Sem 1 - U - Anterior forearm&wrist - Superficial/Intermediate/Deep compartments, carpal bones, flexor retinaculum,carpal tunnel

Question 1

Name all the muscles in the anterior compartment of the forearm

Answer 1

• * Pronator teres
• * Palmaris longus
• * Flexor carpi radialis
• * Flexor carpi ulnaris

Flexor digitorum superficialis

• * Flexor digitorum profundus
• * Flexor pollicus longus
• * Pronator quadratus

Question 2

What word will the muscles which specifically cause a movement of the wrist have in it? What word will muscles controlling movement of the thumb have in it? What word will muscles controlling movement of the digits have in it? What is the difference in shapes of the pronator teres and quadratus? What nerves supply the anterior compartment of the arm?

Answer 2

* Muscle specifically causing movement of the wrist - will have ‘carpi’ * Muscle controlling movement of the thumb - will have ‘pollicis’ * Muscle controlling movement of the digits - will have ‘digitorum’ * Pronator teres - cord like in shape * Pronator quadratus - square like in shape * Median nerve is the main supply * Ulnar nerve supplies flexor carpi ulnaris and little and ring digits of flexor digitorum profundus

Question 3

The digitis can either be named by number or word ie 1st to 5th digit Usually 1st digit would be starting at the thumb but this can differ depending on the text so safer to use words to describe each of the fingers State the name for all 5 digits? (lateral to medial in the anatomical position) What are the movements permitted by the anterior compartment of the forearm?

Answer 3

Thumb Index finger Middle finger Ring finger Little finger

Flexion of the wrist and digits, abduction/adduction of the wrist and pronation of the forearm

Question 4

What muscles does the ulnar nerve run between?

Answer 4

The ulnar nerve runs between the flexor carpi ulnaris and the ring and digit finger muscles of the flexor digitorum profundus

Question 5

What are the muscles in each of the compartments of the forearm? (from medial to lateral)

Answer 5

https://s3.amazonaws.com/classconnection/403/flashcards/11907403/jpg/ppngjpgpng-167230DA4391DD34D8F.jpg

Question 6

Which muscles insert at the common flexor tendon? Where is the common flexor tendon? What is tendonitis of the common flexor tendon known as?

Answer 6

Common flexor tendon insert tat the medial epicondyle of the humerus Medial epicondylitis = golfer’s elbow Muscles contributing are: * Pronator teres * Flexor carpi ulnaris * Palmaris longus * Flexor carpi radialis * Flexor digitorum superficialis (intermediate anterior compartment of the forearm)

Question 7

What is the most superficial muscle of the anterior compartment of the forearm? What are its attachments?

Answer 7

The most superficial muscle is the palmaris longus It attaches from the medial epicondyle of the humerus to the palmar fascia (aponeurosis)

Question 8

What is the function of the palmaris longus and what is special about it? What is its nerve supply? (state which roots of the nerve if possible)

Answer 8

The palmaris longus functions to tighten the palmar aponeurosis and aids with wrist flexion It is not present in everyone Palmaris longus is supplied by the median nerve (C7,8)

Question 9

If a muscle is to be involved in pronation or supination, it must be attached to the radius at some point What are the attachments of the pronator teres?

Answer 9

The pronator teres attaches from the medial epicodyle of the humerus (humeral head) and the coronoid process of the ulna (ulnar head) to the lateral surface of the radius

Question 10

What is the function of the pronator teres? (there are 2) What is its nerve supply?

Answer 10

Pronator teres pronates the forearm but also assists in elbow flexion as it crosses the elbow joint It is supplied by the median nerve (C6,7, roots)

Question 11

State the attachments, functionn and nerve supply of the pronator teres? Where does the nerve run in this muscle?

Answer 11

Attachments - Medial epicondyle of humerus and coronoid fossa of the ulna to the lateral surface of the radius Pronates the forearm (and assists in elbow flexion) Median nerve (C6,7) runs between the humeral and ulnar head to supply this muscle

Question 12

Once the median nerve passes through the pronator teres, what does it branch into and why?

Answer 12

The median nerve gives off the anterior interosseus branch which will go on to supply the deep muscles of the anterior forearm Flexor digitorum profundus Flexor pollicis longus Pronator quadratus Main branch of the median nerve will supply the other anterior forearm muscles & wrist/hand structures

Question 13

So we have discussed the pronator teres and palmaris longus On either side of the palmaris longus is a flexor carpi Which side is the flexor carpi ulnaris and which side is the flexor carpi radialis on? What is their function?

Answer 13

The flexor carpi ulnaris lies medially to the pamaris longus The flexor carpi radialis lies laterally to the palmaris As their name suggest they both act to flex the wrist Although the flexor carpi ulnaris also adducts the wrist and the flexor carpi radialis also abducts the wrist

Question 14

The carpis acts with their companion extensor muscles to abduct and adduct the wrist What are these muscles known as?

