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MSK > Upper Limb Muscles > Flashcards

Upper Limb Muscles Flashcards

1
Q

Where is the pectoral region of the body

A

On the anterior chest wall

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2
Q

Which muscles are present in the pectoral region of the body? (4)

A

Pectoralis major
Pectoralis minor
Serratus anterior
Subclavius

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3
Q

Which is the most superficial muscle in the pectoral region?

A

Pectoralis major

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4
Q

The pectoralis major is large and ______ shaped

A

Fan

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5
Q

The pectoralis major consist of a ______________ and a _____________ head

A

Clavicular

Sternocostal

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6
Q

What is the distal attachment of both the clavicular and sternocostal head of the pectoralis major?

A

The intertubercular sulcus of the humerus

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7
Q

Where does the clavicular head of the pectoralis major originate?

A

The anterior surface of the medial clavicle

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8
Q

Where does the sternocostal head of the pectoralis major originate?

A

From the anterior surface of the sternum, superior six costal cartilages and the aponeuorsis of the external oblique muscle

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9
Q

What is the function of the pectoralis major?

A

Addicts and medially rotates the upper limb and draws the scapular anterioinferiorly

The clavicular head of the pectoralis major can act individually to flex the upper limb

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10
Q

What innervates the pectoralis major?

A

Lateral and medial pectoral nerves

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11
Q

Where does the pectoralis minor lie in relation to the pectoralis major?

A

Lies underneath the pectoralis major

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12
Q

Where does the pectoralis minor originate and attach?

A

Originates from the 3rd and 5th ribs

Attaches into the coracoid process of the scapula

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13
Q

What is the function of the pectoralis minor?

A

Stabilises the scapula by drawing it anteroinferiorly against the thoracic wall

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14
Q

What innervates the pectoralis minor?

A

Medial pectoral nerve

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15
Q

Where is the serratus anterior located in the body?

A

More laterally in the chest wall

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16
Q

The serratus anterior muscle consists of several ________

A

Strips

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17
Q

Where does the serratus anterior originate and attach?

A

Originates from the lateral aspects of ribs 1-8

Attaches to the costal surface of the medial border of the scapula

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18
Q

What is the function of the serratus anterior?

A

Rotates the scapula allowing the arm to be raised over 90 degrees
Holds the scapula against the ribcage

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19
Q

Which nerve innervates the serratus anterior?

A

Long thoracic nerve

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20
Q

Where is the subclavius located?

A

Located directly underneath the clavicle running horizontally

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21
Q

Where does the subclavius originate and attach?

A

From the junction of the 1st rib and its costal cartilage

Attaches into the inferior surface of the middle third of the clavicle

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22
Q

What is the function of the subclavius?

A

Anchors and depresses the clavicle

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23
Q

Which nerve innervates the subclavius?

A

Nerve to subclavius

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24
Q

What can result from damage to the long thoracic nerve?

A

Paralysis of the serratus anterior, scapula no longer held against the ribcage resulting in profusion out of the back - winged scapula

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25
Q

Winged scapula results from damage to which nerve?

A

Long thoracic nerve

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26
Q

Long thoracic nerve damage usually results from which kinds of injuries?

A

Traction injuries - where upper limb is stretched violently

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27
Q

Which wall of the axilla does the serratus anterior form?

A

Medial

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28
Q

The muscles of the shoulder can be divided into which 2 groups

A

Extrinsic

Intrinsic

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29
Q

What is common of the extrinsic muscles of the shoulder?

A

Originates from the torso and attach to the bones of the shoulder

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30
Q

What is common of the intrinsic muscles of the shoulder?

A

Originate from the scapula/clavicle and attach to the humerus

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31
Q

The intrinsic muscles of the shoulder originate from the…

and atttach to the…

A

Scapula and/or clavicle

Humerus

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32
Q

How many intrinsic muscles of the shoulder are there?

How many rotator cuff muscles are there?

A

6

4

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33
Q

Name the six intrinsic muscles of the shoulder

A 
Deltoid 
Teres major 
Supraspinatus 
Infraspinatus 
Subscapularis 
Teres minor
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34
Q

Name the 4 rotator cuff muscles of the shoulder

A

Supraspinatus
Infraspinatus
Subscapularis
Teres minor

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35
Q

The deltoid muscle can be divided into which 3 parts?

