Forearm, Wrist, and Hand I

Question 1

The wrist joint exists between the distal surface of the radius and the three most lateral carpal bones of the proximal row which are called what?

Answer 1

scaphoid, lunate, triquetrum

Question 2

The elbow is a hinge joint, allowing what type of movement and in what plane?

Answer 2

flexion/extension in sagittal plane

Question 3

The interosseous membrane between the radius and ulna forms a ___ joint, binding the bones together and allowing pronation and supination

Answer 3

syndesmotic

Question 4

In regards to the distal radioulnar joint, there is a strong ______ ____ that binds the two bones together and when injured, is a common source of wrist pain.

Answer 4

articular

Question 5

The wrist (radoiocarpal) is a condyloid joint that allows what type of movements in what plane?

Answer 5

flexion/extension in sagittal plane; abduction/adduction in frontal plane

Question 6

In regards to the wrist joint, an articular disc is located in the gap between the distal end of the ___ and the ___ and ___

Answer 6

ulna; lunate; triquetrum

Question 7

A fibrous capsule is attached to the distal radius and ulna and the proximal row of carpal bones. It is thickened anteriorly and posteriorly by ____ ligaments and medially and laterally by ____ and ___ _____ ligaments

Answer 7

radiocarpal; ulnar; radial collateral

Question 8

Each carpal bone makes a ____ joint with any other carpal joint that it abuts

Answer 8

synovial

Question 9

Injury of the ____ ligaments is a common source of chronic wrist pain

Answer 9

interosseus

Question 10

In regards to the carpometacarpal (CMC) joints, the motion is _____, except the 1st is very ____ and 5th has some play

Answer 10

minimal; mobile

Question 11

The thumb is oriented at ___ degrees in anatomical position and ____ degrees at rest

Answer 11

45; 90

Question 12

Flexion/extension of the thumb is across the ____

Answer 12

palm

note: occurs in oblique plane

Question 13

In regards to the CMP joint, ____ moves the thumb away from the palm, while ___ moves the thumb towards the palm

Answer 13

abduction; adduction

note: occurs in flex/extend plane

Question 14

The heads of the metacarpals ___-___ are prevented from separating by ligaments, especially the deep transverse metacarpal ligament

Answer 14

2-5

Question 15

Metacarpophalangeal (MP) joints allow abduction only when ____, as ligaments tighten when MP joint is ___

Answer 15

extended; flexed

Question 16

The thumb’s MCP joint’s ability to abduct/adduct is very restricted, thus most abduction/adduction is from the ___ joint

Answer 16

CMC

Question 17

When referring to gamekeeper’s thumb or skier’s thumb injuries, what ligament is torn?

Answer 17

ulnar collateral

note: sometimes the ligament is displaced by the adductor policies aponeurosis (stener lesion)

Question 18

Proximal (PIP) and Distal Interphalangeal (DIP) joints are structurally ___ joints, but restrictive ulnar/radial collateral ligaments create a functional pure ___ joint

Answer 18

condyloid; hinge

Question 19

The thumb IP joint ____/_____ parallel to the CMC joint motion

Answer 19

flex/extends

Question 20

Anterior forearm muscles primarily perform ___ of the forearm while posterior forearm muscles primarily perform ___ of the forearm

Answer 20

pronation; supination

Question 21

The ___ ____ ligament is the most superficial at the wrist and is continuous with the extensor retinaculum

Answer 21

palmar carpal

Question 22

The ___ _____ is deep to the palmar carpal ligament and attaches to the tubercles on the scaphoid and trapezium laterally and to the hook of the hamate and pisiform medially creating a fibro-osseus tunnel between the retinaculum and the intermediate carpal bones, a ___ ___

Answer 22

flexor retinaculum; carpal tunnel

Question 23

the ______ ______ spans the dorsum of the wrist region and helps form the six separate tunnels through which pass the extensor and abductor tendons

Answer 23

extensor retinaculum

Question 24

Nerves, superficial veins, and lymphatics cross the wrist ____ to the deep fascia

Answer 24

superficial

Question 25

True or false, the ante brachial fascia continues into the hand where it encases the hand and the digits

Answer 25

true

Question 26

The thinner compartment contains muscles that move the ____

Answer 26

thumb

note: adductor pollicis compartment is often recognized as a separate space deep to the thinner compartment. The deep fascia here is relatively thin

