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Limbs and Back > Forearm, Wirst and Hand > Flashcards

Forearm, Wirst and Hand Flashcards

1
Q

Anterior Forearm

What are the muscles in the superficial compartment and where do they originate and how are they innervated?

A
  • Pronator Teres
  • Flexor Carpi Radialis
  • Palmaris Longus
  • Flexor carpi ulnaris
    Origin: medial epicondyle of the humerus.
    Innervation: Median nerve except FCU (Ulnar nerve).
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2
Q

Pronator Teres;

origin(s), insertion(s), action, innervation.

A 
Origin: 1. medial epicondyle
2. coronoid process of ulna
Insertion: laterally to mid-shaft of the radius
Action: pronation of the forearm.
Innervation: Median nerve.
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3
Q

Flexor Carpi Radialis;

origin(s), insertion(s), action, innervation.

A

Origin: medial epicondyle
Insertion: base of metacarpals II and III
Action: Flexion and abduction at the wrist
Innervation: median nerve

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4
Q

Palmaris Longus;

origin(s), insertion(s), action, innervation.

A

Origin: medial epicondyle
Insertion: flexor retinaculum of the wrist
Action: flexion of wrist
Innervation: median nerve

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5
Q

Flexor Carpi Ulnaris;

origin(s), insertion(s), action, innervation.

A

Origin: 1. medial epicondyle 2. long origin from the ulna
Insertion: pisiform carpel bone
Action: flexion and adduction at the wrist
Innervation: ulnar nerve

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6
Q

Anterior Forearm
What is the muscle in the intermediate compartment?
- Origin(s), Insertion(s), Action, Innervation.

A

Flexor Digitorum Superficialis

Origin: it has 2 heads;
one originates from medial epicondyle and the other from the radius.
Insertion: Muscle splits into 4 tendons at the wrist which travel though the carpel tunnel, and attaches to the middle phalanges of the four fingers.

Action: Flexes the metacarpophalangeal joints and proximal interphalangeal joints at the four fingers, and flexes at the wrist
Innervation: Median nerve.

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7
Q

Anterior Forearm

What are the muscles in the deep compartment? How are they innervated?

A
  • Flexor Pollicus Longus
  • Flexor Digitorum Profundus
  • Pronator Quadratus
    Innervation: mostly median except medial half of FDP
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8
Q

Flexor Pollicus Longus;

origin(s), insertion(s), action, innervation.

A

Origin: Anterior surface of the radius and surrounding interosseous membrane
Insertion: Base of the distil phalanx of the thumb
Action: Flexes interphalangeal joint and metacarpophalangeal joint of the thumb
Innervation: median nerve

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9
Q

Flexor Digitorum Profundus;

origin(s), insertion(s), action, innervation.

A

Origin: Ulna and associated interosseous membrane.
Insertion: At wrist, it splits into 4 tendons that pass through the carpel tunnel and attach to the distil phalanges of the four fingers.

Action: Only muscle able to flex the distil interphalangeal joints. Also flexes at the metacarpophalangeal joints and at the wrist.
Innervation: Medial half (acting on little and ring fingers) - ulnar nerve
Lateral half (acting on middle and index fingers) innervated by median nerve (interosseous branch).
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10
Q

Pronator Quadratus;

origin(s), insertion(s), action, innervation.

A

Origin: Anterior surface of the ulna
Insertion: anterior surface of the radius
Action: Pronation of the forearm
Innervation: Median nerve (interosseous branch)

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11
Q

What are the anterior and posterior compartments of the forearm commonly known as?

A

Anterior - Flexor muscles

Posterior - Extensor muscles

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12
Q

What is the general function of the flexor muscles?

A

Perform flexion at the wrist and fingers, and pronation.

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13
Q

What is the general function of the extensor muscles?

A

Produce extension at the wrist and fingers.

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14
Q

ALL of the muscles in the posterior compartment are innervated by which nerve?

A

The radial nerve.

