Upper limb II: The arm and forearm Flashcards
1
Q
Parts of the elbow join
A
humeroradial, humeroulnar, proximal radioulnar
2
Q
Vasculature of brachium
A
axillary artery—–> brachial artery gives rise to profunda brachii (deep brachial artery), as well as the superior ulnar collateral and inferior ulnar collateral
3
Q
The profunda brachii (deep brachial artery) has two branches named
A
posterior descending branch (middle collateral) and anterior descending branch (radial collateral)
4
Q
musculature in the anterior (flexor) compartment of arm (brachium)
A
Biceps brachii (long and short head), brachialis, coracobrachialis
5
Q
musculature in the anterior (flexor) compartment of arm (brachium) are innervated by
A
Musculocutaneous nerve
6
Q
Proximal attachment of biceps brachii
A
- long head: supraglenoid tubercle of scapula
- Short head: coracoid process of scapula
7
Q
distal attachement of biceps brachii
A
-radial tuberosity and fascia of forearm via bicipital aponeurosis
8
Q
Actions of biceps brachii
A
- supinates forearm, when supine will flex forearm
- resists dislocation of shoulder (short head)
9
Q
Blood supply for the biceps brachii
A
brachial artery
10
Q
innervation of biceps brachii
A
Musculocutaneous nerve (C4,C6)
11
Q
Proximal attachment of coracobrachialis
A
coracoid process of scapula
12
Q
Distal attachment of coracobrachialis
A
middle 1/3 of medial humeral surface
13
Q
Actions of coracobrachialis
A
- Flexes and adducts arm at shoulder joint
- resists dislocation of shoulder joint
14
Q
Blood supply of coracobrachialis
A
brachial artery
15
Q
Innervation of coracobrachialis
A
Musculocutaneous Nerve (C5,C6,C7)
16
Q
Proximal attachement of brachialis
A
distal 1/2 of anterior surface of humerus
17
Q
Distal attachment of brachialis
A
coronoid process and tuberosity of ulna
18
Q
Actions of brachialis
A
flexes forearm at elbow joint
19
Q
Blood supply of brachialis
A
brachial artery
20
Q
Innervation of brachialis
A
- musculocutaneous nerve (C5, C6)
- Lateral portions may receive radial nerve contributions
21
Q
Musculature of Arm (brachium) posterior (extensor) compartment
A
- Triceps brachii
- long head
- lateral head
- Medial head
- Anconeus
22
Q
Musculature of Arm (brachium) posterior (extensor) compartment are innervated by
A
Radial nerve
23
Q
Proximal attachment of Anconeus
A
-Lateral epicondyle of humerus
24
Q
Distal attachement of Anconeus
A
-Lateral surface of olecranon, superior part of surface of ulna
25
Actions of Anconeus
- Assists triceps in extension of forearm and stabilizes elbow joint; also abducts ulna during pronation
26
Blood supply of Anconeus
Deep Brachial artery
27
innervation fo Anconeus
Radial nerve (C7,C8,T1)
28
Proximal attachment of triceps brachii
- long: infraglenoid tubercle
- lateral: posterior surface of humerus
- medial: posterior surface of humerus, inferior to radial groove (spiral groove)
29
Distal attachment of triceps brachii
-Proximal end of olecranon and fascia of forearm
30
Actions of triceps brachii
- extends forearm at elbow joint (main)
| - resists dislocation of shoulder joint (long head)
31
Blood supply of triceps brachii
-deep brachial artery
32
Innervation of triceps brachii
-radial nerve (C6,C7,C8)
33
The triceps are constantly acting as ______ to the forearm flexors
antagonists
34
boundaries of the cubital fossa
Lateral: Brachioradialis
Medial: Pronator teres
Superior: an imaginary line between medial and lateral epicondyles of humerus
Roof: skin, superficial and deep fascia, bicipital aponeurosis
Floor: supinator and brachialis
35
contents of the cubital fossa
1. ) median nerve
2. ) bifurcation of radial and ulnar arteries
3. ) Brachial veins (vernae comitantes)
4. ) tendon of biceps brachii and bicipital aponeurosis
5. ) radial nerve
- deep radial nerve
- superficial radial nerve
36
The radial nerve is between _____ and _____ in the cubital fossa
brachioradialis and brachialis
37
The superficial radial nerve radial nerve is underneath the _____ in the cubital fossa
Brachioradialis
38
The supinator is penetrated by
deep radial nerve
39
Posterior to the cubital region: elbow region
- triceps and olecranon process
- anconeus
- ulnar nerves runs posterior to medialepicondyle of humerus ("funny bone")
- posterior ulnar recurrent artery
40
The ulnar nerve runs posterior to
medial epicondyle of humerus
41
Cubital anastomosis
- Brachial Artery- Ulnar artery
- superior ulnar collateral-Posterior ulnar recurrent
