elbow and forearm

Question 1

bones of elbow, foreaerm and wrist

Answer 1

humerus, radius, ulna, and carpal bones

Question 2

bones of elbow DIAGRAM- fossa, epi/condyles, ridges, oblique lines

Answer 2

lateral (extensors) and medial (flexors) epicondyles for muscle attachment of forearm condyles articulate with heads of ulna (medial) and radius (lateral) anteriorly there is radial and coronoid fossa- olecranon of ulna binds to posterior olecranon fossa also lateral and medial supra-epicondyle ridges radius has anterior and posterior oblique lines

Question 3

DIAGRAM bones of forearm- at distal and proximal end, how ulna connects

Answer 3

both have styloid processes at distal end (for muscle attachment and shape of wrist) both have tuberosities at proximal end radial head is at proximal end (like a circle), ulnar head at distal end ulna connects to humerus with trochlear notch (connects to trochlea) and olecranon)

Question 4

interosseous membrane and importance

Answer 4

between shafts- separates anterior/posterior compartments, and some forearm muscles attach here

Question 5

DIAGRAM bones of wrist and articulations with exception and PNEUMONIC

Answer 5

SOME LOVERS TRY POSITIONS THEY CAN’T HANDLE radius and ulna articulate with carpal bones- - scaphoid , lunate, triquetrum and pisiform (proximal row) and distal row (trapezium, trapezoid, capitate and hamate) articulates with all EXCEPT pisiform, as it’s a sesamoid bone (embedded in tendon of FCU)

Question 6

biceps, brachialis and triceps relation to forearm

Answer 6

bicep heads merge into tendon which attach to radial tuberosity, as well an aponeurosis which merges with fascia of region brachialis attaches to coronoid process of ulna triceps attach to olecranon process of ulna

Question 7

general points of forearm muscles

Answer 7

many cross elbow joint ie attach to distal humerous flexors and pronators anteriorly, extensors and supinators posterior

Question 8

DIAGRAM superficial muscles of anterior forearm

Answer 8

pronator teres, flexor carpi radialis, palmaris longus, flexor carpi ulnaris from lateral to medial also flexor digitorum superficialis

Question 9

deep muscles of anterior forearm

Answer 9

flexor digitorum profundus, flexor pollicis longus, pronator quadratus

Question 10

DIAGRAM attachments of anterior compartment muscles

Answer 10

4 superficial muscles attach to COMMON FLEXOR TENDON at medial epicondyle many muscles also attach to shafts and interosseous membrane

Question 11

DIAGRAM fascia/tendons of regon

Answer 11

palmaris longus has long tendon going to palmar aponeurosis- protects muscles/tendons flexor retinaculum- where tendons merge forming roof of CARPAL TUNNEL- preventing BOWING of tendons (ie popping out, this fascia holds them down): also protects median nerve

Question 12

extensor muscles of forearm

Answer 12

move wrist joint- extensor carpi radialis (acts on radial side) longus, brevis and ulnaris (acts on ulnar side) move digits- extensor digitorum (groups of digits), indicis, digit minimi (ALSO contributes to wrist) move thumb- abductor policis longus, extensor pollicis brevis (short) and longus (long) other- brachioradialis, supinator

Question 13

DIAGRAM anatomical snuff box- tendons defining it, what’s in it, and clinical significance

Answer 13

borders are tendons of extensor policis longus and brevis- branch of radial nerve goes through it, and also important in seeing if SCAPHOID bone in it blood supply (radial artery) is recurrent (ie comes back ground, so supplies from distal to proximal)- thus if vascular occlusion in this region occurs, can lead to wrist disability

Question 14

joints of region

Answer 14

elbow joint, proximal radio-ulnar joint, distal radio-ulnar joint, wrist joint

Question 15

DIAGRAM elbow joint

Answer 15

see olecranon, coronoid process, and trochlear notch

Question 16

DIAGRAM ligaments of elbow joint

Answer 16

radial collateral ligament, anular ligament of radius, and ulnar collateral ligament- stablise joint AND allow pronation/supination

Question 17

carrying angle DIAGRAM

Answer 17

sex differences at elbow (between forearma and arm)- larger in females due to difference in hip width

Question 18

DIAGRAM proximal and distal radio-ulnar joints- ligament involved and what occurs in pronation

Answer 18

anular ligament holds proximal radio-ulnar joint in place when pronation occurs, bones cross over another

