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MSK anatomy > Muscles Of The Forearm And Carpal Tunnel > Flashcards

Muscles Of The Forearm And Carpal Tunnel Flashcards

1
Q

How many muscles are in the anterior compartment of the forearm

A

8

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2
Q

How are the muscles arranged in the anterior compartment of the forearm

A

3 layers: superficial, middle and deep

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3
Q

Number of muscles in superficial layer of the anterior compartment of the forearm

A

4

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4
Q

Muscles in superficial layer of the anterior compartment of the forearm from lateral to medial

A

Pronator teres
Flexor carpi radialis
Palmaris longus
Flexor carpi ulnaris

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5
Q

What are the superficial muscles of the anterior compartment of the forearm attached to

A

Medial epicondyle of humerus

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6
Q

Pronator teres function

A

Pronator of proximal radioulnar joint

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7
Q

Flexor carpi radialis function

A

Flexes and abducts the wrist

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8
Q

Palmaris longus

A

Small muscle belly but a long thin easily recognisable tendon when present
Tendon inserts into the fascia of the palm of the hand

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9
Q

Flexor carpi ulnaris function

A

Flexes and adducts the wiret

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10
Q

Flexor carpi ulnaris innervation

A

Ulnar nerve

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11
Q

Pronator teres innervation

A

Median nerve

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12
Q

Flexor carpi radialis innervation

A

Median nerve

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13
Q

Palmaris longus innervation

A

Median nerve

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14
Q

Which muscle makes up the middle layer of the anterior compartment of the forearm

A

Flexor digitorium superficialis

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15
Q

Flexor digitorum superficialis

A

Gives rise to 4 tendons
Flexor of the digits

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16
Q

Flexor digitorum superficialis innervation

A

Median nerve

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17
Q

Path of median nerve in anterior compartment of the forearm

A

Travels between flexor digitorum superficialis and flexor digitorum profundus

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18
Q

Number of muscles in deep layer of anterior compartment of the forearm

A

3

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19
Q

Muscles in deep layer of anterior compartment of the forearm

A

Flexor digitorum profundus
Flexor pollicis longus
Pronator quadratus

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20
Q

Flexor pollicis longus function

A

Flexes the thumb

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21
Q

Flexor digitorum profundus function

A

Flexor of the digits
Gives rise to 4 tendons

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22
Q

Innervation of lateral half of flexor digitorum profundus

A

Median nerve
Index to middle finger

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23
Q

Innervation of medial half of the flexor digitorum profundus

A

Ulnar nerve
Ring and little fingers

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24
Q

Pronator quadratus

A

Deepest forearm muscle
Square-shaped
Located over the distal ends of the radius and ulnar

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25
Q

Function of Pronator quadratus

A

Pronates the distal radioulnar joint

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26
Q

All anterior forearm muscles are flexors except…

A

Pronator teres and Pronator quadratus

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27
Q

All anterior forearm muscles are innervated by the median nerve except…

A

Flexor carpi ulnaris and medial half of flexor digitorum profundus— ulnar nerve

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28
Q

Layers of muscles in the posterior compartment of the forearm

A

Superficial and deel

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29
Q

What are all muscles of the posterior compartment of the forearm innervated by

A

Radial nerve

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30
Q

Number of muscles in the superficial layer of the posterior compartment of the forearm

A

7

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31
Q

Muscles in the superficial layer of the posterior compartment of the forearm

A

Brachioradialis
Extensor carpi radialis longus
Extensor carpi radialis brevis
Extensor digitorum
Extensor digiti minimi
Extensor carpi ulnaris
Anconeus

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32
Q

What are the muscles of the superficial layer of the posterior compartment of the forearm attached to proximally

A

Lateral epicondyle of the humerus

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33
Q

Where is the common extensor origin

A

Lateral epicondyle of humerus

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34
Q

Where is the common flexor origin

A

Medial epicondyle of humerus

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35
Q

Extensor digiti minimi function

A

Extends the little finger via its insertion into the dorsum of the little finger

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36
Q

Extensor carpi ulnaris function

A

Most medial
Extends and adducts the wrist via insertion onto the 5th metacarpal

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37
Q

Extensor digitorum function

A

Extends the digits via 4 long tendons that insert into the dorsal aspects if the fingers
Connected by fibrous bands

