lecture 13: anterior forearm and hand Flashcards
know the elements of the radius and ulna
styloid processes heads ext
explain the projection of the styloid process of the ulna
projects from medial side (palpated medially and extends posterioly)
is the dorsal tubercle located psoterior or anterior
posterior
how many radioulnar joints are there
3
what are the 3 radioulnar jpints
proximal
middle
distal
what type of joint is the proximal radioulnar jt
synovial pivot
what makes the proximal RU jt a pivot
annular ligament
the radius or the ulna moves in supination/pronation
the radius moves reltaive to ulna
what type of joint is the middle RU jt
solid, syndesmosis (no articular cartilage)
what makes up the middle RU jt
interosseus membrane
what is the function of the interosseus membrane
keeps both shafts together under tendion
important for muscle attachments
what type of joint is the distal RU jt
synovial pivot
(doesal and ventral radioulnar lig)
where is the annular lig of the elbow found
proximal RU jt
where are the ventral and dorsal radioulnar ligaments of the elbow found
distal
what are the movements possible at the radioulnar joints
pronation and supination
know the difference btween pronation and supination
,
explain the movement of the radius during ponarion
the ulna is locked in the humerus therefore the radius rotates over the fixed ulna
(moves obliquely) so that the head of the radius moves medially)
only the BLANK moves during pronation and supination
RADIUS
explain the movement of the distal end of the radius during RU movement
only the radius moves during pronation and supination with the distal end pivoting around ulnar head
how many carpal bones
8
how many metacarpals
5
what are the bones of the palm
metacarpas
what are the aspects of the metacarpals
head body and base
where does the base of the metacarpals sit
prxomial to the carpas
phalanges make up the blank
fingers
how many phalanges are there in digets 2-5
3 (middle, distal and proximal)
how many phalanges are there in thumb
proximal and sital
how many rows of carpal bones
8 bones in two rows (proximal and distal)
what are the carpal bones in the proximal row, from lateral to medial
scaphoid
lunate
triquetrium
pisiform
which carpal bone lies most laterally
scaphoid
what are the carpal bones in the distal row from medial to lateral
hamate
capitate
trapezoid
trapezium
what carpal bone is a sesmoid bone
pisiform
what is the anatomical aspect of the hammate
hook of the hammate
what fills in the medial gap in the hand
triangular fibrocartilagenous complex TFCC
the intercarpal joints are what type
synovial, plane/gliding
what is the most common wrist injury
scaphoid fracture (FOOSH)
compromision vasculatorue
what type of joint it the wrist joint
synovial
condylloid/ellipsoidal
what are the articulations of the wrist joint
articulations between distal radius, TFCC and proximal row of carpals
the articulations of the wrist joint is between distal radius, TFCC and proximal row of carpals (all of them)
false, all except pisiform
what is the articular disk in the wrist
TFCC
TRUE OR FALSE: THERE IS no direct contact between ulna and carpal bones
true, thats why we have the TFCC
which bone artilates most with the wrist
carpal and radius
true or false: ulna has a lot of contact in the wrist joint
false, raddius
since wrist joint is condyllois that means it has what type of movement
biaxial
what are the movements possible at the wrist joint because of the condylloid joint
extension/flexion
abduction/adduction
what is another name for abduction of the wrist
radial deviation
what is another name for adduction of the wrist
ulnar deviation (toward midline)
what is the ROM in ulnar deviation greater
beacuse of the TFCC (squishy)
what are the important lkigaments at the wrist
ulnar and radial collateral ligaments
what motion fdoes the radial collateral ligament limit
ulnar deviation
what motion does the ulnar colalteral ligament limit
radial deviateion
bixai lhas motion in BLANK planes
two planes and combination
what are the intrinsic hand joints
metacarpophalangeal (MCP) joints I-V
carpometacarpal (CMC) joint 1
interphalangeal (IP) joint
carpometacarpal (CMC) joints II-V
what type of joint is the metacarpophalangeal (MCP) joints I-V
synovial. condyloid
between what two bones is the metacarpophalangeal (MCP) joints I-V
between metacaral and proximal phalanx
what type of joint is the carpometacarpal CMC joint 1
synovial saddle
between what two bones in the carpometacarpal joint 1
1st metacarpal and trapezium
what type of joint is the interphalangeal joints (IP)
synovial hunge
what are the two subsets of the IP joints
distal IP joint (DIP)
proximal IP joint (PIP)
what type of joint is the carpometacarpla CMC joints II-V
synoval, condyloid
true or false; there is limited. ovement in the carpometacarpal joints II-V
true because there are many ligaments
true or false< there are only collateral ligaments at elbow and wrist
false, also at the fingers
what joints do flexion and extension at the hand
interphalangeal joints (PIP and DIP-hinge)
also at thumb PIP
what is the motion of the metacarpophalangeal MCP joits
abduction
adduction
flexion and extension
what is the movement of the 1st carpometacarpal CMC joint (thumb)
flexion and extension (coronal plane=same plane as other fingers)
abduction and addction (out of the plane, saggital)
opposition (combining)
anterior compartment of the forearm is aka
flexor compartments
posterior compartment of the forearm is aka
extensor compartments
what general types of muscles are on the anterior comparment of the forearm
flexors and pronators of the wrist and flexors of the digits
what general types of muscles are on the posterior comparment of the forearm
extensors and supinators of the wrist and extensors of the digits
what is the anterior compartment/flexor compartment innervated by
