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GROSS ANATOMY > Muscles And Fasciae Of The Upper Limb part 2 > Flashcards

Muscles And Fasciae Of The Upper Limb part 2 Flashcards

1
Q

The superior aspect of the arm communicates medially with the __.

A

Axilla

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2
Q

Inferiorly, a number of important structures pass between the arm and the forearm through the __, which is positioned anterior to the elbow joint.

A

Cubital fossa

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3
Q

The MUSCLES OF THE ARM are divided into two compartments by:

A

Anterior compartment

Posterior compartment

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4
Q

The __ contains muscles that predominantly flex the elbow joint.

A

Anterior compartment

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5
Q

The __ contains muscles that extend the joint.

A

Posterior compartment

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6
Q

3 muscles of the ANTERIOR COMPARTMENT (of the arm)

A

▪ Coracobrachialis
▪ Brachialis
▪ Biceps brachii - which are innervated predominantly by the musculocutaneous
nerve.

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7
Q

ORIGIN OF THE CORACOBRACHIALIS

A

Medial side of the midshaft of the humerus

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8
Q

INSERTION OF THE CORACOBRACHIALIS

A

Tip of the coracoid process of the scapula

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9
Q

INNERVATION OF THE CORACOBRACHIALIS

A

Musculocutaneous nerve Action: o flexes

the arm

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10
Q

Clinical: CORACOBRACHIALIS

A

Since the Musculocutaneous Nerve runs through the Coracobrachialis muscle, it is vulnerable to nerve compression within the muscle and this can lead to weakness of elbow flexion (loss of some Brachialis and biceps function) and
Hypesthesia of lateral forearm.

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11
Q

ORIGIN (Proximal) OF THE BICEPS BRACHII

A

o Short head - Coracoid process.
o Long head –Supraglenoid tubercle of scapula.
o The tendon of the long head passes through the
glenohumeral joint superior to the humeral
head, then passes through the intertubercular
sulcus and enters the arm.
o In the arm, the tendon joins with its muscle belly
and, together with the muscle belly of the short
head, overlies the brachialis muscle.

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12
Q

INSERTION (Distal) OF THE BICEPS BRACHII

A

o The long and short heads converge to form a single tendon, which inserts onto the radial
tuberosity.
o Comment: As its name implies, the biceps is a
fusiform muscle that has 2 heads.
o As the tendon enters the forearm, a flat sheet of connective tissue (bicipital aponeurosis) fans out from the medial side of the tendon to blend with deep fascia covering the anterior
compartment of the forearm.

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13
Q

ACTION OF THE BICEPS BRACHII

A

Flexor of the forearm at the elbow joint.

Most powerful supinator of the forearm when the elbow joint is flexed.

Because the two head cross the glenohumeral joint, it can also flex the glenohumeral joint.

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14
Q

INNERVATION OF THE BICEPS BRACHII

A

▪ Musculocutaneous nerve (C5 & C6)

▪ A ‘Tap’ on the tendon of Biceps brachii at the elbow tests predominantly spinal cord segment C6

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15
Q

IN THE CLINIC OF THE BICEPS BRACHII

A

▪ Rupture of the Biceps tendon
o The tendon that most commonly ruptures is the tendon of the long head of the biceps brachii muscle.
o In isolation, this has relatively little effect on the upper limb.
o There is an extremely prominent bulge of the muscle belly as its unrestrained fibers contract the ‘POPEYE’ sign.

▪ Treatment consists of primary repair in proximal rupture or reattachment of the tendon to the bone in case of distal rupture.

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16
Q

ORIGIN (Proximal) OF THE BRACHIALIS

A

▪ Distal half of the anterior aspect of the humerous.

▪ Adjacent parts of the intermuscular septa, particularly on the medial side.

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17
Q

INSERTION (Distal) OF THE BRACHIALIS

A

▪ It lies beneath the biceps brachii muscle, is flattened dorsoventrally, and converges to form a tendon, which attaches to the tuberosity of the ulna.

