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p55-75 Flashcards

1
Q

Inflammation of common flexor tendon resulting from overuse of flexors–activities that require a lot of gripping is called

A

Medial Epicondylitis (Golfer’s elbow)

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2
Q

Name the injury that results in: Loss of flexion to PIPs in 1st-3rd digits, Weakened flexion to PIPs in 4th and 5th digits, Loss of flexion to DIPs in 2nd-3rd digits BUT no issues with 4th and 5th digits. Ability to flex MPs of 2nd and 3rd digits is affected.

(What is this injury also known as)

A

Injury to Median n, (C6-T1) at elbow/forearm

Hand of Benediction

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3
Q

How do you decipher between an injury to the Median n. or A.I.N.?

A

Attempt to make the “okay” sign– if it results in a “pinch” posture it is the Median n.

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4
Q

What is the deepest muscle in the anterior forearm that covers distal radius, ulna, and interosseous membrane?

What passes deep to this muscle?

What innervated it?

A

Pronator Quadratus

A.I.A. and A.I.N.

A.I.N

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5
Q

What is the origin and insertion of the Pronator Quadratus m.?

A

O: Distal 1/4 of anterior surface of ulna
I: Distal 1/4 of anterior surface of radius

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6
Q

What muscle lies lateral to Flexor Digitorum Profundus and covers aspect of radius distal to supinator?

Does it pass through the carpal tunnel?

A

Flexor Pollicis Longus

It DOES pass through the carpal tunnel and has its own synovial tendon sheath (radial bursa)–> lateral to common flexor sheath.

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7
Q

What is the origin and insertion and innervation of Flexor Pollicis Longus?

At which joint does this m. flex the thumb?

A

O: Anterior surface of radius and adjacent interosseous membrane
I: Base of distal phalanx of thumb
N: A.I.N. (C8, T1)

ONLY muscle that flexes thumb at interphalangeal joint. Secondarily flexes proximal phalanx, 1st MP and CM joints respectively

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8
Q

In the flexor compartment, what four muscles comprise the superficial layer?

A

Superficial Layer:

  1. ) Pronator teres m
  2. ) Flexor carpi radialis m.
  3. ) Palmaris longus m.
  4. ) Flexor carpi ulnaris m.
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9
Q

In the flexor compartment, what muscle comprise the intermediate layer and what three comprise the deep layer?

A

Intermediate layer:
Flexor digitorum superficialis m.

Deep layer:

  1. ) Flexor digitorum profundus m.
  2. ) Flexor pollicis longus m.
  3. ) Pronator quadratus m.

**Superficial and intermediate groups cross elbow AND wrist joints. Deep group ONLY crosses wrist.

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10
Q

What is the only muscle to flex distal interphalangeal joints (DIPs) and covers anterior aspect of ulna?

A

Flexor Digitorum Profundus

  • Gives rise to 4 tendons at wrist.
  • Has 2 innervations
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11
Q

What is the Origin, Insertion and Innervation of Flexor Digitorum Profundus?
*Hint: Lateral and medial halves share an origin but not I/A/N

A

O: Medial and lateral halves – Proximal ¾ medial and anterior surfaces of ulna and
interosseous membrane

I: Medial half – Bases of distal phalanges of 4th and 5th digits
Lateral half – Bases of distal phalanges of 2nd and 3rd digits

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12
Q

What is the action and innervation of the medial and lateral halves of Flexor Digitorum Profundus?

A

A: Medial half – Flexes DIPs of 4th and 5th digits
Lateral half – Flexes DIPs of 2nd and 3rd digits
N: Medial half – Ulnar n. (C8, T1)
Lateral half – A.I.N. (C8, T1)

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13
Q

Assists in making a fist, Can only flex pointer finger independently.

A

Flexor Digitorum Profundus

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14
Q

Testing these muscles of the flexor compartment tests the integrity of the Median nerve:

A 
Pronator teres
Flexor Carpi Radialis
Flexor Digitorum Superficialis
Flexor Digitorum Profundus (by way of index finger--> Why?)
Flexor Pollicis Longus
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15
Q

Gives Rise to four tendons at wrist and shares a common flexor sheath with FDP:

A

Flexor Digitorum Superficialis

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16
Q

Which four muscles originate from the medial epicondyle via a common flexor tendon?

