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Anatomy Unit I > GA6: Arm & Anterior Forearm > Flashcards

GA6: Arm & Anterior Forearm Flashcards

0
Q

What are the fascial specializations of the arm?

A
  1. Deep (investing) fascia of the UE (fibrous and dense)
  2. Medial and lateral intermuscular septa
  3. Retinacula (retinaculum si.)
  4. Synovial tendon sheaths
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1
Q

Name the anatomical regions of the Upper extremity

A
  1. Brachium (arm)
  2. Antebracheum (Forearm)
  3. Carpus (wrist)
  4. Hand
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2
Q

What are the investing (deep) fascia of the arm?

A

a. Brachial fascia: deep fascia of the arm

b. antebrachial fascia: the deep fascia of the fa

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3
Q

Describe the medial and lateral intermuscular septa

A

extensions of the deep fascia that attach to the medial and lateral supracondylar ridges of the humerus and the shafts of the radius and ulna

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4
Q

Describe the Retinacula

A

Thickenings of the antebrachial fascia that attach to the distal radius and ulna and the carpal bones.

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5
Q

The retinacula forms ___________tunnels for the tendons of the fa muscles –> prevents “bowstringing”

A

Osseofibrous

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6
Q

Tendons of the extrinsic flexors flexors and extensors of the hand are enveloped within ________ _________

A

Synovial sheaths

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7
Q

How are are synovial sheaths structured?

A

thin-walled fibrous sacs lined with synovial membrabe and lubricated by synovial fluid.

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8
Q

Function of synovial sheath?

A

Reduce friction and allow tendons to slide smoothly beneath retinacula

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9
Q

The arm is divided into Ant and Post compartments separated by the shaft of the humerus and the ______ &______ _________ ______

A

Medial and lateral intermuscular septa

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10
Q

The fa is divided into ant and post compartments separated by the shafts of the:

A
  1. shafts of radius and ulna
  2. interosseous membrane,
  3. the medial and lateral intermuscular septa
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11
Q

Ant and post compartment muscles are segregated based on:

A
  1. embryonic origin
  2. Function
  3. innervation
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12
Q

The Anterior compartment muscles primarily produce what type of mvmt?
And are innervated by what nerves?

A

a. Flexors & pronators

b. nerves derived from the ant divisions (medial and lateral cords) of the brachial plexus

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13
Q

Posterior compartment muscles produce what type of mvmt?

And are innervated by what nerves?

A

a. extensors & supinators

b. innervated by nerves derived from the post divisions (posterior cord) of the brachial plexus

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14
Q

What is a myotome:

A

a group of muscles innervated (wholly or in part) by a single spinal segment

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15
Q

Myotomes are distributed along what axis of the extremity?

A

Proximodistal axis

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16
Q

Dermatomes are distributed along what borders of the UP

A

Pre- and Postaxial borders

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17
Q

Muscles that act across the shoulder are supplied mainly by what spinal segment(s)?

A

C5-C6

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18
Q

Muscles that act across the elbow are supplied mainly by what spinal segment(s)?

A

C6-C7

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19
Q

Muscles that act across the wrist are supplied mainly by what spinal segment(s)?

A

C7-C8

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20
Q

Muscles that move the digits are supplied mainly by what spinal segment(s)?

A

C8-T1

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21
Q

What nerve innervates the anterior compartment of the arm, and what artery supplies it?

A

a. musculocutaneous n.

b. Brachial a.

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22
Q 
Biceps brachii m
O:
I:
A:
N:
A

O: Long head — supraglenoid tubercle
& short head– coracoid process of scapula
I: Radial tuberosity; antebrachial fascia via bicipital aponeurosis
A: Flexes and supinates fa; long head weakly flexes arm; short head weakly adducts the abducted arm
N: Musculocutaneous n.
A: in ant compartment of arm so supplied by brachial a.

