Gross Anatomy quiz 4 Flashcards
Cubitus Valgus
An Abnormal increase in the carrying angle.
An Abnormal increase in the carrying angle.
Cubitus Valgus
Carrying angle
In anatomical position, the lateral angle between the ulna and humerus , the angle is bigger in females. Females deviates laterally 15 degrees
and males deviates laterally around 5 to 10 degrees.
Females deviates laterally 15 degrees
and males deviates laterally around 5 to 10 degrees.
Carrying angle
What allows the hand to be brought close to the face for eating or placed at a distance from the body, equal to the length of the upper extremity?
Elbow Complex
The joint and muscles of elbow serve the hand and pivot the mobility for the hand in space, by being able to shorten and lengthen the upper extremity
Elbow Complex
What two joints are included in the elbow complex?
Elbow joint and proximal radio-ulnar joint.
Why are the elbow and proximal radio-ulnar joint considered to be a part of one complex
The radius and ulna are common articulating surfaces.
The joint cavity for the elbow is continuous with the joint cavity of the proximal radio ulnar joint
The ligaments associated with the elbow joint are continuous and part of the proximal radio-ulnar joint.
What are the articulations for the elbow joint ?
Trochlea fossa of the humerus with the trochlear notch of the ulna and the capitulum of the humerus with the head of the radius.
What is the elbow joint classified as ?
Hinge/Ginglymus
What is the nerve supply to the elbow joint
Musculocutaneous ,radial, ulna and radial nerve.
What are the ligaments of the elbow joint
Capsular ligament
Lateral or radial collateral ligament
Medial or ulnar collateral ligament
Annular ligament
The Elbow joint requires that the capsular ligament to be ____ both anterior and posterior in order to permit maximum ___ and ___
Loose; Flexion; Extension
Strong collateral ligaments are required to limit ____ and ___ movements
Medial; Lateral
Which bone do the capsular ligament of the elbow joint have attachments to ?
Humerus and ulna ( NOT Radius)
Which ligament of the elbow joint runs form the lateral epicondyle of the humerus to the annular ligament ( so rotation of the radius is not limited)
Lateral or Radial Collateral ligaments.
What doe the lateral or radial collateral ligament prevent ?
Adduction (medial movement ) at the elbow joint.
What is the classification of the lateral or radial collateral ligament
Extrinsic ( acts like a rope)
What ligament runs from the medial epicondyle to the proximal part of the ulna
Medial or ulnar collateral
What does the medial or ulnar collateral prevent ?
Abduction ( lateral movement) at the joint
What is the classification of the medial or ulnar collateral e
Extrinsic ( acts like a rope)
What ligament is attached the margins of the radial notch of the ulna and surrounds but does NOT attach to the head and neck of the radius
Annular ligament
Which ligament keeps the head of the radius in place
Annular ligament
What is the classification of the annular ligament
Extrinsic ( acts like a wall)
The elbow joint is very stable ____ joint because of the wrench shape of the ____ ___ of the ulna articulating with the ___ of the humerus
Hinge; trochlea notch ; trochlea
The elbow joint is strengthened by strong _____ ligaments.
Collateral
What is the flexion at the elbow joint limited by ?
Soft tissue of the forearm meeting soft tissue of the arm.
What is extension at the elbow joint limited by
contact of the
Olecranon process
Olecranon Fossa
Anterior part of the capsular ligament
What type of elbow joint dislocation are common in which the proximal end of the ulna ( olecranon process) will become dislocated from the trochlea of the humerus
Posterior Dislocations
What other issues can accompany a posterior dislocation ?
Fracture of the head of radius
Fracture of the coronoid process of the ulna
Fracture of the olecranon process of the ulna
Torn ligament (ulnar collateral)
Injury to the ulnar nerve.
The close relationship of the ulnar nerve to the medial side of the elbow joint often results in the nerve becoming _____ or____ in dislocations or fracture dislocations of the joint
Compressed; lacerated
What injury joint would result in a patient complaining of paresthesia ( Numbness, pins and needle feeling) in the area of the fifth digit ?
Elbow joint ( ulnar Nerve)
What injured might show weakened flexion and addition of the hand at the wrist joint ?
Elbow Joint ( ulnar nerve )
What are the ways the ulnar nerve could get injured during an elbow dislocation ?
Being stretched or lacerated ( torn or deep Cut)
May become entrapped in scar tissue at the torn ligament
May become entrapped in new bone formation.
