Elbow, forearm and wrist Flashcards

1
Q

important features of the radius

A

proximal:
Head
Neck
Radial tuberosity

distal:
radial styloid process

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2
Q

important features of the ulna

A
Olecranon and coronoid processes
Trochlear notch
Ulnar tuberosity
ulnar head
styloid process
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3
Q

proximal row of carpal bones (lateral to medial)

A

Scaphoid
Lunate
Triquetrum
Pisiform

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4
Q

distal row of carpal bones (lateral to medial)

A

trapezium
trapezoid
capitate
hamate

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5
Q

scaphoid

A

Most lateral
Boat shaped
Articulates with radius
Has an anteriorly projecting tubercle

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6
Q

lunate

A

Crescent shaped, also articulates with radius

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7
Q

triquetrum ,why is it called so?

A

3 sided bone

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8
Q

pisiform

which tendon does it lie in?

A

sesamoid bone in the tendon of the flexor carpi ulnaris

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9
Q

which distal row carpal bone is the largest?

A

capitate

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10
Q

which distal row carpal bone has a hook?

A

hamate

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11
Q

which distal row carpal one has a tubercle next to the thumb?

A

trapezium

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12
Q

what type of joint is the elbow joint?

A

synovial hinge joint

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13
Q

what movement does the elbow joint allow?

A

flexion and extension only

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14
Q

what part of the humerus articulates with the ulna?

A

trochlea

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15
Q

which part of the humerus articulates with the radius?

A

capitulum

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16
Q

what does the proximal radio-ulnar joint, near the elbow joint, allow?

A

supination

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17
Q

what are the three ligaments that stabilise the elbow joint?

A

1) Radial collateral ligament (lateral)
2) Ulnar collateral ligament (medial)
3) Annular ligament (Strictly part of the proximal radio-ulnar joint)

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18
Q

what are the parts of the ulnar ligament?

A

anterior cordlike band
posterior fanlike band
oblique band

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19
Q

proximal attachment of coracobrachialis (ant. arm)

A

coracoid process

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20
Q

distal attachment of coracobrachialis (ant. arm)

A

humeral shaft

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21
Q

function of coracobrachialis

A

flexion at glenohumeral joint

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22
Q

innervation to coracobrachialis

A

musclocutaneous

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23
Q

proximal attachment of biceps brachii (ant. arm)

A

short head: coracoid process

long head: superior glenoid tubercle

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24
Q

distal attachment of biceps brachii (ant. arm)

A

radial tuberosity

bicipital aponeurosis

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25
Q

function of the biceps brachii

A
  • Flexion at the glenohumeral joint
  • Flexion at the elbow joint
  • Supination of the forearm at the proximal radioulnar joint.
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26
Q

innervation to biceps brachii

A

musculocutaneous

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27
Q

proximal attachment of the brachialis (ant. arm)

A

anterior humeral shaft

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28
Q

distal attachment of the brachialis (ant. arm)

A

ulnar tuberosity

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29
Q

function of the brachialis

A

flexion at the elbow joint

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30
Q

innervation to the brachialis

A

musculocutaneous

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31
Q

proximal attachment of the triceps (post. arm)

A

Long head : Infraglenoid

Medial and lateral head : Posterior humeral shaft

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32
Q

distal attachment of the triceps

A

olecranon

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33
Q

function of the triceps

A

Extension of the elbow joint

Long head extends the glenohumeral joint

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34
Q

innervation to the triceps

A

radial nerve

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35
Q

what are the borders of the cubital fossa

A

Line between the medial epicondyles
Brachioradialis
Pronator teres

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36
Q

what is the roof of the cubital fossa?

A

Aponeurosis of the biceps brachii and deep fascia of the forearm

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37
Q

what is contained in the cubital fossa?

A

Median cubital vein

Medial and lateral cutaneous nerves of the forearm

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38
Q

what passes from the arm to the forearm via the cubital fossa?

A
  • Median nerve
  • Radial nerve
  • Brachial artery (divides in the cubital fossa)
  • Biceps tendon
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39
Q

which epicondyle does the radial nerve pass over?

A

anterior to the lateral epicondyle

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40
Q

what epicondyle is transversed by the ulnar nerve?

A

the ulnar nerve passes posterior to the medial epicondyle

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41
Q

what type of joint is the proximal radioulnar joint?

what does this joint allow?

A

pivot joint

supination and pronation

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42
Q

what holds the radius over the ulnar?

A

The radius is held over the ulna by the annular ligament but is allowed free rotation

Commonly dislocated in children

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43
Q

what does the distal radioulnar joint do?

