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Anatomy > EXAM2 G12_Flexor_UE > Flashcards

EXAM2 G12_Flexor_UE Flashcards

1
Q

What styloid process extends further?

What is the ulnar slant?
Distal radius has a normal volar tilt of ?

A

Radial styloid process extends 9-12mm further than ulnar sP.

distal radius slant angle of 15-25degrees AP view
volar tilt of 10-25 degrees Lateral view

important for evaluating fracture of radius and ulna

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2
Q

SO LONG TO PINKY HERE COMES THE THUMB

A

Scaphoid, Lunate, Triquetrium, Pisiform, Hamate, Capitate, Trapezoid, Trapezium

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3
Q

PIP, DIP, MCP

What are the bones of the thumb and what is the joint of the thumb?

A 
Proximal interphalangeal joints (middle knucks)
Distal interphalangeal joints (tip joints)
Metacarpophalangeal joints (knucks) 
THUMB only has proximal and distal phalanx and a single IP joint
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4
Q

What types of HUMERUS fractures? What risk with each type of fracture?

A

Surgical neck (axillary nerve PCHA)

MID shaft (Radial nerve and Profunda brachii artery)

Distal fracture (Ulnar nerve at medial epicondyle)
(Median nerve and Brachial artery at distal humerus)
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5
Q 
COLLES FRACTURE
how common?
How broken?
What broken?
What is deformity seen?
What lost?
what is also broken?
What is at risk?
A

Most common wrist fracture in adults

fall on outstretched hand- complete transverse fracture of the radial metaphysis

Posterior displacement of wrist and hand results in dinner fork deformity and loss of volar tilt of distal radius

60-70% fracture Styloid process of ULNA too

MEDIAN NERVE AT RISK

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6
Q

SMITHS FRACTURE

A

Forced flexion (reverse colles fracture)
complete transverse fracture of distal metaphysis of Radius
Anterior displacement= garden spade deformity
- Syloid process of ULNA (arrowhead) commonly fractured too

  • MORE RISK OF MEDIAN NERVE than colles
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7
Q

Transverse Humeral Ligament

A

converts intertubercular sulcus into a canal where long biceps tendon passe through

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8
Q

Distal biceps brachii forms what tendon sheet ?

A

Bicipital aponeurosis covering cubital fossa

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9
Q

What is the division in the inner arm seen and can be palpated for brachial pulse called?

A

Medial bicipital groove

Medial intermuscular septum

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10
Q

What deformity if long head of biceps tendon ruptures?

A

Popeye deformity

Chronic degenerative tendinitis >35yo; muscle belly balls up inside distal arm

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11
Q

Tapping the biceps tendon at cubital fossa. what is this test?

What does it test?

A

Bicipital myotatic Reflex

reflex contraction testing C5,C6 spinal cord segments

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12
Q

Which muscle mostly resists dislocation in the arm?

What spinal nerve contributors?

A

Coracobrachialis (C5,6,7)

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13
Q

What nerve pierces the coracobrachialis?

A

Musculocutaneous nerve and runs inbetween the plane of the biceps and the brachialis

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14
Q

What muscle flexes the arm regardless of position

SN contributors?

A

Brachialis (c5,C6)

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15
Q 
Superficial forearm group
where do these muscles originate?
what joints do they cross?
What do they act on ?
What innervations?
A

Originates at medial epicondyle
Crosses elbow joint
Mainly acts on wrist
Innervation is Medain except for 1 muscle

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16
Q 
Deep forearm group
Where is attachments and actions relative to superficial forearm group?
Do they cross the elbow joint?
What do they act on?
What is innervation?
A

Attachments and actions more distal
Dont cross elbow joint
Act on digits
INNERVATION IS ANTERIOR INTEROSSEOUS N. except 1/2 muscle

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17
Q

What nerve passes between the two heads of the pronator teres?

A

MEDIAN

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18
Q

What is the landmark for the median nerve and radial artery in the forearm?

A

Flexor Carpi Radialis
median nerve medial to tendon of FCR
Radial artery lateral to tendon of FCR

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19
Q

Flexor carpi ulnaris is the landmark for what ?

Origin insertion?

A

Ulnar nerve and artery (lies deep to the FCU)

originates CFO inserts on 5th metacarpal

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20
Q

FDS
origin
insertion
Action

A 
origin Medial epicondyle and coronoid process (humeroulnar head)
Proximal radius (radial head)

inserts (middle phalanx shaft of digits 2-5)
Flexes at proximal interphalangeal joints
can also flex metacarpophalangeal joint

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21
Q

What is the cause of Golfers elbow or medial epicondylitis?

A

Median nerve being compressed as it passes under tendinous arch of flexor digitorum superficialis

22
Q

Flexor digitorum profundus Origin insertion

A

Origin proximal ulna and interosseous membrane
inserts distal phalanx base of digits 2-5
Ulnar head innervated by ULNAR NERVE
Radial lateral head innervated by Anterior interosseous N.

23
Q

Where does the FDP tendon pass to get to the distal phalanx of 2-5?

