Week 2 Flashcards
(291 cards)
1
Q
What does the Central Nervous System consist of?
A
Brain and spinal cord
2
Q
What is the function of the CNS?
A
Integrative and control centers.
3
Q
What does the Peripheral Nervous System consist of?
A
Cranial nerves and spinal nerves (all the nerves in the body).
4
Q
What is the function of the PNS?
A
Serves as the communication lines between the CNS and the rest of the body.
5
Q
Where does the spinal cord end at?
A
Around L1-L2 (mainly L2)
6
Q
At what vertebrae do all of the lumbar nerves come out at? Why is this?
A
Around T12. This is because the spinal cord ends at L1-2, so all of the nerves are in a “rush” to branch off of the spinal cord.
7
Q
At what vertebrae do all of the sacral nerves come out at? Why is this?
A
Around L1. This is because the spinal cord ends at L1-2, so all of the nerves are in a “rush” to branch off of the spinal cord.
8
Q
What area of the body is the Somatic division responsible for?
A
Anything on the outer part of the body like muscles and skin.
9
Q
What area of the body is the Visceral division responsible for?
A
Viscera (internal organs) in body cavities.
10
Q
Both the Somatic and Visceral division can be divided into __________ and ________.
A
sensory; motor
11
Q
Regarding Nervous Tissue, what are the two main cell types?
A
Neurons and Neuroglial/Helper cells
12
Q
What acts as the structural and functional unit of the nervous system?
A
Neurons.
13
Q
Define Neuron.
A
A specialized cell that conducts electrical impulses along the plasma membrane.
14
Q
Are neuroglial cells excitable? What does this mean?
A
No. This means that they CANNOT conduct electrical impulses.
15
Q
T/F: Both neurons and neuroglial cells are excitable.
A
False! Only neurons are excitable, but neuroglial cells are NOT.
16
Q
What do neuroglial cells in the CNS do?
A
Support cells; Surround and wrap neurons.
17
Q
What is another name for the cell body?
A
Soma
18
Q
What are dendrites and what do they do?
A
Dendrites are processes that receive signals and transmit them towards the cell body.
19
Q
What does the cell body contain?
A
Contains the nucleus and organelles.
20
Q
What is the function of the Axon?
A
Axons send electrical signals elsewhere.
21
Q
Define Nerves.
A
Nerves are collections of axons.
22
Q
Define Synapse.
A
A junction between neurons or a neuron and a muscle.
23
Q
What is the Synaptic Cleft?
A
This is the space where neurotransmitters are released between neurons or a neuron and a muscle.
24
Q
Where does the spinal cord begin superiorly?
A
At the base of the occipital bone.
25
How many pairs of spinal nerves are there? Name how many are in each level.
31 total spinal pairs
8 cervical
12 thoracic
5 lumbar
5 sacral
1 coccygeal
26
Where would we find enlargements in the spinal cord?
Cervical and lumbosacral enlargements.
27
How does the angle at which the spinal nerve exits the cord change as we go inferior? Why is this?
As we move further down the spinal cord, the nerves start to come out at an inferior angle, especially from the lumbar, sacral, and coccygeal regions.
The spinal cord ends at L2, thus, the nerves have to come out off of the spinal cord earlier to go down to the regions they must reach.
28
Why are there 8 cervical nerves?
At C1, the 1st spinal nerve comes out on the superior part of C1. The 2nd spinal nerve comes out the inferior part of C1. Thus, when C8 spinal nerves comes out below C7, T1 spinal nerve comes out below T1 vertebra.
29
What is the Conus Medullaris?
The cone-shaped inferior end of the spinal cord, at L2.
30
What accounts for the cervical and lumboscaral enlargements of the spinal cord?
The spinal cord gets bigger at these regions due to more nerves coming from and going to the limbs.
31
What is Filum Terminale? What is it made of?
A long filament of connective tissue running from the peak of the conus medullaris to the inferior coccyx.
The Filum Terminale is a layer of Pia Mater.
32
What is Cauda Equina?
A collection of spinal nerve roots continuing down past L1-L2.
33
What does White Matter contain?
Contains mainly myelinated axons.
34
What does Gray Matter contain?
Contains mainly cell bodies & short unmyelinated axons.