- Inferior ulnar collateral- anterior ulnar recurrent
- Deep brachial artery-Radial and interosseous arteries
- Radial collateral artery- Radial recurrent artery
- Middle collateral artery- interosseous recurrent artery
42
Arterial supply and cubital anastomoses (around elbow joint)
- Proximal sources (collateral)
- Superior ulnar collateral (from brachial artery)
- Inferior ulnar collateral (from brachial artery)
- Radial collateral (anterior descending branch of deep brachial)
- Middle collateral (posterior descending branch of deep brachial)
- Distal Sources (recurrent)
- anterior ulnar recurrent artery (from ulnar artery)
- posterior ulnar recurrent artery (from ulnar artery)
- Radial recurrent artery (from radial artery)
- Interosseous arteries
- recurrent interosseous arteries (from common interosseous artery, which is a branch of the ulnar artery)
43
what are the interosseous arteries and which two are not part of the cubital anastomoses
- Recurrent interosseous artery
- Anterior interosseous artery (not part of cubital anastomosis)
- posterior interosseous artery (not part of cubital anastomosis)
44
Blood supply to anterior forearm
- ulnar artery
- common interosseous artery (via anterior interosseous artery)
- Radial artery
45
Blood supply to anterior hand
- Superficial Palmar arch
- ulnar artery
- Deep planar ach
- radial artery
46
arterial supply to posterior forearm and hand
- radial artery
- via deep palmar arch (hand)
- Via dorsal carpal arch (hand)
- common interosseous artery
- posterior interosseous artery
- perforating (posterior) branch of anterior interosseous artery
47
Superficial forearm muscles
- Pronator teres
- Flexor carpi radialis
- Palmaris longus
- Flexor carpi ulnaris
48
Intermediate forearm muscle (s)
Flexor digitorum superficialis
49
Deep forearm muscle (s)
- Flexor digitorum profundus
- Flexor pollicis longus
- Pronator quadratus
50
Proximal attachment of pronator teres
-Coronoid process of ulna; Medial epicondyle of the humerus; the common flexor tendon
51
Distal attachment of pronator teres
-middle of lateral surface of radius
52
Actions of pronator teres
Pronates and flexes forearm at elbow
53
Innervation of pronator teres
median nerve
54
Proximal attachment of flexor carpi radialis
medial epicondyle of humerus (common flexor origin)
55
Distal attachment of the flexor carpi radialis
Base of 2nd metacarpal
56
Actions of flexor carpi radialis
flexes and abducts hand at wrist
57
Innervation of flexor carpi radialis
median nerve
58
Proximal attachment of palmaris longus
medial epicondyle of humerus
59
Distal attachment of palmaris longus
flexor retinaculum; continuous with palmar aponeurosis
60
actions of palmaris longus
-flexes hand at wrist, tenses palmar aponeurosis
61
Innervation of palmaris longus
Median nerve
62
What forearm muscle may be absent
Palmaris longus
63
Proximal attachment of carpi ulnaris
-Medial epicondyle of humerus
64
Distal attachment of flexor carpi ulnaris
- Pisiform, hook of hamate, 5th metacarpal
65
Actions of flexor carpi ulnaris
Flexes and adducts hand at wrist
66
Innervation of flexor carpi ulnaris
ulnar nerve (C7-T1)
67
Proximal attachment of flexor digitorum superficialis
-Medial epicondyle of humerus, superior 1/2 of anterior border of radius
68
Distal attachment of flexor digitorum superficialis
-Shafts of middle phalanges of medial 4 digits
69
Actions flexor digitorum superficialis
- flexes middle phalanges at proximal interphalangeal joint
| - flexes proximal phalanges at metacarpophalangeal joints
70
Innervation of flexor digitorum superficialis
Median nerve
71
Proximal attachment of flexor digitorum profundus
-proximal 3/4 of medial and anterior surfaces of ulna and interosseous membrane
72
Distal Attachment of flexor digitorum profundus
-bases of distal phalanges of 2nd-5th fingers
73
Actions of flexor digitorum profundus
- flexes distal phalanges at interphalangeal joints (power grip)
74
Innervation of flexor digitorum profundus
median and ulnar nerves
75
Proximal attachment of flexor pollicicis longus
Anterior surface of radius and interosseous membrane
76
Distal attachment of flexor pollicis longus
base of distal phalanx of thumb
77
Actions of flexor pollicis longus flexes thumb
Flexes thumb
78
Innervation of flexor pollicis longus
median nerve via anterior interosseos nerve
79
Proximal attachment of pronator quadratus
Distal 1/4 of anterior surface of ulna
80