Question 27

The hypothenar compartment contains muscles that move the ____

Answer 27

pinky

Question 28

This compartment is located between thinner and hypothenar compartments, deep to the thickened deep fascia, the palmar aponeurosis. It contains the flexor tendons and their synovial sheaths, the lumbricals and the superficial palmar arch

Answer 28

central

Question 29

In regards to the superficial layer of posterior muscles of the forearm, the muscles arise proximally from the supracondylar line or from the lateral epicondyle of the humerus forming a ___ ___ tendon

Answer 29

common extensor

Question 30

This muscle arises from the supracondylar line of the humerus, passes anterior to the elbow joint and inserts on the radius. It aids in elbow flexion

Answer 30

brachioradialis

Question 31

This muscle arises from the supracondylar line and inserts on the base of the 2nd metacarpal. It extends and abducts the wrist.

Answer 31

Extensor carpi radialis longus

Question 32

This muscle arises form the common extensor tendon and inserts on the extensor hood. It extends all joints of the fingers (2-5) and the wrist.

Answer 32

extensor digitorum

Question 33

This muscle arises form the common extensor tendon and inserts on the base of the 3rd metacarpal. Extends and abducts the wrist

Answer 33

extensor carpi radialis brevis

Question 34

The intertendinous connections of extensor digitorum link adjacent tendons proximal to the MP joint resulting in what?

Answer 34

inability to fully isolate extension of digits 2-5 when extensor digitorum is the sole mover

Question 35

the extensor expansion (hood) is the flattening/widenting of the ___ ____ tendons on the posterior surface of digits 2-5 as they pass the ___ joint

Answer 35

extensor digitorum; MP

Question 36

This muscle arises in common with the extensor digitorum but has its own separate tendon to the little finger, inserting into hood. Extends all joints of 5th digit

Answer 36

extensor digiti minimi

Question 37

This muscle arises from common extensor tendon and ulna and inserts on the base of the 5th metacarpal. Extends and adducts the wrist

Answer 37

extensor carpi ulnaris

Question 38

What is “tennis elbow”?

Answer 38

lateral epicondylitis - wrist stabilization while forcefully extending the elbow

Question 39

This muscle arises from the lateral epicondyle of the humerus and the proximal ulna, wraps around the upper part of the radius and inserts on it. The deep branch of the radial nerve passes deep to this muscle. It supinates.

Answer 39

supinator

Question 40

This muscle arises from the lower part of the ulna and its tendon joining the extensor digitorum tendon, goes to the index finger (digit 2). Extends all joints of 2nd digit.

Answer 40

extensor indicis

Question 41

This muscle arises form the interosseous membrane and bones of the forearm and inserts on the base of the 1st metacarpal. Abducts and helps extend CMC joint of thumb

Answer 41

abductor pollicis longus

Question 42

This muscle arises from the interosseous membrane and ulna, its tendon curves around the dorsal tubercle of the radius and inserts on the base of the distal phalanx of the thumb. Extends all joints of the thumb.

Answer 42

extensor pollicis longus

Question 43

This muscle arises from the interests membrane and radius and inserts on the base of the proximal phalanx of the thumb. Extends CMC and MP joints of the thumb

Answer 43

extensor pollicis brevis

Question 44

What forms the anatomical snuff box and what is found inside?

Answer 44

the tendons of the extensor pollicis braves and longus; the radial artery passes along the floor of this box which is formed by the scaphoid bone

Question 45

This is a group of 4 muscles on the dorsal hand that arise by 2 heads adjacent from metacarpal bases and shafts, and insert on extensor expansions

Answer 45

dorsal interossei

Question 46

Each dorsal interossei ____ its respective finger away from the 3rd finger at the MP joint; aids ____ in flexion of MP and extension of IP

Answer 46

abducts; lumbricals

Question 47

In regards to the superficial layer of anterior forearm muscles, they arise proximally from the ___ epicondyle of the humerus by fused ___ ___ tendon

Answer 47

medial; common flexor

Question 48

This muscle arises by 2 heads (humeral/ulnar) and inserts into the radius, just distal to the supinator. The median nerve passes between the two heads of this muscle. Pronates the forearm/hand

Answer 48

pronator teres

Question 49

This muscle abducts the ulna during pronation to keep the hand spinning on one central axis rather than allowing to just turn over around a distal ulnar axis

Answer 49

anconeus

Question 50

This muscle arises from common tendon and inserts on the base of the second metacarpal. Fees and abducts the wrist.

