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Anatomy of the limbs > Elbow, forearm and wrist > Flashcards

Elbow, forearm and wrist Flashcards

1
Q

What are the bones of the elbow, forearm and wrist?

A

Humerus
Radius
Ulna
Carpal bones (from lateral to medial):
-Proximal row: scaphoid, lunate, triquetrum, pisiform
-Distal row: trapezium, trapeze, capitate, hamate

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2
Q

What are the muscles of the anterior compartment of the arm?

A

Biceps brachii
Brachialis
Coracobrachialis

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3
Q

What are the muscles of the posterior compartment of the arm?

A

Triceps

Anconeus

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4
Q

What are the muscles of the superior anterior compartment of the arm?

A 
Pronator teres
Flexor carpi radialis (FCR)
Palmaris longus (PL)
Flexor digitorum superficialis (FDS)
Flexor carpi ulnaris (FCU)
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5
Q

What are the muscles of the deep anterior compartment of the arm?

A 
Flexor digitorum profundus (FDP)
Flexor pollicis longus (FPL)
Pronator quadratura (PQ)
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6
Q

What are the muscles of the extensor compartment of the arm that move the wrist joint?

A

Extensor carpi radialis longus (ECRL)
Extensor carpi radialis brevis (ECRB)
Extensor carpi ulnari (ECU)

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7
Q

What are the muscles of the extensor compartment of the arm that move the digits?

A 
Extensor digitorum (ED)
Extensor indicis (EI)
Extensor digitorum minimi (EDM)
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8
Q

What are the muscles of the extensor compartment of the arm that move the thumb?

A

Abductor pollicis longus (APL)
Extensor pollicis brevis (EPB)
Extensor pollicis longus (EPL)

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9
Q

What type of joint is the elbow joint?

A

Synovial hinge joint between the humerus proximally and the ulna and radius distally.

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10
Q

What does the distal humerus articulate with?

A

Ulna via trochlea

Radius via capitulum

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11
Q

What are the important ligaments at the elbow which contribute to the stability of the joint?

A

Medial (ulnar) collateral ligaments
Lateral (radial) collateral ligaments
Annular ligament (part of the proximal radio-ulnar joint)

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12
Q

What are the main flexors of the elbow?

A

Brachialis
Biceps brachii
Brachioradialis
Some assistance from pronator teres

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13
Q

What are the extensors of the elbow?

A

Triceps

Anconeus

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14
Q

What is the carrying angle?

A

The deviation of the long axis of the radius and ulna from that of the humerus (in extension). It is greater in women than men and averages 7 degrees.

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15
Q

What type of joint is the proximal radio-ulnar joint?

A

Uni-axial pivot-type synovial joint that allows the head of the radius to rotate within the annular ligament that attaches it to the margins of the radial notch of the ulna.

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16
Q

What type of joint is the distal radio-ulnar joint?

A

Pivot-type synovial joint that allows the radius to rotate around the distal ulna and the articular surfaces are held together by a fibrocartilage articular disc.

17
Q

What movements take place at the proximal and distal radio-ulnar joints?

A

Supination and pronation

18
Q

What muscles produce supination of the upper limb?

A

Supinator, biceps brachii

19
Q

What muscles produce pronation of the upper limb?

A

Pronator quadrates, pronator teres

20
Q

What is the interosseous membrane of the forearm?

A

Fibrous sheet that connects the radius and ulna, forming a fibrous joint (syndesmosis) between the 2 bones.
Divides the forearm into anterior and posterior compartments, gives rise to muscle attachments and transfers forces from the radius to the ulna to the humerus and vice versa.

21
Q

What type of joint is the wrist joint?

A

Elipsoid synovial joint between the distal radius and its associated triangular fibrocartilage articular disc, with the proximal row of the carpal bones (scaphoid, lunate and triquetrum).

22
Q

What are the strong ligaments that stabilise the wrist joint?

A 
Ulnar collateral ligament
Radial collateral ligament
Palmar radio-carpal ligament
Palmar ulno-carpal ligament
Dorsal radio-carpal ligament
Inter-carpal ligaments
23
Q

What muscles provide flexion at the wrist joint?