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18
Q

ACTION OF THE BRACHIALIS

A

▪ Flexes the forearm at the elbow joint.

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19
Q

INNERVATION OF THE BRACHIALIS

A

▪ Predominantly by the Musculocutaneous nerve (C5 & C6).

▪ Small component of the lateral part is innervated by the radial nerve (C7).

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20
Q

Clinical OF THE BRACHIALIS

A

Damage to the musculocutaneous nerve proximal to the Brachialis (compression injury as it passes through the Coracobrachialis muscle) can lead to weakness in the brachialis & Biceps brachii muscles, thus affecting elbow flexion.

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21
Q

The only muscle of the posterior compartment of the arm is the __.

A

Triceps brachii muscle

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22
Q

ORIGIN OF THE TRICEPS BRACHII

A

▪ Long head - Infraglenoid tubercle of the scapula
▪ Medial head - extensive area on the shaft of the humerus inferior to the radial groove
▪ Lateral head - linear roughening superior to the radial groove of the humerus

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23
Q

INSERTION OF THE TRICEPS BRACHII

A

▪ 3 heads converge to form a large tendon, which inserts on the superior surface of the olecranon of the ulna.

The anconeus inserts into the lateral aspect of the olecranon and into the upper dorsal surface of the body of the ulna.

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24
Q

INNERVATION OF THE TRICEPS BRACHII

A

▪ Branches of the Radial nerve [C6, C7, C8] A ‘tap’ on the tendon of triceps tests predominantly spinal cord segment C7

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25
Q

ACTION OF THE TRICEPS BRACHII

A

▪ Extension of the forearm at the elbow joint

▪ Long head can also extend and adduct the arm at the shoulder joint

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26
Q

Proximally, most major structures pass between the arm and forearm through, or in relation to, the __, which is anterior to the elbow joint

A

Cubital fossa

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27
Q

The exception is the __, which passes posterior to the medial epicondyle of the humerus

A

Ulnar nerve

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28
Q

Distally, structures pass between the forearm and the hand through, or anterior to, the __

A

Carpal tunnel

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29
Q

The major exception is the __, which passes dorsally around the wrist to enter the hand posteriorly

A

Radial artery

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30
Q

The forearm is divided into __ and __

compartments

A

Anterior

Posterior

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31
Q

The muscles of the forearm compartments are separated by:

A

Lateral intermuscular septum
Interosseous membrane
Attachment of deep fascia along the posterior border of the ulna

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32
Q

It passes from the anterior border of the radius to deep fascia surrounding the limb

A

Lateral intermuscular septum

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33
Q

It links adjacent borders of the radius and ulna along most of their length

A

Interosseous membrane

34
Q

Muscles in the anterior compartment of the forearm:

A

o Flex the wrist and digits

o Pronate the hand

35
Q

Muscles in the posterior compartment:

A

o Extend the wrist and digits

o Supinate the hand

36
Q

Muscles in the anterior (flexor) compartment of the forearm occur in three layers:

A

o Superficial
o Intermediate
o Deep

37
Q

Generally, Muscles in the anterior (flexor) compartment of the forearm are associated with:

A

o Movements of the wrist joint
o Flexion of the fingers including the thumb
o Pronation

38
Q

All muscles in anterior compartment of the forearm are innervated by the __.