A

Flexor Carpi Radialis
Palmaris Longus
Flexor Carpi Ulnaris (humeral head only)
Flexor Digitorum Superficialis (along with the coronoid process)

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17
Q

Which muscles pass through the carpal tunnel?

A

Flexor Digitorum Superficialis
Flexor Digitorum Profundus
Flexor Pollicis Longus

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18
Q

What is the Origin (of the two heads) and Insertion of Flexor Digitorum Superficialis?

A

O: Humeroulnar head – ME via common flexor tendon and coronoid process
Radial head – Superior ½ anterior border
I: Shafts of middle phalanges of medial 4 digits via split tendon

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19
Q

What is the Action and Innervation of Flexor Digitorum Superficialis?

A

A: Flexion of PIPs; strong flexion of MPs
N: Median n. (C7, C8, T1)

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20
Q

Flexion of the wrist is produced when which two muscles act together?

A

Flexor Carpi Radialis and Ulnaris

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21
Q

Ulnar n. enters forearm by passing between humeral and ulnar heads through what is called…

this is a potential site of:

A

The Cubital Tunnel

Inpingement

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22
Q

When Flexor Carpi ulnaris acts alone what action is produced?

A

Alone, it produces a combination of flexion and ulnar deviation
o Moves hand anteromedially

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23
Q

stabilize shoulder / prevent dislocation:

A 
subscapularis
supraspinatus
infraspinatus
teres minor
biceps brachii (short head)
triceps brachii (long head)
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24
Q

aDduct humerus:

A

subscapularis
teres major
coracobrachialis

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25
Q

aBduct humerus:

A

deltoid (middle)

supraspinatus

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26
Q

laterally rotate humerus

A

deltoid (posterior)
infraspinatus
teres minor

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27
Q

medially rotate humerus

A

deltoid (anterior)
subscapularis
teres major

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28
Q

extend humerus

A

deltoid (posterior)

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29
Q

flex humerus

A

deltoid (anterior)
biceps brachii
coracobrachialis

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30
Q

flex forearm (elbow)

A 
biceps brachii (when supinated)
brachialis
pronator teres
flexor carpi radialis
palmaris longus
flexor carpi ulnaris
flexor digitorum superficialis
brachioradialis
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31
Q

extend forearm (elbow)

A

triceps brachii

anconeus

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32
Q

stabilize elbow

A

anconeus

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33
Q

supinate forearm

A

biceps brachii

supinator

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34
Q

pronate forearm

A

pronator teres

pronator quadratus

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35
Q

flex wrist

A 
flexor carpi radialis
palmaris longus
flexor carpi ulnaris
flexor digitorum superficialis
flexor digitorum profundus
flexor pollicis longus
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36
Q

extend wrist

A 
extensor carpi radialis longus
extensor carpi radialis brevis
extensor digitorum
extensor carpi ulnaris
extensor indicis
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37
Q

aBduct hand (radial flexion)

A 
flexor carpi radialis
extensor carpi radialis longus
extensor carpi radialis brevis
abductor pollicis longus
extensor pollicis longus
extensor pollicis brevis
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38
Q

aDduct hand (ulnar flexion)

A

flexor carpi ulnaris

extensor carpi ulnaris

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39
Q

flex metacarpals/proximal/intermediate/distal phalanges

A 
flexor digitorum superficialis (P/I, 2-5)
flexor digitorum profundus (P/I/D, 2-5)
flexor pollicis longus (M/P/D, 1)
flexor pollicis brevis (M/P, 1)
flexor digiti minimi brevis (P, 5)
lumbricals (P, 2-5)
dorsal interossei (P, 2-4)
palmar interossei (P, 2,4,5)
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40
Q

