MSK Nuggets Flashcards

1
Q

What are the trunks of the brachial plexus?

A

Superior

Middle

Inferior

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2
Q

What are the cords of the brachial plexus?

A

Lateral

Posterior

Medial

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3
Q

What important nerve is formed by the lateral cord?

A

Musculocutaneous

Others include:

Lateral pectoral

Lateral root of median nerve

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4
Q

What important nerves are formed by the posterior cord?

A

Axillary

Radial

(others include thoracodorsal nerve, upper and lower subscapular nerve

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5
Q

What important nerve is formed by the medial cord?

A

Ulnar nerve

Others include: Medial pectoral, median root of median nerve, median curaneous nerve of arm, median cutaneous nerve of forearm

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6
Q

What nerve is formed by the combination of the lateral and medial cords?

A

Median nerve

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7
Q

At what anotomical landpoint does the axillary artery begin?

A

The lateral border of the first rib

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8
Q

When does the axillary artery become the brachial artery?

A

Lower border of teres major

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9
Q

What trunk is affected in erbs palsy?

A

Upper trunk

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10
Q

What are the features of erbs palsy?

A

Waiter’s tip appearance

Nerves affected = musculocutaneous, radial and axillary

Musculocuteneous = affects biceps, brachialis and coracobrachialis

Brachoradialis (radial nerve)

Deltoid through axillary nerve

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11
Q

What is damage to the lower trunk called?

A

Klumpkes palsy

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12
Q

What are the features of klumpkes palsy?

A

Muscles affected = intrinsic muscles of the hand and ulnar felxors of the wrist and fingers

Cause of injury = undue abduntion of the arm

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13
Q

What are the branches of the brachial artery?

A

Superior ulnar collateral artery

Radial artery (this then gives of the ulnar artery)

Deep brachial

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14
Q

Which veins arise from the dorsal venous arch?

A

Basilic cephalic

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15
Q

Where does the median cubital vein allow shunting or blood?

A

Allows the shunting of blood from the cephalic vein to the basillic vein

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16
Q

What are the 5 groups of axillary lymph nodes?

A

Anterior

Posterior

Apical

Central

Lateral

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17
Q

To which group of lymph nodes do the following conditions spread?

A

Infection on the little finger = axillary

Boil in the scapular region = axillary

Medial part of the breast = internal thoracic

Lateral part of the breast = axillary

Infection around the umbilicus = Parasternal lymph nodes drain deep structures of the anterior abdominal wall above the level of the umbilicus. Below the level of umbilicus is supplie by the superficial inguinal nodes.

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18
Q

What is the function of the conoid ligament?

A

It binds the clavicle to the coracoid process of the scapula

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19
Q

Where is the clavicle most likely to break?

A

The junction between the medial two thirds and the lateral third.

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20
Q

Which muscles are responsible for elevation of the scapula?

A

Upper fibres of trapezius

Levator scapulae

Rhomboids

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21
Q

What are the muscles responsible for depression of the scapula?

A

Latissimus dorsi

Gravity

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22
Q

What muscles are resonsible for protraction of the scapula?

A

Serratus anterior

Pectoralis major

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23
Q

Which muscles are responsible for retraction of the scapula?

A

Trapezius (middle fibres)

Rhomboids

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24
Q

Which muscles are repsonsible for lateral rotation?

A

Serratus anterior

Upper fibres of trapezius

Lower fibres of trapezius

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25
Q

What muscles are responsible for medial rotation: depressing the glenoid cavity

A

Gravity

Levator scapulae and the rhomboids

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26
Q

What is this ligament?

A

Trapezoid ligament

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27
Q

What is this ligament?

A

Acromioclavicular

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28
Q

What is this ligament?

A

Transverse humeral ligament

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29
Q

What is this ligament?

A

Coracohumeral ligament

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30
Q

What is this ligament?

A

Conoid ligament

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31
Q

What is this ligament?

A

Superior transverse scapular ligament

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32
Q

What ligament prevents superior dislocation of the humeral head?

