Forearm and Wrist Flashcards
Which distal end of the radius or ulna is larger?
Distal end of radius is larger than distal end of ulna
Which 2 carpal bones of the wrist does the radius articulate with?
Scaphoid
Lunate
What process on the distal radius articulates with the carpal bones?
Radius styloid process
Name the tubercle on the posterior side of the distal end of the radius
Dorsal tubercle
Name the notch on distal end of radius that articulates with the ulna
Ulnar notch
Name the notch on distal end of radius that articulates with the ulna
Ulnar notch
Which order of bones does force through the hand pass through?
Force will go through radius distally then pass through ulna (size of bone reflects where force is beared)
What joins the radius and ulna in the forearm?
Interosseous membrane
Does the ulna directly articulate with carpal bones?
No, it articulates with an fibrocartilage disc positioned above the carpal bones
Name the carpal bones of the hand
Trapezium
Scaphoid
Trapezoid
Capitate
Lunate
Hamate
Triquetrum
Pisiform
How many carpal bones are there?
8
How many metacarpals are there?
5
How many proximal phalanges are there?
5
How many middle phalanges are there?
4
How many distal phalanges are there?
5
Which carpal has a prominent hook?
Hamate
Which carpal bone articulates with the thumb?
Trapezium
Which carpal bone articulates with the fibrocartilage disc attached to the ulna?
Triquetrum
Through which carpal bone is most force of the hand transmitted through?
Scaphoid (little bit through lunate)
Which forearm bone crosses over in pronation?
The radius crosses over the ulna in pronation
All muscles involved in movement of the hand are _________ to the hand
Extrinsic
What does it mean if the muscle is extrinsic to the hand?
The main belly of the muscle is in the forearm, only tendons are sent to the hand
Why can the hand adduct more than it can abduct?
The radius styloid process is larger than the ulnar styloid process, so less movement is possible around the radius styloid process
What movement can the thumb do that the other digits cannot do?
Opposition (contact to other digits)
What movement can the thumb do that the other digits cannot do?
Opposition (contact to other digits)
What type of joint is the wrist joint?
Synovial joint - all carpal bones are contained in the same synovial membrane
Which bones are involved in the mid carpal joint
The proximal and distal row of carpal bones
Can all mammals carry out supination?
No, most 4 legged mammals are permanently pronated so that the digits face forwards
How are the anterior and posterior compartments of the arm displaced?
Anterior compartment displaces towards the ulna
Posterior compartment displaces towards the radius
What wrist action does the anterior compartment of the arm conduct?
Flexion and abduction
What wrist action does the posterior compartment of the arm conduct?
Extension and adduction
Which side of the arm conducts abduction?
Radial side
Which side of the arm conducts adduction?
Ulnar side
Which side of the arm conducts adduction?
Ulnar side
What nerve innervates the whole posterior compartment of the arm?
Radial nerve
How many muscles are present on the superficial layer of posterior compartment of forearm?
7 muscles
Name the 7 muscles of the superficial layer of the posterior compartment of forearm
Brachioradialis
Extensor carpi radialis longus
Extensor carpi radialis brevis
Extensor digitorum
Extensor digiti minimi
Extensor carpi ulnaris
Anconeus
What is the origin of brachioradialis?
Lateral supraepicondylar ridge
What is the insertion of brachioradialis?
Lateral surface of distal radius
What innervates brachioradialis?
Radial nerve
What is the action of brachioradialis?
Flexion of elbow when arm is partially pronated
What is the action of brachioradialis?
Flexion of elbow when arm is partially pronated
What is the origin of extensor carpi radialis longus and brevis?
Lateral supraepicondylar ridge (longus)
Lateral epicondyle (longus and brevis)
What is the insertion of extensor carpi radialis longus and brevis?
Base of metacarpal 2 (longus and brevis)
Base of metacarpal 3 (brevis)
What innervates extensor carpi radialis longus and brevis?
Radial nerve
What is the action of extensor radialis longus and brevis?
Extension and abduction of the wrist
What is the origin of extensor digitorum?
Lateral epicondyle
What is the insertion of extensor digitorum?
Extensor hoods of digits 2-5
What innervates extensor digitorum?
Radial nerve
(Posterior interosseous nerve)
What is the action of extensor digitorum?
Extends digits 2-5 and the wrist
What is the origin of extensor digiti minimi?
Lateral epicondyle
What is the insertion of extensor digiti minimi?
Extensor hood of digit 5
What innervates extensor digiti minimi?
Radial nerve
(Posterior interosseus)
What is the action of extensor digit minimi?
Accessory extensor of digit 5
What is the origin of extensor carpi ulnaris?
Lateral epicondyle
What is the insertion of extensor carpi ulnaris?
Base of metacarpal 5
What innervates extensor carpi ulnaris?
Radial nerve
(Posterior interosseous)
What is the action of extensor carpi ulnaris?
Extension and adduction of the wrist
What is the origin of aconeus?
