Quiz 5 Review Flashcards
Common Flexor Tendinitis
-Common Flexor Tendinitis
-a.k.a. Medial Epicondylitis
Layman’s Term = Golfers Elbow
Muscles of Anterior Forearm (flexor-pronator group)
3 Layers: Superficial, Intermediate, Deep
-Has septum of deep fascia that separates deep layer of flexor muscles from superficial and intermediate layers
-Dividing line between flexor-pronator and extensor-supinator group is Posterior Border of Ulna
-There is a common proximal tendinous attachment: common flexor tendon (CFT) which attaches to medial epicondyle of humerus
Palmar Aponeurosis
-Strong connective tissue (CT) covers palm of hand
-PROXIMAL PART IS CONTINUOUS WITH FLEXOR RETINACULUM & FASCIA OF FOREARM (ANTEBRACHIAL FASCIA)
Pronator Teres (Attachment)
-Superior/Proximal Attachment: Medial epicondyle, coronoid process of the ulna
-Inferior/Distal Attachment: Middle, Lateral surface of the Radius
Superficial Layer of the Anterior Forearm
-Pronator Teres
-Flexor Carpi Radialis (FCR)
-Palmaris Longus
-Flexor Carpi Ulnaris (FCU)
Pronator Teres (Action)
-Action: Pronation (radioulnar joints)
-Action: Elbow Flexion (Weak)
Flexor Carpi Radialis (Attachment)
-Superior/Proximal Attachment: Medial Epicondyle
-Inferior/Distal Attachment: Base of 2nd metacarpal (slip also runs to base of the 3rd)
*RADIAL ARTERY IS JUST LATERAL TO IT
Flexor Carpi Radialis (Action)
-Action: Radiocarpal Joint Flexion
-Action: Radial Deviation (abduction) (with ECRL/ECRB)
-Action: Elbow Flexion (weak)
Palmaris Longus (attachment)
-Superior/Proximal Attachment: Medial Epicondyle
-Inferior/Distal Attachment: Palmar Aponeurosis
*Absent on one or both sides (usually the left) in 14% of the population
*If absent, its actions are easily compensated for by FCU, FCR
Palmaris Longus (Action)
-Action: Radiocarpal Joint Flexion
-Action: Elbow Flexion (weak)
Flexor Carpi Ulnaris (Attachment)
*MUSCLE HAS 2 HEADS: HUMERAL HAD & AN ULNAR HEAD
*ULNAR NERVE PASSES BETWEEN THE 2 HEADS
*ULNAR NERVE & ARTERY ARE JUST LATERAL TO IT
Superior/Proximal Attachment (humeral head): Medial Epicondyle
-Superior/Proximal Attachment (ulnar head): Olecranon & Upper 1/2 of the posterior ulna
-Inferior/Distal Attachment: Pisiform, hook of hamate, base of the 5th metacarpal
Flexor Carpi Ulnaris (Action)
-Action: Radiocarpal joint flexion
-Action: Ulnar Deviation (adduction) (with ECU)
-Action: Elbow Flexion (weak)
Flexor Digitorum Superficialis (Attachments)
-Superior/Proximal Attachment (humeroulnar head): Medial epicondyle, coronoid process of Ulna
-Superior/Proximal Attachment (radial head): Anterior/superior radius
-inferior/Distal Attachment: Sides of bases of intermediate phalanges of medial four digits
Flexor Digitorum Superficialis (Actions)
-Action: 2nd-5th CMC, MCP, PIP joint flexion (PIPs BASED ON ATTACHMENT TO INTERMEDIATE PHALANGES)
* NOTE HOW TENDON SPLITS AT DISTAL ATTACHMENT
-Action: Radiocarpal joint flexion
-Action: Elbow flexion (weak)
The Deep Layer of the Anterior Forearm
-Flexor Digitorum Profundus (FDP)
-Flexor Pollicis Longus (FPL)
-Pronator Quadratus
*None of these muscles attach proximally to humerus
Flexor Digitorum Profundus (attachments)
Superior/Proximal Attachment: Proximal anterior surface of ulna and interosseous membrane
Inferior/Distal Attachment: Bases of distal phalanges of medial four digits
* All tendons pass over the flexor retinaculum
* As each of the tenants travel into the fingers, it is enclosed with a common sheath
Flexor Digitorum Profundus (actions)
-Action: 2nd-5th CMC, MCP, IP joint flexion
-Action: Radiocarpal joint flexion
Pollicis/Pollux = ________________
Thumb
Flexor Pollicis Longus (attachments)
-Superior/Proximal Attachment: Anterior middle surface of radius and interosseous membrane
-Inferior/Distal Attachment: Base of distal phalanx of thumb
Flexor Pollicis Longus (actions)
-Action: IP joint flexion of 1st digit
-Action: MCP, CMC joint flexion of the first digit
Pronator Quadratus (attachments)
-Medial Attachment: Distal anterior Ulna
-Lateral Attachment: Distal anterior Radius
* Cannot be palpated nor observed
* Also helps to hold Ulna and Radius together
Pronator Quadratus (action)
-Action: Pronation (prime mover) (radioulnar joints)
Muscles that Rotate the Forearm/Hand
Pronator Quadratus, Pronator Teres
Muscles that Flex the Hand
FCR, FCU, Palmaris Longus
Muscles that Flex the Digits
FDS, FDP, FPL
Structures Passing Through the Carpal Tunnel