Answer 50

flexor carpi radialis

Question 51

This muscle is not alway present. It arises from the common tendon and inserts on the palmar aponeurosis. Flexes wrist

Answer 51

palmaris longus

Question 52

This muscle arise by 2 heads and inserts on the pisiform, then continues via the pisohamate and pisometacarpal ligaments. The ulnar nerve passes between the two heads of this muscle. Flexes and adducts the wrist

Answer 52

flexor carpi ulnaris

Question 53

This muscle arises from common flexor tendon and the bones of the forearm and splits to insert on the middle phalanges of the fingers 2-5. The median nerve courses on its deep surface. Flexes wrist and flexes MP and PIP joints of digits 2-5

Answer 53

flexor digitorum superficialis

Question 54

This muscle arises from the ulna and the interosseous membrane and inserts on the distal phalanges of fingers 2-5. It flexes all joints of digits 2-5 and the wrist

Answer 54

flexor digitorum profundus

Question 55

This muscle arises from the radius and the interosseous membrane and inserts on the distal phalanx of the thumb. Flexes all joints of the thumb

Answer 55

flexor pollicis longus

Question 56

This muscle is located on the distal part of the forearm, its fibers coursing transversely, originated from the ulna and inserting on the lateral aspect of the radius. Pronates.

Answer 56

pronator quadratus

Question 57

This small, often indistinct muscle arises form the medial side of the palmar aponeurosis and inserts into the skin on the medial part of the palm helping to form creases when gripping

Answer 57

palmaris brevis

Question 58

What muscles form the thenar eminence?

Answer 58

abductor pollicis brevis, opponens pollicis and the flexor pollicis

Question 59

This muscle arises from trapezium to insert on radial side of the base of the proximal phalanx. Abducts thumb at CMC joint

Answer 59

abductor pollicis brevis

Question 60

This muscle arises from trapezium to insert on base of the proximal phalanx. Flexes thumb at MP and CMC joints

Answer 60

flexor pollicis brevis

Question 61

This muscle arises from the trapezium to insert on the radial side of the first metacarpal. Abduct, flex, and medially rotates thumb at CMC joint

Answer 61

opponens pollicis

Question 62

This muscle has 2 heads: transverse head from 3rd metacarpal, oblique head from bases of metacarpals 1-2; both heads insert into the ulnar side of the base of the proximal phalanx. Adducts thumb at CMC joint and aids in flexion of the CMC and MP joints

Answer 62

adductor pollicis

Question 63

What 3 muscles make up the hypothenar eminence?

Answer 63

abductor digiti minimi, flexor digiti minimi, opponens digiti minimi

Question 64

This muscle arises from the pisiform to insert on the medial side of the base of the proximal phalanx. Abducts MP joint of 5th digit

Answer 64

abductor digiti minimi

Question 65

This muscle arises from the hook of hamate to the medial side of the base of the proximal phalanx. Flexes MP joint of 5th digit

Answer 65

flexor digiti minimi

Question 66

This muscle arises from the hook of hamate to the body of metacarpal 5. Laterally rotates and helps flex the CMC joint very slightly, bringing 5th digit toward the mid palm for opposition

Answer 66

opponens digit minimi

Question 67

This is a group of 4 worm-like muscles. Each arise from the tendons of the flexor digitorum profundus from the radial side for the first 2 lumbricals and from adjacent tendons for the last 2 lumbircals and insert into the extensor hood. Flex MP joint and exerted IP joint

Answer 67

lumbricals

note: “keyboarding” muscles

Question 68

This is a group of 3 deep, slender muscles. All insert on the extensor hood of the same digit from which they arise. Each adducts its respective finger toward the 3rd finger at the MP joint; aids lumbricals in flexion of MP and extension of IP

Answer 68

palmar interossei

2nd adducts ->

Question 69

In regards to the forearm, which two muscles are innervated by deep radial nerve? which 3 muscles are innervated by radial nerve?

Answer 69

deep radial: ECRB, supinator

radial: anconeus, brachioradialis, ECRL

Question 70

In regards to the anterior forearm, which two muscles are innervated by the ulnar nerve?