35
Describe the difference in gray and white matter size between cervical, thoracic, lumbar, and sacral spinal cord.
Cervical: Lots of white matter. Medium gray matter.
Thoracic: Majority white matter. Minimal gray matter.
Lumbar: Some white matter. Lots of gray matter.
Sacral: Minimal white matter. Lots of gray matter.
36
Why would a cervical spinal cord have lots of white matter?
There are tons of axons from every single nerve in the body coming up to the brain and then leaving to get to the rest of the body.
37
Why would a lumbar spinal cord have lots of gray matter?
There is a lot of sensory + motor function going on here. Think of how much sensory info your limbs take in and how much motor function your legs perform.
38
T/F: The ventral horn is responsible for sensory info. The dorsal horn is responsible for motor info.
False! The dorsal horn is responsible for sensory info, and the ventral horn is responsible for motor info.
39
In what section of the spinal cord could we visualize lateral horns in addition to the dorsal and ventral horn? Why?
Only present in T1-L2 as a result of the autonomic nervous system.
40
If we examined spinal cord from T1-L2, what horns would we see?
Dorsal horn, ventral horn, and LATERAL horn.
41
What would we find in the Dorsal Root Ganglion?
All cell bodies responsible for sensory information
42
T/F: A spinal nerve contains only sensory info.
False! A spinal nerve contains a mix of both sensory and motor info.
43
What are the dorsal rami of spinal nerves responsible for?
Innervate deep muscles and skin of back.
44
What are the ventral rami of spinal nerves responsible for?
Every part of the body other than the deep muscles and skin of back.
45
What is larger in size: Dorsal or Ventral Ramus? Why?
Ventral ramus is larger, because it accounts for a MUCH larger amount of the body.
46
What do roots (dorsal/ventral) of the spinal cord contain?
Contain only sensory OR motor information.
47
What do roots (dorsal/ventral) merge to form?
Merge to form a spinal nerve (sensory AND motor fibers mixed).
48
What do spinal nerves split to form?
Rami (sensory AND motor fibers mixed).
49
What do rami go on to form?
Rami go on to form the named nerves in the body.
50
What is the difference in the spinal cord between a root and rami?
A root contains only sensory OR motor information.
A rami is a branch off of the spinal nerve that contains both sensory AND motor information mixed.
51
Ventral rami recombine in _____________ that go to the limbs.
plexuses
52
Other than the number of nerves coming out at these regions, what else accounts for the cervical and lumbosacral spinal cord enlargements?
The cervical enlargement gives off the brachial plexus to the upper limb.
The lumbar enlargement gives off the lumbosacral plexus to the lower limb.
53
What gives off the brachial plexus to the upper limb?
Cervical enlargement
54
What gives off the lumbosacral plexus to the lower limb?
Lumbosacral enlargement
55
What is a Dermatome?
A dermatome is a strip of skin supplied by a single pair of spinal nerves.
56
Why is T4 dermatome an important landmark?
Its at the level of the nipple.
57
Why is T10 dermatome an important landmark?
Its at the level of the umbilicus.
58
How could a dermatome help with a patient presenting with numbness on the posterolateral aspect of the leg?
Dermatome could help to determine what spinal nerve may be getting irritated, potentially from a herniated IV disc.
59
What are Meninges?
Protective supportive membranes covering the CNS.
60
Name the 3 layers of meninges from superficial to deep.
Superficial: Dura Mater
Middle: Arachnoid Mater
Deep: Pia Mater
61
Describe the Pia Mater.
Thin meningeal layer directly adhered to nerve tissue (spinal cord + brain).
62
T/F: We are able to pull the Pia Mater off of the brain & spinal cord to observe it.
False! It is directly adhered and cannot be pulled off.
63
Describe the Arachnoid Mater.
A web of connective tissue that contains cerebrospinal fluid.
64
Describe the Dura Mater.
Tough and thick, outermost meningeal layer.
65
T/F: There are no spaces between the layers of the meninges.
False! There are spaces (real or potential) between each layer.
66
What is the function of Denticulate Ligaments?
An extension of the Pia Mater that anchors the spinal cord to hold it in place.
67
Where is the Epidural Space in relation to the meninges?
Superficial to the Dura Mater (most superficial layer).
68
What is the Epidural Space filled with generally?