A

Anterior
Middle
Posterior

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36
Q

Where does the deltoid originate and attach?

A

Originates from the scapula and clavicle

Attaches to the deltoid tuberosity on the lateral surface of the humerus

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37
Q

Which nerve innervates the deltoid?

A

Axillary nerve

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38
Q

What are the actions of the deltoid muscle?

A

Anterior fibres - flex the arm at the shoulder
Posterior fibres - extend the arm at the shoulder
Middle fibres - major abductor of the arm

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39
Q

The teres major forms which border of the quadrangular space?

A

Inferior border

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40
Q

Name two structures that pass through the quadrangular space

A

Axillary nerve

Posterior circumflex humeral artery

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41
Q

Where does the teres major originate and attach?

A

Originates from the posterior surface of the inferior angle of the scapula

Attaches to the intertubercular groove of the humerus

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42
Q

Which nerve innervates the teres major?

A

Lower subscapular nerve

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43
Q

What are the actions of the teres major?

A

Adducts at the shoulder

Medially rotates the arm

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44
Q

What are the 4 rotator cuff muscles?

A

Subscapularis
Infraspinatus
Supraspinatus
Teres minor

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45
Q

The rotator cuff muscles originate at the _________ and attach to the ________ _________

A

Scapula

Humeral head

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46
Q

How do the rotator cuff muscles provide stability to the glenohumeral joint?

A

The resting tone of the muscles act to pull the humeral head into the glenoid fossa

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47
Q

Where does the supraspinatus originate and attach?

A

Originate from the supraspinous fossa of the scapula

Attaches to the greater tubercle of the humerus

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48
Q

Which nerve innervates the supraspinatus?

A

Suprascapular nerve

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49
Q

What are the actions of the supraspinatus?

A

Abducts the arm 0-15 degrees and assists the deltoid for 15-90 degrees

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50
Q

Where does the infraspinatus originate and attach?

A

Originates from the infraspinous fossa of the scapula

Attaches to the greater tubercle of the humerus

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51
Q

Which nerve innervates the infraspinatus?

A

Suprascapular nerve

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52
Q

What does the infraspinatus do?

A

Laterally rotates the arm

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53
Q

Where does the subscapularis originate and attach?

A

Originates from the subscapular fossa of the scapula

Attaches to the lesser tubercle of the humerus

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54
Q

Which nerve innervates the subscapularis?

A

Upper and lower subscapular nerves

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55
Q

What is the action of the subscapularis?

A

Medially rotates the arm

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56
Q

Where does the teres minor originate and attach?

A

Originates from the posterior surface of the scapula

Attaches to the greater tubercle of the humerus

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57
Q

Which nerve innervates the teres minor?

A

Axillary nerve

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58
Q

What is the action of the teres minor?

A

Laterally rotates the arm

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59
Q

What is rotator cuff tendonitis? What usually causes it?

A

Inflammation of the tendons of the rotator cuff muscles

Repetitive use of the shoulder joint

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60
Q

Which muscle is most commonly affected by rotator cuff tendonitis? What happens?

A

Supraspinatus

During abduction, the supraspinatus rubs against the coraco-acromial arch

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61
Q

What treatments are given for rotator cuff tendonitis?

A

Rest
Analgesia
Physiotherapy

Steroid injections
Surgery

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62
Q

Extrinsic muscles of the shoulder originate from the…

and attach to the…

Where in the body are the extrinsic muscles of the shoulder located?

A

Torso

Bones of the shoulder (scapula, clavicle, humerus)

In the back

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63
Q

The extrinsic muscles of the shoulder are arranged in which 2 layers?

A

Superficial layer

Deep layer

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64
Q

How many extrinsic superficial muscles of the shoulder are there?

Name them

A

2

Trapezius
Latissimus dorsi

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65
Q

Which is the most superficial of all the back muscles?

A

Trapezius

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66
Q

Where does the trapezius originate and attach?

A

Originates from the skull, nuchal ligament and spinous processes of C7-T12

Attaches to the clavicle, acromion and the scapula spine

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67
Q

Which nerve innervates the trapezius?

A

Accessory nerve for motor innervation

Also receives proprioceptor fibres from C3 and C4 spinal nerves

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68
Q

What is the action of the trapezius?

