UPPER LIMB 2

Question 1

Anterior compartment of the forearm

Answer 1

• Significantly FLEXES at wrist joint

1. BRACHIORADIALIS - lateral
   (radial n.)
2. PRONATOR TERES
   (median n. - c6,c7)
3. FLEXOR CARPI RADIALIS
   (median n. - c6, c7)

+PALMARIS LONGUS
(median n. - c7, c8)

4. FLEXOR DIGITORUM SUPERFICIALIS
   (median n. - c7, c8, t1)

+FLXOR DIGITORUM PROFUNDUS

5. FLEXOR CARPI ULNARIS
   (ulnar n. - c7, c8)

Question 2

Interesting innervation of flexor digitorum profundus

Answer 2

Ulnar nerve supplies the ulnar half (C8 and T1)

Median nerve supplies the radial half.

Question 3

Movements of anterior compartment of the forearm

Answer 3

• Significantly FLEXES at wrist joint

Brachioradialis supinates

Pronator Teres pronates

Flx. C. Radialis = Radial deviation (abducts)

Flx. C Ulnaris = Ulnar deviation (adducts)

Question 4

Actions of Flexor digitorum superficialis

Answer 4

Flexes the proximal interphalangeal (PIP) and metacarpophalangeal (MCP) joints as well as the wrist joint.

CANNOT FLEX DIP.

Question 5

Actions and significance of Flexor digitorum profundus

Answer 5

Flexes the distal interphalangeal (DIP), proximal interphalangeal (PIP) and metacarpophalangeal (MCP) joints of the fingers and also the wrist joint.

+The lumbricals arise from the tendons of flexor digitorum profundus.

Question 6

What is the common origin of the anterior compartment?

Answer 6

Medial epicondyle acts as common superficial and intermediate flexor origin

Question 7

Where do the tendons of FDSuperficialis insert?

Answer 7

Attach. to the middle phalanx of the INDEX, LONG, RING, AND SMALL fingers.

Question 8

What n innervates FDS?

Answer 8

Median N (C7-T1)

Question 9

What n innervates Brachioradialis?

Answer 9

Radial N (C5-C7)

Question 10

Deep Anterior Forearm Muslces

Answer 10

1. FLEXOR DIGITORUM PROFUNDUS
   (Ulnar nerve (C7,C8) supplies the ulnar half.
   Median nerve (C8 and T1) supplies the radial half.)

2. FLEXOR POLLICIS LONGUS
Median nerve (C8, T1).

3. PRONATOR QUADRATUS (deepest)
   (Median nerve (C8, T1))

Question 11

What is the action of the Flexor Pollicis Longus?

Answer 11

Flexes the interphalangeal (IP) and metacarpophalangeal (MCP) joints of the thumb.

Question 12

What is the action. of the FDP?

Answer 12

Flexion of

• distal interphalangeal (DIP),
• proximal interphalangeal (PIP)
• metacarpophalangeal (MCP)

joints of the fingers and also the wrist joint.

Question 13

Significance of the Flexor Retinaculum

Answer 13

Forms roof of carpal tunnel, significantly binds down passing tendons, preventing bow-stringing upon muscle contraction

Question 14

What is the innervation of the pronator quadratus?

Answer 14

(Median nerve (C8, T1))

Question 15

What is the innervation of the FDP?

Answer 15

Ulnar for ulnar half (C7, C8)

Median N. for radial. half (C8-T1)

Question 16

What is the innervation of the Flexor Pollicis Longus

Answer 16

Median nerve (C8, T1).

Question 17

What nerve passes betwen FDS and FDP?

Answer 17

Median N.

Question 18

Which forearm artery gives rise to the superficial palmar arch?

Answer 18

Ulnar artery

Question 19

Course of the Radial Artery

Answer 19

Continues as the deep palmar arch

Question 20

Most superficial palmar structures and significance

Answer 20

1. PALMAR FASCIA
   = protect underlying deep muscles and neurovasc.

+ contnuaton of palmaris longus if present

2. FLEXOR RETINACULUM

Question 21

Thenar Muscles

Answer 21

*Thenar eminence, lateral aspect of palm

1. ABDUCTOR POLLICIS BREVIS - lateral
   (Median nerve (C8, T1))
2. FLEXOR POLLICIS BREVIS
   (Median nerve.
   Ulnar nerve (C8, T1) - deep belly)
3. OPPONENS POLLICIS BREVS - deep
   (Median nerve (C8, T1))

Question 22

Which nerve segment from the brachial plexus serves to provide. majority of the thenar innervation?

