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Gross Anatomy > Upper Extremity: Forearm > Flashcards

Upper Extremity: Forearm Flashcards

1
Q

Forearm

A
  • Elbow to wrist
  • Radius and ulna
  • Connected by interosseous membrane
  • Divided into compartments by deep fascia and interossesous membrane
  • Muscles primarily are involved in wrist and finger movement (also elbow)
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2
Q

Interosseous Membrane of Forearm

A
  • Syndesmosis: fibrous joint that permits some movement
  • Separates compartments
  • Muscle attachment
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3
Q

Syndesmosis

A
  • Fibrous joint that permits some movement
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4
Q

Proximal Joints of Forearm (Elbow Joint)

A
  • Humeroradial
  • Humeroulnar
  • Proximal radioulnar
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5
Q

Distal Joints of Forearm

A
  • Distal radioulnar

- Radiocarpal

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6
Q

Anterior Forearm Functions

A
  • Flexors and pronators
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7
Q

Anterior Forearm Innervation

A
  • Median nerve

- 1 ½ by ulnar

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8
Q

Anterior Forearm Muscle Origination

A
  • Medial epicondyle

- Anterior surface of radius, ulna, interosseous membrane

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9
Q

Posterior Forearm Functions

A
  • Extensors and supinators
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10
Q

Posterior Forearm Innervation

A
  • Radial nerve or one of its branches
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11
Q

Posterior Forearm Muscle Origination

A
  • Lateral epicondyle
  • Supracondylar ridge
  • Posterior surface of radius, ulna, interosseous membrane
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12
Q

Anterior Compartment Muscles

A
  • 8 muscles
  • Some have multiple “heads”
  • 3 layers
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13
Q

Superficial (1st) Layer Muscles of Anterior Compartment

A
  • Pronator teres
  • Flexor carpi radialis
  • Palmaris longus
  • Flexor carpi ulnaris
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14
Q

Intermediate (2nd) Layer Muscle of Anterior Compartment

A
  • Flexor digitorum superficialis
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15
Q

Deep (3rd) Layer Muscles of Anterior Compartment

A
  • Flexor digitorum profundus
  • Flexor pollicis longus
  • Pronator quadratus
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16
Q

Superficial Layer Muscles Proximal Attachment

A
  • All have proximal attachment to medial epicondyle via common flexor tendon
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17
Q

Flexor Carpi Ulnaris and Pronator Teres

A
  • Both have 2 heads
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18
Q

Superficial Layer Muscle Innervation

A
  • All innervated by median nerve

- EXCEPT FCU (innervated by ulnar nerve)

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19
Q

Flexor Carpi Radialis Distal Attachment

A
  • Base of 2nd metacarpal
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20
Q

Flexor Carpi Radialis Function

A
  • Wrist (hand) flexion and abduction
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21
Q

Palmaris Longus Distal Attachment

A
  • Flexor retinaculum and palmar aponeurosis
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22
Q

Palmaris Longus Function

A
  • Tenses palmar aponeurosis (wrist flexion?)
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23
Q

Flexor Carpi Ulnaris Proximal Attachment

A
  • Humeral head: medial epicondyle (via common flexor tendon)

- Ulnar head: olecranon and posterior ulnar border

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24
Q

Flexor Carpi Ulnaris Distal Attachment

A
  • Pisiform
  • Hook of hamate
  • 5th metacarpal
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25
Q

Flexor Carpi Ulnaris Function

A
  • Wrist flexion and adduction
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26
Q

Pronator Teres Proximal Attachment

A
  • Ulnar head: coronoid process

- Humeral head: medial epicondyle (via common flexor tendon) and medial supracondylar ridge

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27
Q

Pronator Teres Distal Attachment

A
  • Lateral radius
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28
Q

Pronator Teres Function

A
  • Pronation
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29
Q

Median Nerve Passes

A
  • Deep to bicipital aponeurosis (lacertus fibrosus)
  • Between the 2 heads of pronator teres
  • Both are potential sites of entrapment
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30
Q

Flexor Digitorum Superficialis Proximal Attachment

A
  • Humero-ulnar head: medial epicondyle (common flexor tendon) and coronoid process
  • Radial head: anterior surface of proximal radius
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31
Q

Flexor Digitorum Superficialis Distal Attachment

A
  • Base of middle phalanges of digits 2-5
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32
Q

Flexor Digitorum Superficialis Innervation

A
  • Median nerve
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33
Q

Flexor Digitorum Superficialis Function

A
  • Flexes proximal interphalangeal joint and MCP joint
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34
Q