A

Coracoacromial ligament

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33
Q

Which part of the shouler capsule is the weakest?

A

Inferior portion

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34
Q

Which bursa communicates with the joint cavity?

A

Subscapular

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35
Q

Which bursa articulates with the joint cavity

A

Subscapular

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36
Q

What is the role of the subacromial bursa?

A

Decreases friction and allows free motion of the rotator cuff relative to the coracoacromial arch and deltoid muscle

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37
Q

What common sporting injury damages the subacromial bursa?

A

Throwing

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38
Q

What are the actions of the subscapularis?

A

Internal rotation and extension of the arm

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39
Q

What are the actions of the supraspinatous?

A

Abduction of the arm

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40
Q

What are the actions of the infraspinatous?

A

External rotation of the arm

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41
Q

What are the actions of teres minor?

A

External rotation and adduction of the arm

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42
Q

What movements of the glenohumeral joint are generated by the rotator cuff?

A

Abduction and adduction

Internal and external rotation

Their main function is to maintain joint stability

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43
Q

What are the movements of the deltoid?

A

Anterior fibres = flexion and internal rotation

Middle fibres = abduction

Posterior fibres = extension and external rotation

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44
Q

What nerve supplies the deltoid?

A

Axillary nerve

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45
Q

What injury results in trapping and damage of the axillary nerve?

A

Fracture of the surgical neck of the humerus

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46
Q

What are the actions of the pec muscles on the shoulder?

A

Internal rotation

adduction

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47
Q

What is the nerve supply of seratus anterior?

A

Long thoracic nerve

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48
Q

What clinical sign is seen when this nerve is injured?

A

Winged scapula

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49
Q

During what procedure is the long thoracic nerve commonly injured?

A

Removal of axillary lymph nodes

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50
Q

What are the actions the trapezius has on the scapula?

A

Superior fibres = elevating the sacpula

Middle fibres = retracting the scapula

Inferior fibres = depressing the scapula

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51
Q

Which nerve supplies the trapezius muscle?

A

Accessory nerve (cranial nerve)

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52
Q

What are the actions of teres major on the shoulder?

A

Internal rotation

Extension

Adduction

(These are also the actions of latissimus dorsi on the shoulder joint)

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53
Q

What muscles are responsible for flexion of the shoulder?

A

Anterior deltoid

Upper part of pectoralis major

Coracobrachialis

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54
Q

What muscles are responsible for extension of the shoulder?

A

Posterior deltoid

Latissiums dorsi

Teres major

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55
Q

What muscles are responsible for adduction of the shoulder?

A

Lower part of pec major

Lat dorsi

Teres major

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56
Q

Which muscles are responsible for abduction of the shoulder?

A

Middle part of the deltoid

Supraspinatous

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57
Q

What muscles are responsible for medial or itnernal rotation?

A

Subscapularis

Latissimus dorsi

Teres major

Pectoralis major

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58
Q

What are the muscles responsible for lateral or external rotation?

A

Teres minor and infraspinatous

Posteroir deltoid

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59
Q

What muscles attach to the greater tubercule and the lesser tubercule o the humerus?

A

Greater tubercule = teres minor, infraspinatous, supraspinatous

Lesser tubercule = subscapularis

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60
Q

What is the highlighted part of the bone?

A

Trochlea

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61
Q

What is the highlighted part of the bone?

A

Capitulum

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62
Q

What is the highlighted part of the bone?

A

Coronoid fossa

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63
Q

What is the highlighted part of the bone?

A

Radial fossa

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64
Q

What is the highlighted part of the bone?

A

Olecranon fossa

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65
Q

What is the highlighted part of the bone?

A

Groove for radial nerve

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66
Q

What is the highlighted part of the bone?

A

Lesser tubercule of humerus

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67
Q

What is the highlighted part of the bone?

A

Greater tubercule

68
Q

What is the highlighted part of the bone?