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15
Q

What are the superficial muscles of the posterior forearm?

A

7 muscles; four of what share a common tendinous origin at the lateral epicondyle.

  • Extensor carpi radialis brevis
  • Extensor digitorum
  • Extensor carpi ulnaris
  • Extensor digiti minimi
  • Brachioradialis
  • Extensor Carpi Radialis Longus
  • Anconeus
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16
Q

Extensor Carpi Longus and Brevis;

origin(s), insertion(s), action, innervation.

A 
Origin of Longus: Supracondylar ridge
Origin of Brevis: lateral epicondyle
Insertion: Metacarpal bones II and III
Action: Extends and abducts the wrist
Innervation: Radial Nerve
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17
Q

Extensor Digitorum;

origin(s), insertion(s), action, innervation.

A

Origin: Lateral epicondyle
Insertion: Tendon continues into distil part of forearm where it splits into 4 and inserts into the extensor hood of each finger
Action: Extends medial four fingers at the MCP and IP joints
Innervation: Radial nerve

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18
Q

Extensor Digiti Minimi;

origin(s), insertion(s), action, innervation.

A

Lies medially to the extensor digitorum

Origin: Lateral epicondyle
Insertion: W/ the extensor digitorum tendon, into the extensor hood of the little finger
Action: Extends the little fingers and contributes to extension at the wrist
Innervation: Radial nerve

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19
Q

Extensor Carpi Ulnaris;

origin(s), insertion(s), action, innervation.

A 
Located on medial aspect.
Origin: Lateral epicondyle
Insertion: base of metacarpal V
Action: Extension and adduction of the wrist
Innervation: Radial Nerve
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20
Q

Anconeus;

origin(s), insertion(s), action, innervation.

A

Situated medially and superiorly in extensor part of forearm.
Origin: lateral epicondyle
Insertion: Posterior and lateral part of olecranon
Action: Extends and stabilises the elbow joint; Abducts the ulna during pronation of the forearm
Innervation: Radial Nerve

21
Q

What are the deep muscles of the posterior forearm? What do they act on?

A

There are 5.

  • Supinator
  • Abductor polices longus
  • Extensor pollicus brevis
  • Extensor polices longus
  • Extensor indices

Except the supinator, these muscles act on the thumb and the index finger.

22
Q

Supinator;

origin(s), insertion(s), action, innervation.

A

It has two heads and the deep branch of the radial nerve passes between them.

Origin: One head from lateral epicondyle and one from posterior surface of the ulna
Insertion: posterior surface of the radius
Action: Supination of the forearm
Innervation: Radial nerve (deep branch)

23
Q

Abductor Pollicis Longus;

location, origin(s), insertion(s), action, innervation.

A

Location: Immediately distil to the supinator muscle.
Origin: Interosseous membrane and adjacent posterior surfaces of the radius and ulna
Insertion: Lateral side of base of metacarpal I
Action: Abducts the thumb
Innervation: radial nerve (posterior interosseous branch)

*In the hand, the tendon contributes to the lateral border of the anatomical snuffbox

24
Q

Extensor Pollicis Brevis;

location, origin(s), insertion(s), action, innervation.

A

Location: Medially and deep to the abductor policies longs
Origin: Posterior surface of radius and interosseous membrane
Insertion: the base of the proximal phalanx of the thumb
Action: extends the metacartpophalangeal and carpometacarpal joints of the thumb
Innervation: radial nerve (posterior interosseous branch)

*Contributes to lateral border of anatomical snuffbox

25
Q

Extensor Pollicis Longus;

location, origin(s), insertion(s), action, innervation.

A

Location: The tendon travels medially to the dorsal tubercle at the wrist, using the tubercle as a pukkey to increase entered force

Origin: Posterior surface of the ulna and interosseous membrane
Insertion: Distil phalanx of the thumb
Action: Extends all joints of the thumb (carpometacarpal, metacarpophalangeal, interphalangeal)
Innervation: Radial nerve (posterior interosseous branch)

*forms medial border of anatomical snuffbox

26
Q

Extensor Indicis Proprius;

origin(s), insertion(s), action, innervation.