Median Nerve and Ulnar Artery Pass

A
  • Deep to flexor digitorum superficialis (FDS)
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35
Q

Flexor Digitorum Profundus Proximal Attachment

A
  • Proximal ulna/interosseous membrane
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36
Q

Flexor Digitorum Profundus Distal Attachment

A
  • Bases of distal phalanges 2-5
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37
Q

Flexor Digitorum Profundus Innervation

A
  • Ulnar nerve: medial half (digits 4,5)

- Anterior interosseous nerve (median), lateral half (digits 2,3)

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38
Q

Flexor Digitorum Profundus Function

A
  • Flexes distal interphalangeal joints of 2-5
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39
Q

Flexor Pollicis Longus Proximal Attachment

A
  • Anterior radius

- Interosseous membrane

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40
Q

Flexor Pollicis Longus Distal Attachment

A
  • Base of distal phalanx of thumb
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41
Q

Flexor Pollicis Longus Innervation

A
  • Anterior interosseous nerve
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42
Q

Flexor Pollicis Longus Function

A
  • Flexes interphalangeal joint of thumb
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43
Q

Pronator Quadratus Proximal Attachment

A
  • Distal anterior ulna
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44
Q

Pronator Quadratus Distal Attachment

A
  • Distal anterior radius
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45
Q

Pronator Quadratus Innervation

A
  • Anterior interosseous nerve
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46
Q

Pronator Quadratus Function

A
  • Pronation
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47
Q

8 Tendons of FDS and FDP Pass Through Carpal Tunnerl

A
  • Deep to flexor retinaculum (transverse carpal ligament)

- Surrounded by a synovial sheath as they pass through the wrist (ulnar bursa)

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48
Q

Tendon of FPL Passes Through Carpal Tunnel

A
  • Has its own synovial sheath (radial bursa)
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49
Q

Posterior Compartment Muscles of the Forearm

A
  • 11 muscles
  • 2 layers
  • Innervated by radial nerve or a branch of radial nerve
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50
Q

Superficial Posterior Compartment Muscles of Forearm

A
  • Brachioradialis
  • Extensor carpi radialis longus
  • Extensor carpi radialis brevis
  • Extensor digitorum
  • Extensor digiti minimi
  • Extensor carpi ulnaris
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51
Q

Deep Posterior Compartment Muscles of Forearm

A
  • Supinator
  • Extensor indicis
  • Abductor pollicis longus
  • Extensor pollicis brevis
  • Extensor pollicis longus
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52
Q

Brachioradialis Proximal Attachment

A
  • Supracondylar ridge
53
Q

Brachioradialis Distal Attachment

A
  • Distal lateral radius
54
Q

Brachioradialis Innervation

A
  • Radial nerve
55
Q

Brachioradialis Function

A
  • Elbow (forearm) flexion
56
Q

Extensor Carpi Radialis Longus Proximal Attachment

A
  • Supracondylar ridge
57
Q

Extensor Carpi Radialis Longus Distal Attachment

A
  • Dorsal aspect of 2nd metacarpal base
58
Q

Extensor Carpi Radialis Longus Innervation

A
  • Radial nerve
59
Q

Extensor Carpi Radialis Longus Function

A
  • Extension and abduction of wrist
60
Q

Extensor Carpi Radialis Brevis Proximal Attachment

A
  • Lateral epicondyle (via common extensor tendon)
61
Q

Extensor Carpi Radialis Brevis Distal Attachment

A
  • Dorsal aspect of 2nd & 3rd metacarpal base
62
Q

Extensor Carpi Radialis Brevis Innervation

A
  • Deep branch of radial nerve
63
Q

Extensor Carpi Radialis Brevis Function

A
  • Extension, abduction of wrist
64
Q

Extensor Carpi Ulnaris Proximal Attachment

A
  • Lateral epicondyle (common extensor tendon)

