Gross Anatomy > Upper Extremity: Forearm > Flashcards

Upper Extremity: Forearm Flashcards

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1
Q

Forearm

A
  • Elbow to wrist
  • Radius and ulna
  • Connected by interosseous membrane
  • Divided into compartments by deep fascia and interossesous membrane
  • Muscles primarily are involved in wrist and finger movement (also elbow)
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2
Q

Interosseous Membrane of Forearm

A
  • Syndesmosis: fibrous joint that permits some movement
  • Separates compartments
  • Muscle attachment
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3
Q

Syndesmosis

A
  • Fibrous joint that permits some movement
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4
Q

Proximal Joints of Forearm (Elbow Joint)

A
  • Humeroradial
  • Humeroulnar
  • Proximal radioulnar
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5
Q

Distal Joints of Forearm

A
  • Distal radioulnar

- Radiocarpal

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6
Q

Anterior Forearm Functions

A
  • Flexors and pronators
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7
Q

Anterior Forearm Innervation

A
  • Median nerve

- 1 ½ by ulnar

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8
Q

Anterior Forearm Muscle Origination

A
  • Medial epicondyle

- Anterior surface of radius, ulna, interosseous membrane

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9
Q

Posterior Forearm Functions

A
  • Extensors and supinators
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10
Q

Posterior Forearm Innervation

A
  • Radial nerve or one of its branches
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11
Q

Posterior Forearm Muscle Origination

A
  • Lateral epicondyle
  • Supracondylar ridge
  • Posterior surface of radius, ulna, interosseous membrane
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12
Q

Anterior Compartment Muscles

A
  • 8 muscles
  • Some have multiple “heads”
  • 3 layers
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13
Q

Superficial (1st) Layer Muscles of Anterior Compartment

A
  • Pronator teres
  • Flexor carpi radialis
  • Palmaris longus
  • Flexor carpi ulnaris
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14
Q

Intermediate (2nd) Layer Muscle of Anterior Compartment

A
  • Flexor digitorum superficialis
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15
Q

Deep (3rd) Layer Muscles of Anterior Compartment

A
  • Flexor digitorum profundus
  • Flexor pollicis longus
  • Pronator quadratus
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16
Q

Superficial Layer Muscles Proximal Attachment

A
  • All have proximal attachment to medial epicondyle via common flexor tendon
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17
Q

Flexor Carpi Ulnaris and Pronator Teres

A
  • Both have 2 heads
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18
Q

Superficial Layer Muscle Innervation

A
  • All innervated by median nerve

- EXCEPT FCU (innervated by ulnar nerve)

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19
Q

Flexor Carpi Radialis Distal Attachment

A
  • Base of 2nd metacarpal
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20
Q

Flexor Carpi Radialis Function

A
  • Wrist (hand) flexion and abduction
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21
Q

Palmaris Longus Distal Attachment

A
  • Flexor retinaculum and palmar aponeurosis
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22
Q

Palmaris Longus Function

A
  • Tenses palmar aponeurosis (wrist flexion?)
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23
Q

Flexor Carpi Ulnaris Proximal Attachment

A
  • Humeral head: medial epicondyle (via common flexor tendon)