extend metacarpals/proximal/intermediate/distal phalanges

A 
extensor digitorum (M/P/I/D, 2-5)
extensor digiti minimi (M/P/D, 5)
extensor indicis (2)
extensor pollicis longus (M/P/D, 1)
extensor pollicis brevis (M/P, 1)
lumbricals (I/D, 2-5)
dorsal interossei (I/D, 2-4)
palmar interossei (I/D, 2,4,5)
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41
Q

aBduct digits

A 
flexor pollicis longus (1) (c-m joint)
abductor pollicis longus (1) (c-m joint)
abductor pollicis brevis (1)
abductor digiti minimi (5)
dorsal interossei (2-4)
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42
Q

aDduct digits

A 
adductor pollicis (1)
palmar interossei (2,4,5)
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43
Q

oppose digits

A

abductor pollicis brevis
opponens pollicis
opponens digiti minimi

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44
Q

What is the most medial of the superficial flexors?

A

Flexor Carpi Ulnaris

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45
Q

What Action is produced when Flexor carpi ulnaris acts with Flexor carpi radialis? Extensor Carpi Ulnaris?

A

Flexion is produced when acting with FCR

 Ulnar deviation is produced when acting with ECU

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46
Q

Which muscle is absent in one or both sides of around 14% of people?

A

Palmaris Longus

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47
Q

Which flexor muscle does not pass through carpal tunnel and lies medial to Pronator Teres m?

A

Flexor Carpi Radialis

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48
Q

What action is produced when Flexor Carpi Radialis is acting with Extensors carpi radialis longus and brevis?

A

Radial deviation is produced when acting with ECRL and ECRB

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49
Q

What action does Flexor Carpi Radialis produce when acting alone?

A

When acting alone, it produces a combination of flexion and radial deviation
o Hand moves anterolaterally

50
Q

Median n. passes between two heads of this muscle

o Common site of impingement

A

Pronator Teres m.

51
Q

Most lateral of superficial forearm flexors

A

Pronator Teres m.

52
Q

A: Pronation (when more speed and power is needed) and flexion of forearm

A

Pronator Teres m.

53
Q

What compartments are the muscles of the forearm broken into?

A

Divided into anterior (flexor) and posterior (extensor) compartments

54
Q

Lateral epicondyle and supracondylar ridge provide attachment for (hint: group)

A

Extensors

*Proximal parts of extensor compartment lie posterolaterally

55
Q

Medial epicondyle and supracondylar ridge provide attachment for

A

Flexors

*Proximal parts of flexor compartment lie anteromedially

56
Q

Information ONLY:

Flexors and pronators are in anterior compartment

A

o Served by median n.
o One and a half exceptions innervated by ulnar n.
o Supplied by radial and ulnar aa.

57
Q

Information ONLY:

Extensors and supinators are in the posterior compartment

A

o Innervated by radial n.
 Directly or its deep branch
o Supplied by radial and ulnar aa.

58
Q

T/F: Antebrachial fascia is continuous with Brachial fascia superiorly?

A

True

59
Q

Antebrachial fascia divides forearm into:

A

 Anterior (flexor) compartment
 Posterior (extensor) compartment

Compartments are separated by interosseous membrane
 Demarcated by subcutaneous border of ulna and the radial a.

60
Q

What is Antebrachial fascia continuous with distally?

A

Extensor and flexor retinaculums

*Flexor retinaculum converts anterior concavity into carpal tunnel

61
Q

In the distal radio-ulnar joing, which bone moves?

A

Radius

62
Q

Where are the heads of the ulna and radius located?

A

 Head of ulna is distal

 Head of radius is proximal

63
Q

Radius and ulna are united by

A

interosseous membrane

64
Q

What overlies the cubital fossa

A

o Median cubital v.
 Anterior to brachial a.
o Medial and lateral antebrachial cutaneous nn.

65
Q

What are the contents of the cubital fossa?

A 
Terminal part of brachial a.
Deep accompanying vv.
Biceps brachii t.
Median n.
Radial n.
66
Q

What are the boundaries of the cubital fossa? (Lateral, medial, base (superior), floor, roof)

A

o Lateral – brachioradialis m.
o Medial – pronator teres m.
o Base (superior) – line between medial and lateral epicondyles
o Floor – supinator and brachialis mm.
o Roof – skin, fascia and bicipital aponeurosis

67
Q

What is the most commonly injured nerve?

