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Clinical Anatomy > Flexor, Elbow Joint, Hand > Flashcards

Flexor, Elbow Joint, Hand Flashcards

1
Q

What 3 muscles flex the wrist?

A

1) Flexor carpi radialis
2) Flexor carpi ulnaris
3) Palmaris longus

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2
Q

What 3 muscles flex the digits?

A

1) Flexor digitorum superficialis
2) Flexor digitorum profundus
3) Flexor pollicis longus

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3
Q

What muscle flexes the DIP joints?

A

Flexor digitorum profundus

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4
Q

What muscle flexes the PIP joints?

A

Flexor digitorum superficialis

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5
Q

What 2 muscles flex the MCP joints?

A

1) Flexor digitorum superficialis

2) Flexor digitorum profundus

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6
Q

What muscle flexes the thumb joint?

A

Flexor pollicis longus

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7
Q

What muscle is the strongest flexor of the elbow (in the absence of supination)?

A

Brachialis

NOT biceps brachii

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8
Q

What is the common origin point for the flexor muscles?

A

Medial epicondyle

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9
Q

What nerve allows for abduction + adduction of the fingers?

A

Ulnar nerve

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10
Q

What is the stabilizing bone of the forearm?

A

Ulna

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11
Q

Name the fossae of the distal humerus

A

1) Radial fossa
2) Coronoid fossa
3) Olecranon fossa

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12
Q

Name the two articular surfaces of the distal humerus

A

1) Capitulum

2) Trochlea

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13
Q

Name the two proximal projections of the ulna

A

1) Olecranon

2) Coronoid process

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14
Q

What part of the ulna articulates with the radius?

A

1) Radial notch articulates w/ head of radius on proximal ulnar end
2) Head of ulna articulates w/ ulnar notch at distal radial end

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15
Q

What are the bony projections at the distal end of the radius & ulna?

A

Ulnar & radial styloid processes

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16
Q

Name the articular surfaces of the proximal ulna with the humerus

A

1) Trochlear notch
2) Olecranon
3) Coronoid process

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17
Q

Does the ulna articulate with the carpal bones?

A

No

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18
Q

Name the proximal row of carpal bones

A 
(Lateral to medial)
Scaphoid
Lunate 
Triquetrum
Pisiform

“So Long To Pinky”

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19
Q

Name the distal row of carpal bones

A 
(medial to lateral)
Hamate
Capitate
Trapezoid
Trapezium

“Here Comes The Thumb”

*trapezi-UM rhymes with thUMB

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20
Q

What nerve is injured with fracture of the surgical neck of the humerus?

A

Axillary nerve

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21
Q

What nerve is injured with fracture of the mid humeral shaft?

A

Radial nerve

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22
Q

What nerve is injured with fracture of the distal humerus?

A

Median nerve

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23
Q

What nerve is injured with fracture of the medial epicondyle?

A

Ulnar nerve

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24
Q

Colles fracture

A
  • Complete fracture of distal 2 cm of radius
  • Most common fracture of the forearm
  • Ulnar styloid process often is avulsed
  • Typically occurs when people try to break fall with arm
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25
Q

Which carpal bone is susceptible to avascular necrosis and why?

A
  • Scaphoid bone

- Poor blood supply in that area

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26
Q

What nerve can be injured if hamate bone is fractured?

A

Ulnar nerve (+ possibly artery)

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27
Q

What test assesses status of ulnar nerve?

A

ABduction/ADduction of fingers

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28
Q

Name parts of proximal end of radius

A
  • Articular fossa
  • Articular circumference
  • Radial tuberosity
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29
Q

What ligament holds the proximal radioulnar joint together?

A

Annular ligament (of radius)

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30
Q

Where are the posterior interosseous vessels located?

A
  • Pass through gap between oblique cord and upper end of the interosseous membrane
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31
Q

Oblique cord

A
  • Flat band running obliquely to interosseous membrane

- Slope proximally from just below radial tuberosity superiorly to side of ulnar tuberosity

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32
Q

What two strong ligaments hold the elbow joint together?