In full extension of the upper extremity, are the forearm and arm exactly aligned ?
no
It Is normal, especially in female, for the forearm to deviate laterally ___ degrees or a little more ( in males the angle is around ___ to ___ degrees)
15 degrees
5 to 10 degrees
What does the carrying angle allow
Allows the elbow to fit closely into the depression at the waist.
What is an increase in the carrying angle known as
Cubitus Valgus
What is the large bursa between the olecranon process and the skin known as ?
Olecranon bursa
Repeated excessive pressure on the olecranon bursa may cause it to become inflamed and produce a friction
friction;bursitis
What is the olecranon bursa’s function
Dissipate( dissolve) the pressure produced when one leans on their elbow.
If the olecranon bursa is exposed to injury, during a fall or a abrasions or the skin covering the bursa, ____ ____ can occur
Bacterial infection
What is the articulation of the proximal radio ulna joint ?
Head of radius
radial notch of the ulna
what is the classification of the proximal ( superior) Radio- ulnar joint, and what does that mean?
pivot/ trocrochoid joint ( supination / pronation)
where ONLY rotational movement is possible.
The capsular ligament of the proximal ( superior) radio- ulnar joint is continuous with that of the ____ joint
Elbow joint.
What two ligaments are specific to the proximal ( superior) radio ulnar joint
Interosseous membrane ( ligament) and the oblique chord.
what is the function of the interosseous membrane (ligament)
Limit supination beyond anatomical position
What is the function of the oblique chord?
Limits supination beyond anatomical position
What is the classification of the interosseous membrane ( ligament) ?
Extrinsic and acts like a rope.
What is the classification of the oblique chord ?
Extrinsic and acts like a rope
What is one of the most common musculosketal injuries seen in preschool children
Subluxation of the head of radius ( pulled or slipped elbow)
What injury is usually seen when the child is suddenly lifted (jerked) by the hand or forearm?
subluxation of the head of the radius (pulled or slipped elbow; nursemaid’s elbow)
When a child is suddenly lifted (jerked) by the hand or forearm, that movement may tear the ________ ligament or pull the _____ of the _______ from under the ________ ligament.
annular; head; radius; annular
What are the signs and symptoms of a subluxation of the head of the radius (pulled or slipped elbow; nursemaid’s elbow)?
very painful, extremity is held limply at the side (forearm is flexed and pronated), palpation reveals tenderness at the radial head, and supination of the forearm causes increased pain
What is the lateral bone of the forearm?
radius
Slipping of the head of radius from under the annular ligament. May caused by a sudden pulling of the arm or hand.
Arm is held in pronation, supination causes great pain
Subluxation of radial head
pulled/ slipped elbow
( nursemaids Elbow)
Fracture of distal radius, fragment is displaced posteriorly. Due to a forward fall with an outstretched hand.
Clinically referred to as a dinner fork deformity.
Common in elderly women due to osteoporosis
Colle’s Fracture
The radius articulates proximally with the humerus at the _______ ______ and with the ulna at the ________ ______-_____ ______.
elbow joint; proximal radio-ulna joint
The radius articulates distally with the ulna at the ______ ______-______ ________ and with the scaphoid and lunate to form the ______ ______.
distal radio-ulnar joint; wrist joint
What is the pivot bone, which moves during pronation and supination?
radius
What is the medial bone of the forearm?
ulna
The proximal end of the ulna articulates with the humerus at the ______ _____ and the radius at the ________ ______-______ ______.
elbow joint; proximal radio-ulnar joint
Distally, the ulna articulates with the radius to form the ______ ____-____ ______.
distal radio-ulna joint
What bone does not take part in the articulation of the wrist joint since there is a piece of cartilage known as the articular disc of the wrist found between the distal end of the ulna and the carpal bones?
ulna
What is the piece of cartilage found between the distal end of the ulna and the carpal bones?
articular disc of the wrist
What is the stabilizing bone of the forearm?
ulna
How many ossification centers does the radius have?
3
How many ossification centers does the ulna have?
3
How many primary centers does the radius have, and where are they located?
1, shaft
How many primary centers does the ulna have, and where are they located?
1, shaft
How many secondary centers does the radius have, and where are they located?
2, one for the distal end and one for the proximal end
How many secondary centers does the ulna have, and where are they located?