A

Upper fibres - elevate scapula and rotate it during abduction of the arm

Middle fibres - retract the scapula

Lower fibres - pull the scapula inferiorly

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69
Q

What is the most common cause of accessory nerve damage?

A

Iatrogenic (as a result of a medical procedure)

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70
Q

Give an example of a medical procedure which has risks for damaging the accessory nerve

A

Cervical lymph node biopsy

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71
Q

How can the accessory nerve be tested?

A

By testing trapezius function - shrugging of the patient’s shoulders

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72
Q

What are some clinical features of accessory nerve damage? (3)

A

Muscle wasting, partial paralysis of the sternocleidomastoid, asymmetrical neckline

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73
Q

Where does the latissimus dorsi originate and attach?

A

Has a broad origin in the lower part of the back - arises from the spinous processes of T6-T12, iliac crest, inferior 3 ribs

Attaches at the intertubercular sulcus of the humerus

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74
Q

Which nerve innervates the latissimus dorsi?

A

Thoracodorsal nerve

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75
Q

What are the actions of the latissimus dorsi?

A

Extends, adducts and medially rotates the upper limb

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76
Q

How many deep extrinsic muscles of the shoulder are there? Name them. Where are they situated?

A

3

Rhomboid major
Rhomboid minor
Levator scapulae

In the upper back under the trapezius

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77
Q

Describe the levator scapulae. Where does it originate and attach?

A

Small strap-like muscle

From the transverse processes of the C1-C4 vertebrae

Medial border of the scapula

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78
Q

Which nerve innervates the levator scapulae?

A

Dorsal scapular nerve

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79
Q

What is the action of the levator scapulae?

A

Elevates the scapula

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80
Q

Where is the rhomboid minor situated compared to the rhomboid major muscle?

A

Rhomboid minor situated superiorly to rhomboid major

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81
Q

Which nerve innervates both the rhomboid major and rhomboid minor?

A

Dorsal scapular nerve

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82
Q

What is the action of both the rhomboid minor and rhomboid major muscles?

A

Retracts and rotates the scapula

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83
Q

What is the origin and attachment of the rhomboid major?

A

Originates from the spinous processes of T2-T5

Attaches to the medial border of the scapula - between the scapula spine and inferior angle

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84
Q

What is the origin and attachment of the rhomboid minor muscle?

A

Originates from the spinous processes of C7-T1

Attaches to the medial border of the scapula at the level of the scapula spine

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85
Q

Between which joints is the upper limb located?

How many muscles are there in the upper limb?

How many of these muscles are in the anterior compartment of the upper limb and how many in the posterior compartment?

Name them.

A

Between the shoulder joint and the elbow joint

4

Anterior - 3
Posterior - 1

Anterior - Biceps brachii, brachialis, coracobrachialis
Posterior - Triceps brachii

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86
Q

All the muscles of the anterior compartment of the upper limb are innervated by which nerve?

A

Musculocutaneous nerve

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87
Q

What is a pneumonic for the muscles in the anterior compartment of the upper limb?

A

BBC

Biceps, brachialis, coracobrachialis

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88
Q

Arterial supply to the anterior compartment of the upper arm is via branches of the…

A

Brachial artery

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89
Q

The biceps brachii consists of 2 ___________

A

Heads (long and short)

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90
Q

Do the biceps brachii have any attachments to the humerus?

A

No

Most of its muscle mass is located anterior to the humerus

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91
Q

What is the bicipital aponeurosis?

Which part of the cubital fossa is formed by the bicipital aponeurosis?

A

A connective tissue sheet given off as the biceps brachii enters the forearm

Roof of the cubital fossa

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92
Q

Where does the biceps brachii originate?

A

Long head originates from the supraglenoid tubercle of the scapula

Short head originates from the coracoid process of the scapula

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93
Q

Where does the biceps brachii attach?

A

Both heads insert into the radial tuberosity and the fascia of the forearm via the bicipital aponeurosis

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94
Q

What is the function of the biceps brachii?

A

Supination of the forearm

Flexes the arm at the elbow/shoulder

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95
Q

What nerve innervates the biceps brachii?

A

Musculocutaneous nerve

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96
Q

Where does the coracobrachialis lie in relation to the biceps brachii?

A

Deep to the biceps brachii in the arm

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97
Q

Where does the coracobrachialis originate and attach?

