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Forearm and elbow Flashcards

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1
Q

What are the bones in this region of elbow, forearm and wrist

What makes up the elbow joint

A

The Humerus
The Radius
The Ulna
The carpal bones

Elbow joint is the humerus articulating with the forearm bones…..

NOT between the forearm bones (which are the radio-ulnar joints involved in pronation and supination….. these actions do not come from the elbow)

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2
Q

What is the name of the two rounded regions on each side of the humerus

A

Medial and lateral epicondyle

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3
Q

What is the T/f the capitulum lies lateral to the trochlea

A

T

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4
Q

Which is more lateral, the coranoid fossa or the radial fossa.

A

These are present anteriorly on the humerus

Coranoid medial to the lateral epicondyle

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5
Q

Where does the head of the radius articulate with the humerus

A

Laterally, onto the capitulum/lateral epicondyle

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6
Q

Where does the ulna articulate with the humerus

A

At the trochlea, the coranoid process of the ulna articulates,

Posteriorly, the oleranon of the ulna articulates with the olecranon fossa of the humerus

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7
Q

What is related to the medial epicondyle anteriorly and posteriorly

A

Ant: flexors

Post: flexors and the ulnar nerve

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8
Q

What is related to the lateral epicondyle anteriorly and posterirly

A

Ant: extensors
Post: extensors, anconeus muscle

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9
Q

Which way does the radial tuberosity point

A

Medially

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10
Q

What lies between the radius and the ulna

A

Interosseus membane

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11
Q

Where is the syloid process of the ulna

A

inferior and medially

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12
Q

Where is teh styloid process of the radius

A

Inferior and laterally

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13
Q

Where does the ulna artiuclate with the radius inferiorly

A

articular circumference of head of ulna inserts into the ulnar notch of the radius

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14
Q

What is the interosseus membrane, why is it important

A

The interosseous membrane separates the anterior and posterior compartments, and is a site of attachment for muscles in the forearm

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15
Q

On the distal ends of the ulna and radius there are facets (at the radio-ulnar joint)…. state the bones that go therefrom medial to lateral

A

On yourself

Medial for articular disk, then for lunate then for scaphoid

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16
Q

Name the proximal and distal row of the carpal bones

A

Proximal row: scaphoid, lunate, triquetrum, pisiform

Distal row: trapezium, trapezoid, capitate, hamate

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17
Q

Which bone in the wrist does not articulate with the radius or ulna

A

Pisiform (sesamoid bone)

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18
Q

Which arm muscles act across elbow joint and what is their innervation

A

Biceps and brachialis

musculocutaeneous nerve

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19
Q

Where do the arm muscles attach on the forearm

A

Biceps –> radial tuberosity and then there is a biceps aponeurosis (merges with connective tissue)

