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GROSS ANATOMY > Muscles And Fasciae Of The Upper Limb part 3 > Flashcards

Muscles And Fasciae Of The Upper Limb part 3 Flashcards

1
Q 
SUPERFICIAL LAYER (POSTERIOR COMPARTMENT)
All extend as tendons into the hand except:
A
  • Brachioradialis

* Anconeus

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2
Q

BRACHIORADIALIS Origin:

A

proximal part of the supraepicondylar ridge of the humerus

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3
Q

BRACHIORADIALIS Insertion:

A

lateral side of the distal end of the radius just proximal to the radial styloid process

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4
Q

BRACHIORADIALIS Innervation::

A

radial nerve

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5
Q

BRACHIORADIALIS Origin:

A

accessory flexor of elbow joint

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6
Q

forms the lateral boundary of the cubital fossa.

A

BRACHIORADIALIS

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7
Q

EXTENSOR CARPI RADIALIS LONGUS

Origin:

A

o distal part of the supraepicondylar ridge

o lateral epicondyle of the humerus

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8
Q

EXTENSOR CARPI RADIALIS LONGUS

Insertion:

A

dorsal surface of the base of metacarpal II

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9
Q

EXTENSOR CARPI RADIALIS LONGUS

Innervation:

A

deep branch of the radial nerve

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10
Q

EXTENSOR CARPI RADIALIS LONGUS

Action:

A

extends and abducts the wrist

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11
Q

EXTENSOR CARPI RADIALIS BREVIS Origin:

A

lateral epicondyle of the humerus

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12
Q

EXTENSOR CARPI RADIALIS BREVIS Insertion:

A

adjacent dorsal surfaces of the bases of metacarpals II and III

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13
Q

EXTENSOR CARPI RADIALIS BREVIS Innervation:

A

deep branch of the radial nerve

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14
Q

EXTENSOR CARPI RADIALIS BREVIS Action:

A

extends and abducts the wrist

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15
Q

EXTENSOR DIGITORUM Origin:

A

lateral epicondyle of the humerus

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16
Q

EXTENSOR DIGITORUM Insertion:

A 
via the triangular-shaped
connective tissue
aponeurosis (extensor hood) into
the base of the dorsal surfaces of
the middle and distal phalanges
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17
Q

EXTENSOR DIGITORUM Innervation:

A

posterior interosseous nerve

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18
Q

EXTENSOR DIGITORUM Action:

A

Major extensor of the 4 fingers (index, middle, ring, and little fingers

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19
Q

EXTENSOR DIGITORUM
o It results from the distal interphalangeal joint suddenly being forced into extreme flexion
o Sudden severe tension on a long extensor tendon, avulse attachment to the phalanx
o Treatment: use of finger splint to approximate the edges of the torn tendon

A

Mallet or baseball finger:

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20
Q

EXTENSOR DIGITI MINIMI Origin:

A

medial to extensor digitorum in the forearm arising from lateral epicondyle of the humerus

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21
Q

EXTENSOR DIGITI MINIMI Insertion:

A

together with the tendon of extensor digitorum into the dorsal digital expansion of the little finger

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22
Q

EXTENSOR DIGITI MINIMI Innervation:

A

posterior interosseous nerve

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23
Q

EXTENSOR DIGITI MINIMI Action:

A

accessory extensor of the small finger

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24
Q

EXTENSOR CARPI ULNARIS Location:

A

medial to the extensor digiti minimi

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25
Q

EXTENSOR CARPI ULNARIS Location:

A

lateral epicondyle of the humerus

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26
Q

EXTENSOR CARPI ULNARIS Origin:

A

medial
side of the base of
metacarpal V

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27
Q

EXTENSOR CARPI ULNARIS Insertion:

A

posterior interosseous nerve

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28
Q

EXTENSOR CARPI ULNARIS Innervation:

A

extends and adducts the wrist

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29
Q

ANCONEUS Location:

A

most medial

of the superficial extensors

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30
Q

ANCONEUS Shape:

A

triangular

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31
Q

ANCONEUS Origin:

A

lateral

epicondyle of the humerus

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32
Q

ANCONEUS Insertion:

A

o Posterolateral surface
of the olecranon
o Posterior surface of the ulna

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33
Q

ANCONEUS Innervation:

A

branch of the radial nerve

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34
Q

ANCONEUS Action:

A

abducts the ulna during pronation & accessory extensor of the elbow joint

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35
Q

5 muscles in the DEEP LAYER (POSTERIOR COMPARTMENT)

A 
o Supinator
o Abductor pollicis longus
o Extensor pollicis brevis
o Extensor pollicis longus
o Extensor indicis
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36
Q

All deep layer muscles originate from the posterior surfaces of the radius, ulna, interosseous membrane, and pass into the thumb & fingers except: __

A

supinator muscle

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37
Q

3 muscles that emerge from between extensor digitorum and extensor carpi radialis brevis tendons of the superficial layer and pass into the thumb:

A

o Abductor pollicis longus
o Extensor pollicis brevis
o Extensor pollicis longus

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38
Q

2 of the three outcropping muscles that form a distinct muscular bulge in the distal posterolateral surface of the forearm:

A

o Abductor pollicis longus

o Extensor pollicis brevis

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39
Q

All muscles of the deep layer are innervated by the __ (continuation of radial nerve deep branch)

A

posterior interosseous nerve

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40
Q

SUPINATOR

Has 2 heads of origin:

A

o Superficial humeral head

o Deep ulnar head

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41
Q

SUPINATOR Insertion:

A

proximal aspect of radius

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42
Q

SUPINATOR Innervation:

A

posterior interosseous nerve that innervates the medial head of the triceps brachii

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43
Q

SUPINATOR Action:

A

supinates forearm

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44
Q

ABDUCTOR POLLICIS LONGUS Origin:

A

o Proximal posterior surfaces of the radius & ulna

o Interosseous membrane

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45
Q

ABDUCTOR POLLICIS LONGUS Insertion:

A

lateral side of the base of metacarpal I

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46
Q

ABDUCTOR POLLICIS LONGUS Innervation:

A

posterior interosseous nerve (C7 and C8)

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47
Q

ABDUCTOR POLLICIS LONGUS Action:

A

abduct the thumb at the joint between metacarpal I and trapezium bones

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48
Q

It contributes to the lateral border of the anatomical snuffbox

A

Abductor pollicis longus tendon

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49
Q

EXTENSOR POLLICIS BREVIS Origin:

A

distal to the origin of abductor pollicis longus from the posterior surface of the radius and interosseous membrane

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50
Q

EXTENSOR POLLICIS BREVIS Insertion:

A

dorsal surface of the base of the proximal phalanx

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51
Q

EXTENSOR POLLICIS BREVIS Innervation:

A

Posterior interosseous nerve

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52
Q

EXTENSOR POLLICIS BREVIS Action:

A

extends the MCP and carpometacarpal joints of the thumb

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53
Q

contributes as well to the lateral border of the anatomical snuffbox

A

Extensor pollicis brevis tendon

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54
Q
  • Occurs when the tendons around the base of thumb (APL and EPB) are irritated or constricted
  • Noticeable when forming a fist; grasping; gripping; turning the wrist
  • Characterized by tendon swelling and causes pain and tenderness along the thumb side of the wrist
A

De Quervain’s Tenosynovitis

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55
Q

De Quervain’s Tenosynovitis
Dx: placing thumb against your hand. Making a fist with your fingers closed over your thumb and then bending wrist toward little finger

A

Finkelstein test

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56
Q

EXTENSOR POLLICIS LONGUS Origin:

A

posterior surface of the ulna & adjacent interosseous membrane

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57
Q

EXTENSOR POLLICIS LONGUS Insertion:

A

long tendon into the dorsal surface of distal phalanx of the thumb

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58
Q

EXTENSOR POLLICIS LONGUS Action:

A

Extension of all joints of the thumb

59
Q

EXTENSOR POLLICIS LONGUS Innervation:

A

posterior interosseous nerve (C7 and C8)

