Elbow, forearm and wrist Flashcards
Week 8
Structural and functional joint type of the Elbow joint
Structural type: Synocial hinge joint
Functional type: diarthrosis (uniaxial)
Name the elbow joints and their articulation.
Humeroulnar
Trochlea with ulna
Humeroradial
Capitulum with radius
Proximal radio-ulnar
Name the ligaments of the elbow joint
Articular capsule
collateral (radial and ulna) ligaments
annular ligament
What is the attachment of the articular capsule?
Capitulum and trochlea –> coronoid process (ant) and olecranon process (pos)
What is the attachment of the ulna collateral and radial collateral ligament?
Ulnar CL:
Medial epicondyle –> coronoid process of olecranon
Radial CL:
Lateral epicondyle –> annular ligament
what is the function of the annular ligament?
Covers radial head (binds radial head into radial notch of ulna = supination and pronation)
Where doe the ulnar and radial bones articulate eachother?
proximal and distal radio-ulnar joints
What movements does the radio-ulnar joint allow for? What hold these joints together to allow for this movement?
pronation and supernation
Held together by annular ligament at proximal end, articular disc at distal end and the interossues membrane.
What type of joint is the radio-ulnar joint?
synovial pivot
diarthrosis (uniaxial)
Name the superficial muscles of the anterior compartment of the forearm.
Flexor carpi ulnaris
Palmaris longus
Flexor carpi radialis
Pronator teres
Flexor carpi ulnaris: O/I, innervation and movement
Medical epicondyle and olecranon –> pisiform and palmar surface of metacarpal V
Ulnar nerve
Wrist flexion
And adduction
Palmaris longus: O/I, innervation and movement
Medial epicondyle –> palmar aponeurosis
Median nerve
Wrist flexion
Flexor carpi radials : O/I, innervation and movement
Medial epicondyle –> palmar surface of metacarpal II-III
Median nerve
Wrist flexion and abduction
Pronator teres: O/I, innervation and movement
Medial epicondyle and coronoid process –> lateral surface of radius
Median nerve
Pronation
What is the name, O/I, innervation and movement of the intermediate muscle of the anterior compartment of the forearm?
Flexor digitorum superficialis
Medial epicondyle and coronoid process –> through carpal tunnel –> middle phalanges (II-V)
Median nerve
Wrist flexion
Finger flexion
Name the deep muscles of the anterior compartment of the forearm.
Flexor digitorum profundus
Flexor pollicis longus
Pronator quadratus
Flexor digitorum profundus: O/I, innervation and movement
Anterior and medial surface of ulna and interosseous membrane –> carpal tunnel –> distal phalanges (II-V)
Medial half = ulnar nerve
Lateral half= Median nerve
Wrist flexion
Finger flexion
Flexor pollicis longus: O/I, innervation and movement
Anterior surface of radius and radial half of interosseous membrane –> through carpal tunnel –> distal phalanx of thumb
Median nerve
Thumb flexion
pronator quadratus: O/I, innervation and movement
Linear ridge of distal anterior surface of ulna –> distal anterior surface of radius.
Median nerve
Pronation
Name the muscles of the anterior compartment of the forearm that are innervated by the median nerve.
Palmaris longus
flexor carpi radials
pronator teres
flexor digitorum superficialis
lateral half of flexor digitorum profundus
flexor pollicsis longus
pronator quadratus
(all expect medial half of FDP and flexor carpi)
Name the superficial muscles of the posterior compartment of the forearm.
brachioradialis
Extensor carpi radialis longus
Extensor carpi radialis brevis
Extensor digitorum
Extensor digiti minimi
Extensor capri ulnaris
What are all the muscles of the posterior compartment of the forearm innervated by?
Radial nerve
O/I and movement of brachioradialis.
Lateral supracondylar ridge –> lateral surface of distal radius
Elbow flexion
O/I and movement of Extensor carpi radialis longus
Lateral supracondylar ridge –> dorsal surface of base of metacarpal II
Wrist:
Extension
Abduction
O/I and movement of Extensor carpi radialis brevis
Lateral epicondyle –> dorsal surface of metacarpals II-III
Wrist:
Extension
Abduction
O/I and movement of Extensor digitorum
Lateral epicondyle –> dorsal surface of middle and distal phalanges II-V
Finger and wrist extension
O/I and movement of Extensor capri ulnaris .
Lateral epicondyle and posterior boundary of ulna –> tubercule base of metacarpal V
Wrist ext and adduction
O/I and movement of Extensor digiti minimi
Lateral epicondyle –> extensor hood of little finger
Little finger extension
Which muscles of the posterior compartment of the forearm originate at the lateral epicondyle?
