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S3- Musculoskeletal > iRA/tRA- Elbow, Forearm, Wrist, and Hand > Flashcards

iRA/tRA- Elbow, Forearm, Wrist, and Hand Flashcards

1
Q

What parts make up the distal humerus?

A
  • capitulum
  • trochlea
  • medial and lateral epicondyles
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2
Q

The capitulum articulates with the _________ while the trochlea articulates with the _______.

A
  • radial head

- ulna

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3
Q

What are the parts of the proximal ulna?

A
  • hook for articulation
  • olecranon (posterior) and coronoid process (anterior)
  • medial and lateral articulating surface, seperated by ridge
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4
Q

What are the parts of the proximal radius?

A
  • head
  • neck
  • tuberosity
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5
Q
  • The carrying angle is also known as cubital ________.
  • It is typically __-__ degrees.
  • The greater angle is greater in females or males?
  • Does it increase or decrease with age?
A
  • valgus
  • 10-15 degrees
  • females
  • increase
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6
Q

What is the functional importance of the carrying angle?

A

Compensates for the change of orientation of the radius; allows the axis of the hand to stay in the longitudinal plane.

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7
Q
  • What parts make up the humeroulnar joint?
  • What stabilizes the humeroulnar joint?
  • The humeroulnar joint has a ___-axial motion.
  • Is the humeroulnar joint stable or unstable?
A
  • humeral trochlea and ulnar trochlear notch
  • anterior capsule, radial and ulnar collateral ligaments
  • uni-axial
  • stable
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8
Q
  • What parts make up the humeroradial joint?
  • What stabilizes the humeroradial joint?
  • The humeroradial joint has a ___-axial motion.
A
  • capitulum of humerus and radial head
  • anterior capsule, radial and ulnar collateral ligaments
  • uni-axial
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9
Q

Radial Collateral Ligament:

  • Taut throughout most of the _______ range
  • Attaches to _____ epicondyle and ______ ligament
  • Posterior fibers blend with _____
  • Blends with _________ and ______
A
  • flexion
  • lateral epicondyle and annular ligament
  • ulna
  • supinator and ECRB
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10
Q

Ulnar Collateral Ligament:

  • _________ band (anterior, posterior, inferior parts)
  • Attaches to ________ epicondyle, medial _______ margin, medial margin of ___________
  • Anterior band taut throughout most of ______, posterior band taut between ½ and full ________.
A
  • triangular
  • medial epicondyle, medial coronoid margin, medial margin of olecranon
  • flexion, extension
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11
Q

The proximal radioulnar joint involves a radial notch of the ulna that is _______ anterio-posteriorly.

A

concave

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12
Q

The proximal radioulnar joint involves pronation and supination. Describe this.

A
  • The radial head rotates around the long axis in respect to the capitulum.
  • The axis of the radial head is translated laterally (due to the oval shape of the head).
  • Allows the radius to move out of the way of the ulna for the radial tuberocity to move into the superior fossa of the ulna.
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13
Q

The distal radioulnar joint involves the ulnar notch of the radius which is ___________ anterio-posteriorly.

A

concave

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14
Q

What is the resting and closed packed position of the humeroulnar joint?

A

Resting
-70 degrees flexion, 10 degrees supination
Closed
-full extension and supination

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15
Q

What is the resting and closed packed position of the humeroradial joint?

A

Resting
-full extension and supination
Closed
-90 degrees flexion, 5 degrees supination

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16
Q

What are the bones of the wrist and hand?

A
  • Radius
  • Ulna
  • Carpals
  • Metacarpals
  • Proximal, medial, and distal phalanges
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17
Q
  • What are the 8 carpal bones?

- Which has no vascular supply to the proximal region?

A
  • Scaphoid
  • Lunate
  • Triquetrium
  • Pisiform
  • Hamate
  • Capitate
  • Trapezoid
  • Trapezium

-Scaphoid

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18
Q

What are the articulations of the radiocarpal joint?

A
  • proximal carpal row

- distal radius/ulna

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19
Q

The carpal bones have 2 convexities, _______ and ________.

A
  • sagital

- transverse

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20
Q

The TFCC (triangular fibrocartilage complex) is located between the distal _____ and proximal _________ both convex. It is continuous with ________ collateral ligament. Its anterior and posterior aspects are continuous with the __________ joint capsular ligaments.

A
  • distal ulna and proximal triquetrium
  • ulnar collateral ligament
  • radioulnar
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21
Q

What are the functions of the TFCC?

A
  • Primary stabilizer of the distal radioulnar joint.

- Elastic cushion between ulnar heads and Os triquetrium during wrist adduction- increases contact surface area.

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22
Q

By the age of ___, the TFCC is commonly damaged.

A

60

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23
Q
  • The flexor retinaculum of the wrist creates the _____________.
  • What structures pass posterior to the flexor retinaculum?
  • It prevents ______________ during wrist flexion.
A
  • carpal tunnel
  • FDS, FDP, FPL, and median nerve
  • bow-stringing
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24
Q

What are the 3 columns of the hand?

