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Musculoskeletal > Elbow and Forearm > Flashcards

Elbow and Forearm Flashcards

1
Q

Which of these is the ulna? Identify the landmarks

A
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2
Q

Which of these is the radius? Identify the landmarks

A
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3
Q

Which joints form the elbow joint?

A

Collection of 3 joints

  1. Ulno humeral - hinge joint
  2. Radio humeral - ball and socket
  3. Upper radioulnar - trochoid (pivot joint)
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4
Q

What type of joint is the elbow?

A

Synovial hinge joint

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5
Q

What is cubitus varus?

A

Elbow joint points towards the midline

Carrying angle is less than normal

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6
Q

What is cubitus valgus?

A

Carrying angle is greater than normal

Elbow points away from midline

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7
Q

Are cubitus valgus and cubitus varus both functional problems?

A

Cubitus varus is simply cosmetic. Valgus may lead to impingment of the ulna nerve posterially = tardy ulna nerve palsy.

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8
Q

What things are responsible for the stability of the elbow?

A
  • Capsule that lines the joints
  • Ligaments (reinforce joint)
  • Muscles passing over joint
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9
Q

What are the ligaments of the elbow?

A

Medial collateral ligament

Lateral collateral ligament

Annular ligament

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10
Q

Medial collateral ligament

A

The ulnar collateral ligament originates from the medial epicondyle, and attaches to the coronoid process and olecranon of the ulna.

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11
Q

Lateral collateral ligament

A

The radial collateral ligament is found on the lateral side of the joint, extending from the lateral epicondyle, and blending with the annular ligament of the radius (a ligament from the proximal radioulnar joint).

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12
Q

Annular ligament

A

Holds radial head in position

Superior radioulnar nerve stabilised

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13
Q

Why is the fat pad of the elbow clinically important?

A

Fracture = Effusion in joint (fluid or blood)

Confined within joint

Fat pad is lifted away from bone = fat pad sign

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14
Q

What are the movements that take place in the elbow joint?

A
  1. Ulna humeral (flexion and extension = -5 - 140)
  2. Radio humeral (flexion and extension = -5 - 140)
  3. Upper radioulnar joint (pronation and supination = 90 - 90)
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15
Q

What is the most important movement performed by the elbow joint?

A

Flexion and extension

Pronation and supination can be compensated for by shoulder joint. Many people have fused ulna and radius. Goes unoticed.

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16
Q

What are the flexor muscles of the elbow?

A

Brachialis (main flexor)

Brachioradialis

Brachial biceps

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17
Q

What are the extensors of the elbow?

A

Triceps

Anconeus

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18
Q

What muslces are responsible for supinating the elbow?

A

Supinator brevis

Brachial biceps

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19
Q

Which muscles are responsible for pronation at the elbow?

A

Pronator teres

Pronator quadratus

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20
Q

Which nerve is most likely to be damaged in a humeral fracture?

A

Radial nerve as it wraps around it.

21
Q

What are the common flexor pronator muscles?

A
  • Pronator teres
  • Flexor carpi radialis
  • Palmaris longus
  • Flexor digitoram superficialis
  • Flexor carpi ulnaris
22
Q

What are the deep flexor muscles?

A
  • Flexor digitorum profundus
  • Flexor pollicis longus
  • Pronator quadratus
23
Q

Which two digits have independant extensor muscles?

A

Index finger

Little finger

24
Q

What are the extensor muscles of the wrist and fingers?

A

Extensor carpi radialis longus

Extensor carpi radialis brevis

Extensor carpi ulnaris

Extendor digitoram communis

25
Q

What are the flexor muscles of the wrist and fingers?

A

Flexor carpi radialis

Flexor carpi ulnaris

Palmaris longus

Superficial flexor digitorum

Flexor pollicis longus

26
Q

Anconeus (location, origin, insertion, innervation and action)

A

Origin: Lateral epicondyle of the humerus

Insertion: Lateral side of the olecranon and superior part of the posterior ulna distally

Action: Extension of forearm

Innervation: Radial nerve

27
Q

Brachioradialis (location, origin, insertion, innervation and action)

A

Origin: Distal lateral supracondylar ridge of the humerus and the lateral intermuscular septum

Insertion: Lateral part of the styloid process of the radius

Action: Flexion of the elbow; supination and pronation fo the forearm

Innervation: Radial nerve (C5 - 6)

28
Q

Pronator teres (location, origin, insertion, innervation and action)

A

Origin: Medial epicondyle of the humerus; the coronoid process of the ulna; the common flexor tendon.