-Flexor Digitorum Superficialis
-Flexor Digitorum Profundus
-Flexor Pollicis Longus
-The Median Nerve
Muscles of the Posterior Forearm (extensor–supinator group)
2 Layers: Superficial and deep
-Brachioradialis (although it’s on anterolateral part of the forearm, it’s a elbow, flexor, forms lateral border of cubital fossa, is innervated by the radial nerve, therefore is considered part of the extensor group)
-Extensor Carpi Radialis Longus (ECRL)
-Extensor Carpi Radialis Brevis (ECRB)
-Extensor Digitorum (ED) *NOTE THAT IN ARM IT IS ED, IN LEG IT IS EDL, EDB
-Extensor Digiti Minimi
-Extensor Carpi Ulnaris (ECU)
Extensor Retinaculum
-Extensor tendons at the wrist pass under the extensor retinaculum
-With each tendon is a sheath for protection
Brachioradialis (attachments)
-Superior/Proximal Attachment: Lateral supracondylar ridge of the humerus (proximal part)
-Inferior/Distal Attachment: Lateral distal radius
Brachioradialis (action)
-Action: Elbow flexion (strongest when form is in neutral)
Extensor Carpi Radialis Longus (attachments)
-Superior/Proximal Attachment: Supracondylar ridge of humerus (distal part)
-Inferior/Distal Attachment: Base of the 2nd metacarpal
Extensor Carpi Radialis Longus (action)
-Action: Radiocarpal extension
-Action: Radial deviation (abduction) (with FC and ECRB)
For muscles ECRB, ED, Extensor Digiti Minimi, and ECU what is the common proximal tendon attachment?
The common extensor tendon (CET) which attaches to the lateral epicondyle of the humerus
Extensor Carpi Radialis Brevis (attachments)
-Superior/Proximal Attachment: Lateral epicondyle
-Inferior/Distal Attachment: Base of the 3rd metacarpal
Extensor Carpi Radialis Brevis (action)
-Action: Radiocarpal extension
-Action: Radial deviation (abduction) (with FCR and ECRL)
What is the WAD of 3?
-Brachioradialis
-Extensor Carpi Radialis Longus
Extensor Carpi Radialis Brevis
Extensor Digitorum (attachments)
-Superior/Proximal Attachment: Lateral Epicondyle
-Inferior/Distal Attachment: Distal Phalanges of the Medial 4 Digits
Extensor Digitorum (actions)
-Action: 2nd-5th MCP, IP extension
-Action: Radiocarpal extension
Extensor Digiti Minimi (attachments)
-Superior/Proximal Attachment: Lateral Epicondyle
-Inferior/Distal Attachment: Extensor expansion of the 5th digit (CONNECTIVE TISSUE THAT FORMS A ‘ HOOD’ AT THE 2nd 5th MCPs SO AS TO SUPPORT LOCAL STRUCTURES (TENDONS, JOINTS))
Extensor Digiti Minimi (action)
-Action: 5th digit extension
Extensor Carpi Ulnaris (attachments)
-Superior/Proximal Attachment: Lateral Epicondyle
-Inferior/Distal Attachment: Base of the 5th metatarsal
Extensor Carpi Ulnaris (action)
-Action: Radiocarpal extension
-Action: Ulnar Deviation (with FCU)
Deep Layer of the Posterior Forearm
-Supinator
-Extensor Indicis
-Abductor Pollicis Longus
-Extensor Pollicis Brevis
-Extensor Pollicis Longus
Supinator (Attachments)
-Superior/Proximal Attachment (superficial layer): Lateral Epicondyle, LCL, Annular Ligament
-Superior/Proximal Attachment: (deep layer): Supinator Fossa/Crest of Ulna (posterior proximal ulna)
-Inferior/Distal Attachment: Anterior/Lateral/Posterior Parts of Proximal Radius
Supinator (Action)
Supination (radioulnar joints) (especially slow, non-resisted supination)
Extensor Indicis (Attachment)
-Superior/Proximal Attachment: Posterior Mid-Distal Forearm (posterior mid-distal ulnar surface & interosseous membrane)
-Inferior/Distal Attachment: Extensor Expansion of the 2nd digit (@ MCP)
Extensor Indicis (Action)
Extends 2nd Digit
Abductor Pollicis Longus (attachment)
-Superior/proximal attachment: posterior mid-distal forearm (posterior surface of ulna, radius, and interosseous membrane)
-Inferior/distal attachment: Base of 1st metacarpal
Abductor Pollicis Longus (action)
Action: 1st CMC abduction
Extensor Pollicis Brevis (attachment)
-Superior/proximal attachment: posterior mid-distal forearm (posterior mid-distal radial surface and interosseous membrane)
-inferior/distal attachment: Base of the proximal phalanx of the thumb
Extensor Pollicis Brevis (action)
-Action: 1st MCP extension
-Action: 1st CMC extension
Extensor Pollicis Longus (attachment)
-Superior/proximal attachment: posterior mid-distal forearm (posterior ulnar surface and interosseous membrane) (superior to the extensor indicis)
-Inferior/distal attachment: base of the distal phalanx of the thumb
Extensor Pollicis Longus (action)
-Action: 1st IP extension
-Action: 1st MCP extension