A

Origin: posterior surface of ulna and interosseous membrane, distil to the extensor pollicis longus
Insertion: extensor hood of the index finger
Action: extends the finger (allows the index finger to be independent of other fingers during extension)
Innervation: radial nerve (posterior interosseous branch)

27
Q

What are the borders of the carpal tunnel?

A

It is formed by two layers;

  • Deep carpal arch
  • Superficial flexor retinaculum
28
Q

What is the carpal arch?

A
  • Concave arch on the palmar side; forms base and sides of tunnel.
  • Formed laterally by; scaphoid and trapezium tubercles.
  • Formed medially by; hook of hamate and the pisiform.
29
Q

What is the flexor retinaculum?

A
  • Thick, connective tissue forming room of carpal tunnel.
  • Turns the arch into a tunnel by bridging medial and lateral parts of the arch.
  • Originates on lateral side and inserts on medial side of carpal arch.
30
Q

What are the contents of the carpal tunnel?

A

It contains 9 tendons (surrounded by synovial sheaths) and the median nerve.

*The palmar cutaneous branch of the median nerve is given off prior to the carpal tunnel, travelling superficially to the flexor retinaculum.

31
Q

What are the tendons within the carpal tunnel and how are they grouped?

A
  • Tendon of flexor policies longus
  • 4 tendons of flexor digitorum superficialis
  • 4 tendons of flexor digitorum profundus

The 8 tendons or the flexor digitorum superficialis and profundus are surrounded by a single synovial sheath.
*Sheaths allow free movement of tendons.

32
Q

What happens to the median nerve after passing through the carpal tunnel?

A

It divides into 2 branches
- recurrent branch
(supplies the thenar muscle group)

  • palmar digital branch
    (sensory innervation to palmar skin and dorsal nail beds of lateral 3.5 digits. Also provide motor innervation to lateral 2 lumbricals)
33
Q

How can the muscles acting on the hand be divided?

A

Extrinsic Muscles;
located in the anterior and posterior forearm - they control crude movements and produce a strong grip.

Intrinsic Muscles;
located within the hand - responsible for fine motor functions of the hand.

34
Q

What are the thenar muscles (generally), where are they and how are they innervated?

A
  • 3 short muscles on the base of the thumb. The muscle bellies produce a bulge (thenar eminence).
  • Responsible for fine movements of the thumb
  • Innervated by the median nerve
35
Q

What muscles make up the thenar muscle group?

A
  • Opponens Pollicis
  • Abductor Pollicis Brevis
  • Flexor Pollicis Brevis
36
Q

Opponens Pollicis;

location, attachments, actions, innervation.

A

*Largest of the 3, lies underneath the other two.

Origin: Tubercle of trapezium and associated flexor retinaculum.
Insertion: lateral margin of metacarpal I (i.e. of the thumb).
Action: Opposes the thumb by medially rotating and flexing the metacarpal on the trapezium.
Innervation: Median nerve.

37
Q

Abductor Pollicis Brevis;

location, attachments, actions, innervation.

A

Location: Found anteriorly to opponents policies and proximal to the flexor policies brevis.
Origin: Tubercles of scaphoid and trapezium and associated flexor reticulum.
Insertion: Lateral side of the proximal phalanx of the thumb.
Action: Abducts the thumb
Innervation: Median Nerve

38
Q

Flexor Pollicis Brevis;

location, attachments, actions, innervation.

A

Location: The most distil of the thenar muscles.
Origin: Tubercle of the trapezium and from associated flexor retinaculum.
Insertion: base of the proximal phalanx of the thumb.
Action: Flexes the MCP joint of the thumb.
Innervation: Median nerve.

*Deep hand is innervated by the deep branch of the ulnar nerve.

