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Neurological, neuromuscular and musculoskeletal disease > PBL 40 > Flashcards

PBL 40 Flashcards

1
Q

The radius articulates in 4 places, where?

A
  1. Elbow joint
  2. Proximal radio ulnar joint
  3. Distal radio-ulnar joint
  4. Wrist joint
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2
Q

What are the 3 bony landmarks of the proximal radius?

A
  1. Head
  2. Neck
  3. Radial tuberosity
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3
Q

Which muscle inserts onto the radial tuberosity?

A

Biceps brachii

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4
Q

Which muscle inserts onto the shaft of the radius?

A

Pronator teres

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5
Q

The lateral side of the distal radius projects distally as the…

A

Styloid process

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6
Q

In the medial surface of the distal radius, there is a concavity called the…

A

Ulnar notch

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7
Q

What makes up the distal radio-ulnar joint?

A

The ulnar notch from the radius and the head of the ulna

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8
Q

What are the important landmarks of the proximal ulna?

A
  1. Olecranon
  2. Coronoid process
  3. Trochlear notch
  4. Radial notch
  5. Tuberosity of the ulnar
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9
Q

Which muscle attaches onto the olecranon?

A

Triceps brachii

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10
Q

What are the muscles of the superficial layer of the anterior forearm?

A
  1. Flexor carpi ulnaris
  2. Flexor carpi radialis
  3. Palmaris longus
  4. Pronator teres
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11
Q

What are the muscles of the intermediate layer of the forearm?

A

Flexor digitorum superficialis

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12
Q

What are the muscles of the deep layer of the forearm?

A
  1. Flexor pollicis longus
  2. Flexor digitorum profundus
  3. Pronator quadratus
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13
Q

The anterior/flexor aspect of the forearm is most innervated by which nerve?

A
  • Median nerve

- FCU and medial half of FDP is ulnar nerve!

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14
Q

Where do the muscles of the superficial layer of the forearm originate?

A

The medial epicondyle of the humerus

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15
Q

What is the action of the flexor carpi ulnaris & nerve supply?

A
  • Flexion and adduction at the wrist

- Ulnar nerve

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16
Q

Where does the flexor carpi ulnaris originate and attach?

A

Originate: humeral head = the medial epicondyle of humerus, and the ulnar head = olecranon of the ulnar
Attach: The pisiform bone, hook of hamate and base of the 5th metacarpal

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17
Q

Where does the palmaris longus attach?

A

The flexor retinaculum

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18
Q

What is the action of the palmaris longus & nerve supply?

A

Flexion at the wrist

Median nerve

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19
Q

Where does the flexor carpi radialis attach?

A

The base of metacarpals 2 and 3

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20
Q

What is the action and nerve supply of flexor carpi radialis?

A

Action: Flexion and abduction at the wrist

Nerve supply: median nerve

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21
Q

Where does the pronator teres originate?

A

1st origin: Medial border of the antecubital fossa

2nd origin: Coronoid process of the ulna

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22
Q

Where does the pronator teres attach?

A

The shaft of the radius

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23
Q

What is the action of the pronator teres muscles and nerve supply?

A

Action: Pronation of the forearm

Nerve supply: median nerve

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24
Q

What passes through the two heads of the flexor digitorum superficialis?

A

Median nerve and ulnar artery

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25
Q

Where does the flexor digitorum superficialis originate

A

1st origin: medial epicondyle of humerus

2nd origin: radius

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26
Q

What happens to the flexor digitorum superficialis at the wrist? Where does it attach?

A

It splits into four tendons which travel through the carpal tunnel and attaches to the MIDDLE phalanges of the four fingers

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27
Q

What is the action and nerve supply of the flexor digitorum superficialis?

A

Action: flexion of the MCP joins and the PIP joints at the 4 fingers, and flexes the wrist
Nerve supply: median nerve

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28
Q

Where does the flexor digitorum profundus originate?

A

The ulna

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29
Q

What happens to the flexor digitorum profundus at the wrist?

A

It splits into four tendons that pass through the carpal tunnel and attach to the DISTAL phalanges of the four fingers

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30
Q

What is the action and nerve supply of the flexor digitorum profundus?

A

Action: Flexion of the DIP joints, MCP joints and at wrist
Nerve supply: Medial half that acts on little and half of ring fingers is ulnar nerve and the lateral half which acts on the middle and index fingers is median nerve.

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31
Q

Where does the flexor pollicis longus attach?

A

To the base of the distal phalanx of the thumb

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32
Q

What is the action and innervation of the flexor pollicis longus?

A

Flexion of the IP and MCP joint of the thumb

Median nerve

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33
Q

Where does the pronator quadratus originate and attach?

A

Origin: anterior surface of ulna and attaches to the anterior surface of radius

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34
Q

What is the action and nerve supply of the pronator quadratus?

A

Action: pronates the forearm

Nerve supply: Median nerve

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35
Q

Which nerve innervates all muscles in the posterior/extensor aspect of the forearm?

A

Radial nerve

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36
Q

Which nerve innervates all muscles in the posterior forearm?