A

allows the radius to move around the ulna in rotation

in pronation and supination

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44
Q

what are the ligaments of the distal radioulnar joint?

A
  • Palmar radioulnar ligament
  • Dorsal radioulnar ligament
  • Articular disk (triangular fibrocartilage)
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45
Q

where does the articular disk of the distal radioulnar joint lie?

A

between the distal radio-ulnar and the radio-carpal joint

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46
Q

supination

A

palms up

[cup for soup]

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47
Q

pronations

A

palm down

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48
Q

what are the three ways in which the radius and ulna are connected?

A

(1) Proximally: by proximal radioulnar joint

(2) Interosseus membrane
(2 apertures, one superiorly, one inferiorly)

(3) Distally: Distal radioulnar joint

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49
Q

what muscles are responsible for pronation?

A

Pronator teres

pronator quadratus

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50
Q

what muscles are responsible for supination?

A
Supinator
biceps brachii (when in a pronated position)
51
Q

what type of muscles are contained in the anterior forearm?

A

superficial
intermediate
deep

52
Q

what separates the posterior and anterior compartment of the forearm?

A

interosseous membrane between the radius and ulna

53
Q

what type of muscles are contained in the posterior forearm?

A

wrist extensors
digit extensors
thumb extensors

54
Q

what are the superficial muscles of the anterior forearm? (lateral to medial)

A
Pronator teres
Flexor carpi radialis
Palmaris longus
Flexor carpi ulnaris
[4 fingers from medial epicondyle]
55
Q

what is the common proximal attachment for the 4 superficial anterior forearm muscles?

A

common flexor origin

56
Q

distal attachment of pronator teres?

A

radius

57
Q

function of pronator teres

A

wrist pronation and flexion

58
Q

innervation to pronator teres

A

median nerve

59
Q

distal attachment of flexor carpi radialis?

A

metacarpals 2 and 3

60
Q

function of the flexor carpi radialis?

A

wrist adduction and flexion

61
Q

innervation to flexor carpi radialis?

A

median nerve

62
Q

distal attachment of palmaris is longus?

A

palmar aponeurosis of the hand

63
Q

function of the palmaris longus?

A

wrist flexion

64
Q

innervation to palmar is longus

A

median nerve

65
Q

distal attachment of flexor carpi ulnaris?

A

carpal and metacarpals

66
Q

function of flexor carpi ulnaris?

A

wrist adduction and flexion

67
Q

innervation to the flexor carpi ulnaris?

A

ulnar nerve

68
Q

which muscle is the intermediate muscle of the anterior forearm?

A

flexor digitorium superficialis (FDS)

69
Q

function of the FDS?

A

Flexion at the proximal interphalangeal, MCP and wrist joints

70
Q

proximal attachment of the FDS?

A

Radial and ulnar heads

Partial attachment to the humerus

71
Q

innervation to the FDS

A

median nerve

72
Q

which muscles make up the deep layer of the anterior forearm?

A
  • flexor digitorium profundus (FDP)
  • flexor pollicus longus
  • pronator quadratus
73
Q

proximal attachment of the FDP?

A

ulnar and interosseous membrane

74
Q

distal attachment of the FDP?

A

anterior distal phalanges of the digits (finger tips)

75
Q

distal attachment of the FDS?

A

middle phalanges (earlier)

76
Q

function of the FDP?

A

Flexion of distal interphalangeal joints and wrist

77
Q

innervation of FDP?

A

medial half of muscles (towards little and ring finger): ulnar nerve

lateral half of muscles (middle and index fingers): anterior interosseous branch of median nerve

78
Q

proximal attachment of the flexor pollicus longus?

A

radius

79
Q

distal attachment of the flexor pollicus longus?

A

distal phalanx of the thumb

80
Q

function of the flexor pollicus longus?

A

Flexes interphalangeal joints of thumb

81
Q

proximal attachment of the pronator quadratus?

A

distal ulna

82
Q

distal attachment of the pronator quadratus?

A

distal radius

83
Q

function of the pronator quadratus?

A

pronation

84
Q

innervation of flexor pollicus longus?

A

Median nerve (anterior interosseous branch)

85
Q

innervation of pronator quadratus?

A

Median nerve (anterior interosseous branch)

86
Q

what are the extensors of the wrist?

A
  • Extensor carpi radialis longus
  • Extensor carpi radialis brevis
  • Extensor carpi ulnaris
87
Q

what are the extensors of the digits?

A
Extensor digitorum (all 4 digits)
Extensor indicis (index digit)
Extensor digiti minimi (little finger)
88
Q

innervation of the posterior forearm?