Distal attachment of pronator quadratus
Distal 1/4 of anterior surface of radius
81
Actions of pronator quadratus
-Pronates forearm, deep fibers bind radius and ulna together
82
Innervation of pronator quadratus
median nerve via anterior interosseous nerve
83
What innervates the posterior forearm
The radial nerve-
- Superficial branch of radial nerve (later, runs beneath brachioradialis)
- Deep branch of radial nerve (posterior, becomes posterior interosseous nerve)
84
The deep branch of the radial nerve continues as the
posterior interosseous nerve
85
Superficial extensors of the forearm mostly attach to the
lateral epicondyle of humerus
86
Superficial extensors of the forearm
- Brachioradialis (flexes elbow joint)
- Extensor carpi radialis longus
- extensor carpi radialis brevis
- extensor digitorum
- extensor digit minimi
- extensor carpi ulnaris
87
All muscles of the posterior forearm are innervated by the _____ via the ___________ or _______
radial nerve, via the deep branch of the radial nerve or posterior interosseous nerve
88
Proximal attachment of brachioradialis
-Proximal 2/3 of supraepicondylar ridge of humerus
89
Distal attachment of brachioradialis
- Distal radius, proximal to styloid process
90
Actions of brachioradialis
flexes forearm when it is pronated (about mid prone position)
91
Innervation of brachioradialis
Radial nerve
92
Proximal attachment of extensor carpi radialis longus
-lateral supracondylar ridge of humerus
93
distal attachment of extensors carpi radialis longus
Dorsal aspect of base of 2nd metacarpal
94
Actions of extensor carpi radialis longus
extend and abduct hand at wrist
95
Innervation of extensor carpi radialis longus
radial nerve
96
Proximal attachment of extensor carpi radialis brevis
-Lateral epicondyle of humerus (common extensor origin)
97
Distal attachment of extensor carpi radialis brevis
-dorsal aspect of base of 3rd metacarpal
98
Actions of extensor carpi radialis brevis
- Extend and abduct hand at wrist
99
Innervation of extensor carpi radialis brevis
deep branch of radial nerve
100
proximal attachment of extensor digitorum
lateral epicondyle of humerus (common extensor origin)
101
Distal attachment of extensor digitorum
extensor expansion of medial 4 fingers
102
Actions of extensor digitorum
extends medial 4 fingers at metacarpophalangeal joints and somewhat at interphalangeal joints
103
Innervation of extensor digitorum
posterior interosseous nerve
104
Proximal attachment of extensor digit minimi
Lateral epicondyle of humerus (common extensor origin)
105
Distal attachment of extensor digit minimi
Extensor expansion of 5th finger
106
Actions of extensor digit minimi
Extends 5th finger at metacarpophalangeal joint and secondarily at interphalangeal joint
107
innervation of extensor digit minimi
posterior interosseous nerve
108
Proximal attachment of extensor carpi ulnaris
-lateral epicondyle of humerus and posterior border of ulna
109
Distal attachment of extensor carpi ulnaris
dorsal aspect of base of 5th metacarpal
110
Actions of extensor carpi ulnaris
extends and adducts at wrist
111
Innervation of extensor carpi ulnaris
posterior interosseous nerve
112
Deep extensors of forearm and hand
- supinator
- extensor indicis
- abductor pollicis longus
- extensor pollicis longus
- extensor pollicis brevis
113
All the deep extensors are innervated by
deep branch of the radial nerve, or the posterior interosseus nerve, which is the continuation of this same nerve
114
proximal attachment of supinator
- lateral epicondyle of humerus
- Radial collateral and anular ligaments
- Ulnar crest
115
Distal attachment of supinator
proximal 1/3 of radius (nearly all surfaces, as it wraps around the bone)
116
Actions of supinator
-supinates forearm, bringing radius back to anatomical position
117
Innervation of supinator
deep branch of radial nerve
118
Proximal attachement of Extensor inidicis
posterior surface of distal 1/3 of ulna and interosseous membrane
119
Distal attachement of extensor indicis
Extensor expansion of 2nd finger
120
Actions of extensor indicis
Independent extension of 2nd finger, but also helps with extension of wrist
121
Innervation of extensor indicis
- Posterior interosseous nerve (this nerve is the continuation of the deep branch of the radial nerve)
122
What nerve is the continuation of the deep branch of the radial nerve
Posterior interosseous nerve
123
Proximal attachment of abductor pollcis longus
