Upper Limb 2 Flashcards
What are the muscles of the superficial anterior forearm?
Pronator teres, flexor carpi radialis, palmaris longus, flexor carpi ulnaris.
What are the muscles of the intermediate anterior forearm?
The flexor digitorum superficialis.
Which muscles attach to the common flexor tendon on the medial epicondyle?
Pronator teres, flexor carpi radialis, palmaris longus, flexor carpi ulnarus, flexor digitorum superficialis.
How many people have an absent palmaris longus?
20%
What is the action of pronator teres?
Pronation of the wrist (pulls radial head above the ulnar bone) + elbow flexion
What is the action of flexor carpi ulnaris?
flexion of the wrist, ulnar deviation of the wrist
What is the action of flexor carpi radialis?
Flexion of the wrist and radial deviation of the wrist.
What muscles of the forearm does the median nerve supply?
pronator teres, palmaris longus and flexor carpi radialis, flexor digitorum superficialis.
What muscle of the forearm does the ulnar nerve supply?
Flexor carpi ulnaris.
What happens to the tendons of flexor digitorum superficialis?
there is 4 tendons, these split into 2, passing round the back of the phalanx making a tunnel for flexor digitorum profundus.
Where do the two heads of flexor digitorum superficialis arise from?
One arises from the radial head and ulna, one comes from the common flexor tendon - in between is where the median nerve and ulnar artery runs.
Where do the tendons of flexor digitorum superficialis end?
They split into two and end on the lateral side of the middle phalanx.
Where does the tendons of flexor digitorum profundus end?
Stays as one and inserts onto the base of the distal phalanx
What is the function of flexor digitorum superficialis?
Flexion of the proximal interphalangeal joint and metacarpophalangeal joint and wrist joint.
What is the function of flexor digitorum profundus?
Flexion of the distal and proximal interphalangeal joints and metacarpophalangeal joints and wrist joint.
Where does the flexor digitorum profundus arise from?
the anterior and medial surface of the ulnar bone and interosseous membrane.
Which muscles does the flexor digitorum profundus muscles give rise to?
The lumbrical muscles of the hand.
What is the function of the brachoradialis muscle?
Flexion of the elbow in the mid-prone position - innervated by the radial nerve.
It flexes the arm against resistance.
What are the 3 deep muscles in the anterior forearm?
Flexor digitorum profundus, flexor pollicis longus and pronator quadratus.
What does the median nerve supply?
All muscles in the anterior forearm apart from flexor carpi ulnaris and the medial half of flexor digitorum profundus.
Where does the median nerve come out and into the carpal tunnel?
It comes out of the flexor digitorum superficialis about 5cm from the wrist then enters the carpal tunnel.
which structures enter the carpal tunnel?
4 tendons of flexor digitorum profundus, 4 tendons of flexor digitorum superficialis and 1 tendon of flexor pollicus longus + median nerve.
Which muscles cause ulnar deviation of the wrist?
Flexor carpi ulnaris + extensor carpi ulnaris.
Which muscles cause radial deviation of the wrist?
Flexor carpi radialis and extensor carpi radialis.
Which nerves supply the flexor digitorum profundus?
medial half - ulnar nerve.
lateral hald - median nerve.
What muscles of the anterior forearm produce pronation?
Pronator teres and pronator quadratus
Where does the median nerve go after the cubital fossa?
In between the two heads of pronator teres.
What structure creates the carpal tunnel?
The flexor retinaculum.
Where does the ulnar nerve go?
Between flexor carpi ulnaris and flexor digitorum profundus.
Which artery causes the superficial palmar arch?
The ulnar artery.
Which artery creates the deep palmar arch?
The radial artery.
Which carpal bones is the flexor retinaculum anchored to?
The scaphoid and trapezium - on lateral side.
The pisiform and hamate on the medial side.
Which muscle is continuous with the palmar fascia?
The palmaris longus.
What are the thenar muscles?
