Arm, forearm and hand I week 3 Flashcards Preview

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Flashcards in Arm, forearm and hand I week 3 Deck (63):
1

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2

What is the group function of muscles in the anterior compartment of the arm? What nerve are they innervated by?

group function: flexion of the arm at the glenohumeral joint and/or flexion of the forearm at the elbow joint

innervation: musculocutaneous nerve (C5, C6)

3

What is the origin, insertion, function, and innervation of the biceps brachii?

origin:

long head: supraglenoid tubercle (on glenoid fossa of scapula) (passes through the bicipital/intertubercular groove which is covered by transverse humeral ligament)

short head: coracoid process of the scapula

insertion: radial tuberosity; fascia of the forearm

function: flexes the elbow and supinates forearm at proximal radio-ulnar joint. the long head can flex the arm at the glenohumeral joint

innervation: musculocutaneous nerve (C5, C6)

4

What is the origin, insertion, function, and innervation of the coracobrachialis?

origin: coracoid process of scapula

insertion: medial surface of the humerus

function: adducts and flexes the arm at the glenohumeral joint (is a weak flexor)

innervation: musculocutaneous nerve (C5, C6)

5

What is the origin, insertion, function, and innervation of the brachialis?

origin: anterior surface of the humerus

insertion: anterior surface of the ulna

function: flexes the elbow

innervation: musculocutaneous nerve (C5, C6)

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6

What is the origin, insertion, function, and innervation of the triceps brachii?

origin:

long head: infraglenoid tubercle of glenoid fossa

lateral and medial heads: posterior surface of the humerus

insertion: olecranon process of the ulna

function: all heads can extend the forearm at the elbow joint. only the long head can extend the arm at the glenohumeral joint

innervation: radial nerve

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7

Identify the branches of the axillary and brachial arteries. 

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8

Identify these veins. 

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9

Identify these nerves. 

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10

lateral epicondylitis

 

inflammation of the common tendinous origin of extensor muscles that originate at lateral epicondyle of humerus. is associated with overuse that not only affects tennis players but is associated with occupational overuse of extensor muscles in the forearm

11

carpal tunnel syndrome

caused by entrapment of median nerve as it passes under the flexor retinaculum (through the carpal tunnel) with the long flexor tendons of the hand

12

What is significant about scaphoid bone fractures?

one of the most frequently broken bones in a fall onto an outstretched hand-its location and shape make it susceptible to fracture. can go undiagnosed as sx can be mild. may need surgery. the scaphoid can easily disconnected from its blood supply and avascular necrosis can result

13

mallet finger

finger that does not straighten at the tip (DIP joint) due to trauma that results in overstretching or tearing of the extensor tendon

14

trigger finger

results when inflammation develops in the flexor tendons or their associated digital sheaths. the sheath or tendon may thicken or nodules may form resulting in decreased ability of the tendon to glide through the sheath during finger movement

15

What are the boundaries of the cubital fossa? What structures are contained in the cubital fossa?

The cubital fossa is the area of transition btwn the arm and forearm. It lies btwn the brachioradialis and the pronator teres muscle. The floor is formed mainly by the brachialis muscle and the roof is formed by superficial fascia and skin. 

Major contents from lateral to medial: TAN

tendon of biceps brachii

brachial artery

median nerve

note: the radial nerve also passes through the cubital fossa

the brachial artery and median nerve are covered by the bicipital aponeurosis. contained within the roof the cubital fossa is the median cubital vein which connects the cephalic vein (lateral) and the basilic vein (medial)

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16

What is the bicipital aponeurosis? What structures does it provide protection to?

the bicipital aponeurosis is a flattened extension of the biceps brachii tendon. is superficial to the brachial artery and median nerve and provides some protection to these structures during blood draws

17

Where do the cephalic and basilic veins terminate? What vein are they connected by?

cephalic (more lateral superficial vein): terminates in subclavian vein

basilic (more medial vein): terminates in axillary vein

are connected by the median cubital vein

18

Where does the radial nerve travel in the forearm and generally, what structures does it innervate? 