A

posterior interosseous nerve (continuation of the deep motor branch of radial nerve)

89
Q

extensors of the thumb

A

Extensor pollicis brevis
Extensor pollicis longus
Abductor pollicis longus (thumb abduction)

90
Q

additional posterior forearm muscles

A

supinator and brachioradialis

91
Q

proximal attachment of the supinator?

A

lateral epicondyle of humerus

92
Q

distal attachment of the supinator?

A

proximal third of the radius

93
Q

function of the supinator?

A

wrist supination

94
Q

proximal attachment of the brachoioradialis?

A

distal humerus

95
Q

distal attachment of the brachoioradialis?

A

lateral distal radius

96
Q

function of the brachioradialis?

A

elbow flexion

97
Q

brachial artery

A

-lateral to median nerve
-gives off profunda brachii
(runs alongside the radial nerve)
-gives off nutrient artery to humerus
- divides at elbow into ulnar and radial arteries

98
Q

ulnar artery

A
  • the anterior compartment of the forearm
  • Passes medially and then shifts laterally and comes into contact with the Flexor carpi ulnaris and Ulnar nerve
  • common interosseous artery branches off the ulnar artery
  • this branches into anterior and posterior interosseous arteries that goers into the anterior and posterior compartments of the forearm
99
Q

where does the ulnar artery anastamose in the dorsal hand?

A

with the dorsal carpal branches of the radial and ulnar arteries to form the dorsal carpal arch

100
Q

ulnar artery into the hand

A

over flexor retinaculum

101
Q

radial artery

A

-passes under the cover of the brachioradialis
- Crosses the floor of the anatomical snuff box
- enters hands through the two heads of the first dorsal interosseous muscle
- forms palmar arches
- gives off Dorsal carpal branch of the radial which anastomoses with the dorsal carpal branch of the ulnar
and interosseous arteries to form the Dorsal carpal arch

102
Q

superficial veins

A

Basilic – draining medial part

Cephalic – draining lateral part

103
Q

deep veins

A

The venae comitantes of the profunda brachii (VCPB)

104
Q

where does the basilic vein become deep

A

Basilic pierces deep fascia midway up arm to become deep and joins the VCPB

105
Q

where does the axillary vein form?

A

border of teres minor

106
Q

where does the cephalic vein join the axillary vein?

A

delta-pectoral triangle

107
Q

what forms the cephalic vein laterally and the basilic vein medially

A

dorsal venous arch (superficial)

108
Q

what connects the basilic and cephalic veins

A

median cubital vein (site of venepuncture)

109
Q

what forms the venae comitantes of the radial and ulnar veins?

A

palmar venous arches

eventually into brachial veins (venae com of profunda brachii)

110
Q

median nerve relevant to brachial artery

A

medial at the level of the elbow

111
Q

how can the median nerve be damaged?

A

by supracondylar elbow fractures or dislocations

112
Q

how does the median nerve enter the forearm?

A

Enters forearm between heads of the pronator teres

113
Q

what branch does the median nerve give off in the forearm?

A

anterior interosseous nerve which supplies the anterior compartment, except for
Flexor carpi ulnaris and
Medial flexor digitorum profundus

114
Q

what nerve does the median nerve give off just prior to the wrist?

A

palmar cutaneous branch

median then enters through the carpal tunnel

115
Q

how does the ulnar nerve enter the forearm?

A

Enters forearm between heads of the flexor carpi ulnaris

116
Q

what does the ulnar nerve supply in the forearm?

A

Supplies FCU and medial FDP

117
Q

what does the ulnar nerve give off at the wrist?

A

Palmar cutaneous branch

Dorsal cutaneous branch

118
Q

position of the ulnar nerve at the wrist

A

medial to the FCU

lateral to the ulnar artery

119
Q

sensory and motor divisions of the radial nerve

A

Sensory: Superficial radial nerve
Motor: Posterior interosseous nerve

120
Q

what branch becomes the posterior interosseous?

A

the deep branch of the radial nerve becomes the post interseous which then supplies the extensor compartment

121
Q

what is a supracondyle fracture?

what is its cause?

A

Fracture of the humerus above the epicondyles

Caused by hyperextension of the humerus due to a fall

122
Q

what can a supracondyle fracture lead to?

A

Can tear, entrap or compress the brachial artery which leads to compartment syndrome
the median nerve can also be compressed

123
Q

what is a Colles fracture?

what causes this?

A

A fracture of the distal radius bone just above the wrist

Common following a fall onto the outstretched hand

124
Q

what are the symptoms of a Colles fracture?

A

Wrist pain
Wrist swelling
Dinner fork deformity