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Anatomy Exam 3 > Anterior Forearm and Palmer Hand > Flashcards

Anterior Forearm and Palmer Hand Flashcards

(75 cards)

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1
Q

Which group of muscles crosses the elbow?

A

superficial group, deep group does NOT

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2
Q

What is the innervation rule for the anterior forearm?

A

“mostly median” C6-T1

exception: 1.5 muscles are innervated by ulnar nerve (flexor carpi ulnaris and ulnar half of flexor digitorum profundus)

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3
Q

What are the actions of the anterior compartment of the forearm?

A

Flex wrist joint

Flex fingers

Pronation

Abduction/Adduction of wrist joint

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4
Q

Where do the SF muscles of the anterior forearm originate?

A

Medial epicondyle of the humerus

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5
Q

What is medial epicondylitis?

A

AKA “golfer’s elbow”

inflammation of the common flexor origin and periosteum of the medial epicondyle

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6
Q

What muscles make up the SF group of the anterior compartment of the forearm?

A

pronator teres

flexor carpi radialis

flexor carpi ulnaris

palmaris longus

flexor digitorum superficialis

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7
Q

Insertion of pronator teres?

A

lateral radius

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8
Q

Action of pronator teres?

A

protonate forearm

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9
Q

Insertion of flexor carpi radialis?

A

radial side of hand

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10
Q

Action of flexor carpi radialis?

A

flex wrist joint, abduct wrist joint

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11
Q

Insertion of flexor carpi ulnaris?

A

ulnar side of hand

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12
Q

Action of flexor carpi ulnaris?

A

flex wrist joint, adduct wrist

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13
Q

What innervates flexor carpi ulnaris?

A

ulnar nerve

exception to innervation rule

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14
Q

Which muscle of the anterior forearm is missing in 15% of ppl? Where does this muscle insert?

A

palmaris longus

palmar aponeurosis

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15
Q

Action of palmaris longus?

A

flex wrist joint

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16
Q

Insertion of flexor digitorium superficialis?

A

middle phalanges of digits 2-5

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17
Q

Actions of flexor digitorum superficialis?

A

flex digits 2-5 at MCP & PIP joints

flex wrist joint

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18
Q

What are the origins of the deep group of the anterior compartment of the forearm?

A

ulna, radius, interosseous membrane

do not cross elbow

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19
Q

What are the muscles of the deep group of the anterior forearm?

A

flexor digitorum profundus

flexor pollicis longus

pronator quadratus

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20
Q

Insertion of flexor digitorum profundus?

A

distal phalanges of digits 2-5

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21
Q

Actions of flexor digitorum profundus

A

flex digits 2-5 at MCP, PIP & DIP joints

flex wrist joint

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22
Q

How can you test flexor digitorum profundus (FDP)?

A

have pt flex DIP joint

digits 2&3: median nerve, digits 4&5 ulnar nerve

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23
Q

How can you test flexor digitorum superficialis (FDS)?

A

have pt flex PIP joint

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24
Q

What innervates flexor digitorum profundus?

