Gross Exam 2 Flashcards
1
Q
what are the 4 muscles of the anterior superficial compartment
A
- pronator teres
- flexor carpi radialis
- palmaris longus
- flexor carpi ulnaris
2
Q
what are the 1 muscles of the anterior middle compartment
A
flexor digitorum superficialis
3
Q
what are the 3 muscles of the anterior DEEP compartment
A
- flexor digitorum profundus
- flexor pollicis longus
- pronator quadratus
4
Q
what are the 6 muscles of the posterior superficial compartment
A
- brachioradialis
- extensor carpi radialis longus
- extensor carpi radialis brevis
- extensor carpi ulnaris
- extensor digitorum
- extensor digiti minimi
5
Q
what are the 5 muscles of the posterior DEEP compartment
A
- supinator
- abductor pollicus longus
- extensor pollicus longus
- extensor pollicus brevis
- extensor indicis
6
Q
what does pollicis mean
A
thumb
7
Q
what does digitorum mean
A
fingers
8
Q
what does carpi mean
A
wrist
9
Q
what does palmaris mean
A
palm
10
Q
what muscles are innervated my the median nerve
A
ALL ANTERIOR COMPARTMENT EXCEPT FLEXOR CARPI ULNARIS (ulnar nerve) and 1/2 of flexor digitorum profundus (ulnar)
11
Q
what muscles are innervated by the ulnar nerve
A
flexor carpi ulnaris and 1/2 of flexor digitorum profundus (other 1/2 is median nerve)
12
Q
what muscles are innervated by the radial nerve?
A
ALL posterior compartment muscles!
13
Q
what does pronator teres do
what compartment?
what nerve?
A
pronates forearm and flexes forearm/elbow
anterior superficial
median n
14
Q
what does flexor carpi radialis do
what compartment?
what nerve?
A
flex wrist
anterior superficial
median
15
Q
what does palmaris longus do
what compartment?
what nerve?
A
tension of palmar aponeurosis
anterior superficial
median
16
Q
what does flexor carpi ulnaris do
what compartment?
what nerve?
A
flex wrist (ulnar side)
anterior superficial
ULNAR!!! exception to rule
17
Q
what does flexor digitorum superficialis do
what compartment?
what nerve?
A
flex digits
anterior middle
median
18
Q
what does flexor digitorum profundus do
what compartment?
what nerve?
A
flex digits
anterior DEEP
1/2 ulnar and 1/2 median
EXCEPTION!!!
19
Q
what does flexor pollicis longus do
what compartment?
what nerve?
A
flex thumb
anterior DEEP
median
20
Q
what does pronator quadratus do
what compartment?
what nerve?
A
pronate forearm
anterior DEEP
median
21
Q
what does brachioradalis do
what compartment?
what nerve?
A
flex forearm
posterior superficial
radial
22
Q
what does extensor carpi radialis brevis do
what compartment?
what nerve?
A
extend wrist (radial side)
posterior superficial
radial nerve
23
Q
what does extensor carpi radialis longus do
what compartment?
what nerve?
A
extend wrist (radial side)
posterior superficial
radial
24
Q
what does extensor carpi ulnaris do
what compartment?
what nerve?
A
extend wrist (ulnar side)
posterior superficial
radial
25
what does extensor digitorum do
what compartment?
what nerve?
extend fingers
posterior superficial
radial
26
what does extensor digiti minimi do
what compartment?
what nerve?
extend little finger
posterior superficial
radial
27
what does supinator do
what compartment?
what nerve?
supinates
posterior deep
radial
28
what does abductor pollicis longus do
what compartment?
what nerve?
adbucts thumb
posterior deep
radial
29
what does extensor pollicis longus do
what compartment?
what nerve?
extends thumb
posterior deep
radial
30
what does extensor pollicis brevis do
what compartment?
what nerve?
extends thumb
posterior deep
radial
31
what does extensor indicis do
what compartment?
what nerve?
extends index finger
posterior deep
radial
32
what artery supplies posterior muscles?
