Lecture 7: Upper limb & anterior forearm Flashcards

1
Q

The arm is divided into anterior and posterior compartments by extensions of deep fascia called what?

A

Medial and lateral intermuscular septae

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2
Q

What is the anterior compartment of the arm occupied by?

A

Flexor compartment:
-Biceps brachii
-Coracobrachialis
-Brachialis

Innervated by the: Musculocutaneous nerve

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3
Q

What is the posterior arm compartment occupied by?

A

Extensor compartment:
-Triceps brachii

Innervated by the: Radial nerve

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3
Q

Origin & Insertion of the Biceps brachii:

A

Origin:
Short head-Coracoid process of scapula
Long head-Supraglenoid Tubercle of scapula

Insertion: Radial tuberosity and fascia of forearm via bicipital aponeurosis

Innervation: Musculocutaneous nerve

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4
Q

Origin & insertion of the Coracobrachialis:

A

Origin: Coracoid process of scapula

Insertion: Middle third of the medial surface of humerus

Innervation: Musculocutaneous nerve

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5
Q

Origin & Insertion of the Brachialis:

A

Origin: Distal half of the anterior surface of the humerus

Insertion: Ulnar tuberosity & coronoid process of ulna

Innervation: Musculocutaneous nerve

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6
Q

Origin & insertion of Triceps brachii:

A

Origin:
Long head- infraglenoid tubercle
Lateral head-Lateral, posterior humerus (superior to radial groove)
Medial head-Posterior surface of humerus (inferior to radial groove)

Insertion: Olecranon process of ulna

Innervation: Radial nerve

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7
Q

Where do the tendons of the forearm muscles pass through?

A

Distal part of the forearm and into the hand

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8
Q

What structures divide the forearm into anterior and posterior compartments?

A

Radius, Ulna, interosseous membrane, and intermuscular septum

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9
Q

Muscles of the anterior (flexor-pronator) forearm compartment are innervated by which nerve?

A

Median nerve

EXCEPT: FCU and medial half of FDP-these are innervated by the ulnar nerve

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10
Q

All muscles of the posterior (extensor-supinator) forearm compartment are innervated by which nerve?

A

Radial nerve

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11
Q

Most of the flexor-pronator muscles arise from the _______________ of the ____________ via _________________.

A

-medial epicondyle
-humerus
-common flexor tendon

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12
Q

The tendons of the flexor muscles of the forearm pass across _________ and are held in place by the ____________.

A

-the anterior surface of the wrist
-flexor retinaculum

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13
Q

The muscles of the anterior (flexor-pronator) compartment of the forearm are divided into three layers, what are these layers and which muscles are in each?

A

1) Superficial layer: Pronator teres(PT), flexor carpi radialis(FCR), palmaris longus (PL), flexor carpi ulnaris (FCU)

2) Intermediate layer: Flexor digitorum superficialis (FDS)

3) Deep layer: Flexor digitorum profundus(FDP), flexor pollicis longus (FPL), and pronator quadratus (PQ)

All muscles are innervated by the median nerve EXCEPT the FCU and medial half of the FDP-Ulnar nerve

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14
Q

The superficial layer of the extensor supinator muscles of the forearm are:

A

1) Brachioradialis (BR)
2) Extensor carpi radialis longus (ECRL)
3) Extensor carpi radiais brevis (ECRB)
4) Extensor digitorum (ED)
5) Extensor digiti minimi (Edm)
6) Extensor Carpi ulnaris (ECU)
7) Anconeus

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15
Q

The deep layers of the extensor supinator muscles of the forearm are:

A

1) Supinator
2) Abductor pollicis longus (APL)
3) Extensor pollicis brevis (EPB)
4) Extensor pollicis longus (EPL)
5) Extensor indicis (EI)

16
Q

The most superficial extensor muscles of the forearm originate from the ____________________ via ___________________.

A

-lateral epicondyle of the humerus
-common extensor tendon

17
Q

The deep extensor muscles of the forearm arise MAINLY from ________, ________, and ______________.

A

-posterior ulna
-radius
-interosseous membrane

18
Q

All extensor muscles of the forearm are innervated by what nerve?

A

Radial nerve

19
Q

The Origin & insertion & function of brachioradialis:

A

-Distal humerus to distal radius
-Anterolateral forearm muscle

Function: Flexion of the elbow in “mid pronation”
(beer drinking muscle)

Innervated by: Radial nerve

20
Q

Name the main muscle being used, action, and nerve associated with this muscle.