- Posterior ulna

65
Q

Extensor Carpi Ulnaris Distal Attachment

A
  • Dorsal aspect of 5th met base
66
Q

Extensor Carpi Ulnaris Innervation

A
  • Posterior interosseous nerve
67
Q

Extensor Carpi Ulnaris Function

A
  • Extension, adduction of wrist
68
Q

Extensor Digitorum Proximal Attachment

A
  • Lateral epicondyle (common extensor tendon)
69
Q

Extensor Digitorum Distal Attachment

A
  • Middle & distal phalanges digits 2-5 via the extensor expansion
70
Q

Extensor Digitorum Innervation

A
  • Posterior interosseous nerve
71
Q

Extensor Digitorum Function

A
  • Extends digits
72
Q

Extensor Digiti Minimi Proximal Attachment

A
  • Lateral epicondyle (via common extensor tendon)
73
Q

Extensor Digiti Minimi Distal Attachment

A
  • Middle and distal phalanges of 5th digit via the extensor expansion
74
Q

Extensor Digiti Minimi Innervation

A
  • Posterior interosseous nerve
75
Q

Extensor Digiti Minimi Function

A
  • Extends 5th digit
76
Q

Aconeus Proximal Attachment

A
  • Lateral epicondyle of humerus
77
Q

Aconeus Distal Attachment

A
  • Olecranon

- Posterior ulna

78
Q

Aconeus Innervation

A
  • Radial nerve
79
Q

Aconeus Function

A
  • Elbow extension and stabilization
80
Q

Supinator Proximal Attachment

A
  • Lateral epicondyle

- Supinator crest

81
Q

Supinator Distal Attachment

A
  • Proximal 1/3 of radius
82
Q

Supinator Innervation

A
  • Posterior interosseous nerve

- ierced by deep branch of radial nerve

83
Q

Supinator Function

A
  • Supination
84
Q

Abductor Pollicis Longus Proximal Attachment

A
  • Posterior proximal ulna & radius

- Interosseous membrane

85
Q

Abductor Pollicis Longus Distal Attachment

A
  • Base of 1st metacarpal
86
Q

Abductor Pollicis Longus Innervation

A
  • Posterior interosseous nerve (radial)
87
Q

Abductor Pollicis Longus Function

A
  • Thumb (1st digit) abduction and extension at carpometacarpal jt. (CMC)
88
Q

Extensor Pollicis Brevis Proximal Attachment

A
  • Posterior, distal radius

- Interosseous membrane

89
Q

Extensor Pollicis Brevis Distal Attachment

A
  • Dorsal, base of thumb proximal phalanx
90
Q

Extensor Pollicis Brevis Innervation

A
  • Posterior interosseous nerve (radial)
91
Q

Extensor Pollicis Brevis Function

A
  • Extends thumb at MCP

- Extends CMC joints

92
Q

Extensor Pollicis Longus Proximal Attachment

A
  • Posterior ulna

- Interosseous membrane

93
Q

Extensor Pollicis Longus Distal Attachment

A
  • Dorsal, base of thumb distal phalanx
94
Q

Extensor Pollicis Longus Function

A
  • Extend thumb IP joint

- Extend MCP and CMC joints

95
Q

Extensor Pollicis Longus Innervation

A
  • Posterior interosseous nerve (radial)
96
Q

Extensor Indicis Proximal Attachment

A
  • Posterior, distal ulna

- Interosseous membrane

97
Q

Extensor Indicis Distal Attachment

A
  • Extensor expansion of 2nd digit
98
Q

Extensor Indicis Function

A
  • Extension of 2nd digit (independently)
99
Q

Extensor Indicis Innervation

A
  • Posterior interosseous nerve (radial)
100
Q

Extensor Retinaculum

A
  • Anchors extensor tendons on dorsum of wrist
  • Extensor tendons pass through synovial sheaths , deep to extensor retinaculum
  • 6 osseofibrous tunnels lined with synovium
101
Q

Extensor Retinaculum Compartments (Medial to Lateral)

A

1: APL & EPB
2: ECRB & ECRL
3: EPL
4: ED & EI
5: EDM
6: ECU

102
Q

Extensor Expansion (extensor hood, dorsal digital expansion)

A
  • Expansion of extensor digitorum and EPL tendons over dorsum of digits
  • Triangular shaped structure that gives rise to a median and 2 lateral bands
  • Located over proximal phalanx, from MCP joint to PIP joint
  • Tendons of EDM, EI, EPB join the hoods
  • Intrinsic hand muscles insert into the exapansion (later)
  • Important in precision function and deformities
103
Q

Anatomical Snuff Box Boundaries (Remember Anatomical Position)

A
  • Medial: extensor pollicis longus tendon
  • Lateral: abductor pollicis longus and extensor pollicis brevis tendons
  • Proximal: radial styloid process
  • Floor: scaphoid and trapezium
104
Q

