forearm, hand and wrist Flashcards

1
Q

how many bones are in the skeleton

A

206

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2
Q

appendicular skeleton

A
  • supports body weight
  • 126 bones
  • essential for mobility
  • allows for complex movement
  • ensures stability
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3
Q

axial skeleton

A
  • forms central axis of body
  • 80 bones
  • main support structure
  • allow for movement, protection of organs, posture and balance
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4
Q

carpal bones (from radius to ulnar)

A
  • scaphoid
  • lunate
  • triquetrum
  • pisiform
  • trapezium
  • trapezoid
  • capitate
  • hamate
  • s,l,t,p are proximal
  • t,t,c,h are distal
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5
Q

what are CMC joints

A

connect the carpals to the metacarpals

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6
Q

how many phalanges are there

A

14

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7
Q

ossification of carpal bones

A
  • capitate. 1-3 months
  • hamate. 2-4 months
  • triquetrum. 2-3 years
  • lunate 2-4 years
  • scaphoid 4-6 years
  • trapezium 4-6 years
  • trapezoid. 4-6 years
  • pisiform 8-12 years
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8
Q

what are the arteries in the hand and wrist supplied by

A
  • oxygenated blood by the radial and ulnar artery which are branch’s of the brachial arteries
  • form a series of interconnected arterial arches in the hand and supply blood to fingers, palms and wrist
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9
Q

radial artery

A
  • supplies lateral hand and forms deep palmer arch
  • lateral to the forearm
  • gives rise to the palmar metacarpal arteries which gives blood to the metacarpals and contribute to the digital arteries (in fingers)
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10
Q

ulnar artery

A
  • supplies medial hand including middle and ring finger
  • forms superficial palmer arch - beneath skin
  • gives rise to the common palmar digital arteries and further divide into proper palmar digital arteries
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11
Q

what do both arteries contribute to

A
  • dorsal carpal arch to the back of the hand
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12
Q

what are veins in hand and wrist responsible for

A

draining blood from this region and returning it to the heart
- venous system consists of superficial and deep veins paired with the corresponding arteries

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13
Q

what do the superficial veins do’

A
  • drain the skin and superficial tissues of hand and wrist
  • located at the surface of the skin
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14
Q

cephalic vein

A
  • superficial
  • runs along lateral side of forearm and arm
  • corresponds to radial artery
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15
Q

basilic vein

A
  • superficial
  • runs down the medial side of the forearm and the arm
  • corresponds to ulnar artery
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16
Q

basilic and cephalic vein

A

join to form dorsal venous plexus which drains the dorsal aspect of the hands and fingers
- connects to b and c veins

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17
Q

ulnar and radial veins

A
  • deep
  • accompany the arteries & not as visible
  • draining deeper structure of the hand and wrist
  • ulnar = medial
  • radial = lateral
  • join to form the palmar venous arch drains blood from palm and fingers
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18
Q

nerves of hand

A
  • crucial for sensory and motor functions, enabling movement and sensation in upper limb
  • primary nerves involved are branches of the brachial plexus
    (median, ulnar and radial)
    D - superficial branch of radial nerve innervates the lateral dorsum of the hand, thumb, index, middle and half of ring
    D - dorsal cutaneous branch of the ulnar nerve innervates half of ring and little
    P - median nerve innervates the palmer surface of the thumb, index, middle and lateral half of ring finger.
    P - ulnar nerve digital branch innervates little, medial half of ring on the palmar surface
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19
Q

what is the hand primarily innervates by

A

median and ulnar nerve in the palmar aspect
radial and ulnar nerve in dorsal aspect

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20
Q

medial nerve location

A

runs near the radial artery until reaches carpal tunnel

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21
Q

ulnar nerve location and radial nerve location

A

U = runs alongside the ulnar artery
R = runs alongside radial artery in forearm but in the hand the superficial branch runs along the lateral side

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22
Q

extensor tendons

A
  • allow you to straighten your wrist and finger
  • pass thru compartment in the wrist known as extensor retinaculum
  • helps maintain smooth movement at wrist
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23
Q

major tendons

A

extensor digitorum- extends index, middle, little and ring
extensor indicis- extend index (isolated)
extensor digiti minimi- extend little (isolated)
extensor pollicis brevis- extend thumb at metacarpophalangeal joint
extensor pollicis longus- thumb (interphalangeal joint)
abductor pollicis longus- extend thumb and abduction at some extent