A

Originates from the coracoid process of the scapula

Attaches to the medial side of the humeral shaft at the level of the deltoid tubercle

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98
Q

What is the function of the coracobrachialis?

A

Flexion of the arm at the shoulder and weak adduction

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99
Q

Which nerve innervates the coracobrachialis?

A

Musculocutaneous nerve

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100
Q

Where does the brachialis lie in the upper arm?

A

Deep to the biceps brachii

Found more distally than the other muscles in the arm

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101
Q

What portion of the cubital fossa is formed by the brachialis?

A

Forms the floor of the cubital fossa

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102
Q

Where does the brachialis originate and attach?

A

Originates from the medial and lateral surfaces of the humeral shaft

Attaches at the ulna tuberosity

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103
Q

What is the function of the brachialis?

A

Flexion at the elbow

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104
Q

What nerve innervates the brachialis?

A

Musculocutaneous nerve with contributions from the radial nerve

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105
Q

Are complete ruptures of tendons relatively common or rare?

Which tendon in the upper limb is one of the most commonly ruptured?

A

Rare

Long head of the biceps brachii

106
Q

How does a rupture of the biceps tendon clinically present?

A

A bulge where the muscle belly is on elbow flexion (Popeye’s sign)

107
Q

Why does a patient with a ruptured biceps tendon not notice much weakness in the upper limb?

A

Due to the action of the brachialis and supinator muscles

108
Q

The triceps brachii consists of how many heads?

In which compartment of the upper arm does the triceps brachii lie?

A

3 - Long head, lateral head, medial head

Posterior compartment

109
Q

What is the relative positions of the three heads of the triceps brachii in the upper arm?

A

Medial head lies deeper than the other two which cover it

110
Q

Which vessel supplies blood to the posterior compartment of the upper arm?

A

Profunda brachii artery

111
Q

Where do the lateral, medial and long head of the triceps brachii originate?

A

Long head - infraglenoid tubercle
Lateral head - humerus, superior to the radial groove
Medial head - humerus, inferior to the radial groove

112
Q

Where do the three heads of the triceps brachii converge and attach in the upper arm?

A

Into the olecranon of the ulna

113
Q

What is the function of the triceps brachii?

A

Extension of the arm at the elbow

114
Q

What is the innervation of the triceps brachii?

A

Radial nerve

115
Q

A tap on the triceps tendon tests which spinal segment?

A

C7

116
Q

A bicep tendon reflex test, tests which spinal cord segment?

A

C6

117
Q

The muscles in the anterior compartment of the forearm are split into which categories?

A

3 categories

Superficial
Intermediate
Deep

118
Q

In general, muscles in the anterior compartment of the forearm perform… (2)

A

Flexion at the wrist/fingers

Pronation

119
Q

How many superficial muscles are there in the anterior compartment of the forearm? Name them

A

4

Flexor carpi ulnaris
Palmaris longus
Flexor carpi radialis
Pronator teres

120
Q

All the superficial muscles in the anterior compartment of the forearm originate from…

A

A common tendon, which arises from the medial epicondyle of the humerus

121
Q

Where does the flexor carpi ulnaris originate and attach?

A

Originates from the medial epicondyle and has a long origin from the ulna

Attaches to the pisiform

122
Q

What are the actions of the flexor carpi ulnaris?

A

Flexion and adduction at the wrist

123
Q

What nerve innervates the flexor carpi ulnaris?

A

Ulnar nerve

124
Q

Which superficial anterior forearm muscle is absent in some of the population?

A

Palmaris longus - absent in ~15% of the population

125
Q

In a dissection, what will you find directly underneath the palmaris longus?

A

Median nerve

126
Q

Where does the palmaris longus originate and attach?

A

Originates - medial epicondyle

Attaches - flexor retinaculum of the wrist

127
Q

What is the function of the palmaris longus?

A

Flexion at the wrist

128
Q

What nerve innervates the palmaris longus?

A

Median nerve

129
Q

Where does the flexor carpi radialis originate and attach?

A

Originates - medial epicondyle

Attaches - base of metacarpals II and III

130
Q

What is the function of the flexor carpi radialis?

A

Flexion and abduction at the wrist?

131
Q

Which nerve innervates the flexor carpi radialis?