39
Q

What are the hypothenar muscles (generally), where are they and how are they innervated?

A
  • Produce the hypothenar eminence; a muscular protrusion on the medial side of the palm at the base of the little finger.
  • Muscles are similar to thenar muscles in both name and organisation
  • Innervated by the ulnar nerve.
40
Q

What muscles make up the thenar muscle group?

A
  • Opponens Digiti Minimi
  • Abductor Digiti Minimi
  • Flexor Digiti Minimi Brevis
41
Q

Opponens Digiti Minimi;

location, attachments, actions, innervation.

A

Location: lies deep to the other hypothenar muscles
Origin: Hook of hamate and associated flexor retinaculum
Insertion: Medial margin of metacarpal V
Action: Rotates metacarpal of little finger towards the palm, producing opposition.
Innervation: Ulnar nerve.

42
Q

Abductor Digiti Minimi;

location, attachments, actions, innervation.

A

Location: Most superficial of the hypothenar muscles.
Origin: Pisiform and the tendon of the flexor carpi ulnaris.
Insertion: Base of the proximal phalanx of the little finger.
Action: Abducts little finger.
Innervation: Ulnar Nerve.

43
Q

Flexor Digiti Minimi Brevis;

location, attachments, actions, innervation.

A

Location: lies laterally to the abductor digiti minimi.
Origin: Hook of hamate and adjacent flexor retinaculum.
Insertion: Base of proximal phalanx of the little finger.
Action: Flexes the MCP joint of the little finger.
Innervation: Ulnar Nerve.

44
Q

Where are interossei muscles located and what do they do?

A
  • Located between the metacarpals.
  • Abduction and adduction of fingers
  • Can be divided into 2 groups; dorsal and palmar interossei.
45
Q

Dorsal Interossei;

location, attachments, actions, innervation.

A

Location: Most superficial of all dorsal muscles which can be palpated on dorsal of the hand.
Number of muscles: 4
Origin: Each originates from lateral and medial surfaces of the metacarpal.
Insertion: Into the extensor hood and proximal phalanx of each finger.
Action: Abducts the fingers at the MCP joint.
Innervation: Ulnar Nerve.

46
Q

Palmar Interossei;

location, attachments, actions, innervation.

A

Location: Anteriorly on the hand.
Number of muscles: 3
Origin: Each originates from a medial or lateral surface of a metacarpal.
Insertion: Into the extensor hood and proximal phalanx of the same finger.
Action: Adducts the fingers at the MCP joint.
Innervation: Ulnar nerve.

47
Q

Palmaris Brevis;

location, attachments, actions, innervation.

A

Location: Small, thin muscle found very superficially in the subcutaneous tissue of the hypothenar eminence.
Origin: Palmar aponeurosis and flexor retinaculum.
Insertion: Dermis of the skin on medial margin of the hand
Action: Wrinkles skin of hypothenar eminence and deepens curvature of the hand, improving grip.
Innervation: Ulnar Nerve

48
Q

Adductor Pollicis;

shape, attachments, actions, innervation.

A

Shape: Large triangular muscle with two heads.
Origin: One head originates from Metacarpal III and the other from the capitate and adjacentt areas of metacarpal II and III.
Insertion: Both insert into the base of proximal phalanx of the thumb.
Action: Adductor of the thumb.
Innervation: Ulnar Nerve.

49
Q

What are the lumbricals and;

attachments, actions, innervation.

A
  • 4 lumbricals, each associated with a finger. Very crucial to finger movement, linking extensor and flexor tendons together.

Origin: A tendon of the flexor digitorum profundus.
Insertion: they pass dorsally and laterally around each finger and inserts into the extensor hood.
Action: Flex at MCP joint and extend at IP joints of each finger.

Innervation: Lateral lumbricals (index and middle) - median nerve. Medial lumbricals (little and ring) - ulnar nerve.
*Denervation of these muscles is basis for ulnar claw and hand of benediction.

Limbs and Back (6 decks)

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