A

Median nerve

39
Q

All muscles in anterior compartment of the forearm are innervated by the median nerve except:

A

o Flexor carpi ulnaris muscle
o Medial half of the flexor
o Digitorum profundus muscle

40
Q

These muscles are innervated by?

o Flexor carpi ulnaris muscle
o Medial half of the flexor
o Digitorum profundus muscle

A

Ulnar nerve

41
Q

SUPERFICIAL LAYER OF FOREARM MUSCLE

A
  • Flexor carpi ulnaris
  • Palmaris longus
  • Flexor carpi radialis
  • Pronator teres
42
Q

INTERMEDIATE LAYER OF FOREARM MUSCLE

A

Flexor digitorum superficialis

43
Q

DEEP LAYER OF FOREARM MUSCLE

A
  • Flexor digitorum profundus
  • Flexor pollicis longus
  • Pronator quadratus
44
Q

SUPERFICIAL LAYER OF FOREARM MUSCLE

Common origin:

A

Medial epicondyle of the humerus

45
Q

SUPERFICIAL LAYER OF FOREARM MUSCLE

Common origin except:

A

Pronator teres, all extend distally from the forearm into the hand

46
Q

Most medial of the muscles in the superficial layer of flexors

A

FLEXOR CARPI ULNARIS

47
Q

ORIGIN OF THE FLEXOR CARPI ULNARIS

A

▪ Long linear origin from the olecranon and posterior border of the ulna
▪ Medial epicondyle of the humerus
▪ The ulnar nerve enters the anterior compartment of the forearm by passing through the triangular gap between the humeral and ulnar heads of flexor carpi ulnaris

48
Q

INSERTION OF THE FLEXOR CARPI ULNARIS

A

INSERTION
▪ Pisiform bone
▪ Hamate
▪ Base of metacarpal V

o The muscle fibers converge on a tendon that passes distally and attaches to the pisiform bone of the wrist.
o From this point, force is transferred to the hamate bone of the wrist and to the base of metacarpal V by the pisohamate and pisometacarpal ligaments

49
Q

ACTION OF THE FLEXOR CARPI ULNARIS

A

▪ Powerful flexor

▪ Adductor to the wrist

50
Q

INNERVATION OF THE FLEXOR CARPI ULNARIS

A

Ulnar nerve

51
Q

▪ Absent in about 15% of the population
▪ Lies between the flexor carpi ulnaris and the flexor carpi radialis muscles
▪ It is a spindle-shaped muscle with a long tendon

A

PALMARIS LONGUS

52
Q

INSERTION OF THE PALMARIS LONGUS

A

▪ Flexor retinaculum
▪ Thick layer of deep fascia, the palmar aponeurosis, which underlies and is attached to the skin of the palm and fingers
▪ Its tendon can easily be demonstrated by flexing the wrist with the thumb opposed to the small finger
▪ The tendon will easily stand out with this maneuver

53
Q

Thick layer of deep fascia, which underlies and is attached to the skin of the palm and fingers

A

Palmar aponeurosis

54
Q

ACTION OF THE PALMARIS LONGUS

A

▪ Accessory flexor of the wrist joint

▪ Opposes shearing forces on the skin of the palm during gripping

55
Q

INNERVATION OF THE PALMARIS LONGUS

A

Median nerve

56
Q

▪ Lateral to palmaris longus and has a large and prominent tendon in the distal half of the forearm
▪ Tendon is positioned just lateral to the midline
▪ In this position, the tendon can be easily palpated, making it an important landmark for finding the pulse in the radial artery, which lies immediately lateral to it.

A

FLEXOR CARPI RADIALIS

57
Q

INSERTION OF THE FLEXOR CARPI RADIALIS

A

▪ Anterior surfaces of the bases metacarpals II and III

58
Q

ACTION OF THE FLEXOR CARPI RADIALIS

A

▪ Powerful flexor of the wrist

▪ Abduct the wrist

59
Q

INNERVATION OF THE FLEXOR CARPI RADIALIS

A

Median nerve

60
Q

ORIGIN OF THE PRONATOR TERES

A

▪ Medial epicondyle
▪ Supraepicondylar ridge of the humerus
▪ Small linear region on the medial edge of the coronoid process of the ulna
▪ The median nerve often exits the cubital fossa by passing between the humeral and ulnar heads of this muscle

61
Q

INSERTION OF THE PRONATOR TERES

A

▪ Crosses the forearm and attached to an oval roughened area on the lateral surface of the radius approximately midway along the bone