- Ulnar head: olecranon and posterior ulnar border

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24
Q

Flexor Carpi Ulnaris Distal Attachment

A
  • Pisiform
  • Hook of hamate
  • 5th metacarpal
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25
Flexor Carpi Ulnaris Function
- Wrist flexion and adduction
26
Pronator Teres Proximal Attachment
- Ulnar head: coronoid process | - Humeral head: medial epicondyle (via common flexor tendon) and medial supracondylar ridge
27
Pronator Teres Distal Attachment
- Lateral radius
28
Pronator Teres Function
- Pronation
29
Median Nerve Passes
- Deep to bicipital aponeurosis (lacertus fibrosus) - Between the 2 heads of pronator teres - Both are potential sites of entrapment
30
Flexor Digitorum Superficialis Proximal Attachment
- Humero-ulnar head: medial epicondyle (common flexor tendon) and coronoid process - Radial head: anterior surface of proximal radius
31
Flexor Digitorum Superficialis Distal Attachment
- Base of middle phalanges of digits 2-5
32
Flexor Digitorum Superficialis Innervation
- Median nerve
33
Flexor Digitorum Superficialis Function
- Flexes proximal interphalangeal joint and MCP joint
34
Median Nerve and Ulnar Artery Pass
- Deep to flexor digitorum superficialis (FDS)
35
Flexor Digitorum Profundus Proximal Attachment
- Proximal ulna/interosseous membrane
36
Flexor Digitorum Profundus Distal Attachment
- Bases of distal phalanges 2-5
37
Flexor Digitorum Profundus Innervation
- Ulnar nerve: medial half (digits 4,5) | - Anterior interosseous nerve (median), lateral half (digits 2,3)
38
Flexor Digitorum Profundus Function
- Flexes distal interphalangeal joints of 2-5
39
Flexor Pollicis Longus Proximal Attachment
- Anterior radius | - Interosseous membrane
40
Flexor Pollicis Longus Distal Attachment
- Base of distal phalanx of thumb
41
Flexor Pollicis Longus Innervation
- Anterior interosseous nerve
42
Flexor Pollicis Longus Function
- Flexes interphalangeal joint of thumb
43
Pronator Quadratus Proximal Attachment
- Distal anterior ulna
44
Pronator Quadratus Distal Attachment
- Distal anterior radius
45
Pronator Quadratus Innervation
- Anterior interosseous nerve
46
Pronator Quadratus Function
- Pronation
47
8 Tendons of FDS and FDP Pass Through Carpal Tunnerl
- Deep to flexor retinaculum (transverse carpal ligament) | - Surrounded by a synovial sheath as they pass through the wrist (ulnar bursa)
48
Tendon of FPL Passes Through Carpal Tunnel
- Has its own synovial sheath (radial bursa)
49
Posterior Compartment Muscles of the Forearm
- 11 muscles - 2 layers - Innervated by radial nerve or a branch of radial nerve
50
Superficial Posterior Compartment Muscles of Forearm
- Brachioradialis - Extensor carpi radialis longus - Extensor carpi radialis brevis - Extensor digitorum - Extensor digiti minimi - Extensor carpi ulnaris
51
Deep Posterior Compartment Muscles of Forearm
- Supinator - Extensor indicis - Abductor pollicis longus - Extensor pollicis brevis - Extensor pollicis longus
52
Brachioradialis Proximal Attachment
- Supracondylar ridge
53
Brachioradialis Distal Attachment
- Distal lateral radius
54
Brachioradialis Innervation
- Radial nerve
55
Brachioradialis Function
- Elbow (forearm) flexion
56
Extensor Carpi Radialis Longus Proximal Attachment
- Supracondylar ridge
57
Extensor Carpi Radialis Longus Distal Attachment
- Dorsal aspect of 2nd metacarpal base
58
Extensor Carpi Radialis Longus Innervation
- Radial nerve
59
Extensor Carpi Radialis Longus Function
- Extension and abduction of wrist
60
Extensor Carpi Radialis Brevis Proximal Attachment
- Lateral epicondyle (via common extensor tendon)
61
Extensor Carpi Radialis Brevis Distal Attachment
- Dorsal aspect of 2nd & 3rd metacarpal base
62
Extensor Carpi Radialis Brevis Innervation
