Tutorial 3: Upper Limb, Wet Lab Flashcards
What are the 4 muscles of the superficial group of the wrist flexors of the forearm?
Pronator teres
Flexor carpi radialis
Palmaris longus
Flexor carpi ulnaris
Where is the superficial group of the wrist flexors attached to?
Common flexor tendon to the medial epicondyle of the humerus
What is the action of the pronator teres?
Pronation of the forearm
What innervates the pronator teres?
Median nerve
Which muscle flexes the wrist and adducts the hand at the wrist joint?
Flexor carpi ulnaris
Which muscle flexes the wrist and abducts the hand at the wrist joint?
Flexor carpi radialis
Is the palmaris longus always present?
No
Which nerve innervates 3 of the superficial group of the flexor compartment of the forearm?
Median
What nerve innervates the flexor carpi ulnaris?
Ulnar nerve
What is the action of the brachioradialis muscle?
Flexion of the elbow
What nerve innervates the brachioradialis?
Radial nerve
Brachioradialis is an exception the the rule that the radial nerve only innervates the extensor muscles
Which digits are the tendons of the flexor digitorum superficialis attached to?
2nd-5th
Onto which phalanx are the tendons of the flexor digitorum superficialis attached to?
Middle phalanx
Can the flexor digitorum superficialis act on the distal interphlangeal joint?
No
What nerve innervates the flexor digitorum superficialis?
Median nerve
What are the 3 muscles of the deep group of the anterior forearm>
Flexor digitorum profundus
Flexor pollicis linugs
Pronator quadratus
Does the flexor digitorum profundus act on the wrist and all the joints of the wrist?
Yes
What is the main action of the flexor digitorum profundus on the wrist and finger joints?
Flexion
Which part of the flexor digitorum profundus is supplied by the ulnar nerve?
Medial part - digits 4 and 5
Which part of the flexor digitorum profundus is supplied by the median nerve?
Lateral part - digits 2 and 3
What innervates the flexor pollicis longus?
Anterior interosseous nerve (from the median nerve)
Where is the pronator quadratus connected to?
It arises from in front of the ulna and passes across until it is inserted into the radius
What is the action of the pronator quadratus?
Pronation of the forearm
What is the innervation of the pronator quadratus?
Anterior interosseous nerve from the median nerve
See page 54 of booklet for diagram of the neuromuscular structures of the anterior forearm?
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What is the relationship between the brachial artery with the median nerve in the cubital fossa?
The nerve is medial to the brachial artery
Which muscles does the median nerve not supply in the forearm?
Flexor carpi ulnaris
Medial flexor digitorum profundus
Brachioradialis
What path does the ulnar nerve follow in the forearm?
After passing posterior to the medial epicondyle of the humerus the ulnar nerve enters the forearm by passing between the heads of the flexor carpi ulnaris muscle. Both the ulnar nerve and the ulnar artery descend close to each other
What is the relationship between the ulnar artery and ulnar nerve?
The ulnar nerve is medial to the ulnar artery
Is it possible to feel the ulnar artery pulse?
No - it’s too deep
What are the 2 terminal branches of the brachial artery?
Ulnar artery
Radial artery
Which arterial pulse can you feel at the distal third of the forearm medial to the tendon of the flexor carpi radialis muscle?
Radial pulse
What is the relationship of the ulnar artery and ulnar nerve during their course in the forearm?
The nerve is medial to the artery
What is the carpal tunnel?
The passageway deep to the flexor retinaculum between the scaphoid and the trapezium on the lateral side and the pisiform and hamate bone on the medial side.
What is the flexor retinaculum?
A strong fibrous band which converts which converts the concavity of the palmar surface of the carpus (carpal bones) into a channel
What passes through the carpal tunnel?
Median nerve
4 tendons of the flexor digitorum superficialis
4 tendons of the flexor digitorum profundus
1 tendon of the flexor pollicis longus
Which is the most sensitive structure in the carpal tunnel that can be affected in carpal tunnel syndrome?
Median nerve
What are the 5 intrinsic muscle compartments of the hand?
Thenar compartment Hypothenar compartment Adductor compartment Lumbricles and long flexor tendons (central compartment) Interossei compartment
What are the thenar muscles responsible for?
Apposition of the thumb
What 3 muscles make up the thenar eminence?
Abductor pollicis brevis
Flexor pollicis brevis
Opponens pollicis
Diagrams of the thenar eminence on page 59 of the booklet
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Which nerve innervates the thenar eminence?
Median nerve
Diagram of the hypothenar eminence on page 60 of the booklet
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What nerve innervates the hypothenar muscles?
Ulnar nerve
What is the segmental value of the median nerve?
C6-T1
What is the segmental value of the ulnar nerve?
C8-T1
What are the muscles of the hypothenar eminence?
Abductor digiti minimi
Flexor digiti minimi
Opponens digiti minimi
What are the 2 heads of the adductor pollicis muscle?
Transverse head
Oblique head
What nerve innervates the adductor pollicis muscle?
Ulnar nerve
What is the action of the adductor pollicis muscle?
Adduction of the thumb
How many lumbricals are there?
4
From which long flexor tendons do lumbricals originate?
Tendons of the flexor digitorum profundus
What is the action of the lumbrical muscles?
Flexion of the fingers at the metacarpophalangeal joint and extension of the interphalangeal joint of the 2nd-5th digits
What nerve(s) innervate the lumbricals?
Medial 2 - Ulnar nerve
Lateral 2 - Median nerve
What is the action of the dorsal interossei?
Abduction of the fingers
What is the action of the palmar interossei?
Adduction of the fingers
How many dorsal interossei exist?
4
How many palmar interossei exist?
3
Which nerve innervates both the palmar and dorsal interossei?
Ulnar nerve
See page 64 of the booklet for diagram of the palmar arches
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What does the median nerve enter the hand through?
The carpal tunnel
Which muscles in the hand are not innervated by the ulnar nerve?
The thenar eminence and the lateral 2 lumbrical muscles
See page 66 of the booklet for a diagram of the dermatomes of the arm
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Which bone forms the proximal part of the wrist joint?
Radial bone
What are the carpal bones?
Scaphoid Lunate Triquetrum Pisiform Trapezium Trapezoid Capitate Hamate
What bones form the distal articulation of the wrist joint?
Scaphoid
Lunate
What movements can occur at the wrist joint?
Extension Flexion Circumduction Adduction Abduction