60
Q 
Extensor pollicis longus (EPL) and Extensor
pollicis brevis (EPB) tendon
A 
Extensor pollicis longus (EPL) and Extensor
pollicis brevis (EPB) tendon
61
Q

EXTENSOR INDICIS Origin:

A

adjacent interosseous membrane & distal to extensor pollicis longus from the posterior surface of the ulna

62
Q

EXTENSOR INDICIS Insertion:

A

extensor hood of the index finger with the tendon of extensor digitorum

63
Q

EXTENSOR INDICIS Innervation:

A

posterior interosseous nerve (C7 and C8)

64
Q

EXTENSOR INDICIS Action:

A

accessory extensor of the index finger

65
Q

SURFACE ANATOMY OF THE FOREARM

A

▪ Medial part: flexor muscles

▪ Lateral part: extensor muscles

66
Q

FUNCTIONAL POSITIONS OF THE HAND

A 
Power Grip
Hook Grip
Precision Handling Grip
Pinching
Position of Rest
67
Q

▪ forcible motions of the digits acting against the palm.
▪ the fingers are wrapped around an object with counter pressure from the thumb like when grasping a cylindrical structure.
▪ it involves the:
• long flexors of the fingers
• intrinsic muscles in the palm
• extensors of the wrist.

A

Power Grip

68
Q

▪ posture of the hand used when carrying a briefcase.
▪ consumes less energy, involving mainly the long flexors of the fingers, which are flexed to a varying degree, depending on the size of the object that is grasped.

69
Q

▪ involves a change in the position of a handled object that requires fine control of the movements of the fingers and thumb
▪ for example: holding a pencil, manipulating a coin, threading a needle, buttoning a shirt.
▪ Wrist and fingers are held firmly by the long flexor and extensor muscles, and the intrinsic hand muscles perform fine movements of the digits.

A

Precision Handling Grip

70
Q

▪ compression of something between the thumb and the index finger
▪ for example, handling a teacup or holding a coin on edge.

71
Q

is assumed by an inactive hand
▪ for example, when the forearm and hand are laid on the table.
▪ is often used when it is necessary to immobilize the wrist and hand in a cast to stabilize a fracture.

A

Position of Rest

72
Q

are located entirely in the hand and mainly execute precision movements (‘precision grip’) with the fingers and thumb.

A

INTRINSIC MUSCLES OF THE HAND

73
Q

The intrinsic muscles are the:

A
  • Palmaris brevis
  • Interossei (Dorsal and Palmar)
  • Adductor pollicis
  • Thenar muscles
  • Hypothenar muscles
  • Lumbrical muscles
74
Q

All of the intrinsic muscles of the hand are innervated by the

A

deep branch of the ulnar nerve

75
Q

All of the intrinsic muscles of the hand are innervated by the deep branch of the ulnar nerve except:

A

3 thenar and 2 lateral lumbrical muscles

76
Q

3 thenar and 2 lateral lumbrical muscles which are innervated by the

A

median nerve.

77
Q

PALMARIS BREVIS Origin:

A

tendinous fasciculi from the transverse carpal ligament and palmar aponeurosis.

78
Q

PALMARIS BREVIS Insertion:

A

skin on the ulnar border of the palm of the hand, occasionally on the pisiform

79
Q

PALMARIS BREVIS Actions:

A

tenses the skin of the palm on the ulnar side during a grip action, deepens the hollow of the palm

80
Q

PALMARIS BREVIS Innervation:

A

only

muscle innervated by the superficial branch of the ulnar nerve (C8, T1)

81
Q

INTEROSSEI MUSCLES Divided into two groups

A
  • dorsal interossei,

* palmar interossei

82
Q

are muscles between and attached to the metacarpals.

A

INTEROSSEI MUSCLES

83
Q

INTEROSSEI MUSCLES Insertion:

A

proximal phalanx of each digit and into the extensor hood.

84
Q

INTEROSSEI MUSCLES Innervation:

A

All are innervated by the deep branch of the ulnar nerve

85
Q

INTEROSSEI MUSCLES actions

A

o abduct and adduct the digits

o contribute to the complex flexion and extension movements generated by the extensor hoods.

