Final: Lecture 18 Flashcards
Radial artery give rise to….
•Princeps pollicis artery
T/F the ulna doesn’t articulate with the carpels.
•True, articular disc inbetween
Princeps pollicis artery may give rise to….
•Radialis indicis artery
Pronator teres
- Proximal: coronoid process of ulna
- Distal: middle of lateral surface of radius
- Actions: pronates and flexes forearm at elbow
- Innervation: median nerve
- Large head on medial epicondyle of humerus
Flexor carpi radialis
- Proximal: medial epicondyle of humerus (common flexor origin)
- Distal: base of 2nd metacarpal
- Actions: flexes and abducts hand at wrist, abduction same as radial deviation
- Innervation: median
Palmaris longus
- Proximal: medial epicondyle of humerus
- Distal: flexor retinaculum, continuous with palmar aponeurosis
- Actions: flexes hand at wrist, tenses palmar aponeurosis
- Innervation: median
Flexor carpi ulnaris
- Proximal: medial epicondyle of humerus
- Distal: pisiform, hook of hamate, 5th metacarpal
- Actions: flexes and adducts hand at wrist
- Innervation: ulnar nerve
Flexor digitorum superficialis
- Proximal: medial epicondyle of humerus, superior 1/2 of anterior border of radius
- Distal: shafts of middle phalanges of medial 4 digits
- Actions: flexes middle phalanges at proximal interphalangeal joint, flexes proximal phalanges at metacarpophalangeal joints
- Innervation: median
Flexor digitorum profundus
- Proximal: proximal 3/4 of medial and anterior surfaces of ulna and interosseous membrane
- Distal: bases of distal phalanges of 2nd-5th fingers
- Actions: flexes distal phalanges at interphalangeal joints (power grip)
- Innervation: median (anterior interosseus nerve branch) and ulnar
Flexor pollicis longus
- Proximal: anterior surface of radius and interosseous membrane
- Distal: base of distal phalanx of thumb
- Actions: flexes thumb
- Innervation: median via anterior interosseous
Pronator quadratus
- Proximal: distal 1/4 of anterior surface of ulna
- Distal: distal 1/4 of anterior surface of radius
- Actions: pronates forearm, deep fibers bind radius and ulna together
- Innervation: median via anterior interosseous
What keeps tendons in place and wraps in synovial sheathes in the wrist?
•Extensor Retinaculum
Innervation of Posterior forearm is supplied by?
- Radial Nerve
- Superficial branch runs lateral, beneath brachioradialis
- deep branch posterior, becomes posterior interosseous
What are the superficial extensors of the forearm?
- Brachioradialis (a flexor)
- Extensor carpi radialis logus and brevis
- Extensor digitorum/digiti minimi/carpi ulnaris
Brachioradialis
- Proximal: proximal 2/3 of supraepicondylar ridge of humerus
- Distal: distal radius, proximal to styloid process
- Actions: flexes forearm when it is pronated (about midprone position)
- Innervation: radial
Extensor carpi radialis longus
- Proximal: lateral supracondylar ridge of humerus
- Distal: dorsal aspect of base of 2nd metacarpal
- Actions: extend and abduct hand at wrist
- Innervation: radial
Extensor carpi radialis brevis
- Proximal: lateral epicondyle of humerus (common extensor origin)
- Distal: dorsal aspect of base of 3rd metacarpal
- Actions: extend and abduct hand at wrist
- Innervation: deep branch of radial
Extensor digitorum
- Proximal: lateral epicondyle of humerus
- Distal: extensor expansions of medial 4 fingers (often just 3)
- Actions: extends medial 4 fingers at metacarpophalangeal joints and somewhat at interphalangeal joints
- Innervation: posterior interosseous
Extensor digiti minimi
- Proximal: lateral epicondyle of humerus
- Distal: extensor expansion of 5th finger
- Actions: extends 5th finger at metacarpophalangeal joint and secondarily at interphalangeal joints
- Innervation: posterior interosseous
Extensor carpi ulnaris
- Proximal: lateral epicondyle of humerus and posterior border of ulna
- Distal: dorsal aspect of base of 5th metacarpal
- Actions: extends and adducts hand at wrist
- Innervation: posterior interosseous
Abductor pollicis longus, extensor pollicis longus/brevis are call the _________ muscles.