Insertion: Lateral radius distal to the insertion of the spinator muscle

Action: Weak flexion of the elbow joint; pronation of the forearm

Innervation: Median nerve (C6-C7)

29
Q

Median cubital vein

A
30
Q

Flexor carpi radialis (origin, inerstion, innervation and action)

A

Origin: Medial epicondyle of humerus

Insertion: Base of the 2nd and 3rd metacarpal

Action: Flexion of the wrist and abduction of the hand

Innervation: Median nerve (C6-7)

31
Q

Palmaris longus (origin, inerstion, innervation and action)

A

Origin: Medial epicondyle of humerus

Insertion: Palmar aponeurosis

Action: Tightens the palmer aponeurosis, flexion at wrist, weak flexion of the elbow joint

Innervation: median nerve (C7-C8)

32
Q

Flexor carpi ulnaris (origin, inerstion, innervation and action)

A

Origin: Medial epicondyle of humerus

Insertion: Pisiform

Action: Flexion of the wrist and adduction of the hand

Innervation: Ulnar nerve (C7-T1)

33
Q

Flexor digitorum superficialis (origin, inerstion, innervation and action)

A

Origin: Humeroulnar head: the medial epicondyle of the humerus, radial head: the middle third of the radius

Insertion: Shafts of the middle phalanges of the 2nd and 5th digits

Action: Weak flexion of the elbow; flexion of the wrist; flexion of the metocarpophalangeal and proximal interphalangeal joints of the 2nd and 5th digits.

Innervation: Median nerve (C8-T1)

34
Q

Flexor difitorum profundus (origin, inerstion, innervation and action)

A

Origin: Posterior and medial borders of the ulna

Insertion: Base and palmar surface of the distal phalanges of the 2nd and 5th digits

Action: Flexion of the wrist and flexion of the metacarpophalangeal, proximal interphalangeal and distal interphalangeal joints of the 2nd and 5th digits.

Innervation: Median nerve and the ulnar nerve

35
Q

Flexor pollicis longus (origin, inerstion, innervation and action)

A

Origin: Interosseous membrane and anterior surface of the radius

Insertion: Palmar side of the sital phalanx of the 1st digit

Action: Abduction of the wrist, flexion of the carpometacarpal, metacatpopharalangeal and interphalangeal joint of the 1st digit.

Innervation: Median nerve

36
Q

Extensor carpi radialis brevis (origin, inerstion, innervation and action)

A

Origin: Lateral epicondyle of the humerus

Insertion: Dorsal base of the 3rd metacarpal bone

Action: Weak flexion of the elbow and extension and abduction of the wrsit

Innervation: Deep branch of radial nerve (C7-8)

37
Q

Supinator (origin, inerstion, innervation and action)

A

Origin: Supinator crest of the ulna and lateral epicondyle of humerus

Insertion: Lateral one-third of proximal radius

Action: Supination of the forearm at the radioulnar joints

Innervation: Deep branch of the radial nerve (C6-7)

38
Q

Flexor carpi radialis brevis (origin, inerstion, innervation and action)

A

Origin: Lateral epicondyle of the humerus

Insertion: Dorsal base of the 3rd metacarpal bone

Action: Weak flexion of the elbow and extension and abduction of the wrist

Innervation: Deep branch of the radial nerve (C7-8)

39
Q

Extensor pollicus brevis (origin, inerstion, innervation and action)

A

Origin: Posterior surface of the distal radius; interosseaous membrane

Insertion: Base of the proximal phalanx of the 1st digit

Action: Abduction of the radiocarpal joint; extension of the carpometacarpal and metacarpophalangeal joints

