Elbow and forearm Flashcards

1
Q

Which structure does the proximal humerus articulate with?

A

Glenoid fossa

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2
Q

Which 2 structures wrap around the surgical neck of the humerus?

A

Axillary nerve

Posterior humeral circumflex artery

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3
Q

Which 2 structures run through the posterior spiral groove (shaft) of the humerus?

A

Radial nerve

Deep brachial artery

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4
Q

What do the radial nerve and deep brachial artery pass through before wrapping round the posterior spiral groove of the humerus?

A

Triangular interval

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5
Q

Which condyle is next to the medial epicondyle?

A

Trochlea

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6
Q

Which condyle is next to the lateral epicondyle?

A

Capitulum

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7
Q

A fracture of the medial supracondylar ridge could injure which nerve?

A

Median nerve

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8
Q

Which nerve passes anterior to the medial epicondyle?

A

Median nerve

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9
Q

Which nerve passes posterior to the medial epicondyle?

A

Ulnar nerve

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10
Q

What shape is the head of the radius?

A

Circular

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11
Q

Which muscle attaches to the radial tuberosity?

A

Biceps brachii

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12
Q

Which muscle attaches to the olecranon process?

A

Triceps brachii

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13
Q

Which muscle attaches to the coronoid process of the ulna?

A

Brachialis

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14
Q

Which structure stretches between the radius and ulna?

A

Interosseous membrane

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15
Q

The elbow joint is formed by what 3 things?

A

Humerus

Proximal medial ulna

Proximal lateral radius

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16
Q

The head of the radius articulates with what?

A

Capitulum of the humerus

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17
Q

What causes the hands to be slightly lateral to the upper arm?

A

Carrying angle

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18
Q

The carrying angle helps to prevent what?

A

Hands hitting the body when swinging arms

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19
Q

As the ulnar nerve passes posterior to the medial epicondyle, what structure does it travel through?

A

Cubital tunnel

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20
Q

Which nerve passes through the cubital tunnel?

A

Ulnar nerve

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21
Q

The posterior interosseous nerve is a branch of which nerve?

A

Radial nerve

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22
Q

Damage to which nerve causes wrist drop?

A

Radial nerve

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23
Q

What is the function of the medial collateral ligament of the elbow?

A

Resists abduction / valgus

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24
Q

What is the function of the lateral collateral ligament of the elbow?

A

Resists adduction / varus

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25
Q

Which structure circles the head of the radius?

A

Annular ligament

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26
Q

What is Nursemaid’s Elbow?

A

When the annular ligament which wraps around the radial head slips off, causing subluxation or dislocation of the radial head

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27
Q

What is the term for the safe access point on the posterior elbow?

A

Anconeus triangle

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28
Q

The Anconeus triangle is formed by what 3 things?

A

Olecranon

Lateral epicondyle

Radial head

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29
Q

Describe which 2 muscles permit supination and the nerves which innervate each muscle.

A

Biceps - musculocutaneous nerve

Supinator - radial nerve

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30
Q

Describe which 2 muscles permit pronation and the nerve that innervates them.

A

Pronator teres + pronator quadratus

Median nerve

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31
Q

What are the 2 functions of the anterior forearm muscles?

A

Flexion
Pronation

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32
Q

What is the golden rule of innervation of the anterior forearm?

A

All anterior forearm muscles are innervated by the median nerve, except for 1.5 muscles (ulnar nerve)

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33
Q

What are the 3 functions of the posterior forearm muscles?

A

Extension
Supination
Thumb abduction

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34
Q

What is the golden rule of innervation of the posterior forearm?

A

All posterior forearm muscles are innervated by the radial nerve or its posterior interosseous branch

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35
Q

Which joints allow for pronation + supination of the forearm?

A

Proximal and distal radioulnar joints

36
Q

How many muscles are in each of the 3 layers of the anterior compartment of the forearm?

A

Layer 1 (superficial) - 4 muscles
Layer 2 - 1 muscle
Layer 3 - 3 muscles

37
Q

What are the 4 muscles in the superficial layer of the anterior compartment of the forearm?

A

Pronator teres
Flexor carpi radialis
Palmaris longus
Flexor carpi ulnaris

38
Q

Where do all of the muscles of the superficial layer of the anterior compartment of the forearm originate?

A

Medial epicondyle of humerus

39
Q

Which pathology is golfer’s elbow?

A

Medial epicondylitis

40
Q

Describe the innervation of the 4 muscles of the superficial layer of the anterior compartment of the forearm.

A

Pronator teres - median nerve

Flexor carpi radialis - median nerve

Palmaris longus - median nerve

Flexor carpi ulnaris - ulnar nerve

41
Q

Which muscle of the superficial layer of the anterior compartment of the forearm is absent in about 20% of people?

A

Palmaris longus

42
Q

What is the only muscle in the middle layer of the anterior compartment of the forearm?

What is its innervation?

A

Flexor digitorum superficialis - median nerve

43
Q

Which joints does the FDS flex and which does it not?

A

Carpometacarpal joints
MCP joints
PIP joints

NOT DIP joints

44
Q

Tendons of the FDS travel underneath what?

A

Transverse carpal ligament (flexor retinaculum)

45
Q

What forms the roof of the carpal tunnel?

A

Transverse carpal ligament (flexor retinaculum)

46
Q

What are the 3 muscles of the bottom layer of the anterior compartment of the forearm and their innervation?