A

Radial nerve

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37
Q

What is the general function of the posterior forearm muscles?

A

Produce extension at the wrist and fingers

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38
Q

What are the layers of the posterior forearm?

A

Superficial

Deep

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39
Q

Where do the majority of posterior forearm muscles originate?

A

Lateral epicondyle of the humerus

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40
Q

What are the superficial muscles of the posterior forearm?

A

Extensor carpi ulnaris
Extensor carpi radialis brevis
Extensor digitorum
Extensor digiti minimi

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41
Q

What are the deep muscles of the posterior forearm?

A 
Supinator
Abductor pollicis longus
Extensor pollicis brevis
Extensor pollicis longus
Extensor indicis proprius
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42
Q

Where does the brachioradialis originate and attach?

A

Origin: lateral epidondyle of humerus
Attach: distal end of radius just before the radial styloid process

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43
Q

What is the action and nerve supply of the brachioradialis?

A

Flexion of the elbow

Radial nerve

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44
Q

Where do extensor carpi radialis longus and brevis attach?

A

The metacarpal bones 2 and 3

45
Q

What is the action and nerve supply to extensor carpi radialis longus and brevis?

A

Action: extension and abduction at the wrist

Nerve supply: Radial nerve

46
Q

What is the role of extensor digitorum communis?

A

The main extensor of the fingers

47
Q

Where does the extensor digitorum originate and attach?

A

Origin: lateral epicondyle of the humerus
Attach: the extensor hood of each finger

48
Q

What is the action and nerve supply of the extensor digitorum?

A

Action: Extends the four fingers at the MCP and IP joints

Nerve supply: radial nerve

49
Q

Where does the extensor digiti minimi originate and attach?

A

Origin: lateral epicondyle of humerus
Attach: the extensor hood of the little finger

50
Q

What is the action and nerve supply to the extensor digiti minimi?

A

Extension of the little finger

Radial nerve

51
Q

Where does the extensor carpi ulnaris originate and attach

A

Origin: lateral epicondyle of humerus
Attach: base of the 5th metacarpal

52
Q

Action and nerve supply of the extensor carpi ulnaris?

A

Extension and ADDuction of the wrist

Radial nerve

53
Q

Where does the supinator originate and insert?

A

Origin: lateral epicondyle of humerus and posterior surface of ulna
Attach: insert into the posterior surface of the radius

54
Q

What is the action and nerve supply of the supinator?

A

Action: Supination of the forearm

Nerve supply: Radial nerve

55
Q

What are the borders of the anatomical snuff box? (brevis sandwich)

A

Lateral: abductor pollicis longus
Medial: extensor pollicis longus
Between: extensor pollicis brevis

56
Q

Where does the abductor pollicis longus originate and attach?

A

Origin: interosseous membrane and posterior surfaces of radius and ulna
Attach: Lateral side of the base of metacarpal 1

57
Q

What is the action and nerve supply of abductor pollicis longus?

A

Abduct the thumb

Radial nerve

58
Q

Where does the extensor pollicis brevis originate and attach?

A

Originates from the posterior surface of the radius and attaches to the proximal phalanx of thumb

59
Q

What is the action and nerve supply of the extensor pollicis brevis?

A

Action: extension at the MCP and CMC joints of the thumb
Nerve: Radial nerve

60
Q

Where does the extensor pollicis longus originate and attach?

A

Origin: posterior surface of the ulna and interosseous
Attachment: distal phalanx of the thumb

61
Q

What is the action and nerve supply of extensor pollicis longus?

A

Action: extension of all joints of the thumb: CMC, MCP and IP
Nerve: radial nerve

62
Q

Where does the extensor indicis proprius originate and attach?

A

Origin: posterior surface of ulna
Attach: Extensor hood of the index

63
Q

What is the action and nerve supply of the extensor indicis proprius?

A

Action: extension of the index finger

Nerve supply: radial nerve

64
Q

What are the carpal bones in the proximal row from lateral to medial?

A

Scaphoid
Lunate
Triquetrum
Pisiform

65
Q

What are the carpal bones in the distal row from lateral to medial?

A

Trapezium
Trapezoid
Capitate
Hamate

66
Q

Which tendons travel through the carpal tunnel?

A

The tendon of the flexor pollicis longus
The four tendons of flexor digitorum profundus
The four tendons of flexor digitorum superficialis

67
Q

What are the four ligaments of the wrist joint?

A
  1. Palmar radiocarpal
  2. Dorsal radiocarpal
  3. Ulnar collateral
  4. Radial collateral
68
Q

Contents of the anatomical snuff box?

A

Radial artery
Superficial branch of radial nerve
Cephalic vein

69
Q

Which nerve innervates all thenar muscles?

A

Median nerve

70
Q

What are the thenar muscles responsible for?

A

Fine movements of the thumb

71
Q

What are the 3 thenar muscles? OAF

A

Opponens pollicis
Abductor pollicis brevis
Flexor pollicis brevis

72
Q

What is the action and innervation of opponens pollicis?

A

Oppose the thumb

Median nerve

73
Q

Where does opponens pollicis originate and attach?