Innervation: Posterior interosseus nerve

40
Q

Extensor carpi radialis longus (origin, inerstion, innervation and action)

A

Origin: Lateral supracondylar ridge of distal humerus and the lateral intermuscular septum

Insertion: Dorsal base of the 3nd metacarpal bone

Action: Weak flexion of the elbow and extension and abduction of the wrsit

Innervation: Radial nerve (C6-7)

41
Q

Abductor pollicis longus (origin, inerstion, innervation and action)

A

Origin: Middle one-third of the posterior surface of the radius and ulna

Insertion: Base of the 1st metacarpal bone at the radial side

Action: Abduction of the radiocarpal joint and carpometacarpal joint of the 1st digit

Innervation: Deep branch of the radial nerve

42
Q

Extensor pollicis longus (origin, inerstion, innervation and action)

A

Origin: Posterolateral surface of the ulna

Insertion: Base of the distal phalanx of the 1st digit

Action: Extension and radial abduction of the wrist; adduction of the carpometacarpal joint of the 1st digit; extension of the metacarpophalangeal and interphalangeal joints of the 1st digit.

Innervation: Posterior interosseous nerve

43
Q

Extensor indicis (origin, inerstion, innervation and action)

A

Origin: Posterolateral surface of the ulna and the interosseous membrane

Insertion: Tendons join the extensor digitorum tendon to the 2nd digit

Action: Extension of the wrist; extension of the metacarpophalangeal, proximal interphalangeal and distal interphalangeal joints of the 2nd digit.

Innervation: Posterior interosseous nerve

44
Q

Extensor carpi ulnaris (origin, inerstion, innervation and action)

A

Origin: Lateral epicondyle of humerus

Insertion: Base of the medial side of the 5th metacarpal bone

Action: Extension and adduction of the wrist

Innervation: Deep branch of the radial nerve (C7-C8)

45
Q

Extensor digiti minimi (origin, inerstion, innervation and action)

A

Origin: Lateral epicondyle of humerus

Inserton: Extensor digitorum tendon to the 5th digit

Action: Extension and ulnar abduction of the wrist; abduction and extension of the metacarpophalangeal, proximal interphalangeal and distal interphalangeal joints of the fifth digit.

Innervation: Posterior interosseous nerve

46
Q

Extensor carpi radialis longus (origin, inerstion, innervation and action)

A

Origin: Lateral supracondylar ridge of the distal humerus

Insertion: Dorsal base of the 2nd metacarpal bone

Action: Weak flexion of the elbow and extension and abduction of the wrist

Innervation: Radial nerve (C6-7)

47
Q

Extensor digitorum of hand (origin, inerstion, innervation and action)

A

Origin: Lateral epicondyle of the humerus

Insertion: Dorsal digital expansion of the 2nd-5th digits

Action: Extension of the wrist; extension of the metacarpophalangeal, proximal interphalangeal and distal interphalangeal joints of the 2nd and 5th fingers, abduction of the fingers

Innervation: Deep branch of radial nerve

48
Q

What are the borders of the cubital fossa?

A

Lateral border – The medial border of the brachioradialis muscle.

Medial border– The lateral border of the pronator teres muscle.

Superior border – An imaginary line between the epicondyles of the humerus.

Floor - Proximally by the brachialis, and distally by the supinator muscle.

Roof - Skin and fascia, and is reinforced by the bicipital aponeurosis.

49
Q

What are the contents of the cubital fossa?

A

Lateral to medial

Radial nerve – This is not always strictly considered part of the cubital fossa, but is in the vicinity, passing underneath the brachioradialis muscle. As is does so, the radial nerve divides into its deep and superficial branches.

Biceps tendon – It runs through the cubital fossa, attaching to the radial tuberosity, just distal to the neck of the radius.

Brachial artery – The brachial artery supplies oxygenated blood the forearm. It bifurcates into the radial and ulnar arteries at the apex of the cubital fossa.

Median nerve – Leaves the cubital between the two heads of the pronator teres. It supplies the majority of the flexor muscles in the forearm.

Mnemonic for contents of the cubital fossa – Really Need Beer To Be At My Nicest.

Musculoskeletal (27 decks)

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