Brachialis –> coranoid process of ulna

Biceps also a supinator due to its attachment to the radial tuberosity

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20
Q

Which posterior arm mucles act over the elbow + their innervation

A

Triceps and anconeus

radial nerve (c7, 8

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21
Q

Where do the arm muscles attach to the foreaem

A

Triceps attach onto the elecranon process of ulna

Anconeus to olecranon process of ulna and lateral epicondyle of the humerus

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22
Q

What to the forearm muscles do

A

Conrol hand and wrist muscles

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23
Q

Where do the forearm muscles originate generally

A

from the distal humerus as well as the radius and ulna

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24
Q

Outline the distribution of the forearm muscles

A

Flexors (and pronators) anteriorly

Extensors (and supinators) posteriorly

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25
What are the muscles in the superficial compartment of the forearm
``` Pronator teres (PT) Flexor carpi radialis (FCR) Palmaris longus (PL) Flexor digitorum superficialis (FDS) Flexor carpi ulnaris (FCU) ```
26
What muscles are in the deep forearm
Flexor digitorum profundus (FDP) Flexor pollicis longus (FPL) Pronator quadratus (PQ)
27
Muscles in the anterior forearm generally perform which functions
Flexion and pronation
28
Flexor Carpi Ulnaris function and innervation
Flexion and adduction at the wrist. | Innervation: Ulnar nerve.
29
Where do all of the superficial flexors originate
medial epicondyle (at the common flexor tendon)
30
Pronator teres innervation and function
Pronation of the forearm Median nerve.
31
Flexor carpi radialis function and innervation
Flexion and abduction at the wrist Median nerve
32
Palmaris longus function and innervation
Flexion at the wrist Absent in 15% Median nerve
33
Where can median nerve be found
Just behind palmaris longus
34
Summary of the innervation of forearm muscles
All median nerve apart from flexor carpi ulnaris (ulnar)
35
Summary of function of forearm muscles
FCR does adduction FCU does abduction
36
What is the flexor retinaculum and what combines with it
The transverse carpal ligament..... palmaris longus tendon combines
37
Why is the flexor retinaculum important
forms the roof of the carpal tunnel
38
What is the most superficial to deepest of the deep muscles of the anterior compartment of the forearm
Flexor digitorum profundus Flexor pollicis longus Pronator quadratus
39
What assists in teh abduction of the wrist by the flexor carpi radialis
radial extensors
40
Function of Flexor digitorum superficialis and innervation (also superfiial forearm)
Flexor of proximal interphalangeal joints Median nerve (C7,8 T1)
41
Function and innervation of Flexor digitorum profundus (FDP)
Flexor of the distal interphalangeal joints Medial part: ulnar nerve 9C8, T1) Lateral part by the anterior interosseus branch of the median nerve (C8 and T1)
42
Function adn innervation of Flexor pollicis longus (FPL)
Function flexion of distal phalanx of the thumb and the proximal phalanx anterior interosseus branch of the median nerve (C7,8 and T1)
43
Function and innervation of pronator quadratus
Pronates the hand. Assisted by pronator teres when extra power needed Median nerve C8 T1
44
State the extensor muscles that move the wrist joint
Extensor carpi radialis longus (ECRL) Extensor carpi radialis brevis (ECRB) Extensor carpi ulnaris (ECU)
45
State the extensor muscles moving the digits
``` Extensor digitorum (ED) Extensor indicis (EI) Extensor digit minimi (EDM) ```
46
State the extensor muscles moving the thumb
Abductor pollicis longus (APL) Extensor pollicis brevis (EPB) Extensor pollicis longus (EPL)
47
State other extensor muscles in the extensor compartment of the forearm
Brachioradialis | Supinator
48
Carpi muscles do what
Movers of the wrist (the “carpi” muscles) act on the radial (radialis) or ulnar (ulnaris) aspects of the forearm.
49
Which digits do these muscles move digitorum pollicis indicis digiti minimi
on groups of digits (digitorum muscles) or on individual digits (pollicis (thumb), indicis (index finger) digiti minimi (little finger)) (these muscles also contribute to wrist movements).
50
Why is the anatomical snuff-box useful
Important in determining if the scaphoid might be fractured: a common injury.
51
Which tendons can be seen in the anatomical snuff box
EPL (superiorly) EPB (inferiorly)
52
What are the joints in this region
Elbow joint Proximal radio-ulnar joint Distal radio-ulnar joint Wrist joint
53
Function of the ligaments of the elbow joint
Ligaments at the elbow joint are arranged to stabilise the joint, but allow pronation/supination movements (BUT THESE MOVEMENTS DO NOT ORIGINATE FROM THE ELBOW!)
54
What are the main ligaments and their attachments
Radial collateral.... from the lateral epicondyle to blend with the anular ligament of the radius Ulnar collateral... from the medial epicondyle to the coranoid process and the olecranon of the ulna
55
What is the firrence in carrying angle between men and women
men 10-15 degrees woman greater than 15 degreees
56
Where does the anular ligament of the radius extend from
This is part of the proximal radio-ulnar joint Attahes to the radial notch of the ulna anteriorly and posteriorly after wrapping around the head of the radius..... allows radial head to slide against radial notch of ulna and pivot on the capitulum during pronation and supination
57
Explain the distal radial ulnar joints
The 3 carpals involved in this joint are the triquetrum (medial), lunate and scaphoid (lateral) The articular surfaces of these 3 bones forms a convex surface, which articulates with the concave surface of the radius, and the articular disc of the ulna
58
Why can the hand be adducted more than abducted
Becase the radial styloid process extends further distally than the styloid process of the ulna does
59
Which ligaments support the wrist joint
palmar radiocarpal, palmar ulnocarpal, dorsal radiocarpal ligaments. Radial and ulnar collateral ligaments of the wrist span distance between styloid processes of radius and ulna and the adjacent carpal bones
