Forearm And Hand Flashcards
State the boundaries of the cubital fossa.
Medial border – Pronator Teres
Lateral border – Brachioradialis
Superior border – imaginary line between medial & lateral epicondyles
Floor – Brachialis
Roof – Bicipital aponeurosis, adipose tissue & skin
State the deep contents of the cubital fossa from lateral to medial.
Radial nerve, biceps brachii tendon, brachial artery and median nerve.
State the superficial contents of the cubital fossa from lateral to medial.
Cephalic vein, lateral cutaneous nerve of forearm, median cubital vein, medial cutaneous nerve of forearm and basilic vein.
Label and state the side of the forearm.
Right hand side
1=radial notch of ulna
2=head of radius
3=neck of radius
4=radial tuberosity
5=radius
6=distal radioulnar joint
7=trochlear notch
8=coronoid process
9=proximal radioulnar joint
10=interosseous membrane
11=ulna
12=ulnar notch of radius
13=head of ulna
14=styloid process of ulna
15=styloid process of radius
16=olecranon process
17=ulna
18=ulnar notch of radius
19=head of ulna
20=styloid process of ulna
21=styloid process of radius
22=head of radius
23=neck of radius
24=radius
Label and state the side of hand.
Left hand side
1=distal phalange
2=proximal phalange
(carpals)
3=trapezium
4=trapezoid
5=scaphoid
6=metacarpals 1 to 5
7=hamate
8=capitate
9=pisiform
10=triquetrum
11=lunate
12=ulna
13=radius
14=head
15=shaft
16=base
17=distal
18=middle
19=proximal
20=head
21=shaft
22=base
23=trapezium
24=trapezoid
25=scaphoid
26=phalange
Classify the muscles of the anterior forearm by location; into superficial, intermediate and deep.
Superficial: Pronator Teres, Flexor Carpi Radialis, Palmaris Longus, Flexor Carpi Ulnaris.
Intermediate: Flexor Digitorum Superficialis
Deep: Flexor Digitorum Profundus, Flexor Pollicis Longus, Pronator Quadratus.
Classify the muscles of the anterior forearm by function; into pronators of the forearm, flexors of the hand, flexors of the digits.
Pronators of the forearm: pronator teres and pronator quadratus.
Flexors of the hand: flexor carpi radialis, flexor carpi ulnaris, palmaris longus.
Flexors of the digits: flexor pollicis longus, flexor digitorum profundus, flexor digitorum superficialis.
What muscles emerge from the common flexor tendon and where does it originate?
Pronator teres, flexor carpi radialis, palmaris longus, flexor carpi ulnaris, flexor digitorum superficialis (proximal to distal attachments). The common flexor tendon itself originates from the medial epicondyle.
Name the location, origins, insertions, actions and nerve supply of the pronator teres.
Location: superficial, anterior forearm
Origins: common flexor tendon, coronoid process
Insertions: middle of the lateral radius
Actions: pronates forearm, flexes elbow
Nerve supply: median nerve (C6,7)
Name the location, origins, insertions, actions and nerve supply of flexor carpi radialis.
Location: superficial, anterior forearm
Origins: common flexor tendon
Insertions: base of the 2nd and 3rd metacarpals
Actions: wrist flexion and radial deviation
Nerve supply: median nerve (C6,7)
Name the location, origins, insertions, actions and nerve supply of palmaris longus.
Location: superficial, anterior forearm
Origins: common flexor tendon
Insertions: palmar aponeurosis and flexor retinaculum
Actions: wrist flexion and palmar aponeurosis tension
Nerve supply: median nerve (C7,8)
Name the location, origins, insertions, actions and nerve supply of flexor carpi ulnaris.
Location: superficial, anterior forearm
Origins: common flexor tendon (humeral head), olecranon and posterior border of ulna (ulnar head)
Insertions: pisiform, hook of hamate, base of 5th metacarpal
Actions: ulnar deviation and wrist flexion
Nerve supply: ulnar nerve (C8,T1), this nerve travels between its superficial and deep heads, injury to this muscle is significant in diagnosis of nerve damage.