86
Q

They are unipennate muscles originating from the metacarpals of the digits with which is associated.

A

Palmar Interossei

87
Q

o Origin: medial side of the palmar surface of metacarpal I

o Insertion: base of the proximal phalanx of the thumb, extensor hood

A

First palmar interosseous muscle

88
Q

o Origin: medial side of metacarpal II

o Insertion: medial side of the dorsal expansion of the index finger

A

Second palmar interosseous muscle

89
Q

o Origin: lateral surfaces of metacarpals IV and V
o Insertion: lateral sides of the respective dorsal hoods
o actions:
• adduct the thumb, index, ring, and little fingers
• flexion of the MCP joints
• extension of the PIP & DIP joints of the fingers through their attachments to the dorsal hoods

A

Fourth & Fifth palmar of interosseous muscle

90
Q

LUMBRICAL MUSCLES Origin:

A

tendons of flexor digitorum profundus

91
Q

The 1st and 2nd lumbricals are __ muscles associated with index and middle fingers.

A

unipennate

92
Q

The 3rd and 4th lumbricals are __ associated with the ring and little fingers.

93
Q

1st and 2nd lumbricals Insertions:

A

digital branches of the median nerve

94
Q

3rd and 4th lumbricals Insertions:

A

deep branch of the ulnar nerve

95
Q

Large triangular muscle anterior to the plane of the interossei that crosses the palm

A

ADDUCTOR POLLICIS

96
Q

ADDUCTOR POLLICIS Origins:

A

o Transverse head – anterior aspect of the shaft of metacarpal III
o Oblique head – capitate, bases of metacarpals II and III

97
Q

ADDUCTOR POLLICIS Insertions:

A

o medial side of the base of the proximal phalanx of the thumb
o extensor hood

98
Q

ADDUCTOR POLLICIS Actions

A

o powerful adductor of the thumb and opposes the thumb to the rest of the digits in gripping

99
Q

THUMB MOVEMENTS

A

▪ rotated 90 degrees to the other digits.
▪ Abduction and adduction occur in a sagittal plane
▪ Flexion and Extension occur in a coronal plane
▪ Opposition is the most complex movement.

100
Q

Responsible for the prominent swelling on the lateral side of the palm at the base of the thumb.

A

(thenar eminence)

101
Q

▪ Largest of the thenar muscles

A

OPPONENS POLLICIS

102
Q

▪ Distal to the abductor policis brevis

A

FLEXOR POLLICIS BREVIS

103
Q

▪ There are 3 hypothenar muscles:

A

o Opponens digiti minimi
o Abductor digiti minimi
o Flexor digiti minimi brevis

104
Q

lies deep to the other two hypothenar muscles.

A

OPPONENS DIGITI MINIMI

105
Q

overlies the opponens digiti minimi.

A

ABDUCTOR DIGITI MINIMI

106
Q

Fascia deep surface, which occasionally serves to extend the surface area available for muscular origin, is attached directly or via __

A

intermuscular septa to the enclosed bones.

107
Q

Deep fascia which forms the floor of the axilla

A

AXILLARY FASCIA

108
Q

Deep fascia which forms a tubular investment of the arm

A

BRACHIAL FASCIA

109
Q

BRACHIAL FASCIA Attached to the __ via medial and lateral intermuscular septae

110
Q

Deep fascia which form a tubular investment of the forearm muscles

A

ANTEBRACHIAL FASCIA

111
Q

ANTEBRACHIAL FASCIA Attached to the __ via the lateral intermuscular septum

112
Q

divides the forearm into volar and dorsal muscular compartments.

A

Intermuscular septum together with the radius

113
Q

o formed by the carpal arch and the flexor retinaculum

o a rigid and confining space that contains the long flexor tendons of the fingers and the thumb and the median nerve

A

Carpal tunnel

114
Q

The median nerve is the most sensitive structure in the carpal tunnel and therefore is the most affected.

