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The arm and the forearm Flashcards

1
Q

Four main segments of the upper limb

A

shoulder
arm
forearm
hand

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2
Q

Where is the clavipectoral region

A
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3
Q

what is the cubital region

A

anterior to the elbow

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4
Q

What is the main difference between the upper and lower limb

A

Stability of the lower limbs versus mobility of the upper limbs

  • The iliac bones are anatomically connected posteriorly (at the sacroiliac joint); as a result, movement of one lower limb affects movement of the other lower limb
    *The scapulae are not connected posteriorly, such that the upper limbs can move relatively
    independently
    *In addition, although both are ball and socket joints, the hip has a much deeper bony
    articulation than the glenohumeral joint
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5
Q

Function of the clavicle

A
  • acts as a mobile strut keeps the upper limb away from the thorax to improve range of motion
  • attaches the upper limb to the trunk
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6
Q

can you tell the difference between the ends and surfaces of the clavicle?

A

conoid tubercle and trapezoid line are on the under side toward the acromial end

allow for attachment of the respective named ligaments

the inferior surface is rough whereas the top can be described as smooth

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7
Q

Clavicular fracture types

what ligaments can be affected

what may be required?

A

displaced (unaligned fragment from main bone) and non displaced (broken bone but still aligned with main bone)

coracoclavicular ligament (trapezoid and conoid)

surgical stabilization and perhaps ligament fixing

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8
Q

Where does the humerus tend to break?

A

surgical neck

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9
Q

What fascia surround the structures of the upper arm and forearm?

A

brachial fascia: proximal to elbow
antebrachial fascia: distal to elbow

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10
Q

what divides the space inside the brachial fascia into anterior and posterior components

A

intermuscular septa and the humerus

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11
Q

what divides the space inside the antebrachial fascia into anterior and posterior components

A

interosseous membrane and radius and ulna

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12
Q

what does the antebrachial fascia divide into

A

palmar carpal ligament, flexor retinaculum, extensor retinaculum

both retinaculum are important for flexion and extension of hand and digits at the wrist and the interphalangeal and metacarpal joints

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13
Q

Describe the layers of the arm proximal to the elbow, distal to the elbow, and at the wrist

A

see slide

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14
Q

what is the importance of the transverse carpal ligament/ flexor retinaculum

A

forms the roof of the carpal tunnel

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15
Q

Describe the contents of the carpal tunnel

A

flexor retinaculum/transverse carpal ligament
- contains 9 tendons and the median nerve

  • 4 flexor digitorum profundus
  • 4 flexor digitorum superficialis
  • 1 flexor pollicis longus
  • median nerve

Mnemonic: my (median) fingers (FDP) funny (FDS) for (FPL) many (median) nights (9 tendons total)

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16
Q

What muscles flex the forearm

A

biceps brachii (short and long head)

brachialis

brachioradialis

pronator teres (not main action)

palmaris longus

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17
Q

Muscle: Biceps brachii
* origin
* insertion
* action
* innervation

A

origin:
Long head: Supraglenoid tubercle of the scapula
Short head: coracoid
process of scapula

insertion: Radial tuberosity + bicipital aponeurosis

action:
Both heads: Flexion of forearm, supination of forearm
Long head: Flexion of arm
(weakly)

innervation: musculocutaneous nerve

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18
Q

Muscle: brachialis
* origin
* insertion
* action
* innervation

A

origin: body of humerus

insertion: ulnar tuberosity

action: flexion of forearm

innervation: musculocutaneous nerve and radial nerve

most powerful forearm flexor; loses power in supination

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19
Q

Muscle: triceps brachii
* origin
* insertion
* action
* innervation

A

origin:
* Long head: infraglenoid tubercle of scapula
* Lateral head: Body of the humerus, superior to the radial groove
* Medial head: Body of the humerus, inferior to the radial groove

insertion: Posterior olecranon process of the ulna

action:
All heads: Extension of forearm
Long head: Extension of arm; adduction of arm