Fat
69
T/F: The Epidural Space is a real space in the brain in healthy individuals.
False! The Epidural Space is only a real space in the spinal cord. It is NOT a real space in the brain, and if it is, something is wrong.
70
T/F: The Subdural Space is a real space.
False! It is a potential space ONLY.
71
What is the Subarachnoid Space filled with?
Cerebrospinal Fluid (CSF).
72
Where performing a lumbar puncture/epidural, where should we always aim below? Why?
Always below L2, because the spinal cord ends at L2.
73
What vertebral region is a lumbar puncture generally performed at?
L3-4 or L4-5
74
When performing a lumbar puncture, what is the goal?
To enter the subarachnoid space to get CSF.
75
To enter the subarachnoid space during a lumbar puncture, where does the needle need to penetrate through?
Penetrate the Dura Mater, Arachnoid Mater, and Ligamentum Flavum.
76
What determines the flow of CSF?
Pressure buildup in the subarachnoid space.
77
How might the needle position (depth) of a lumbar epidural anesthetic differ from a lumbar puncture?
For a lumbar epidural, we want to penetrate superficial to the Dura Mater (where the epidural region is), so we are not piercing the meninges at all, thus, not very deep.
78
What bones serve as the main articulation for the elbow joint?
Trochlea of the humerus articulating with the trochlear notch of the ulna.
79
T/F: The radius contributes to the elbow joint more than the ulna.
False! The ulna actually contributes more to the elbow joint, however, the radius contributes more to pronation/supination movements.
80
Which is more important for supination/pronation: Ulna or Radius?
Radius
81
Name the ligaments of the elbow.
Radial collateral ligament
Ulnar collateral ligament
Anular ligament
82
What is the Radial Collateral Ligament?
Thickened lateral ligament from the lateral epicondyle of the humerus that blends with anular ligament.
83
What does the Anular Ligament do?
Encircles and holds the head of the radius in the radial notch. This allows for pronation/supination movements.
84
What is the Ulnar Collateral Ligament?
Extends from the medial epicondyle to the coronoid process and olecranon of ulna. It consists of 3 bands.
85
Which elbow ligament is often torn in baseball pitchers?
Ulnar Collateral Ligament
86
What does the Brachial artery splint into? Where at?
The Brachial artery splits into the radial and ulnar artery. This happens at the elbow.
87
What is the blood supply for the Brachioradialis?
Radial artery
88
Where does the Radial Artery travel once it breaks off the Brachial Artery?
The radial artery travels laterally to supply the brachioradialis and the posterior compartment of the forearm.
89
At the wrist, where does the radial artery move?
At the wrist, the radial artery moves distally through the anatomical snuffbox and contributes to the distal palmar arch.
90
Where does the Ulnar Artery travel once it breaks off the Brachial Artery?
Ulnar Artery travels deep and lets off a common interosseous artery before it runs medially to the wrist under the flexor carpi radialis.
91
What does the Ulnar Artery let off?
A common interosseous artery
92
What does the Common Interosseous Artery branch into?
Branches into the anterior and posterior interosseous artery.
93
T/F: Every human body has a Common Interosseous Artery.
False! Not all bodies have this. Instead, they just have anterior and posterior interosseous arteries.
94
What does the Posterior Interosseous Artery pierce?
It pierces the interosseous membrane to supply the posterior compartment.
95
What does the Ulnar Artery become?
**Not thinking of the Common Interosseous Artery, think past that**
Superficial palmar arch
96
What provides SENSORY information of the forearm?
Lateral cutaneous nerve, which comes from the musculocutaneous branch.
97
T/F: The Axillary nerve branch provides both sensory and motor information to the forearm.
False! The Axillary nerve branch has NOTHING to do with the forearm.
98
Which compartment of the forearm does the radial nerve innervate?
The Radial nerve innervates the posterior compartment of the arm.
99
Does the Radial Nerve provide sensory or motor information to the posterior compartment of the forearm?
Motor info
100
Where does the posterior interosseous nerve come from? How does this differ from the posterior interosseous artery?
The posterior interosseous nerve comes from the radial nerve.
The posterior interosseous artery comes from the ulnar artery.
101
What innervates most of the anterior compartment of the forearm?
Median Nerve
102
Does the median nerve provide motor or sensory info to the anterior compartment of the forearm?
