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64 Cards in this Set

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  • Back
  • 3rd side (hint)
axilla pyramid:
1.anterior wall
2.posterior wall
3. medial wall
4. apex
folds:
1.anterior fold
2.posterior fold
folds meet ?
1.pec major
2.latissimus dorsi
3.serratus anterior
4.head of humerus
folds
1.pec major
2.latissimus dorsi and teres Major
3.folds meet at intertubercular groove of humerus
contents of axilla (5)
1.axillary artery-extension of subclavian...begins as it cross first rib
2.axillary vein-DRAINS INTO SUBCLAVIAN VEIN AT DELTOPECTORAL TRIANGLE
-CEPHALIC VEIN DRAINS INTO AXILLARY VEIN
3.axillary lymph nodes
4.fat
5.brachial plexus
scapula
-angles: SITS
-glenoid
-spine-
-attachment point
-fossae
-articulation with?
-spine: acromion
-attchmnt point:
coracoid process
-fossae-tissue makes into a foramen and suprascap artery goes on top of it.
-articulates with humerus and clavicle
army goes over bridge, navy goes under bridge
rotator cuff (angles of scapula)
Supraspinous
Infraspinous
Teres Minor
Subscapular
SITS
clavicle
-sternal extremity
-acromial extremity
-complex joint
-synovial joint, but doesn't move much
sternoclavicular joint
-type of joint
-ligaments:
(4) including an anterior and posterior
-complex joint that joins the clavicle and the sternum
-sternoclavicular
-sternoclavicular
-interclavicular (~middle on top of manubrium)
-costoclavicular (1st rib to clavicle)
SSIC
acromioclavicular
-type of joint
-ligaments
-plane type of synovial joint
-acromioclavicular
-coracoclavicular
--->trapezoid ligament
--->conoid ligament
-coracoacromial ligament
ac
cc-tl, cl
ca
glenohumeral joint
-type
-ligaments
-stability provided by ?
-bursae is ?
--subscapular is where?
--subacromial/subdeltoid
-ball and socket
-->glenoid labrum (on lip of socket..adds width and depth)

-glenohumeral-(separate but blend into one sheet – they hold the joint together)
-superior, middle, inferior
-transverse humeral- (2 parts of same bone –covers intertebucliar grove – helps hold contents in grove)
-coracohumeral
-coracoacromial
-provided by rotator cuff muscles (hold humerus into joint)
-synovial sac ( connective tissue membrane filled with synovial fluid made by the membrane itself. Found where tendons are moving over bones. Function is to facilitate motion & remove friction.)
-->between scapula and rib cage
-->cushions deltoid muscle; also cushions supraspinatus and prevents muscles from being damaged by rubbing against bone as it glides over.
gh
th (get the coca cola)
ch
ca
superficial muscles:
-Trapezius
-Latissimis Dorsi
-Teres Major
-Sternocleidomastoid
-Pec Major
-Deltoid
Teres Major
Teres Major is NOT part of SITS (rotator cuff).

TERES MAJOR (Teres means muscle is round) Helps make the fold of the pyramid.
ORIGIN: INFERIOR ANGLE OF THE SCAPULA
INSERTION: INTERTUBERCULAR GROOVE OF THE HUMERUS
ACTIONS: ADDUCTS AND MEDIALLY ROTATES ARM (arm = shoulder to elbow only)
INNERVATION: LOWER SUBSCAPULAR NERVE
AD
Med R.
STERNOCLEIDOMASTOID (STERNOMASTOID)
Really a muscle of the neck.
ORIGIN: BY TWO HEADS FROM STERNUM AND CLAVICLE
INSERTION: MASTOID PROCESS OF TEMPORAL BONE
ACTION: ELEVATES AND ROTATES HEAD
INNERVATED BY CN XI (along with trapezius.)
PECTORALIS MAJOR
ORIGIN:
CLAVICULAR HEAD: MEDIAL HALF OF THE CLAVICLE
STERNOCOSTAL HEAD: STERNUM, SUPERIOR 6 COSTAL CARTILAGES, EXTERNAL OBLIQUE APONEUROSIS
INSERTION: Lateral lip of INTERTUBERCULAR GROOVE OF THE HUMERUS
ACTION: ADDUCTS AND MEDIALLY ROTATES HUMERUS, AIDS IN FLEXING THE SHOULDER JOINT
INNERVATION: BOTH MEDIAL AND LATERAL PECTORAL NERVES
DELTOID
(can act as it’s own antagonist)
ORIGIN: LATERAL THIRD OF CLAVICLE, ACROMION, AND SPINE OF THE SCAPULA (Trap origin is on other side.)
INSERTION: DELTOID TUBEROSITY OF HUMERUS
ACTIONS: FLEXES AND MEDIALLY ROTATES ARM (ANTERIOR PART); ABDUCTS ARM (from about 30 degrees out and on – not from anatomical position) (MIDDLE PART); AND EXTENDS AND LATERALLY ROTATES ARM (POSTERIOR PART)
INNERVATION: AXILLARY NERVE
Deep muscles that move scapula and therefore are upper extremity muscles
Rhomboid major
Rhomboid minor
Levator Scapulae
Serratus Anterior
SERRATUS ANTERIOR
ORIGIN: RIBS 1-8
INSERTION: MEDIAL (VERTEBRAL) BORDER OF THE SCAPULA
ACTION: PROTRACTS (ABDUCTS) SCAPULA (major function), HOLDS SCAPULA AGAINST THORACIC WALL, ROTATES SCAPULA.
INNERVATION: LONG THORACIC NERVE (VIA BRACHIAL PLEXUS) Damaged nerve can usually be seen because medial border of scapula is separated away from body.
Pec minor
ORIGIN: RIBS 3-5
INSERTION: CORACOID PROCESS OF THE SCAPULA
ACTION: DEPRESSES SCAPULA, ROTATES IT INFERIORLY, [weakly] PULLS SCAPULA ANTERIORLY which aids in protraction
INNERVATION: MEDIAL PECTORAL NERVE (goes through pectoralis minor into major)
Subclavius
ORIGIN: 1ST RIB
INSERTION: INFERIOR SURFACE OF MIDDLE THIRD OF THE CLAVICLE
ACTION: DRAWS CLAVICLE MEDIALLY kind of like a shock absorber
INNERVATION: NERVE TO SUBCLAVIUS
supraspinatus
ORIGIN: SUPRASPINOUS FOSSA OF SCAPULA
INSERTION: GREATER TUBERCLE OF THE HUMERUS
ACTION: ABDUCTION OF HUMERUS (gets first 30 degrees of lift), COMMON ACTION OF ROTATOR CUFF MUSCLES
INNERVATION: SUPRASCAPULAR NERVE
infraspinatus
ORIGIN: INFRASPINOUS FOSSA OF SCAPULA
INSERTION: GREATER TUBERCLE OF HUMERUS
ACTION: LATERALLY ROTATE HUMERUS, COMMON ACTION OF ROTATOR CUFF MUSCLES
INNERVATION: SUPRASCAPULAR NERVE
teres minor
ORIGIN: LATERAL BORDER OF THE SCAPULA
INSERTION: GREATER TUBERCLE OF THE HUMERUS
ACTION: LATERALLY ROTATE HUMERUS, COMMON ACTION OF ROTATOR CUFF MUSCLES
INNERVATION: AXILLARY NERVE
subscapularis
ORIGIN: SUBSCAPULAR FOSSA
INSERTION: LESSER TUBERCLE OF THE HUMERUS
ACTION: MEDIAL ROTATE AND ADDUCTS ARM, COMMON ACTION OF ROTATOR CUFF MUSCLES
INNERVATION: UPPER AND LOWER SUBSCAPULAR NERVES

