Mod 2: Lecture 4 - Forearm and Wrist Flashcards Preview

Gross Anatomy > Mod 2: Lecture 4 - Forearm and Wrist > Flashcards

Flashcards in Mod 2: Lecture 4 - Forearm and Wrist Deck (37)
Loading flashcards...
1

Axillary Artery --->____

- brachial artery
- at the inferior border of the teres major muscle, the axillary artery changes name to become the brachial artery
- subclavian --> axillary --> brachial

2

Brachial Artery

- Brachial Profunda
---- a branch of the brachial artery that comes off in the upper arm
---- runs deep into the arm to supply the deep tissue/muscle
- Terminal Branches: where the brachial artery splits at the elbow region
---- Radial Artery
---- Ulnar Artery
---- these run into the forearm

3

Ulnar Artery Branches

- common interosseous artery branches off the ulna
- common interosseous artery --> anterior interosseous artery + posterior interosseous artery
---- supply the deep tissue/muscle of the forearm

4

Elbow anastomosis formed by....

- ulnar collaterals (vessels from the ulnar artery)
- radial and ulnar recurrent arteries
- ensures a good blood flow to the arm at all times

5

Superficial Palmar Arch

- formed from the ulnar artery as it goes into the hand
- a curve of vessel in the palm that is closer to the fingers than the wrist
- vessels coming off of it
---- supply 2 vessels each to the pinky, ring, and middle finger
---- supply 1 vessel to the index finger

6

Deep Palmar Arch

- formed by the radial artery
- vessels coming off of it
---- supply 2 vessels to the thumb
---- supply 1 vessel to the index finger
- a curve of vessel in the palm that is closer to the wrist than fingers

7

Upper Extremity: Venous Drainage

- a dorsal venous network drains the superficial and deep venous palmar arches
---- back of the hand
- superficial to the metacarpus , the network is prolonged proximally
---- the network goes just above the wrist where it enters into other veins
---- lateral side (thumb side): cephalic vein
---- medial side (pinky side): basilic vein

8

Basilic and Cephalic veins -->

- Median cubital vein is the communication between the basilic and cephalic veins in the cubital fossa
---- the median cubital vein branches across the arm at the elbow to connect these two parallel veins
- Basilic --> origin of the axillary vein
- Cephalic --> termination of the axillary vein

9

The radial and ulnar styloids limit ____

- lateral deviation of the wrist
- the styloids are the pointed projections on the distal end of the bones

10

Clinical Correlation: Colle's Fracture

- 70% in post-menopausal women
---- protective effect on bone density of estrogen
---- so old ladies are more likely to fall and try to break it with their hands
---- but they end up snapping their wrist
- distal radius fracture with dorsal displacement of distal fragment
---- the end of the radius breaks and is pushed up toward the dorsal side of the hand/wrist

11

Clinical Correlation: Smith Fracture

- reverse of Colle's fracture
- occurs when there is force to a flexed wrist
---- such as in sports if a player falls while holding a ball and lands on the back of his wrist
- distal radius fracture with palmar displacement of distal fragment
---- the end of the radius breaks and is pushed up toward the palmar side of the hand/wrist

12

Carpal Bones

- Two Rows: Proximal and Distal
---- "So Long to Pinky, Here Comes The Thumb"
---- clockwise from thumb on volar surface, beginning in proximal row
- carpal bones are very tightly packed, close proximity to each other
- distal radial articulates with the carpals
- distal ulna does not articulate with them

13

Proximal Row Of Carpal Bones

- Proximal row approximates with the radius
---- is closer to arm
----- scaphoid, lunate, triquetrum, pisiform ( Lat- Med)
---- the scaphoid is on the thumb side
---- you cannot see the pisiform from the dorsal surface of the hand, you can only see it in a palmar view
- "So Long to Pinky,..."

14

Distal Row of Carpal Bones

- Distal row approximates with metacarpals
---- is closer to fingers
---- hammate, capitate, trapezoid, trapezium (Med - Lat)
---- hammate is under the pinky bc this little piggy goes to the market
- ".... Here Comes The Thumb."