posterior interosseous artery -> common interosseous a -> ULNAR ARTERY
33
once the brachial artery enters the cubital fossa it splits into:
radial and ulnar a
34
what does the ulnar artery split into right away
common interosseous a and ulnar a
35
what does the common interosseous artery split into
posterior interosseous and anterior interosseous artery
36
where can you feel your pulse- what artery
radial artery
37
what artery passes deep to the pronator teres
ulnar artery
38
what artery parallels brachioradalis muscle
radial artery
39
what compartment does the post and ant interosseuous arteries stay in
anterior compartment
40
what nerve passes between pronator teres heads
median nerve
41
what is the nerve of most** anterior compartments?
median n
42
what does the median nerve become
anterior interosseous NERVE and recurrent branch of median nerve
43
where is the ulnar nerve
behind medial epicondyle, between carpal, around elbow
44
what nerve is funny bone
ulnar
45
where does the radial nerve enter
enters cubital fossa b/w brachialis and brachioradialis
46
what does the radial nerve split into
deep radial n (into posterior compartment) and superficial radial n
47
what does the radial nerve innervate
ALL post. compartment
48
what is the terminal branch of the radial n
post. interosseous nerve
49
what does the musculocutaneous n become
once it crosses comers out from biceps -> lateral cutaneous n of forearm
50
numbness on lateral side of forearm- what nerve damaged
lateral cutaneous n of forearm
51
numbness in middle posterior forearm - what nerve damaged
post. cutaneous nerve of forearm (radial)
52
numbness on median side of forearm- what nerve damaged
medial cutaneous n of forearm
53
radius is thumb or pinky
THUMB! wrist
54
does radius or ulnar move
RADIUS
55
3 types of joints in forearm
1. fibrous
2. synovial
3. cartilaginous
56
forearm joints (3)
1. humeroulnar joint
2. humeroradial joint
3. proximal radioulnar joint
57
what holds the proximal radioulnar joint in place
held in place via annular ligament, head of radius rotates with this ligament
58
what does the humeroradial joint do
contributes to hinge, adds stability, carrying angle
59
humeroulnar joint
what does it do
HINGE JOINT-> flexion/extension. primarily contracts
60
distal radioulnar joint is held by what. What is its role?
held in place by fibrocartilage articular disc. base of radius pivots around head of ulna.
61
what does the interosseous membrane connects
the radius and ulna and also separates the anterior from pst. distributes forces transmitted from distal to proximal
62
what are the two main supinators ms
supinator and biceps brachii
63
what are the 2 main pronators ms
pronator teres and pronator quadratus
64
cubital fossa boundaries
SUPERIOR: "line" joining medial and lateral epicondyles
LATERAL: brachioradialis and supinator
MEDIAL: pronator teres and brachialis
65
medial epicondyle is radius or ulnar side
ulnar side
66
what nerve innervates brachioradialis
radial nerve. ONLY MS THAT IS A FLEXOR THAT IT INNERVATES since it is in extensor superficial compartment
67
median cubital vein has an anastamosis b/w what 2 veins
cephalic and basilic v
where you get blood drawm
68
what is golfers elbow
inflam at median epicondyle
69
what is tennis elbow
lateral epicondyle inflam
70
where do extensors originate from
lateral supracondylar ridge or lateral epicondyle of humerus and posterior forearm
71
what muscles originate from lateral supracondylar ridge
brachioradialis and extensor carpi radialis longus (ECRL)
72
what is the clinical sig. of the median nerve passing b/w the pronator teres heads?