38
Q

Why is it difficult to fully extend the middle or ring fingers independently

A

Tendons of the extensor digitorum are connected by fibrous bands

39
Q

What does the extensor carpi radialis longus insert into

A

2nd metacarpal

40
Q

What does the extensor carpi radialis brevis insert into

A

3rd metacarpal

41
Q

Function of the extensor carpi radialis longus and brevis

A

Extend and abduct the wrist

42
Q

Brachioradialis location

A

On the boundary between the anterior and posterior compartments of the forearm
Originates at the humerus, proximal to the lateral epicondyle and inserts on the distal radius

43
Q

Brachioradialis functions

A

Weak flexor of the elbow joint

44
Q

Extensor retinaculum

A

A band of tissue which prevents the tendons from bowing when the wrist is extended

45
Q

Anconeus location

A

Small muscle found proximally near the olecranon

46
Q

Anconeus function

A

Very weak extensor of the elbow

47
Q

Number of muscles in the deep layer of the posterior compartment of the forearm

A

5

48
Q

Muscles in the deep layer of the posterior compartment of the forearm

A

Supinator
Abductor pollicis longus
Extensor pollicis brevis
Extensor pollicis longus
Extensor indicis

49
Q

Supinator function

A

Supinates forearm

50
Q

Supinator location

A

Attached proximally to humerus
Wraps around the proximal part of the radius

51
Q

Abductor pollicis longus function

A

Abducts the thumb

52
Q

Where does the abductor pollicis longus insert

A

1st metacarpal

53
Q

Extensor pollicis longus and brevis function

A

Extend the thumb

54
Q

Extensor indicis

A

Inserts on the dorsum of the index finger
Allows independent extension

55
Q

Extensor pollicis brevis insertion

A

Proximal phalanx- so extends the metacarpophalangeal joint

56
Q

Extensor pollicis longus inserts

A

Distal phalanx- so extends the interphalangeal joint of the thumb

57
Q

Where do the tendons of the extensor pollicis brevis and longus lie

A

Superficially at the wrist as they wrap around the distal radius

58
Q

All posterior forearm muscles are extensors except…

A

Brachioradialis
Supinator
Abductor pollicis longus

59
Q

Except for the Supinator, where do all muscles of the deep layer of the posterior compartment of the forearm attach

A

Proximally to the forearm bones and interosseous membrane

60
Q

Which arteries anastomose in the palm of the hand to form the palmar arches

A

Radial and ulnar

61
Q

2 terminal branches of the brachial artery

A

Radial and ulnar artery

62
Q

Path of radial artery

A

Lateral aspect of forearm

63
Q

Path of ulnar artery

A

Medial aspect of forearm

64
Q

Where can the radial artery be palpated

A

At the wrist by locating the tendon of the flexor carpi radialis at the level of the distal radius and palpating just lateral

65
Q

Where can the ulnar artery be palpated

A

Not easily as deep to the flexor carpi ulnaris tendon

66
Q

Carpal tunnel

A

A narrow passageway at the wrist

67
Q

What forms the floor and sides of the carpal tunnel

A

Carpal bones

68
Q

Flexor retinaculum

A

A fibrous band which forms the roof of the carpal tunnel

69
Q

What forms the roof of the carpal tunnel

A

Flexor retinaculum

70
Q

What does the flexor retinaculum attach to laterally

A

Scaphoid and trapezium

71
Q

What does the flexor retinaculum attach to medially

A

Hook of the hamate and pisiform

72
Q

Which tendons of the anterior forearm muscles travel through the carpal tunnel

A

Flexor digitorum superficialis (4)
Flexor digitorum profundus (4)
Flexor pollicis longus (1 to thumb)

73
Q

What travels through the carpal tunnel

A

Median nerve
Tendons of anterior forearm muscles
Tendon of the FCR travels through the flexor retinaculum which forms the roof of the carpal tunnel

74
Q

Carpal tunnel syndrome

A

The carpal tunnel is very narrow, so the tendons and median nerve are tightly packed into it. Any condition that further reduces space in the carpal tunnel, such as swelling of the tendons or arthritis between the joints of the carpal bones, will decrease the space and increase the pressure in the carpal tunnel. This can compress the median nerve and cause carpal tunnel syndrome (CTS). A patient with carpal tunnel syndrome typically presents with:
• impaired or altered sensation over the skin of the hand supplied by the median nerve. The patient may experience tingling, numbness, or pain in the hand.
• weakness of the hand muscles supplied by the median nerve – particularly the small muscles of the thumb.
It is important to recognise and treat CTS. If left untreated, the small muscles of the thumb may atrophy and weakness may be permanent, which has serious consequences for a patient. The flexor retinaculum is divided to alleviate the compression. The radial artery, ulnar artery and ulnar nerve do not travel through the carpal tunnel.

