EXAM2_G14_EXTENSOR_UE Flashcards

1
Q

What is the grove on the diaphysis of the humerus? what travels along that groove?

A

Radial or Spiral Groove

-radial nerve

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2
Q

What is feature proximal to the lateral epicondyle?

A

Supra epicondylar ridge

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3
Q

What is the bony feature on the lateral inferior surface of the trochlear notch?

A

Supinator Crest

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4
Q

What is the tubercle on the posterior side of the distal end of the radius called?

A

Lister’s tubercle

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5
Q

What part of the ulna dives into the fossa of the humerus?

What is inferior process called?

What feature called where radius articulates with ulna?

A

Olecranon process

Coronoid process

Radial notch of ulna

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6
Q

TRICEPS

OINA

A

Long- infraglenoid tubercle
Lateral- Posterior humerus above spiral groove
Medial- Posterior humerus below spiral groove

Inserts on OLECRANON

EXTENDS FOREARM

RADIAL C6,7,8

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7
Q

What neurovascular structures course through the spiral groove? between what two muscles?

A

Between Lateral and medial head of triceps brachii

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8
Q

What part of triceps participates in extension of the shoulder?

A

Long head

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9
Q

ANCONEUS

OINA

A

o- lateral epicondyle
I- olecranon, proximal ulna
WEAK extensor of elbow- stabilizes elbow

RADIAL (7,8,t1)

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10
Q

What reflex tested by tapping on back of elbow (distal humerus) proximal to elbow..
What spinal cord segments tested by this reflex?

A

Triceps reflex tests C7 spinal cord segment

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11
Q

characteristics of superficial group of extensor forearm muscles

A
  • attach at lateral epicondyle
    Cross elbow joint
    innervation is radial nerve or deep branch of radial nerve
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12
Q

Deep group muscle characteristics

A
  • dont cross elbow joint (except 1)

- Innervates deep branch of radial nerve and posterior interosseous nerve

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13
Q

BRACHIORADIALIS

What compartment does it belong to?

A

lateral supracondylar ridge to distal radius
Flexes elbow
Radial nerve
C5,6,7)

IT IS PART OF THE POSTERIOR COMPARTMENT

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14
Q

Brachioradialis is a landmark for what neurovasculature?

A

Radial artery and superficial radial nerve

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15
Q

Brachioradialis tendon reflex tests what spinal cord segment?

A

C6 Spinal cord segment

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16
Q

Extensor carpi radialus longus

A

lateral supracondylar ridge to base of 2nd metacarpal
Extends abducts wrist
Radial (C6,C7)

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17
Q

Extensor carpi radialis brevis

A

lateral epicondyle to base of 3rd metacarpal
Extends abducts wrist
deep branch radial (c7, 8)

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18
Q

Extensor digitorum

A

Lateral epicondyle to extensor expansions of digits 2-5
Extend wrist, extends digits 2,3,4,5
Deep branch radial (c7,c8)

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19
Q

Extensor digiti minimi

A

Lateral epicondyle to extensor expansion of digit 5
extends pinky
deep branch of radial C7,c8)

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20
Q

What limits the independent movement of fingers from a flexed position?

A

Intertendinous connections

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21
Q

What tendon sheath for extensors? which one has its own?

A

common synovial sheath

extensor digiti minimi travels with extensor digitorum but its tendon enters the hand in a separate tendon sheath

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22
Q

Extensor carpi ulnaris

A

Lateral epicondyle to base of 5th metacarpal
extension adduction of wrist
deep branch radial c7,c8

23
Q

What is tennis elbow called?

A

Lateral epicondylitis

Tinitis- or inflammation of common extensor tendon and periosteum of the lateral epicondyle

24
Q

What are the 6 muscles of the superficial group?

A

ECU,EDM,ED,ECR longus, ECR brevis, Brachioradialis

25
Q

What are the 6 muscles of the deep posterior forearm?

A

Supinator, Aconeus, AbPL, EPB, EPL,

26
Q

What is the supinator a landmark for?

A

This is where the deep branch of radial nerve becomes the Posterior Interosseous nerve

27
Q

Supinator OINA

A

Lateral epicondyle, supinator crest (proximal ulna)
to proximal radius

Supinates forearm

Deep branch radial c7,c8

Landmark for posterior interosseous nerve

28
Q

Abductor pollicis longus

A

proximal ulna, radius, and interosseous membrane to base of metacarpal 1

extends thumb (mainly CMC joint ) abduction of thumb

Posterior interosseous nerve c7,c8

29
Q

Extensor Pollicis Brevis

A

Distal 1/3 of radius, interosseous membrane to proximal phalanx base of thumb

Extends thumb at MCP

Posterior interosseous nerve C7,c8

30
Q

Extensor pollicis Longus

A

middle 1/3 of ulna and interosseous membrane to distal phalanx of thumb at IP joint

Extension of thumb at IP joint

Posterior interosseous (c7c8)

31
Q

In order to extend the thumb at the IP joint:

What muscle?
Tendon travels around what bony feature? why?

A

Extensor pollicis longus passes medial to LISTERS tubercle which changes direction of pull for the EPL from the forearm to the thumb

32
Q

Where is Listers tubercle? What muscle uses it as a tension point?