at risk for compression!! all anterior compartments innervated by this nerve would not work right
73
ELBOW ANASTAMISIS:
4 of them name
1. radial collateral a -> radial recurrent a -- DEEP BRACHIAL ARTERY then RADIAL ARTERY
2. middle collateral a -> interosseous recurrent -- DEEP BRACHIAL ARTERY then ULNAR ARTERY
3. inferior ulnar collateral a -> anterior ulnar recurrent a. -- MAIN BRACHIAL ARTERY then ULNAR ARTERY
4. superior ulnar collateral a -> posterior ulnar recurrent a. -- MAIN BRACHIAL ARTERY then ULNAR ARTERY
74
ELBOW ANASTAMISIS:
what artery does radial recurrent come from
radial a
75
ELBOW ANASTAMISIS:
what artery does radial collateral a come from
anterior branch of deep brachial a
76
ELBOW ANASTAMISIS:
what artery does interosseous recurrent a come from
post. interosseous a
77
ELBOW ANASTAMISIS:
what artery does middle collateral a come from
post. branch of deep brachial a
78
ELBOW ANASTAMISIS:
what artery does anterior ulnar recurrent come from
ulnar a
79
ELBOW ANASTAMISIS:
what artery of posterior ulnar recurrent come from
ulnar a
80
ELBOW ANASTAMISIS:
what artery does superior ulnar collateral come from
BRACHIAL ARTERY
81
what does a fracture on ulnar mean -> nerve and muscles affected
ulnar n could have damage! flexor digitorum profundus (1/2) and flexor carpi ulnaris. Tons of hand muscles also would not work such as Hypothenar
82
what could a fracture on the MEDIAL epicondyle mean
Many flexors also connect there! hard to flex fingers and wrist. All anterior superficial plus extensor digitorum connect there
83
what holds the radius in place anteriorly
annular ligament
84
what structure attaches to the long sharp ridge on the lateral aspect of the shaft of the ulna?
interosseous membrane
85
what muscle lies superficial to the ulnar nerve
flexor carpi ulnaris
86
what anastomoses is with the posterior branch of the deep brachial
Middle collateral -> interosseous recurrent
Radial collateral -> radial recurrent.
87
with what bony landmark does the head of the distal ulna articulate
ulnar notch of the radius
88
what joint does FLEXION of the elbow occur?
humeroulnar joint -> hinge joint!!
89
primary blood supply to FLEXOR/ANT compartment of the forearm is
anterior interosseous a (a branch of ulnar a -> common interosseous a)
90
what nerve enters cubital fossa deep to brachioradalis ms
radial nerve
91
ELBOW ANASTAMISIS:
what artery does INFERIOR ulnar collateral come from
BRACHIAL ARTERY
92
explain the branches off of the brachial artery:
Brachial Artery -> Deep Brachial Artery and Brachial Artery (continues)
Brachial artery -> superior and inferior ulnar collaterals.
Deep Brachial Artery -> Radial Collateral Artery and Middle Collateral Artery
Brachial Artery (crosses cubital fossa) -> Radial Artery and Ulnar Artery
Radial Artery (branches right away) -> Radial Recurrent Artery and Radial Artery (continues)
Ulnar Artery (passes deep to pronator teres. Branches right away) -> COMMON INTEROSSEOUS ARTERY and Ulnar Artery (continues)
Common Interosseous Artery -> Posterior Interosseous Artery and Anterior Interosseous Artery
Posterior Interosseous Artery -> Interosseous Recurrent Artery and Posterior Interosseous Artery (continues)
93
boarders of the quadrangular space:
teres minor, teres major, humerus, and triceps brachii
94
what is in the quadrangular space
axillary nerve and posterior circumflex humerus artery AND vein
95
what are the boarders of the triangular space
teres minor, teres major, triceps brachii
96
what is in the triangular space
circumflex scapula artery and vein
97
are triceps ant or post
post
98
are biceps ant or post
ant
99
where is the long head of the biceps
LATERAL side. looks like shorter one
100
first part of axillary artery contains:
superior thoracic artery
101
second part of axillary artery contains:
thoracromical artery (CAPD) and lateral thoracic artery
102
third part of axillary artery contains:
subscapular artery -> circumflex scapular artery** and thoracodorsal artery
Posterior circumflex humeral artery **
Anterior circumflex humeral artery
103
what muscle divides up the axillary artery?
PEC MINOR!
