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Anatomy > Exam #6: Anterior Arm & Forearm > Flashcards

Exam #6: Anterior Arm & Forearm Flashcards

1
Q

Review the bony landmarks of the humerus.

A

N/A

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2
Q

Review the bony landmarks of the radius & ulna.

A

N/A

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3
Q

Which is lateral, the radius or the ulna?

A

Radius

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4
Q

What does the radial head articulate with?

A

Capitulum of the humerus

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5
Q

What is the name for the proximal part of the ulna?

A

Olecranon process

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6
Q

What is the difference between the heads of the ulna and radius?

A 
Radius= proximal
Ulna= distal
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7
Q

What is the mechanism for a radius fracture?

A

Falling on an outstretched arm

*This can occur across the length of the shaft

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8
Q

What is the mechanism for ulna fracture?

A
  • Falling on the forearm

- Defensive wounds

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9
Q

What is a nightstick fracture?

A

Ulnar fracture

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10
Q

What is an ulnar pseudoarthrosis?

A

Congenital or improperly set ulnar fracture that results in the formation of a “joint” midshaft in the ulna

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11
Q

Radiographically, how can you tell the difference between an ulnar fracture and a pseudoarthrosis?

A

Acute fracture= subtle

Pseudoarthrosis= prominent

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12
Q

What is the elbow joint proper? How many joints make the elbow? What types of joints are these?

A

Humeroradial & humeroulnar joints together

  • Humeroradial= ball & socket
  • Humeroulnar= hinge
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13
Q

What is the radio-ulnar joint? What is the function?

A

Annular ligament connects the radius & ulnar, which limits the humeroradial joint to a hinge joint

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14
Q

What are the ligaments of the elbow?

A

1) Annular ligament*****
2) Ulnar collateral ligaments
- Posterior
- Anterior
- Transverse
3) Radial collateral ligament

*****Most important ligament

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15
Q

What are the three main parts of the ulnar collateral ligaments? What is the clinical significance?

A

1) Posterior
2) Anterior
3) Transverse

*Baseball players rupture this ligament & ALL 3x of the components have to be replaced

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16
Q

Review the radiographic landmarks of the elbow.

A

N/A

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17
Q

What typically happens when you get a posterior dislocation of the elbow?

A

Fracture of the coronoid process

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18
Q

What is a nursemaid’s elbow?

A

Dislocated radial head i.e. rupture of the fibers of the annular ligament

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19
Q

What nerve innervates the anterior compartment of the arm?

A

Musculocutaneous n.

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20
Q

Which muscle of the anterior compartment has dual innervation? Why is this important?

A

Brachialis

*****Also innervated by the Radial N.; thus, if the musculocutaneous branch in damaged, you can still flex your arm at the elbow

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21
Q

What is the function of all the muscles of the anterior compartment?

A

Flexors

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22
Q

List the muscles of the anterior compartment or the arm.

A

1) Biceps brachii
2) Brachialis
3) Coracobrachialis

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23
Q

What are the origins of the Biceps Brachii?

A

Coracoid process

Supraglenoid tubercle

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24
Q

What are the insertions of the Biceps Brachii?

A
  • Radial tuberosity

- Bicipital aponeurosis that blends with the antebrachial fasica, indirectly connecting to the ulna

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25
Q

What is the function of the Biceps Brachii?

A

Flexion of the shoulder
Flexion of the elbow
Supination

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26
Q

What is the origin of the Brachialis?

A

Anterior humerus

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27
Q

What is the insertion of the Brachialis?

A

Ulnar tuberosity

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28
Q

What muscle is the main flexor of the arm?

A

Brachialis

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29
Q

What is the function of the Brachialis?

A

Flexion of the elbow

*****This is where most of the power of flexion comes from i.e. MAIN FLEXOR

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30
Q

What are the origins of the Coracobrachialis?

A

Coracoid process

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31
Q

What is the insertion of the Coracobrachialis?

A

Medial humerus

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32
Q

What are the function of the Corachobrachialis?

A

1) Prevention of dislocation of the humerus
2) Flexion of the shoulder
3) Adduction of the arm

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33
Q

Anterior compartment of the forearm are innervated by what nerve?