A

radial 1/2 (digits 2 &3): median nerve

ulna 1/2 (digits 4&5): ulnar nerve

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25
Action of flexor pollicis longus?
Flex pollex, flex wrist joint
26
Insertion of pronator quadratus?
distal radius
27
Action of pronator quadratus?
pronate forearm
28
What is the flexor retinaculum?
band of deep fascia holding long flexor tendons in place as they cross the wrist joint tendons are surrounded by synovial sheaths to permit movement
29
What forms the roof of the carpal tunnel?
flexor retinaculum
30
What are the contents of the carpal tunnel?
9 tendons & median nerve: tendons of FDSF (4) tendons of FDP (4) tendon of flexor pollicis longus (1)
31
What are the compartments of the palm?
thenar compartment adductor compartment hypothenar compartment central compartment interosseous compartments
32
Central compartment of palm
deep to palmar aponeurosis contains long flexor tendons (FDSF, FDP) and lumbricals
33
Where can infections of the central compartment of the hand spread to? how?
infections can travel deep to flexor retinaculum through carpal tunnel and into the anterior forearm
34
Interosseous compartments of palm
between metacarpals, contain interossei
35
Thenar compartment of palm
contains 3 thenar muscles, act on thumb
36
Adductor compartment of palm
contains adductor pollicis muscle
37
hypothenar compartment of palm
contains 3 hypothenar muscles, acting on digit 5
38
What innervates the intrinsic muscles of the hand?
most are innervated by ulnar nerve (C8-T1) but some are innervated by the median nerve (C8-T1)
39
What are the thenar muscles>
Abductor pollicis brevis Flexor pollicis brevis opponens pollicis
40
What innervates the thenar muscles?
recurrent branch of the median nerve
41
What movements can occur at the CMC joint of the pollex?
Flexion/Extension Abduction/Adduction Opposition/Reposition
42
Actions of abductor pollicis brevis?
abduct thumb at CMC joint
43
Action of flexor pollicis brevis?
flex thumb at CMC and MCP joints
44
Action of opponens pollicis?
opposition of thumb (CMC joint)
45
What makes up the adductor compartment of the palm?
1 muscle: adductor pollicis (oblique and transverse heads)
46
What innervates adductor pollicis?
ulnar nerve
47
Action of adductor pollicis?
Adduct thumb
48
What makes up the hypothenar compartment of the palm?
3 "digiti minimi" muscles: - Abductor digiti minimi - Flexor digiti minimi brevis - Opponens digiti minimi
49
What innervates the hypothenar muscles?
the ulnar nerve
50
Action of abductor digiti minimi?
abduct digit 5 at MCP joint
51
Action of flexor digiti minimi brevis?
flex digit 5 at CMC and MCP joints
52
Action of opponens digit minimi?
opposition of digit 5 (CMC) joint
53
What are the muscles of the central compartment of the palm?
lumbricals (n=4) originate on the tendons of FDP and insert on the extensor expansions of digits 2-5
54
Action of lumbricals?
Flex MCP joint and extend PIP &DIP joints of digits 2-5
55
What innervates the lumbricals?
medial nerve (radial 1/2) ulnar nerve (ulnar 1/2)
56
What innervates the interossei?
ulnar nerve
57
Action of interossei?
PAD: palmar interossei (3) adduct digits 2, 4 and 5 DAB: dorsal interossei (4) abduct digits 2-4
58
What does the median nerve innervate?
courses through cubital fossa and innervates most of the muscles of the anterior forearm recurrent branch-thenar muscles common and proper digital nerves- motor to lumbricals to digits 2&3, sensory to skin on lateral palm and lateral 3.5 digits Does NOT innervate structures in the arm
59
Compression of what nerve leads to carpal tunnel syndrome?
median nerve
60
What will occur if there is a proximal lesion of the median nerve?
pronation lost flexion and abduction of wrist dramatically weakened flexion of MCPs, PIPs and DIPs of digits 2-3 lost, flexion of MCPs and PIPs flexion and opposition of thumb lost abduction of thumb weakened lumbricals of digits 2 & 3 paralyzed skin on lateral palm and lateral 3.5 digits anesthetized
61
What causes carpal tunnel syndrome?
any significant reduction in the size of the carpal tunnel, such as inflammation of the synovial sheaths of the flexor tendons
62
clinical presentation of carpal tunnel syndrome
progressive weakening of thenar muscles which weaken grip loss of sensation on lateral 3.5 digits also affects grip
63
treatment of carpal tunnel syndrome
usually conservative treatment but can require surgery-partial to full opening of the flexor retinaculum
64
What does the ulnar nerve innervate
Flexor carpi ulnaris and ulnar .5 of FDP (digits 4&5) does not innervate structures in the arm
65
Where does the ulnar nerve travel?
posterior to the medial epicondyle in the cubital tunnel (can be compressed here-cubital tunnel syndrome) travels superficial to the flexor retinaculum with the ulnar artery
66
What do the branches of the ulnar nerve innervate?
deep branch: motor to hypothenar muscles, all interossei, lumbricals to digits 4&5 and adductor pollicis common and proper digits nn: sensory to skin on ulnar palm, and ulnar 1.5 digits and ulnar aspect of dorsal hand
67
What will a proximal lesion of the ulnar nerve result in?
flexion &adduction of wrist weakened flexion of DIPs of digits 4-5 lost flexion of MCP & PIPs of digits 4-5 weakened affects grip (hypothenar/adductor pollicis) interossei paralyzed- no abduction/adduction lumbricals to digits 4&5 skin of medial pal and 1.5 digits
68
How can you test for a proximal lesion of the ulnar nerve?
abduct/adduct digits 2-5, cutaneous sensation of tip of digit 5
69
How can you test for a proximal lesion of the median nerve?
pad-pad opposition of thumb, cutaneous sensation tip of digit 2
70
What does the brachial artery give rise to in the cubital fossa?
ulnar and radial arteries
71
What are the main branches off the ulnar artery?
ulnar recurrent aa. common interosseous a. superficial palmer arch
72
What does the SF palmar arch give off?
common and proper digits aa. which anastomose with the deep palmer arch from the radial a.
73
What does the common interosseous artery give off?
the anterior and posterior interosseous artery
74
What are the branches off the radial artery?
radial recurrent a deep palmer arch- anastomoses with SF palmer arch
75
Where can you palpate the radial pulse?
lateral to the tendon of flexor carpi radialis

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