A

Surgical neck of humerus

69
Q

What is the highlighted part of the bone?

A

Anotomical neck of humerus

70
Q

What is the origin of the short head of the bicep?

A

Coracoid process

71
Q

What is the origin of the long head of the bicep?

A

Supragleoid tubercule

72
Q

Where is the insertion of the biceps tendon?

A

Radial tuberosity

73
Q

What is the action of the biceps on the radioulnar joint?

A

Suppination

74
Q

What is the nerve supply to the biceps?

A

Musculocutaneous nerve

75
Q

Which cervical segments are mainly responsible for innervating the biceps brachii muscle?

A

C-5,6,7

76
Q

Which cord of the brachial plexus does the musculocuteneous nerve arise from?

A

Lateral cord

77
Q

What is the origin and insertion of the coracobrachialis?

A

Origin = coracoid process

Insertion = upper one third of frontal humerus

78
Q

What are the actions of the coracobrachialis?

A

Flexion, adduction and internal rotation

79
Q

What is the nerve supply of the coracobrachialis?

A

Musculocutaneous

80
Q

What is the origin and insertion of the brachialis?

A

Origin = distal half of the shaft of the humerus

Insertion = coronoid process of ulna

81
Q

Which nerve supplies the brachialis muscle?

A

Musculocutaneous nerve

82
Q

How does the musculocutaneous nerve enter the arm?

A

Enters the arm by penetrating the coracobrachialis

83
Q

What does the musculocutaneous nerve continue as?

A

Lateral cutaneous nerve of the forearm

84
Q

Segmental root value for musculocutaneous nerve

A

c5,c6,c7

85
Q

Which artery gives of the profunda brachii?

A

Brachial artery

86
Q

How is the median nerve formed?

A

Formed by two roots

One by the medial cord

One from the lateral cord

87
Q

What does the medial nerve supply?

A

Medial nerve supplies flexor muscles of the forearm as well as skin of the radial half of the palm and lateral digits

88
Q

What muscles does the median nerve supply?

A

Superficial layer = pronator teres, flexor carpi radialis and palmaris longus

Intermediate layer = flexor digitorum superficialis

89
Q

Which cord of the brachial plexus does the ulnar neve arise from?

A

It arises from the medial cord

90
Q

What does the ulnar nerve supply?

A

Ulnar nerve supplies the flexor carpi ulnaris

Flexor digitorum profundus (medial half)

Supplies the skin of the medial wrist hands and digits

91
Q

Which fracture of the humerus can cause damage to the :

  1. radial nerve
  2. ulnar nerve
  3. axillary nerve
A
  1. radial groove
  2. medial epicondyle
  3. surgical neck
92
Q

What are the borders of the cubital fossa?

A

Medial border = lateral border of pronator teres

Lateral border = medial border of brachoradialis

93
Q

What are the insertions of the triceps heads?

A

Long head of triceps originates at the infraglenoid tubercule

Lateral head of the triceps originates at posterolateral humerus

They insert at the olecranon process of the ulna

94
Q

What is the action of the anconeus muscle?

A

Extension

95
Q

What is the nerve supply to the anconeus and triceps?

A

Radial nerve

96
Q

Wihch artery does the radial artery travel with?

A

Profunda brachii

97
Q

What is the root value of the radial nerve?

A

C5 - T1

98
Q

What is the characteristic sign of radial nerve damage?

A

Wrist drop, patient cannot extend elbow

99
Q

What is the ligament

A

annular ligament

100
Q

What is the ligament?

A

Radial collateral ligament of elbow joint

101
Q

What is the ligament?

A

Ulnar colalteral ligament of elbow joint

102
Q

What muscles are involved in supination?

A

Biceps brachii

Supinator

103
Q

What muscles are responsible for pronation?

A

Pronator teres

Pronator quadratus

104
Q

What are other muscles that assist during supination?

