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Upper Extremity: Muscles Flashcards

1
Q

What are the anterior muscles of the arm?

and posterior?

A 
ANTERIOR ARM: "BBC"
Coracobrachialis,
Brachialis
Biceps Brachii
Innervation: Musculocutaneous nerve

POSTERIOR:
Triceps brachii
Innervation: radial nerve

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2
Q

What are the superficial anterior forearm muscles?

Innervation?

A

SUPERFICIAL ANTERIOR FOREARM: “3Fs, 2Ps”

  1. Flexor carpi ulnaris (ulnar deviation = aDduction of wrist, flexes wrist)
  2. Palmaris longus (some people don’t have it)
  3. Flexor carpi radialis (radial deviation = aBducts wrist!, flexes wrist)
  4. Pronator Teres
  5. Flexor Digitorum Superficialis (intermediate superficial muscle)

Innervation: Median nerve, except flexor carpi ulnaris

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3
Q

What are the deep anterior forearm muscles?

Innervation?

A

DEEP ANTERIOR FOREARM: “2Fs, 1P”

  1. Flexor digitorum profundus (median + ulnar nerve)
  2. Flexor Pollicis longus
  3. Pronator quadratus

Innervation: Median nerve

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4
Q

What are the posterior superficial forearm muscles?

Innervation?

A

POSTERIOR SUPERFICIAL FOREARM: “5Es, AB”

  1. Extensor carpi ulnaris
  2. Extensor carpi radialis longus
  3. Extensor carpi radialis brevis
  4. Extensor digitorum
  5. Extensor digiti minimi
  6. Anconeus
  7. Brachioradialis (only flexor in posterior forearm!)

Innervation: Radial

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5
Q

What are the deep posterior forearm muscles?

A

DEEP POSTERIOR FOREARM: “3 Es,AS”

  1. Abductor pollicis longus
  2. Extensor pollicis longus
  3. Extensor pollicis brevis
  4. Extensor indices
  5. Supinator

Innervation: Radial

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6
Q

What are intrinsic muscles of the hand?

Which groups of muscles are innervated by the median nerve?

A
  1. Thenar (3)
    - opponens policis
    - flexor policis brevis
    - aBductor pollcis brevis
  2. Hypothenar (3)
    - opponens digiti minimi
    - flexor digiti minimi brevis
    - aBductor digiti minimi brevis
  3. Dorsal interossei (4) = Dorsal does ABduction “DABB”
  4. Palmar interossei (3) = Palmar does ADduction (PAD)
  5. Adductor pollicis (1)
  6. Palmaris brevis (1)
  7. Lumbercles (4)

Median nerve:
1. Thenar
2. Lumbercles
The rest are innervated by ULNAR nerve.

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7
Q

Pronator Teres

A

= MEDIAL boundary of CUBITAL FOSSA, runs between Brachioradialis and Flexor carpi ulnaris
O: 2 Origins (humeral and ulnar heads) = MEDIAL HUMERUS (medial epicondyle of humerus) & CORONOID PROCESS of ULNA
I: RADIUS (lateral side)
A: PRONATES forearm, weakly flexes elbow
N: median nerve

Anterior superficial forearm

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8
Q

Palmaris longus

A

= MEDIAN NERVE IS LATERAL TO PALMARIS LONGUS, not everyone has it

O: MEDIAL HUMERUS = medial epicondyle of humerus
I: palmar aponeurosis (FASCIA of palm)
A: accessory flexor of wrist and elbow
N: median nerve

Anterior superficial forearm

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9
Q

Flexor carpi ulnaris

A

= MOST MEDIAL anterior superficial forearm muscle

O: 2 heads = MEDIAL HUMERUS (median epicondyle of humerus), OLECRANON PROCESS at ULNA
I: MEDIAL CARPALS (pisiform + hamate bones + 5th METACARPAL)
A: aDducts WRIST/hand, flexes WRIST, acts together with extensor carpi ulnaris to stabilize wrist during finger extension
N: ulnar nerve (C7, C8)

Anterior superficial forearm

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10
Q

Flexor carpi radialis

Is ulnar nerve lateral to flexor carpi radialis?