Answer 70

FCU and half of FDP; everything else is innervated by median nerve

Question 71

Palmaris brevis is innervated by what?

Answer 71

superficial ulnar nerve

Question 72

dorsal interossei, palmar interossei, adductor pollicis, and lumbricals 3-4 are all innervated by what?

Answer 72

deep ulnar nerve

Question 73

lumbricals 1-2 are innervated by what?

Answer 73

digital median nerve

Question 74

the thenar muscles are all innervated by what?

Answer 74

recurrent median nerve

Question 75

All of the hypothenar muscles are innervated by what?

Answer 75

deep ulnar nerve

Question 76

Injury of the main radial nerve causes what?

Answer 76

“wrist drop” - no wrist extension, no finger/thumb extension

Question 77

As the deep branch of the radial nerve emerges from the supinator, it changes its name to ___ ___ nerve, which innervates the rest of the posterior forearm musculature

Answer 77

posterior interosseus

Question 78

Injury to the radial nerve at the distal arm effects cutaneous sensation and muscular function how?

Answer 78

cutaneous sensation: lost beyond level of lesion

muscular function: all posterior forearm actions lost

Question 79

Injury to the deep branch of the radial nerve between the elbow and supinator effects cutaneous sensation and muscular function how?

Answer 79

cutaneous sensation: normal

muscular function: weak wrist extension, unable to extend fingers and thumb

Question 80

Injury to the posterior interosseus nerve distal to supinator effects cutaneous sensation and muscular function how?

Answer 80

cutaneous sensation: normal

muscular function: good wrist extension, unable to extend fingers and thumb

Question 81

Injury to the superficial branch of radial nerve between elbow and distal forearm, deep to brachioradialis effects cutaneous sensation and muscular function how?

Answer 81

cutaneous sensation: lost beyond level of lesion

muscular function: all good

Question 82

True or false? no muscles of the hand are innervated from the dorsal perspective

Answer 82

true

Question 83

The ___ nerve innervates the thinner muscles via the ___ branch and the 1st and 2nd lumbricals by the ___ branch

Answer 83

median; recurrent; digital

Question 84

Distal to the pisiform, the ulnar nerve divides into deep and superficial branches. The superficial branch innervates ____ ____ and is also cutaneous. The deep branch innervates what?

Answer 84

palmaris brevis; the remaining musculature

Question 85

The ulnar nerve courses posterior to the elbow joint via the ___ ____, a fiber-osseus channel bound by the humeral medial epicondyle and the ulnar olecranon process

Answer 85

cubital tunnel

Question 86

The ulnar nerve enters the anterior compartment of the forearm between the 2 heads of the ___ ___ ___ which it also innervates along with ___ ____ ___

Answer 86

flexor carpi ulnaris; flexor digitorum profundus

Question 87

The ulnar nerve provides a ___ ___ branch in the distal forearm which eventually supplies the dorsal of the medial hand and the dorsal of the 5th and medial 1/2 of the 4th digits

Answer 87

dorsal cutaneous

Question 88

The ulnar nerve bifurcates near/within ___ canal to form the superficial and deep branches

Answer 88

guyon’s

Question 89

The ___ branch of the ulnar nerve pierces the hypothenar eminence to then arch laterally through the deep palm on the anterior surfaces of interpose muscles, then ending in the adductor pollicis

Answer 89

deep

Question 90

Chronic compression at Guyon’s canal yields ___ ____, which has an impact on ulnar innervated hand muscles and palmar cutaneous distribution, but not dorsal cutaneous distribution. The dorsal cutaneous branch of the ulnar nerve branches before guyon’s canal. A more proximal compression will elicit both ____ and ___ cutaneous loss

Answer 90

handlebar palsy; palmar; dorsal

Question 91

The median nerve enters the anterior compartment of the forearm between the 2 heads of the ____ ____

Answer 91

pronator teres

Question 92

The median nerve gives a superficial palmar branch prior to reaching the ____ ____ to feed the palm

Answer 92

carpal tunnel

Question 93

The median nerves divides into common palmar digital nerves after exiting the carpal tunnel, following the deep surface of the palmar aponeurosis, innervating the ___-___ lumbricals

Answer 93

1-2

Question 94

Each common palmar digital nerve from the median nerve divides into ____ palmar digital branches which pass along the sides of the digits 1 to lateral half of 4