Answer 14

Flexor carpi ulnaris and extensor carpi ulnaris adduct the wrist Flexor carpi radialis, extensor carpi radialis longus and extensor carpi radialis brevis will abduct the wrist

Question 15

Whhich muscle tendon lies laterally to the flexor carpi radialis although this muscle is actually considered to be one of the posterior forearm?

Answer 15

The brachioradialis

Question 16

What is the attachment of the flexor carpi ulnaris? What nerve supplies it and what roots of this nerve?

Answer 16

Attaches from the common flexor tendon at the medial epicondyle of the humerus to the base of the pisiform, hamate and 5th metacarpal It is supplied by the ulnarnerve (C7.8 roots)

Question 17

What is the attachment of the flexor carpi radialis? What nerve supplies it and what roots of this nerve?

Answer 17

Attaches from the medial epicondyle of the humerus to the base of the 2nd metacarpal It is supplied by the median nerve (C6,7 roots)

Question 18

So covering the superficial compartment of the anterior forearm Pronator teres Palmaris longus Flexor carpus ulnaris (ulnar side) Flexor carpus radialis (radial side) State each muscles attachment and function and nerve supply (include roots)

Answer 18

https://s3.amazonaws.com/classconnection/403/flashcards/11907403/jpg/ppngjpgpngjpgpng-16726F218D7179FF224.jpg

Question 19

The final muscle to attach to the common flexor tendon is the flexor digitorum superficialis This is the only muscle form the intermediate compartment of the forearm What are the attachments of this muscle?

Answer 19

Attaches at the medial epicondyle of the humerus (humeral head) and the coronoid process of the ulna (Ulnar head) to the lateral sides of the middle phalanges of digits 2-5 (all except the thumb) The FDS divides into 4 tendons as it crosses the wrist joint as shown in pic

Question 20

What is the function of the flexor digitorum superficialis and what is its nerve supply?

Answer 20

Flexes the wrist, metacarpophalyngeal joints and proximal interphalyngeal joints It is supplied by the median nerve (C7,8, T1)

Question 21

State the attachments, function and nerve supply of the flexor digitorum superficialis

Answer 21

FDS Medial epicondyle of humerus and coronoid process of ulna to the lateral aspect of the middle phalanges digits 2-5 Function - flexion of the wrist, MCP and PIP joints Nerve supply - median nerve (C7,8,T1)

Question 22

The deep compartment of the anterior forearm has which muscles? What is the nerve supplying these muscles? (state the nerve roots)

Answer 22

Flexor digitorum profundus Flexor pollicis longus Pronator quadratus These muscles are supplied by the anrerior interoseus branch of the median nerve or the ulnar nerve (both C8,T1 nerve roots)

Question 23

Where does the anterior interosseus branch of the median nerve come from?

Answer 23

Once the median nerve passes through the two heads of the pronator teres, it gives off the anterior interosseus nerve which descends onto the anterior aspect of the interosseus membrane innervating the deep compartment of the anterior forearm

Question 24

What is the attachments of the flexor digitorum profundus?

Answer 24

This muscle originates from the ulna and associated interosseus membrane and inserts at the distal phalanges of digits 2-5 it is the only flexor of the distal interphalngeal joints

Question 25

What is the function of the flexor digitorum profundus? What is its nerve supply?

Answer 25

It flexes the wrist, MCP, PIP and DIP joints Ring and little fingers - ulnar nerve (C8,T1) Middle and index fingers - anterior interosseus branch of the median nerve - (C8,T1)

Question 26

What is the attachment of the flexor pollicis longus?

Answer 26

It attaches from the radius and associated interosseus membran to the base of the distal phalnyx of the thumb

Question 27

What is the function of the flexor pollicis longus? What is its nerve supply?

Answer 27

It flexes MCP and IP joint of the thumb and flexes the wrist It is supplied by the anterior interosseus branch of the median nerve (C8,T1)

Question 28

Need to understand the movements of the thumb State what each of the movements of the thumb are

Answer 28

Movements of the thumb are in the same plane as the palm of the hand 1. Flexion of the thumb 2. Extension of the thumb 3. Abduction of the thumb 4. Adduction of the thumb 5. Opposition of the thumb

Question 29

State the attachments of the pronator quadratus?

Answer 29

Attaches from the distal anterior ulna to the distal anterior radius

Question 30

What is the function of the pronator quadratus and what is its nerve supply?

