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Musculoskeletal forearm > Forearm > Flashcards

Forearm Flashcards

1
Q

What are the boundaries of the cubital fossa?

A

CF: a trianglular area between the pronator teres, brachioradialis, and a line joining the humeral epicondyles. Floor: brachialis & supinator muscle Roof: bicipital aponeurosis & deep fascia of forearm

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2
Q

What are the contents of the cubital fossa?

A

-Brachial artery, vein & median n (lie media to biceps tendon) -Lateral cutaneous n. (lie lateral to the biceps tendon) -Radia n. dividing into deep & superficial radial ns. Lie deep to the brachialis.

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3
Q

What structures contact the roof of the CF but not technically within it?

A

Cephalic vein Median cubital bein Basillic vein

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4
Q

Extrinsic vs Intrinsic muscles of the hand (definitions)

A

-Extrinsic-those that arise on the forearm and insert into the fingers. For strength/power/grip -Intrinsic-those that arise within the hand (bones) for fine movement and precision

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5
Q

Prime movers for: -Ulnar deviation (adduction) -Radial deviation (abduction)

A

Adduction: Flexor and extensr carpi ulnaris Abduction: Flexor + extensor carpi radialis and snuffbox muscles

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6
Q

Muscles of the superficial flexor compartment of the forearm

A

-Pronator teres (two heads:origin on the medial epicondyle, one from the coronoid process of the ulna) -Fexor carpi radialis (medial epicondyle –> base of 2nd metacarpal) -Palmaris longus (medial epicondyle –> ligament that spread across the palm) -Flexor carpi ulnaris (medial epicondyle –> the ulnar side of the hand -at base-ish)

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7
Q

Muscles of the intermediate flexor group

A

One muscle-Flexor digitorum superficialis, kind of rectangle shape-originates from the medial epicondyle, the proximal ulna and attach to the base of the phalangial of all but the thumb -this compartment also contains the median n that runs under the flexor digitorum superficialis. Also has the ulnar nerve that runs deep to the FDS.

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8
Q

Muscles of the deep flexor group

A

-Flexor pollicis longus-ant surface of radius & interosseous membrane –> base of distal phalanx of thumb -Flexor digitorum profundus - ant ulna & interosseous membrane –> distal phalanges 4 digits -Pronator quadratus - distal 1/4 ulna –> distal 1/4 radius -Median n. also runs through here but at the cubital fossa area it gives off the anterior interosseus branch that run along the surface of the interosseus membrane. -Ulnar n. runs on the surface of the flexor digitorum profundus

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9
Q

What is the prime mover of flexion at the interphalangeal (IP) joints?

A

Flexor digitorum superficial (FDS) and flexor digitorum profundus (FDP). FDP attaches to the distal phalanx and is the only one that flexes the DIP joint.

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10
Q

Innervation of the flexor compartment

A

Median nerve innervates all except flexor carpi ulnaris and the ulnar two tendons of the flexor digitorum profundus (tendons to the ring and small finger)

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11
Q

Anterior interosseus nerve

A

Branch of the median nerve. Supplies most of the deep muscles of forearm flexors (except for the two tendons of the flexor digitorum profundus. In other words, it supplies the pronator quadratus, flexor pollicis longus, and radial two tendons of the flexor digitorum profundus.

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12
Q

Extensor compartment:

Mobile Wad (muscles that pass along the radial border)

A

Brachioradialis

Extensor carpi radialis longus

Extensor carpi radialis brevis

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13
Q

Extensor compartment:

Long extensors (muscles that pass along the posterior surface of the forearm)

A

Extensor digitorum communis

Extensor digiti minimi (quinti)

Extensor carpi ulnaris

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14
Q

How do you test for damage to the anterior interosseus nerve?

A

This innervates muscles that allows you to make an O with the thumb and index finger. FDP and FPL (flexor pollicis longus)

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15
Q

What are the muscles of the mobile wad?

A

(muscles that pass along the radial border)

Brachioradialis

Extensor carpi radialis longus

Extensor carpi radialis brevis

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16
Q

What are the long extensors of the forearm?

A

These are muscles that pass along the posterior surface of the forearm

Extensor digitorum communis

Extensor digiti minimi (quinti)

Extensor carpi ulnaris

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17
Q

What are the short extensors of the forearm?

A

Called short because they arise not from the lateral epicondyle but rather from the radius, interosseus membrane and ulna. These muscles have no actions at the elbows but serves the thumb and forefinger.

Three for the thumb:

Abductor pollicis longus

Extensor pollicis brevis

Extensor pollicis longus

and one for the forefinger: Extensor indicis proprius

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18
Q

What are the other two extensors of the forearm?

A

Aconeus and supinator muscle

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19
Q

Outline the path of the radial nerve

A

After leaving the extensor compartment of the arm (where it innervates the triceps), the radial nerve dives into the extensor compartment of the forearm where it innervates the mobile wad (brachioradialis, extensor carpi radialis longus, and extensor carpo radialis brevis) before giving off two branches:

  1. Deep radial nerver-innervates the rest of the muscles
  2. Superficial radial nerve - does not innervate muscles but supplies cutaneous innervation to much of the radial side of the dorsum of the hand
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20
Q
A

Left to Right

Pronator teres

Flexor carpi radialis

Palmaris longus

Flexor carpi ulnaris

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21
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30
Q

What are the attachment points for the retinaculum forming the carpal tunnel?