A

Origin: tubercle of trapezium
Attach: lateral margin of thumb metacarpal

74
Q

Where does abductor pollicis brevis originate and attach?

A

Origin: Tubercles of scaphoid and trapezium
Attach: lateral side of proximal phalanx of thumb

75
Q

What is the action and nerve supply of abductor pollicis brevis?

A

Action: abducts the thumb

Nerve supply: median nerve

76
Q

Where does flexor pollicis brevis originate and attach?

A

Origin: tubercle of trapezium
Attach: base of proximal phalanx of thumb

77
Q

What is the action and nerve supply to flexor pollicis brevis?

A

Flexes the MCP joint of thumb

Median nerve, the deep head is ulnar nerve innervated

78
Q

Where are the hypothenar muscles situated?

A

The medial side of the palm at the base of the little finger

79
Q

Which nerve supplies the hypothenar muscles?

A

Ulnar nerve

80
Q

What are the 3 hypothenar muscles?

A

Opponens digiti minimi
Abductor digiti minimi
Flexor digiti minimi brevis

81
Q

What is the origin and attachment of the opponens digiti minimi?

A

Origin: hook of hamate
Attach: inserts into the medial margin of metacarpal 5

82
Q

What is the action and nerve supply of opponens digiti minimi?

A

Opposes the little finger, rotates the metacarpal towards the palm
Ulnar nerve

83
Q

What is the origin and attachment of abductor digiti minimi?

A

Origin: Pisiform
Attach: base of proximal phalanx of little finger

84
Q

What is the action and nerve supply to abductor digiti minimi?

A

Abducts the little finger

Ulnar nerve

85
Q

What is the origin and attachment site of flexor digiti minimi brevis?

A

Origin: hook of hamate
Attach: base of proximal phalanx of middle finger

86
Q

What is the action and nerve supply to flexor digiti minimi brevis?

A

Action: flexes the MCP joint of the little finger

Nerve supply: ulnar nerve

87
Q

How many lumbrical muscles does each hand have?

A

4 - each associated with a finger

88
Q

What does denervation of the lumbricals lead to?

A

Ulnar claw and hand of benediction

89
Q

What is the origin and attachment of the lumbricals?

A

Each lumbrical originates from a tendon of the flexor digitorum profundus, passing dorsally and laterally around each finger to insert into the extensor hood

90
Q

What is the action and nerve supply to the lumbrical muscles?

A

Action: flexion at the MCP joint and extension at the IP joints of each digit
Nerve supply: index and middle finger = median nerve, little and ring finger = ulnar nerve

91
Q

Where are the interossei muscles located?

A

Between the metacarpals

92
Q

What are the two groups of interossei muscles?

A

Palmar and dorsal

93
Q

Where do the dorsal interossei originate and attach?

A

Origin: lateral and medial surfaces of the metacarpals
Attach: extensor hood and proximal phalanx of each finger

94
Q

What is the action and nerve supply of the dorsal interossei?

A

Action: DAB: abduct the fingers at the MCP joint
Innervation: Ulnar nerve

95
Q

How many dorsal interossei muscles are there?

96
Q

How many palmar interossei muscles are there?

97
Q

Where do the palmar interossei muscles originate and attach?

A

Origin: medial or lateral surface of metacarpal
Attach: extensor hood and proximal phalanx of same finger

98
Q

What is the action and nerve supply to the palmar interossei?

A

Action: PAD: Adducts the fingers at the MCP joint
Nerve: Ulnar nerve

99
Q

What is the action and nerve supply of adductor pollicis?

A

Action: adduct the thumb

Nerve supply: ulnar nerve

100
Q

What is the arterial supply to the hand?

A

Ulnar artery –> deep palmar branch –> superficial palmar arch

Radial artery –> branches to the thumb, index and superficial palmar arch –> continues as the deep palmar arch

101
Q

What are the 5 degrees of nerve injury?

A
  1. Neuropraxia
  2. Axonotmesis (2,3,4)
  3. Neurotmesis
102
Q

What is the consequence of neuropraxia?

A

Focal segmental demyelination

103
Q

What is the consequence of axonotmesis (G2)?

A

Damaged axon with intact endoneurium

104
Q

What is the consequence of axonotmesis (G3)?

A

Damaged axon and endoneurium with intact perineurium

105
Q

What is the consequence of axonotmesis (G4)?

A

Damaged axon, endoneurium, and perineurium with intact epineurium

106
Q

What is the consequence of neurotmesis?

A

Complete nerve transection

107
Q

Characteristic of ulnar hand

A

Ulnar nerve damage at forearm/elbow
Hyperextension at the MCP joints and flexion of the PIP and DIP joints of the 4th and 5th fingers
- Can make a full fist but when they extend their fingers, the hand posture is referred to as claw hand

108
Q

Characteristic of hand of benediction

A

Median nerve damage at the forearm/elbow
- When a patient is asked to make a fist, the ring finger and little finger flex but the index and middle fingers cannot flex at the MCP, PIP and DIP joints

Neurological, neuromuscular and musculoskeletal disease (36 decks)

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