A

Predominantly the median nerve with a few exceptions:

  • Flexor carpi ulnaris (ulnar n.)
  • Medial 1/2 of the flexor digitorum profundus (ulnar n.)
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34
Q

What are the muscles in the superficial group of the anterior compartment of the forearm?

A

Pronator teres
Palmaris longus
Flexor carpi radialis
Flexor carpi ulnaris

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35
Q

What is the origin of the Pronator teres?

A

Medial epicondyle of the humerus

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36
Q

What is the insertion of the Pronator teres?

A

Midshaft of the radius

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37
Q

What is the function of the Pronator teres?

A

Pronation

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38
Q

What is the origin of the Palmaris longus?

A

Medial epicondyle of the humerus

39
Q

What is the insertion of the Palmaris Longus?

A

Palmar aponeurosis

40
Q

What is the function of the Palmaris longus?

A
  • Flex wrist

- Tense palmar aponeurosis

41
Q

What is the origin of the flexor carpi radialis?

A

Medial epicondyle of the humerus

42
Q

What is the insertion of the flexor carpi radialis?

A

Base of MC II

43
Q

What is the function of the flexor carpi radialis?

A

Flex & abduct the wrist

44
Q

What is the origin of the flexor carpi ulnaris?

A

Medial epicondyle of the humerus & olecranon process

45
Q

What is the insertion of the flexor carpi ulnaris?

A

Hook of hamate
Pisiform
Base of MC B

46
Q

What nerve innervates the flexor carpi ulnaris?

A

Ulnar nerve

47
Q

What is the function of the flexor carpi ulnaris?

A

Flex & adduct wrist

48
Q

What are the muscles of the intermediate group of of muscles in the anterior compartment of the forearm?

A
  • Pronator teres (deep head)

- Flexor digitorum superficialis

49
Q

What is the origin of the flexor digitorum superficialis?

A

Medial epicondyle

Proximal radius

50
Q

What is the insertion of the flexor digitorum superficialis?

A

Middle phalanges (#2-5)

51
Q

What nerve innervates the flexor digitorum superficialis?

52
Q

What is the function of the flexor digitorum superficialis?

A

Flex PIP, MCP, & wrist

53
Q

What is the origin of the flexor digitorum profundus?

A

Ulnar shaft

Interosseous membrane

54
Q

What is the insertion of the flexor digitorum profundus?

A

Distal phalanges (2-5)

55
Q

What nerve innervates the flexor digitorum profundus?

A

Medial 1/2= ulnar n

Lateral 1/2= Median n., specifically anterior interosseous nerve

56
Q

What is the function of the flexor digitorum profundus?

A

Flex DIP, PIP, MCP, wrist

57
Q

What is the origin of the flexor pollicis longus?

A

Radial shaft

Interosseous membrane

58
Q

What is the insertion of the flexor pollicis longus?

A

Base of distal phalanx of digit 1

59
Q

What is the innervation of the flexor pollicis longus?

A

Median n., specifically anterior interosseous nerve

60
Q

What is the function of the flexor pollicis longus?

A

Flex CMC, MCP, IP of digit 1

Flex wrist

61
Q

What is the origin of the pronator quadratus?

A

Distal ulnar shaft

62
Q

What is the insertion of the pronator quadratus?

A

Distal radial shaft

63
Q

What is the innervation of the pronator quadratus?

A

Anterior interosseous n.

64
Q

What is the function of the pronator quadratus?

65
Q

What are the major branches of the brachial artery?

A 
Profunda barchii 
Superior ulnar collateral
Inferior ulnar collateral
Radial a. 
Ulnar a.
66
Q

What are the branches of the Profunda Brachii a?

A

Middle collateral a.

Radial collateral a.

67
Q

What are the branches of the Superior Ulnar Collateral?

68
Q

What are the branches of the Inferior Ulnar Collateral?

69
Q

What are the two terminal branches of the brachial artery?

A

1) Radial artery

2) Ulnar artery

70
Q

What are the branches of the radial artery?

A

1) Radial recurrent artery

71
Q

What artery does the radial recurrent artery anatamose with?

A

Radial collateral a.

72
Q

What are the branches of the ulnar arteries?