A

Biceps
Flexion w/ supination
Musculocutaneous nerve

21
Q

Name the main muscle being used, action, and nerve associated with this muscle.

A

Brachialis
Flexion w/pronation
Musculocutaneous nerve

22
Q

Name the main muscle being used, action, and nerve associated with this muscle.

A

Brachioradialis
Flexion in mid-pronation
Radial nerve

23
Q

The forearm (antebrachial) fascia: The fascia thickens posteriorly over _______________ to form a transverse band called ____________________.

A

-the distal ends of the radius and ulna
-The extensor retinaculum

24
Q

What does the extensor retinaculum do?

A

Retains the extensor position and holds the tendons of the muscles in place

25
Q

What thick fascia converts the anterior concavity of the carpus into the carpel tunnel?

A

The flexor retinaculum

26
Q

What passes through the carpel tunnel?

A

Flexor tendons, and median nerve

(Flexor pollicis longus, flexor digitorum profundus, flexor digitorum superficialis)

27
Q

What prevents bowstringing of the tendons when the hand flexed or hyperextended at the wrist joint?

A

Retinacula

28
Q

As the extensor tendons pass over the dorsum of the wrist they are invested by ___________ which reduces friction between the extensor tendons and the bones.

A

Synovial sheaths

29
Q

Origin & Insertion of Pronator teres

A

O: Humeral head-Medial epicondyle of humerus (via common flexor tendon)

Ulnar head-Coronoid process of ulna

I: Middle of the lateral surface of radius

Innervation: Median nerve

(Note: Impingement of median nerve between two heads of PT; pronator syndrome)

30
Q

Origin & Insertion of flexor carpi Radialis (FCR):

A

O: Medial epicondyle of the humerus (via common flexor tendon)

I: Base of the 2nd & 3rd metacarpals

Innervation: Median nerve

(Radial A. Pulse)

31
Q

Origin & Insertion of Palmaris Longus (PL):

A

O: Medial epicondyle of humerus (via common flexor tendon)

I: Palmar aponeurosis, flexor retinaculum

Innervation: Median Nerve

(Absent in 12-20% of the population)

32
Q

Origin & Insertion of Flexor Carpi Ulnaris (FCU):

A

O: Humeral head- Medial epicondyle of humerus (via common flexor tendon)

Ulnar head- Olecranon process of ulna, Posterior border of ulna

I: Base of the 5th metacarpal, Hook of hamate, Pisiform

Innervation: Ulnar nerve

(Course of ulnar nerve is between FCU’s two heads)

33
Q

How to find the first four flexors of the forearm:

A

From Pinky to Index finger:
1) FCU
2) PL
3) FCR
4) PT

34
Q

Origin & Insertion of Flexor Digitorum Superficialis (FDS):

A

O: Humero-ulnar head- Medial epicondyle of humerus (via common flexor tendon), & coronoid process of ulna

Radial head: Proximal of anterior border of radius

I: Base of middle phalanges of fingers #2-5

Innervation: Median Nerve

INTERMEDIATE LAYER

(Irritation of the tendon sheath in CT & pressing the median nerve-Carpel tunnel)

35
Q

Name the structures:

A

1) Flexor digitorum superficialis tendons
2) Carpal Tunnel
3) Flexor digitorum profundus tendons
4) Flexor retinaculum
5) Median Nerve
6) Flexor pollicis longus tendon

36
Q

Origin & Insertion of Flexor Digitorum Profundus (FDP):

A

O: Proximal anterior & medial surface of ulna, Interosseous membrane

I: Base of distal phalanges of fingers #2-5

Nerve: Median & Ulnar nerve

(Role of medial and lateral halves of muscle in flexing the fingers)

(Tendons pass through the carpal tunnel)

37
Q

Origin & Insertion of Flexor Pollicis Longus (FPL):

A

O: Anterior surface of the: radius, & interosseous membrane

I: Base of distal phalanx of thumb

Innervation: Median nerve

(One of the carpal tunnel muscles)

38
Q

Origin & Insertion of Pronator Quadratus (PQ):

A

O: Anterior surface of distal 1/4 of ulna

I: Anterior surface if distal 1/4 of radius

Innervation: Median Nerve