Lecture 23 - Forearm and Hand Flashcards

1
Q

Forearm is

A

between elbow joint and wrist joint

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2
Q

Hand is

A

from wrist joint onwards

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3
Q

Elbow joint is a

A

synovial hinge joint

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4
Q

Function of elbow

A

forearm flexion and extension (i.e. the movements involved in a bicep curl)

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5
Q

Elbow joint is made of 3 different bones…

A

Humerus
Ulna
Radius

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6
Q

Coronoid process

A

on the ulna for brachialis

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7
Q

Radial tuberosity

A

on radius for biceps brachii

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8
Q

Anatomical postion - order of the forearm bones

A

Radius, Ulna, Middle (RUM)

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9
Q

Proximal radio-ulnar joint is a

A

synovial pivot joint

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10
Q

Pivot joint

A

Uniaxial

A rounded process of bone fits into a bony ligamentour socket, permitting rotation

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11
Q

Nerve behind medial epicondyle of humerus =

A

ulnar nerve

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12
Q

Capitulum

A

more rounded structure

on the lateral side of the humerus

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13
Q

Trochlear notch

A
of ulna 
pulley 
more 'w' in shape
medial 
fits the trochlea of the humerus
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14
Q

Radial notch

A

of ulnar
part of the ulnar
bit concave to accomodate for radius

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15
Q

Radio-ulnar joints are between

A

radius and ulnar

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16
Q

Proximal radioulnar joint and ligaments

A

Ligaments aid stability

Anular ligament
• Laxity in childhood
• Yanking movements can dislocate the radius
  • Potential damage to ligament
• aka Nursemaid’s elbow
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17
Q

Anular ligament

A

Anular ligament
• Laxity in childhood - so need to take care and be careful with childrens arms and pulling on them with a large amount of force
• Yanking movements can dislocate the radius - head of radius comes off ligament
• Potential damage to ligament
• aka Nursemaid’s elbow

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18
Q

distal radioulnar joint is a

A

synovial pivot joint

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19
Q

Distal radioulnar joint

A
  • For pronation and supination

* Has an articular disc to allow twisting of joint capsule during pronation

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20
Q

Pronation in terms of radius

A

only the radius moves in pronation, croses over the ulna

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21
Q

Supination in terms of radius

A

radius and ulna parallel to one another

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22
Q

Pronation and supination happens

A

at the radiuolnar joints (have proximal and distal ones)

distal radioulnar joint has a disc to attach to ulna (articular disc is made up of fibrocartilage)

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23
Q

Cubital fossa is a triangular space bordered by…

A

Pronator teres
Brachioradialis
Epicondyles

^ think of triangle opposite to this i.e. with base up
base is lateral epicondyle ——medial epicondyle
Left border is brachioradialis (more lateral)
RIght border is pronator teres (more medial)

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24
Q

Nearby structures to cubital fossa

A
Brachialis 
Biceps brachii 
Median cubital vein 
Brachial artery 
Median nerve
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25
Q

Median cubital veins connects

A

the cephalic vein and the basilic vein

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26
Q

Forearm muscles - pronators for pronation

A

pronator teres

pronator quadratus

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27
Q

Forearm muscles - supinators for supination

A

Biceps brachii

Supinator (on lateral side)

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28
Q

pronator teres

A

quite superficial
pronator
part of cubital fossa
anterior

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29
Q

pronator quadratus

A

deep
pronator
anterior

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30
Q

Forearm muscles - anterior compartment movement

A

Flexors are in the anterior compartment

31
Q

Forearm muscles - posterior compartment movement

A

Extensors are in the posterior compartment

32
Q

Forearm muscles useful for

A

Useful for control and forceful movements of the wrist and hand. e.g., grip, lifting, writing, grabbing, etc

33
Q

extension of hand =

A

pointing hand up towards face

34
Q

flexion of hand =

A

pointing hand down away from face

35
Q

Forearm muscles and tendons

A

muscle bellies are in the forearm and the tendons extend to the digits

36
Q

Flexor retinaculum

A

Median nerve under here
anterior
compression of median nerve = carpal tunnel syndrome