A

Pisiform and hook of hamate on the ulnar side

Tubercles of scaphoid and trapezium on the radial side

31
Q

What goes through the carpal tunnel?

A

4 tendons of the flexor digitorum superficialis

4 tendons of the flexor digitorum profundus

Tendon of the flexor pollicis longus

The median nerve (not the palmar branch because that originates in the forearm)

32
Q

What structures in the forearm do NOT go through the carpal tunnel?

A

Ulnar n

Radial and ulnar artery

wrist flexor muscles

Flexor carpi radialis looks like it goes through but it has its own compartment

33
Q

Muscles in the thenar group

What innervates them

A

Opponens pollicis

Flexor pollicis brevis

Abductor pollicis brevis

The thenar group is innervated by recurrent branch of median n

34
Q

Muscles of the hypothenar group

What innervates them

A

Opponens digiti minimi

Flexor digiti minimi brevis

Abductor digiti minimi

All muscles in the hand except the thenar group and first two lumbricals are innervaed by ulnar n.

35
Q

Muscles of the central group (of the hand)

A

Adductor pollicis

Lumbricals

Interosseus (palmar & dorsal)

36
Q

Cutaneous innervation of the hand

A

Medial, radial and ulnar n.

Ulnar covers the pinky + ulnar half of the ring finger on both dorsal and palmar side

Median covers the thumb through radial half of ring finger on the palmar side

Radial covers thumb through radial half of finger on the dorsal side

Innervations to the palms usually arise in the forear, so injuries at the wrist wont affect them. Only sensation in the digits will be affected. Carpal tunnel-radial half or so of the palm is spared

37
Q

Innervation of the hand muscles

A

All of the hand muscles are innervated by the ulnar n. except the thenar muscles and the first two lumbricals. Those are inervated by the recurrent branch of median n.

Another exception is the deep head of the flexor pollicis brevis is innervated by the ulnar n.

So in the end, the ulnar nerve divides into two branches, the deep one supplies hypothenar, interossei, ulnar two lumbricals and the deep head of flexor pollicis brevis

38
Q

Motion of the finger joints:

Flexion at

MCP

PIP

DIP

A

MCP-lumbricals and interossei

PIP-flextor digitorum superficialis

DIP-flexor digitorum profundus

39
Q

Motion at the finger joint:

Extension at

MCP

PIP

DIP

A

MCP: extensor digitorum communis

PIP: central slip of lumbricals and interossei

DIP: terminal slip of lumbricals and interossei

40
Q

Motion at finger joint:

Abduction at MCP joint

Adduction of MCP joint

A

Dorsal interossei (ab)

Palmar interossei (add)

41
Q

Motion of the thumb joint

Flexion at

CMC

MCP

IP

A

CMC-none

MCP-Flexor pollicis brevis

IP-Flexor pollicis longus

42
Q

Motion of the thumb joint

Extension at

CMC

MCP

IP

A

CMC-none

MCP-extensor pollicis brevis

IP-extensor pollicis longus

43
Q

Motion of the thumb joint

Adduction at

CMC

MCP

IP

A

CMC-none

MCP-Adductor pollicis

IP-none

44
Q

Motion of the thumb joint

Abduction at

CMC

MCP

IP

A

CMC-abductor pollicis longus

MCP-abductor pollicis brevis

IP-none

45
Q

Motion of the thumb joint

Opposition at

CMC

MCP

IP

A

CMC-Opponens pollicis

MCP-none

IP-none

46
Q

What are the cutaneous innervation of hte hand by

Median

Ulnar

Radial

A
47
Q

Outline the path of the ulnar nerve

A

C8-T1, goes through the axilla, down the media side of arm, into cubital fossa, run down through Guyon canal-separate from Carpal tunnel.

Innervates all of the intrinsic muscles of the hand except the thenar muscles and first two lumbricals (which are innervated by the median nerve)

48
Q

What muscles elevate the scapula

A

Levator scapule

Upper trapezius

49
Q

What muscles depress scapula

A

Lower trapezius

Serratus anterior (lower fibers)

Pect minor

(indirectly-pec major and latissimus dorsi)

50
Q

What muscles protract scapula

A

Pect minor (and major)

Serratus anterior

51
Q

What muscles retract scapula

A

Middle trapezius

Rhomboids

52
Q

What muscles rotate scapula upward

A

Upper and lower trapezius

serratus anterior

53
Q

What muscles flex arm

A

Biceps

Anterior deltoid

Coracobrachialis

Pect major-clavicular head

54
Q

What muscles extend arm (and their origin/insertion)

A

Triceps (3 heads: long-medial humerus to infraglenoid tubercle, medial-

55
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59
Q
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Musculoskeletal forearm (2 decks)

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