104
GO OVER FOREARM CUTANEOUS INNERVATION
look at notes picture
105
What are the 3 muscles of the thenar compartment
thumb side:
Abductor pollicus brevis
flexor pollicus brevis
opponens pollicus
106
what nerve in located on the base of thumb
recurrent branch of median nerve
107
what are the hypothenar muscles
pinky side
abductor digiti minimi
flexor digiti minimi
opponens digiti minimi
108
which side on hand has an adductor?
adductor POLLICUS
right between index finger and thumb
109
nerve and artery names running up fingers and what distinguishes them?
COMMON digital a/n before they branch and then PROPER digital a/n after they branch
110
what does the COMMON digital arteries come off of?
Superficial palmar arch
111
what supplies the superficial palmar arch?
ulnar artery/ superficial branch of radial artery
112
what supplies the DEEP palmar arch?
radial artery/ DEEP ulnar artery
113
what tissue covers your palm
palmar aponerousis
114
What muscles does the median nerve specifically innervated +4
pronator teres, flexor carpi radalis, palmaris longus, flexor digitorium superficialis
115
What muscles does the Anterior Interosseous nerve specifically innervated and what is the nerve is came from 3
MEDIAN NERVE
flexor digitorum profundus (1/2), flexor pollicis longus, pronator quadratus,
HAND is from recurrent branch of median nerve : abductor pollicis brevis, opponens pollicus, first lumbrical, second lumbrical
116
What muscles does the ulnar nerve specifically innervated
flexor carpi ulnar and flexor digitorum profundus (1/2) (BOTH WEIRD ONES)
HAND: adductor pollicis, flexor pollicis brevis, 1st dorsal interosseous, 1st palmar interosseous, 3rd lumbrical, 4th lumbrical, digiti minimi
117
What muscles does the radial nerve specifically innervated 4
triceps, brachioradalis, extensor carpi radalis longus, extensor carpi radalis brevis
118
What muscles does the Posterior Interosseous nerve specifically innervated and what main nerve did it branch from 8
RADIAL NERVE
supinator, ECU, ED, EDM, abductor pollicis longus, EPL, EPB, extensor indicis
119
what are the order of bones on the "fingers" starting at the bottom
carpals, metacarpals, proximal phalanges, intermediate phalanges, distal phalanges
120
what two wrist bones physically touch the radius
scaphoid and lunate
121
what does the distal ulnar bone come into contact with by wrist
articular disk (cartilage) MINIMAL contact on ulnar side
122
carpal-metacarpal joint is what type of joint and significant where
it is a SADDLE joint. -> flexion/extension and abduction/adduction and opposition/reposition
its on all 5 fingers but only really important on thumb
on thumb, it is the scaphoid and 1st MC = CMC joint
123
metacarpophalangeal joint location and movement
where your knuckles are. does flexion/extension and adduction/abduction
this all equals circumduction
124
interphalangeal joint. location
it is in all 4 fingers in two rows on you PIP and DIP
it is in thumb ONLY at IP
125
flexor retinaculum attachments
Lateral: tubercle of scaphoid and trapezium (thumb side)
Medial: pisiform bone and hook of hamate (ulnar side)
126
flexor retinaculum functions (3)
1. closes carpal groove and creates tunnel
2. holds flexor tendons in place and prevents bowstringing
3. thenar and hypothenar muscle group orgins
127
flexor retinaculum has what nerve lying deep to it
Median nerve
128
flexor retinaculum has what nerve and artery lying superficial
ulnar a and n
129
what muscles/vessels lie superficial to flexor retinaculum -5
1. FCU
2. tendon of palmaris longus (CAN BE MISSING)
3. ulnar nerve
4. ulnar artery and vein
5. superficial radial artery SOMETIMES
NONE OF THESE CAN CAUSE CARPAL TUNNEL PROBLEMS BC THEY ARENT IN THE TUNNEL
130
What does extrinsic mean
muscle bellies proximal to hand
131
what extrinsic muscles/nerve are located in the carpal tunnel --4
1. FDS
2. FDP
3. FPL pollicus
4. median nerve
THESE ALL CAN CAUSE CARPEL TUNNEL PROBLEMS
***FCR is right away in its own separate compartment
132
What nerve can cause carpal tunnel issues?