Answer 94

proper

Question 95

The median nerve gives a ____ branch just distal to the carpal tunnel, which swings back over the FPB, then pierces between FPB and APB to access OP

Answer 95

recurrent

Question 96

The radial nerve courses anterior to the ___ joint, deep to the ____, where it bifurcates into its superficial and deep branches

Answer 96

elbow; brachioradialis

Question 97

The ___ branch of the radial nerve courses deep to the brachioradialis with the radial artery. In the distal forearm, it sweeps laterally and posteriorly to gain access to the dorsal of the hand

Answer 97

superficial

Question 98

The deep branch of the radial nerve passes deep between the heads of the supinator to become the ___ ____ nerve

Answer 98

posterior interosseus

Question 99

In the cubital fossa, near the neck of the radius, the brachial artery divides into the ___ and ___ arteries to distribute to the entire forearm and hand

Answer 99

radial; ulnar

Question 100

The radial artery courses distally deep to the ____

Answer 100

brachioradialis

Question 101

The radial artery gives a superficial palmar branch in the distal forearm which continues anteriorly through the ___ ___ to contribute to the ____ ____ ___

Answer 101

thenar eminence; superficial palmar arch

Question 102

___ ___ artery feeds the thumb

Answer 102

princeps pollicis

Question 103

___ ____ arch is the continuation of the radial artery.

Answer 103

deep palmar

Question 104

The deep palmar arch gives rise to 3 ____ ____ arteries which feed into 3 common palmar digital arteries

Answer 104

palmar metcarpal

Question 105

Scaphoid bone is fed by a ___ branch of radial artery; the proximal half of scaphoid can die due to a fracture

Answer 105

recurrent

Question 106

The ulnar artery gives rise to a ____ ___ artery deep to the pronator teres

Answer 106

common interosseus

Question 107

the ulnar artery becomes the supericial ___ ___ which provides 3 common and proper palmar digital arteries

Answer 107

palmar arch

Question 108

Match the arterial supply to the compartment
posterior forearm:
anterior forearm:
hand:

Answer 108

posterior forearm: radial, radial recurrent, deep brachial artery, posterior interosseus

anterior forearm: ulnar, ulnar recurrent, anterior interosseus

hand: numerous branches of ulnar and radial arteries, including dorsal carpal branches

Question 109

The correct order of structures in the wrist from medial to lateral is: tendon of flexor carpi ulnas, ulnar nerve, ulnar artery, palmaris longs tendon, median nerve, flexor carpi radialis, radial artery. True or false?

Answer 109

true

Question 110

True or false? the tendon of the flexor carpi radials and the tendon of flexor carpi ulnaris run within the carpal tunnel

Answer 110

false; separate fibrous tunnels deep to the palmar carpal ligament

Question 111

The ___ nerve is found deep to the flexor retinaculum within the carpal tunnel

Answer 111

median

Question 112

The ___ artery runs through the floor of the anatomical snuff box

Answer 112

radial

Question 113

What are the contents of the carpal tunnel

Answer 113

tendons of the flexor digitorum superficial, flexor digitorum profundus, flexor pollicis longus and the median nerve

Question 114

One continuous synovial sheath encases all the flexor digitorum tendons forming the ___ bursa, which is continuous with the synovial sheath to the flexor tendons of the fifth digit

Answer 114

ulnar

Question 115

The tendon of the flexor pollicis longus lies laterally in a separate synovial sheath that forms the ___ bursa which is continuous into the first digit

Answer 115

radial

Question 116

There are three separate synovial sheaths for the distal parts of the tendons of fingers __, ___, and ___

Answer 116

2,3,4

Question 117

Stenosing tenosynovitis (trigger finger) - caliber of opening for tendon to pass through the sheath is reduced and tendon has a ___ ___

Answer 117

swollen nodule

Question 118

What are the boundaries of the cubital fossa?

Answer 118

proximal: line connecting humeral epicondyles
lateral: brachioradialis
medial: pronator teres
floor: brachialis and supinator
roof: skin, deep fascia, bicipital aponeurosis

Question 119

Give the contents of the cubital fossa from lateral to medial

Answer 119

deep branch of radial nerve, radial recurrent artery, tendon of biceps brachia, brachial artery, median nerve, anterior ulnar recurrent artery