A 
FCR - important
FCU - important
Long flexors of the thumb and fingers
Palmaris longus
APL
24
Q

What muscles provide extension at the wrist joint?

A

ECRL – important
ECRB – important
ECU – important
Long extensors of the thumb and fingers

25
Q

What muscles provide radial deviation at the wrist joint?

A 
FCR
ECRL
ECRB
APL
Extensor pollicis brevis
26
Q

What muscles provide ulnar deviation at the wrist joint?

A

ECU

FCU

27
Q

Describe the path of the ulnar artery.

A

Descends in the anterior compartment of the forearm and passes into the hand anteriorly, on the ulnar side of the wrist (just lateral to FCU).
The ulnar nerve lies medial to it at the wrist joint, i.e. from medial to lateral, the relationships are FCU, ulnar nerve, ulnar artery.

28
Q

What does the ulnar artery supply in the forearm?

A

Medial muscles of the forearm, via branches including the common interosseous artery, the anterior interosseous artery and the posterior interosseous artery.

29
Q

Describe the path of the radial artery.

A

Descends the lateral aspect of the forearm under the cover of the brachioradialis muscle. It is easily palpable at the wrist where it lies anteriorly on its radial aspect.
Crosses the floor of the anatomical snuff box and ultimately anastomosis with branches of the ulnar artery to form the palmar arches.

30
Q

What connects the cephalic and basilic veins at the level of the elbow, and what is its clinical significance?

A

Median cubital vein- common site for venipuncture, variable in its anatomy.

31
Q

What are the 3 main nerves of the forearm?

A

Ulnar nerve
Median nerve
Radial nerve

32
Q

Describe the path of the ulnar nerve (C8,T1).

A

Has no branches in the arm and initially descends in its anterior compartment, but distally passes into the posterior compartment to lie superficially, posterior to the medial epicondyle of the elbow, where it is at risk of damage.
Enters the forearm passing between the heads of flexor carpi ulnaris, then descends on the medial side of the forearm where it supplies the more medial muscles in the anterior compartment.

33
Q

What does the ulnar nerve (C8,T1) supply in the forearm?

A

Flexor carpi ulnaris (FCU).
Medial portion of flexor digitorum profundus (FDP), i.e. to the ring and little fingers.
Sensory supply to the medial aspect of the ventral forearm.
At the wrist, it lies between the FCU (medially) and the ulnar artery (laterally) and then passes into the hand where it supplies most of the intrinsic muscles.

34
Q

Describe the path of the median nerve (C678,T1).

A

Descends in the anterior compartment of the arm, within which it does not give any branches.
Anterior to the elbow, it lies medial to the brachial artery, where it is at risk of damage by supracondylar fractures of the humerus.
Descends into the forearm between the heads of pronator teres to become the principal motor nerve of the anterior compartment.
At the anterior wrist, the median nerve lies quite superficially between the tendons of FDS and FDP and deep to palmaris longus (if present), prior to entering the hand through the carpal tunnel.

35
Q

What does the median nerve (C678,T1) supply?

A 
Pronator teres
FDS
Lateral portion of FDP (to the index and middle fingers)
FCR
Pronator quadratus
Palmaris longus
36
Q

What does the radial nerve (C5678,T1) supply?

A

Posterior (extensor) compartment of the arm. In the forearm: brachioradialis, ECL.
Deep branch: ECRB, supinator.

37
Q

Describe the path of the radial nerve (C5678,T1).

A

It lies on the humerus in the radial (spiral) groove where it is at risk in humeral shaft fractures. Just superior to the elbow it divides into the superficial radial nerve (cutaneous sensory) and the deep branch of the radial nerve (motor), which descends into the forearm between the heads of supinator, to be come the posterior interosseous nerve and to supply all of the muscles of the posterior (extensor) compartment of the forearm and it ends as a pseudoganglion below the extensor retinaculum.

38
Q

What does the posterior interosseous nerve supply?

A 
ED
ED minimi
ECU
APL
EPB
EPL
E indicis

Anatomy of the limbs (9 decks)

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