37
Q

Extensor retinaculum

A

posterior

38
Q

Forearm arteries

A
  • Brachial artery divides into radial and ulnary arteries
  • As the names suggest, radial artery runs along the radius, and ulnar artery runs along the ulna
  • Pulse can easily be palpated in distal radial artery

radial and ulna artery empty into the superior and deep palmar arch

39
Q

Innervation of anterior forearm muscles

A

median nerve supplies most of the forearm muscles, ulnar nerve supplies some of the forearm muscles

40
Q

Innervation of posterior forearm muscles

A

radial nerve

41
Q

Innervation of posterior hand muscles

A

none as there are non muscles on the posterior hand

42
Q

Anterior hand and nerves

A

Most muscles =ulnar

some muscles= median

43
Q

Anterior forearm and nerves

A

Most muscles = median

some muscles = ulnar

44
Q

Location of the biceps tendon

A

Biceps tendon in groove between the greater and lesser tubercle of the humerus

45
Q

Wrist =

A

radiocarpal joint

46
Q

What does the articular disc do ?

A

Articular disc does not allow the ulna to come in contact with the carpal

47
Q

Wrist joint is an

A

ellipsoid (condyloid) synovial joint

48
Q

Wrist joint is between

A

between radius and proximal carpals

49
Q

Movements of wrist

A
flexion 
extension 
adduction 
abduction 
circumduction
50
Q

Carpometacarpal joint =

A

between carpal and metacarpal

51
Q

Metacarpophalangeal joint =

A

between metacarpal and phalanges

52
Q

Interphalangeal joint =

A

between phalanges

53
Q

Intercarpal joints are

A

synovial plane joints

54
Q

Carpal tunnel

A

The carpal tunnel is a narrow passageway surrounded by bones and ligaments on the palm side of your hand. When the median nerve is compressed, the symptoms can include numbness, tingling and weakness in the hand and arm.

The flexor retinaculum is a fibrous connective tissue band that forms the anterior roof of the carpal tunnel.

Narrow space so not a lot of movement
there are ten different tendons that go through here as well as the median nerve

55
Q

Hand bony features

A

metacarpals

phalanges

56
Q

Function of the hand

A
  • Manipulation
  • Sensation
    • Interaction with environment
  • Joints within hands are synovial joints
57
Q

Movement of interphalangeal joints

A

flexion and extension

58
Q

Movement of metacarpo-phalangeal joints

A

flexion, extension
abduction, adduction
circumduction

59
Q

abduction in hands =

A

spreading fingers

60
Q

carpometacarpal joint 1 movement

A

joint at thumb, more flexible
important for opposition (and subsequent reposition which is going back to a flat hand)
flexion and extension of thumb (extension is moving out in coronal plane, flexion is bring in like when you show four fingers on your hand)
abduction and adduction of thumb (abd = moving out in sagittal plane)

61
Q

Carpometacarpal joints 2-5 movement

A

minimal movement possible

62
Q

Arterial supply to hand

A

Radial and ulnar arteries form superficial and deep palmar arches in the hand

superficial = digits 
deep = thumb
63
Q

Venous supply to hand

A

the dorsal side of the hand has the dorsal venous network/arch

cephalic vein originates on the lateral side

basilic vein originates from the medial side

64
Q

Innervation of anterior muscles of the hand

A

median nerve supplies some hand muscles

ulnar nerve supplies most hand muscles

65
Q

innervation of the posterior muscles of the hand

A

no posterior hand muscles so no need for innervation by nerves

66
Q

Intrinsic hand muscles functions

A

small so do not generate as much force

for fine motor movements such as writing and clay making

67
Q

Intrinsic hand muscles

A

Thenar and hypothenar

Interossei

68
Q

Thenar and hypothenar muscles are for

A

thumb and digit 5 movements

used in grips, precise movement and control of the digits

intrinsic hand muscles

69
Q

Thenar and median nerve

A

supplied by median nerve so carpel tunnel sundrome affects thumb movement

70
Q

thenar movement of

A

thumb

71
Q

hypothenar movement of

A

digit 5 (pinky finger)

72
Q

Interossei muscles are for

A

digits abduction and adduction

intrinsic hand muscles

located between the metacarpals
palmar interossei = attaches more on medial side, PADduciton
Dorsal interossei = attaches more on lateral side, DABduction

73
Q

palmar interossei

A

palmar interossei = attaches more on medial side, PADduciton

74
Q

dorsal interossei

A

Dorsal interossei = attaches more on lateral side, DABduction