median nerve since it lies within tunnel
133
what are sensory and motor characteristics of median nerve compression in carpal tunnel -> finger flexor tendontis
sensory: tingling burning of lateral 3 1/2 digits (starting on thumb to half of ring finger)
motor: weakness of thenar muscles and radial 2 lumbericals
134
what is ulnar nerve compression clinical condition called
Ulnar tunnel or Guyon's canal syndrome
135
what is Guyons canal syndrome/ulnar tunnel syndrome characterized by
paresthesia of medial (ulnar) 1 1/2 digits on palmar and dorsal side.
weakness of the intrinsic hand ms. innervated by the ulnar nerve )hypothenar, all interossei, add. pollicis and ulnar side 2 lumbricals)
136
what are the dorsal wrist extensors from radial to ulnar side -6 compartments
1. abd PL and ext. PB
2. ECRL and ECRB
3.EPL
4. ED and extensor indicis
5. EDM
6. ECU
137
do we have a extensor retinaculum
Yes but no problems because we have no nerve involved on dorsal side
138
what does intrinsic mean
whole muscle in hand
139
palmar brevis
function
nerve
ulnar n
cups a little bit
140
what are the thenar muscles and what nerve
abductor pollicis brevis
flexor pollicis brevis
opponens pollicis
SUPER SUPER IMPORTANT. THUMB ACTION
recurrent branch of median nerve
141
what are the hypothenar muscles and nerve
abductor digiti minimi
flexor digiti minimi
opponens digiti minimi
ULNAR NERVE
not as important as thenar group
142
dorsal interosseous
function
nerve
ABducts -> middle finger is midline so does not abduct
ulnar nerve
4 ms. on fingers not thumb
DAB
143
palmar interosseous
function
nerve
ADDuction
deep branch of ulnar nerve
3 ms SUPER DEEP.
middle finger is midline and has no muscle. muscles on three other fingers (not thumb) and lies medial to middle finger
PAD
144
adductor pollicis
function
nerve
adducts thumb
ulnar nerve
145
lumbericals
function
nerve
flexion of MCP and IP extension
comes off FDP tendon
4 ms that lie on radial side
1st and 2nd lumbericals -> median nerve
3rd and 4th lumbericals -> deep branch of ulnar nerve
NOT on thumb
146
what ligament holds knuckles together
deep transverse metacarpal ligament
separates dorsal and palmar
sits between Proximal Phalanges and metacarpals
147
what is the flexor digital sheath
fibrous tube that holds the flexor tendons in place on fingers
148
what NERVE passes b/w the brachioradialis and brachialis in the cubital fossa
RADIAL nerve.
149
The musculocutaneous n becomes the lateral cutaneous nerve of the forearm when it comes out from
bicep heads
150
what nerve passes through the head of the pronator teres
MEDIAN neve
151
what artery passes deep to the pronator teres
ULNAR artery
152
what artery parallels the brachioradialis
the radial artery
153
what muscle does flexion of elbow/forearm and pronation of forearm
pronator teres
154
what muscle is sometimes missing in people
palmaris longus -> ant compartment
155
what nerve goes behind flexor carpi ulnar
ulnar nerve
156
what nerve lies on top of pronator quadratus
anterior interosseous nerve
157
radial nerve becomes what
Comes into cubital fossa: deep radial nerve and superficial radial nerve
Deep radial nerve pierces supinator and is now posterior interosseous nerve
158
does the thumb have an intermediate phalange?