Question 19

DIAGRAM wrist joint- ulna vs raidus, and articulations

Answer 19

gap between radius and proximal carpal bones small unlike with ulna, as between ulna and carpal bones there is an ARTICULAR disc (attached to styloid process of ulna), whereas radius articulates directly radius articulates with lunate and scaphoid (C shaped bone), and ulna doesn’t articulate directly with triquetrum bone

Question 20

DIAGRAM movements of radioulnar joint and muscles involved

Answer 20

supination (supinator, biceps, as biceps attached to radial tuberosity) pronation (quadratus, teres)

Question 21

movements of wrist joint with muscles involved

Answer 21

flexion, extension, abduction (abductor policis longus, flexor carpialis radialis, extensor carpialis radialis longus/brevis), adduction (extensor carpialis ulnaris, flexor carpialis ulnaris) thus extensors AND flexors involved in both abduction/adduction

Question 22

arteries of region including wrist with branches

Answer 22

ulnar and radial arteries- ulnar immediately branches off to common interosseuous artery, which branches to posterior (pierces membrane) and anterior interosseuous arteries hand supplied by anastomosis of radial and ulnar arteries ie both cross wrist

Question 23

DIAGRAM cubital fossa- structures inside, and median nerve, with EXCEPTION

Answer 23

biceps, brachialis, tendon, aponeurosis, brachioradialis and pronator teres median nerve medial to brachial artery at fossa, BUT lateral at shoulder joint- radial nerve also present ulnar nerve does NOT go through fossa, goes posterioly in arm

Question 24

superficial veins of region, relation to deep veins and taking blood

Answer 24

cephalic (lateral) and basilic (medial)- both come from DORSAL VENOUS ARCH of hand, and are connected at cubital fossa by MEDIAN CUBITAL VEIN (used to take blood)- if not present, cephalic/basilic used to take blood basilic joins venae comitantes to form axillary vein at border of TERES MAJOR, cephalic joints axillary vein

Question 25

DIAGRAM deep venous drainage

Answer 25

follows arteries, radial and ulnar veins from PALMAR VENOUS ARCH are both PAIRS of veins known as venae comitanets

Question 26

DIAGRAM lymphatic drainage of area

Answer 26

drainage runs with veins- cubital lymph nodes mainly, but also axillary nodes

Question 27

musculocutaneueous nerve

Answer 27

upper arm and SENOSRY TO LATERAL FOREARM

Question 28

median nerve

Answer 28

goes anteriorly in upper arm with no branches, but supplies forearm muscles

Question 29

common sites of damage of nerves

Answer 29

often due to fractures- wrist joint, elbow joint- median nerve next to brachial artery ie vulnerable to dislocation/supracondylar elbow fractures, ulnar nerve behind medial epicondyle (funny bone) shaft- radial nerve damaged easily mid-shaft of humerus in radial groove shoulder joint- axillary nerve

Question 30

ulnar nerve- pathway, function, and relation to artery

Answer 30

goes posteriorly in upper arm with no branches, behind medial epicondyle, supplying hand and FCU/FDP of forearm lateral to ulnar artery at wrist

Question 31

radial nerve- function, branches

Answer 31

supplies ALL posterior muscles in upper arm and forearm goes anteriorly in upper arm, and divides into superficial radial nerve (sensory) and posterior interosseous nerve (deep motor)

Question 32

motor supply in forearm

Answer 32

median nerve supplies all anterior forearm muscles except FCU and FDP (ulnar nerve) radialis supplies posterior muscles

Question 33

DIAGRAM ulna

Answer 33

de

Question 34

DIAGRAM how to remember carpal bones

Answer 34

scaphoid C shaped, hamate has hook trapezium has tubercle next to thumb capitate is largest bone

Question 35

function of coracobrachialis

Answer 35

flexion at shoulder joint

Question 36

DIAGRAM borders of cubital fossa

Answer 36

pronator teres, brachioradialis, and line between epicondyles

Question 37

elbow joint, proximal and distal radio-ulnar joint, with damage

Answer 37

elbow joint is a hinge joint, the radio-ulnar joints are pivot joints both allow supination/pronation, but distal joint allow radius to move over ulna during pronation- proximal joint often dislocated in children

Question 38

supracondylar fracture

Answer 38

humerus of fracture above epicondyles- due to hyperextension of humerus in a fall can tear/compres brachial artery= compartment syndrome, OR compress median nerve

Question 39

DIAGRAM colles fracture

Answer 39

fracture of radius just above wirst, due to fall onto outstretched hand leads to wrist pain, and dinner fork deformity