TBL 11 Flashcards
extends from the elbow to the wrist and contains the radius and ulna, joined by interosseous membrane
forearm
strongly but flexibly connects the forearm bones permitting pronation and supination
interosseous membrane
provides proximal attachment for some deep forearm muscles
interosseous membrane
forearm is divided into:
3 fascial compartments (anterior, lateral, posterior)
muscles that lay within the same fascial compartment have
similar action and innervation
muscles that produce mainly flexion or pronation
anterior compartment muscles
the anterior compartment muscles produce mainly
flexion or pronation
nerve(s) that supplies the anterior compartment
median and ulnar
the median and ulnar nerves supply the
anterior compartment (AC)
muscles that produce mainly extension or supination
lateral (LC) and posterior (PC) compartment muscles
the lateral compartment muscles produce mainly
extension and supination
LES
the posterior compartment muscles produce mainly
extension and supination
nerve(s) that supplies the lateral compartment
radial nerve
nerve(s) that supplies the posterior compartment
radial nerve
anatomically, the proximal end of the forearm is defined by the
joint plane of the elbow
functionally, the forearm includes the
distal humerus
to maximize their functionality in close proximity, the wrist and hand are operated by
extrinsic muscles
extrinsic muscles have their bulky, contractile parts in the ___ and ___ extending distally to the palm and fingers
forearm; long tendons
extrinsic muscles have their ___ in the forearm and long tendons extending ___ to the ___
bulky, contractile parts; distally; palm and fingers
flexors lie
anteriorly
extensors lie
posteriorly
attachment site of the chief flexors and extensors of the elbow
medial and lateral epicondyles of the humerus
the medial and lateral epicondyles of the humerus are the attachment site of the chief ___ and ___ of the ___
flexors; extensors; elbow
articulation of the elbow joint is between the ___ and ___ of the humerus and the ___ of the ulna and ___ of the radius
trochlea; capitulum;
trochlear notch;
head
articulation between the trochlea and capitulum of the humerus, trochlear notch of the ulna, and the head of the radius
elbow joint
ligaments that surround the joint
joint capsule
the elbow joint capsule is anteriorly attached to the humerus along the upper margins of the ___, to the front of the ___, to the margin of the ___, and to the ___ ligament
coronoid fossa and radial fossa;
medial and lateral epicondyles;
coronoid process of the ulna;
anular ligament
the elbow joint capsule is posteriorly attached above to the margins of the ___, and below to the upper margin and sides of the ___, and to the ___ ligament
olecranon fossa of the humerus;
olecranon process of the ulna;
anular
lines the capsule and covers fatty pads in the floors of the coronoid, radial, and olecranon fossae
synovial membrane of the elbow joint
the synovial membrane of the elbow joint is continuous below with the synovial membrane of the
proximal radioulnar joint
the synovial membrane of the elbow joint lines the ___ and covers ___ in the floors of the ___
capsule; fatty pads; coronoid, radial, and olecranon fossae
continuous below with the synovial membrane of the proximal radioulnar joint
synovial membrane of the elbow joint
nerve supply of the elbow joint
branches from the median, ulnar, musculocutaneous, and radial nerves
triangular and attached by its apex to the lateral epicondyle of the humerus and by its base to the upper margin of the anular ligament
lateral (radial) collateral ligament
the radial collateral ligament is attached by its apex to the ___ and by its base to the ___
lateral epicondyle of the humerus;
upper margin of the anular ligament
ligament that runs around the head of the radius
anular
ligament with 3 bands (or bundles) forming a triangle
medial (ulnar) collateral ligament
bundle that passes from the medial epicondyle of the humerus to the medial margin of the coronoid process
anterior
the anterior bundle passes from the ___ to the ___
medial epicondyle of the humerus;
medial margin of the coronoid process
the posterior bundle passes from the ___ to the ___
medial epicondyle of the humerus;
medial side of the olecranon
bundle that passes from the medial epicondyle of the humerus to the medial side of the olecranon
