Elbow, forearm and wrist Flashcards

1
Q

Name the carpal bones.

A

1st row: scaphoid, lunate, triquetrum, pisiform

2nd row: 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 head of radius
Trochlea: articulates with head of 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 (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: 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 2 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 + 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

+ aponeurosis merges with fascia of the region

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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 of ulna

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15
Q

Which compartment are the flexors, extensors, pronators and supinators in?

A

Pronators + flexors: anterior

Supinators + extensors: posterior

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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 (esp. superficial muscles) originate

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19
Q

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

A

Pronator teres

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20
Q

Describe the attachments of pronator quadratus.

A

Attached between the distal ends of ulna + 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
(palmaris longus tendon isn’t present in everyone + 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 extensor 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

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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 3 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 (cord like)
Posterior band (fan like)
Oblique band
31
Q

What is the role of the anular ligament?

A

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

32
Q

Describe the difference in carrying angle between genders.

A

Men: 10-15 degrees
Women: > 15 degrees

33
Q

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

A

Distal end of radius articulates with scaphoid + lunate

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 + C6
Elbow extension: C7 + C8
Wrist flexion: C6 + C7
Wrist extension: C6 +C7

36
Q

Which muscles are involved in supination?

A

Supinator
Biceps brachii
(EPL, ECRL)

37
Q

Which muscles are involved in pronation?

A

Pronator teres
Pronator quadratus
(FCR, PL, brachioradialis)

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
FCU + FCR
Long flexors of thumb + fingers 
(APL, PL)
Extension of the wrist 
ECRL, ECRB, ECU 
Long extensors of the thumb + fingers
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

Immediately splits into anterior + posterior interosseous arteries

41
Q

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

A

Anastomosis of the radial + ulnar arteries

42
Q

What is the name given to the space anterior to the elbow? What important vessels and nerves pass through here?

A

Cubital fossa
Brachial artery + veins
Median nerve

43
Q

What happens to the biceps aponeurosis in the cubital fossa?

A

It merges with the fascia of the region

44
Q

Describe the arrangement of superficial veins in the upper limb.

A

Cephalic vein (lateral)+ basilic vein (medial) originate from the dorsal venous arch of the hand
Basilic joins venae commitantes to form the axillary vein in the arm
Cephalic vein joins the axillary vein at the axilla
Axillary vein becomes subclavian vein at level of 1st rib
(there is normally a median cubital vein joining the cephalic + basilic at the cubital fossa)

45
Q

Describe the deep venous drainage of the upper limb.

A

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

46
Q

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

A

Superficial venous palmar arch

Deep venous palmar arch

47
Q

Where lymph nodes are found in the upper limb?

A

Cubital lymph nodes

Axillary lymph nodes

48
Q

Name the 5 subsets of axillary lymph nodes.

A
Pectoral 
Central 
Apical 
Subscapular 
Humeral
49
Q
State which spinal nerves roots make up:
Musculocutaneous nerve 
Radial nerve 
Median nerve 
Ulnar nerve
A

Musculocutaneous nerve = C5-7
Radial nerve = C5-8 + T1
Median nerve: C6-8 + T1
Ulnar nerve: C8 + T1

50
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

51
Q

Describe the passage of the median nerve through the arm.

A

Courses through the anterior compartment + lies anterior to the elbow, with the brachial artery
Main nerve to the muscles of the anterior compartment of the forearm

52
Q

Where can the median nerve be damaged easily?

A

Elbow + wrist

53
Q

Where is the ulnar nerve easily damaged?

A

Elbow + wrist

54
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
Axillary region
Elbow
Wrist

55
Q

What two branches does the radial nerve divide into?

A

Posterior interosseous nerve (motor, deep)

Superficial radial nerve (sensory)

56
Q

Which muscles of the forearm does the ulnar nerve supply?

A

FCU
Ulnar half of FDP
Most intrinsic muscles of the hand

57
Q

What is the role of the flexor retinaculum?

A

It holds down the long tendons + prevents them from bowing

58
Q

What is the distal attachment of anconeus?

A

Lateral epicondyle of humerus

59
Q

Describe the passage of the ulna nerve through the arm.

A

Courses via posterior compartment of upper arm
No significant branches in upper arm
Lies behind the medial epicondyle of the humerus
Main nerve of the hand

60
Q

Describe the supply and passage of the radial nerve through the arm.

A

Supplies all muscles in posterior compartment of upper arm + forearm
Passes around body of humerus at mid-shaft in radial groove
Courses via anterior compartment of upper arm more distally
Divides just above the elbow

61
Q

Which nerve supplies the majority of the anterior muscles of the forearm?

A

Median nerve