2, one for the distal end and one for the proximal end
What forearm bone starts to ossify first?
radius
What forearm bone starts to ossify last?
ulna
What forearm bone completes ossification first?
They both end at the same time.
Radius: distal ossification first appears
1-2 years
Radius: distal ossification fusion with shaft Occurs ?
20-24 yrs
Radius: proximal
ossification first appears
4-7 years
Radius: proximal ossification fusion with shaft Occurs ?
14-17 years
Ulna: distal Ossification first appears ?
4-7 years
Ulna: Distal fusion with shaft
20-24 yrs
Ulna: proximal ossification first appears?
9-11 yrs
Ulna: proximal fusion with shaft appears
14-17 yrs
Fractures of the radius and ulna are usually due to severe and ______ _______ and produce a __________ fracture to the ______ of both bones.
direct trauma; transverse; shaft
Are isolated fractures to either the radius or ulna possible?
yes
Why is displaced of a fragment during a fracture of the radius or ulna usually considerable
the pull of muscle that attached.
can there be comminuted fractures in the radius and/ or ulna ? Explain ?
Yes,
What does comminuted mean
Broken in pieces
If the anatomical relationship of the radius, ulna, and the interosseous membrane are not restored, ________ and ________ may be impaired.
pronation; supination
What fracture is one of the most common fractures in adults, especially women over the age of 50 (due to osteoporosis)?
colles fracture
What fracture occurs at the distal end of the radius?
colles fracture
What type of fracture occurs when an individual falls on an outstretched hand with the forearm pronated and the force of the trauma moves through the carpal bones to the distal end of the radius?
colles fracture
In a colles fracture, the ______ fragment is displaced _________, producing a shortening of the ______ and this fragment may be ______
distal; posteriorly; radius; comminuted
What is dinner fork deformity a sign of?
colles fracture
Do colles fractures heal well? Why?
yes, since the bone has a good vascular supply
Failure to restore the normal articulation between the radius and carpal bones can lead to severe limitations of _______ and __________ at the wrist and may cause ______ ________ of the wrist joint.
flexion; extension; traumatic arthritis
What fracture is a reverse colles fracture?
smith’s fracture
What fracture is due to a fall on the back of the hand, with the distal fragment of the radius displaced anteriorly?
smith’s fracture
How many bones compose the carpus?
8 carpal bones
Fracture of the distal radius, fragment is displaced anteriorly. Due to a fall on the back of the hand.
Smiths Fracture.
What is the proximal row of carpal bones from lateral to medial
Scaphoid, lunate, triquetral( triquetrum) and pisiform
What is the distal row of carpal bone from lateral to medial
Trapezium
Trapezoid
Capitate
Hamate
How many ossification centers do the carpal bones have ?
1 each
When do the carpal bone begin to ossify
usually after birth, however in females, centers may appear in the capitate and hamate during the 9th month of development
What is the order the carpal bones ossify?
- capitate and hamate
- triquetral
- lunate
- trapezium, trapezoid, scaphoid
- pisiform
When is ossification of the carpal bones completed?
14-16 years of age
What bones are used to estimate the age of a child of unknown age?
carpal bones
What are the five long bones of the hand?
metacarpals
What direction are the metacarpals numbered?
radial to ulnar side
What do the base of the metacarpals articulate with?
distal row of carpal bones
What do the heads of the metacarpals articulate with?
base of the proximal phalanges
What is the broadest and shortest metacarpal?
1st
What is the longest metacarpal?
2nd
List the metacarpals in order from longest to shortest.
2nd, 3rd, 4th, 5th, 1st
What are the short bones of each digit?
phalanges
How many phalanges does each digit have?
3 (proximal, middle, and distal) with the exception of the thumb which only has 2 (proximal and distal)
What are the varying number of bones embedded in some of the flexor tendons of the hand?
sesamoid bones
Where are the sesamoid bones most constant over?
MP joints of digit 1, 2, and 5; IP joint of digit 1
What are the functions of the sesamoid bones?
to protect and stabilize tendons, and
they change the angle of the tendons as they pass to their insertion (increase leverage)
What is the most commonly fractured carpal bone?
scaphoid
What carpal fracture often results from a fall on the palm with the hand hyperextended?
scaphoid
How much force does it take to fracture the scaphoid?
twice as much force as is needed to fracture the radius
What fracture is often confused with a “sprained” wrist?
scaphoid fracture
Tenderness and swelling in the anatomical snuffbox makes one suspicion for what type of fracture?
scaphoid fracture
Why can a scaphoid fracture be a serious issue?
some individuals will have a blood supply to the bone that is different than normal and this can cause a necrosis to the proximal part of the bone, and that can lead to a degenerative arthritis of the wrist joint
What fracture may lead to a nonunion of the fractured parts because of the pull of muscles that attach to the bone?