posterior
passes between the ulnar attachments of the anterior and posterior bands
transverse ligament
movements of the elbow joint include:
only flexion and extension
when the arm is down at the side with the forearm extended, the long axis of the forearm lies at an angle to the long axis of the arm of 10-15 degrees out from the body laterally
carrying angle of the elbow joint
the carrying angle of the elbow joint is ___ degrees between ___
10-15; the long axis of the forearm and the long axis of the arm
what happens to the carrying angle when the elbow joint is fully flexed
disappears
when the carrying angle is >15 degrees
cubitus valgus
increases the risk of ulnar neuropathy
cubitus valgus
LmNoP
cubitus valgus increases the risk of
ulnar neuropathy and ulnar nerve damage
when the carrying angle is <10 degrees
cubitus varus
cubitus varus increases the risk of
a supracondylar fracture (humeral) and can cause ulnar nerve problems
increases the risk of a supracondylar fracture (humeral)
cubitus varus
what can cause ulnar nerve problems and/or damage
cubitus varus and cubitus valgus
articulation is between the head of the radius, the anular ligament, and the radial notch of the ulna
proximal radioulnar joint
the proximal radioulnar joint articulates between the
head of the radius, anular ligament, and radial notch of the ulna
encloses the joint and is continuous with that of the elbow joint
proximal radioulnar joint capsule
attached to the anterior and posterior margins of the radial notch on the ulna and forms a collar around the head of the radius
anular ligament
ligament of proximal radioulnar joint
anular ligament
ligament continuous above with the capsule of the elbow joint
anular ligament
is the anular ligament attached to the radius
no
anular ligament is attached __ and forms a collar around __
anterior and poster margins of the radial notch on the ulna;
head of the radius
nerve supply of proximal radioulnar joint includes:
branches of the median, ulnar, musculocutaneous, and radial nerves
movements of the proximal radioulnar joint include:
pronation and supination of the forearm
proximal radioulnar joint: the __ of the radius fits into the ___ of the ulna
head; radial notch
radial head is held in place in the radial notch of the ulna by the
anular ligaments
anular ligaments hold the
radial head in place in the radial notch of the ulna
occurs when the elbow is pulled on and the anular ligament is displaced
radial head subluxation (nursemaid’s elbow)
radial head subluxation often results from
axial traction on a pronated forearm with the elbow extended
in nursemaid’s elbow, the sudden pulling on the distal radius causes the anular ligament to
slip over the head of the radius and slide into the radiohumeral joint where it becomes trapped
classic mechanism of a __ is common in RHS
“pull injury”
in nursemaid’s elbow, pain occurs
with even mild supination of the forearm
unites the shafts of the radius and ulna
interosseous membrane
interosseous membrane fibers run obliquely ___ and ___
downward and medially;
resist proximal displacement of the radius
interosseous membranes prevent you from
pushing the radius up
due to the presence of the interosseous membrane, force applied to the lower end of the radius is transmitted from
the radius to the ulna and from there to the humerus and scapula
its fibers run obliquely downward and medially and resist proximal displacement of the radius
interosseous membrane
articulation between head of the ulna and the ulnar notch of the radius
distal radioulnar joint
distal radioulnar joint articulates
between the head of the ulna and ulnar notch of the radius
encloses the joint but is deficient superiorly
distal radioulnar joint capsule
distal radioulnar joint capsule is
deficient superiorly
ligaments of distal radioulnar joint
weak anterior (ventral) and posterior (dorsal) radioulnar ligaments
weak anterior (ventral) and posterior (dorsal) radioulnar ligaments strengthen the
capsule of the distal radioulnar joint
disc of fibrocartilage attached to the lateral side of the base of the styloid process of the ulna and to the radius
radioulnar articular disc
radioulnar articular disc is attached to
lateral side of the base of the styloid process of the ulna and to the radius