Answer 30

Pronator quadratus - pronation of the forearm and stabilises the distal radioulnar joint Nerve supply - anterior interosseus branch of the median nerve (C8,T1)

Question 31

So covering the deep compartment of the anterior forearm \* Flexor digitorum profundus \* Flexor pollicis longus \* Pronator quadratus State each muscles attachment and function and nerve supply (include roots)

Answer 31

https://s3.amazonaws.com/classconnection/403/flashcards/11907403/jpg/ppngjpgpng-167272AEFF3727CFE36.jpg

Question 32

Which nerve of the forearm will pass through the carpal tunnel? What is the main nerve of the thumb? (thenar prominence muscles) What is the main nerve of the little finger? (hypothenar prominence muscles)

Answer 32

Median nerve will pass through the carpal tunnel (anterior interosseus nerve ends at the pronator quadratus) and gives off digital and recurrent median branches after the wrist) Neither radial or ulna nerve passes through the carpal tunnel \* Main nerve of the thumb is the median nerve \* Main nerve of the little finger is the ulnar nerve

Question 33

What are the nerve roots of the axillary, musculocutaneous, radial, ulnar and median nerve?

Answer 33

Axillary nerve - C5,6 Musculocutaneous nerve - C5,6,7 Radial nerve - C5-T1 Median nerve - C6-T1 Ulnar nerve - C(7),8, T1

Question 34

Which bone of the finger does the ulnar nerve travel above? Where does the ulnar artery arise from and what is its biggest branch?

Answer 34

The ulnar nevre will travel above the carpal tunnel over the pisiform carpal bone Ulnar artery is a branch of the brachial artery and gives off the large common interosseus artery which divides into the anterior and posterior interosseous arteries

Question 35

Ulnar artery will pass from the brachial artery over the roof of the carpal tunnel to contribute to what arch? What does the anterior and posterior interosseus arteries supply?

Answer 35

Ulnar artery will be the main contributor to the superficial palmar arch Anterior interosseus artery will run on the anterior aspect of the interosseus membrane supplying structures here The posterior interoessues artery pierces the interosseus membrane to supply the deep posterior forearm muscles

Question 36

What arteries run with the ulnar nerve and radial nerve? What artery does the median nerve run superficial to?

Answer 36

The ulnar nerve runs with the ulnar artery The superficial branch of the radial nerve (cutaneous branch) runs with the radial artery The median nerve runs superficial to the anterior interosseus artery which runs with the anterior interossus nerve

Question 37

First, lets discuss the carpal bones (forming the floor of the carpal tunnel) What are the carpal bones? Useful to know the mnemonic which distinguishes between the proximal and distal rows

Answer 37

Proximal row (lateral - medial) * \* Scaphoid \* Lunate \* Triquetral \* Pisiform Distal row (lateral - medial) * \* Trapezium \* Trapezoid \* Capitate \* Hamate Some Lovers Try Positions That They Cannot Handle

Question 38

What forms the roof and floor of the carpal tunnel?

Answer 38

The roof of the carpal tunnel is formed by the flexor retinaculum (aka the transverse carpal ligament) The floor of the carpal tunnel is formed by the carpal bones

Question 39

Which bone dominates the proximal row of the carpals? What shape is the lunate? What is the most mobile carpal bone and what does it sit on? Which bone sits under the MCP of the thumb? What is the biggest carpal bone? Why does the hamate have a small hook?

Answer 39

Scaphoid bone dominates the proximal row of the carpals. Next to it is the moon shaped lunate bone Most mobile carpal bone is the pisiform & this sits on top of the triquetral bone Trapezium sits under the base of the thumb Biggest carpal bone is the capitate and the Hamate has a small hook for the attachment of the flexor retinaculum

Question 40

What joints exist between the carpal bones? What joints exist between the carpometacarpal joints?

Answer 40

Between carpal bones are synovial plane joints Between the carpometacarpal joints of digtis 2-5 are synovial plane joints Between the 1st carpometacarpal joint - the joint between the metacarpal of the thumb and the trapezium is a synovial saddle joint allowing opposition of the thumb

Question 41

Which ligaments stabilise the wrist joint?

Answer 41

The medial and lateral collateral ligaments of the wrist The intercarpal ligaments And the transverse carpal ligament ie the flexor retinaculum

Question 42

Why is there an increased level of adduction compared to abduction?

Answer 42

The ulna bone does not actually articulate with the carpal bones of the wrist, instead there is an articular disc which can be compressed allowing for greater adduction of the wrist compared to the radius articulation with the carpal bones

Question 43

The roof of the carpal tunnel is formed by the flexor retinaculum What is the flexor retinacuum attached to?

Answer 43

Medially it attaches to the pisiform and hook of hamate Laterally it attaches to the tubercle on the scaphoid and ridge on the trapezium Thenar and hypothenar muscles attach to the flexor retinaculum

Question 44

What structures pass through the carpal tunnel? What is special about the flexor carpi radialis?

Answer 44

The tendons of the flexor digitorum superficialis, flexor digitorum profundus, flexor pollicis longus and median nerve pass through The flexor carpi radialis is sectioned off by connective tissue from the trapezium (septum of trapezium) so that it passes through the tunnel in its own compartment to reach the base of the 2nd metacarpal