Motor info
103
Where does the anterior interosseous nerve come from? How does this differ from the anterior interosseous artery?
The anterior interosseous nerve comes from the median nerve.
The anterior interosseous artery comes from the ulnar artery.
104
What nerve is responsible for 1.5 muscles in the anterior compartment?
Ulnar nerve
105
Does the ulnar nerve provide sensory or motor info to the anterior compartment?
Motor info
106
In terms of the wrist, what is another word for adduction?
Ulnar deviation
107
In terms of the wrist, what is another word for abduction?
Radial deviation
108
What is abduction of the thumb?
Moving thumb away from the palm.
109
What is adduction of the thumb?
Moving thumb towards the palm.
110
Are extensors or flexors in the anterior compartment? What about pronators or supinators?
Flexors and pronators in the anterior compartment.
111
What innervates the majority of the anterior compartment of the forearm?
Median nerve
112
What innervates 1.5 muscles of the anterior compartment of the forearm?
Ulnar nerve
113
Are extensors or flexors in the posterior compartment of the forearm? What about pronators or supinators?
Extensors and supinators are in the posterior compartment.
114
What innervates the posterior compartment of the forearm?
Radial Nerve (directly or by its deep branch).
115
Where do flexors originate from?
Medial epicondyle
116
Where do extensors originate from?
Lateral epicondyle
117
What muscle that performs flexion is actually found in the posterior compartment?
Brachioradialis
118
What is special about the compartment that the Brachioradialis is in?
The Brachioradialis is a muscle that performs elbow flexion, however, it is located in the posterior compartment due to its innervation by the Radial Nerve.
119
There is ____________ separating the anterior and posterior forearm compartment.
fascia
120
Does the fascia in the forearm play a role in infection? Explain.
The fascia in the forearm is important in preventing the spread of infection, because it keeps infection in one compartment due to grouping and separation.
121
Name the 8 muscles of the anterior compartment of the forearm.
Flexor carpi radialis
Flexor carpi ulnaris
Palmaris longus
Flexor digitorum superficialis
Flexor digitorum profundus
Flexor pollicis longus
Pronator teres
Pronator quadratus
122
The muscles in the anterior forearm compartment are ___________ or _____________.
flexors; pronators
123
All of the forearm muscles of the anterior compartment are innervated by the Median Nerve, EXCEPT for which ones?
Flexor carpi ulnaris
Flexor digitorum profundus
124
Name the 3 wrist flexors of the anterior forearm compartment.
Flexor carpi radialis
Flexor carpi ulnaris
Palmaris longus
125
Name the 3 digit flexors of the anterior forearm compartment.
Flexor digitorum superficialis
Flexor digitorum profundus
Flexor pollicis longus
126
Name the 2 pronators of the anterior forearm compartment.
Pronator teres
Pronator quadratus
127
Name the 10 forearm muscles of the posterior compartment.
Extensor carpi radialis longus
Extensor carpi radialis brevis
Abductor pollicis longus
Extensor pollicis brevis
Extensor pollicis longus
Extensor digiti minimi
Extensor indicis
Extensor digitorum
Supinator
Brachioradialis
128
Forearm muscles in the posterior compartment are all _______________ and/or ______________. What is the exception to this?
Extensors; Supinators
The exception to this is Brachioradialis.
129
Name the 4 superficial anterior forearm muscles.
Pronator teres
Flexor carpi radialis
Palmaris longus
Flexor carpi ulnaris
130
Name the only intermediate anterior forearm muscle.
Flexor digitorum superficialis
131
What is the proximal attachment of Pronator Teres?
Medial epicondyle of humerus
132
What is the distal attachment of Pronator Teres?
Lateral surface of radius
133
What is the action of Pronator Teres?
Pronates the forearm
134
What innervates Pronator Teres?
Median Nerve
135
What is the proximal attachment for Flexor Carpi Radialis?
Medial epicondyle of humerus
136
What is the distal attachment for Flexor Carpi Radialis?
2nd metacarpal
137
What is the action of Flexor Carpi Radialis?
Flexes and abducts/radially deviates the wrist.
138
What innervates the Flexor Carpi Radialis?
Median Nerve
139
What is the proximal attachment for Palmaris Longus?
Medial epicondyle
140
What is the distal attachment for Palmaris Longus?
