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Limbs > Elbow forearm and Wrist > Flashcards

Elbow forearm and Wrist Flashcards

1
Q

Name the carpal bones.

A

Proximal – scaphoid, lunate, triquetrum, pisiform

Distal – hamate, capitate, trapezoid, trapezium

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2
Q

What are the two articular surfaces of the distal humerus and what do they articulate with?

A

Capitulum – articulates with the head of the radius

Trochlea – articulates with the head of the ulna

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3
Q

What is the importance of the epicondyles of the humerus?

A

They are important sites of attachment of forearm muscles

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4
Q

Which fossae are present on the anterior side of the distal humerus?

A 
Radial fossa
Coranoid fossa (the coranoid process of the ulna slots in here when the elbow is flexed)
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5
Q

Which fossa is present on the posterior side of the distal humerus?

A

Olecranon fossa – the olecranon process of the ulna slots in here when the elbow is extended

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6
Q

Where are tuberosities found near the elbow joint?

A

Radial tuberosity

Ulnar tuberosity

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7
Q

What are the two ridges running down the anterior and posterior of the radius?

A

Anterior oblique line

Posterior oblique line

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8
Q

What does the distal end of the ulna articulate with?

A

An articular disc (not with carpal bones)

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9
Q

What does the distal end of the radius articulate with?

A

Scaphoid and lunate

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10
Q

What separates the anterior and posterior compartments of the forearm?

A

Interosseous membrane

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11
Q

Which carpal bone is a sesamoid bone and which muscle tendon is it enclosed in?

A

Pisiform

It is within the flexor carpi ulnaris tendon

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12
Q

What is the distal attachment of biceps brachii?

A

Radial tuberosity

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13
Q

What is the distal attachment of brachialis?

A

Coronoid process of ulna

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14
Q

What is the distal attachment of triceps?

A

Olecranon process

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15
Q

Which compartment are the pronators and supinators in?

A

Pronators – anterior

Supinators – posterior (except biceps brachii)

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16
Q

Which muscles are in the superficial anterior compartment of the forearm?

A 
Pronator teres 
Flexor carpi radialis 
Palmaris longus 
Flexor digitorum superficialis 
Flexor carpi ulnaris
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17
Q

Which muscles are in the deep anterior compartment of the forearm?

A

Flexor digitorum profundus
Flexor pollicis longus
Pronator quadratus

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18
Q

What is the common flexor origin?

A

Medial epicondyle of the humerus – this is where most of the anterior compartment muscles (particularly the superficial muscles) originate

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19
Q

Which of the superficial anterior compartment muscles do not cross the wrist?

A

Pronator teres

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20
Q

Describe the attachments of pronator quadratus.

A

It is attached between the distal ends of ulna and radius

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21
Q

What forms the roof of the carpal tunnel?

A

Flexor retinaculum

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22
Q

Which tendon is continuous with the palmar aponeurosis?

A

Palmaris longus tendon

NOTE: palmaris longus tendon isn’t present in everyone and before it spreads to form the palmar aponeurosis, it is attached to the flexor retinaculum

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23
Q

Name all the muscles in the posterior compartment of the forearm.

A

Muscles that move the wrist:
Extensor carpi radialis longus
Extensor carpi radialis brevis
Extensor carpi ulnaris

Muscles that move the fingers:
Extensor indicis
Extensor digitorum
Extensor digiti minimi

Muscles that move the thumb:
Abductor pollicis longus
Extensor pollicis longus
Extensor pollicis brevis

Others:
Brachioradialis
Supinator

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24
Q

Where is the common extensor origin?

A

Lateral epicondyle of the humerus

25
Q

What can be palpated in the anatomical snuffbox?

A

Scaphoid (this is often fractured when trying to break a fall)

26
Q

Which tendons mark the anatomical snuffbox?

A

Lateral – Extensor Pollicis Brevis + Abductor Pollicis Longus
Medially – Extensor Pollicis Longus

27
Q

Which blood vessel is present in the anatomical snuffbox?

A

Branch of the radial artery

28
Q

What does the head of the radius articulate with?

A

Capitulum

29
Q

What are the main ligaments found at the elbow joint?

A

Radial collateral ligament
Ulnar collateral ligament
Anular ligament

30
Q

What are the three parts of the ulnar collateral ligament?

A

Anterior band
Posterior band
Oblique band

31
Q

What is the role of the anular ligament?

A

It goes around just under the head of the radius and it helps hold the radius in place
It allows the radius to rotate

32
Q

Describe the difference in carrying angle between genders. (Angle between hand and body)

A

Men – 10-15 degrees

Women - > 15 degrees

33
Q

Describe the articulation of the radius and ulna with the carpal bones.