A

Radial n. (C5-8) in Arm

68
Q

Injury to the radial n. superior to the origin of its branches to the triceps brachii m. results in paralysis of:

A

Triceps brachii, brachioradialis, supinator mm. and extensors of wrist and fingers

69
Q

Injury to which nerve is known as “Saturday night palsy?” and it’s characteristic disability is the “wrist drop’

A

Injury to the Radial n. (C5-8) in Arm

70
Q

Injury to which nerve can be caused by:
 Improper use of crutches
 Falling asleep with arm over chair
 Posterior dislocation of glenohumeral joint (rare)

A

Injury to the Radial n. (C5-8) in Arm

71
Q

Injury to the radial n. in the radial groove would weaken which muscle and paralyze which muscles?

Can be caused by?

A

weaken triceps brachii. All other posterior compartment forearm mm. would be paralyzed

Fracture to humeral shaft

72
Q

Musculocutaneous n. supplies:

A

biceps brachii M
brachialis M
coracobrachilalis M (pierces it)
skin of lateral forearm (as lateral antebrachial cutaneous n)

73
Q

What n. emerges lateral to biceps tendon as lateral antebrachial cutaneous n?

A

Musculocutaneous n.

74
Q

Terminal branches of posterior cord of brachial plexus

A

Axillary n.

Radial n.

75
Q

What does the Radial n. run with in the radial groove?

What branch arises here?

A

profunda brachii a.

Branch to lateral head of triceps arises here

76
Q

What nerve continues between brachialis and brachioradialis mm. to level of lateral epicondyle

A

Radial n.

77
Q

What type of joints are the distal and proximal radio-ulnar joints?

A

Synovial, Pivot. (pronation, supination)

78
Q

The radio-ulnar joint has an articular disc that is what shape?

A

Triangular. It is called the Triangular ligament clinically/

79
Q

Where is the ulnar notch located?

A

On the distal end of the radius

80
Q

There are five ligaments associated with the radio-ulnar joints: Annular l, Anterior l, Posterior l, Oblique cord, and Interosseous membrane– Where are they located: proximal or distal radio-ulnar joint?

A

Anterior and posterior ll= Distal radio-ulnar joint

The rest= Proximal “ jt

81
Q

What is found overlying the cubital fossa? (NAV?)

A

o Median cubital v.
 Anterior to brachial a.
o Medial and lateral antebrachial cutaneous nn.

82
Q

Which cord of the brachial plexus can Musculocutaneous nerve be traced to?

A

Lateral cord

83
Q

T/F: Venae comitantes are unpaired

A

False

84
Q

Name the superficial veins of the arm and forearm (4)

A

Basilic
Median Cubital
Cephalic
Intermediate Antebrachial

85
Q

Cephalic v can be found in what structure of the arm?

A

deltopectoral groove

86
Q

Intermediate antebrachial v divides into:

(A clear M is formed)

A

Median Cephalic and Basilic vv.

87
Q

The Brachial artery terminates in the cubital fossa as what structure/s

A

Radial and Ulnar aa.

88
Q

Aconeus m is nicknamed what?

Point to where it is located

A

The homeless guy? (IDK)

I hope you’re pointing at the postero-lateral portion of your elbow

89
Q

What is the main extensor of the forearm?

A

Triceps brachii m

90
Q

Rupture of what leads to “Popeye Deformity”?

A

Rupture of tendon of long head of biceps brachii

Associated with a snap or a pop

91
Q

Injury to musculocutaneous nerve usually occurs due to

A

Knife fight

92
Q

Point to where your coracobrachialis is located

What runs deep to it and can be compressed by it?

A

Superomedially on upper arm

Medial N and/or Brachial artery

93
Q

What is the main flexor muscle of the forearm?

A

Brachialis

94
Q

Bicipital aponeurosis covers what structures?

A

Brachial artery and Median N.