Hamate fracture
What nerve may be injured in the fracture of the hamate?
Ulnar nerve, Because it is close to the hook of the hamate.
Since the ___ to the ___ metacarpals are closely attached by ligaments, fractures tend to be stable.
2nd to the 5th
Do metacarpals have a good blood supply?
Yes, they tend to heal quickly
What is fractured during a boxers fracture
5th metacarpal
How is the 5th metacarpal fractured?
When an individual punches someone with a closed fist.
What fracture will cause instability to the first CM joint
Base of the 1st metacarpal
What is the CM joint?
Carpometacarpal ligament
What is usual cause of fracture of the phalanges?
Crushing injuries ( e.g. Finger caught in a door)
A fracture of what part of a phalanx may result in painful hematomas
Distal
What type of fracture ae commonly associated with extensor or flexor tendons by the phalanges?
Avulsion Fracture
What movement of the had at the wrist joint is the act of bending the palm of the hand toward the forearm ?
Flexion
What movement of the hand at the wrist joint is the movement of straightening the flexed hand?
Extension
What movement of the hand at the wrist joint is when the movement of extension is continued beyond anatomical position ?
Hyperextension
What movement of the hand at the wrist joint is the movement of the hand laterally away from the body
Abduction
What movement of the hand at the wrist joint is the movement of the hand medially toward the body ?
Adduction
What movement of the digits is bending the digit toward the palm
Flexion
What movement of the digits is straightening the flexed digits
Extension
What movement of the digits is movement of digits 1, 2,4 and 5 away from the midline
Abduction
What movement of the digits is movement of the digits 1,2,4 and 5 toward the midline of the hand?
Adduction
Can digit 3 adduct ?
No, it can only abduct either laterally or medially.
Where do the muscle of forearm mainly act?
Wrists and digits, although a few do act at the elbow and radio ulnar joint.
Where is majority of the fleshy mass on the forearm? why is it that way
Proximal part of the forearm, because the distal is mostly tendons it allows a greater number of muscles to have access to the hand than would otherwise be possible.
What is the common tendon of origin of origin for the anterior superficial forearm muscles?
Medial epicondyle of the humerus
List the anterior superficial forearm muscles.
Pronator teres
Flexor Carpi
Palmaris Longus
Flexor carpi Ulnaris.
What is a small muscle found crossing the anterior aspect of he proximal anterior forearm
Pronator Teres
What forms the medial border of the cubital fossa
Pronator Teres
What is the origin of the pronator teres ?
Medial Epicondyle
Humerus and coronoid process/ ulna
What is the insertion of pronator teres
Pronator ridge/ radius
What are the actions of the pronator teres ?
Pronation of the forearm at the proximal radio- ulnar joint
and Assist in flexion of the forearm.
What is the nerve supply to the pronator teres
Medium Nerve
What is a compression of the median nerve in the proximal forearm ?
Pronator teres Syndrome
What is the median nerve compressed between in pronator teres syndrome?
the two heads of the pronator teres.
Due to either trauma or excessive pronation or supination
What muscle is a typical long forearm muscle, and its tendon of insertion is the most laterally of the flexor group
Flexor carpi radials
What is the origin of the flexor carpi radialis ?
Medial epicondyle/ humerus
What is the intorsion of the flexor carpi radialis
Second metacarpal ( with a small slip to the 3rd metacarpal)
What are the actions of the flexor carpi radialis ?
Equal prime mover for flexion at the wrist joint and abduction of the hand.
What is the nerve supply to the flexor carpi radialis
Median Nerve
What can a weakness in the flexor carpi radialis cause
Abnormal type of the hand at the wrist joint known as ulnar deviation.
What muscle is missing in about 15 % of the population ?
Palmaris longus
What muscle is found just medial to the flexor carpi radials
Palmaris longus
What muscle in many species operates the claw ?
Palmaris longus
What muscle is vestigial in humerus
Palmaris longus
What is the origin of the palmaris longus
The medial epicondyle and the
What is the insertion of the palmaris longus ?