medial and ulnar nerves
what is the posterior compartment/extensor compartment innervated by
radial n (deep branch)
why is the flexor compartment so much larger than the extensor compartment in the forearm
beacuse functionally flexing the digits for hanging onto things is more evolutionarry important
what are the pronators of the forearm
pronator teres
pronator quadratus
what is the origin of the pronator teres
medial epicondyle of the humerus
what is the insertion of the pronator teres
proximal radius (lateral)
what is the function of the pronator teres
pronation
what is the origin of the pronator quadratus
distal ulna
what is the isnertion of the pronator quadratus
distal radius
what is the motion of the pronation
rotation of the radius at the humeroradial and radioulnar joints, radius crosses over ulna
pronator teres is located in what layer
superficial laye
pronator quadratus is located in what layer
deepest layer
true or false: pronator quadratus is located in the superficial layer
false, deepest
what are the supinators of the forearm
biceps brachii and supinator
what muscle is the primary suppinator
biceps brachii
explain biceps brachii and how it is a supinator of the foream
supragelnoid tubercle (long) and coracoid process (short) to the radial tuberocity
primary fucntion, strong supinator especially with elbow at 90 degrees)
what two muslces make a v and aid in supination and pronation
supinator and pronateor teres
explain motion of ulna during supination
rotation of the radius @ humeroradial and radioulnar joints, radius uncrosses back over the ulna to become parallel to it
what is the origin of the supinator
lateral epicondyle of the humerus and proximal ulna
what is the insertion of the supinator
;proximal radius (lateral) posterior compartment muscles
how many muscles are ther ein the superficial layert os the anterior compartment of the forarm
4
what are the 4 muscles of the superficial layer of the anterior forearm
pronator teres
flexor carpi radialis
palmaris longus
flexor carpi ulnaris
arrange these muscles from lateral to medial
pronator teres
flexor carpi radialis
palmaris longus
flexor carpi ulnaris
pronator teres
flexor carpi radialis
palmaris longus
flexor carpi ulnaris
what it the shared origin/common attachement of the 4 muscles of the superficial muscle of the anterior compartment of the forearm
medial humeral epicondylu
what is the origin of the pronator teres
medial humeral epicondule
what is the insertion of the pronator teres
distal attachement at the radius
what is the function of the pronator teres
pronation
which muscle of the supercfical layer of the anterior comparement of forearm is most lateral
pronator teres
what is the origin of the flexor carpi radialis
medial humeral epicondyle
what is the insertion of the flexor carpi radialis
MC II and III
what is the function of the flexor carpi radialis
flexion and abduction (radial devation) of the carpus/wrist
what is the origin of the palmaris longus
medial humeral epicondyle
what is the insertion of the palmaris longus
palmar apioneurosis
what is the function of the palmaris longus
weak wrist flexion (absent in 3%-60% of indivualsO)
what is the origin of the flexor carpis ulnaris
medial humeral epicondyle
what is the insertion of the flexor carpis ulnaris
pisiform, hamate and MC V
what is the function of the flexor carpis ulnaris
flexion and adduction (ulnar deviation) of tje wrist
what is the most medial muscle of the superficial layer of anterior compartment of the forearm
flexor carpi ulnaris
how many muscles of the intermediate layer of the anterior compartment of the forearm
1
what muscle makes up the intermediate layer of the anterior compartment of thje forearm
flexor digitorem superficialis (FDS)
true or false, the flexor digi superficialis has 2 heads
yes, two heads that split into 4 tendons
the two heads of the flexor digitorem superficialis split into how many tendons
4
what is the origin of the flexor digitorem supericialis (FDS)
medial epicondyle and coronoid process of ulna (humeroulnar head) and proximal half of the anterior surface of radius (radial head)
what is the insertion of the flexor digitorem supericialis (FDS)
via four tendons onto the sides of the middle phalantages of digits II to V
true or false, flexor digi superficialis extends all the way to the distal phalanges
false, middle
what is the function of the flexor digitorem supericialis (FDS)
flexion of wrist, MCP and PIP joints of digits II-V (no thumb or DIP)
what happens to the flexor digi superificalis tendon when it reaches the middle phalanx
splits into two divisions
where does the flexor digitorem superficialis not act op
the thumb or the DIP
how many muscles makei up the deepest layer of the anterior compartment of the forearm
3
what are the muscles of the deepest layer of the anterior forearm
flexor pollicus longus (FPL)
flexor digi profundus (FDP)
pronator quadratus
what is the orogin of the flexor pollicis longus (FPL)
radius, interosseus membrane
what is the insertion of the flexor pollicis longus (FPL)
distal phalanx of digit 1 (thumb)
what is the function of the flexor pollicis longus (FPL)
flexion of the wrist and joints of the thumb
what is the oringin of the flexor digitorem profundus (FDP)
ulna and interosseus membrane
what is the insertion of the flexor digitorem profundus (FDP)
base of distal phalanx of digits II to V
what is the function of the flexor digitorem profundus (FDP)
flexion of the wrist, MCP joints, PIP and DIP joints of digits II to V
true or false: flexor digitorem profundus (FDP) acts on PIP and DIP joints
true
why does the flexor digitorem superifialis split into t2
so that the flexor digi profundus tendon passes thorugh it
pronator quadratus lies deep to what
flexor digitorem profundus and flexor pollics longus