•outcropping
Supinator
- Proximal: lateral epicondyle of humerus, radial collateral and anular ligaments, ulnar crest
- Distal: proximal 1/3 of radius (nearly all surfaces, as it wraps around the bone)
- Actions: supinates forearm, bringing radius back to anatomical position
- Innervation: deep branch of raidal
Extensor indicis
- Proximal: posterior surface of distal 1/3 of ulna and interosseous membrane
- Distal: extensor expansion of 2nd finger
- Actions: independent extension of 2nd finger, but also helps with extension of wrist
- Innervation: posterior interosseous (continuation of deep branch of radial)
Abductor pollicis longus
- Proximal: posterior surface of proximal 1/2 of ulna and raidius, interosseous membrane
- Distal: base of 1st metacarpal
- Actions: abducts thumb and extends it at carpometacarpal joint
- Innervation: posterior interosseous
Extensor pollicis brevis
- Proximal: posterior surface of distal 1/3 of radius, interosseous membrane
- Distal: dorsal aspect of proximal phalanx of thumb
- Actions: extends proximal phalanx of thumb at its metacarpophalangeal joint, also extends carpometacarpal joint
- Innervation: posterior interosseous
Extensor pollicis longus
- Proximal: posterior surface of middle 1/3 of ulna, interosseous membrane
- Distal: dorsal aspect of base of distal phalanx of thumb
- Actions: extends distal phalanx of thumb at its interphalangeal joint and extends the metacarpophalangeal and carpometacarpal joint
- Innervation: posterior interosseous
Extensor pollicis longus/brevis and abductor pollicis longus form what on the hand?
•Anatomical snuff box
Progressive shortening and thickening of the palmar fascia that pulls the 4th and 5th digits into partial flexion is called?
- Dupuytren’s Contracture
* Tends to be hereditary
Infection in the digital synovial sheaths can cause inflammation of the tendon and synovial sheath. In the 5th digit, it can extend into the carpal tunnel and into the forearm. This is called?
•Tensosynovitis
The extensor tendons form a moveable hood over the MP and IP joints of the fingers called?
•extensor expansion
The Thenar Eminence is formed by what three muscles?
- Abductor pollicis brevis, flexor pollicis brevis, and opponens pollicis
- one muscle NOT part of the eminence is adductor pollicis
What 3 muscles form the Hypothenar Eminence?
•flexor digiti minimi, abductor digiti minimi, and opponens digiti minimi
Opponens pollicis
- Proximal: flexor retinaculum and tubercles of scaphoid and trapezium
- Distal: lateral side of 1st metacarpal
- Actions: oppose thumb and medially rotate 1st metacarpal
- Innervation: recurrent branch of median
Abductor pollicis brevis
- Proximal: flexor retinaculum and tubercles of scaphoid and trapezium
- Distal: lateral sie of base of proximal phalanx of thumb
- Actions: abduct thumb, aid in opposition
- Innervation: recurrent branch of median
Flexor pollicis brevis
- Proximal: flexor retinaculum and tubercles of scaphoid and trapezium
- Distal: lateral side of base of proximal phalanx of thumb
- Actions: flexes thumb
- Innervation: recurrent branch of median, deep branch of ulnar
Adductor pollicis
- Proximal: bases of 2nd and 3rd metacarpals, capitate, and adjacent carpals
- Distal: medial side of base of proximal phalanx of thumb
- Actions: adducts thumb toward lateral border of palm
- Innervation: deep branch of ulnar
Abductor digiti minimi
- Proximal: pisiform
- Distal: medial side of base of proximal phalanx of 5th digit
- Actions: abducts 5th digit, aids in flexion of 5th proximal phalanx
- Innervation: deep branch of ulnar
Flexor digiti minimi
- Proximal: hook of hamate and flexor retinaculum
- Distal: medial side of base of proximal phalanx of 5th digit
Actions: flexes proximal phalanx of digit 5
•Innervation: deep branch of ulnar
Opponens digiti minimi
- Proximal: hook of hamate and flexor retinaculum
- Distal: medial border of 5th metacarpal
- Actions: brings 5th metacarpal anterior and rotates it to bring it into opposition with thumb
- Innervation: deep branch of ulnar
Lumbricals
- 1st and 2nd attached to lateral 2 tendons of FDP, median nerve
- 3rd and 4th attached to medial 3 tendons of FDP, deep branch of ulnar
- insert on the lateral sides of the extensor expansions of digits 2-5
- flex the metacarpophalangeal joints and extend interphalangeal joints of 2-5
Palmar Interossei
- 3 of them, attach to palmar surfaces of 2nd, 4th, and 5th metacarpals
- Insert at bases of proximal phalanges and the extensor expansions of digits 2, 4, and 5
- P.A.D.- adducts 2, 4, 5 toward axial line, assist lumbricals
- Innervation: deep branch of ulnar
Dorsal Interossei
- 4 of them, attach to adjacent sides of 2 metacarpals
- insert at bases of proximal phalanges and the extensor expansions of digits 2-4
- D.A.B.-abduct 2-4 fingers toward axial line, assist lumbricals
- Innervated by deep branch of ulnar