- Deep branch of radial nerve
63
Extensor Carpi Radialis Brevis Function
- Extension, abduction of wrist
64
Extensor Carpi Ulnaris Proximal Attachment
- Lateral epicondyle (common extensor tendon) | - Posterior ulna
65
Extensor Carpi Ulnaris Distal Attachment
- Dorsal aspect of 5th met base
66
Extensor Carpi Ulnaris Innervation
- Posterior interosseous nerve
67
Extensor Carpi Ulnaris Function
- Extension, adduction of wrist
68
Extensor Digitorum Proximal Attachment
- Lateral epicondyle (common extensor tendon)
69
Extensor Digitorum Distal Attachment
- Middle & distal phalanges digits 2-5 via the extensor expansion
70
Extensor Digitorum Innervation
- Posterior interosseous nerve
71
Extensor Digitorum Function
- Extends digits
72
Extensor Digiti Minimi Proximal Attachment
- Lateral epicondyle (via common extensor tendon)
73
Extensor Digiti Minimi Distal Attachment
- Middle and distal phalanges of 5th digit via the extensor expansion
74
Extensor Digiti Minimi Innervation
- Posterior interosseous nerve
75
Extensor Digiti Minimi Function
- Extends 5th digit
76
Aconeus Proximal Attachment
- Lateral epicondyle of humerus
77
Aconeus Distal Attachment
- Olecranon | - Posterior ulna
78
Aconeus Innervation
- Radial nerve
79
Aconeus Function
- Elbow extension and stabilization
80
Supinator Proximal Attachment
- Lateral epicondyle | - Supinator crest
81
Supinator Distal Attachment
- Proximal 1/3 of radius
82
Supinator Innervation
- Posterior interosseous nerve | - ierced by deep branch of radial nerve
83
Supinator Function
- Supination
84
Abductor Pollicis Longus Proximal Attachment
- Posterior proximal ulna & radius | - Interosseous membrane
85
Abductor Pollicis Longus Distal Attachment
- Base of 1st metacarpal
86
Abductor Pollicis Longus Innervation
- Posterior interosseous nerve (radial)
87
Abductor Pollicis Longus Function
- Thumb (1st digit) abduction and extension at carpometacarpal jt. (CMC)
88
Extensor Pollicis Brevis Proximal Attachment
- Posterior, distal radius | - Interosseous membrane
89
Extensor Pollicis Brevis Distal Attachment
- Dorsal, base of thumb proximal phalanx
90
Extensor Pollicis Brevis Innervation
- Posterior interosseous nerve (radial)
91
Extensor Pollicis Brevis Function
- Extends thumb at MCP | - Extends CMC joints
92
Extensor Pollicis Longus Proximal Attachment
- Posterior ulna | - Interosseous membrane
93
Extensor Pollicis Longus Distal Attachment
- Dorsal, base of thumb distal phalanx
94
Extensor Pollicis Longus Function
- Extend thumb IP joint | - Extend MCP and CMC joints
95
Extensor Pollicis Longus Innervation
- Posterior interosseous nerve (radial)
96
Extensor Indicis Proximal Attachment
- Posterior, distal ulna | - Interosseous membrane
97
Extensor Indicis Distal Attachment
- Extensor expansion of 2nd digit
98
Extensor Indicis Function
- Extension of 2nd digit (independently)
99
Extensor Indicis Innervation
- Posterior interosseous nerve (radial)
100
Extensor Retinaculum
- Anchors extensor tendons on dorsum of wrist - Extensor tendons pass through synovial sheaths , deep to extensor retinaculum - 6 osseofibrous tunnels lined with synovium
101
Extensor Retinaculum Compartments (Medial to Lateral)
1: APL & EPB 2: ECRB & ECRL 3: EPL 4: ED & EI 5: EDM 6: ECU
102
Extensor Expansion (extensor hood, dorsal digital expansion)
- Expansion of extensor digitorum and EPL tendons over dorsum of digits - Triangular shaped structure that gives rise to a median and 2 lateral bands - Located over proximal phalanx, from MCP joint to PIP joint - Tendons of EDM, EI, EPB join the hoods - Intrinsic hand muscles insert into the exapansion (later) - Important in precision function and deformities
103
Anatomical Snuff Box Boundaries (Remember Anatomical Position)