Palmaris Aponeurosis
What are the actions of the palmaris longus
Weak flexion of the wrist.
Tightness palmer aponeurosis and thus helps palmer grip.
What is the nerve supply for the palmaris longus
median nerve
What is the most medially situated of the long forearm muscles of the superficial anterior layer ?
Flexor carpi Ulnaris
What are the origins of the flexor carpi Ulnaris ?
Olecranon Process of the ulnar
And Medial epicondyle.
What are the insertions of the flexor carpi Ulnaris
Pisiform, Hamate and 5th metacarpal.
What are the actions of the flexor carpi Ulnaris
Equal Prime movers for the flexion at the wrist joint.
Adduction of the hand.
What is the nerve supply to the flexor carpi Ulnaris ?
Ulnar nerve
What will a weakness of the flexor carpi Ulnaris cause
An abnormal type of flexion of the hand at the wrist joint known as radial deviation.
What is the only muscle that is located in the intermediate layer of the anterior forearm ?
flexor Digitorum superficialis
As the flexor Digitorum superficialis tendons of insertion cross the ___ join, it splits into a ___ separate tendons, which split at their point of attachment to permit the tendons of the _____ ______ _____ to pass through.
Wrist; four ; Flexor Digitorum profundus
what are the origins of the flexor Digitorum superficialis
shaft of the radius
and
Medial epicondyle of the humerus.
What are the actions of the flexor Digitorum superficialis ?
Flexes the Proximal interphalangeal jjoint of digit 2-5
Assist with flexion at wrist joints
What is the nerve supply of the flexor Digitorum superficialis
Median Nerve
What are the deep anterior forearm muscles ?
Flexor Digitorum Profundus
Flexor pollicis longus
pronator quadratus.
What muscle is found deep to the flexor Digitorum superficialis
Flexor Digitorum Profundus
what muscle, at the wrist, gives off four separate tendons, which pas thorugh the split tendons of the flexor Digitorum superficialis to their insertion on the medial four digits?
Flexor Digitorum profundus
What is the origin of the flexor Digitorum profundus
Shaft/Ulna
What is the insertion of the flexor Digitorum profundus
Distal phalanges digits 2-5
What are the actions of the flexor Digitorum profundus
Flexes Distal phalanges of digits 2-5
What is the nerve supply to the flexor Digitorum profundus ?
Median and Ulna nerves.
Is it possible to flex the DIP joints and PIP joints Separately ?
Yes
What is the most laterally places of the deep anterior forearm muscles?
Flexor pollicis Longus
What is the origin of the flexor pollicis longus
Shaft/ Ulna
What is the action of the flexor pollicis longus ?
Flexes digit 1 at the IP joint
What is the nerve supply to the flexor pollicis longus
Median nerve
What is a flat, quadrilateral shaped muscle which is found at the anterior distal of the forearm
Pronator Quadratus
All of the tendons of the other long anterior forarm muscle are superical to what muscle ?
Pronator Quadratus
what is the origin of the protanor quadratus
Shaft/Ulna
What is the insertion of the pronator quadratus
Shaft/ radius
What are the action of the pronator quadratus ?
Pronates the forearm at the distal radio-ulnar joint and helps stabilize the distal ulnar joint.
What is the nerve supply to the pronator quadratus
Median nerve
What is a compression neuropathy to the median nerve at the proximal part of the forearm ?
pronator teres syndrome
What is a compression neuropathy to the median nerve at the distal part of the forearm ?
carpal tunnel syndrome
Radiocarpal Classification
Condyloid joint
Distal end of radius articular disc, scaphoid, lunate and triquetral.
Condyloid joint
Compression of the median nerve by the pronator teres muscle. Symptoms are similar to carpal tunnel syndrom, but also include the forearm
Pronator teres syndrome
Weakness of the flexor carpi ulnaris causes a more laterally favored flexion of the hand
Ulnar deviation
Weakness of the flexor carpi radialis causes a more laterally favored flexion of the hand
Radial deviation
Medium nerve damage, causes atrophy if the thenar muscles. The thumb is held close to the 2nd metacarpal.
Ape Hand
Ulnar Nerve damage, cannot fully flex digit 4 and 5
Claw hand
Compression of the ulnar nerve between the pisiform and the hook of the hamate
Guyons Canal Syndrome
Cyclist may put pressure on the area with their handlebars
Guyons Canals Syndroms