separates the distal radioulnar joint from the wrist joint (separates synovial cavities of the joints) and holds the radius to the ulna
radioulnar articular disc
radioulnar articular disc separates the ___ joint from the ___ joint and holds ___
radioulnar; wrist;
the radius to the ulna
lines the capsule passing from the edge of one articular surface to that of the other
distal radioulnar joint synovial membrane
the synovial membrane of the distal radioulnar joint lines the ___ passing from the __ to that of the other
capsule; edge of one articular surface
nerve supply of the distal radioulnar joint includes:
anterior interosseous nerve and the deep branch of the radial nerve
anterior interosseous nerve and the deep branch of the radial nerve supplies the
distal radioulnar joint
movement of the distal radioulnar joint include:
pronation and supination of forearm
the movements of pronation and supination of the distal radioulnar joint involve ___ around a __ at the ___
rotary movement;
vertical axis;
proximal and distal radioulnar joints
the axis of the pronation and supination performed by the distal radioulnar joint passes through ___ above and ___ below
the head of the radius;
head of the ulna
in the movement of pronation, the head of the radius rotates within the ___
anular ligament
the radius moves ___ of the head of the ulna at the ___ end
around the circumference; distal
the radius moves ___ of the head of the ulna at the ___ end
around the circumference; distal
key landmark that separates the flexor muscles on the anterior of the forearm from the extensor muscles of the back of the forearm
brachioradialis
the brachioradialis separates the ___ on the ___ of the forearm form the ___ on the ___ of the forearm
flexor muscles; anterior;
extensor muscles; posterior
anterior compartment muscles are divided into:
3 layers (superficial, intermediate, deep)
anterior compartment muscles perform ___
flexion and pronation
anterior compartment muscles are innervated by
median (major) and ulnar (minor) nerves
superficial and intermediate group of anterior muscles originate on this tendon
medial epicondyle of the humerus
superficial group of anterior muscles include:
pronator teres
flexor carpi radialis
palmaris longus
flexor carpi ulnaris
Terry’s Superficial Carps have 4 LongPalms
intermediate group of anterior muscles include:
flexor digitorum superficialis
Intermediate Digits are Flexed Superficially
deep group of anterior muscles include:
flexor pollicis longus
flexor digitorum profundus
pronator quadratus
Deeps has a LongPole, Quads, and Profound Digits
superficial and intermediate anterior muscle(s) innervated by the median nerve
pronator teres
flexor carpi radialis
palmaris longus
flexor digitorum superficialis
superficial and intermediate anterior muscle(s) innervated by the ulnar nerve
flexor carpi ulnaris
deep anterior muscle(s) innervated by the median nerve
flexor pollicis longus
flexor digitorum profundus
pronator quadratus
deep anterior muscle(s) innervated by the ulnar nerve
flexor digitorum profundus
runs under the flexor retinaculum
carpal tunnel
carpal tunnel runs under which tissue band
flexor retinaculum
tendons that run through the carpal tunnel
flexor digitorum profundus (4 tendons), flexor digitorum superficialis (4 tendons), flexor pollicis longus (1 tendon)
total of 9 tendons run through the carpal tunnel with the ___ nerve
median
insertion and action of pronator teres
mid-lateral surface of radius;
pronates forearm and hand
insertion and action of flexor carpi radialis
metacarpals 2 and 3;
flexes and abducts wrist
insertion and action of palmaris longus
palmar fascia;
flexes wrist
insertion and action of flexor carpi ulnaris
pisiform, hamate, 5th metacarpal;
flexes and adducts wrist
insertion and action of flexor digitorum superficialis
middle phalanges;
flexes proximal and middle phalanges of each finger
insertion and action of flexor pollicis longus
bones of thumb;
flexes the thumb
insertion and action of flexor digitorum profundus
base of the distal phalanges;
flexes distal phalanges of each finger
insertion and action of pronator quadratus
distal anterior surface of radius;
pronates forearm and hand
lateral compartment muscles include:
brachioradialis (except flexor of elbow)
extensor carpi radialis longus
anconeus
Brachio+Long radial ladder
