Cubital Fossa and Forearm Flashcards

1
Q

Boundaries of the Cubital Fossa

A
  1. Superior (base)- imaginary line between medial and lateral epicondyles of humerus
  2. Medially- pronator teres
  3. Laterally- brachioradialis
  4. Inferiorly (apex)- meeting of brachioradialis and pronator teres
  5. Posteriorly (floor)- brachialis superiorly and supinator muscle inferiorly
  6. Anteriorly (roof)- skin, superficial and deep fasciae and bicipital aponeurosis
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2
Q

List the superficial content of the cubital fossa

A

o Median cubital vein
o Medial cutaneous nerve of forearm
o Upper lateral cutaneous nerve of forearm

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3
Q

list the deep content of the cubital fossa

A

o Median nerve
o Biceps brachii tendon
o Radial nerve deep to brachialis
o Terminal end of brachial artery
o Radial and ulnar arteries
o Radial recurrent artery

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4
Q

one function of the bicipital aponeurosis

A

Bicipital aponeurosis separates
superficial and deep structures
of the cubital fossa

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5
Q

Vein associated with IV and venipuncture injections

A

median cubital vein

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6
Q

Vein that runs diagonally from cephalic vein of forearm to basilic vein of arm

A

medial cubital vein

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7
Q

which vein is fixed by a communicating perforating vein (pierces the bicipital aponeurosis as it becomes
superficial)

A

median cubital vein

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8
Q

bone that articulates with 2 carpal bones of the wrist: lunate medially and scaphoid laterally

A

radius

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9
Q

bone that articulates proximally with the humerus at the capitulum and medially with the ulna on both proximal
and distal ends

A

radius

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10
Q

List the 9 landmarks of the radius

A

radial head, radial neck, radial tuberosity, shaft, interosseus border, anterior oblique line, ulnar notch, styloid process, suprastyloid crest

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11
Q

Describe the radial head landmark of the radius

A
  1. Radial head
    * Round articular structure on the proximal end of the radius
    * Cupped proximal surface (articular fovea or facet) articulates with the capitulum of the humerus
    * The articular circumference articulates with the ulna
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12
Q

describe the radial neck landmark of the radius

A
  1. Radial neck
    * Slender segment of the radius between the head and the radial tuberosity
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13
Q

describe the radial tuberosity landmark of the radius

A
  1. Radial (bicipital) tuberosity
    * Blunt variably shaped structure on the anteromedial side of the proximal radius
    * Marks the insertion of the biceps brachii
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14
Q

Describe the landmark of the radius: shaft

A

Long, thin section between the radial tuberosity and the expanded distal end
* Divided into 3 surfaces- anterior, posterior and lateral

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15
Q

Describe the landmark of the radius: interosseus border

A
  • Sharp medial edge of the radial shaft
  • Serves as attachment site for interosseus membrane which divides forearm into anterior and
    posterior compartments
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16
Q

Describe the landmark of the radius: anterior oblique line

A

Gives origin to the extrinsic muscles of the hand

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17
Q

Describe the landmark of the radius: ulnar notch

A

Concave articular hollow surface on the medial corner of the distal radius, articulating with distal
ulna

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18
Q

Describe the landmark of the radius: styloid process

A

Sharp projection on the lateral side of the distal radius

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19
Q

Describe the landmark of the radius: Suprastyloid crest

A

Runs obliquely over the styloid process on the anterior surface
* Serves as attachment for brachioradialis

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20
Q

Describe the landmark of the ulna: olecranon

A
  1. Olecranon
    * Most proximal part of the bone
    * Massive blunt process
    * Triceps brachii inserts onto the tuberosity of this process
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21
Q

Describe the landmark of the ulna: trochlear notch

A
  1. Trochlear notch
    * Articulates with the trochlea of the distal humerus
    * Rotary motion is restricted at the ulnar part of the elbow which limits its ability to rotate along its long
    axis
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22
Q

Describe the landmark of the ulna: coronoid process

A
  • Anterior beak-shaped projection at the base of the trochlear notch
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23
Q

Describe the landmark of the ulna: ulnar tuberosity

A
  • Roughened depression immediately inferior to the coronoid process
  • Marks the insertion of the brachialis muscle
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24
Q

Describe the landmark of the ulna: radial notch

A
  • Small articular surface for the radius
  • Located along the lateral margin of the coronoid process
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25
Q

Describe the landmark of the ulna: shaft

A
  • Long segment between the brachial tuberosity and the distal end of the ulna
  • Divided into 3 surfaces by the 3 borders- interosseus, anterior (medial), posterior
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26
Q

Describe the landmark of the ulna: interosseus border

A
  • Sharpest border of the ulna
  • Lies opposite to radius
  • Between the anterior and posterior surfaces
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27
Q

Describe the landmark of the ulna: ulnar head

A
  • Enlarged distal end of the bone
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28
Q

Describe the landmark of the ulna: ulnar styloid process:

A
  • Sharp distalmost projection of the ulna
  • On the posteromedial aspect of the bone
  • Provides attachment to the ulnar collateral ligament of the wrist
  • Separated from the remainder of the head by a deep groove, the fovea
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29
Q

Describe the landmark of the ulna: articular circumference

A
  • Distal, lateral, round articulation that conforms to the ulnar notch of the radius (in the same way that
    the radial head conforms to the radial notch of the proximal ulna)
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30
Q

Type of joint in the elbow joint

A

hinge type synovial joint

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31
Q

What movements does the elbow joint allow

A

o Flexion by brachialis and biceps brachii
o Extension by triceps brachii assisted by anconeus

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32
Q

The elbow joint has 2 articulations. Describe the articulations?