A

Flexor pollicis longus - median nerve

Flexor digitorum profundus - 1/2 median + 1/2 ulnar nerve

Pronator quadratus - median nerve

47
Q

Which is the only muscle that can flex the distal phalanges?

A

Flexor digitorum profundus (FDP)

48
Q

Describe which parts of the FDP muscle are innervated by the median and ulnar nerves.

A

Median nerve - lateral half of the muscle (digits 2 + 3)

Ulnar nerve - medial half of the muscle (digits 4 + 5)

49
Q

Describe the anatomical relationship between the tendons of the FDS and FDP.

A

The tendons of the FDS sit on top of the tendons of the FDP. The FDP tendons pass through a split in the FDS tendons to reach the distal phalanx

50
Q

Where do the tendons of the FDS reach up to / end?

A

Middle phalanx

51
Q

Where do the tendons of the FDP reach up to / end?

A

Distal phalanx

52
Q

Which nerve would a fracture in the surgical neck of the humerus damage and what symptoms would this cause?

A

Axillary nerve - deltoid muscle weakness and loss of sensation over lateral shoulder

53
Q

Fractures in the shaft of the humerus would damage which nerve and cause which main symptom?

A

Radial nerve - causing wrist drop

54
Q

Lateral epicondylitis is otherwise known as what?

A

Tennis elbow

55
Q

Medial epicondylitis is otherwise known as what?

A

Golfer’s elbow

56
Q

A fracture of the neck of the radius can damage which nerve?

A

Posterior interosseous nerve (branch of radial nerve)

57
Q

What would be the symptoms of cubital tunnel syndrome?

A

Numbness and/or tingling in the ring and little fingers

58
Q

Where do all of the muscles of the posterior compartment of the forearm originate?

A

Lateral epicondyle

59
Q

A FOOSH injury can cause a fracture where?

A

Lateral epicondyle

60
Q

What are the 6 muscles of the superficial layer of the posterior forearm?

A

Anconeus muscle
Extensor digitorum
Extensor digiti minimi
Extensor carpi ulnaris
Extensor carpi radialis brevis
Extensor carpi radialis longus

61
Q

What is the primary muscle responsible for extending the fingers and wrist?

A

Extensor digitorum

62
Q

Which muscle is responsible for extending the 5th digit?

A

Extensor digiti minimi

63
Q

Which structure holds tendons in place on the posterior wrist?

A

Extensor retinaculum

64
Q

What are the 5 muscles of the deep layer of the posterior forearm?

A

Supinator muscle
Extensor indicis
Extensor pollicis longus
Extensor pollicis brevis
Abductor pollicis longus

65
Q

Which muscle specifically extends the index finger?

A

Extensor indicis

66
Q

Which 3 extensor synovial compartments of the wrists are most susceptible to wear & tear and rupture?

A

1, 3, and 6

67
Q

Which bony structure makes the 3rd extensor compartment susceptible to wear & tear and which particular tendon is at risk?

A

Dorsal radial tubercle

EPL

68
Q

Which bony structure makes the 6th extensor compartment susceptible to wear & tear and which particular tendon is at risk?

A

Ulnar styloid process

ECU

69
Q

An issue with the 1st extensor compartment can cause which pathology? What is this condition otherwise known as?

When will pain present?

A

De-Quervain’s tenosynovitis

Mommy’s thumb

Pain on extension + abduction of thumb

70
Q

Which muscle is a forearm flexor but is in the posterior compartment?

A

Brachioradialis

71
Q

How can the brachioradialis reflex be tested and which spinal cord levels does this test?

A

Tapping its distal insertion near the wrist - assesses C5 and C6

72
Q

What forms the medial, lateral, superior borders and roof of the cubital fossa?

A

Medial - pronator teres

Lateral - brachioradialis

Superior - inter-epicondylar line

Roof - aponeurosis of biceps brachii

73
Q

What are the 3 structures in the cubital fossa, from lateral to medial?

A

Biceps brachii tendon

Brachial artery

Median nerve

74
Q

What are the 3 main veins in the cubital fossa?

A

Cephalic vein

Median cubital vein

Basilic vein

75
Q

Which vein is most commonly used for cannulation?

Which vein is considered the safest to use?

A

Median cubital vein most often used

Cephalic vein is considered safest

76
Q

What are the spinal cord levels of the radial nerve?

77
Q

What are the spinal cord levels of the median nerve?

78
Q

What are the spinal cord levels of the ulnar nerve?

79
Q

What does the radial nerve split into?

A

Deep branch - becomes posterior interosseous nerve

Superficial branch

80
Q

What does the superficial branch of the radial nerve innervate?

A

Cutaneous innervation to the anatomical snuffbox and hand

81
Q

What does the ulnar nerve pass through as it enters the hand?

A

Guyon’s canal

82
Q

What passes through Guyon’s canal?

A

Ulnar nerve + ulnar artery

83
Q

The brachial artery is a continuation of which artery?

A

Axillary artery

84
Q

The brachial artery splits into which 2 arteries?

A

Radial artery

Ulnar artery

85
Q

Which artery gives off the common interosseous artery?

A

Ulnar artery

86
Q

Which artery primarily contributes to the deep palmar arch?

A

Radial artery

87
Q

Which artery primarily contributes to the superficial palmar arch?

A

Ulnar artery