A

1) Radial collateral ligament

2) Ulnar collateral ligament

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33
Q

Attachments of radial collateral ligament

A

1) Lateral epicondyle

2) Annular ligament of radius

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34
Q

Attachments of ulnar collateral ligament

A

1) Medial epicondyle
2) Coronoid process + olecranon of ulna

*3 bands
Strongest = anterior (cord-like)
Weakest = posterior (fan-like)
Oblique band - deepens socket for trochlea of humerus

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35
Q

Triangular fibrocartilage complex (TFCC)

A
  • Load-bearing structure between lunate, triquetrum, & ulnar head
  • Main uniting structure of distal radius + ulna
  • Acts as stabilizer for distal ulna
  • Consists of: articular disc, meniscus homologue, ulnocarpal ligament, dorsal & volar radioulnar ligament and extensor carpi ulnaris sheath
36
Q

Complete fracture

A
  • Cortex to cortex

- Longer to heal

37
Q

Incomplete fracture

A
  • Cortex one side, not to cortex of other
  • Faster to heal
  • More commonly seen in Peds due to plasticity of bones
38
Q

Closed fracture

A

No skin break

39
Q

Open (compound) fracture

A

Skin break

40
Q

Spiral fracture

A
  • Anterior + posterior component

- Implies rotational force causing fracture

41
Q

Comminuted fracture

A
  • Multiple fracture lines in one area

- Longer recovery time

42
Q

Segmental fracture

A
  • Multiple fracture lines with free floating bone segment in between
  • Longer recovery time due to blood supply being cut off on both ends (delay osteogenesis)
43
Q

Stress fracture

A

Fracture in which bone is “torn” off instead of ligament tearing

44
Q

Avulsion fracture

A

Ligament torn off and pulled off piece of bone

45
Q

Greenstick fracture

A
  • Bone bends & cracks instead of breaking completely
  • Think ‘green’ wood
  • Intact appearing side likely has microtrabecular fracture
46
Q

Supination

A
  • Turning palm up

* Think of holding Soup

47
Q

Pronation

A
  • Turning palm down

* Think of Pouring soup

48
Q

What muscles supinate the forearm?

A
  • Supinator (resistance absent)
  • Biceps brachii (resistance present)

Helped by:

  • EPL
  • ERCL
49
Q

What muscles pronate the forearm?

A
  • Pronator quadratus (primary)
  • Pronator teres (secondary)

Helped by:

  • FCR
  • Palmaris longus
  • Brachioradialis (when in mid-pronated position)
50
Q

How to describe alignment of fractures

A

Always describe the distal fracture fragment

51
Q

8 ways to describe alignment of fractures

A

1) Lateral displacement
2) Medial displacement
3) Medial angulation
4) Lateral angulation
5) Internal rotation
6) External rotation
7) Overriding with foreshortening (shortening w/ overlapping)
8) Distraction (pulled apart)

52
Q

Transverse fracture

A

Straight across

53
Q

Oblique fracture

A

Angled

54
Q

Damage to intra-articular bones means certain damage to what?

A

Cartilage –> early DJD

55
Q

Epiphyseal plate

A
  • Growth plate

- Becomes scar in adults

56
Q

3 causes for pathologic fractures

A

1) Tumor (benign, malignant)
2) Stress fractures (insufficiency, fatigue)
3) Metabolic bone disease (osteomalacia, renal osteodystrophy, etc.)

57
Q

What are the hallmarks of bone formation?

A

Calcium + phosphate

58
Q

Normal appearance of elbow joint on XR

A
  • Anterior humeral line lines up w/ capitellum

- Midline of radius lines up w/ capitellum

59
Q

Sail sign

A
  • Dark sails (fat pads) seen around distal humerus
  • Should NEVER see posterior fat pad
  • Indicates radial head fracture until proven otherwise
60
Q

Most common elbow fracture in adults

A

Radial head fracture

61
Q

Most common elbow fracture in peds

A

Distal humerus/supra-epicondylar fracture

62
Q

Interosseous membrane

A

Strong connective membrane connecting radius + ulna

63
Q

What muscles does the ulnar nerve innervate in the forearm?

A

1) Flexor carpi ulnaris

2) Flexor digitorum profundus (pinky + medial half of digit 4)

64
Q

What muscles does the median nerve innervate in the forearm?

A

1) Flexor carpi radialis
2) Palmaris longus
3) Pronator teres
4) Pronator quadratus
5) Flexor digitorum superficialis
6) Flexor digitorum profundus (except last 1.5 fingers)
7)

65
Q

How many muscles does the anterior compartment of the forearm have?

A

8

66
Q

Name the superficial forearm muscles of the anterior compartment.