A

Median nerve

132
Q

The lateral border of the pronator teres forms the __________ border of the cubital fossa

A

Medial

133
Q

What are the origins and attachments of the pronator teres?

A

Originates - medial epicondyle, coronoid process of the ulna

Attaches - laterally to the mid shaft of the radius

134
Q

How do the superficial muscles of the anterior forearm appear medially to laterally?

A

Flexor carpi ulnaris
Palmaris longus
Flexor carpi radialis
Pronator teres

135
Q

What is the action of the pronator teres?

A

Pronation of the forearm

136
Q

Which nerve innervates the pronator teres?

A

Median nerve

137
Q

How many muscles are there in the intermediate layer of the anterior forearm muscles?

Name them

A

Flexor digitorum superficialis

138
Q

Which neurovascular structures pass between the two heads of the flexor digitorum superficialis?

A

Median nerve and ulnar artery and then travel posteriorly

139
Q

Where does the flexor digitorum superficialis originate and attach?

A

Two heads, originates from the medial epicondyle of the humerus and from the radius

Attaches to the middle phalanges of the four fingers as it splits into four tendons at the wrists

140
Q

What is the action of the flexor digitorum superficialis?

A

Flexes the metacarpophalangeal joints and proximal interphalangeal joints at the 4 fingers
Flexes at the wrist

141
Q

Which nerve innervates the flexor digitorum superficialis?

A

Median nerve

142
Q

How many muscles are there in the deep compartment of the anterior forearm?

Name them

Describe their relative positions

A

3

Flexor digitorum profundus
Flexor pollicis longus
Pronator quadratus

Flexor digitorum profundus lies most medially, then flexor pollicis longus more laterally and pronator quadratus found deep to the tendons of these two muscles

143
Q

Where does the flexor digitorum profundus originate and attach?

A

Originates - ulna/interosseous membrane

Attaches - splits into 4 tendons and attaches to the distal phalanges of the four fingers

144
Q

What is the action of the flexor digitorum profundus?

A

Flexes the distal interphalangeal joints of the fingers
Flexes at metacarpophalangeal joints of the fingers
Flexes at the wrist

145
Q

What nerve innervates the flexor digitorum profundus?

A

The medial half (little and ring fingers) innervated by the ulnar nerve

The lateral half (middle and index) innervated by the anterior interosseous branch of the median nerve

146
Q

Where does the flexor pollicis longus originate and attach?

A

Originates from the anterior surface of the radius and interosseous membrane

Attaches - base of the distal phalanx of the thumb

147
Q

What is the function of the flexor pollicis longus?

A

Flexes the interphalangeal and metacarpophalangeal joint of the thumb

148
Q

Which nerve innervates flexor pollicis longus?

A

Anterior interosseous branch of the median nerve

149
Q

The pronator quadratus muscle takes which rough shape?

A

Square shape

150
Q

Where does the pronator quadratus originate and attach?

A

Originates - anterior surface of the ulna

Attaches - anterior surface of the radius

151
Q

What is the function of the pronator quadratus?

A

Pronates the forearm

152
Q

Which nerve innervates the pronator quadratus?

A

Anterior interosseous branch of the median nerve

153
Q

The muscles in the posterior compartment of the forearm are commonly known as the…

A

Extensor muscles

154
Q

The general function of the posterior forearm muscles is to…

A

Produce extension at the wrist and fingers

155
Q

The posterior forearm muscles are all innervated by the…

A

Radial nerve

156
Q

The posterior forearm muscles are divided into which layers?

A

2 layers - superficial/deep

157
Q

The two layers of muscles (superficial and deep) in the posterior compartment of the forearm and spared by…

A

A layer of fascia

158
Q

How many superficial posterior forearm muscles are there?

Name them

A

7

Brachioradialis 
Extensor carpi radialis longus 
Extensor carpi radialis brevis 
Extensor carpi ulnaris 
Aconeus 
Extensor digitorum 
Extensor digiti minimi
159
Q

Which 4 of the superficial posterior forearm muscle share a common origin?

What is this origin?

A

Extensor carpi radialis brevis
Extensor digitorum
Extensor carpi ulnaris
Extensor digiti minimi

Lateral epicondyle

160
Q

All the posterior forearm muscles are innervated by which nerve?

A

Radial nerve

161
Q

In the distal forearm the __________ artery and _________ nerve are sandwiched between the ______________ and the deep flexor muscles.