A

1) Anterior ulnar recurrent
2) Posterior ulnar recurrent
3) Common interosseous

73
Q

What does the Anterior Ulnar Recurrent anastamose with?

A

Inferior ulnar recurrent

74
Q

What does the Posterior Ulnar Recurrent anastamse with?

A

Superior ulnar collateral

75
Q

What are the branches of the common interosseous artery?

A

Anterior interosseous a.

Posterior interosseous a.

76
Q

What is the branch of the posterior interosseous a? What does this artery anastamose with?

A

Recurrent interosseous a. that anastamoses with the middle collateral a.

77
Q

What are the borders of the cubital fossa?

A 
Superior= line connecting the medial & lateral epicondyles
Lateral= brachioradialis 
Medial= Pronator teres
78
Q

What are the contents of the cubital fossa?

A
  • Superficial veins
  • Brachial a.
  • Ulnar a.
  • Radial a.
  • Median n.
  • Radial n.
  • Biceps brachii tendon
  • Bicipital aponeurosis
79
Q

What covers the brachial a. & median nerve?

A

Bicpitial aponeurosis

80
Q

What injury can damage the cubital fossa? What are the consequences of this injury?

A

Supra-epicondylar fracture

  • Brachial a. damage leads to:
    1) Ischemia of the forearm
    2) Tightness of the muscles
    3) “Volkman’s ischemic contracture” i.e. a tightly curled fist
81
Q

What is the clinical sign for a median nerve injury in the cubital fossa, or more proximal?

A

“Hand of the Benediction”

82
Q

What is pronator syndrome?

A

Pronator teres compression of the median nerve

83
Q

What is anterior interosseous syndrome?

A

“Kiloh -Nevin Syndrome”

84
Q

What is the “Hand of the Benediction?”

A

Median nerve injury proximal to cubital fossa; ask patient to make a fist & digits 1, 2, & 3 remain extended

85
Q

Explain the underlying nerve pathology underlying Hand of the Benediction.

A
  • Median nerve innervates all flexors EXCEPT the medial 2x digits of the flexor digitorum profundus; thus, digit # 4 & 5 can still flex
  • All thenar muscles are out via recurrent branch of median nerve
86
Q

What is Pronator Syndrome?

A

Pain in the forearm with pronation

87
Q

Explain the underlying nerve pathology underlying Pronator Syndrome.

A
  • Compression of the median nerve between the superficial & deep heads of the pronator teres
  • Can lead to weakness & paresthesias
88
Q

What is Anterior Interosseous Syndrome?

A

Damage to the anterior interosseous nerve by trauma–>patient cannot make the “OK sign”

*****NO sensory deficits, but patient will have problems with fine motor movement of the first two digits of the affected hand

89
Q

What are the three muscles innervates by the anterior interosseous nerve?

A

1) Pronator quadratus
2) Flexor pollicics longus
3) Lateral half of the flexor digitorum profundus

90
Q

Explain the underlying nerve pathology of Anterior Interosseous Syndrome.

A

1) Flexor pollicis longus cannot flex thumb

2) Cannot flex the DIP of the index finger b/c of flexor digitorum profundus injury

91
Q

What is the clinical sign associated with ulnar nerve injury proximal to the elbow?

A

“Ulnar Claw”

92
Q

What is ulnar claw? How is it different from “Hand of the Benedicition?”

A

Passive vs. active Hand of the Benediction

1) Extension of MCP in digits #4 & 5
2) Flexion at PIP joints
3) Wasting of the first dorsal interosseous

93
Q

Explain the underlying nerve pathology associated with ulnar claw.

A
  • Ulnar nerve damage=
    1) No Flexor Carpi Ulnaris, cannot flex wrist
    2) No medial flexor digitorum profundus, cannot flex DIP of #4 & 5
    3) Numbness in digits 4 & 5
    4) Loss of intrinsic hand muscles= wasting of first dorsal interosseous

Superficialis is still functioning= not FULL loss of flexion

94
Q

What is cubital tunnel syndrome?

A

Compression of the ulnar nerve as it passes through the cubital tunnel leads to paresthesias in digits #4 & 5

Anatomy (35 decks)

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