60
Which carpals does the radius and ulnar interact with
RADIUS with the scaphoid laterally and the lunate medially ULNA does not articulate directly with the triquetrum carpal bone. An articular disc intervenes.
61
In resting position, where is the radius with respect to the ulna
Look at slide 31 when palm faces the trunk, radius essentially above the ulna
62
Outline the movements at the elbow joint and the muscles causing it
``` Flexion: Brachialis Biceps (Brachioradialis) (Pronator teres) C5-C6 (musclocutaneous nerve) ``` Extension: Triceps (Anconeus) C7-8 (radial nerve) Flexion C7 (&C6) Extension C6 (&C7)
63
Outline the movements of the radioulnar joints
Supination: supinator/biceps/EPL/ECRL | Pronation: Pronator quadratus Pronator teres FCR, PL, brachioradialis
64
Outline movements at the wrist joint
FLEXION: - FCR/FCU - Long flexors of thumb and fingers - PL/APL EXTENSION: - ECRL, ECRB, ECU - Long extensors of thumb and fingers ``` RADIAL DEVIATION (abduction): APL, FCR, ECRL, ECRB ``` ``` ULNAR DEVIATION (addution) ECU, FCU ``` LOGICAL: flexors/extensors working on the radius cause abduction Those working on the ulnar cause adduction
65
Explain the arteries from the elbow
Brachial arteries give a large branch to the arm (produnda brachii) then at the elobow divides into: ULNAR AND RADIAL ARTERIES. Ulnar art. Has common interosseous branch which imediately branches to give the anterior and posterior interosseous atreries Arches of the hand – anastomosis of the radial and ulnar arteries
66
Where is the cubital fossa
the space anterior to the elbow joint.
67
Borders of the cubital fossa
Lateral border – medial border of the brachioradialis muscle. Medial border – lateral border of the pronator teres muscle. Superior border – hypothetical line between the epicondyles of the humerus.
68
What are the contents of the cubital fossa
Really Need Beer To Be At My Nicest. RN-radial nerve BT- biceps tendon BA- brachial artery MN- median nerve
69
Venous drainage of the forearm elbow and wrist
-Cephalic vein (superficial) runs up lateral border of arm -Basilic vein (superficial) runs up the medial border of arm -Basilic veins joins venae comitantes to form the axillary vein in the arm -Cephalic vein joins axillary vein in the axilla -Axillary vein becomes the subclavian vein at the level of the first rib
70
Where do the cephalic and basilic veins arise
Cephalic and Basilic veins arise from the dorsal venous arch of the hand.
71
What are the cephalic and basilic veins connected by and where
Commonly connected at the cubital fossa by the median cubital vein (not always present or prominent). (used in phlebotomy)
72
What does deep drainage of this region follow
the arteries (vanae comitantes)
73
Where are the lymph nodes
Superficial and deep systems, run with veins Cubital lymph nodes Axillary nodes are also draining nodes for the distal parts of the upper limb
74
What are the main nerves of the upper limb and their spinal cord levels
Musculocutaneous nerve (C5,6,7) Ulnar nerve (C8,T1) Median nerve (C6,7,8,T1) Radial nerve (C5,6,7,8,T1)
75
Functions of the musculocutaneous nerve (C5,6)
Supplies all the anterior compartment of the upper arm Sensory to the lateral forearm (as the lateral cutaneous nerve of the forearm)
76
Course and function of median nerve
Courses through the anterior compartment of the arm (no significant branches) and lies anterior to the elbow, with the brachial artery (easily damaged!) Main nerve to the muscles of the forearm
77
Common sites of nerve damage
Axillary nerve posteriorly in the armpit Radial nerve around triceps brachii Ulnar nerve near the medial epicondle, or medial part of the distal radio-ulnar joint
78
Course and function of the radial nerve
Supplies all the muscles of the posterior compartments of the upper arm and forearm Passes around the body of the humerus at its mid-shaft in the radial groove (easily damaged!) Supplies triceps in the arm Courses via the anterior compartment of the upper arm more distally Divides just above the level of the elbow into; Deep branch – the posterior interosseous nerve (motor) Superficial branch – the superficial radial nerve (sensory)
79
What is a sesamoid bone
Bone forming in a tendon/muscle near a joint... e.g. pisiform and patella
80
Which superficial flexors cross over the wrist
Flexor carpi radialis (FCR) Palmaris longus (PL) Flexor carpi ulnaris (FCU)
81
Where does the Flexor digitorum superficialis (FDS) | attach
On the common flexor origin.... and the radial head
82
What muscles in the anterior forearm move the digits
Flexor digitorum superficialis (FDS) (superficial flexor of the digit) Flexor digitorum profundus (FDP) (deep flexor of the digits) Flexor pollicis longus (FPL) (flex thumb)
83
Where do most extensor muscles originate
Common origin extensor origin
84
T/F..... extnsor digitorum is medial to extensor digiti minimi
F... think that the small finger is medial to the other fingers so this muscle will be too
85
Extensorys slide 22..
.....
86
Extensors slide 22
.....
87
Functin of the extensor retunaculum
Prevents movement of tendons away from bone
88
What is found on the floor of the anatomical snuffbox
Scaphoid bone
89
What is the anular ligament important in
Pronation (because the radius has to rotate)
90
T/F the ulnar articulates directly with the carpal bones
F...
91
Which part of the radius moves in pronation
the proximal part
92
Which vessel pierces the interosseus membrane
The posterior interosseus artery (goes to the dorsal of the hand)
93
Function of brachioradialis
Can contribute to flexion or extension..... and pronation and supination (adjunct muscle) involved in cubital fossa
94
T/f musculocutaneous nerve supplies muscles in the forearm
F... only supplies muscles in the upper arm.... involved in moving the elbow joint tho
95
Radial nerve supplies both arm and forearm posteriorly
T... supplies all muscles in both posterior compartments of upper arm and forearm
96
Which muscles does ulnar nerve supply? What are the remaining anterior forearm muscles supplied by
The Ulnar Nerve supplies only FCU and the Ulnar half of FDP . The Median Nerve supplies all of the remaining anterior muscles.

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