Lateral epicondyle
What is the insertion of aconeus?
Olecranon and posterior surface of ulna
What is the innervation of aconeus?
Radial nerve
What is the action of aconeus?
Abducts ulna to maintain position of the hand, stabilises elbow joint
How many muscles are in the deep layer of posterior compartment of forearm?
5
How many muscles are in the deep layer of posterior compartment of forearm?
5
Which 2 superficial muscles of posterior compartment of forearm do not cross the wrist joint?
Brachioradialis
Anconeus
Name the 5 deep muscles of the posterior compartment of forearm
Supinator
Abductor longus
Extensor pollicis brevis
Extensor pollicis longus
Extensor indicis
What is is difference between the direction of muscle fibres in the superficial and deep layer of posterior compartment of arm?
Deep layer fibres point towards the thumb, superficial layers point towards the pinky
What is the origin of supinator?
Lateral epicondyle and ulna
What is the origin of supinator?
Lateral epicondyle and ulna
What is the insertion of supinator?
Oblique line of radius
What innervates the supinator?
Radial nerve
(Posterior interosseous)
What is the action of supinator?
Supinates forearm (when arm is extended)
What is the action of supinator?
Suoinates forearm (when arm is extended)
What is the origin of abductor pollicis longus?
Posterior surface of radius and ulna, interosseus membrane
What is the insertion of abductor pollicis longus?
Lateral side of metacarpal 1
What innervates the abductor pollicis longus?
Radial nerve
(Posterior interosseus)
What is the action of abductor pollicis longus?
Abduction of the thumb
What is the origin of extensor pollicis brevis and longus?
Posterior radius (brevis)
Posterior ulna (longus)
Interosseus membrane (both)
What is the insertion of extensor pollicis longus and brevis?
Proximal phalanx of digit 1 (brevis)
Distal phalanx of digit 1 (longus)
What innervates the extensors pollicis longus and brevis?
Radial nerve
(Posterior interosseus)
What is the action of extensors pollicis longus and brevis?
Extension of the thumb
What is the origin of extensor indicus?
Posterior ulna
Interosseus membrane
What is the insertion of extensor indicus?
Extensor hood of digit 2
What innervates extensor indicus?
Radial nerve
(Posterior interosseus)
What innervates extensor indicus?
Radial nerve
(Posterior interosseus)
What is the action of extensor indicus?
Extends digit 2
How many muscles are part of the superficial layer of the anterior compartment of the forearm?
4
Name the 4 muscles in the superficial layer in the anterior compartment of the forearm
Pronator teres
Flexor carpi radialis
Palmaris longus
Flexor carpi ulnaris
Which is the only superficial muscle of anterior compartment of forearm that doesn’t cross wrist joint?
Pronator teres
What is the origin of flexor carpi ulnaris?
Humeral head (medial epicondyle)
Ulnar head (Olecranon and posterior border of ulna)
What is the insertion of flexor carpi ulnaris?
Pisiform and hamate (base of 5th metacarpal)
What innervates the flexor carpi ulnaris?
Ulnar nerve
What is the action of flexor carpi ulnaris?
Flexion and adduction of wrist
What nerve passes between the 2 heads of flexor carpi ulnaris?
Ulnar nerve
What is the origin of palmaris longus?
Medial epicondyle
What is the insertion of palmaris longus?
Palmar aponeurosis, base of 2nd and 3rd metacarpal
What innervates palmaris longus?
Median nerve
What is the action of palmaris longus?
Flexion of wrist and tightening of palm skin
Is palmaris longus a common muscle in all people?
No, it can be absent in 15% of population, could be in one forearm and not the other
What is the origin of flexor carpi radialis?
Medial epicondyle
What is the insertion of flexor carpi radialis?
Base of metacarpal 2 and 3
What innervates flexor carpi radialis?
Median nerve
What is the action of flexor carpi radialis?
Flexion and abduction of the wrist
What is the origin of pronator teres?
Medial epicondyle (humeral head)
Coronoid process of ulna
(ulnar head)
What is the insertion of pronator teres?
Lateral mid shaft of the radius
What innervates pronator teres?
Median nerve
What is the action of pronator teres?
Pronation of the forearm
What nerve passes between the 2 heads of palmaris longus?
Median nerve
Which superficial muscle of the anterior compartment forearm forms a border of the cubital fossa?
Pronator teres
Does the anterior or posterior compartment of the forearm have an intermediate layer of muscle?
Only the anterior of the forearm has an intermediate layer of muscle
Name the intermediate muscle of the anterior compartment of the forearm
Flexor digitorum superficialis
What is the origin of flexor digitorum superficialis?
Medial epicondyle and coronoid process of ulna (Humero-ulnar head)
Oblique line of radius (Radial head)
What is the insertion of flexor digitorum superficialis?
Splits into 4 tendons at the wrist. Attaches to margins of middle phalanges digits 2-5
What innervates flexor digitorum superficialis?