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23
Q 
Coracobrachialis m.
O:
I:
A:
N:
B:
A 
O: Coracoid process
I: Ant surface of humerus midshaft
A: Flexes & adducts arm
N: Musculocutaneous n.
B: ant compart of arm --> brachial a.
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24
Q 
Brachialis m.
O:
I:
A:
N:
B:
A 
O: Ant surface of humeral shaft inf to coracobrachialis m.
I: Ulnar tuberosity & coronoid process
A: Flexes fa
N: Musculocutaneous n.
B: ant compt of arm --> brachial a.
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25
Q

Posterior Compartment of the arm is innervated by what nerve?
& supplied by what artery?

A

a. Radial n.

b. branches of the profunda brachii a.

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26
Q 
Triceps brachii m.
O:
I:
A:
N:
B:
A

O: Long head – infraglenoid tubercle of scapula
Lateral head – post surface of humerus superior to spiral groove
Medial head – Post surface of humerus inferior to spiral groove
I: Olecranon process of ulna
A: Extends fa; long head weakly extends and adducts arm
N: Radial n.
B: profunda brachii m. (post compt of arm)

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27
Q 
Anconeus m.
O:
I:
A:
N:
B:
A

O: Lateral epicondyle of humerus
I: Lateral surface of olecranon process of ulna
A: Weakly extends fa and stabilizes elbow joint
N: Radial n.
B: profunda brachii a. (post compt of arm)

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28
Q

What is the nerve that supplies the superficail Anterior compartment of the forearm (fa) for the most part?

A

Median n.

there are exceptions

29
Q

What arterie(s) supply the sperficial anterior compartment of the fa

A

branches of Radial & ulnar aa.

30
Q 
Pronator teres m. 
O:
I:
A:
N:
B:
A

O: Medial epicondyle of humerus, coronoid pprocess of ulna
I: Lateral radius at midshaft
A: pronates fa
N: median n.
B: radial & ulnar aa. ( in ant compt of fa sup layer)

31
Q 
Flexor carpi radialis m.
O:
I:
A:
N:
B:
A 
O: Medial epicondyle of humerus
I: Base of metacarpal II
A: Flexes and abducts wrist
N: Median n.
B: radial and ulnar aa.    ( in ant compt of fa sup layer)
32
Q 
Palmaris longus m.
O:
I:
A:
N:
B:
A 
O: Medial epicondyle of humerus
I: Palmar aponeurosis
A: Weakly flexes wrist
N: Median n.
B: radial and ulnar aa.  ( ( in ant compt of fa sup layer))
33
Q

What muscle is absent in over 10% of the polulation & its tendon is sometimes harvested for use in reconstructive surgery?

A

Palmaris longus m.

34
Q 
Flexor carpi ulnaris m.
O:
I:
A:
N:
B:
A

O: Humeral head– medial epicondyle of humerus
Ulnar head– medial olecranon process, post border of ulna
I: Pisiform bone, hook of hamate bone, and base of Metacarpal V
A: Flexes and adducts wrist
N: ULNAR N. (THIS IS THE EXCEPTION)
B: radial & ulnar aa. ( in ant compt of fa sup layer)

35
Q 
Flexor digitorum superficialis m.
O:
I:
A:
N:
B:
A

O: Humeroulnar head: medial epicondyle, coronoid process of ulna
Radial head: proximal ant surface of radius
I: By 4 separate tendons to bases of IF, MF, RF, & SF
A: Flexes proximal interphalangeal (PIP), mflexes metacarpophalangeal (MP), and Flexes wrist joints
N: Median n.
B: Radial $ ulnar aa. ( in ant compt of fa sup layer)

36
Q

What are the muscles in the DEEP Anterior compartment of the forearm?

A
  1. Flexor digitorum profundus m
  2. Flexor policis longus m.
  3. Pronator quadratus m.
37
Q

Name the muscles in the Anterior compartment of the brachium

A
  1. Biceps brachii m.
  2. Coracobrachialis m.
  3. Brachialis m.
38
Q

Name the muscles in the Posterior compartment of the brachium

A
  1. Trceps brachii m.