A

Carpal Tunnel Syndrome

115
Q

Carpal Tunnel Syndrome has 2 terminal sensory branches that supply the skin of the hand

A
  • paresthesia (tingling)

* hyposthesia (diminished sensation)

116
Q

Carpal Tunnel Syndrome may occur in the

A

lateral 3 ½ digits

117
Q

Individuals with carpal tunnel syndrome are unable to

A

oppose the thumb and have difficulty buttoning shirt or blouse as well as gripping things such as a comb.

118
Q

refers to a deformity in which thumb movements are limited to flexion and extension of the thumb in the plane of the palm
• caused by the inability to oppose and by limited abduction of the thumb

119
Q

To relieve both the compression and the resulting symptoms, complete surgical division of the flexor retinaculum, a procedure called

A

carpal tunnel release,

120
Q

The incision for carpal tunnel release is made toward the medial side of the wrist and flexor retinaculum to avoid possible injury to the

A

recurrent branch of the median nerve

121
Q

o thickening of the deep fascia covering the palm of the hand
o composed of very dense connective tissue that extends out into each of the fingers

A

Palmar Aponeurosis

122
Q

Dapuytren’s Contracture
o a disease of the palmar fascia resulting in progressive shortening, thickening, and fibrosis of the palmar fascia and aponeurosis

A

Dapuytren’s Contracture

123
Q

Dapuytren’s Contracture cause

A

fibrous degeneration of the longitudinal bands of the palmar aponeurosis

124
Q

stenosing tenosynovitis

A

Trigger Finger

125
Q

a condition in which one of your fingers gets stuck in a bent position.

A

Trigger Finger

126
Q

▪ covering the thenar muscle group
▪ blends with the palmar aponeurosis and attaches to the third metacarpal bone as the lateral fibrous septum
▪ defines the thenar compartment of the hand

A

THENAR FASCIA

127
Q

▪ covers the hypothenar muscle group
▪ blends with the palmar aponeurosis and attaches to the fifth metacarpal bone as the medial fibrous septum
▪ defines the hypothenar compartment of the hand

A

HYPOTHENAR FASCIA

128
Q

CENTRAL COMPARTMENT

In between thenar and hypothenar compartments are:

A

o Flexor tendons and sheaths
o Lumbricals
o Superficial palmar arterial arch
o Digital vessels and nerves

129
Q

ADDUCTOR COMPARTMENT
▪ Deepest muscular plane of the palm
▪ Contains:

A

adductor pollicis

130
Q

o is responsible for the smooth contour
of the lateral side of the neck and
over the superior aspect of the
shoulder.

131
Q

o forms much of the muscle mass
underlying the posterior axillary fold
extending obliquely upward from the
trunk to the arm.

A

Latissimus dorsi

132
Q

o passes from the inferior angle of the
scapula to the upper humerus and
contributes to the fold laterally.

A

Teres major

133
Q

The rounded curve of the shoulder is formed
by the thick __, which is a
frequent site for intramuscular injections.

A

deltoid muscle

134
Q

The __ forms the fleshy anterior
axillary fold, which acts as the anterior border
of the axilla.

A

pectoralis major

135
Q

The __ and __
form the fleshy posterior axillary fold, which
is the posterior border of the axilla.

A

latissimus dorsi and teres major muscles

136
Q

becomes prominent

when the elbow is flexed.

A

Biceps brachii muscle

137
Q

Cubital fossa

A

o biceps brachii tendon
o brachial artery
o median nerve

138
Q 
It is a depression within
which the median cubital vein connects the basilic and
cephalic veins.
▪ is a common site for
venipuncture.
A

Cubital fossa

139
Q

formed by the bulk of

the posterior surface of the brachium.

A

Triceps brachii muscles

140
Q

The __ is a
rounded lateral projection at the distal end of the
humerus.

A

lateral epicondyle of the humerus

141
Q

The __ is palpated easily

along the posterior aspect of the elbow.

A

olecranon of the ulna

142
Q

located
approximately at the junction between the
lateral and middle thirds of an imaginary line
drawn transversely across the distal forearm.

A

tendon of flexor carpi radialis

143
Q

immediately lateral to this
tendon and this site is used for taking a radial
pulse.

A

radial artery

GROSS ANATOMY (8 decks)

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