A

Lateral
-scaphoid, trapezium, trapezoid, 1st and 2nd metacarpal and phalanx
Intermediate
-lunate, capitate, metacarpal of 3rd digit and phalanxes
Medial
-triquetrium, pisiform, hamate, 4th and 5th metacarpal and phalanxes

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25
Q

What are the 3 joints of the fingers?

A
  • Intermetacarpal Joints
  • MCPs (proximal concave on distal convex)
  • IPs (proximal convex on distal concave)
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26
Q

What ligaments connect the intermetacarpal joints?

A

-dorsal, palmar, and interosseous ligaments

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27
Q

What are the palmar plates?

A

Fibrocartilage attachment off of the base of the anterior aspect of the proximal phalanx to the neck of the metacarpal (or distal phalanx to proximal phalanx)

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28
Q

What are the functions of the palmar plates?

A
  • increases area of the articular surfaces
  • resist hyperextension with ligamentous attachment to proximal bony structure
  • reinforce the joint capsule
  • prevent impingement of flexor tendons during MCP flexion
  • protects articular cartilage in extension with impact
  • has healing capacity
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29
Q

Along the phalanges, there are a series of _______ and _________ ligaments that help do what?

A
  • arcuate and cruciate ligaments
  • Help hold the tendons of the finger to the axis of rotation. Synovial sheath deep to pulleys to aid in gliding of tendons.
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30
Q

The CMC (________) joint has a _______ surface for flexion/extension and a ________ surface for ab/adduction.

A
  • saddle
  • concave on convex
  • convex on concave
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31
Q
  • What is the resting position of the radiocarpal and midcarpal?
  • What is the closed position of the radiocarpal and midcarpal?
A
  • slight palmar flexion, slight ulnar deviation

- max extension

32
Q
  • What is the resting position of the proximal and distal carpal row?
  • What is the closed position of the proximal and distal carpal row?
A
  • slight palmar flexion

- max extension

33
Q
  • What is the resting position of MCP (1)?

- What is the closed position of MCP (1)?

A
  • slight flexion

- max extension

34
Q
  • What is the resting position of MCP (2-5)?

- What is the closed position of MCP (2-5)?

A
  • slight flexion and ulnar deviation

- max flexion

35
Q
  • What is the resting position of IPJ?

- What is the closed position of IPJ?

A
  • slight flexion

- max extension

36
Q

MUSCULATURE

A

MUSCULATURE

37
Q

What are the elbow flexor muscles and what innervates them?

A
  • Brachialis (musculocutaneous nerve)
  • Brachioradialis (radial nerve)
  • Biceps Brachii (*primary) (musculocutaneous nerve)
38
Q

What are some accessory elbow flexor muscles and their innervators?

A
  • ECRL (radial nerve)

- Pronator Teres (median nerve)

39
Q
  • The elbow flexors have a peak mechanical advantage at around __-__ degrees of flexion.
  • The brachioradialis has a peak mechanical advantage at around ___-___ degrees of flexion.
A
  • 80-90 degrees

- 100-110 degrees

40
Q

What are the elbow extensors muscles and what innervates them?

A
  • Triceps Brachii (radial nerve)

- Anconeus

41
Q

What are the supinators of the forearm and what innervates them?

A
  • Supinator (deep branch of radial nerve)

- Biceps Brachii (musculocutaneous nerve)

42
Q

What are the pronators of the forearm and what innervates them?

A
  • Pronator Quadratus (anterior interosseous nerve)

- Pronator Teres (median nerve)

43
Q

What muscles perform wrist flexion?

A
  • FCR (lateral deviation)
  • FCU (medial deviation)
  • Flexor digitorum superficialis and profundus
  • Pronator teres
  • Brachioradialis
  • Palmaris longus
44
Q

What muscles perform wrist extension?

A
  • ECRL
  • ECRB
  • Extensor digitorum
  • Extensor digiti minimi
  • Extensor carpi ulnaris
  • Extensor indicis
45
Q

What muscles perform wrist medial deviation?

A
  • FCU

- ECU

46
Q

What muscles perform wrist lateral deviation?

A
  • FCR
  • ECRL
  • ECRB
  • Abductor pollicis longus
47
Q

What is the difference between the palmar and dorsal interosseous muscles?

A
  • Palmar = adduction

- Dorsal = abduction

48
Q
  • What muscles perform DIP flexion?

- What muscles perform DIP extension?

A
  • flexor digitorum profundus

- extensor digitorum, extensor digiti minimi (5th), extensor indiis (2nd)

49
Q
  • What muscles perform PIP flexion?

- What muscles perform PIP extension?

A
  • flexor digitorum superficialis

- extensor digitorum, extensor digiti minimi (5th), extensor indicis (2nd)

50
Q
  • What muscles perform MCP flexion?

- What muscle perform MCP extension?

