Lecture 11: Antebrachium and Elbow Flashcards
What is the ante brachium divided into?
anterior and posterior compartments by facial septae that are continuous with the deep fascia that
on the posterior surface the deep fascia thickens and forms a _________ that converts the grooves form the radius into________ for extensor tendons.
transverse; tunnels
What is the common origin of the anterior compartment of muscles?
medial epicondyle of the humerus
What is the common function of the anterior compartment of muscles?
wrist and digit flexion
What is the innervation of the anterior compartment of muscles?
median and ulnar nerves
What are the superficial muscles of the anterior compartment of muscles?
pronator teres
flexor carpi radialis
palmaris longus
flexor carpi ulnaris
What are the intermediate muscles of the anterior compartment of muscles?
flexor digitorum superficialis
Proximal attachment of flexor digitorum superficialis
humero ulnar head
radial head
distal attachment of flexor digitorum superficialis
shafts of middle phalanges of digest II through V
Action of flexor digitorum superficialis
flexes middle phalanges of medial four fingers
flex proximal phalanges at MP joints by continued action
capable of flexing each finger independently
Innervation of flexor digitorum superficialis
median nerve (C7, 8, T1)
Proximal attachment of flexor digitorum profundus
proximal two thirds of anterior surface of ulna and interosseous membrane
Distal attachment of flexor digitorum profundus
distal phalanges 2-5
What muscle is the only one that can flex the distal IP joints of the fingers?
flexor digitorum profundus
What is the action of the flexor digitorum profundus?
flex index finger independently
Blood supply of flexor digitorum profundus
anterior interosseous artery
Innervation of flexor digitorum profundus
median nerve via anterior interosseous nerve (C8, T1) and ulnar nerve (C8, T1)
Proximal attachment of flexor pollicis longus
mid anterior surface of radius and interosseous membrane
Distal attachment of flexor pollicis longus
distal phalanx of thumb
Action of flexor pollicis longus
flexes distal phalanx of thumb
Innervation of flexor pollicis longus
median nerve (C8, T1)
Common function of muscles of posterior antebrachium
primarily wrist and hand extensors
Common origin of muscles of posterior antebrachium
lateral epicondyle of humerus
What are the muscles of the posterior antebrachium?
brachioradialis extensor carpi radialis longus extensor carpi radialis brevis extensor digitorum extensor digiti minimi extensor carpi ulnaris
All muscles of the posterior forearm are innervated by the _____ via the deep branch or the _________ nerve
radial nerve, posterior interosseous nerve
Brachioradialis proximal attachment
proximal 2/3 of supraepicondylar ridge of humerus
Brachioradialis distal attachment
distal radius, proximal to styloid process
Brachioradialis actions
flexes forearm when it is pronated (about mid prone position)
Brachioradialis blood supply
radila collateral artery, radial recurrent artery, radial artery
Brachioradialis innervation
radial nerve (C5, 6, 7)
Extensor carpi radialis longus proximal attachment
lateral supracondylar ridge of humerus
Extensor carpi radialis longus distal attachment
dorsal aspect of base of 2nd metacarpal
Extensor carpi radialis longus actions
extends and abducts hand at wrist
Extensor carpi radialis longus blood supply
radial collateral artery, radial recurrent artery, recurrent interosseous artery and posterior interosseous
Extensor carpi radialis longus innervation
radial nerce (C6, 7)
Extensor carpi radialis brevis proximal attachment
lateral epicondyle of humerus (common extensor origin)
Extensor carpi radialis brevis distal attachment
dorsal aspect of base of 3rd metacarpal
Extensor carpi radialis brevis actions
extends and abducts hand at wrist
Extensor carpi radialis brevis blood supply
radial collateral artery, radial recurrent artery, recurrent interosseous artery, and posterior interosseous artery
Extensor carpi radialis brevis innervation
deep branch of radial nerve (C7, 8)
extensor digitorum proximal attachment
lateral epicondyle of humerus
extensor digitorum distal attachment
extensor expansions of medial four fingers
extensor digitorum actions
extends medial 4 fingers at metacarpophalangeal joints and somewhat at interphalangeal joints
extensor digitorum blood supply
posterior interosseous artery, recurrent interosseous, and perforating branch of the anterior interosseous arteries
extensor digitorum innervation
posterior interosseous nerve (C7, 8)
extensor digiti minimi proximal attachment
lateral epicondyle of humerus
extensor digiti minimi distal attachment
extensor expansion of fifth finger
extensor digiti minimi actions
extends 5th finger at metacarpophalangeal joint and somewhat at interphalangeal joint
extensor digiti minimi blood supply
posterior interosseous artery, recurrent interosseous, and perforating branch of the anterior interosseous arteries
extensor digiti minimi innervation
posterior interosseous nerve (C7, 8)
extensor carpi ulnaris proximal attachment
lateral epicondyle of humerus and posterior border of ulna
extensor carpi ulnaris distal attachment
dorsal aspect of base of fifth metacarpal
extensor carpi ulnaris actions
extends and adducts hand at wrist
extensor carpi ulnaris blood supply
radial collateral artery, recurrent interosseous, and posterior interosseous artery
extensor carpi ulnaris innervation
posterior interosseous nerve (C7, 8)
What are the four deep muscles of the posterior ante brachium?