Name the location, origins, insertions, actions and nerve supply of flexor digitorum superficialis.
Location: intermediate, anterior forearm
Origins: common flexor tendon and coronoid process (humeroulnar head), superior half of anterior border of radius (radial head)
Insertions: Middle phalanges of the 2nd to 5th fingers (via four separate tendons that split at the base of the proximal phalanges and insert on the sides of the middle phalanges)
Actions: wrist flexion, flexion of proximal interphalangeal joints of 2nd to 5th fingers, flexion of metacarpophalangeal joints
Nerve supply: median nerve (C7,C8,T1)
Name the location, origins, insertions, actions and nerve supply of flexor digitorum profundus.
Location: deep, anterior forearm
Origins: superior 3/4 of the anterior and medial ulna and interosseous membrane
Insertions: Base of distal phalanges of 2nd to 5th fingers, via 4 tendons
Actions: flexion of wrist, metacarpophalangeal joints, proximal interphalangeal joints and distal interphalangeal joints (2-5).
Nerve supply: ulnar nerve (4/5), anterior interosseous branch of median nerve (2/3), (C8,T1)
Name the location, origins, insertions, actions and nerve supply of flexor pollicis longus.
Location: deep, anterior forearm
Origins: middle 3rd of radius and interosseous membrane
Insertions: base of distal phalanx of thumb
Actions: flexion of interphalangeal joint of thumb, metacarpophalangeal joint of thumb and wrist
Nerve supply: anterior interosseous branch of median nerve (C8,T1)
Name the location, origins, insertions, actions and nerve supply of pronator quadratus.
Location: deep, anterior forearm
Origins: distal quarter of ulna
Insertions: distal quarter of radius
Actions: pronation of forearm, stabilization of the distal radioulnar joint
Nerve supply: anterior interosseous branch of median nerve (C8,T1)
Classify the muscles of the posterior forearm.
There are 12 muscles in the posterior forearm. 4 sets of 3:
Passing from humerus to radial side of forearm: brachioradialis, extensor carpi radialis longus, extensor carpi radialis brevis.
Passing from humerus to middle and ulnar side: extensor digitorum, extensor digiti minimi, extensor carpi ulnaris
Deep outcropping muscles of thumb: abductor policis longus, extensor pollicis brevis, extensor policis longus.
Extra: anconeus, supinator, extensor indicis.
What muscles emerge from the common extensor tendon and where does it originate?
Extensor carpi radialis brevis, extensor digitorum, extensor digiti minimi, extensor carpi ulnaris. It originates from the lateral epicondyle.
Label and state the side of hand.
Right hand side
A=flexor retinaculum
B=thenar muscles
C=palmar cutaneous branch of median nerve
D=flexor digitorum superficialis
E=radial artery
F=median nerve
G=flexor carpi radialis
H=flexor pollicis longus
I=flexor digitorum profundus
J=ulnar artery
K=ulnar nerve
L=hypothenar muscles
M=superficial palmar arterial arch
N=ulnar bursa
O=deep palmar arterial arch
P=princeps pollicis
Label and state the side of hand.
Right hand side
A=extensor carpi ulnaris
B=extensor digiti minimi
C=extensor indicis
D,E,F,G=4 tendons of extensor digitorum
H=extensor pollicis longus
I=extensor carpi radialis brevis
J=extensor carpi radialis longus
K=abductor pollicis longus
L=extensor pollicis brevis
Name the classification, origins, insertions, actions and nerve supply of the brachioradialis.
Classification: passing from humerus to radial side
Origins: proximal 2/3 of the lateral supracondylar ridge
Insertions: base of radial styloid process
Actions: elbow flexion, supination and pronation of forearm
Nerve supply: radial nerve (C5-7)
Name the classification, origins, insertions, actions and nerve supply of the extensor carpi radialis longus.
