MSK - Upper Limb 2 Flashcards

1
Q

what are the three parts of the hand?

A

phalanges
metacarpals
carpals

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2
Q

label the parts of the ulna

A

the suppinator attatches to the suppinator crest

anconeus attatches to roughening for acconeus

Ulna bone
1) Olecranon process
2) Trochlea notch (hosts trochlea of humerus)
3) Radial notch
4) Coronoid Process
5) Ulnar tuberosity

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3
Q

label what you can of the radius

A
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4
Q

What does the ulna articulate with?

What does the radius articulate with?

A

Trochlea of humerus - it helps you flex and extend your arm
Head of radius
Distal end of radius

Capitulum- it helps you rotate your arm
Radial notch of ulna
Distally articulates with head of ulna and carpal bones (scaphoid and lunate articular facets)

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5
Q

Which wrist bone?

A

Pisiform

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6
Q

what are the diff types of joints

A

pivot
ball and socket
hinge
condyloid
plane
saddle

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7
Q

What type of joint is the wrist joint?

A

Condyloid (Ellipsoid) synovial joint

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8
Q

Which carpal bone is most commonly fractured? - falling on hand

A

scaphoid bone - which arti ulates with the radius -

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9
Q

what movements does the ulnar and radius allow?

A

pronation
supination

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10
Q

label the different wrist joints and articular disk

A

distal radioulnar = pivot joint

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11
Q

what movements are allowed by the wrist joints and what is it

A

wrist joint = radiocarpal - is a condyloid joint

circumduction is when all 4 work together

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12
Q

What type of joint is the metacarpophalangeal joint?

A

joint between a phalanx and metacarpal is called the metacarpal phalangeal joint and it is a condyloid joint

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13
Q

What type of joint is formed between the carpal bones and metacarpals? AND THUMB?

A

Carpometacarpal plane synovial APART FROM THUMB = SADDLE

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14
Q

What joint is formed between the radius and carpal bones?
What is this joint also called?

A

Radiocarpal condyloid joint
Wrist joint

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15
Q

What are the 3 divisions of the phalanges?

A

proximal, middle and distal

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16
Q

What are the fingers called? thumb?

A

digits and the thumb is called the pollex

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17
Q

What attaches at the supinator crest of the ulnar?

A

supinator muscle

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18
Q

What is the roughening for aneconeus?

A

attachment of the aneconeus muscle

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19
Q

What is the ulnar styloid process?

A

pointed projection on lateral surface of ulnar head which allows for attachment of different ligaments

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20
Q

Which other bones does the radius articulate with?

A
  • facet for articulation with the scaphoid bone
  • facet for articulation with lunate bone
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21
Q

What happens at the radial tuberosity?

A

insertion of ligaments which support the elbow

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22
Q

How are the ulnar and the radius reinforced and held together?

A

interosseous membrane

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23
Q

What is the anular ligament?

A

strong fibers that completely encircle the head of the radius
- holds head of radius within the radial notch of the ulna

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24
Q

What is proximal to the anular ligament?

A

radioulnar joint (pivot joint)

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25
Q

What does the articular disc do?

A

fibrocartilage which divides joint into upper and lower compartments reinforcing the wrist joint with the distal radioulnar joint

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26
Q

Role of ulnar in pronation and supination

A

ulna is fixed

27
Q

What is the movement range of the wrist?

A
  • abduction and adduction
  • extension and flexion
    all of these movements come together to allow for circumduction
    4
28
Q

What are the different hand bones? and types of joints

A
  • carpometacarpal and intermetacarpal (plane synovial)
  • metacarpopharyngeal (condyloid)
  • interpharangeal (hinge)
29
Q

What is the exception in the carpometacarpal?

A

thumb which is a saddle joint instead of a plane synovial

30
Q

What are some of the ligaments in the hand reinforcing it?

A
  • palmar radiocarpal
  • dorsal radiocarpal
  • ulnar radiocollateral
  • ulnar/radial collateral ligament (prevent excessive lateral flexion)
31
Q

what is carpal tunnel syndrome

A

compression of median nerve in carpal tunnel apace due to fracture or inflammation

32
Q

What are the joints in the fingers?

A
  • metacarpophalangeal joint (MCP) = separates the metacarpal and proximal phalanx
  • proximal interphalangeal joint (PIP) = separates the proximal phalanx and middle phalanx
  • distal interphalangeal joint (DIP) = separates middle phalanx and distal phalanx
33
Q

Which movements are allowed by interphalangeal joints?

Which movements are allowed by the metapharyngeal joints?

A

flexion and extension due to hinge joint

abduction and adduction

34
Q

What are the 6 movements of the thumb? and what joints aid this

A
  1. adduction
  2. abduction
  3. flexion
  4. extension
  5. opposition
  6. reposition
    saddle joint at carpal metacarpal joint
35
Q

What are the compartments of the forearm?

