joints
Synovial joints
Bones of the hand
Carpals
Metacarpals
Phalanges
Bones of the digits
Phalanges
Number of phalanges bones in each finger
3
Number of phalanges in thumb
2
Cubital fossa
The region anterior to the elbow joint
Often referred to as antecubital fossa (ACF)
Triangular shaoed
3 borders of cubital fossa
Lateral border
Medial border
Superior border
Lateral border of cubital fossa
Brachioradialis (posterior forearm muscle)
Medial border of cubital fossa
Pronator teres (anterior forearm muscle)
Superior border of cubital fossa (base)
Imaginary line between the media, and lateral epicondyles of humerus
Apex of cubital fossa
Most distal
Points towards the forearm and hand
Contents of the cubital fossa
Tendon of biceps brachii
Bicipital aponeurosis
Brachial artery
Median nerve
Radial nerve
Where does the tendon of the biceps brachii insert onto
Radial tuberosity
Bicipital aponeurosis
A fascial extension of the biceps tendon
Continuous with the fascia on the surface of the anterior forearm muscles
Separates the superficial veins from deeper structures in the fossa: the brachial artery and median nerve
Brachial artery
Medial to biceps tendon
Bifurcates into its terminal branches -radial and ulnar arteries- deep in the cubital fossa
Terminal branches of the brachial artery
Radial and ulnar arteries
Median nerve
Medial to brachial artery
Travels through anterior compartment of arm and cubital fossa on its journey to the anterior forearm and hand
Radial nerve
Passes through lateral aspect of the cubital fossa
Deep to brachioradialis
Superficial veins in the subcutaneous tissue over the cubital fossa
Cephalic
Basilic
Median cubital
Radial head subluxation (pulled elbow)
This is seen in young children and is often caused by the child being pulled upwards by their arm. The annular ligament is partially torn, and the radial head moves distally out of the ligament (subluxation). It is painful and when assessing children in whom you suspect this injury, you may only notice that are not using the affected limb. The subluxed head can be reduced with relative ease using a simple manoeuvre.
Scaphoid fracture
The scaphoid forms from two bones, each with its own blood supply, that fuse together. With fusion, the artery to the proximal end degenerates, and the bone is supplied from its distal end. When the scaphoid fractures, the proximal part of the bone may be disconnected from the blood supply and death of the proximal segment results – this is called avascular necrosis.
Avascular necrosis is a serious problem because the proximal scaphoid articulates with the distal radius at the wrist joint. For this reason, fractures must not be missed. However, scaphoid fractures are not always evident on X-rays taken soon after the fracture has occurred. If a fracture is suspected but not seen on X-ray, patients are still followed-up.
Fracture of the distal radius
A fracture of the distal radius is very common in older people, especially females (in whom osteoporosis is more common). It is usually caused by a Fall Onto an OutStretched Hand (FOOSH). Simple distal radius fractures can be manipulated into an acceptable position for healing in the emergency department, but more complex fractures may require surgery.
- What are the names of the fossae on the anterior and posterior surfaces of the distal humerus?
Anterior= coronoid fossa
Posterior = Olecranon
- Name the three major superficial veins of the forearm.
Cephalic
Basilic
Median cubital vein
Course of the Cephalic vein
Arises from the lateral aspect of the dorsal venous network in the dorsum of the hand
Courses laterally up the forearm to the cubital fossa where it communicates with the Basilic vein via the median cubital vein
Continues proximally io the arm and later runs in the deltopectoral groove before joining the Axillary vein
Course of the Basilic vein
Arises from the medial aspect of the dorsal venous network in the dorsum of the hand
Courses medially up the forearm
Medial cubital vein connects the Basilic and Cephalic veins in the cubital fossa
Continues proximally up the medial side of the arm in the groove between the triceps and biceps
Proximally in the arm it passes deeper and joins the brachial vein to become the Axillary vein
Which 2 veins form the Axillary vein
Brachial and Basilic veins
What does the Cephalic vein join onto
The Axillary vein
What connects the Basilic and Cephalic veins
Median cubital vein
- What key structures can be found in the cubital fossa? Where are they located relative to each other?
Biceps tendon, brachial artery and median nerve
Brachial artery and median nerve lie medial to biceps tendon
- Which carpal bone is most prone to fracture? What complication may result if a fracture of this bone is missed?
Scaphoid - fall onto an outstretched hand
- What is the name of the pointed distal process of the radius and ulna that is palpable under the skin, and often implicated in fractures?
Styloid process
Which bones form the wrist joint
Radius
Scaphoid and lunate
- What is the name of the ring-like structure that holds the head of the radius in position proximally?
Annular ligament of the radius
Which bones form the true elbow joint
Humerus
Radius
Ulna
Movements of the true elbow joint
Flexion
Extension
Which bone moves during pronation or supination
Radius
Pneumonic to remember carpal bones
Straight line to pinkie
Here comes the thumb
Path of ulnar nerve
Posterior to elbow
‘Funny’ bone