95
Q

T/F Flexors are twice as strong as extensors

A

T (Better pullers than pushers)

96
Q

Deep

A

Breath.

Everything is going to be alllll right

97
Q

Name a few ways an elbow joint can be dislocated posteriorly

A

o From a fall to the hands when the elbow is flex
o Hyperextension
o Blow that drives ulna posterior and posterolateral

98
Q

What nerve can be injured due to elbow dislocation?

A

Ulnar N

99
Q

The real name for “student’s elbow”

A

Subcutaneous Olecranon Bursitis

100
Q

During flexion, head of radius contacts

A

radial fossa of humerus

101
Q

The capitulum of the humerus contacts what part of the radius?

A

The head.

102
Q

What type of joint is the humeroradial joint?

What type of joint is the humeroulnar joint?

A

 Limited ball-and-socket, hinge type joint
 Flexion/extension and supination/pronation permitted

Hinge joint

103
Q

During flexion what contacts the coronoid fossa of humerus

A

The coronoid process of Ulna

104
Q

During extension, olecranon process of ulna contacts

A

olecranon fossa of humerus

105
Q

The elbow is what type of joint?

A

Synovial

106
Q

How often do lower brachial plexus injuries occur? How do they occur?

A

Not too common
Injuries occur here when upper limb is suddenly pulled superiorly
o e.g. grasping something to break a fall or baby’s upper limb being pulled during delivery

107
Q

What is another name for lower brachial plexus injuries? What does it look like?

A

Klumpke’s palsy, claw hand (Unopposed action of extensors and flexor digitorum profundus m.)

108
Q

Erb-Duchenne palsy is what type of injury?

A

Injury to upper brachial pexus

109
Q

What causes Erb Duchenne palsy and what does it look like?

A

Injuries occur here with excessive increase in angle between neck and shoulder
 e.g. thrown from horse or baby with shoulder dystocia
Waiter’s tip position/ Flintstones men.

110
Q

What nerves are associated with the lateral cord of the brachial plexus?

A

 Lateral pectoral n.
 Musculocutaneous n. (terminal branch)
 Lateral root of median n. (terminal branch)

111
Q

What nerves are associated with the mediaL cord of the brachial plexus?

A 
 Medial root of median n. (terminal branch)
 Medial pectoral n.
 Medial brachial cutaneous n.
 Medial antebrachial cutaneous n.
 Ulnar n. (terminal branch)
112
Q

What nerves are associated with the posterior cord of the brachial plexus?

A 
 Upper subscapular n.
 Thoracodorsal n.
 Lower subscapular n.
 Axillary n. (terminal branch)
 Radial n. (terminal branch)
113
Q

Cords are named for their relationship to

A

2nd part of the axillary a.

114
Q

INFORMATION:

A

o C5-6 – primarily innervate mm. that act at shoulder or flex elbow
o C7-8 – innervate mm. that extend elbow or are part of forearm
o T1 – primarily innervates intrinsic mm. of hand

115
Q

Which parts of the brachial plexus can we see in lab?

A

Cords and branches

116
Q

How many groups of lymph nodes are located in the axillary region?

A

Five.

117
Q

Axillary artery begins where? ends?

A

Lateral border of the first rib. It ends at the inferior border of teres major m.(becomes brachial a).

118
Q

Name the branch of the first part of the axillary artery

A

Superior (Supreme) Thoracic a.

119
Q

What are the two branches from the second part of the axillary artery?

A 
Thoracoacromial trunk (CAPD)
Lateral Thoracic a.
120
Q

What are the three branches from the third part of the axillary artery?

A

o Subscapular a.
 Terminates as circumflex scapular and thoracodorsal aa.
o Anterior humeral circumflex a.
o Posterior humeral circumflex a. - found in quadrangular space

121
Q

Where does each section of the axillary artery begin? (Boundaries of 1st-3rd parts)

A

1: From lateral border of 1st rib to medial border of pectoralis minor m.
2: Posterior to pectoralis minor
3: From lateral border of pectoralis minor to inferior border of teres major

GA Upper Limbs (1 decks)

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