A

= MOST LATERAL muscle of anterior superficial forearm, runs diagonally across forearm

O: MEDIAL HUMERUS (medial epicondyle of humerus)
I: base of LATERAL METACARPALS, insertion tendon can be seen, serves as guide for finding radial artery
A: ABducts WRIST/hand = RADIAL DEVIATION of HAND, does hand WAVE, FLEXES WRIST, weak synergist of elbow flexion
N: Median

YES!
Anterior superficial forearm

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11
Q

Flexor digitorum superficialis

A

= has split tendons before when enters digits, before PIP of digits 2-5
O: MEDIAL HUMERUS AND RADIUS
I: middle phalanges of digits 2-5
A: flexes digits 2-5 at 2 joints = metacarpal-phalangeal joint and proximal interphalangeal joint (PIP)
N: median

Anterior superficial forearm

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12
Q

Pronator Quadratus

A 
= DEEPEST muscle in anterior forearm
O: ULNA of forearm and interosseous membrane
I: RADIUS
A: forearm pronation
N: median

Anterior deep forearm

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13
Q

Flexor pollicis longus

A

O: forearm and interosseous membrane
I: phalanx of thumb
A: flexes interphalangeal joint and MCP
N: median

Anterior deep forearm

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14
Q

Flexor digitorum profundus

A

O: forearm and interosseous membrane
I: distal phalanges of digits 2-5
A: flex DIP (also can flex at PIP, MCP and wrist joint)
N: 1/2 from median AND 1/2 from ulnar

Anterior deep forearm

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15
Q

Brachioradialis

A 
= MUSCLE BULGE on lateral side of forearm, in between Anterior and Posterior Forearm (Use Brachioradialis to orient yourself in posterior forearm)
O: Arm/Humerus
J: lateral elbow 
I: Radius
A: accessory FLEXOR of elbow/forearm
N: radial nerve

Posterior superficial forearm

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16
Q

AnConeus

A 
= small triangular muscle posterior/behind elbow joint
O:
I:
A: accessory extensor
N: radial nerve

Posterior superficial forearm

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17
Q

Extensor carpi ulnaris

A

MOST MEDIAL Posterior superficial forearm muscle
O: LATERAL HUMERUS lateral epicondyle of humerus (and posterior border of ulna)
I: MEDIAL METACARPALS (base of 5th metacarpal)
A: aDducts wrists (along w/ flexor carpi ulnaris) EXTENDS wrist (along with extensor carpi radialis),
N: posterior interosseous nerve (branch of RADIAL NERVE)

Posterior superficial forearm

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18
Q

Extensor digitorum

A

= MEDIAL to extensor carpi radialis brevis

O: LATERAL HUMERUS (epicondyle of humerus)
I: by 4 tendons into extensor expansions and distal phalanges of fingers 2-5
A: finger extension, extends wrists, can abduct (flare) fingers
N: posterior interosseous nerve, a branch of radial nerve (C5,C6)

Posterior superficial forearm

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19
Q

Extensor carpi radialis longus & brevis

A

= Brevis is DEEP to longus

O: LATERAL HUMERUS (epicondyle)
I: LATERAL metacarpals (brevis to base of third metacarpal and longus to 2nd)
A: ABducts & extends wrist (acts synergistically w/ extensor carpi radialis longus to steady wrist during finger flexion)
N: longus = radial nerve brevis = deep branch of radial nerve

Posterior superficial forearm

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20
Q

Digiti Minimi

A

= Detached part of extensor digitorum
A: extends little finger
N: posterior interosseous nerve of RADIAL nerve

Posterior superficial forearm

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21
Q

Supinator

A

= Wraps around lateral side of elbow

O: 2 heads = LATERAL epicondyle of HUMERUS, Proximal ULNA
I: proximal end of RADIUS
A: assists biceps brachii to supinate forearm, works alone in slow supination, antagonist of pronator muscles
N: posterior interosseous nerve

Posterior deep forearm

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22
Q

What is the tiny muscle arising close to the wrist?

A

Extensor indices in Posterior deep forearm

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23
Q

Abductor pollicis longus

A

= DISTAL to SUPINATOR
O: posterior surface f radius and ulna, interosseous membrane
I: LATERAL METACARPAL of thumb (base of 1st metacarpal) and trapezium
A: aBducts and extends thumb
N: posterior interosseous nerve (RADIAL)

Posterior deep forearm

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24
Q

Extensor pollicis brevis and longus

A

=Deep to extensor carpi ulnaris

O: dorsal shaft of radius and ulna, interosseous membrane
I: base of proximal (brevis) and distal (longus) phalanx of thumb
A: extends joints of thumb
N: posterior interosseous nerve