Palmar aponeuorsis
141
What is the action of Palmaris Longus?
Flexes hand/tenses palmaris aponeurosis
142
What innervates Palmaris Longus?
Median Nerve
143
Which muscle do some individuals not have? What percentage of people don't have this?
Not everybody has Palmaris Longus.
14% of people do not have this.
144
T/F: If a person does not have Palmaris Longus, the Palmar Aponeurosis will also be missing.
False! The Palmar Aponeurosis will always be present even if Palmaris Longus is not present.
145
T/F: You can tell a person is missing their Palmaris Longus, becuase they will have deficits present.
False! The person will not have deficits due to other muscles still performing the same actions.
146
How do we test if Palmaris Longus is present on surface anatomy?
Touch thumb + pinky finger, then flex your wrist and look for tendon to pop at median.
147
What is the proximal attachment for Flexor Carpi Ulnaris?
Medial epicondyle/olecranon
148
What is the distal attachment for Flexor Carpi Ulnaris?
5th metacarpal
149
What are the actions of Flexor Carpi Ulnaris?
Flexes and adducts/ulnar deviation the wrist.
150
What innervates Flexor Carpi Ulnaris?
Ulnar Nerve!
This is 1 of the 1.5 muscles not innervated by the Median Nerve in the anterior forearm compartment.
151
What is the proximal attachment for Flexor Digitorum Superficialis?
Medial epicondyle
152
What is the distal attachment for Flexor Digitorum Superficialis?
Middle phalanges of digits 2-5
153
What are the actions of Flexor Digitorum Superficialis?
Flexes proximal and middle phalanges (PIP joint) and flexes the wrist.
154
What innervates Flexor Digitorum Superficialis?
Median Nerve
155
What is the only intermediate anterior compartment forearm muscle?
Flexor Digitorum Superficialis
156
What are the 3 deep muscles of the anterior forearm?
Flexor digitorum profundus
Flexor pollicis longus
Pronator quadratus
157
What innervates the deep muscles of the anterior forearm?
All deep muscles of the anterior forearm are innervated by the anterior interosseous branch of the Median Nerve.
158
The Anterior Interosseous Nerve is a branch of the ___________ nerve.
Median
159
What is the proximal attachment for Flexor Digitorum Profundus?
Ulna
160
What is the distal attachment for Flexor Digitorum Profundus?
Distal phalanges of digits 2-5.
161
What are the actions of Flexor Digitorum Profundus?
Flexes wrist and flexes distal phalanges (DIP joint).
162
What innervates Flexor Digitorum Profundus?
Two nerves innervate this:
The Anterior Interosseous Nerve of the Median branch innervates the 2nd and 3rd digits.
The Ulnar Nerve innervates the 4th and 5th digits.
163
What muscle in the anterior compartment of the forearm helps to make a fist?
Flexor Digitorum Profundus
164
Explain how the Flexor Digitorum Superficialis (FDS) versus Flexor Digitorum Profundus (FDP) differ in their distal attachment.
FDS attaches at the middle phalanges of digits 2-5. The tendon splits in two and attaches on the outsides of each finger.
FDP attaches at the distal phalanges of digits 2-5. These are deep to the FDS, then they go through the split of the FDS tendons to attach to the distal phalanges.
165
What is the proximal attachment for Flexor Pollicis Longus?
Radius
166
What is the distal attachment for Flexor Pollicis Longus?
Distal phalanx of thumb
167
What are the actions of Flexor Pollicis Longus?
Flexes the thumb and the wrist.
168
What innervates Flexor Pollicis Longus?
Anterior Interosseous Nerve of the Medial Branch.
169
What muscle has a feather-like appearance?
Flexor Pollicis Longus
170
What is the proximal attachment for Pronator Quadratus?
Distal radius and distal ulna
171
What is the distal attachment for Pronator Quadratus?
Distal radius and distal ulna
172
What is the action of Pronator Quadratus?
Pronates forearm
173
What innervates Pronator Quadratus?
Anterior Interosseous Nerve of the Median Branch.
174
What muscle does the Anterior Interosseous Nerve of the Median Branch run deep to?
Pronator Quadratus
175
What is the Superficial Neurovasculature of the Anterior Forearm?