The radial nerve lies just deep to the brachioradialis and gives off superficial and deep branches. The superficial branch continues into the forearm on the deep surface of the brachioradialis and is entirely cutaneous. It innervates the dorsal surface of the hand and digits

the deep branch pierces the supinator msucle and supplies the muscles of the posterior forearm and contributes to innervation of the elbow

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19

Where does the ulnar nerve travel in the forearm?

It does not pass through the cubital fossa! It passes posterior to the medial epicondyle (funny bone). It is held down tightly by connective tissue which serves as a potential site of entrapment. 

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20

The gateway for structures passing between the arm and forearm is the ____ ____. The gateway for structures passing between the foreamr and hand is the ____ ____.

1. cubital fossa

2. carpal tunnel

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21

Muscles in the anterior (flexor) compartment of the forearm are generally divided into what 3 layers? What are their general functions?

1. superficial, intermediate, and deep

2. movements of wrist joint, flexions of fingers including the thumb, and pronation of the forearm

22

What are the muscles of the superficial layer of the forearm? What is their common origin?

1. from lateral to medial: pronator teres, flexor carpi radialis, palmaris longus, and flexor carpi ulnaris

2. all originate on the medial epicondyle of the humerus

23

The muscles of the anterior compartment of the forearm are innervated by the ____ nerve with the exception of what muscles? What are those muscles innervated by?

1. median nerve

2. the flexor carpi ulnaris and the medial half of the flexor digitorum profundus are innervated by the ulnar nerve

24

What is the origin, insertion, function, and innervation of the pronator teres?

origin: medial epicondyle of humerus, ulna

insertion: lateral surface of radius

function: pronates forearm at distal radioulnar joint

innervation: median nerve

25

What is the origin, insertion, function, and innervation of the flexor carpi radialis?

origin: medial epicondyle of humerus

insertion: base of 2nd or 3rd metacarpal

function: flexes and abducts the wrist

innervation: median nerve

26

What is the origin, insertion, function, and innervation of the palmaris longus?

origin: medial epicondyle of humerus

insertion: palmar aponeurosis

function: flexes wrist

innervation: median nerve

27

What is the origin, insertion, function, and innervation of the flexor carpi ulnaris?

origin: medial epicondyle of humerus, olecranon process of ulna

insertion: 5th metacarpal, pisiform, and hamate

function: flexes and adducts the wrist

innervation: ulnar nerve

28

Identify these muscles of the anterior forearm. What group of muscles of the anterior forearm are they in?

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superficial layer

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29

What is contained in the intermediate layer of the anterior forearm? What structures pass in this pass. 

1. flexor digitorum superficialis

2. the median nerve and the ulnar artery pass deep to the flexor digitorum superficialis btwn the two heads 

30

What is the origin, insertion, function, and innervation of the flexor digitorum superficialis?

note: the flexor digitorum superficialis has a radial and humero-ulnar head

origin: medial epicondyle of humerus, proximal ulna and radius

insertion: shafts of the middle phalynx of digits 2-5

function: flexes MCP and PIP joints of digits 2-4, flexes the wrist

note: it does not go up to DIP

innervation: median nerve

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31

What muscles comprise the deep layer of the anterior compartment of the forearm?

flexor pollicis longus

flexor digitorum profundus

pronator quadratus

32

What is the origin, insertion, function, and innervation of the flexor pollicis longus?

origin: radius, interosseous mebrane

insertion: base of the distal phlaynx of the thumb

function: flexes thumb at carpometacarpal, MCP, and IP joints (PIP)

innervation: median nerve

33

What is the origin, insertion, function, and innervation of the flexor digitorum profundus?

origin: medial and anterior surfaces of the ulna, interosseus membrane

insertion: bases of the distal phalynx of digits 2-5

function: flexes MCP, PIP, and DIP joints, flexes wrist

note: causes flexion of fingers at all joints

innervation: lateral half (index and middle fingers): median nerve

medial half (ring and pinky fingers): ulnar nerve

34

What is the origin, insertion, function, and innervation of the pronator quadratus?

origin: ulna

insertion: radius

function: pronates forearm at distal radio-ulnar joint

innervation: median nerve

35

Identify these muscles. What layer of the anterior portion of the forearm are they a part of?