innervation: radial nerve

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20
Q

Muscle: Pronator teres
* origin
* insertion
* action
* innervation

A

origin: medial epicondyle of the humerus

insertion: lateral surface of the radius

action: pronation and flexion of forearm

innervation: median nerve

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21
Q

Muscle: flexor carpi radialis
* origin
* insertion
* action
* innervation

A

origin: medial epicondyle of the humerus

insertion: base of 2nd metacarpal

action: flexion of hand/ abduction/radial deviation of hand

innervation: median nerve

22
Q

Muscle: palmaris longus
* origin
* insertion
* action
* innervation

A

origin: Medial epicondyle of humerus

insertion: Palmar aponeurosis

action:
Flexion of hand;
Weak flexion of forearm
Tenses palmar aponeurosis

innervation: median nerve

23
Q

Muscle: flexor carpi ulnaris
* origin
* insertion
* action
* innervation

A

origin:
Medial epicondyle of humerus and olecranon of ulna

insertion: Base of the 5th metacarpal;
hook of the hamate; pisiform bone

action: Flexion of hand;
adduction/ulnar deviation of
hand

innervation: ulnar nerve

24
Q

Can you describe all the veins, arteries and nerves in the upper arm’s cross section

A

biceps brachii most superficially,
brachialis deep to biceps brachii. musculocutaneous nerve between

within the lateral intermuscular septum that separates barchialis and lateral head of triceps: radial nerve

medial to brachialis and deep to biceps brachii: median nerve, brachial artery, basilic vein, ulnar nerve.

posterior compartment: triceps (lateral, medial, and long head)

see notes for that picture

25
Q

Describe the articulations of the elbow joint and what stabilizes them (ligaments)

A

3 articulations
* humeroulnar joint: trochlear of humerus and trochlear notch of the ulna
* humeroradial joint: capitulum of humerus and the head of radius
* proximal radioulnar joint: head of radius and radial notch of ulna; mediates pronation and supination of the forearm at the elbow

  • radial collateral ligament, ulnar collateral ligament
  • anular ligament (stabilizes proximal radial ulnar joint)
26
Q

what muscles cause pronation

A

pronator teres and pronator quadratus

27
Q

What muscles cause supination

A

supinator and biceps brachii contract

28
Q

distal radioulnar joint
* articulation

A
  • head of ulna and ulnar notch of radius
    the ulnar notch of the radius slides anteriorly over the head of the ulna to produce pronation
29
Q

What permits pronation

A
  • interosseous membrane + proximal and distal radioulnar joint
30
Q

Anterior compartment of the forearm:

  • What is a good tip for remembering flexor origination?
  • what movements are done by muscles here
  • what are the nerves that innervate these muscles
A
  • The superficial ones originate at the medial epicondyle humerus
  • flexion and pronation
  • median and ulnar nerve (only one is innervated by ulnar)
31
Q

What muscles are in the superficial layer of the forearm anterior compartment; intermediate layer, and deep layer

A

Superficial layer (medial to lateral):
* pronator teres
* flexor carpi radialis
* palmaris longus
* flexor carpi ulnaris

Intermediate layer: flexor digitorum superficialis

Deep layer (medial to lateral):
* flexor pollicis longus
* flexor digitorum profundus
* pronator quadratus

32
Q

Muscle: flexor digitorum superficialis
* origin
* insertion
* action
* innervation

A

origin: Medial epicondyle of humerus, coronoid process of ulna, upper surface of radius

insertion: Middle phalanges of digits 2-5

action: Flexion of proximal and middle phalanges of digits 2-5, flexion of hand, (weak) flexion of forearm

innervation: median nerve

33
Q

Muscle: Flexor pollicis longus
* origin
* insertion
* action
* innervation

A

origin: anterior surface of the radius; interosseous membrane

insertion: distal phalanx of digit 1 (thumb)

action: Flexion of proximal and distal phalanges of digit 1 (thumb); abduction of hand/radial deviation; flexion of hand

innervation: median nerve

34
Q

Muscle: Flexor digitorum profundus

  • origin
  • insertion
  • action
  • innervation
A

origin: Anterior surface of the ulna; interosseous membrane

insertion: distal phalanges of digits 2-5

action: Flexion of proximal, middle and distal phalanges of digits 2-5, flexion of hand

innervation: Median nerve (laterally); ulnar nerve (medially)

35
Q

How can we differentiate the actions of flexor digitorum profundus and flexor digitorum superficialis

A

Digit flexion occurs via a pulley system, in which the tendons of FDP pierce the tendons of FDS to reach the distal phalange.

Thus, proximal and distal digital flexion can be
used to differentiate between the actions of FDP
and FDS.

36
Q

What is jersey finger?