aductor pollicis longus extensor pollicis brevis extensor pollicis longus extensor indicis supinator
pronator quadratus proximal attachment
distal third of ulna
pronator quadratus distal attachment
distal third of radius
pronator quadratus action
pronates forearm, helps interosseous membrane to hold radius and ulna together
pronator quadratus innervation
anterior interosseous branch of median nerve (C8, T1)
pronator teres proximal attachment
ulnar head: coronoid process of ulna; humeral head: medial epicondyle and supracondular ridge
pronator teres distal attachment
middle third of lateral surface of radius
pronator teres action
pronates forearm, flexes antebrachium
pronator teres innervation
median nerve (C6,7)
supinator proximal attachment
lateral epicondyle of humerus, radial collateral and annular ligaments, ulnar crest
supinator distal attachment
proximal 1/3 of radius
supinator action
supinates forearm, brings radius back to anatomical position
supinator innervation
deep branch of radial nerve (C7, 8)
What is the functional neurological level of the median nerve?
C7
What does the ulnar nerve supply?
flexor carpi ulnaris
half of flexor digitorum profundus
What are the branches of the ulnar artery?
anterior ulnar recurrent to inferior ulnar collateral
posterior ulnar recurrent to anterior ulnar collateral
common interosseous to anterior and posterior interosseous
What are the branches of the radial artery?
radial recurrent
dorsal carpal artery
dorsal metacarpal and digital arteries
first dorsal metacarpal: princeps pollicis and radialis indicis
What type of joint is the elbow complex?
hinge joint
uniaxial
What is the function of the elbow complex?
antebrachium extension, flexion, supination, and pronation
What are the joints of the elbow complex?
humeroulnar joint humeroradial joint radioulnar joint (superior, inferior, intermediate)
What does the humeroulnar joint articulate with and do?
trochlear notch to trochlear
flexion and extension
What does the humeroradial joint articulate with and do?
fovea of head of radius and capitulum
flexion, extension, pronation and supination
What does the superior radioulnar joint articulate with
radial notice of ulna and annular ligament
What does the inferior radioulnar joint articulate with
ulnar notch of radius, articular disc, head of ulna
What does the intermediate radiounlar joint articulate with?
interosseous membrane
syndesmosis
What are the three different articulations of the elbow joint?
humeroulnar articulation
humeroradial articulation
proxiaml radioulnar articulation
Describe the medial (ulnar) collateral ligament
medial epicondyle to coronoid process and olecranon process
slack ligament results in valgus deformity
Describe the lateral (radial) collateral ligament?
lateral epicondyle to annular ligament and olecranon process
slack ligament results in varus deformity
Describe the annular ligament
attached to ulna
forms sling around neck of radius
Describe the close packed position
extension
What are the axes of the carrying angle?
longitudinal axis of humerus
long axis through trochlea
What is increase in the carrying angle?
cubitus valgus
What is the decrease in the carrying angle?
cubitus varus
What is the relationship of the ulnar nerve to the elbow complex?
medial epicondyle
olecranon process
ulnar nerve runs posterior to medial epicondyle of humerus
origins of flexor carpi ulnaris
What is the relationship of the bicipital aponeurosis to the elbow complex?
brachial artery and median cubital vein
What is the relationship of the median to the elbow complex?
to the brachial artery
In the elbow complex the epicondyles of the humerus go to
collateral arteries of cubital region
In the elbow complex the ulnar artery goes to the
deep head of pronator teres
In the elbow complex the median nerve goes to the
heads of pronator teres
In the elbow complex the superficial and deep radial nerves go to
supinator