A

The distal end of the radius articulates with scaphoid and lunate
The distal end of the ulna does not directly articulate with the carpal bones, it articulates with an articular disc

34
Q

What is the name given to the joint between the first and second rows of carpal bones?

A

Midcarpal joint

35
Q 
Which nerves are responsible for:
Elbow flexion 
Elbow extension 
Wrist flexion 
Wrist extension
A

Elbow flexion
C5-6

Elbow extension
C7-8

Wrist flexion
C6-7

Wrist extension
C6-7

36
Q

Which muscles are involved in supination?

A

Supinator
Biceps brachii
(EPL, ECRL minor role)

37
Q

Which muscles are involved in pronation?

A

Pronator teres
Pronator quadratus
(FCR, PL, brachioradialis minor role)

38
Q

Describe how the biceps contribute to supination.

A

The biceps tendon inserts into the radial tuberosity
When prone, the radial tuberosity is turned posteriorly
So then when the biceps contract, it will pull the tuberosity back around

39
Q 
Which muscles are important for:
Flexion of the wrist 
Extension of the wrist 
Radial deviation (abduction) 
Ulnar deviation (adduction)
A

Flexion of the wrist
Flexor Carpi Ulnaris and Radialis
(APL, PL)

Extension of the wrist
ECRL, ECRB, ECU

Radial deviation (abduction) 
ECRL, ECRB, FCR, APL 
Ulnar deviation (adduction) 
ECU, FCU
40
Q

What is an important branch of the ulnar artery?

A

Common interosseous branch

This splits into the anterior and posterior interosseous arteries

41
Q

What are the arterial arches of the hand made up of?

A

Anastomosis of the radial and ulnar arteries

42
Q

What is the name given to the space anterior to the elbow and what are its boundaries?

A

Cubital fossa
Superior border – line between the medial and lateral epicondyles of the humerus
Medial border – lateral border of pronator teres
Lateral border – medial border of brachioradialis

43
Q

What happens to the biceps aponeurosis in this area?

A

It merges with the fascia of the region

44
Q

What important vessels and nerves pass through the cubital fossa?

A

Brachial artery and veins

Median nerve

45
Q

Describe the arrangement of superficial veins in the upper limb.

A

The cephalic vein (runs laterally) and the basilic vein (runs medially) originate from the dorsal venous arch of the hand
The basilica vein joins venae commitantes to form the axillary vein in the arm
The cephalic vein joins the axillary vein at the axilla
The axillary vein becomes the subclavian vein at the level of the 1st rib

NOTE: there is normally a median cubital vein joining the cephalic and basilic at the cubital fossa

46
Q

Describe the deep venous drainage of the upper limb.

A

The deep venous drainage of the upper limb runs in reverse to the arterial supply

47
Q

What are the two venous arches present on the palmar side of the hand?

A

Superficial venous palmar arch

Deep venous palmar arch

48
Q

Where lymph nodes are found in the upper limb?

A

Cubital lymph nodes

Axillary lymph nodes

49
Q

Name the difference subsets of axillary lymph nodes.

A 
Pectoral 
Central 
Apical 
Subscapular 
Humeral
50
Q 
State which spinal nerves roots make up:
Musculocutaneous nerve 
Radial nerve 
Median nerve 
Ulnar nerve
A

Musculocutaneous nerve
C567

Radial nerve
C5678 T1

Median nerve
C678 T1

Ulnar nerve
C8 T1

51
Q

What is the role of the musculocutaneous nerve in the forearm?

A

It has a lateral cutaneous branch, which provides sensory innervation to the lateral part of the forearm

52
Q

Describe the passage of the median nerve through the arm.

A

Courses through the anterior compartment and lies anterior to the elbow, with the brachial artery
It is the main nerve to the muscles of the anterior compartment of the forearm

53
Q

Where can the median nerve be damaged easily?

A

Elbow and wrist

54
Q

Where is the ulnar nerve easily damaged?

A

It lies behind the medial epicondyle of the humerus where it can easily be damaged

It can also be damaged at the wrist

55
Q

Where is the radial nerve easily damaged?

A

It lies close to the humerus in the radial groove so fractures of the humerus could damage the radial nerve
It can also be damaged in the axillary region

56
Q

What two branches does the radial nerve divide into?

A

Posterior interosseous nerve (motor)

Superficial radial nerve (sensory)

57
Q

Which muscles of the forearm does the ulnar nerve supply?

A

FCU

Ulnar half of FDP

58
Q

What is the role of the flexor retinaculum?

A

It holds down the long tendons and prevents them from bowing

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