Answer 22

C8

Question 23

Hypothenar Muscles

Answer 23

*Medial fleshy belly of the balm

1. ABDUCTOR DIGITI MINIMI - lateral
   (Ulnar nerve (C8, T1, deep branch))
2. FLEXOR DIGITI MINIMI
   (Ulnar nerve (C8, T1))
3. OPPONENS DIGITI MINIMI
   (Ulnar nerve (C8, T1))

Question 24

Significance of the flexor retinaculum as origins for certain intrinsic muscles

Answer 24

Gives off Thenar and Hypothenar Muscles (eminences either side of the hand)

Question 25

Central Compartment Contents and Significance

Answer 25

*Contain flexor tendons passing from forearms to digits 1. FLEXOR DIGITORUM SUPERFICIALIS (Median nerve (C7, 8 and T1)) 2. FLEXOR DIGITORUM PROFUNDUS (Ulnar nerve supplies the ulnar half. Median nerve (C8 and T1) supplies the radial half) 3. FLEXOR POLLICIS LONGUS (Median nerve (C8, T1)) 4. LUMBRICALS - arise from medial and lateral aspects of the FDP tendon (Median nerve (C8, T1))

Question 26

Actions and innervations of the LUMBRICALS

Answer 26

FLEXION @ MCPhalangeal Joint EXTENSION @ IP joint 2nd to 5th digits ``` Medial Lumbricals (ULNAR N.) Lateral Lumbricals (RADIAL N.) ```

Question 27

ADDUCTOR COMPARTMENT

Answer 27

INFERIOR TO FLEXOR POLLICIS LONGUS 1. ADDUCTOR POLLICIS (Ulnar nerve (C8, T1)) Made up of (coming from middle finger): - OBLIQUE HEAD - TRANSVERSE HEAD

Question 28

Significance of Interossei

Answer 28

1. PALMAR INTEROSSEI = ADDUCTION (Ulnar nerve) 2. DORSAL INTEROSSEI = ABDUCT (Ulnar nerve) PAD, DAB

Question 29

Which spinal segment contributes the most to the innervation of the interossei?

Answer 29

C8 + T1

Question 30

Significance of the neurovasculature of the hand (anterior)

Answer 30

* Superior Palmar Arch visble but deep is not as it lies inferior. to muscles etc. * Ulnar n travels. w/ palmar digital branch and innervates 4th and 5th fingers * Medial n. Under the flexor retinaculum the median nerve divides into five digital branches that run distally through the palm The digital branches run along the medial and lateral aspects of the 1st, 2nd and 3rd fingers and the lateral aspect of the 4th finger.

Question 31

The ulnar nerve is a branch of which cord of the brachial plexus?

Answer 31

Medial Cord

Question 32

What type of joint is the distal radio-ulnar joint?

Answer 32

pivot type synovial joint

Question 33

Identifying radius, ulnar, and bones of the hand

Answer 33

Radial stylus, radius larger than ulna. * Radius articulates with scaphoid and lunate

Question 34

What sits between the ulna and the carpal bones?

Answer 34

triangular fibrocartilage complex (TFCC) connects the bones in your forearm with bones in your wrist.

Question 35

Contents of the posterior forearm: acting on. hands and wrist

Answer 35

* EXTENSION * origin: lateral epicondyle / lateral supracondyle 1. EXTENSOR CARPI RADIALIS LONGUS - supracondylar ridge origin (Radial nerve (C6, 7)) 2. EXT. CARPI RADIALIS BREVIS (Radial nerve (C7, 8)) 3. EXTNSOR CARPI ULNARIS ( Radial nerve (C7, 8)) ---- deeper 4. SUPINATOR (Radial nerve (C5, 6))

Question 36

What is the action of EXT. CARPI RADIALIS LONGUS?

Answer 36

Abduction and extenson of the wrist joint

Question 37

Contents of the posterior forearm: acting on digits

Answer 37

1. EXTENSOR DIGITORUM (Radial nerve (C7, 8)) 2. EXTENSOR DIGITI MINIMI (Radial nerve (C7, 8)) ``` --- deeper 3. EXTENSOR INDICIS ---- thumb action 4. ABDUCTOR POLLICIS LONGUS - lateral ``` 5. EXT. POLLICIS BREVIS 6. EXT. POLLICIS LONGUS - medial (radial n. - C7, C8)

Question 38

Course of the radial n. and its significance in the posterior compartment

Answer 38

Wthin the posterior forearm, after exiting cubital fossa = SUPERFICIAL BRANCH * purely sensory; distributed to skin on dorsum of hand, passes over anatomical snuffbox DEEP BRANCH = POSTERIOR INTEROSSEUS N. * main motor nerve * pierces supinator to enter extensor compartment

Question 39

Arterial Supply of the posterior forearm

Answer 39

POST. INTEROSSEUS ART. (ULNAR ART.) RECURRENT INTEROSSEOUS ART. (ULNAR ART.)

Question 40

Significance of synovial cysts

Answer 40

Occur at. dorsal sheaths, associated w/ carpal tunnel, which the EXTENSOR RETINACULUM acts as a floor of.