Forearm Flexors/Palm of Hand Blue Boxes

Question 1

Repetitive use of superficial extensors of the forearm will result in what condition characterized by pain over lateral epicondyle and radiating down the posterior surface of forearm?

Answer 1

Elbow tendinitis (“Tennis elbow”)

Question 2

Repeated forceful extension and flexion of the wrist strains the common extensor tendon. This will produce inflammation where?

Answer 2

Periosteum of the lateral epicondyle (lateral epicondylitis)

Question 3

What is the injury called when the tendon is torn off the distal phalanx? It usually happens during a baseball game.

Answer 3

Mallet Finger/Baseball Finger

Question 4

In “Mallet Finger” what function will be lost.

Answer 4

Extension of the finger at the distal interphalangeal joint.

Question 5

A “fractured elbow” will break what bone?

Answer 5

Olecrannon of the ulna.

Question 6

In a fractured elbow what problem does the triceps brachii pose?

Answer 6

When you fall on your elbow and break it the triceps will contract. This will pull the fractured olecrannon apart and become an avulsion fracture.

Question 7

What is the common place for cystic swelling to occur.

Answer 7

Dorsum of the wrist. (See Katie for example) Or in other cases the distal attachment of the extensor carpi radialis brevis.

Question 8

What action makes a cyst on the wrist swell and become painful over time?

Answer 8

Wrist flexion.

Question 9

Painful swelling of a cyst on the wrist is referred to as what?

Answer 9

A ganglion

Question 10

A cyst on the common flexor sheath on anterior of wrist will compress which nerve?

Answer 10

Median

Question 11

True or false? The brachial artery can divide more proximally than normal.

Answer 11

True. When this happens the median nerve runs between the eary divisions of the brachial artery. (Between the radial and ulnar arteries)

Question 12

What about the ulnar artery needs to be kept in mind when withdrawing blood or making intravenous injections?

Answer 12

In about 3% of people the ulnar artery descends superficially to the superficial flexors of the forearm. So the ulnar artery could possibly be mistaken for a vein and punctured. If drugs are injected here it could kill the patient.

Question 13

Best places to get a pulse on the forearm/wrist?

Answer 13

Distal end of the radius lateral to the tendon of the flexor carpi radialis. Or the anatomical snuffbox.

Question 14

Why is it a bad idea to use thumb to measure pulse?

Answer 14

Thumb has it’s own pulse that will completely mess up the results.

Question 15

A superficial vessel pulsating near the wrist is most likely what?

Answer 15

Superficial radial artery.

Question 16

What is the danger of the radial artery being superficial to the deep fascia instead of deep to it?

Answer 16

It becomes vulnerable to laceration.

Question 17

If a person can’t make a proper “ok” signal which nerve is damaged? Due to absence of flexion of IP joint of thumb and distal IP joint of index finger.

Answer 17

Anterior interosseous

Question 18

What will lose the ability to flex if median nerve is damaged at elbow?

Answer 18

Proximal IP joints for digits 1-3 and flexion of 4th and 5th digits weakened. Distal IP flexion of 2nd and 3rd digits lost as well.

Question 19

What muscle is disabled by median nerve damage that prevents flexion of MP joints at digits 2 and 3?

Answer 19

Lumbricals.

Question 20

In pronator syndrome where is the median nerve entrapped?

Answer 20

Between the heads of the pronator teres.

Question 21

What is responsible for when a median nerve is lesioned completely but not all the muscles it innervated are paralyzed?

Answer 21

Communications between the ulnar and median nerve. These small branches between the two can keep muscles that should be paralyzed active and lead to the conclusion that the median nerve isn’t damaged.

Question 22

Where is the ulnar nerve most commonly injured?

Answer 22

Posterior medial epicondyle of humerus.

Question 23

Main four places ulnar nerve damage is going to happen?

Answer 23

Posterior medial epicondyle of humerus, cubital tunnel, wrist, and in the hand.

Question 24

“Claw hand” is produced by what and affects what movements?

Answer 24

It’s produced by ulnar nerve damage and affects the 4th and 5th digits at the distal IP joints.

Question 25

What makes up the cubital tunnel?

Answer 25

Tendinous arch joining the humeral and ulnar heads of attachment to the flexor carpi ulnaris.

Question 26

Humeral shaft fracture will damage what nerve?

Answer 26

Radial

Question 27

What is the proper specific name for the deep branch of the radial nerve?

Answer 27

Posterior Interosseous nerve

Question 28

If a dude gets stabbed in the posterior forearm and the deep radial nerve is severed what won’t work anymore?

Answer 28

Inability to extend the thumb or digits at the MP joint.

Question 29

What sensory functions are lost when a stabbing cuts the deep radial nerve?

Answer 29

None. Deep radial is muscle only.

Question 30

If the superficial branch of radial nerve is cut what sensory function is lost?

Answer 30

Small coin shaped area at base of metacarpals 1 and 2 will lose feeling because of the overlap between ulnar and median nerves.

Question 31

Which disease of the hand produces palmar fascia progressively shortening, thickening, and becoming more fibrous along with the aponeurosis?

Answer 31

Dupuytren Contracture

Question 32

Degeneration of the palmar aponeurosis in Dupytren Contracture disease will cause what sign in the hand?

Answer 32

It will pull the 4th and 5th digits into a partial flexion at the MP and proximal IP joints.

Question 33

What do fascial spaces determine?

Answer 33

The extent and direction of the spread of pus in infection.

Question 34

Without antibiotic treatments for hand infections where will the pus and disease spread?

Answer 34

Through carpal tunnel and into the forearm.

Question 35

What is tenosynovitis?

Answer 35

Inflammation of the tendon and synovial sheath.

Question 36

What is the danger of leaving an infected synovial sheath untreated?

Answer 36

It’ll rupture proximally and leak infection to midpalmar space which in turn can go through carpal tunnel and spread to forearm.

Question 37

What is the space between the pronator quadratus and overlying flexor tendons called?

Answer 37

Parona space.