Forearm Flexor Aspect Flashcards

1
Q

What is the only intrinsic movement of forearm? and what muscles are used to do this movement?

A

Rotatory

the radius is moved in an arc medially around the ulna in pronation and laterally in supination, with the proximal (upper) and distal (lower) radio-ulnar joints acting as pivots and the interosseous membrane as a hinge.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

interosseous membrane attaches what together and how

A

The interosseous membrane is attached to the medial border of the radius and the lateral border of the ulna and, together with medial and lateral intermuscular septa, separate the anterior (or flexor) compartment from the posterior (or extensor) compartment in the forearm. These compartments are not symmetrically arranged in front of and behind the bones until the distal end of the forearm.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What 8 carpal bones make up the wrist
Forms how many rows?

A

2 rows:

scaphoid, lunate, triquetral and pisiform

proximally; trapezium, trapezoid, capitate and hamate distally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

3 joints of the wrist

A

1 the wrist joint proper (radio-carpal) between the radius and the fibrous articular disc (also known as
the triangular ligament) proximally, and the scaphoid, lunate and triquetral distally (the ulna is excluded from the wrist joint by the articular disc, but articulates with the lower end of the radius at the distal radio-ulnar joint)

2 the mid-carpal or transverse intercarpal joint between the two rows of carpal bones

3 the carpo-metacarpal joint between the distal row of carpals and the medial 4 digits.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Define Supination and pronation in terms of bone position
- what muscles allow pronation and what ones allow supination

A

Sup: Bones parallel
pronation -> distal end of radius rolls up over top of the ulna I just rotates at humeral-radial joint

pronator teres and pronator quadratus muscles in the forearm allow pronation

supinator and biceps brachii muscles allow supination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Proximal vs distal end difference

A

Prox end: Forearm compartments still lateral
Distal: Forearm compartments now anterior and posterior and tendons down by wrist, no muscle bellies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Where is the Sacciform recess, Fibrious articlaur disc, Wrist joint proper

A

lecture slide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Inferior (distal) radio-ulnar joint: Where is it?

A

Lecture Slide
Head of ulna and ulna notch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the only sexually
dymorphic features in forearmbones

A

Carrying angle:
Males less 15 degrees, females greater 15 degrees as it gives them more clearance due to wider hips

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Functions of the Interosseous membrane

A
  • Hinge
  • Muscle attachment
  • Force transmission
    -allows bones to change position we each other but not drift too far apart
  • also gives more attachment sites for your forearm muscles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Where is anular ligament (insertion and origin), fibruous articular disc, oblique cord

A

Lecture Slide
Anular ligament:
o= radial notch on ulna
i= radial head of radius

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Interosseous membrane characteristics

A

investing fascia between the bones
Strong, fibrous collagenous sheet
Links lateral edge of ULNA to medial border of RADIUS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Movement options at each joint

A

flexion/extension, abduction/adduction and some rotation at the wrist

some flexion/extension at the mid-carpal joint

very little movement at the carpo-metacarpal joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Carpal Tunnel is made up of

A

The flexor retinaculum spans the medial half to two thirds of the wrist (i.e. it doesn’t extend near the radial edge of the wrist). It is attached to the pisiform and hook of the hamate medially, and the tubercles of the scaphoid and trapezium laterally.

Within this carpal tunnel the common synovial sheath houses the long flexor tendons, and the sometimes a separate synovial sheath for the long flexor of the thumb can be found.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Label the hand
How many carpals, metacarpals, digits

A

Lecture Slide
carpals: 8
metacarpals: 5
digits: 5 (thumb is #1)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What/where are the joints in the carpal and movements at each joint

A

1 = Radiocarpal joint: Radius, scaphoid, triquetral and lunate
(almost all wrist movement comes from this joint, flexion/extension
abduction/adduction)
2 = Midcarpal joint (slight flexion and extension)
3 = Carpometacarpal joint (almost immobile except for saddle joint at thumb with trapezium giving flexion/extension, abduction/adduction, little bit of rotation)

17
Q

What are the rows of the carpal?