A

Radial
Radial
Brachioradialis

162
Q

Where does the brachioradialis originate and attach?

A

Originates - proximal aspect of the lateral supracondylar ridge of the humerus

Attaches - distal end of the radius, before the radial styloid process

163
Q

What is the action of the brachioradialis?

A

Flexes at the elbow

164
Q

Where are the extensor carpi radialis brevis and longus situated?

A

Lateral aspect of the posterior forearm

165
Q

Where does the extensor carpi radialis longus originate and attach?

A

Originates from the supracondylar ridge

Attaches to metacarpal bones II and III

166
Q

Where does the extensor carpi radialis brevis originate and attach?

A

Originates - lateral epicondyle

Attaches - metacarpals II and III

167
Q

What is action of the extensor carpi radialis longus and brevis?

A

Extends and abducts the wrist

168
Q

Which muscle is the main extensor of the fingers?

A

Extensor digitorum

169
Q

How do you test the function of the extensor digitorum?

A

Pronate the forearm and extend the fingers against resistance

170
Q

Where does the extensor digitorum originate and attach?

A

Originates - lateral epicondyle

Attaches - splits into 4, inserts into the extensor hood of each finger

171
Q

What is the action of the extensor digitorum?

A

Extends the medial four fingers at the metacarpophalangeal and interphalangeal joints

172
Q

Where does the extensor digiti minimi lie in the posterior forearm?

A

Medially to the extensor digitorum

Thought to originate from the extensor digitorum - two muscles are fused together in some individuals

173
Q

Where does the extensor digiti minimi originate and attach?

A

Originates - lateral epicondyle of the humerus

Attaches - into the extensor hood of the little finger

174
Q

What is the action of the extensor digiti minimi?

A

Extends the little finger and contributes to extension at the wrist

175
Q

Where does the extensor carpi ulnaris lie in the posterior forearm?

A

On the medial aspect of the posterior forearm

176
Q

Where does the extensor carpi ulnaris originate and attach?

A

Originates - lateral epicondyle of the humerus

Attaches - base of metacarpal V

177
Q

What is the action of the extensor carpi ulnaris?

A

Extension and adduction of the wrist

178
Q

Where is the aconeus situated in the posterior forearm?

A

Medially and superiorly

179
Q

The aconeus is blended with the fibres of the ____________ _________

A

Triceps brachii

180
Q

Where does the aconeus originate and attach?

A

Originates - lateral epicondyle

Attaches - posterior and lateral part of the olecranon

181
Q

What is the action of the aconeus?

A

Extends and stabilises the elbow joint

Abducts the ulna during pronation

182
Q

What is lateral epicondylitis? What is another term for it?

A

Inflammation of the periosteum of the lateral epicondyle

Tennis elbow

183
Q

What is the peak age of onset of lateral epicondylitis?

A

40-50 years of age

184
Q

What causes lateral epicondylitis?

A

Repeated use of the superficial extensor muscles

185
Q

How many deep muscles of the posterior forearm are there?

Name them

A 
Supinator 
Abductor pollicis longus 
Extensor pollicis brevis 
Extensor pollicis longus
Extensor indicis
186
Q

All the deep muscles of the posterior forearm excluding the supinator act on the…

A

Thumb and index finger

187
Q

Name the deep muscles of the posterior forearm, laterally to medially

A

Supinator
Abductor pollicis longus
Extensor pollicis longus/brevis
Extensor indicis

188
Q

The supinator forms the ___________ of the cubital fossa

The supinator consists of how many heads?

What passes between heads of the supinator?

A

Floor

2 heads

Deep branch of the radial nerve

189
Q

Where does the supinator originate and attach?

A

Two heads

Originates - lateral epicondyle and posterior surface of the ulna

Attaches - posterior surface of the radius

190
Q

What is the action of the supinator?

A

Supinates the forearm

191
Q

The abductor pollicis longus is situated immediately _______ to the supinator muscle

A

Distal

192
Q

The tendon of the abductor pollicis longus contributes to the lateral border of the…

A

Anatomical snuffbox

193
Q

Where does the abductor pollicis longus originate and attach?

A

Originates - interosseous membrane and the posterior surfaces of the radius/ulna

Attaches - lateral side of the base of metacarpal I

194
Q

What is the action of the abductor pollicis longus?