posterior compartment muscles are divided into:
2 groups (superficial and deep)
superficial posterior muscles (lateral to medial)
extensor carpi radialis brevis
extensor digitorum
extensor digiti minimi
extensor carpi ulnaris
CRaB auditorium minimizes ulnaris
deep posterior muscles (lateral to medial)
abductor pollicis longus
extensor pollicis brevis
extensor pollicis longus
extensor indicis
Abs, Brev, Long, Indie
supinator
open area of the radius on the outside of the arm
supinator
lateral compartment muscles are innervated by the
radial nerve
posterior compartment muscles are innervated by the
radial (posterior interosseous nerve)
the posterior interroseous nerve is a continuation of the
deep radial branch
movements of the abductor pollicis longus
abduction of the thumb
movements of the extensor pollicis longus and brevis
extension of the thumb
terminal branches of the brachial artery include:
ulnar artery and radial artery
in the upper forearm, the ulnar artery is located under the ___ running over the ___
superficial and intermediate muscles of anterior compartment;
flexor digitorum profundus
the ulnar artery runs along the
ulnar nerve
located under the superficial and intermediate anterior muscles running over the flexor digitorum profundus
ulnar artery
in the lower forearm, the ulnar artery is more ___ and lies between the ___ and the
superficial;
tendons of the flexor carpi ulnaris and ulnar nerve;
tendons of the flexor digitorum profundus
lies between the tendons of the flexor carpi ulnaris and ulnar nerve & tendons of the flexor digitorum profundus
ulnar artery
the ulnar artery enters the ___ running over the ___ with the ___ and ends by forming the ___
palm of the hand;
flexor retinaculum;
ulnar nerve;
superficial palmar arch
transverse carpal ligament
flexor retinaculum
enters the palm over the transverse carpal ligament with the ulnar nerve and forms the superficial palmar arch
ulnar artery
the ulnar artery runs between the ___ and ___ to the ___
pisiform; hook of the hamate; palmar arches
runs between the pisiform and hook of the hamate to the palmar arches
ulnar artery
branches of the ulnar artery include:
muscular, anterior and posterior ulnar recurrent, common interosseous artery, anterior interosseous artery, posterior interosseous artery
run in opposite direction
recurrent
ulnar branch that supplies medial anterior group of muscles
muscular branch of ulnar artery
ulnar branch that participates in the anastomosis around the elbow joint
A and P ulnar recurrent arteries
ulnar branch that originates from the upper part of the ulnar artery and divides into A and P
common interosseous artery
ulnar branch that runs inferiorly on the anterior aspect of the interosseous membrane and above the wrist and enters posterior compartment of forearm
anterior interosseous artery
ulnar branch that passes posteriorly between the ulna and radius, and above the superior border of the interosseous membrane to enter the posterior compartment of the forearm
posterior interosseous artery
anastomoses of the ulnar arteries:
superior ulnar collateral – posterior ulnar recurrent
inferior UC – anterior UR
begins in the cubital fossa
ulnar and radial arteries
in the upper forearm, the radial artery is under the
brachioradialis
in the lower 2/3s of the forearm, the radial artery runs along the
radial nerve
in the lower forearm, the radial artery is ___ and lies between the ___ and the
superficial; tendons of the brachioradialis; tendon of the flexor carpi radialis
radial artery branches include:
superficial palmar branch,
dorsal carpal branch, muscular branch, radial recurrent artery
the superficial palmar branch runs
to the superficial palmar arch in the palm of the hand
the dorsal carpal branch runs
behind the thumb to the dorsal carpal arch (deep palmar arch) on the back of the hand
radial branch that is small and supplies neighboring muscles
muscular branches
radial branch that participates in the anastomosis around the elbow joint
radial recurrent artery
anastomoses of the radial arteries:
radial collateral – radial recurrent
middle collateral – radial
muscle that is not present in 15% of the population
palmaris longus
ulnar branch that passes above the superior border of the interosseous membrane
posterior interosseous artery
ulnar branch that runs above the wrist
anterior interosseous artery