2. Anconeus m.

39
Q

What are the muscles in the SUPERFICIAL anterior compartment of the antebrachium?

A
  1. pronator teres m.
  2. Flexor carpi radialis m.
  3. Palmaris longus m.
  4. Flexor carpi ulnaris m.
  5. Flexor digitorum superficialis m.
40
Q

What is a Cubital Fossa?

A

a triangular hollow anterior to the elbow joint

41
Q

What are the boundaries of the cubital fossa?

A

a. Bounded superiorly by a line connecting the medial and lateral epicondyles
b. Medially by the pronator teres m.
c. and laterally by the brachioradialis
d. The brachialis & supinator mm. form the floor of the triangle, the deep fascia and bicipital aponeurosis form its roof

42
Q

What does the cubital fossa contain (lateral to medial)?

A
  1. Biceps brachii tendon
  2. Terminal brachial artery, proximal radial & ulnar arteries, Venae comitantes
  3. Median n
43
Q

Where is the median cubital vein located?

A

In the superficial fascia overlying the cubital fossa

44
Q

What nerve innervates all muscles in the anterior compartment of the arm?
Where does it run?

A

Musculocutaneous n.

  1. pierces coracobrachialis then courses inferiorly in plane between biceps brachii and brachialis mm.
  2. Emerges sup to the elbow to become the lateral antebrachial cuteaneous n.
45
Q

What nerve innervates all muscles in the anterior compartment of the forearm EXCEPT flexor carpi ulnaris and the medial portion of flexor digitorum profundus

A

The median n.

  1. passes medial to the biceps tendon and deep to the bicipital aponeurosis, then enters the forearm between the heads of pronator teres.
  2. Passes through the hiatus in flexor digitorum superficialis & descends in the plan btwn the sup and deep muscle groups
  3. Crosses the wrist medial to the tendon of flexor carpi radialis m. and passes deep to the flexor retinaculum
46
Q

Which nerve is subject to compression btwn the heads of the pronator teres m. (pronator syndrome)?
& as it passes deep to the flexor retinaculum (carpal tunnel syndrome)?

A

Median n.

47
Q

What nerve supplies one-half of the muscles in the anterior antebrachium?
& where does it run?

A

The Ulnar n.

  1. Pierces the medial intermuscular septum to course in the post brachial compartment, deep to the triceps brachii m.
  2. Enters the Cubital tunnel
  3. Courses btwn heads of flexor carpi ulnaris to enter ant compt of fa and descends deep to flexor carpi ulnaris
  4. Crosses wrist superficial to flexor retinaculum and just lateral to the pisiform bone, where it is secured to connective tissue (Guyon’s canal)
48
Q

What nerve can be injured by blows to the elbow or Fx to the medial epicondyle?

A

Ulnar n.

49
Q

What nerve is subject to compression where it passes through the cubital tunnel between the heads of the flexor carpi ulnaris m?

A

ulnar n.

50
Q

What syndrome is associated with repetitive flexion/extension of the elbow?

A

Cubital tunnel syndrome

51
Q

What nerve innervates all muscles of post compt of the brachium?
And where does it course?

A

Radial n.

  1. Courses inthe spiral (radial) groove btwn the medial and lateral heads of triceps vrachii m.
  2. Pierces the lateral intermuscular septum above the elbow to course in the furrow btwn brachialis and brachioradialis mm.
  3. The course of the radial n. in the fa is in lec GA7
52
Q

What is Saturday night palsy?

A

lesions to the radial nerve from Fx to the humeral shaft or sustained pressure against the posteromedial arm. Can produce wrist drop

53
Q

What makes the radial n. vulnerable to injury from Fx to humeral shaft or sustained pressure?