Posterior deep forearm

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25
Extensor indicis
O: posterior surface of distal ulna, interosseous membrane I: index finger (digit 2), joins tendon of extensor digitorum A: extends index finger (digit 2), assists in extending wrist N: posterior interosseous nerve Posterior deep forearm
26
Opponens pollices
A: opposition of thumb N: median Thenar grp of Intrinsic hand
27
Flexor polices brevis
A: flexes thumb at MCP joint N: median Thenar grp of Intrinsic hand
28
Abductor polices brevis
A: aBducts thumb at MCP joint N: median Thenar grp of Intrinsic hand
29
Coracobrachialis Does it only cross 1 joint?
``` O: CORACOID process of SCAPULA (Common origin: BICEPS BRACHII) I: Medial Shaft of HUMERUS J: acts at SHOULDER JOINT TO A: FLEXES (+ ADducts) HUMERUS/ARM (Common Action: PEC MAJOR) N: Musculocutaneous nerve ``` YES! Anterior arm
30
Brachialis
Deep to Biceps Brachii ``` O: Front of humerus I: Ulna J: Elbow A: MAJOR FOREARM FLEXOR = FLEXES FOREARM at ELBOW (can do HINGE actions) against load N: Musculocutaneous ``` Anterior arm
31
Does Biceps Brachii have action at the shoulder joint?
Yes, but PRIMARY ACTION is at ELBOW O: 2 heads = short (coracoid process) and long (travels through intertubercular sulcus) I: Radius at radial tuberosity J: Shoulder, Elbow A: can pivot bec/ attached to radius! so SUPINATION, FLEXES FOREARM at ELBOW (like Brachialis) *Can do hinge & pivot actions N: MC nerve Anterior arm
32
Triceps brachii
O: 3 heads on scapula I: OLECRANON PROCESS of ULNA A: EXTENDS FOREARM at elbow joint N: radial nerve Posterior arm
33
What's the small quadrangular muscle over the hypothenar eminence in the hand that improves grip?
Palmaris brevis | innervated by ulnar nerve?
34
What's the triangular muscle that attaches to proximal phalanx of thumb that adducts the thumb?
Adductor pollicis | innervated by ulnar nerve
35
What are the muscles in the hands between the metacarpals?
Interossei (innervated by ulnar nerve): 1. Dorsal = 4 muscles = "DABB" = abduction of digits 2-4 2. Palmar = 3 muscles = "PAD" = Adduction of digits 2,4,5
36
What are the 4 muscles extending from tendons of flexor digitorum profundus and attach to tissue on phalanges?
Lumbricals: medial 2 innervated by ulnar nerve, lateral 2 innervated by median nerve *of the hand
37
What do lumbricals of the hand do?
Flex MCP joint, extend PIP and DIP joint
38
What are the muscles of the thenar group in the hand and what do they do?
innervated by median nerve: 1. Opponens pollicis - opposes thumb 2. Flexor pollicis brevis - flexes thumb at MCP joint 3. Abductor pollicis brevis - abducts thumb at MCP joint
39
What are the muscles in the hand that form a bulge of tissue over the lateral palm near the thumb?
Thenar eminence
40
What are the muscles in the hypothenar group of the hand? What do they do?
1. Opponens digiti minimi - opposition of digit 5 (pinky) 2. Flexor digit minimi brevis - flexes pinky at MCP joint 3. Abductor digiti minimi - abducts pinky
41
What are the muscles in the hand that form a tissue bulge over the medial palm near the little finger (pinky)?
Hypothenar eminence
42
Where are the 4 pulse points?
axillary brachial (medial to biceps tendon) radial ulnar
43
What are the 2 connected arterial arches formed by the radial and ulnar arteries when they enter the hand?
BLOOD SUPPLY TO HAND: from radial and ulnar arteries that form 2 interconnected arches: 1. Superficial palmar arch, 2. Deep palmar arch Branches of these arches = Common Digital artery and Proper digital artery both supply the digits
44
What veins drain the hand?
Superficial and deep
45
What's the test for adequate contribution of both the ulnar and radial arteries to the hand?
ALLEN'S TEST
46
What is the cutaneous innervation of hand - what nerves innervate the front and back skin of the hand?
1. Palm: a. medial palm (1.5 digits) - ulnar nerve b. lateral palm - median nerve 2. Dorsum: a. lateral side - radial nerve b. medial side (1.5 digits) - ulnar nerve c. Tips of digits - median nerve
47
What compartment FLEXES elbow, arm, SUPINATES forearm?
ANTERIOR compartment of ARM | Does this at SHOULDER JOINT
48
What compartment EXTENDS the elbow?
POSTERIOR compartment of ARM | extends forearm at elbow joint
49
Which compartment FLEXES wrist, fingers and does PRONATION?
ANTERIOR FOREARM
50
Which compartment EXTENDS wrist, fingers and SUPINATION?
POSTERIOR FOREARM
51
What hand muscles do precision grip?
Intrinsic (19) = thenar, hypothenar, lumbercals, dorsal and palmar interossei grps, palmaris brevis, ADductor pollicis N: median nerve and ulnar nerves
52
Which hand muscles do power grip?
Extrinsic (15) = all forearm muscles except for pronators, supinators, Brachioradialis and anconeus! N: median, ulnar, radial nerves