75
Q

Injury to the flexor tendons

A

The flexor tendons are at risk from lacerations over the anterior forearm and wrist. In patients with such injuries, it is important to test the movements of the wrist and fingers to ascertain whether any tendons have been injured. Patients with confirmed or suspected tendon injuries require a surgical assessment. Failure to recognise tendon injuries may leave patients with permanent impairment.

76
Q

Wrist drop

A

This describes an inability to extend the wrist (and fingers) due to weakness or paralysis of the posterior forearm muscles. It results from injury to the radial nerve proximal to the forearm. It is typically caused by a mid-shaft humeral fracture, as the radial nerve lies close to the bone here. Sensation is also impaired over the lateral aspect of the dorsum of the hand (i.e. in the regions of skin of the hand supplied by the radial nerve).

77
Q

Lateral and medial epicondylitis

A

This is inflammation of the tendinous insertions of the superficial extensor muscles in the forearm at the lateral epicondyle, or the superficial flexor muscles in the forearm at the medial epicondyle. It tends to be caused by repetitive use and strain of the muscles, such as during a tennis serve for lateral epicondylitis (‘tennis elbow’), or a golf swing for medial epicondylitis (‘golfer’s elbow’). Pain is felt around the affected epicondyle and may radiate down the forearm.

78
Q

Arterial blood gas sampling

A

The vast majority of blood tests require venous blood, which can be relatively easily taken from the superficial veins in the forearm and hand as discussed. However, to accurately assess a patient’s blood-oxygen and blood-carbon dioxide level, a sample of arterial blood is required. Most often, this is taken from the radial artery. As it a deep structure, clinicians must know the anatomy well to be able to use one hand to palpate the pulse and use the other to direct a needle into the radial artery to acquire the sample.

79
Q
  1. Name the three major nerves that enter the forearm. What muscle compartments do they supply?
A

Radial- posterior
Median -anterior
Ulnar - some muscles in anterior (flexor carpi ulnaris and ulnar half of flexor digitorum profundus)

80
Q
  1. Which nerve supplies the muscles in the posterior forearm? Which region of skin in the hand does this nerve also innervate?
A

Radial nerve
Skin over the dorsal surface of the lateral side of the hand and the dorsum of the lateral 3 1/2 digits as far as the DIP joitns

81
Q
  1. Which muscles would be affected by an ulnar nerve injury in the mid-forearm?
A

Muscles distal to the mid forearm i.e. most of the small muscles of the hand (abductor pollicis, the hypothenar eminence muscles, the medial two lumbricals and all the interossei)

82
Q
  1. Where is the common flexor origin? Which sport often causes inflammation of this joint?
A

Medial epicondyle of humerus
Golf

83
Q
  1. How would you test the muscles of the forearm supplied by the median nerve?
A

Flexion of thumb and lateral 2 fingers
Movement of the thumb under the control of the thenar eminence muscle

84
Q
  1. Where can the brachial, radial, and ulnar pulses be palpated? Which is easier to palpate, and why?
A

Brachial- in the cubital fossa, immediately medial to the biceps tendon
Radial- just proximal to the wrist joint and immediately lateral to the flexor carpi radialis tendon
Ulnar - just proximal to the wrist joint and immediately lateral to the flexor carpi ulnaris tendon
Radial as not covered by a tendon or deep

85
Q

Which muscles allow supination

A

Supinator
Biceps- when the elbow is flexed

86
Q

Which muscles allow pronation

A

Pronator teres
Pronator quadratus

87
Q

Flexor muscles of the elbow

A

Brachioradialis
Biceps brachii
Brachialis

88
Q

Elbow extensor muscles

A

Triceps

89
Q

Pronator muscles

A

Pronator teres
Pronator quadratus

90
Q

Supinator muscles

A

Supinator
Biceps brachii

91
Q

What percentage of people don’t have Palmaris longus

A

15%

MSK anatomy (13 decks)

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