Median nerve
What is the action of flexor digitorum superficialis?
Flexion of the wrist, metacarpophalangeal and the first interphalangeal joint for digits 2-5
Which 2 structures run between the heads of the flexor digitorum superficialis?
The ulnar artery and median nerve run between the heads of the muscle
How many muscles are in the deep layer of the anterior compartment of the forearm?
3
Name the 3 deep muscles in the anterior compartment of the forearm
Flexor digitorum profundus
Flexor pollicis longus
Pronator quadratus
What is the origin of flexor digitorum profundus
Anterior surface of ulna and interosseus membrane
What is the insertion of flexor digitorum profundus?
Splits into 4 tendons, bases of distal phalanges of digits 2-5
What innervates flexor digitorum profundus?
Median nerve - lateral half
Ulnar nerve - medial half
What is the action of flexor digitorum profundus?
Flexion of the wrist, metacarpophalangeal joints, proximal and distal interphalangeal joints
Name the only muscle in forearm that flexes the distal interphalangeal joints
Flexor digitorum profundus
What is the origin of flexor pollicis longus?
Anterior surface of radius and interosseus membrane
What is the insertion of flexor pollicis longus?
Base of distal phalanx of digit 1
What is the action of flexor pollicis longus?
Flexion of the metacarpophalangeal and interphalangeal joint of digit 1
What innervates flexor pollicis longus?
Median nerve
What is the origin of pronator quadratus?
Anterior surface of distal part of ulna
What is the insertion of pronator quadratus?
Anterolateral surface of distal radius
What innervates pronator quadratus?
Median nerve
What is the action of pronator quadratus?
Pronation of the forearm
Name 3 muscles that carry out abduction
Flexor carpi radialis
Extensor carpi radialis brevis
Extensor carpi radialis longus
Name 2 muscles that carry out adduction?
Flexor carpi ulnaris
Extensor carpi ulnaris
Which 3 muscles contract for pronation
Pronator teres
Pronator quadratus
Anconeus
Which 3 muscles contract for pronation
Pronator teres
Pronator quadratus
Anconeus
Which 3 muscles contract for pronation?
Pronator teres
Pronator quadratus
Anconeus
Which 2 muscles contract for supination?
Supinator and biceps brachii
Name the 4 main arterial branches from the brachial artery that supply the forearm
Radial artery
Ulnar artery
Anterior interosseus artery
Posterior interosseus artery
Does the ulnar or radial artery move lateral down the forearm?
Radial artery is lateral down the forearm
Dos the ulnar or radial artery move medially down the forearm?
Ulnar artery is medial down the forearm
Which 2 arteries of the arm move through the interosseus membrane?
Posterior and anterior interosseus arteries
Outline where the brachial pulse can be found
Medial to the biceps tendon in the cubital fossa
Outline where the radial pulse can be found
Immediately lateral to the tendon of flexor carpi radials at the wrist
What are the only muscles in the anterior compartment that are not innervated by the median nerve, but ulnar nerve instead?
Flexor carpi ulnaris
Medial half of flexor digitorum profundus
Describe pathway of median nerve
Passes through cubital fossa, anterior aspect of arm then through the carpal tunnel, it then gives off 2 branches
Describe the pathway of the ulnar nerve
Passes behind the medial epicondyle, down medial edge of arm (with ulnar artery) then enters carpal tunnel, then gives off 2 branches
Describe the pathway of the radial nerve
Passes around the front of the lateral epicondyle then gives off the posterior interosseus nerve
What is the carpal tunnel formed by?
Carpal bones and flexor retinaculum
Where does the carpal tunnel attach medially?
Medially attaches to pisiform and hook of hamate
What does the carpal tunnel attach laterally?
Scaphoid and trapezium
What does the carpal tunnel attach laterally?
Scaphoid and trapezium
How many tendons are in the carpal tunnel?
9
Which nerve in within the carpal tunnel?
Median nerve
Which nerve and artery passes in their own space not directly inside the carpal tunnel?
Ulnar nerve and artery
What happens to the median nerve in carpal tunnel syndrome?
Compression of median nerve due to swelling of the tendons and the sheath
What can happen to thenar muscles in carpal tunnel syndrome?
Weakness and atrophy of thenar muscles
What is another name for the flexor retinaculum?
Transverse carpal ligament
How many tendons of the flexor digitorum superficialis are found in the carpal tunnel?
4
How many tendons of flexor digitorum profundus are found in the carpal tunnel?
4
The tendons of which 4 muscles are found in the carpal tunnel?
Flexor digitorum superficialis
Flexor digitorum profundus
Flexor carpi radialis
Flexor pollicis longus
Name the group of muscles found above the hamate in the carpal tunnel?
Hypothenar muscles
Name the group of muscles found above the trapezium in the carpal tunnel?
Thenar muscles
The tendon on which muscle in the carpal tunnel is within its own sheath?
Flexor carpi radialis