A

Row 1 lateral -> medial: Scaphoid, lunate, triquetral, pisiform
Row 2 lateral -> medial: Trapezium, Trapezoid, capitate, hamate

18
Q

Extensor retinaculum and Flexor retinaculum (Deep fascia)
- What are they
- Role

A

Extensor retinaculum
same as flexor retinaculum but helps hold tendons on posterior side of wrist. Very inflexible

Flexor retinaculum (Deep fascia)
strap that connects outer carpal bones to stop tendons bowstringing. Connect Scaphoid to pisiform in first row and then trapezium to hamate in second row.

retinaculum act a bit like Pulleys to give muscles
a mechanical advantage so they can do their action more efficiently (deep hold tendons in place)

19
Q

compartment syndrome

A

bones a relatively inflexible retinaculum create carpal tunnel that most of your tendons will run thorugh, any swelling etc there

compartment syndrome , median nerve can be
compressed by inflammation, blood etc and can be overused also compress arterial blood supply

20
Q

he bulky muscles of the flexor compartment fall into 3 groups:

A

superficial, intermediate and deep

21
Q

What are/Where are the superifical forearm muscles
-insertion
-origin

A

Pronator teres
o=supracondylar ridge of humerus
i= middle anterior radius

Flexor carpi radialis
o=Common flexor tendon
i= base of 2 MT

Palmaris longus
o=Common flexor tendon
i= Palmar aponeurosis

Flexor carpi ulnaris
o=Common flexor tendon
i= pisiform and 4 and base of 5th MT

22
Q

What are/Where are the intermediate forearm muscles
-insertion?
-origins

A

Intermediate = between so its insertion is in the middle of the finger aka intermediate)

Flexor digitorum superficialis
I= base of middle phalanx
o = 2:
- front of radius
- superior ulna/medial epicondyle

Divides into 4 tendons as it approaches capral tunnel, one onto each finger

23
Q

What are/Where are the Deep forearm muscles
-insertion?
-origin

A

they are DEEP muscles and so they attach at the deepest (aka FURTHEST DOWN) point = end of finger
Flexor digitiorum profundus
I: base of distal phalanx
o=superior medial aspect of ulna and IM

Flexor pollicisi longus
I: base of distal phalanx
o= anterior radius

Pronator quadratus
I= Lateral side of radius
o= Medial side of ulnar

24
Q

Superior view of the cross section through the right forearm

A

Lecture Slide

25
Q

Label the entire arm with the nerve supply

A

Lecture

Median Nerve (anterior side) supplies ALL muscles of forearm EXCEPT FCU and medial 1/2 FDP (AKA THE ONES ON THE VERY ULNAR SIDE)

Ulnar nerve (anterior side): Medial 1/2 FDP and FCU

Radial (Posterior):
Superificial: Brachilais, Aconeous, ECRL, ECRB, ED, EDM, ECU
Deep: EI, EPL, EPB, APL, Supinator

26
Q

Label the blood supply of forearm

A
  1. Brachial artery
  2. Radial
  3. Ulnar

There are recurrent branches (form anastemoses with collateral branches

27
Q

What goes through carpal tunnel?

A

ESSENTIALLY ALL THE FLEXOR MUSCLES OF THE FOREARM EXCEPT FLEXOR CARPI ULNAR

FPL, FDS, FDP (btoh spilt into 4), FCR medial nerve

PL (above), Radial artery (around), ulnar artey (above), ulnar nerve (above) all dotn go through

28
Q

Median nerve vs Ulnar nerve

A
  1. Both nerves have similar pattern when you get to wrist
  2. Medial nerve goes thorugh carpal tunnel, Ulnar doesnt.
    3.Both have palmer cutaenoues branch, proper palmer digital nerves
  3. Dorsal branch only from ulnar nerve