A

Abducts the thumb

195
Q

Where is the extensor pollicis brevis found in relation to the abductor pollicis longus?

A

Medially and deep to the abductor pollicis longus

196
Q

The tendon of the extensor pollicis brevis contributes to the ___________ border of the anatomical snuffbox

A

Lateral

197
Q

Where does the extensor pollicis brevis originate and attach?

A

Originates - posterior surface of the radius and interosseous membrane

Attaches - base of the proximal phalanx of the thumb

198
Q

What is the action of the extensor pollicis brevis?

A

Extends at the metacarpophalangeal and carpometacarpal joints of the thumb

199
Q

The tendon of the extensor pollicis longus forms the ______________ border of the anatomical snuffbox

A

Medial

200
Q

Where does the extensor pollicis longus originate and attach?

A

Originates - posterior surface of the ulna and interosseous membrane

Attaches - distal phalanx of the thumb

201
Q

What is the action of the extensor pollicis longus?

A

Extends all joints of the thumb

202
Q

Where does the extensor indicis originate and attach?

A

Originates - posterior surface of the ulna and interosseous membrane

Attaches - extensor hood of the index finger

203
Q

What is the action of the extensor indicis?

A

Extends the index finger

204
Q

Wrist drop is a sign of __________ nerve injury that has occurred…

It is caused by…

A

Radial

Proximal to the elbow

Unopposed flexion at the wrist joint

205
Q

What are two common characteristic sites of damage of the radial nerve?

A

Axilla

Radial groove of the humerus

206
Q

What can cause radial nerve damage in the…

I) axilla
II) radial groove of the humerus

A

I) humeral dislocations/fractures of the proximal humerus

II) humeral shaft fracture

207
Q

Muscles acting on the hand can be divided into which 2 categories?

A

Extrinsic and intrinsic muscles

208
Q

Describe the location and action of the extrinsic muscles of the hand

A

Located in the anterior and posterior compartments of the forearm

Control crude movements of the hand and produce a forceful grip

209
Q

Describe the location and action of the intrinsic muscles of the hand

A

Located within the hand itself

Responsible for fine motor functions of the hand

210
Q

How many thenar muscles are there? Where are they located?

A

3

Base of the thumb

211
Q

The muscle bellies of thenar muscles produce a bulge in the hand known as the ________ _____________

What are these muscles responsible for?

A

Thenar eminence

Fine movements of the thumb

212
Q

Which nerve innervates all the thenar muscles?

A

Median nerve

213
Q

Name the three thenar muscles

A

Opponens pollicis
Abductor pollicis brevis
Flexor pollicis brevis

214
Q

What is the largest of all the thenar muscles? Where does the opponens pollicis lie in relation to the other thenar muscles?

A

Opponens pollicis

Lies underneath the other two

215
Q

Where does the opponens pollicis originate and attach?

A

Originates - tubercle of the trapezium

Attaches - lateral margin of the metacarpal of the thumb

216
Q

What is the action of the opponens pollicis?

A

Opposes the thumb

217
Q

Where is the abductor pollicis brevis found in relation to the other thenar muscles?

A

Anteriorly to the opponens pollicis and proximal to the flexor pollicis brevis

218
Q

Where does the abductor pollicis brevis originate and attach?

A

Originates - tubercles of the scaphoid and trapezium

Attaches - lateral side of proximal phalanx of the thumb

219
Q

What is the action of the abductor pollicis brevis?

A

Abducts the thumb

220
Q

Which is the most distal of all the thenar muscles?

A

Flexor pollicis brevis

221
Q

Where does the flexor pollicis brevis originate and attach?

A

Originates - tubercle of the trapezium

Attaches - base of the proximal phalanx of the thumb

222
Q

What is the function of the flexor pollicis brevis?

A

Flexes the metacarpophalangeal joint of the thumb

223
Q

What is the hypothenar eminence? Which set of muscles produces this eminence?

A

The muscular protrusion on the medial side of the palm

Hypothenar muscles

224
Q

Which nerve innervates all the hypothenar muscles?

A

Ulnar nerve

225
Q

How many hypothenar muscles are there?

Name them

A

3

Opponens digiti minimi
Abductor digiti minimi
Flexor digiti minimi brevis

226
Q

Where does the opponens digiti minimi lie compared to the other hypothenar muscles?