A
  • flexor digitorum superficialis and profundus, flexor digiti minimi (5th), lumbricals
  • extensor digitorum, extensor digiti minimi (5th), extensor indicis (2nd), lumbricals
51
Q
  • What muscles perform MCP abduction?

- What muscles perform MCP adduction?

A
  • abductor digiti minimi, dorsal interossei

- palmar interossei

52
Q

The lumbricals help perform ________ at the MCP and _________ at the DIP and PIP.

A
  • flexion

- extension

53
Q

Flexors of the CMC joint?

A
  • adductor pollicis
  • flexor pollicis longus
  • opponens pollicis
  • flexor pollicis brevis
54
Q

Extensors of the CMC joint?

A
  • extensor pollicis brevis
  • extensor pollicis longus
  • abductor pollicis longus
55
Q

Abductors of the CMC joint?

A
  • abductor pollicis brevis

- abductor pollicis longus

56
Q

Adductors of the CMC joint?

A
  • adductor pollicis
  • extensor pollicis longus
  • first dorsal interosseus
57
Q

Opposition muscles of the CMC joint?

A
  • opponens pollicis
  • flexor pollicis brevis
  • abductor pollicis brevis
  • flexor pollicis longus
  • abductor pollicis longus
58
Q

Reposition muscles of the CMC joint?

A

-extensor pollicis longus

59
Q

What makes up the anatomical snuff box?

A
  • Abductor pollicis longus
  • Extensor pollicis brevis
  • Extensor pollicis longus
60
Q

What are the contents of the anatomical snuff box?

A

scaphoid and trapezium

61
Q
  • What is the axis of rotation for ab/adduction of the wrist?
  • The reference point for ab/adduction is through the _____ digit and metacarpal.
  • AROM: Abd = __________, Add = __________
  • Range of both ab/adduction ________ in full flexion/extension secondary to tension in carpal ligaments.
A
  • Head of the capitate
  • 3rd
  • ABD=15 degrees, ADD = 45 degrees
  • decreases
62
Q

What are the borders of the carpal tunnel?

A
  • carpals

- transverse carpal ligament (flexor retinaculum)

63
Q

The transverse carpal ligament goes from the _______/_________ to the __________/____________.

A
  • pisiform/hamate

- scaphoid/trapezium

64
Q

What are the contents of the carpal tunnel?

A
  • median nerve
  • FDS tendons (4) wth synovial sheaths
  • FDP tendond (4) with synovial sheaths
  • FPL tendon
65
Q

An area for potential entrapment of the ulnar nerve is the ________ Canal.

A

Guyon’s

66
Q

What are the borders of Guyon’s Canal?

A
  • lateral border of the pisiform
  • transverse carpal ligament
  • pisohamate ligament
67
Q

What are the contents of Guyon’s Canal?

A
  • ulnar nerve- bifurcates late in the canal

- ulnar artery

68
Q

What are the extensor tendon compartments of the wrist?

A

anatomical tunnels on the back of the wrist that contain tendons of muscles that extend the wrist and the digits. The extensor tendons are held in place by the extensor retinaculum.

69
Q

Nerve-Axillary:

  • Roots?
  • Motor?
  • Sensation?
A
  • Roots = C5,C6
  • Motor = deltoid, teres minor
  • Sensation = lateral proximal upper arm
70
Q

Nerve-Radial:

  • Roots?
  • Motor?
  • Sensation?
A
  • Roots = C5-T1
  • Motor = triceps
  • Sensation = posterior aspect of digits 1-3 and lateral half of digit 4
71
Q

Nerve-Posterior Interosseous Nerve:

  • Roots?
  • Motor?
  • Sensation?
A
  • Roots = C7, C8
  • Motor = ECRB, ECU, EI, EDM, EPB, EPL, APL, ED
  • Sensation = n/a
72
Q

Nerve-Musculocutaneous:

  • Roots?
  • Motor?
  • Sensation?
A
  • Roots = C5-C7
  • Motor = coracobrachialis, biceps, brachialis
  • Sensation = lateral cutaneous nerve of forearm
73
Q

Nerve-Median:

  • Roots?
  • Motor?
  • Sensation?
A
  • Roots = C6-T1
  • Motor = PT, FCR, PL, FDS, APB, FPB, OP, Thenar muscles, radial lumbricals
  • Sensation = palmar lateral hand and digits 1-3 and radial 4th digit
74
Q

Nerve-Anterior Interosseous:

  • Roots?
  • Motor?
  • Sensation?
A
  • Roots = C7, C8
  • Motor = pronator quadratus, FDP (lateral), FPL
  • Sensation = n/a
75
Q

Nerve-Ulnar:

  • Roots?
  • Motor?
  • Sensation?
A
  • Roots = C7-T1
  • Motor = FCU, FDP (medial), hypothenar muscles, dorsal interossei, medial 2 lumbricals
  • Sensation = dorsal cutaneous branch (palmar digit 5 and medial half of digit 4)

S3- Musculoskeletal (27 decks)

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