Median Nerve
Ulnar Nerve
Brachial Artery
Radial Artery
Ulnar Artery (distal ulna)
176
What is the Intermediate Neurovasculature of the Anterior Forearm?
Ulnar Artery becomes visible at the elbow.
177
What is the Deep Neurovasculature of the Anterior Forearm?
Anterior Interosseous Artery
Ulnar Artery (more visible)
Anterior Interosseous Nerve
Musculocutaneous Nerve
Ulnar Nerve and Median Nerve (become more visible)
178
What are the Radial Nerve Branches?
Radial Nerve branches into the Superficial Radial Nerve and the Deep Radial Nerve.
The Deep Radial Nerve then turns into the Posterior Interosseous Nerve.
179
What muscles does the Radial Nerve act as the motor branch to?
Brachioradialis and extensor carpi radialis longus
180
What muscle does the Deep Radial Nerve act as the motor branch to?
Supinator
181
Which nerve pierces the Supinator muscle?
When the nerve exits, what does it become?
The Deep Radial Nerve pierces the Supinator muscle.
When it comes out on the other side of the Supinator muscle, it is the Posterior Interosseous Nerve.
182
What innervates Supinator and Extensor Carpi Radialis Brevis?
Deep Radial Nerve
183
Which nerve acts as the motor branch to the deep posterior forearm?
Posterior Interosseous Nerve
184
What is the proximal attachment for Brachioradialis?
Lateral epicondyle/supracondylar ridge
185
What is the distal attachment for Brachioradialis?
Radial styloid process
186
What is the action of Brachioradialis?
** Beer drinking muscle **
Elbow flexion (weak)
Semi-pronated forearm with flexion
187
What innervates Brachioradialis?
Radial Nerve
188
What is special about the Brachioradialis being in the posterior compartment?
It is a muscle that performs elbow flexion, however, it is innervated by the Radial Nerve, thus, it is in the posterior compartment.
189
What is the proximal attachment for Extensor Digitorum?
Lateral epicondyle
190
What is the distal attachment for Extensor Digitorum?
Extensor expansions ("hoods") of digits 2-5.
191
What are the actions of Extensor Digitorum?
Wrist extension and extends fingers
192
What innervates Extensor Digitorum?
Posterior Interosseous Nerve from the Radial Branch
193
What is the proximal attachment for Extensor Digiti Minimi?
Lateral epicondyle
194
What is the distal attachment for Extensor Digiti Minimi?
Extensor expansion of digit 5
195
What is the action of Extensor Digiti Minimi?
Extends the 5th digit
196
What innervates Extensor Digiti Minimi?
Posterior Interosseous Nerve from the Radial Branch
197
What is the proximal attachment for Extensor Carpi Ulnaris?
Lateral epicondyle
198
What is the distal attachment for Extensor Carpi Ulnaris?
5th metacarpal
199
What are the actions of Extensor Carpi Ulnaris?
Extends wrist and adducts wrist (ulnar deviation).
200
What innervates Extensor Carpi Ulnaris?
Posterior Interosseous Nerve from the Radial Branch
201
What is the proximal attachment for Extensor Carpi Radialis Longus?
Lateral Epicondyle/Supracondylar Ridge
202
What is the distal attachment for Extensor Carpi Radialis Longus?
2nd metacarpal
203
What are the actions of Extensor Carpi Radialis Longus?
Extends wrist and abducts wrist (radial deviation)
204
What innervates Extensor Carpi Radialis Longus?
Radial Nerve
205
What is the proximal attachment for Extensor Carpi Radialis Brevis?
Lateral epicondyle
206
What is the distal attachment for Extensor Carpi Radialis Brevis?
3rd metacarpal
207
What are the actions of Extensor Carpi Radialis Brevis?
Extends wrist and abducts wrist (radial deviation)
208
What innervates Extensor Carpi Radialis Brevis?
Deep branch of radial nerve
209
What is the proximal attachment for Abductor Pollicis Longus?
Radius/Ulna
210
What is the distal attachment for Abductor Pollicis Longus?
1st metacarpal
211
What are the actions of Abductor Pollicis Longus?
Abducts thumb and extends thumb at CMC joint.
212
What is the proximal attachment for Extensor Pollicis Brevis?
Radius
212
What innervates Abductor Pollicis Longus?