A

Deep to the other hypothenar muscles

227
Q

Where does the opponens digiti minimi originate and attach?

A

Originates - hook of the hamate

Attaches - medial margin of metacarpal V

228
Q

What is the action of the opponens digiti minimi?

A

Rotates the metacarpal of the little finger towards the palm - producing opposition

229
Q

Which is the most superficial of all the hypothenar muscles?

A

Abductor digiti minimi

230
Q

Where does the abductor digiti minimi originate and attach?

A

Originates - pisiform and tendon of the flexor carpi ulnaris

Attaches - base of the proximal phalanx of the little finger

231
Q

What is the action of the abductor digiti minimi?

A

Abducts the little finger

232
Q

Where does the flexor digiti minimi brevis lie in relation to the abductor digiti minimi?

A

Lateral to the abductor digiti minimi

233
Q

Where does the flexor digiti minimi brevis originate and attach?

A

Originates - hook of the hamate

Attaches - base of the proximal phalanx of the little finger

234
Q

How many lumbricals are there in each hand?

A

4 - one associated with each finger

235
Q

The lumbricals are crucial to movement of the…

A

Fingers

236
Q

The lumbricals link the __________ tendons to the __________ tendons

A

Flexor

Extensor

237
Q

Where does each lumbrical originate and attach?

A

From a tendon of the flexor digitorum profundus

Attach into the extensor head of each finger

238
Q

How does each lumbrical pass around the fingers?

A

Pass dorsally and laterally around each finger

239
Q

What is the action of the lumbricals?

A

Flex at the metacarpophalangeal joint

Extend at the interphalangeal joints of each finger

240
Q

What nerves innervate the lumbricals?

A

Medial two lumbricals - ulnar nerve

Lateral two lumbricals - median nerve

241
Q

Which of the lumbricals are unipennate and which are bipennate?

A

Unipennate - lateral two lumbricals

Bipennate - medial two lumbricals

242
Q

Where are the interossei muscles located?

A

Between the metacarpals

243
Q

The interossei muscles can be divided into which two groups?

A

Dorsal interossei

Palmar interossei

244
Q

Which are the most superficial of all the dorsal muscles?

A

Dorsal interossei

245
Q

How many dorsal interossei are there?

A

4

246
Q

What are the origins and attachments of the dorsal interossei?

A

Each interossei originates from the lateral and medial surfaces of the metacarpals

Attach - into the extensor hood and proximal phalanx of each finger

247
Q

What is the function of the dorsal interossei?

A

Abducts the fingers at the MCP joint

248
Q

Which nerve innervates both the dorsal and palmar interossei?

A

Ulnar nerve

249
Q

On what aspect of the hand are the palmar interossei muscles located?

How many palmar interossei muscles are there?

A

Anteriorly

3

250
Q

Where do the palmar interossei originate and attach?

A

Originate - medial or lateral surface of a metacarpal

Attach - extensor hood and proximal phalanx of the same finger

251
Q

What is the function of the palmar interossei?

A

Adducts the fingers at the MCP joint

252
Q

What two other muscles in the hand are not lumbricals/interossei or part of the thenar or hypothenar muscle groups?

A

Palmaris brevis

Adductor pollicis

253
Q

Where is the palmaris brevis found?

A

Very superficially in the subcutaneous tissue of the hypothenar eminence

254
Q

Where does the palmaris brevis originate and attach?

A

Originates - palmar aponeurosis

Attaches - dermis of the skin on the medial margin of the hand

255
Q

What is the action of the palmaris brevis?

A

Wrinkles the skin of the hypothenar eminence and deepens the curvature of the hand (improving grip)

256
Q

Which nerve innervates the palmaris brevis?

A

Ulnar nerve

257
Q

Describe the structure of the adductor pollicis?

A

Large triangular muscle with two heads

258
Q

Which neurovascular structure passes anteriorly between the two heads of the adductor pollicis?

A

Radial artery

259
Q

Where does the adductor pollicis originate and attach?

A

Originates - metacarpal III and capitate

Attaches - base of the proximal phalanx of the thumb

260
Q

What is the action of the adductor pollicis?

A

Adductor of the thumb

261
Q

Which nerve innervates the adductor pollicis?

A

Ulnar nerve

MSK (10 decks)

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