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deep layer

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36

In the anterior forearm, what branches does the brachial artery give off? What do those arteries supply and what branches do they give off?

1. radial artery (laterally) and ulnar artery (medially)

2. the radial artery passes distally with the superficial branch of the radial nerve and contributes blood supply to the hand. the ulnar artery also contributes to blood supply of the hand but first gives off a common interosseus artery that divides into anterior and posterior interosseus arteries. the ulnar artery travels with the median nerve passes deep btwn the two heads of the flexor digitorum superficialis

37

Identify the structures in this picture of the anterior forearm.

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38

Both the ___ nerve and the ____ nerve course through the cubital fossa. The ____ nerve courses posterior to the medial epicondyle and thus does not course through the cubital fossa.

1. median nerve and radial nerve

2. ulnar nerve

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39

What are the boundaries of the carpal tunnel?

it is bound anteriorly by the flexor retinaculum and posteriorly by the carpal bones (specifically the hamate and pisiform postero-medially and the trapezium and scaphoid postero-laterally).

40

What structures do and do not pass through the carpal tunnel?

Structures that pass through the carpal tunnel: Median nerve (including its recurrent branch), tendons of the flexor digitorum superficialis and produndus, tendon of the flexor pollicis longus. 

Structures that do not pass through: ulnar nerve and artery and palmar cutaneous branch of the median nerve

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41

What does it mean for muscles of the hand to be intrinsic?

They have origins and insertions on the hand itself.

42

What muscles are considered to be in the thenar compartment of the hand? What are they innervated by?

flexor pollicis brevis

abductor policis brevis

opponens pollicis

innervated by the recurrent branch of the median nerve

43

What muscles are considered to be in the hypothenar compartment of the hand? What are they innervated by?

flexor digiti minimi

abductor digiti minimi

opponens digit minimi

innervated by the deep branch of the ulnar nerve

44

What is the origin, insertion, function, and innervation of the abductor pollicis brevis?

origin: flexor retinaculum, scaphoid, trapezium

insertion: proximal phalynx of the thumb

function: abducts thumb at MCP joint

innervation: recurrent branch of the median nerve

45

What is the origin, insertion, function, and innervation of the flexor pollicis brevis?

origin: flexor retinaculum, capitate, trapezium

insertion: proximal phalynx of thumb

function: flexes thumb at MCP joint

innervation: recurrent branch of the median nerve

46

What is the origin, insertion, function, and innervation of the opponens pollicis?

origin: trapezium

insertion: lateral side of 1st metacarpal

function: opposes thumb

innervation: recurrent branch of the median nerve

47

What intrinsic hand muscle controls thumb movement but is not considered a thenar muscle and why is it not in this group? What is its origin, insertion, innervation, and function?

adductor pollicis. it is in the intermediate compartment of the hand is not in the thenar group bc it is innervated by the deep branch of the ulnar nerve

origin: capitate, base of metacarpals 2 and 3, shaft of 3rd metacarpal

insertion: base of proximal phalynx of thumb

function: adducts the thumb

48

What is the origin, insertion, function, and innervation of the abductor digiti minimi?

origin: pisiform

insertion: proximal phalynx of 5th digit

function: abducts little finger at MCP joint

innervation: deep branch of the ulnar nerve

49

What is the origin, insertion, function, and innervation of the flexor digiti minimi brevis?

origin: hamate and flexor retinaculum

insertion: proximal phalynx of 5th digit

function: flexes little finger at MCP joint

innervation: deep branch of the ulnar nerve

50

What is the origin, insertion, function, and innervation of the opponens digiti minimi?

origin: hamate and flexor retinaculum

insertion: medial border of 5th metacarpal

function: opposes little finger

innervation: deep branch of ulnar nerve

 

51

Identify these muscles of the hand. Are they anterior or posterior?