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24
Q

flexor tendons

A
  • responsible for flexing the fingers and thumbs and originate from muscle in forearm, travel thru wrist into hand
  • flexor digitorum superficialis (flexes the middle phalanges of the medial four digits at the proximal interphalangeal joints)
  • flexor pollicis longus (flexes the thumb- interphalangeal and metacarpophalangeal joint)
  • flexor carpi radialis (flexes wrist and ABDucts the wrist)
  • flexor carpi ulnaris (flexes wrist and ADDucts the wrist)
  • flexor digitorum profundus (flex index, middle, ring and little)
  • palmaris longus (flex wrist)
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25
Q

muscles of hand

A
  • intrinsic= originate within the hand and provide fine motor control
  • extrinsic= originate in forearm and control broader movement of hand and fingers
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26
Q

intrinsic muscles - thumb

A

the inner muscles e.g. thumbs
- located at base of the thumb and resp for movements
- abductor pollicis brevis= abducts thumb
- opponens pollicis= opposes thumb
- adductor pollicis= adducts thumb
- flexor pollicis brevis= flexes thumb
- flexor, abductor and opponens are thenar muscles (thumb muscle)

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27
Q

intrinsic muscles - little finger

A
  • opponens digiti minimi ( opposes the little)
  • flexor digiti minimi brevis (flexes little)
  • abductor digiti minimi (abducts the little)
  • all HYPOTHENAR MUSCLES
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28
Q

central muscles

A

primarily resp for movement of fingers
- lumbrical (flex mcp while extending the PIP and DIP joints)

29
Q

extrinsic muscles

A

originate in forearm, tendon extend into hand and resp for powerful movements of fingers
- flexor muscles flex
- extensor muscles extend
- flexor digitorum profundus and flexor digitorum superficialis are resp for flexing ( grasping stuff)
- extensor digitorum communis extend the fingers at the mcp, pip and dip joint
- when edc contracts, all 4 fingers extend which allow for opening the hand after flexion
- extensor pollicis longus- resp for thumb extension

30
Q

interossei muscles

A
  • dorsal interossei muscles go in between intermetacarpal spaces
  • 4DAB= 4 muscles in each hand, dorsal side of hand, abductor muscles
  • palmar interossei muscle adducts the fingers
31
Q

articulation

A
  • ulnar articulates w humerus
  • radius articles with carpals
  • in between called inter osseous space - fibrous CT - connects 2 bone together and provide stability
32
Q

what does radius articulate to

A

capitulum of humerus= flex and exten of arm

radial notch of ulna= articulates there to form the proximal radio ulnar joint= rotation of arm (pivot)

33
Q

head of radius

A
  • rounded proximal end of the bone
  • crucial 4 movement and stability of elbow joint and proximal radioulnar joint
  • disc shapes and smooth rounded surface that’s concave
  • articulates w capitulum of the humerus = elbow joint = allow 4 flexion and extension of arm
34
Q

neck of radius

A
  • narrow cylindrical region that connects head to shaft
  • provide support 4 head of radius
  • acts as attachment point for muscles
35
Q

radial tuberosity

A
  • roughened oval prominence
  • faces towards ulna
  • located on anterior medial aspect, distal to head and neck
  • serves as p.o.a for bicep brachii via bicep tendon = key 4 elbow flexion and forearm supination
36
Q

anterior border

A
  • sharp elognated ridge
  • runs longitudinally along anterior surface of radius and extends from radial tuberosity to the distal end of the radius
  • provides p.o.a for multiple muscles
37
Q

posterior border

A
  • prominent ridge located on the posterior side of the radius
  • forms distinct ridge that runs parallel to anterior border, on opposite sides of the
  • p.o.a for extensor muscles
38
Q

groove for extensor carpi radialis longus

A
  • on lateral side of radius
  • proximal to styloid process
  • provide path for the tendon of muscle as it travels down the forearm
  • insertion point and helps to protect the tendon
39
Q

groove for extensor digitorum and extensor indicis

A
  • found on distal end of radius
  • protects tendons
40
Q

styloid process

A
  • prominent bony projection
  • located on distal end of radius
  • conical and extends downwards from distal end
  • situated on lateral side of wrist and serves as p.o.a for ligaments
41
Q

dorsal tubercle

A
  • small rounded prominence
  • serves as a pulley
42
Q

summary of radius

A
  • long bone
  • articulates proximally and distally with the ulna at the proximal and distal radioulnar joints
  • PROXIMAL radioulnar joint articulation allows for supination and pronation of the forearm
  • articulates distally with the proximal row of carpal bones at radiocarpal joints (scaphoid and lunate)
  • articulates proximally at the elbow joint with the capitulum of the humerus at the humeroradial joint
43
Q