Classification: passing from humerus to radial side
Origins: lateral supracondylar ridge (distal to brachioradialis)
Insertions: base of 2nd metacarpal
Actions: elbow flexion, extension of wrist, radial deviation
Nerve supply: radial nerve (C6,7)
Name the classification, origins, insertions, actions and nerve supply of the extensor carpi radialis brevis.
Classification: passing from humerus to radial side
Origin: common extensor tendon
Insertion: base of 3rd metacarpal
Actions: wrist extension and radial deviation
Nerve supply: radial nerve (deep branch) (C7,8)
Name the classification, origins, insertions, actions and nerve supply of the extensor digitorum.
Classification: passing from humerus to middle and ulnar side
Origin: common extensor tendon
Insertion: extensor expansion of the 2nd to 5th digits
Actions: finger extension (MCP joints)
Nerve supply: radial nerve (deep branch) (C7,8)
Name the classification, origins, insertions, actions and nerve supply of the extensor digiti minimi.
Classification: passing from humerus to middle and ulnar side
Origin: common extensor tendon
Insertion: extensor expansion of the 5th digit
Actions: extension of 5th digit (MCP and IP joints)
Nerve supply: radial nerve (deep branch) (C7,8)
Name the classification, origins, insertions, actions and nerve supply of the extensor carpi ulnaris.
Classification: passing from humerus to middle and ulnar side
Origin: common extensor tendon, posterior border of ulna
Insertion: base of 5th metacarpal
Actions: extension of wrist, ulnar deviation
Nerve supply: radial nerve (deep branch) (C7,8)
Name the classification, origins, insertions, actions and nerve supply of the abductor pollicis longus.
Classification: deep outcropping muscle of the thumb
Origins: posterior ulna, posterior radius (middle 3rd), interosseous membrane
Insertions: radial base of the 1st metacarpal
Actions: abduction and extension of the thumb, radial deviation
Nerve supply: deep branch of the radial nerve (C7,8)
Name the classification, origins, insertions, actions and nerve supply of the abductor pollicis brevis.
Classification: deep outcropping muscle of the thumb
Origins: Tubercles of scaphoid and trapezium and flexor retinaculum
Insertions: lateral base of the proximal phalanx of the thumb (via extensor expansion)
Actions: abduction and opposition of thumb
Nerve supply: median nerve (recurrent branch) (C8,T1)
Name the classification, origins, insertions, actions and nerve supply of the anconeus.
Classification: extra
Origin: lateral epicondyle
Insertions: lateral olecranon process and proximal posterior surface of ulna
Actions: extension and stabilization of elbow
Nerve supply: radial nerve (C7,8)
Name the classification, origins, insertions, actions and nerve supply of the supinator.
Classification: extra
Origins: lateral epicondyle, radial collateral ligament, annular ligament, supinator fossa of ulna
Insertions: radial tuberosity and proximal 3rd of radius
Actions: supination of forearm
Nerve supply: radial nerve (deep branch) (C7,8), this nerve travels between its superficial and deep heads, injury to this muscle is significant in diagnosis of nerve damage.
State the formation and branches of the superficial palmar arch anastomosis.
Formation: ulnar artery and the superficial palmar branch of the radial artery.
Branching: gives rise to the common digital arteries which divide into the proper digital arteries.
State the formation and branching of the deep palmar arch anastomosis.
Formation: radial artery and deep palmar branch of ulnar artery.
Branching: palmar metacarpal arteries, perforating arteries (supplying the dorsal metacarpal arteries) and the palmar digital arteries.
State the formation and branches of the dorsal carpal arch anastomosis.
Formation: dorsal branches of the radial and ulnar arteries.
Branching: dorsal metacarpal arteries and dorsal digital arteries.
State the boundaries and contents of the anatomical snuffbox.