The Anatomical Snuffbox
-On the lateral aspect at the base of the thumb
-Anterior Border: abductor pollicis longus and extensor pollicis brevis
-Posterior Border: extensor pollicis longus
-Floor: Scaphoid
* Remember this is from anatomical position
Thenar Muscles
Thenar relates to thumb so this is the fleshy part at the base of the thumb
Opponens Pollicis (attachment)
-Proximal attachment: flexor retinaculum, tubercle of the trapezium
-Distal attachment: lateral side of 1st metacarpal
Opponens Pollicis (action)
-Action: plexus and rotates the thumb medially (during grasping) (components of opposition)
Abductor Pollicis Brevis (attachment)
-Proximal Attachment: flexor retinaculum, tubercles of scaphoid and trapezium
-Distal Attachment: lateral side of base of the proximal phalanx thumb
Abductor Pollicis Brevis (action)
-Action: abducts thumb and assists in opposition (abduction being a component of opposition)
Flexor Pollicis Brevis (attachment)
-Proximal Attachment: flexor retinaculum, tubercles of scaphoid and trapezium
-Distill attachment: lateral side of base of proximal phalanx of the thumb
Flexor Pollicis Brevis (action)
-Action: flexes thumb and assists in opposition (flexion being a component of opposition)
The Hypothenar Muscles
The fleshy part at the base of the 5th digit
Opponens Digiti Minimi (attachment)
-Proximal Attachment: hook of hamate and flexor retinaculum
-Distal Attachment: Medial border of the 5th metacarpal
Opponens Digiti Minimi (action)
-Action: draws the 5th metacarpal anteriorly and rotates it to oppose the thumb
Abductor Digiti Minimi (attachment)
-Proximal Attachment: pisiform
-Distal Attachment: medial side of the base of the proximal phalanx of the 5th
Abductor Digiti Minimi (action)
-Action: Abducts 5th finger
Flexor Digiti Minimi Brevis (attachment)
-Proximal Attachment: hook of hamate and flexor retinaculum
-Distal Attachment: Medial side of base of proximal phalanx of the 5th
Flexor Digiti Minimi Brevis (action)
-Action: flexes proximal phalanx of the 5th
Palmaris Brevis (attachments)
-Superior/proximal attachment: flexor retinaculum, palmar aponeurosis
-Inferior/distal attachment: skin on the medial side of the palm
Palmaris Brevis (action)
-Action: wrinkles the skin on the medial side of the palm (this deepens, the hollow of the palm which aids in grip)
-Action: covers/protects the ulnar nerve and artery
* relatively unimportant
Adductor Pollicis (attachment)
-Superior/proximal attachment (oblique head): base of the 2nd metacarpal, trapezoid, capitate
-Superior/proximal attachment (transverse head): shaft of the 3rd metacarpal
-Inferior/distal attachment: medial side of base of proximal phalanx of thumb
* Forms the bulk of the thumb web space on the anterior surface opposite the first dorsal interosseous on the posterior surface
Adductor Pollicis (action)
-Action: adducts the thumb when you (significantly contributes to grasping power)
Lumbricals (attachment)
-Superior/proximal attachment: FDP tendon
-Inferior/distal attachment: extensor expansion of 2nd-5th digits
Lumbricals (action)
-Action: MCP flexion, IP extension
Dorsal Interossei (4 muscles) (attachment)
-Superior/proximal attachment: adjacent sites of two metacarpal bones
-Inferior/distal attachment: extensor, expansions, and bases of proximal phalanges of 2nd-4th digits
Dorsal Interossei (4 muscles) (action)
-Action: Abducts digits
Palmar Interossei (3 muscles) (attachments)
-Superior/proximal attachment: Palmer surfaces of 2nd, 4th, and 5th metacarpals
-Inferior/distal attachment: Extensor expansions, and pieces of proximal phalanges of 2nd, 4th, and 5th digits
Palmar Interossei (3 muscles) (action)
-Action: adducts digits
What are the Thenar Muscles? (*will definitely be test question)
-Opponens Pollicis
-Abductor Pollicis Brevis
-Flexor Pollicis Brevis
What are the Hypothenar Muscles? (*will definitely be test question)
-Opponens Digiti Minimi
-Abductor Digiti Minimi
-Flexor Digiti Minimi Brevis
-Palmaris Brevis
Has _____________ that separates deep layer of flexor muscles from superficial and intermediate layers
Septum of Deep Fascia
Dividing line between flexor-pronator and extensor-supinator group is ___________________.
Posterior Border of Ulna
(Anterior Forearm Flexors) There is a common proximal tendinous attachment: _________________ which attaches to ___________________.
Common Flexor Tendon (CFT), Medial Epicondyle of Humerus