A

Posterior end of radius on dorsal side

used by Extensor Pollicis longus

33
Q

Extensor Indicis

A

Distal 1/3 of ulna and interosseous membrane to extensor expansion of Digit 2

Extends index finger
Posterior interosseous nerve c7,c8.

34
Q

Snuff box muscles
what inside? 3 things

What can you palpate inside the snuff box?

A

AbPL, EPB, EPL
Radial Artery
Scaphoid and trapezium
Superficial branch of radial n.

Can palpate SCAPHOID

35
Q

What is risk of break in scaphoid?

A

Poor blood supply to proximal fragment and can cause avascular necrosis resulting in chronic wrist pain and arthritis

36
Q

What are the muscles in the dorsum of the hand?

A

NONE

37
Q

Septa creates six osseofibrous tunnels (compartments)

1 starts at thumb side 6 ends at pinky side

A
Compartment 1: AbPL, EPB, 
Compartment 2: ECRL, ECRB
Compartment 3: EPL (goes around tubercle)
Compartment 4: ED, Ei
Compartment 5: EDM
Compartment 6: ECU
38
Q

Stenosing tenosynovitis of the synovial sheath of tendonds in the 1st compartment

A

de Quervian’s disease
F>m (6:1)
>40yo
repetitive use causes friction of tendons results in degeneration and thickening of tendon

Pain over lateral wrist radiating into forearm and thumb

39
Q

What is de Quervians disease?

What are symptoms?

What test used?

A

Stenosing Tenosynovitis of synovial sheath of tendons in 1st compartment (AbPL, EPB)

pain over lateral wrist, radiating into forearm and thumb

Finkelstein’s test pathognomonic (diagnostic)- reproduce symptoms

patient grasps thumb and abducts quickly -creates TERRIBLE pain

40
Q

What accounts for 50-70% of all hand masses?

A
Ganglion cyct (synovial cyst)
benign, mucin filled cyst, found in relation to a joint, ligament, or tendon. 

most common arise dorsally from scapholunate ligament

NOT A TRUE CYST not filled w/ synovial fluid or lined by ET.
F>M 20-30yo

41
Q

Lumbercals and interossei muscles

A

FLEX at MCP
EXTEND at PIP and DIP

bc of extensor expansion

42
Q

EXTENSOR EXPANSION Lateral band

A

Insertion of long extensor tendon to base of distal phalanx

43
Q

EXTENSOR EXPANSION Central band

A

Insertion of long extensor tendon to base of middle phalanx

44
Q

Extensor tendon injury

unable to extend distal phalanx

A

Mallet finger
flexion deformity of the DIP joint

Most common- closed tendon injury of athletes, in ring , little fingers

Reptures tendon or avulsion fracture at distal phalanx

Results in inability to actively extend distal phalanx (passive extension unaffected)

45
Q

Chronic untreated Mallet finger turns into what deformity?

A

Swan-neck deformity- hyperextension of PIP joints

Lateral bands displace proximal/dorsally resulting in decreased extension forces on the PIP joint

46
Q

Boutonniere deformity

A

: injury to central band by forced flexion of PIP joint
2nd most common closed tendon injury in athletes
-FDS flexes pip joint and lateral bands become displaced and act as flexors instead of extensors

DIP joint extended while PIP joint flexed

47
Q

LANDMARKS of RADIAL NERVE

A

radial “spiral groove” of humerus
- Radial nerve travels with profunda brachii via spiral groove

  • branches in arm:
  • triceps, anconeus, brachioradialis, ECRL

-cutaneous branches to posterior arm and forearm:
Posterior brachial cutaneous
inferior lateral cutaneous
posterior antebrachial cutaneous n

48
Q

Where does radial nerve enter into the arm?

A

Right under the teres minor and travels between lateral and medial heads of triceps through the radial groove

49
Q

What 3 cutaneous nerves of radial artery and where is sensation?

A
  1. proximal medial dorsal of ARM (post. brachial cut nerve)
  2. Proximal lateral dorsal of ARM (inferior lateral cut n)
  3. elbow and central portion of dorsal aspect of forearm and back of hand of thumb and index finger (posterior antebrachial cutaneous nerve)
50
Q

Where does radial nerve branch?

A

Cubital fossa- MOTOR
- deep branch passes through slit in the supinator called Arcade of Frohse

and superficial branch- SENSORY
lays deep to brachioradialis w/ radial artery

51
Q

IF radial nerve or branches entrapped what two conditions?

A

Radial tunnel syndrome

Posterior interosseous nerve palsy

52
Q

Cheiralgia paresthetica

A

compressed superficial branch of radial n at wrist producting pain and paresthesias in the distribution of the nerve
could be caused by handcuffs, tight bracelets, watches.

53
Q

CUTANEOUS on dorsum of hand for Radial, Median, Ulnar

A

Radial: skin on back of hand of 1,2,3 (not fingertips)
Median- back hand fingertips 1,2,3,
Ulnar- back hand skin of digits 4,5

54
Q

Radial artery branches in dorsum of hand

A
  1. Dorsal carpal arch
    Dorsal metacarpal artery of THUMB

Ulnar artery forms dorsal carpal branch and feeds digital branches