Dorsal border: extensor pollicis longus tendon
Palmar border: abductor pollicis longus and extensor pollicis brevis tendons
Floor: scaphoid and trapezium
Contents: radial artery, superficial branch of radial nerve, cephalic vein.
What is the arrangement of nerve supply of the hand?
Name the origins, insertions, actions and nerve supply of the lumbricals.
Origins: each lumbrical originates from its respective tendon of flexor digitorum profundus.
Insertion: extensor expansion of respective fingers
Actions: flexion of MCP joints and extension of the IP joints
Nerve supply: 1+2: median nerve, 3+4: ulnar nerve
Differentiate between the hand of benediction and ulnar claw.
Ulnar claw is caused by ulnar nerve damage. It is characterised by hyperextension of the 4th and 5th metacarpophalangeal joints and hyperflexion of the 4th and 5th proximal interphalangeal joints.
Hand of benediction is caused by median nerve damage. It is caused by an inability to flex the 2nd and 3rd digit but the apparent ability to flex 4th and 5th digits.
State Wartenburgs sign’s cause and sign.
Ulnar nerve damage. Inability to adduct the 5th digit.
What causes wrist drop?
The inability to extend the wrist and fingers is caused by radial nerve damage.
What is the cause, symptom and treatment of carpal tunnel syndrome?
Cause: compression of the median nerve as it passes through the carpal tunnel.
Symptoms: numbness in 1st 3 fingers
Treatment: corticosteroids to reduce inflammation.
What does anterior interosseous nerve damage cause?
It affects the FPL and FDP.
What is a Colles’ fracture?
It is a fracture of the distal radius.
What does the terminal branch of the musculocutaneous nerve supply?
The terminal branch of the musculocutaneous nerve ( the lateral cutaneous nerve of the forearm) provides sensory innervation to the skin on the ventral aspect of the forearm.
What is the muscle fiber morphology of FPL?
It contains mostly fast-twitch, type II fibers. It is a fusiform muscle with a spindle-like shape, with fibers that run parallel to its long axis. This allows for high precision and moderate force.
In the forearm, the common interosseous artery arises from which blood vessel, also what does it later divide into?
It arises from the ulnar artery and goes onto divide into the anterior and posterior interosseous arteries.
Which carpal bones give attachment to the flexor retinaculum?
Scaphoid, trapezium and pisiform, lunate and hook of hamate.
Which vein is used in routine venepuncture for venous blood sampling?
The median cubital vein
Which purely sensory nerve has a deep course through the anterolateral forearm?
Lateral cutaneous nerve of the forearm (musculocutaneous)
State the origins, insertions, actions and nerve supply of the palmar interosseous muscles.
There exist 3 such muscles.
Origins: medial 1st metacarpal (1st), medial 2nd metacarpal (2nd), lateral 4th metacarpal (3rd)
Insertions: proximal phalanx and extensor expansion of 1st digit (1st), proximal phalanx and extensor expansion of 2nd digit (2nd), proximal phalanx and extensor expansion of 5th digit (3rd)
Action: adduction of digits
Nerve supply: ulnar nerve (C8,T1)
State the origins, insertions, actions and nerve supply of the dorsal interosseous muscles.
There exist 4 such muscles.
Origins: adjacent sides of the nth digit and the (n+1)th digit
Insertions: proximal phalanx and extensor expansion of (n+1)th digit.
Actions: abduction of digits.
Nerve supply: ulnar nerve (C8,T1)
What is the most common carpal bone dissociation?
Scapholunate dissociation, occurring as a result of falling on an outstretched hand. It causes pain and instability, a Terry-Thomas sign should be visible from X-rays. Which is a widened gap between the scaphoid and lunate.
The skin over the thenar eminence is supplied by a branch of what nerve?
recurrent branch of the median nerve
Which tendon passes around the dorsal tubercle of the radius (Lister’s)?
The tendon of EPL passes around Lister’s tubercle.