A
  • Articulation:
    1. Humeroulnar
    o Trochlear of humerus and trochlear notch of ulna
    2. Humeroradial
    o Capitulum of humerus and head of radius
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33
Q

Describe the radial collateral ligament

A

o Fan-like
o Extends from lateral epicondyle of humerus and blends distally with the anular ligament of the
radius

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34
Q

Describe the anular ligament

A

o Encircles and holds the head of the radius in the radial notch of the ulna
o Forms the proximal radio-ulnar joint which allows the pronation and supination of the forearm

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35
Q

describe the ulnar collateral ligament

A

Ulnar collateral ligament
o Triangular
o Extends from the medial epicondyle of the humerus to the coronoid process and olecranon of
the ulna
o Consists of 3 bands:
1. The strongest anterior cord-like band
2. The weakest posterior fan-like band
3. The slender oblique band deepens the socket for the trochlear of the humerus

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36
Q

What is the blood supply of the elbow joint

A

Anastomosis around elbow joint:
* Inferior ulnar collateral artery anastomoses with anterior ulnar recurrent artery
* Superior ulnar collateral artery anastomoses with posterior ulnar recurrent artery
* Middle collateral branch of profunda brachii a. anastomoses with recurrent interosseus a.
* Radial collateral branch of profunda brachii artery anastomoses with radial recurrent artery

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37
Q

innervation of the elbow joints

A

Musculocutaneous, radial and ulnar nerves

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38
Q

Describe the bursae in the elbow joint

A

o Bursae:
1. Intratendinous olecranon bursa- in the tendon of triceps brachii
2. Subtendinous olecranon bursa- between olecranon and triceps tendon
3. Subcutaneous olecranon bursa- in subcutaneous tissue over olecranon
4. Bicipitoradial bursa- separates biceps tendon from the anterior part of the radial tuberosity and
reduces abrasion

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39
Q

Type of joint of the proximal radio-ulnar joint

A

Pivot type synovial joint

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40
Q

Articulation of the proximal radio-ulnar joint

A

Articulation: head of radius and radial notch of ulna

41
Q

Describe the ligament of the proximal radio-ulnar joint

A
  1. Anular ligament:
    o Attached to ulna anterior and posterior to radial notch
    o Creates a ring that completely encircles the head of the radius
    o Synovial membrane continues distally as sacciform recess of proximal radio-ulnar joint on the
    neck of the radius
    (Anular ligament allows the radius to rotate
    within the anular ligament
    without binding, stretching or
    tearing the synovial membrane)
42
Q

Blood supply of the proximal radio-ulnar joint

A

Blood supply:
o Radial portion of the peri-articular arterial anastomosis of elbow joint
o Radial and middle collateral arteries anastomose with the radial and
recurrent interosseus arteries

43
Q

List the movements of the proximal radio-ulnar joint

A
  1. Supination
  2. Pronation
44
Q

Muscles involved with supination at the proximal radio-ulnar joint

A

o When there is no resistance, supinator acts
o With resistance, biceps brachii acts with assistance from extensor pollicis longus and extensor
carpi radialis longus

45
Q

Muscles involved with pronation at the proximal radio-ulnar joint

A

o Primarily pronator quadratus
o Secondarily pronator teres
o When forearm is in mid-pronated position (palm facing thigh), flexor carpi radialis, palmaris
longus and brachioradialis act

46
Q

nerves that allow for supination at the proximal radio-ulnar joint

A

musculocutaneous and radial nn.

47
Q

nerves that allow for pronation at the proximal radio-ulnar joint

A

median nerve

48
Q

type of joint of the distal radio-ulnar joint

A

Pivot type synovial joint

49
Q

Describe the movement that can occur at the distal radio-ulnar joint

A
  1. Pronation
    o Distal end of the radius rotates anteromedially crossing over the ulnar anteriorly
  2. Supination
    o Radius uncrosses from ulna- its distal end rotates posterolaterally to make the bones parallel
50
Q

Blood supply and innervation of the distal radio-ulnar joint

A

o Anterior and posterior interosseus arteries
o Anterior and posterior interosseus nerves

51
Q

type of joint at the wrist joint

A

Condyloid type synovial joint

52
Q

what are the 4 ligaments of the wrist joint

A

palmer radiocarpal ligaments, dorsal radiocarpal ligaments, ulnar collateral ligament, radial collateral ligament

53
Q

the ligament that :
o Attached to radial styloid process and scaphoid
o Strengthens the joint laterally