Anatomical Snuff Box Content

A
  • Radial artery
  • Superficial branch of radial nerve
  • Scaphoid can be palpated in the snuff box
105
Q

Lateral Epicondylitis (Tennis Elbow)

A
  • Tendon degeneration
  • Pain, tenderness at origin of common extensor tendon
  • Overuse, repetitive motions
106
Q

DeQuervain’s Tenovaginitis (Tenosynovitis)

A
  • Thickening of the synovial sheath and tendons of the APL and EPB (1st dorsal compartment)
  • Repetitive strain injury (thumb extension, abduction)
  • Degenerative process, not inflammation
107
Q

Median Nerve Pathway

A
  • Passes between heads of pronator teres
  • Travels deep to FDS
  • Passes through carpal tunnel into hand
108
Q

Median Nerve (Motor)

A
  • Every muscle in the anterior forearm, except those innervated by ulnar
  • Anterior interosseous nerve (FDP to digits 2 and 3, FPL, pronator quadratus)
109
Q

Median Nerve (Sensory)

A
  • Palmar cutaneous innervates the palm

- Other cutaneous branches innervate the digits (later)

110
Q

Ulnar Nerve Pathway

A
  • Enters forearm by passing between 2 heads of FCU
  • Passes posterior to medial epicondyle
  • Enters hand by passing through ulnar canal (between pisiform and hook of hamate)
111
Q

Ulnar Nerve (Motor)

A
  • FCU

- FDP to digits 4,5

112
Q

Ulnar Nerve (Sensory)

A
  • Palmar and dorsal cutaneous branches

- Digital branches

113
Q

Cubital Tunnel Syndrome

A
  • Compression of ulnar nerve in cubital tunnel
114
Q

Cubital Tunnel Boundaries

A
  • Lateral: olecranon
  • Medial: medial epicondyle
  • Roof: tendinous arch connecting the 2 heads of flexor carpi ulnaris
  • Floor: joint capsule and ulnar collateral ligament
115
Q

Cubital Tunnel Syndrome Symptoms

A
  • Paresthesia ulnar nerve distribution
  • Weakness and atrophy of ulnar innervated muscles
  • “Ulnar claw” deformity
116
Q

Radial Nerve

A
  • Divides into the superficial and deep branches of radial nerve
117
Q

Radial Nerve Superficial Branch

A
  • Deep to brachioradialis
  • Passes through anatomical snuff box
  • Sensory to lateral dorsum of hand
118
Q

Radial Nerve Deep Branch

A
  • Pierces supinator muscle
  • Becomes posterior interosseous nerve
  • Motor to all muscles of the posterior compartment of forearm
119
Q

Cutaneous Nerve Supply to Forearm

A
  • Medial cutaneous nerve of the forearm
  • Lateral cutaneous nerve of the forearm
  • Posterior cutaneous nerve of the forearm (radial)
120
Q

Arteries of Forearm

A
  • Radial and ulnar arteries (terminal branches of brachial)

- Arise in cubital fossa, near neck of the radius

121
Q

Radial Artery Pathway

A
  • Smaller than ulnar
  • Deep to brachioradialis muscle
  • Alongside superficial branch of radial
  • Palpable pulse lateral to FCR
  • Wraps around lateral wrist, passes through floor of anatomical snuff box
122
Q

Ulnar Artery Pathway

A
  • Travels deep to PT and FDS
  • Travels down medial side of forearm, lateral to ulnar nerve
  • Palpable pulse lateral to FCU
  • Passes through ulnar canal (NOT CARPAL TUNNEL)
123
Q

Radial Artery Branches

A
  1. Radial recurrent artery
  2. Palmar and dorsal carpal branches
  3. Muscular branches
  4. Superficial palmar branch
  5. Contributes to deep palmar arch
124
Q

Radial Recurrent Artery

A
  • Anastomoses with radial collateral
125
Q

Superficial Palmar Branch (of Radial Artery)

A
  • Helps form superficial palmar arch
126
Q

Ulnar Artery Branches

A
  1. Anterior and posterior ulnar recurrent arteries
  2. Common interosseous artery
  3. Muscular branches
  4. Palmar and dorsal carpal branches
127
Q

Anterior and Posterior Ulnar Recurrent Arteries

A
  • Anastomoses with ulnar collateral arteries
128
Q

Common Interosseous Artery (of Ulnar Artery)

A
  • Anterior interosseous artery
  • Posterior interosseous artery
  • Recurrent interosseous: anastomoses

Gross Anatomy (50 decks)

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