Flexor Forearm and Palm Flashcards Preview

MSI Module II > Flexor Forearm and Palm > Flashcards

Flashcards in Flexor Forearm and Palm Deck (19):

Four principal movements at radiocarpal joint

  • Flexion
  • Extensioin
  • Adduction/ulnar deviation
  • Abduction/radial deviation


Bones of the radiocarpal joint

Distal radius, and scaphoid and lunate bones


Nursemaid's elbow

Sublixation (partial dislocation) of radio-ulnar joint

  • Head of radius displaced from encirclement by anular ligament


Tennis elbow

Lateral epicondylitis

  • Inflammation of common extensor tendon of wrist
  • Caused by overuse or trauma


Golfer's elbow

Medial epicondylitis

  • Inflammation of common flexor tendon of the wrist (originates at medial epicondyle of humerus)
  • Cause is overuse or trauma


Muscles involved in avulsion of medial epicondyle of humerus

Flexors of forearm all have origin on medial epicondyle of humerus

  • Pronator teres
  • Flexor carpi radialis
  • Flexor carpi ulnaris
  • Flexor digitorum superficialis
  • Palmaris longus

The medial epicondyle has its own growth plate on the humerus which is why it can be involved in avulsion in youth


Structures in anterior wrist that are at risk with wrist cutting

Radial/lateral cuts

  • Injure median nerve, radial artery, flexor carpi radialis tendon, and palmaris longus tendon

Ulnar/medial cuts

  • Injure ulnar nerve, ulnar artery, and flexor carpi ulnaris tendon


Colle's versus Smith's fracture

Colle's, radius displaced posteriorly

Smoth's, radius displaced anteriorly

Both occur in FOOSH with children


Mallet/Baseball finger

Injury of extensor digitorum longus tendon at the distal interphalangeal (DIP) joint

  • Causes inability to extend the DIP joint (permanently stuck in a little bit of flexion)


Clinical assesment of median nerve

  • Oppose thumb
  • Make OK sign
  • Forearm pronation (and resist supination)
  • Wrist flexion



Clinical assesment of anterior interosseous nerve branch

Branch of median nerve in cubital fossa (motor, not sensory)

Clinical assesment

  • Cannot touch tips of fingers together (can only do pads)
  • Localized pain in forearm but no sensort loss


Carpal tunnel syndrome and treatment

Compression of median nerve due to inflammation of transverse carpal ligament/flexor tendons

  • Pain and tingling in lateral half of hand

Treatment involves surgery where you cut the transverse carpal ligament to "release" the pressure on the median nerve


10 structures going through the carpal tunnel

  • Median nerve
  • Flexor pollicus longus tendon
  • Flexor digitorum profundus tendons (4)
  • Flexor digitorum superficialis tendons (4)


Tendons through ulnar bursa (common flexor sheath)

Tendons of flexor digitorum superficialis and flexor digitorum profundus


Tendons through radial bursa

Tendons of flexor pollicis longus


Thenar muscles

  • Abductor pollicis brevis
  • Flexor pollicis brevis
  • Opponens pollicis

All innervated by recurrent median nerve


Hypothenar muscles

  • Abductor digit minimi
  • Flexor digiti minimi brevis
  • Opponens digiti minimi

All innervated by deep branch of ulnar nerve


Volkmann ischemic contracture

Deformity of wrist, fingers, and hand caused by injury to muscles of the forearm

  • Ischema due to obstruction of brachial artery, compartment syndrome, or supracondylar fracture of humerus
  • Prolonged ischemia leads to muscle and nerve damage leading to shortened, fibrotic muscle fibers
  • The shortened muscles pull on joint but the joint is stiff so you get contracture

Flexor digitorum profundus (and sometimes pollicis longus) are effected


Dupuytren's contracture

Painless thickening and fibrosis of palmar fascia

  • Etiology is unknown
  • Affects both hands symmetrically and causes progressive fixed flexion deformity of MCP joints, PIP joints, but rarely DIP joints