A

1st layer:

1) Pronator teres
2) Flexor carpi radialis
3) Palmaris longus
4) Flexor carpi ulnaris

2nd layer:
5) Flexor digitorum superficialis

67
Q

Name the deep forearm muscles of the anterior compartment.

A

3rd layer:

6) Flexor digitorum profundus
7) Flexor pollicus longus

4th layer:
8) Pronator quadratus

68
Q

Flexor carpi ulnaris (origin + insertion)

A

Origin:

  • Medial epicondyle of humerus
  • Olecranon

Insertion:

  • Pisiform bone
  • Hook of hamate
  • 5th metacarpal bone
69
Q

Flexor carpi ulnaris (function + innervation)

A

Function:
Flexor + ulnar adductor of wrist

Innervation:
- Ulnar nerve (C8) (C7)

70
Q

Pronator teres (origin + insertion)

A

Origin:

  • Humeral head: Medial epicondyle of humerus
  • Ulnar head: Coronoid process of ulna

Insertion:
- Middle of lateral surface of radius

71
Q

Pronator teres (function + innervation)

A

Function:
- Pronate + flex forearm

Innervation:
- Median nerve (C7) (C6)

72
Q

Flexor digitorum superficialis (origin + insertion)

A

Origin:

  • Humero-ulnar head: Medial epicondyle + coronoid process
  • Radial head: Oblique line of radius

Insertion:
- Shafts of middle phalanges of digits 2-5

73
Q

Flexor digitorum superficialis (function + innervation)

A

Function:

  • Flex PIP joints (1st)
  • Flex MCP + wrist joints (2nd)
  • Assist flexion of elbow + wrist

Innervation:
- Median nerve (C7-T1)

74
Q

Flexor digitorum profundus (origin + insertion)

A

Origin:
- Proximal 3/4 of medial + anterior surface of ulna & IOM

Insertion:
- Bases of distal phalanges of digits 2-5

75
Q

Flexor digitorum profundus (function + innervation)

A

Function:

  • Flex DIP joints (1st)
  • While still acting, rolls fingers + wrist into flexion

Innervation:

  • Lateral (radial) part : Median nerve (C8) (T1)
  • Medial (ulnar) part: Ulnar nerve (C8) (T1)
76
Q

Pronator quadratus (origin + insertion)

A

Origin:
- Distal 1/4 of anterior surface of ulna

Insertion:
- Distal 1/4 of anterior surface of radius

77
Q

Pronator quadratus (function + innervation)

A

Function:
- Pronate forearm

Innervation:
- Anterior interosseus nerve from median nerve (C8,T1)

78
Q

Name the branches of the forearm arteries

A
  • Brachial artery ends in distal cubital fossa
  • Splits into radial + ulnar
  • Each give off anterior + posterior recurrent branches
  • Ulnar gives off common interosseous artery which branches into anterior + posterior
  • Ulnar + radial arteries anastomose to form superficial + deep palmar arches
79
Q

Palmaris longus (origin + insertion)

A

Origin:
- Medial epicondyle of humerus

Insertion:

  • Palmar aponeurosis
  • Distal half of flexor reticulum
80
Q

Palmaris longus (function + innervation)

A

Function:

  • Flex hand (at wrist)
  • Tense palmar aponeurosis

Innervation:
- Median nerve (C7, C6)

81
Q

Flexor carpi radialis (origin + insertion)

A

Origin:
- Medial epicondyle of humerus

Insertion:
- Base of 2nd (3rd) metacarpal

82
Q

Flexor carpi radialis (function + innervation)

A

Function:
- Flex + abduct wrist

Innervation:
- Median nerve (C7) (C6)

83
Q

Flexor pollicis longus (origin + insertion)

A

Origin:
- Anterior surface of radius & adjacent IOM

Insertion:
- Base of distal phalanx of thumb

84
Q

Flexor pollicis longus (function + innervation)

A

Function:

  • Flex MCP & IP joints of thumb
  • Flex wrist joint, CMC joint

Innervation:
- Anterior interosseous nerve, from median nerve (C8) (T1)

85
Q

What major branch does the median nerve give off?

A

Anterior interosseous nerve

86
Q

What muscle does the median nerve pass between to enter the forearm?

A

Heads of the pronator teres

87
Q

What are the 4 muscles of the thumb?

A

1) Flexor pollicis brevis

2)

Clinical Anatomy (25 decks)

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