NO! just distal and proximal
159
what part of your hand is significant to the CMC joint
THUMB! other fingers have no significant movements
allows thumb to do flex/ext, adb/add, and opposition/reposition
160
what are you knuckles
Metacarpalophalangeal joint
circumduction
161
what is circumduction
flex/ext and add/abd
162
what is the extension expansion/Hood do
the contraction of the extensor digitorum muscle tightens this tendon which acts on these attachments and extends the fingers. -> IP joints
163
what joint does the extensor digitorium extend
it extends the MCP -> knuckles
164
ulnar artery in hand:
primary contributor to
superficial palmar arch
165
ulnar artery in hand:
secondary contributor to
DEEP palmar arch (deep ulnar artery)
166
what comes off of the superficial palmar arch
COMMON and PROPER digital arteries (and nerves)
167
Radial artery in hand:
what is it the primary contributor of
DEEP palmar arch
168
Radial artery in hand:
what is it the seconary contributor of
SUPERFICIAL palmar arch (superficial branch of radial artery)
169
what does the radial artery branch off into into palm/hand
princeps pollicis a and radialis indicis a
170
cutaneous hand
look at notes
finger tips are median
171
Median nerve motor does ONLY what parts of the hand
2 lumbricals on radial side and the recurrent branch of the median nerve does the thenar eminence. ULNAR NERVE DOES EVERYTHING ELSE
172
What nerve does a majority of the hand motor innervations
ULNAR NERVE
median nerve just does 2 lumbricals on radial side and the recurrent branch of the median nerve does the thenar eminence.
173
anatomical snuff box boundaries:
Ant/Palmer: tendons of abductor pollicis longus and extensor pollicis brevis
Pos/Dorsal: extensor pollicis longus
Floor: scaphoid and trapezium carpal bones
174
what nerve and artery can we find in the anatomical snuff box
nerve: superficial branch of the radial nerve
artery: radial artery
175
tenderness in snuffbox post fall could mean what
broke scaphoid bone (SUPER BAD bc need for wrist function) or lunate or distal end of radius fracture
176
Posterior cord is what nerve
Radial nerve
177
Lateral cord is what nerve
Musculocutaneous nerve
178
Medial cord is what from nerves
Ulnar
179
What are the 3 cords
Lateral - musculocutaneous
Medial - ulnar
Posterior - radial
180
what all does a synovial joint comprise of -5
two bones usually
synovial membrane
joint capsule
articular covering -> hyaline cartilage
nerve and blood supply IF they cross the joint
ligaments -> intrinsic and extrinsic
181
what joint allows for more movement- fibrous or cartilaginous?
fibrous -> minimal
cart. -> VERY small amt
182
what is a synergist
helps prime mover
183
what is an antagonist
stabilizer
184
what are your primary flexors
brachialis and biceps brachii
185
what are your secondary flexors
all forearm muscles in that originate from the humerus (supracondylar ridge and epicondyle)
186
extension of forearm ms 2
triceps brachii and anconeus
187
proximal radioulnar joint held in place by:
distal radioulnar joint held in place by:
proximal: annular ligament
distal: fibrocartilage articular disc
188
what movement happens are the radioulnar joints and what ms
supination of forearm and hand
supinator and biceps brachii
189
what ms attaches at the radial tuberosity
biceps brachii ms
190
volar is another name for
flexor/anterior compartments
191
what is the motor nerve to MOST of the flexor compartment
median n
192
what is the motor nerve to extensor compartment
radial n
193
what is it called for the mech for blood to flow to an organ or region after its normal course has been blocked
collateral circulatioin
194
a saddle joint does what movements
flex/ext
abd/add
medial/lat rotation = opposition/repost
195
what are the 2 primary movements at the metacarpophalangeal joints
flex/ext
abd/add
=circumduction
196
what does your interphalangeal joints do
HINGE JOINT -> flex/ext
*thumb only has one all other fingers have 2 sets
197
what the space called that is in b/w your flexor retinaculum and palmar surface of carpal bones
carpal tunnel
198
what do you lumbricals do
MCP flexion and IP extension
199
common and proper digital arteries stem from what artery?
ulnar artery (superficial palmar arch)
200
motor innervation ON HAND:
Median nerve: 2 lumbericals on radial side
Recurrent branch of the median nerve: thenar ms
Deep branch of ulnar nerve: does everything else
201
what nerve primarily provides cutaneous/sensory info for hand ulnar side
superficial branch of the ulnar nerve
202
what BONE are your knuckles
HEADS of metacarpals
