Sept 11 - Upper Extremity

Question 1

What do the olecranon fossa and coronoid fossa do?

Answer 1

They allow the other pieces of the arm to lock in place

Question 2

What is a fossa?

Answer 2

A fossa is an opening

Question 3

Describe the ulna

Answer 3

It’s on the little finger side
The proximal end is shaped like a wrench
The inner part of the wrench is the olecranon fossa/trochlear notch
The lower lip of the wrench is the coronoid process
Distal “head” is small and terminates as the ulnar styloid process medially

Question 4

Describe the radius

Answer 4

Thumb side of the forearm
Articulates directly with the wrist
The proximal end is the small rounded head
Distal end is larger and ends as the radial styloid process laterally

Question 5

What is the radius responsible for?

Answer 5

Supination (asking for money) and pronation (tap on the head)

Question 6

Describe the carpel bones

Answer 6

8 short bones arranged in 2 rows in the proximal aspect of hand
Allow for mobility of the hand and opposition (unique to humans)

Question 7

Name the 4 carpel bones in the proximal row of the wrist, from lateral to medial

Answer 7

Scaphoid, Lunate, Triquetrum and Pisiform

Question 8

Name the 4 carpel bones in the distal row of the wrist, from lateral to medial

Answer 8

Trapezium, Trapezoid, Capitate and Hamate

Question 9

Describe the metacarpels

Answer 9

5 metacarpals make up the palm of the hand. They are numbers 1 to 5 (1 = thumb). They consist of the base, shaft and distal head. The middle metacarpal should be the highest

Question 10

Describe the phalanges

Answer 10

Fingers of the hand. The thumb has two phalanges (distal and proximal). The remaining fingers have 3 phalanges (proximal, middle and distal).

Question 11

Describe the elbow joint

Answer 11

Hinge type synovial joint, allows flexion/extension. During flexion, the trochlear notch of the ulna articulates with the trochlear surface of the humerus and the radial head glides on the capitulum

Question 12

What is the carrying angle? What creates the carrying angle?

Answer 12

It’s a 15° angle of the forearm. It is greater in females to accommodate pelvic girdle (wider hips). The ulna migrates laterally because the trochlea is thicker medially.

Question 13

Describe the proximal radioulnar joint

Answer 13

The pivot joint between the proximal radius and ulna.

Question 14

Describe the position of the radius in relation to the ulna

Answer 14

Proximally, the radius and ulna are always side-by-side, but distally, the radius crosses over the ulna during pronation. This happens because the ulna is attached to the humerus, however the radius is only attached by a ligment

Question 15

What comprises the wrist joint?

Answer 15

It is comprised of the distal end of the radius and the proximal row of carpel bones (the ulna is separated by a fibro-cartilagenous disc and does not contribute to the wrist joint).
In between each carpel is a joint, but globally referred to as the wrist joint.
It is a condyloid synovial joint

Question 16

Name the function of the metacarpal-phalangeal joints

Answer 16

Aka MCPs
MCPs allow for flexion/extension, abduction/adduction (the middle finger is used as the point of reference to describe abduction and adduction

Question 17

What makes the 1st MCP unusual?

Answer 17

It’s a saddle type synovial joint between the trapezium and the base of the first metacarpal and it allows for opposition, in addition to flexion/extension and abduction/adduction (opposition is a very limited type of rotation)

Question 18

What are PIPs and DIPs?

Answer 18

Proximal interphalangeal joints and distal interphalangeal joints. They are hinge joints (flexion/extension, abduction/adduction

Question 19

Name the three muscles of the biceps. Where are they located?

Answer 19

Biceps brachii (crosses both the shoulder and eblow)
Brachialis (crosses the elbow)
Coracobrachialis (crosses the shoulder)

Question 20

Describe the biceps brachii

Answer 20

Superficial, 2 headed anterior arm muscle

Crosses the shoulder and the elbow (2 joints)

Question 21

What is the functions of the biceps brachii

Answer 21

Forearm supination (opens a door, opens a twist-off beer)
Secondary movements: elbow flexion (against resistance), shoulder flexion, shoulder adduction

Question 22

Describe the brachialis

Answer 22

Flat thin muscle, deep to biceps brachii.

Question 23

What is the function of the brachialis

Answer 23

Elbow flexion

Question 24

Describe the coracobrachialis

Answer 24

Located deep to pectoralis major, pectoralis minor and deltoid.

Question 25

What are the functions of the coracobrachialis?

Answer 25

Shoulder flexion, shoulder adduction

Question 26

What nerve innervates the three muscles of the biceps?