Posterior Interosseous Nerve from the Radial Branch
212
What is the distal attachment for Extensor Pollicis Brevis?
Proximal phalanx of thumb
213
What are the actions of Extensor Pollicis Brevis?
Extends wrist and extends thumb.
214
What innervates Extensor Pollicis Brevis?
Posterior Interosseous Nerve of the Radial Branch
215
What is the proximal attachment for Extensor Pollicis Longus?
Ulna
216
What is the distal attachment for Extensor Pollicis Longus?
Distal phalanx of thumb
217
What are the actions of Extensor Pollicis Longus?
Extends wrist and extends thumb
218
What innervates Extensor Pollicis Longus?
Posterior Interosseous Nerve of the Radial Branch
219
What is the proximal attachment for Extensor Indicis?
Ulna
220
What is the distal attachment for Extensor Indicis?
Extensor expansion digit 2
221
What is the action of Extensor Indicis?
Extends the 2nd digit
222
What innervates Extensor Indicis?
Posterior Interosseous Nerve of the Radial Branch
223
What is the proximal attachment for Supinator?
Lateral epicondyle
224
What is the distal attachment for Supinator?
Radius
225
What is the action of Supinator?
Supination
226
What innervates Supinator?
Deep branch of the radial nerve
227
What nerve pierces Supinator?
Deep radial nerve pierces the supinator muscle.
228
What does the Deep Radial Nerve pierce?
** Practical may tag this **
Pierces the Supinator muscle
** Practical may tag this **
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What is Golfer's Elbow?
Medial Epicondylitis
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How would a patient present with Medial Epicondylitis?
Pain, stiffness, and swelling of the elbow.
Hand and wrist weakness.
Tingling of 4th and 5th digits.
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What is Tennis Elbow?
Lateral Epicondylitis
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What are the potential causes of injury to the radial nerve?
-Compression of the axilla
-Humeral shaft fracture
-Wrist constriction (tight bracelets)
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What is Saturday Night/Honeymoon Palsey?
This is when a person falls asleep with their arm dangling over a chair or the bed and puts pressure on the axilla for a long period of time.
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What are potential consequences of injury to the Radial Nerve?
-Wrist drop
-Weakened grip strength
-Damaged elbow extension (if lesion is proximal)
-Loss of sensation on dorsum of hand
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How many carpal bones are there?
8 carpal bones
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Name the carpal bones.
Scaphoid, Lunate, Triquetrum, Pisiform, Trapezium, Trapezoid, Capitate, Hamate.
Some Lovers Try Positions That They Cannot Handle
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How many metacarpal bones are there?
5
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How many phalanges are there in one hand?
14 phalanges
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What are Sesamoids? Does everyone have these? Are they problematic?
Bones that develop within a tendon. Not everybody has these. They can be problematic.
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What carpal bone are we not able to see on the dorsal hand? Why is this?
Pisiform.
This is because the Pisiform sits superficially to the Triquetrum on the palmar side of the hand.
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What contributes more to the wrist joint: radius or ulna?
The radius contributes more to the wrist joint.
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What type of joint is the radiocarpal joint?
Condyloid joint
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What type of joint is an intercarpal joint? What does this mean?
Plane joint
This means that the bones just glide past each other.
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What type of joint are carpometacarpal and intermetacarpal joints? What is the EXCEPTION to this?
Plane joints
The CMC joint of the thumb is an exception in that this is a saddle joint.
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What is a Condyloid Joint?
Oval & socket joint.
Think of this as being similar to a ball & socket joint.
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What is a Metacarpophalangeal (MCP) Joint made up of?
Between metacarpal bones and proximal phalanges.
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What is a Proximal Interphalangeal (PIP) Joint made up of?
Between proximal and middle phalanx of finger.
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What is a Distal Interphalangeal (DIP) Joint made up of?
Between middle and distal phalanx of finger.
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What strengthens each MCP and IP joint capsule?
Each MCP and IP joint capsule is strengthened by two (medial and lateral) collateral ligaments.
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What do Palmar ligaments do?
Strengthen the anterior aspect of the MCP joints.
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Why would Palmar ligaments, medial, and collateral ligaments of the fingers be beneficial?
Strengthens the integrity of the fingers.
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How does the fascia of the forearm change as we move to the wrist?