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anterior

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52

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53

What are the origins, insertions, functions, and innervation of the lumbricals?

There are 4 lumbricals. note the 3rd and 4th lumbricals often have two heads. 

origin: all have origins on the tendons of the flexor digitorum profundus

insertion: all insert on the extensor hood

function: flex MCP while simultaneously extending PIP and DIP joints

the 1st and 2nd lumbricals are innervated by the digital branch of the median nerve

the 3rd and 4th lumbricals are inervated by the deep branch of the ulnar nerve

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54

What is the origin, insertion, function, and innervation of the dorsal interosseus muscles? How many of them are there?

There are four dorsal interosseus muscles which can also be called DABS (dorsal abductors). note that each one has 2 heads

origin: adjacent side of two metacarpal bones

insertion: extensor hood, base of proximal phalanges 2-4

function: abduct digits, flex MCP joints, extend PIP and DIP joints

innervation: deep branch of ulnar nerve

note: the middle finger can only abduct

55

What is the origin, insertion, function, and innervation of the palmar interosseus muscles? How many of them are there?

There are 3 palmar interosseus muscles which can also be called PADS (because the adduct fingers). they have 1 head as opposed to 2 heads like DABS

origin: palmar surfaces of metacarpals 2, 4, and 5

insertion: extensor hood, base of proximal phalanges 2, 4, and 5 (note the middle finger cannot adduct bc it is in midline of hand)

function: adduct digits, flex MCP joints, extend PIP and DIP joints

innervation: deep branch of ulnar nerve

56

Identify these muscles. What is their function? What are they innervated by?

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DABS

abduct digits, flex MCP, extend DIP and PIP joints

innervated by deep branch of ulnar nerve

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57

What are these muscles? What is their function and what are they innervated by?

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PADS

adduct digits, flex MCP joint and extend PIP and DIP joints

innervated by deep branch of ulnar nerve

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58

What arteries contribute to the superficial palmar arch? Where is the superficial palmar arch? What are the branches of the supericial palmar arch? What do those branches supply?

The ulnar artery courses laterally across the palm forming the superficial palmar arch. This arch is just deep to the palmar aponeurosis but superficial ot the long flexor tendons of the digits. One branch of the radial artery also contributes to the superficial palmar artery

The superficial palmar aretery gives off a palmar digital branch to the medial side of the little finger and common digital arteries

the common digital arteries are joined by branches deep palmar arch before biforcating into proper digital arteries

59

Identify the arteries of the superficial palm.

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60

What arteries contribute to the deep palmar arch? Where is the deep palmar arch? What are the branches of the deep palmar arch? What do those branches supply?

The radial artery curves around the lateral side of the wrist through the anatomical snuff box into the deep plane of the palm. It passes btwn the 2 heads of the 1st dorsal interosseous mucle (DAB) and then btwn the 2 heads of the adductor pollicis to form the deep palmar arch. The deep palmar arch passes medially in the hand btwn metacarpals and long flexor tendons of digits where it is joint by the deep branch of the ulnar artery. A vessel to the thumb and index finger arise from the radial artery and serve as the primary blood supply to the thumb and lateral index finger.

The deep palmar arch gives rise to a) palmar metacarpal arteries which anastamose with common digitial arteries (that branched from the superficial palmar arch) to form proper digital arteries and b) perforating brances which pass to the dorsum of the hand

61

Identify the arteries of the deep palm. 

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62

What are the 3 branches of the ulnar nerve? What do they innervate?

1. deep branch, superficial branch, and palmar branch

2. the superpicial and palmar branches are cutaneous. the deep branch innervates the hypothenar muscles, the 3rd and 4th lumbricals, PADS, DABS, and adductor pollicis

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63

What are the branches of the median nerve?

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