summary of ulna

A
  • long bone
  • articulates distally with radius at the distal radioulnar joint
  • articulates proximally at the proximal radioulnar joint which allows pronation and supination of the forearm
  • articulates proximally at the elbow joint with the trochlea of the humerus at the humeroulnar joint
44
Q

olecranon

A
  • prominent bony projection proximal end ulna
  • bit that sticks out
  • fits into olecranon fossa of the humerus
45
Q

trochlear notch

A
  • large c shaped depression on the proximal end of the ulna
  • in between olecranon and radial notch
  • articulates with trochlear of the humerus and allows for a hinge like motion (flexion nd extension)
46
Q

coronoid process

A
  • triangular forward-facing structure just below trochlear notch
  • fits into coronoid fossa of humerus when elbow flexed
  • prevents ulna from slipping out of place
  • p.o.a for muscles n ligs
47
Q

radial notch

A
  • smooth concave depression on lateral side of coronoid process
  • articulates with head of radius to form part of the proximal radioulnar joint
  • gives attachment to the annular ligament of the radius
  • holds it into the radial notch = allow pronation and supination of forearm
48
Q

supinator crest

A
  • sharp prominent ridge
  • extends downwards towards middle of ulna
  • serves as attachment site for the supinator muscle (resp for supination of forearm)
  • annular ligament also attaches near
49
Q

posterior border

A
  • sharp palpable ridge
  • extends from olecranon to distal end of ulna
50
Q

vertical ridge

A
  • extends down the shaft of ulna as muscle attachment point
51
Q

head

A
  • rounded distal end of ulna
  • positioned laterally
  • articulates with radius, distal radioulnar joint and triangular fibrocartilage complex (TFCC = stabilises the wrist)
52
Q

styloid process

A
  • pointy bone projection on the distal ulna
  • serves as attachment point for ulnar collateral ligament and TFCC
53
Q

rotation of lower arm

A
  • lower arm primarily rotates thur the action of the radius and ulna w help of muscles
  • radial head fits into radial notch of ulna, prox and dist
  • head of ulna articulates with ulnar notch of the radius
  • parallel when palm is supinated but when pronated radius crosses over ulna at the wrist
    SUPINATE: - supinator muscle and bicep[ brachii contract= radius rotate outwards and uncross from ulna
    PRONATE: - pronator teres & quadratus muscles contract pulling the radius over the ulna= rotate hand downwards
54
Q

main arteries that supply blood to forearm

A

radial and ulnar

55
Q

what do radial and ulnar artery do

A
  • Provide necessary blood flow to forerarm, muscle, bone n tissue
  • radial artery runs alongside lateral side of the forearm and ulna runs alongside medial
56
Q

collateral arteries

A

branches that form connections between major arteries and are essential for maintaining an adequate blood supply
- in case of arterial obstruction
- if blocked, collaterals take on more blood flow

57
Q

types of collateral arteries

A
  • radial collateral
  • ulnar collateral
58
Q

radial collateral artery

A
  • supplies blood 2 muscle on lateral side of the forearm
  • contribute to connections around the elbow joint with radial recurrent artery
59
Q

ulna collateral artery

A
  • contribute 2 blood supply on medial side of below joint
  • connects with ulnar recurrent artery
60
Q

common interosseous arteries

A
  • travel between ulna nd radius providing collateral circulation
61
Q

major superficial veins

A

cephalic and basilic

62
Q

cephalic

A
  • runs alongside lateral side and drains into the subclavian vein
63
Q

basilic

A
  • runs down medial side of forearm and drains into the brachial or auxiliary vein
64
Q

median cubital vein

A
  • found in the cubital fossa at the front of the elbow
  • connects cephalic and basilic
65
Q

superficial anterior muscles

A
  • anterior compartment muscles originate on the humerus, typically on carpals, metacarpal, and phalanges
  • function primarily as flexors
66
Q

names of superficial anterior muscles

A
  • palmaris longus
  • flexor carpi radialis
  • flexor carpi ulnaris
  • flexor digitorum superficialis (largest one)
67
Q

names of superficial posterior muscles in forearm

A
  • extensor carpi radialis longus
  • extensor carpi ulanris
  • extensor carpi radialis brevis
  • extensor digitorum
68
Q

names of deep anterior muscles

A
  • flexor digitorum profundus
  • flexor pollicis longus
  • pronator quadratus
69
Q

deep posterior muscles

A
  • abductor pollicis longus
  • extensor pollicis longus
  • extensor indicis
  • extensor pollicis brevis