15

Hand Osteology

1. Styloid Process of Radius
2. Styloid Process of Ulna
3. Metacarpal
4. Proximal Phalange
5. Middle Phalange
6. Distal Phalange

16

Hand Osteology
1. Styloid Process of Radius
2. Styloid Process of Ulna
3. Metacarpal

1. tip of the triangular distal end of the radius
2. little pointed thing sticking out of the distal end of the ulna
3. bones in the hand, distal to the carpals, proximal to the phalanges
- there are 5, one connecting each finger to the wrist
---- numbered from 1 to 5, starting with the thumb (1) and ending in the pinky (5)
- each has a base (proximal end) and head (distal end)

17

Hand Osteology
4. Proximal Phalange
5. Middle Phalange
6. Distal Phalange

4. the row of phalanges that is closest to the metacarpals
---- there are 5 of them, one in each finger
5. the row of phalanges that is in between the proximal and distal phalanges
---- where the middle knuckle in your fingers is
---- there are 4 of them, one in each finger except the thumb
6. the tips of the fingers, after the last knuckle
---- small little bones
---- there are 5 of them, one in each finger

18

Palmar Arches

- formed by bony structures, ligaments
- Two Transverse Arches
- One Longitudinal Arch
- Functions:
---- balance stability and mobility --> arches are stable structure
---- increase surface contact of palm --> more sensory feedback
---- position thumb for function --> put thumb in opposition to fingers

19

Transverse Palmar Arches

- there are two
-Proximal: runs across the bases of the metacarpals
- Distal: runs across the heads of the metacarpals

20

Longitudinal Palmar Arch

- only one
- runs through the long axis (from wrist to fingertip) of the third digit (middle finger)

21

Articulations: Radiocarpal

- between distal radius and proximal carpals
- condyloid type
---- moves in two planes
- wrist flexion/extension
---- sagittal plane, bending forward and back
- wrist abduction and adduction
---- coronal plane, moving sideways in and out (right and left)

22

Articulations: Midcarpal

- between proximal and distal row of carpal bones
- plane synovial joint
- gliding motions between carpals

23

Arthrokinematics:
1. Flexing the wrist down, like reaching into a bag of chips
2. Wrist Extension, moving the hand up, fingers point up, like going for a high five (without raising your arm)

- full range of motion at the wrist requires movement at both the radiocarpal and midcarpal joints
- so for wrist injuries, you must address movement at both joints

1. - 60% radiocarpal movement
- 40% midcarpal movement

2. - 40% radiocarpal movement
- 60% midcarpal movement

24

Distal Radioulnar Joint

- between the distal ends of the radius and ulna
- pivot synovial joint
- supination/pronation
- separated from the joint space of the radiocarpal joint by an articular disc

25

Stabilizing Ligaments

- Collateral Ligaments
- Retinaculum Ligaments

26

Collateral Ligaments

- stabilizing ligaments
- Radial Collateral Ligament
---- between radius and carpals
---- on the side of the first digit (thumb)
---- prevents deviation to the ulnar side/ pinky
- Ulnar Collateral Ligament
---- between the ulna and carpals
---- prevents deviation toward the radial side/thumb

27

Retinaculum Ligaments

- stabilizing ligaments
- broad bands of fibrous connective tissue that stabilize the wrist and prevent "bowstringing" of the tendons of extrinsic muscles of the hand
- Extensor Retinaculum: dorsal
- Flexor Retinaculum: ventral

28

Extensor Retinaculum Ligament

- dorsal side of wrist
- from distal radius to pisiform and triquetrum
- horizontally across the proximal end of the wrist

29

Flexor Retinaculum Ligament

- ventral side of wrist
- from pisiform and hammate to scaphoid and trapezium
- horizontally across the middle of the carpal bones

30

Carpal Tunnel

- anatomical space between the flexor retinaculum ligament and the carpal bones
- tendons of some muscles (FDS, FDP, FPL) and the main branch of the median nerve pass through the carpal tunnel
---- one branch of the median nerve (palmar cutaneous branch) does not pass through
- ulnar nerve and artery do not pass through the tunnel