A

radial collateral ligament

54
Q

ligament that:
o Attached to ulnar styloid process and triquetrum
o Strengthens the joint medially

A

ulnar collateral ligament

55
Q

the ligament that:
o Pass from radius to the 2 rows of carpals
o Strong and directed so that the hand follows the radius during supination of the forearm

A

palmar radiocarpal ligament

56
Q

the ligament that:
o Take the same direction as palmar radiocarpal ligaments so that the hand follows the radius
during pronation of the forearm

A

dorsal radiocarpal ligament

57
Q

blood supply to the wrist joint

A

Branches of the dorsal and palmar carpal arches

58
Q

innervation of the wrist joint

A

From anterior interosseus branch of median n., posterior interosseus branch of radial n. and the
dorsal and deep branches of the ulnar n.

59
Q

do superficial muscles cross the elbow joint

A

true

60
Q

list the superficial muscles of the anterior flexor-pronator compartment

A
  1. Pronator teres
  2. Flexor carpi radialis
  3. Palmaris longus
  4. Flexor carpi ulnaris
61
Q

what is the intermediate muscle

A

Flexor digitorum superficialis

62
Q

list the deep muscles of the anterior flexor-pronator compartment

A
  1. Flexor digitorum profundus
  2. Flexor pollicis longus
  3. Pronator quadratus
63
Q

innervation of the pronator teres

A

median nerve

64
Q

innervation of the Flexor carpi radialis

A

median nerve

65
Q

innervation of the Palmaris longus

A

median nerve

66
Q

innervation of the Palmaris longus

A

ulnar nerve

67
Q

innervation of the Flexor digitorum superficialis

A

median nerve

68
Q

innervation of the Flexor digitorum profundus

A

lateral half - median nerve

69
Q

innervation of the Flexor pollicis longus

A

anterior interosseous n. from median n.

70
Q

innervation of the pronator quadratus

A

anterior interosseous n. from median n.

71
Q

innervation of the brachioradialis

A

radial nerve

72
Q

innervation of the extensor carpi radialis longus

A

radial nerve

73
Q

innervation of the Extensor carpi radialis brevis

A

Deep branch of radial n.

74
Q

innervation of the extensor digitorum

A

Deep branch of radial n.

75
Q

innervation of the Extensor digiti minimi

A

Deep branch of radial n.

76
Q

innervation of the Extensor carpi ulnaris

A

Deep branch of radial n.

77
Q

innervation of the Supinator

A

Deep branch of radial n.

78
Q

innervation of the extensor indicis

A

Posterior interosseus n. from
deep branch of radial n.

79
Q

innervation of the Abductor pollicis longus

A

Posterior interosseus n.

80
Q

innervation of the extensor pollicis longus

A

Posterior interosseus n.

81
Q

innervation of the extensor pollicis brevis

A

Posterior interosseus n.

82
Q

Pronators of the forearm:

A
  • Pronator teres
  • Pronator quadratus
83
Q

flexors of the wrist:

A
  • Flexor carpi radialis (also abducts wrist)
  • Flexor carpi ulnaris (also adducts wrist)
  • Palmaris longus
84
Q

Flexors of the fingers:

A
  • Flexor digitorum superficialis (middle
    phalanges)
  • Flexor digitorum profundus (distal
    phalanges)
85
Q

Flexor of the thumb:

A
  • Flexor pollicis longus
86
Q

supinator of forearm:

A

Supinator

87
Q

extensors of wrist:

A
  • Extensor carpi radialis longus
  • Extensor carpi radialis brevis
  • Extensor carpi ulnaris
88
Q

extensors of the fingers:

A
  • Extensor digitorum (4 fingers)
  • Extensor indicis (index finger)
  • Extensor digiti minimi (little finger)
89
Q

Extensors of the thumb

A
  • Extensor pollicis longus
  • Extensor pollicis brevis
90
Q

abductor of the thumb:

A
  • Abductor pollicis longus
91
Q

distal articulation of the ulna?

A

Articulates distally with the ulnar notch of the radius and with the articular disc that separates it from
the carpal bones

92
Q

Proximal articulation of the ulnar

A

Articulates proximally with the trochlea of the humerus and with the head of the radius

93
Q

Longest, thinnest bone in the forearm?

A

ulna

94
Q

muscles that flex the wrist joint

A

Flexion- Flexor carpi radialis and flexor carpi ulnaris, with assistance from flexors of the fingers
and thumb, palmaris longus and abductor pollicis longus

95
Q

muscles that extend the wrist joint

A

Extension- extensor carpi radialis longus AND brevis, extensor carpi ulnaris, with assistance
from extensors of the fingers and thumb

96
Q

muscles that abduct the wrist joint

A

Abduction- abductor pollicis longus, flexor carpi radialis, extensor carpi radialis longus AND
BREVIS (limited to 15° by radial styloid process)

97
Q

muscles that adduct the wrist joint

A

Adduction- simultaneous contraction of extensor carpi ulnaris and flexor carpi ulnaris

98
Q
A