Abductor pollicis
flexor pollicis brevis
(deep to these are - opponens pollicis
(+ adductor pollicis - has 2 heads innervated by both median and ulnar nerve)
What are the hypothenar muscles?
flexor digiti minimi brevis
abductor digiti minimi
Deep to these - opponens digiti minimi
Where do the lumbricals arise from?
The tendons of flexor digitorum profundus.
What do the interosseous muscles of the hand do?
Palmar - adduct
dorsal - abduct.
What is the nerve supply to the thenar muscles?
Median nerve apart from deep belly of flexor pollicis braves (ulnar)
Which muscles innervate the hypothenar muscles?
Ulnar nerve
How many lumbrical muscles are there?
4 - arising from the medial and lateral parts of the flexor digitorum profundus tendons.
What is the function of the lumbricals?
They flex the fingers at the metacarpophalangeal joint and extend the interphalangeal joints - of all fingers apart from the thumb.
How are the lumbrical muscles innervated?
Medial two - ulnar nerve
lateral 2 - medial nerve
What are the two heads of the adductor pollicis?
the transverse head
oblique head
Which nerve innervates the adductor pollicis muscle?
Ulnar nerve.
Where are the interossei muscles in relation to the lumbricals?
They are the deepest muscles in the hand - deep to the lumbricals.
How many interossei muscles are there?
4 dorsal - abduction
3 palmar - adduction.
Which nerve innervates the interossei muscles?
The ulnar nerve.
Which muscles of the hand does the median nerve innervate?
LOAF l - lateral 2 lumbricals o - opponens pollicis A - abductor pollicis brevis F - flexor pollicis brevis (superficial belly)
What muscles of the hand does the ulnar nerve innervate?
All apart from the LOAF muscles (+ deep belly of flexor politic brevis).
What sits between the ulna and the carpal bones?
The articular disc (fibrocartilage)
What type of fluid is found between the carpal bones?
Synovial fluid
What is the mnemonic for the carpal bones?
So long the pinky, here comes the thumb. scaphoid lunate triquestral pisiform hamate capitate trapezoid trapezium
What are the main muscles of the posterior forearm?
Extensor digiti minimi extensor carpi ulnaris extensor digititorum extensor carpi radialis longus extensor carpi radialis brevis brachioradialis Abductor pollicis longus extensor pollicis brevis extensor pollicis longus Supinator
What does the extensor digitorum run under?
An extensor retinaculum
What are the boundaries of the anatomical snuff box?
Ulnar: extensor pollicus longus
Radial: extensor pollicis brevis and abductor pollicis longus
floor - scaphoid and trapezium
Which muscles cause ulnar deviation of the wrist?
Extensor carpi ulnaris
Flexor carpi ulnaris
Which muscles cause radial deviation of the wrist?
flexor carpi radialis
extensor carpi radialis longus
extensor carpi radialis brevis
Which part of the radial nerve supplies the muscles of the forearm?
The deep branch
Which muscle does the radial nerve pierce?
The supinator muscle
What are synovial cysts (ganglion)?
these are cysts that grow on the back of the synovial sheath
What is the lateral continuation of the dorsal venous arch?
The cephalic vein
What is the medial continuation of the dorsal venous arch?
The basilica vein
Which artery runs via the anatomical snuffbox?
The radial artery
What is a Colle’s fracture?
Fracture of the distal radius where it displaces anteriorly - falling onto an extended wrist
What is a smiths fracture?
This is less common than a Colle’s fracture - theres posterior displacement of the radius - this is caused by falling onto a flexed wrist
What is a scaphoid fracture?
Occurs in the elderly when falling onto an outstretched wrist. pain is felt on anatomical snuffbox palpation.
What is a complication of a scaphoid fracture?
Avascular necrosis if theres malunion of the bone. theres only one small branch of the radial artery that enters via the thumb side.
Which carpal bone is first to ossify?
The capitate bone