Answer 26

The musculocutaneous nerve

Question 27

Describe the triceps brachii

Answer 27

``` 3 headed muscle on posterior arm (brachium) Long head (crosses shoulder joint)/lateral head/medial head ```

Question 28

What nerve innervated the triceps brachii

Answer 28

Radial nerve

Question 29

What is the function of the triceps brachii?

Answer 29

All involved in powering elbow extension (above the head, not towards the ground)

Question 30

Describe the anterior compartment of the forearm

Answer 30

Arises from the medial epicondyle Involves flexors Involves pronators

Question 31

Describe the posterior compartment of the forearm

Answer 31

Arises from the lateral epicondyle Involves extensors Involves supinators

Question 32

Describe the compartments of the forearm

Answer 32

Each compartment contains a superficial and a deep region All forearm muscles are termed as "extrinsic muscles" of the hand Involved in power movements of the wrist, thumb and fingers

Question 33

Name the movements of the anterior compartment of the forearm

Answer 33

``` Flexion (wrist and fingers) Ulnar deviation (adduction) Radial deviation (abduction) Pronation Thumb Flexion ```

Question 34

Name the movements of the posterior compartment of the forearm

Answer 34

``` Extension (wrist and fingers) Ulnar deviation (adduction) Radial deviation (abduction) Supination Thumb extension Thumb abduction ```

Question 35

Name the common attachment points of the compartments of the forearm

Answer 35

The flexors are pushed medially to medial epicondyle of the humerus The extensors are pushed laterally to lateral epicondyle of the humerus

Question 36

Name the five muscles of the superficial layer of the anterior compartment of the forearm

Answer 36

``` Pronator teres Flexor carpi radialis Palmaris longus Flexor carpi ulnaris Flexor digitorum superficialis ```

Question 37

Name the three muscles of the deep layer of the anterior compartment of the forearm

Answer 37

Flexor digitorum profondus Flexor pollicis longus Pronator quadratus

Question 38

What is flexor retinaculum

Answer 38

It creates the carpal tunnel Each tendon of the wrist is held in place by a thick connective tissue sheath called the flexor retinaculum. Ensure the wrist is thin and efficient

Question 39

Name the five muscles of the superficial layer of the posterior compartment of the forearm

Answer 39

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

Question 40

Name the five muscles of the deep layer of the posterior compartment of the forearm

Answer 40

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

Question 41

What is the brachioradialis

Answer 41

At "top" of forearm (beer drinking muscle) It does not cross the wrist joint so technically is not considered a member of either the flexor or extensor group of forearm muscles Powers elbow flexion in semi-pronation Innervated by the radial

Question 42

What is the function of brachioradialis?

Answer 42

Powers elbow flexion in semi-pronation

Question 43

What nerve innervates the brachioradialis?

Answer 43

The radial nerve

Question 44

What is the thenar

Answer 44

It is the fleshy prominence on the palm | It's comprised of 3 muscles that act on the thumb

Question 45

What is the rule of three, in regards to the muscles of the hand?

Answer 45

Three compartments, each with comprised of 3 muscles and the compartments are innervated by three nerves

Question 46

Name the three compartments of the hand muscles

Answer 46

Thenar Hypothenar Central

Question 47

Name the three nerves that innervate the compartments of the hand muscles

Answer 47

Radial Ulnar (hypothenar group) Median (thenar group)

Question 48

Describe the thenar muscle group of the hand

Answer 48

It is the fleshy prominence on the radial side of the palm

Question 49

Describe the hypothenar muscle group of the hand

Answer 49

It is the fleshy prominence on the ball of the little finger

Question 50

Describe the central compartment of the hand

Answer 50

Muscles between hypothenar and thenar eminences | Muscles are more prominent on palmar surface

Question 51

Name the three muscles the comprise the central compartment and their function

Answer 51

Inter-ossei (abduction/adduction) Lumbricals (flexion of the MCPs) Adductor pollicis

Question 52

What is the palmar aponeurosis

Answer 52

It connects skin to underlying structures of the hand | It helps with holding objects

Question 53

Where do the nerves that innervate your arm muscles come from?

Answer 53

Every one of the muscles receives innervation from nerves that come from you neck, more specifically from the lower cervical (C5-C8) and ending at the upper thoracic level (T1)

Question 54

Name the 5 terminal nerves of the arms

Answer 54

``` Musculocutaneous Axillary Radial Median Ulnar ```

Question 55

Name the root blood takes from the heart to the arm

Answer 55

Heart - (brachiocephalic - subclavian artery)/common carotid artery - axillary artery - exits shoulder/armpit region - brachial artery - ulnar and radial artiery