A

Because it runs through the spiral groove of humerus

54
Q

list the nerves that innervate the arm (brachium) and the specific regions of the arm they supply

A
  1. Medial brachial cutaneous n. : supplies ant & medial arm
  2. Intercostobrachial n. (T2): the lateral cutaneous branch of the 2nd intercostal n.
  3. branches of axillary & radial n. innervate the lateral post aspects of the arm
55
Q

List the nerves that innervate the anterior forearm and the specific regions of the fa they supply

A
  1. Lateral antebrachial cutaneous n. : direct continuation of musculocutaneous n. supplies lateral fa (ant & post spaces)
  2. Medial antebrachial cutaneous n.: supplies medial fa (ant & post aspects)
56
Q

List the arteries that supply the UE and the specific regions/ compartments they supply

A
  1. Brachial Artery: blood supply to the UE
  2. Radial artery: lateral terminal branch of the brachial a.
  3. Ulnar artery: Medial terminal branch of the brachial a.
57
Q

Brachial a.

A

a. Continuation of the axillary a. distal to inferior border of teres major
b. terminates in the cubital fossa by bifurcating into the radial and ulnar aa.
c. Its branches are:
1. Collateral branches to elbow anastamosis and unnamed muscular branches
2. Profunda brachii (deep brachial) a.: arises high in the arm and courses with the radial n. in the spiral groove

58
Q

Radial a.

A

a. Lateral terminal branch of the brachial a.
b. Descends in the lateral forearm deep to brachioradialis m. and becomes superficial just proximal to the wrist (where its pulse is easily palpated)
1. Numerous muscular and collateral branches
2. branches to wrist and hand (lec G8)

59
Q

Ulnar a.

A

a. medial terminal branch of the brachial a.
b. Courses inferomedially btwn sup & deep muscle groups & becomes sup just proximal to the wrist
c. named branches: Common interosseous a., Anterior interosseous a., Posterior interosseous a.

60
Q

Describe the branches of the Ulnar a.

A
  1. Common interosseous a: (sometimes absent) short arterial branch that divides immediately into ant & post interosseous arteries
    a. Anterior interosseous a.: descends on the anterior surface of the interosseus membrane & supplies deep flexor muscles of the fa
    b. Posterior interosseous a.: passes superior to interosseous membrane & descends on its post surface supplying post fa muscles
61
Q

What is Collateral Circulation?

A

Branches of 4 major arteries of the arm and fa (brachial, profunda brachii, radial, and ulnar) form a circular network of interconnected arterial pathways (anastomoses) around the elbow joint

62
Q

Deep veins of the UE

A

a. deep venous return follows arteries, & veins are named for the arteries they accompany.
b. Venae comitantes: multiple anastamosing channels that accompany & surround major arteries
C Deep venous return

63
Q

What mechanisms assist deep venous return?

A
  1. Semilunar valves (also present in sup veins) prevent blood from flowing retrograde (backward) and pooling in the extremeties
  2. Arterial pulsations propel blood towards the heart (arterial pump)
  3. The dense brachial and antebrachial fasciae direct the force of muscular contractions inward, propelling blood towards the heart (muscular pump)
64
Q

What are the superficial veins of the UE?

A
  1. Cephalic v.
  2. Basilic v.
  3. Median cubital v.
65
Q

Where does the cephalic v. course?

A

a. lateral aspect of the fa and arm

b. Pierces the clavipectoral fascia within the deltopectoral triangle and empties into the axillary v.

66
Q

Where does the Basilic v. course?

A

a. medial aspect of the fa and arm
b. pierces the brachial fascia in the lower arm and unites with the venae comitantes of the brachial artery to form the axillary v.

67
Q

Describe the Median Cubital v course and describe it?

A

a. A short, horizontal venous channel connecting the cephalic and basilic veins at the cubital fossa.
b. Blood flow is usually from the cephalic v. to the basilic v.

68
Q

Describe the Lymphatics of the UE

A
  1. Lymphatic vessels accompany both sup and deep veins
  2. The majority of lymph from the UE is filtered through the axillary lymph nodes, however lymph vessels accompyanying the cephalic vein drain into the deltopectoral nodes
69
Q

Excision of axillary lymph nodes in conjunction with mastectomy often results in __________ of the UE

A

Lymphedema (swelling)

Anatomy Unit I (8 decks)

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