A

hyperextension of the first finger joint (distal interphalangeal joint)

caused by grabbing another player’s jersey and getting your distal joint jerked.

causes flexor digitorum profundus avulsion

37
Q

List the muscles in the posterior compartment superficial layer and deep layer

A

Superficial (7) lateral to medial:

  • Brachioradialis
  • Extensor carpi radialis longus
  • Extensor carpi radialis brevis
  • Extensor digitorum
  • Extensor digiti minimi
  • Extensor carpi ulnaris
  • Anconeus

lateral to medial

Deep (5)
* Supinator
* Abductor pollicis longus
* Extensor pollicis brevis
* Extensor pollicis longus
* Extensor indicis

38
Q

Muscle: brachioradialis
* origin
* insertion
* action
* innervation

A

origin: Lateral supracondylar ridge of the humerus

insertion: Styloid process of the radius

action: Flexion of forearm; pronation and supination of forearm (depending on position of forearm)

innervation: Radial nerve

39
Q

Muscle: Extensor carpi radialis longus
* origin
* insertion
* action
* innervation

A

origin: Lateral supracondylar ridge of the humerus

insertion: Dorsal base of second metacarpal

action: Extension of hand; abduction/radial deviation of hand

innervation: Radial nerve

40
Q

Muscle: Extensor carpi radialis brevis
* origin
* insertion
* action
* innervation

A

origin: Lateral epicondyle of the humerus

insertion: Dorsal base of the third metacarpal

action: Extension of the hand at the wrist; Abduction/radial deviation of the hand

innervation: Radial nerve

41
Q

Muscle: Extensor digitorum
* origin
* insertion
* action
* innervation

A

origin: Lateral epicondyle of the
humerus

insertion: Dorsal bases of distal and
middle phalanges of digits
2-5

action: Extension of digits 2-5;
abduction of fingers

innervation: Radial nerve

42
Q

Muscle: Extensor digiti minimi
* origin
* insertion
* action
* innervation

A

origin: Lateral epicondyle of the humerus

insertion: Dorsal aponeurosis (middle and distal phalanges) of 5th
digit

action: Extension of 5th digit; adduction/ulnar deviation of hand; extension of hand

innervation: Radial nerve

43
Q

Muscle: Extensor carpi ulnaris
* origin
* insertion
* action
* innervation

A

origin: Lateral epicondyle of the humerus; Posterior surface of the ulna

insertion: Dorsal base of 5th metacarpal

action: Extension of hand; adduction/ulnar deviation of hand

innervation: Radial nerve

44
Q

Muscle: Supinator
* origin
* insertion
* action
* innervation

A

origin: Lateral epicondyle of the humerus; Supinator crest of the ulna

insertion: Posterior surface of radius

action: Supination of the forearm

innervation: Radial nerve

45
Q

Muscle: Anconeus
* origin
* insertion
* action
* innervation

A

origin: Lateral epicondyle of the humerus

insertion: Olecranon and superior posterior surface of the ulna

action: Extension of forearm; stabilization during pronation/ supination (very weakly tho. probably primarily a stabilizer)

innervation: Radial nerve

46
Q

Muscle: Abductor pollicis longus
* origin
* insertion
* action
* innervation

A

origin: Dorsal surface of radius and ulna and adjacent interosseus membrane

insertion: Lateral side of the base of 1st
metacarpal

action: Abduction of thumb; abduction/radial deviation of
hand

innervation: Radial nerve

47
Q

Muscle: Extensor pollicis brevis
* origin
* insertion
* action
* innervation

A

origin: Posterior surface of the radius; Interosseous membrane

insertion: Dorsal base of the 1st proximal phalanx

action: Extension of the thumb; abduction/radial deviation of hand

innervation: radial nerve

48
Q

Muscle: Extensor pollicis longus
* origin
* insertion
* action
* innervation

A

origin: Posterior surface of the ulna; Interosseous membrane

insertion: Dorsal base of the 1st distal phalanx

action: Extension of the
thumb; abduction of the hand/ radial deviation

innervation: Radial nerve

49
Q

Muscle: Extensor indicis
* origin
* insertion
* action
* innervation

A

origin: Posterior distal ulna; Interosseous membrane

insertion: Distal aponeurosis of the 2nd digit

action: Extension of digit 2, extension of the hand

innervation: Radial nerve

50
Q

list the hand bones

A

Some Lovers Try Positions They Can’t Handle

Scaphoid
Lunate
Triquetrum
Pisiform
Trapezium
Trapezoid
Capitate
Hamate

51
Q

List the bone subtypes from proximal to distal

A

carpal
metacarpal
proximal phalanges
intermediate phalanges
distal phalanges

52
Q

Muscle: pronator quadratus
* origin
* insertion
* action
* innervation

A

origin: distal ulna

insertion: distal radius

action: pronator of forearm

innervation: median nerve

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