A

Passes through the TENDINOUS CHIASM of the FDS to reach distal phalanx

24
Q

What is the ONLY MUSCLE THAT CAN FLEX THE DIP JOINTS

A

Flexor digitorum profundus

25
Q

Flexor pollicis longus origin insertion action

A

Origin at radius and interosseous membrane
Inserts distal phalanx base of thumb
Flexes IP joint of thumb (only has proximal & distal phalanx)
ANTERIOR INTEROSSEOUS NERVE

26
Q

Primary pronator oina

A

Pronator Quadratus origin on ulna inserts radius inn: ant interosseous nerve

27
Q

Describe path of Musculocutaneous

A

Terminal branch of lateral cord pierces coracobrachialis and emerges lateral to biceps as the lateral cutaneous nerve of forearm

ONLY SENSORY AT THAT POINT ON

28
Q 
Median Nerve
What does it travel with in arm?
Where does it enter in the forearm?
What is it deep to?
What does it pass between?
What does it pass behind?
A

travels w/ brachial artery in arm
Enters cubital fossa and lies deep to bicipital aponeurosis and median cubital vein
In forearm passes between heads of pronator teres
passes behind tendinous arch of flexor digitorum superficialis and becomes superficial at the wrist

29
Q

Innervation of forearm except for FCU
What does it branch into/form?
What does it innervate at that point? any sensation?

A

Median Nerve
- Branches to form Anterior interosseous nerve
inn deep forearm flexors
- Palmar cutaneous branch- sensation of central palm

30
Q

What causes central sensation of palm?

A

Palmar cutaneous branch of Median nerve

31
Q

Paresthesias

A

Numbness tingling; LESION OF CUTANEOUS NERVE

32
Q

PARESIS

A

Muscle weakness: LESION OF MOTOR N OR MUSCULAR BR.

33
Q

2 entrapment sites for medain nerve in forarm

What does it cause?

A

between pronator teres and as it descends posterior to tendinous arch of radial head of flexor digitorum superficialis- causes pronator teres syndrome

34
Q

Where does the anterior interosseous nerve run?

sensory or motor or both?

A

lateral and deep to flexor digitorum profundus and flexor pollicis longus

NO SENSORY JUST MOTOR

35
Q

Anterior interosseous nerve palsy

What other muscles affected/actions?

A

entraped between flexor digitorum profundus and flexor pollicis longus

  • Cant make OK sign w/ hand (more like a q in sign language)

Flexion of dIP (FDP), IP joint of thumb (FPL), pronation (PQ)

36
Q

ULNAR NERVE LANDMARKS

A

Ulnar groove (funny bone)
Cubital Tunnel formed by tendinous arch between humeral and ulnar heads of flexor carpi ulnaris
Courses deep to flexor carpi ulnaris w/ ulnar vessels

NO BRANCHES IN ARM

37
Q

Sensory in palm of Ulnar nerve

A 
Dorsal branch (test tip of pinky)
Palmar cutaneous branch (lateral palm)
38
Q

Entrapment of ulnar nerve occurs at two locations and causes what syndrome? What is difficult about Ulnar diagnosis?

A 
Ulnar groove (vulnerable to trauma-distal fracture etc)
Deep to tendinous arch connecting two heads of FCU at humeral and ulnar attachments

CUBITAL TUNNEL SYNDROME

CANT DISTINGUISH WHERE ENTRAPMENT OF ULNAR NERVE IS

39
Q

Brachial artery- origin

A

Inferior border of teres major
Palpable in medial bicipital groove
accompanies median nerve in arm
Ends in cubital fossa and divides into radial and ulnar a’s

40
Q

Profunda brachii

What does it travel with?where

A

deep artery of arm
supplies posterior arm
Travels w radial nerve in Spiral groove
contributes shoulder and elbow arterial anastomoses

41
Q

Superior/inferior ulnar collateral arteries

A

Contribute periarticular anastomoses of elbow

Clinical: can clamp of distal to profundus brachii and still be okay b/c so many anastomoses

42
Q

RADIAL artery

A

Branches to radial recurrent artery

Palmar carpal branch

43
Q

Ulnar artery- ap two branches

A

Anterior ulnar recurrent artery

Posterior ulnar recurrent artery

44
Q

Ulnar forms a common interosseous artery then

A

anterior interosseous artery and posterior dives through interosseous membrane

45
Q

What runs deep to the FCU

A

Ulnar artery and nerve then come superficial at wrist. can get a ulnar pulse lateral to tendon of FCU at wrist

46
Q

Contents of Cubital fossa

A

Brachioradialis and pronator teres and bicipital aponeurosis from biceps protects underlying nv structures

47
Q

3 features occur at the cubital fossa

A

brachial artery branches to radial and ulnar arteries
(median nerve is medial to brachial artery)
Radial nerve divides into deep and superficial branches

48
Q

What vein used to draw blood?

A

Median cubital

49
Q

What provides Superior lateral cutaneous nerves of the ARM ? (around lateral inferior deltoid region)

A

Branch of axillary nerve

50
Q

What provides Inferior lateral cutaneous nerves of the ARM?

A

Branch of RADIAL nerve

51
Q

what provides lateral cutaneous nerves of the forearm?

A

Continuation of musculocutaneous nerve

Anatomy (24 decks)

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