62
Q

ACTION OF THE PRONATOR TERES

A

▪ Forms the medial border of the cubital fossa and rotates the radius over the ulna during pronation

63
Q

INNERVATION OF THE PRONATOR TERES

A

Median nerve

64
Q

Muscle in the intermediate layer of anterior compartment of forearm

A

FLEXOR DIGITORUM SUPERFICIALIS

65
Q

ORIGIN OF THE FLEXOR DIGITORUM SUPERFICIALIS

A 
▪ Humero-ulnar Head
  o Medial epicondyle of the humerus
  o Medial edge of the coronoid process of the ulna
▪ Radial Head
  o Anterior oblique line of the radius

Note: median nerve & ulnar artery pass deep to FDS between the 2 heads.

▪ Tendons of flexor digitorum superficialis are anterior to the tendons of the flexor digitorum profundus muscle in the
▪ FDS forms 4 tendons in the distal forearm which pass underneath flexor retinaculum of the wrist and into the 4 fingers

66
Q

INSERTION OF THE FLEXOR DIGITORUM SUPERFICIALIS

A

▪ Near the base of the proximal phalanx of each finger, the tendon of FDS splits into 2 parts to pass dorsally around each side of the tendon of FDP and ultimately attach to the margins of the middle phalanx

67
Q

ACTION OF THE FLEXOR DIGITORUM SUPERFICIALIS

A

▪ Flexes MCP and PIP joints of fingers

▪ Flexes wrist joint

68
Q

There are 3 deep muscles in the forearm anterior compartment:

A

▪ flexor digitorum profundus
▪ flexor pollicis longus
▪ pronator quadratus

69
Q

ORIGIN OF THE FLEXOR DIGITORUM PROFUNDUS

A

▪ Anterior and medial sides of ulna
▪ Adjacent half of the interosseous membrane anterior surface
▪ Gives rise to 4 tendons, which pass through the carpal tunnel into the 4 medial fingers

70
Q

INSERTION OF THE FLEXOR DIGITORUM PROFUNDUS

A

▪ Each tendon of FDP passes through a split formed in the overlying tendon of the FDS muscle and passes distally to insert into the anterior surface of the base of the distal phalanx

71
Q

INNERVATION OF THE FLEXOR DIGITORUM PROFUNDUS

A

▪ Medial half: ulnar nerve
▪ Lateral half: anterior interosseous nerve forms the median nerve
▪ Blood supply: Anterior interosseous artery

72
Q

ACTION OF THE FLEXOR DIGITORUM PROFUNDUS

A

▪ Flexes MCP joints, PIP & DIP joints of the 4 fingers and the wrist joint as well

73
Q

ORIGIN OF THE FLEXOR POLICIS LONGUS

A

▪ Anterior surface of the radius

▪ Adjacent half of the interosseous membrane anterior surface

74
Q

INSERTION OF THE FLEXOR POLICIS LONGUS

A

▪ Base of the distal phalanx of thumb

75
Q

INNERVATION OF THE FLEXOR POLICIS LONGUS

A

▪ Anterior interosseous nerve from the median nerve

▪ Blood supply: Anterior interosseous artery

76
Q

ACTION OF THE FLEXOR POLICIS LONGUS

A

▪ Flexes thumb

77
Q

ORIGIN OF THE PRONATOR QUADRATUS

A

▪ Linear ridge at the anterior surface of the lower end of the ulna

78
Q

INSERTION OF THE PRONATOR QUADRATUS

A

▪ Flat anterior surface of the radius

79
Q

INSERTION OF THE PRONATOR QUADRATUS (shares the same with FPL)

A

▪ Anterior interosseous nerve from the median nerve

▪ Blood supply: Anterior interosseous artery

80
Q

ACTION OF THE PRONATOR QUADRATUS

A

▪ Pulls the distal end of the radius anteriorly over the ulna during pronation

GROSS ANATOMY (8 decks)

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