Posterior surface of proximal 1/2 of ulna and radius, interosseous membrane
124
Distal attachement of abductor pollicis longus
base of 1st metacarpal
125
Actions of abductor pollicis longus
Abducts thumb and extends it at carpometacarpal joint
126
Innervation of abductor pollicis longus
posterior interosseous nerve
127
Proximal attachment of extensor pollicis brevis
- posterior surface of distal 1/3 of radius
| - interosseous membrane
128
Distal attachement of extensor pollicis brevis
Dorsal aspect of proximal phalanx of thumb
129
Actions of extensor pollicis brevis
-extends proximal phalanx of thumb at its metacarpopalangeal joint, also extends carpometacarpal joint
130
innervation of extensor pollicis brevis
posterior interosseous nerve
131
Proximal attachment of extensor pollicis longus
- posterior surface of middle 1/3 of ulna
| - interosseous membrane
132
Distal attachment of extensor pollicis longus
- dorsal aspect of base of distal phalanx of thumb
133
actions of extensor pollicis longus
extends distal phalanx of thumb at its interphalangeal joint and extends the metacarpopalangeal and carpometacarpal joints
134
Innervation of extensor pollicis longus
posterior interosseous nerve
135
parts of the anatomical snuff box
- extensor pollicis longus (ulnar border-more medial)
- Extensor pollicis brevis (radial border)
- Abductor pollicis longus (runs with e.p. brevis)
136
Causes of radial nerve injury
-fracture to the humeral shaft due to its relationship to the spiral groove.
137
Symptoms of radial nerve injury
- "wrist-drop"
- Full or partial paralysis of the extensors of the wrist and fingers results in the inability to extend and thus the flexors "take-over" and the wrist assumes a partially flexed position
138
proximal attachment of supinator
- lateral epicondyle of humerus
- Radial collateral and anular ligaments
- Ulnar crest
139
Distal attachment of supinator
proximal 1/3 of radius (nearly all surfaces, as it wraps around the bone)
140
Actions of supinator
-supinates forearm, bringing radius back to anatomical position
141
Innervation of supinator
deep branch of radial nerve
142
Proximal attachement of Extensor inidicis
posterior surface of distal 1/3 of ulna and interosseous membrane
143
Distal attachement of extensor indicis
Extensor expansion of 2nd finger
144
Actions of extensor indicis
Independent extension of 2nd finger, but also helps with extension of wrist
145
Innervation of extensor indicis
- Posterior interosseous nerve (this nerve is the continuation of the deep branch of the radial nerve)
146
What nerve is the continuation of the deep branch of the radial nerve
Posterior interosseous nerve
147
Proximal attachment of abductor pollcis longus
Posterior surface of proximal 1/2 of ulna and radius, interosseous membrane
148
Distal attachement of abductor pollicis longus
base of 1st metacarpal
149
Actions of abductor pollicis longus
Abducts thumb and extends it at carpometacarpal joint
150
Innervation of abductor pollicis longus
posterior interosseous nerve
151
Proximal attachment of extensor pollicis brevis
- posterior surface of distal 1/3 of radius
| - interosseous membrane
152
Distal attachement of extensor pollicis brevis
Dorsal aspect of proximal phalanx of thumb
153
Actions of extensor pollicis brevis
-extends proximal phalanx of thumb at its metacarpopalangeal joint, also extends carpometacarpal joint
154
innervation of extensor pollicis brevis
posterior interosseous nerve
155
Proximal attachment of extensor pollicis longus
- posterior surface of middle 1/3 of ulna
| - interosseous membrane
156
Distal attachment of extensor pollicis longus
- dorsal aspect of base of distal phalanx of thumb
157
actions of extensor pollicis longus
extends distal phalanx of thumb at its interphalangeal joint and extends the metacarpopalangeal and carpometacarpal joints
158
Innervation of extensor pollicis longus
posterior interosseous nerve
159
parts of the anatomical snuff box
- extensor pollicis longus (ulnar border-more medial)
- Extensor pollicis brevis (radial border)
- Abductor pollicis longus (runs with e.p. brevis)
160
Causes of radial nerve injury
-fracture to the humeral shaft due to its relationship to the spiral groove.
161
Symptoms of radial nerve injury
- "wrist-drop"
- Full or partial paralysis of the extensors of the wrist and fingers results in the inability to extend and thus the flexors "take-over" and the wrist assumes a partially flexed position