Extensor carpi radialis brevis
Extensor digitorum
Extensor digiti minimi
Extensor capri ulnaris
supinator
O/I and movement of supinator
Lateral epicondyle and supinator crest of ulnar –> lateral surface of radius superior to anterior oblique line
Supination
O/I and movement of abductor pollicis longus
Posterior surface of ulna, radius and interosseous membrane –> lateral side of metacarpal I
Thumb abduction
Accessory extensory of thumb
O/I and movement of extensor pollicis longus
Posterior surface of ulna and and IM –> dorsal surface of distal phalanx of thumb
Thumb extension
O/I and movement of extensor pollicis brevis
Posterior surface of radius and adj IM –> dorsal surface of proximal phalanx of thumb
Radial nerve
Thumb extension
O/I and movement of extensor indicis
Posterior surface of radius and adj IM –> extensory hood of index finger
Index finger extension
What muscles allow for flexion at elbow joint?
Brachialis
Biceps brachii
Brachioradialis
What muscles allow for extension at the elbow joint?
Triceps brachii
what muscles allow for supination at the elbow joint?
Biceps brachii
Supinator
What type of joint is the radio carpal joint?
Synovial condyloid
Diarthrosis (biaxial)
What muscles allow for pronation at the elbow joint?
Pronator teres
Pronator quadratus
Articulation of the radio carpal joint
Radius of scaphoid and lunate
Articular disc of ulna with lunate and triquetrum
What movements does the radiocarpal joint allow for?
flexion, extension, abduction and adduction and circumduction.
Sup, Med, Lat, floor and roof borders of cubital fossa
Sup= lateral amd medial epicondyles
med= lateral margin of pronator teres
lat= medial margin of brachioradialis
floor= brachilais and supinator
roof = bicipital aponeurosi
What does the cubital fossa contain?
Median nerve, brachial artery, radial nerve and tendon of biceps brachii.
What does the roof of the carpal tunnel attach to and what are its contents?
Attach
flexor retinaculum –> trapezium and scaphoid
contents
4 tendons of digitorum superfiialis
4 tendons of flexor digitorum profundus
1 tendon of flexor pollicis longus
median nerve
What are the three nerves of the forearm?
radial, median and ulnar
Root, motor and sensory innervation of radial
C5-8 T1
All posterior compartment
Lateral dorsum of arm and forearm
Palmar surface
Later 3 and ½ digits (dorsal surface)
Root, motor and sensory innervation of median
all ant expect for flexor capri ulnaris, and medial half of flexor digitorum profundus
Palmar surface and lateral 3 and 1/3 digits
Tips of lateral and ½ digits
Root, motor and sensory innervation of ulnar
C7-8 and T1
Flexor digitorun profubndus
Flexor capri ulnaris
Hypothenar group
Lumbricals
Palmar 1st and ½ digists
major arteries of forearm
Subclavian –> axillary –> brachial –> ulnar and radial
Dermatomes of UL
C4- tip of shoulder
C5- regimental badge
C6- thumn
C7- tip o findex fingre
C8- tip of little finger
T1- anterior/medial elbow
Major veins of forearm
cephallic and basilic –> axilliay –> subclavian
Myotomes of the UL
C4- scapular elevation
C5- shoulder abduction
C6- elbow flexion
C7- elbow extension
C8- flexion of digits
T1- abduction and adduction of digits
What type of joint and what movement is allowed by the humeroulnar joint?
Hinge
flexion, ext, cirum
What type of joint and what movement is allowed by the humeroradial joint?
limited ball and socket, hinge type
flex, ext, sup, pro
What bones make up the proximal radioulnar joint, what type of joint is it and what movements does it allow?
Radial head and radial notch of lateral aspect of proximal ulna
pivot
pronation and supranation
What bones make up the distal radioulnar joint, what type of joint is it and what movements does it allow?
Pronation supination
Distal head of ulna and concave ulnar notch of radius
Pivot
What bones make up the radiocarpal joint, what type of joint is it and what movements does it allow?
Flex, ext, add and abd
Distal radius, scaphoid and lunate
condyloid
What is the function of the ulnar and radial collateral ligaments respectively?
U- stablsises by slowing elbow ext during throwing deceleartion phase
R- stability against inner and outer stress of elbow
What are the two main branches of the anterior median nerve and where do they go/innervate?
1- anterior interosseous
-deeper muscles in anterior compartment of forearm
2- recurrent branch
-branches distally near wrist and innervates thenar muscles in the hand
pathway of radial nerve
triceps –> brachioradialis –> branches into superficial and deep –> anatomical snuffbox
Motor and sensory innervation of radial nerve
Motor: all posterior compartment of arm, NONE in hand
Sensory: lateral dorsum of arm and forearm, lateral 3 and ½ digits without tips (dorsal)
Pathway, sensory and motor innervation of ulnar nerve
Pathway: medial to axillary –> medial to brachial artery
Motor: ½ FDP, FCU, Adductor pollicis, Hypothenar, lumbricals 3&4 and all interossei
Sensory: Palmar: 1 ½ digits, medial palm and hypothenar eminence, Dorsal = medial dorsum and median 15/6 digits
Motor and sensory innervations of median nerve
Motor: All flexors (except ½ FDP and FCU), thenar muscles and 1st and 2nd lumbricals
Sensory palmar = lateral palm + lateral 3 ½ digits, Dorsal = tips of latyeral 3 ½ digits