A

anterior and posterior => interosseous membrane holding radius and ulnar

36
Q

What are the anterior and posterior compartments of the forearm?

A

anterior = flexor and pronators - FAP
posterior = extensor and supinators

37
Q

Which nerve mainly supplies the anterior compartment of the forearn?

A

median nerve except from the flexor carpi ulnaris and the medial two parts of flexor digitorum profundus (supplied by the ulnar nerve)

38
Q

What is the nerve supply to the posterior compartment of the forearm?

A

radial nerve

39
Q

What are the 3 layers in the anterior compartment of forearm?

A

superficial, intermediate and deep

40
Q

What are components of the superficial layer of the anterior compartment of forearm? palms protect flexion

A
  • common origin at the medial epicondyle
  • flexor carpi radialis
  • flexor carpi ulnaris
  • pronator teres (2 heads - ulnar and humeral)
  • palmaris longus
41
Q

How is the flexor carpi ulnaris innervated?

A

ulnar nerve which runs past the medial epicondyle and hooks between 2 heads of flexor carpi ulnaris

42
Q

What is involved in flexion of forearm?

What is involved in extension of forearm?

What is involved in abduction of forearm?

What is involved in adduction of forearm?

A

FCR, and FCU

ECU and ECRL and ECRB

FCR and ECRL and ECRB

FCU and ECU

43
Q

What are the components of the intermediate compartment of the forearm?

A
  • flexor digitorium superficialis (only muscle)
  • flexor retinaculum
  • flex the proximal interpharangeal joint
44
Q

What is the flexor retinaculum?

A

Is a double layer of membrane covering the carpal groove anteriorly and produces the carpal tunnel for transmission of flexor muscles and median nerve

45
Q

What are the contents of the deep layer of anterior compartment of forearm?

A
  • flexor pollicis (thumb) longus (runs all the way to distal phalanx of thumb)
  • pronator quadratus
  • flexor digitorum profundus (partially innervated by ulnar nerve)
  • flex distal interphalangeal joint
46
Q

What is the carpal tunnel?

Which bones surround the carpal tunnel?

What can bad posture cause to the wrist?

A

space between carpal bones and flexor retinaculum containing all 9 tendons

scaphoid, lunate, triquetrum and pisiform

irritate tendon = become inflamed = take up empty space m= compress median nerve = carpal tunnel syndrome

47
Q

What are the contents of the superficial layer of posterior compartment?

A

brachioradialis
- start at back of humerus and wrap around to radius again
- flex arm in neutral position

48
Q

What are the contents of the intermediate layer of posterior compartment?

A

-aconeus
- ECU
- ECRL and ECRB
- extensor digitorium
- extensor retinaculum

49
Q

What are the contents of the deep layer of posterior compartment?

A
  • supinator
  • abductor pollicus longus
  • Extensor pollicus brevis and longus
  • extensor indicis
50
Q

What is the nervous supply of the posterior forearm?

A

radial nerve => deep branch of radial nerve and superficial branch of radial nerve

51
Q

what is nervous supply to anteriror part of forearm?

A

all median nerve except for ulnar nerve flexor carpi ulnaris

52
Q

What branch does the deep branch of radial nerve give?

A

posterior interosseous nerve

53
Q

Where does the anterior interosseous nerve come from?

A

median nerve

54
Q

Blood supply of the forearm

A

brachial artery => radial artery and ulnar artery => ulnar branch divides into posterior and anterior interosseuous branch => anasthomoses of both raidal and ulnar nerve to form superifical and deep palmar branch

55
Q

label

A
56
Q

What are the thenar muscles? thumb side msucles

What is the innervation of the thenar muscle?

A

adductor pollicis (transverse and oblique head)
- flexor pollicis brevis

hypothenar is digitis
thenar is pollicisb

recurrent branch of median

57
Q

What are the hypothenar muscle?

What is the innervation of the hypothenar muscles?

A
  • flexor digiti minimi
  • opponens digiti minimi
  • abductor digit minimi

deep branch of ulnar nerve

58
Q

What intrinsic muscles of the hand?

A
  • interosseous muscle
  • lumbricals
  • palmaris brevis
  • adductor pollicis
59
Q

What are the 2 divisions of interosseous muscles?

A

dorsal interosseous muscle = abduction
palmar interosseous muscle = adduction

60
Q

What are the lumbricals?

Function of lumbricals

A

Deep 4 muscles in the palm of the hand that arise from tendons of flexor digitroum profundus

flex at MCP joint and extend DIP and PIP joints

61
Q

How are the 2 palmar arches kept separate?

A

by adductor compartment

62
Q

What is the common artery for both anasthamoses?

A

palmar digital artery which splits into proper further up

63
Q

What is the perfusion test in the hands?

A

Allen’s test = see if arteries are well perfused after cannulation