53
What artery does the axillary nerve travel with in the QUADRANGLE SPACE? Where is the QUADRANGLE SPACE? What is DISTAL to QUADRANGLE SPACE?
posterior circumflex humeral artery QUADRANGLE SPACE is between T. Major, T. Minor & Triceps Brachii DIstal to QUADRANGLE SPACE, Triangular interval
54
The radial nerve comes off of what brachial plexus cord?
Posterior cord
55
What travels through the triangular interval?
Radial nerve, | profunda brachii artery
56
The anatomical area of cubital fossa contains what from lateral to medial?
Tendon of biceps muscle brachial artery median nerve
57
What are the boundaries of the cubital fossa?
Lateral border: Brachioradialis Medial border: Pronator Teres Superior border: imaginary line betw/ epicondyles
58
Where does the ulnar nerve travel behind?
Medial epicondyle (so travels POSTERIOR to medial epicondyle)
59
What is the most lateral muscle of the anterior forearm and what does it do?
Pronator teres attaches to radius to pronate forearm
60
What does the CARPAL TUNNEL contain?
formed by carpal bones arch and flexor retinaculum: 1. Tendons of Flexor digitorum profundus 2. Tendons of flexor digitorum superficialis 3. Tendon of flexor policis longus 4. Median nerve
61
Does the ulnar artery travel above the flexor retinaculum of the carpal tunnel?
YES!
62
Is brachial artery medial to the biceps tendon?
YES!
63
The median nerve gets contributions from the lateral and ____ cords of brachial plexus?
lateral and MEDIAL cords!
64
The radial nerve passes under what muscle?
Brachioradialis
65
What's the funny bone?
Not actually a bone! When you hit your ulnar nerve and causes tingling in fingers!
66
Do all the anterior superficial forearm muscles originate from the medial epicondyle of humerus?
YES!
67
All pronators and supinators must attach/insert into ___________?
radius! to do pivoting action!
68
Which hand muscles have muscle bellies in forearm and tendons in hand?
Extrinsic
69
What apnoneurosis covers the cubital fossa?
bicipital aponeurosis of biceps brachii
70
What vein important for blood draws travel over the bicipital aponeurosis of the cubital fossa?
Median cubital vein
71
What innervates skin of the anterior forearm?
Musculocutaneous nerve
72
What connects the lateral cephalic vein and medial basilica vein?
Median cubital vein
73
Problems with flexion and opposition of thumb/thenar eminence is due to injury to what nerve?
Median nerve Test opposition with: pincer grasp
74
What innervates most muscles in the anterior superficial forearm?
median nerve
75
Where do anterior superficial forearm muscles originate?
medial side of humerus
76
What is the pathway of the ulnar nerve?
in anterior forearm then goes behind medial epicondyle of humerus then goes back into anterior forearm compartment to innervate ultimately 1.5 digits (flexor carpi ulnaris and 1/2 of flexor digitorum profundus)
77
What's in between flexor carpi ulnaris and flexor carpi radialis?
Palmaris longus
78
Does the pronator teres cross the wrist?
No! It attaches to radius, also pronator teres is medial boundary of cubital fossa
79
Which anterior superficial forearm muscle flexes digits (except thumb)?
Flexor digitorum superficialis (intermediate superficial anterior forearm muscle) *its tendon splits before I: middle phalanx of hand
80
Which anterior superficial forearm muscle flexes digits (except thumb)?
Flexor digitorum superficialis (intermediate superficial anterior forearm muscle) *its tendon splits when it gets to digits behind/before Proximal interphalangeal joint (PIP) I: middle phalanx of hand N: Median Nerve Moves metacarpal phalangeal joint and proximal interphalangeal joint BUT does NOT cross distal interphalangeal joint so CANNOT MOVE DISTAL PHALANGES .
81
Which muscle is in between your anterior and posterior forearm compartments?
Brachioradialis = considered part of posterior forearm but is accessory flexor of forearm
82
Which deep anterior forearm muscle receives innervation from both median and ulnar nerve?
Flexor digitorum profundus
83
What is the only posterior superficial forearm muscle that flexes the forearm?
Brachioradialis
84
Where is the brevis sandwich?
Deep Posterior Forearm compartment
85
What forearm muscles originate from the forearm and interosseous membrane?
Anterior Deep Forearm
86
What are the boundaries of the anatomical snuff box and what does it contain?
on the sides: Extensor pollicis longus, Extensor pollicis brevis (area of brevis sandwich just w/out aBductor pollicis longus!) floor: carpal bones = scaphoid, trapezium contains: radial artery
87
What are the intrinsic hand muscles that run between metacarpals?
interossei (Dorsal and palmar) | N: ulnar nerve

Anatomy (8 decks)

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