A

Extensor pollicis longus and extensor carpi radialis longus

105
Q

What other muscles are also associated with pronation

A

Flexor carpi radialis

Palmaris longus

Brachioradialis

106
Q

The subacromial bursa is closely related to which muscle?

A

Supraspinatous

107
Q

What are the muscles of the superficial group of the anterior forearm?

A

Pronator teres, flexor carpi radialis, palmaris longus and flexor carpi ulnaris

108
Q

What is the origin of the muscles of the anterior compartment of the arm (superficial group)?

A

Common flexor tendon attaches to the medial epicondyle

109
Q

What is the innnervation of the superficial group of muscles in the anterior compartment?

A

pronator teres, flexor carpi radialis and palmaris longus are supplied by the median nerve

The flexor carpi ulnaris is supplied by the ulnar nerve

110
Q

What muscle is associated with adduction of the wrist?

A

flexor carpi ulnaris

111
Q

What muscle is associated with abduction of the wrist?

A

Flexor carpi radialis

112
Q

What is the action of the brachioradialis?

A

The brachioradialis is a muscle of the forearm that flexes the forearm at the elbow. It is also capable of both pronation and supination, depending on the position of the forearm.

113
Q

Which nerve innervates the brachioradialis?

A

The radial nerve

114
Q

What are the insertions of the flexor digitorum superficialis?

A

They insert on the middle phalanx of the 2nd-5th digits. They cannot act on the distal interphalngeal joint because that is where the flexor digitorum profundus acts

115
Q

What nerve innervates the flexor digitorum superficialis?

A

Median nerve

116
Q

What is the nerve supply of the flexor digitorum profundus?

A

Medial half = ulnar nerve

Lateral half = median nerve

117
Q

Which bone is the flexor pollicis longus closely related to?

A

Radius

118
Q

What is the nerve supply of the flexor pollicis longus?

A

Median nerve

119
Q

What is the action and neve supply of pronator quadratus?

A

Pronation, median nerve

120
Q

Which muscles in the anterior forearm are not supplied by the median nerve?

A

Flexor carpi ulnaris (ulnar nerve)

Medial half of FDP

The brachioradialis is also suppluied by the radial nerve but I think this is in the extensor compartment (even though it is itself a flexor)

121
Q

What structure does the median nerve pass underneath to enter the hand?

A

It enters the hand by passing underneath the flexor retinaculum

122
Q

The ulnar nerve is ………….. to the ulnar artery?

A

Medial

123
Q

Can you feal the ulnar artery pulse?

A

No - it ies underneath te flexor carpi ulnaris

124
Q

What are the two terminal branches of the brachial artery?

A

Ulnar artery

Radial artery

125
Q

Which part of the radius is assocaited with the division of the brachial artery?

A

Neck of the radius

126
Q

What are the contents of the carpal tunnel?

A

Median nerve

4 tendons of flexro digitorum profundus

4 tendons of flexor digitorum superficialis

1 tendon of flexor pollicis longus

127
Q

What are the three muscles that make up the thenar eminence?

A

Abductor pollicis brevis

Flexor pollicis brevis

Opponens pollicis

128
Q

Which nerve innervates the muscles of the thenar eminence?

A

Median nerve

129
Q

Which segmental levels of the brachial plexus are responsible for innervating the median nerve?

A

C6 - T1 (contains some fibres from C5 in some individuals)

130
Q

What muscles make up the hypothenar eminence?

A

Abductor digiti minimi

Flexor digiti minimi

Opponenes digiti minimi

131
Q

Which nerve innervates the hypothenar eminence?

A

Ulnar nerve

132
Q

What muscles are the adductor pollicis muscles?

A

Adductor pollicis transverse

Adductor pollicis oblique

133
Q

What nerve supplies the adductor muscles?

A

Ulnar nerve

134
Q

What is the action of the adductor pollicis muscles?

A

Adduction of the carpometacarpal joints

Flexion of the metacarophalyngeal joints

135
Q

From which long flexor tendons do these lumbricals originate?

A

Tendon of flexor digitorum profundus

136
Q

What is the nerve supply of the lumbricals?