- Medial: extensor pollicis longus tendon - Lateral: abductor pollicis longus and extensor pollicis brevis tendons - Proximal: radial styloid process - Floor: scaphoid and trapezium
104
Anatomical Snuff Box Content
- Radial artery - Superficial branch of radial nerve - Scaphoid can be palpated in the snuff box
105
Lateral Epicondylitis (Tennis Elbow)
- Tendon degeneration - Pain, tenderness at origin of common extensor tendon - Overuse, repetitive motions
106
DeQuervain’s Tenovaginitis (Tenosynovitis)
- Thickening of the synovial sheath and tendons of the APL and EPB (1st dorsal compartment) - Repetitive strain injury (thumb extension, abduction) - Degenerative process, not inflammation
107
Median Nerve Pathway
- Passes between heads of pronator teres - Travels deep to FDS - Passes through carpal tunnel into hand
108
Median Nerve (Motor)
- Every muscle in the anterior forearm, except those innervated by ulnar - Anterior interosseous nerve (FDP to digits 2 and 3, FPL, pronator quadratus)
109
Median Nerve (Sensory)
- Palmar cutaneous innervates the palm | - Other cutaneous branches innervate the digits (later)
110
Ulnar Nerve Pathway
- Enters forearm by passing between 2 heads of FCU - Passes posterior to medial epicondyle - Enters hand by passing through ulnar canal (between pisiform and hook of hamate)
111
Ulnar Nerve (Motor)
- FCU | - FDP to digits 4,5
112
Ulnar Nerve (Sensory)
- Palmar and dorsal cutaneous branches | - Digital branches
113
Cubital Tunnel Syndrome
- Compression of ulnar nerve in cubital tunnel
114
Cubital Tunnel Boundaries
- Lateral: olecranon - Medial: medial epicondyle - Roof: tendinous arch connecting the 2 heads of flexor carpi ulnaris - Floor: joint capsule and ulnar collateral ligament
115
Cubital Tunnel Syndrome Symptoms
- Paresthesia ulnar nerve distribution - Weakness and atrophy of ulnar innervated muscles - "Ulnar claw” deformity
116
Radial Nerve
- Divides into the superficial and deep branches of radial nerve
117
Radial Nerve Superficial Branch
- Deep to brachioradialis - Passes through anatomical snuff box - Sensory to lateral dorsum of hand
118
Radial Nerve Deep Branch
- Pierces supinator muscle - Becomes posterior interosseous nerve - Motor to all muscles of the posterior compartment of forearm
119
Cutaneous Nerve Supply to Forearm
- Medial cutaneous nerve of the forearm - Lateral cutaneous nerve of the forearm - Posterior cutaneous nerve of the forearm (radial)
120
Arteries of Forearm
- Radial and ulnar arteries (terminal branches of brachial) | - Arise in cubital fossa, near neck of the radius
121
Radial Artery Pathway
- Smaller than ulnar - Deep to brachioradialis muscle - Alongside superficial branch of radial - Palpable pulse lateral to FCR - Wraps around lateral wrist, passes through floor of anatomical snuff box
122
Ulnar Artery Pathway
- Travels deep to PT and FDS - Travels down medial side of forearm, lateral to ulnar nerve - Palpable pulse lateral to FCU - Passes through ulnar canal (NOT CARPAL TUNNEL)
123
Radial Artery Branches
1. Radial recurrent artery 2. Palmar and dorsal carpal branches 3. Muscular branches 4. Superficial palmar branch 5. Contributes to deep palmar arch
124
Radial Recurrent Artery
- Anastomoses with radial collateral
125
Superficial Palmar Branch (of Radial Artery)
- Helps form superficial palmar arch
126
Ulnar Artery Branches
1. Anterior and posterior ulnar recurrent arteries 2. Common interosseous artery 3. Muscular branches 4. Palmar and dorsal carpal branches
127
Anterior and Posterior Ulnar Recurrent Arteries
- Anastomoses with ulnar collateral arteries
128
Common Interosseous Artery (of Ulnar Artery)
- Anterior interosseous artery - Posterior interosseous artery - Recurrent interosseous: anastomoses
Gross Anatomy
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