The fascia of the forearm thickens around the wrists to help form compartments and prevent the spread of infection.
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What is the posterior wrist fascia called?
Extensor retinaculum
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What is the anterior wrist fascia called?
Flexor retinaculum
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What passes under the Extensor Retinaculum?
Extensor tendons pass under here.
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What is another name for the Flexor Retinaculum? What does this create?
Transverse Carpal Ligament (transverse plane over carpal bones).
This creates the carpal tunnel.
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What passes under the Flexor Retinaculum/Transverse Carpal Ligament?
Flexor tendons and Median Nerve pass under here.
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What is the proximal attachment of the Extensor Digitorum?
Lateral epicondyle
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What is the distal attachment of the Extensor Digitorum?
Extensor expansions ("hoods") of digits 2-5.
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What are the actions of the Extensor Digitorum?
Extends wrist and fingers.
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What innervates Extensor Digitorum?
Posterior interosseous nerve (radial branch)
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Notice there are 2 Flexor Digitorum muscles to 1 Extensor Digitorum muscle. How does this affect our hand at rest?
Our hand and fingers remain slightly flexed at rest.
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As the extensors pass under the extensor retinaculum, all 4 tendons are surrounded by ______________ ____________.
synovial sheaths
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What benefit do synovial sheaths provide?
They provide lubrication to prevent friction.
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The tendons of the extensor digitorum flatten and form ______.
Hoods
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What are the boundaries of the anatomical snuffbox?
Tendons of Extensor Pollicis Brevis, Extensor Pollicis Longus, and Abductor Pollicis Longus.
Floor: Scaphoid and Trapezium bones
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What are the contents of the Anatomical Snuffbox?
Radial Artery
Superficial branch of Radial Nerve on top
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What type of pulse can we feel in our Anatomical Snuffbox?
Pulse from the Radial Artery
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A patient presents with tenderness to palpation at the Anatomic Snuffbox. X-rays show a fracture. What bone is likely fractured?
Scaphoid
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In relation to the Flexor Retinaculum, where does the distal tendon of Palmaris Longus travel?
The distal tendon of Palmaris Longus will run superficial to the Flexor Retinaculum.
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What travels under Flexor Retinaculum?
9 tendons and the Medial Nerve
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Where is the Ulnar Tunnel/Guyon's Canal located?
Between Pisiform and hook of the Hamate bone.
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What are the contents of the Ulnar Tunnel/Guyon's Canal?
Ulnar nerve and artery
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What innervates all interossei and medial lumbricals?
Ulnar nerve
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What is the Palmar Aponeurosis?
Triangular-shaped sheet of fascia in the palm of the hand that protects underlying structures.
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What is the Palmar Aponeurosis continuous with?
Continuous with the tendon of Palmaris Longus and Flexor Retinaculum.
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T/F: If Palmaris Longus is absent, the Palmar Aponeurosis will also be absent.
False! The Palmar Aponeurosis will always be present even if Palmaris Longus is absent.
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Where do the fibers of the Palmar Aponeurosis travel distally?
The fibers radiate to extensions of the base of the digits, then become continuous with the fibrous digital sheaths.
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How many compartments does the fascia of the palm have?
5 compartments of the hand
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What muscles are found within the Thenar compartment of the hand?
Abductor pollicis brevis
Flexor pollicis brevis
Opponens pollicis
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What muscles are found within the Hypothenar compartment of the hand?
Abductor digiti minimi
Flexor digiti minimi
Opponens digiti minimi
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What muscle is found within the Adductor compartment of the hand?
Adductor pollicis
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What muscles are found within the Central compartment of the hand?
Lumbricals (4)
Flexor tendons
Superficial palmar arch
Digital vessels and nerves
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What muscles are found within the Interosseous compartment of the hand?
Palmar interossei (3)
Dorsal interossei
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What innervates the thenar compartment of the hand?
Recurrent branch of median nerve
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What innervates the hypothenar compartment of the hand?
Deep branch of ulnar nerve
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What innervates the adductor compartment of the hand?
Deep branch of ulnar nerve
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What innervates the central compartment of the hand?
Lumbricals 1 and 2: Median nerve
Lumbricals 3 and 4: Deep branch of ulnar nerve
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What innervates the interosseous compartment of the hand?
Deep branch of ulnar nerve