A

Medial two lumbricals are supplied by ulnar nerve

Lateral two are supplied by the median nerve

137
Q

What is the action of the lumbricals?

A

flex the metacarpophalangeal joints while extending both interphalangeal joints of the 2nd - 5th digit

138
Q

How many interossei are there?

A

4 dorsal

3 palmar

139
Q

What is the action of the interossei?

A

DAB

PAD

Dorsal = abduct the fingers

Palmar = adduct the fingers

140
Q

Which nerve supplies the interossei muscles?

A

The ulnar nerve

141
Q

Lesion of which trunk causes affects the interossei of the hand?

A

Inferior trunk

142
Q

Which arteries are the main contributors for the palmar arches?

A

Superficial palmar arch = ulnar artery

Deep palmar arch = radial artery

143
Q

Which muscles of the hand are supplied by the median nerve?

A

All the muscles in the hand are supplied by the ulnar nerve apart from the thenar muscles and the 1st and 2nd lumbricals which are supplied by the median nerve.

144
Q

Dermatomes of the hand

A
145
Q

What type of joint is the wrist?

A

It is described as a synovial condyloid joint or ellipsoid

146
Q

What makes up the proximal part of the wrist joint?

A

Radius and articualr disk

147
Q

Which carpal bones make up the distal part of the wrist?

A

Scaphoid, lunate and triquetral

148
Q

What movements are possible at the wrist joint?

A

Flexion

Extension

Circumduction

Abduction

Adduction

149
Q

What is the action of the extensor carpi radialis longus and brevis on the wrist joint?

A
150
Q

Which muscles are responsible for extending the wrist as well as adducting/abducting it?

A

Extensors = Extensor carpi radialis (longus and brevis) - these are also abductors

Extensor carpi ulnaris - this is an extensor as well as an ulnar deviator (adduction)

151
Q

What are the muscles that extend the medial four digits

A

Extensor digitorum

Extensor indicis

Extensor digiti minimi

152
Q

What structure does the extensor digitorum pass underneath?

A

The extensor retinaculum

153
Q

What are the muscles that extend or abduct the thumb?

A

Abductor pollicis longus

Extensor pollicis brevis

Extensor pollicis longus

154
Q

Which nerve innervates all the muscles of the posterior compartment of the forearm

A

Radial nerve

155
Q

What is the nerve supply of the supinator?

A

Radial nerve

156
Q

The radial nerve splits into the superficial and deep branches in the cubital fossa. What is the deep branch of the radial nerve called? and what does the superficial branch supply?

A

Deep branch is called the posterior interosseous nerve. The superficial branch is sensory and is distributed to the dorsum of the hand.

157
Q

Which fracture of the distal radius resembles a dinner fork?

A

Colles fracture

158
Q

What are the tendons responsible for forming the anotomical snuffbox?

A

Laterally = tendon abductor pollicis longus and extensor pollicis brevis

Medially = Extensor pollicis longus

159
Q

Which two bones can you feel in the anotomical snuffbox

A

Scaphoid and trapezium

160
Q

Which artery lies on the floor of the snuffbox?

A

Radial artery

(Cephalic vein

Radial nerve)

161
Q
A
162
Q
A
163
Q

What is the nerve that supplies the APL, EPL, EPB?

A

Radial nerve

164
Q

What are the main actions of the EPL, EPB and the APL?

A

Extensor pollicis longus = extension of the caropmetacarpal joint, extension of the metacarpophalyngeal joint extension of the interphalyngeal joint

Extensor pollicis brevis = extension of the caropmetacarpal joint, extension of the metacarpophalyngeal joint

Abductor pollicis longus = abduction of the radiocarpal joint and carpometacarpal joint of the first digit

165
Q

Which two muscles attach to the extensor expansion?

A

Interossei and lumbricals

166
Q

What is the action of the lumbricals?

A

Flexion at the MP joint and extension at IP joint

167
Q
A