Common [static] action = stabilize glenoid joint.
scapula review
-glenoid
--supraglenoid tubercle
(biceps brachii)
--infraglenoid tubercle
(triceps brachii)
-clavicle
-conoid tubercle (subclavius)
Small bumps and origins for muscles.

SCAPULA
BORDERS (SUPERIOR, MEDIAL (VERTEBRAL), LATERAL)
ANGLES (SUPERIOR, INFERIOR, LATERAL)
PROCESSES
SPINE (deltoid, trapezius)
ACROMION (ACROMIAL PROCESS) (deltoid, trapezius)
CORACOID PROCESS (biceps brachii short head, coracobrachialia, pec minor)
FOSSAE
SUPRASPINOUS (supraspinous)
INFRASPINOUS (infraspinous)
SUBSCAPULAR (subscapularis)
GLENOID
SUPRAGLENOID TUBERCLE (bicepts brachii long head)
INFRAGLENOID TUBERCLE (triceps brachii long head)

CLAVICLE
STERNAL EXTREMITY
ACROMIAL EXTREMITY
CONOID TUBERCLE (subclavious)
Humerus
-head
-anat. neck
-surgical neck
-greater tubercle
-less tubercle
-intertubercular groove
-deltoid tubercle
-radial groove
HEAD
ANATOMICAL NECK
SURGICAL NECK (where most breaks that require open reduction tend to occur)
GREATER TUBERCLE (more lateral) (supraspinatus, infraspinatus, teres min.)
LESSER TUBERCLE (more medial) (subscapularis)
INTERTUBERCULAR GROOVE (a.k.a. bicipital grove) (latiss. dorsi, pectoralis major, teres major)
DELTOID TUBEROSITY (deltoid)
RADIAL GROOVE/SULCUS (hard to see on plastic bones; can run finger along it and it will spiral around the bone)
humerus cont'd
-trochlea
-capitulum
-olecranon fossa
-lateral epicondyle
-medial epicondyle
-supracondylear ridges
TROCHLEA (Latin for pullie - groved surface)
CAPITULUM (means little head – articulation of radius)
Olecranon fossa for olecranon process of ulna.
LATERAL EPICONDYLE (supinator, anconeus, extensor carpi ulnaris, extensor digiti minimi, extensor digitorum, extensor carpi radialis brevis)
MEDIAL EPICONDYLE (flexor carpi radialis, flexor carpi ulnaris* – humeral head, flexor digitorum superficialis – humeroulnar head, palmaris longus, pronator teres – humeral head)
SUPRACONDYLEAR RIDGES
MEDIAL
LATERAL (extensor carpi radialis longus, brachioradialis)

* Innervated by ulnar nerve (rather than medial nerve)
Ulna
-head
-styloid process
-olecranon process
-coranoid process
-trochlear notch
-radial notch
-tuberosity
Head of ulna is distal (only bone like this); head of radius is proximal.
Note coranoid process is not same as coracoid.

HEAD (DISTAL)
STYLOID PROCESS (Latin for needle is stylis)
OLECRANON PROCESS
CORANOID PROCESS (flexor digitorum superficialis – humeroulnar head, pronator teres – ulnar head, brachialis)
TROCHLEAR NOTCH (mirror image of trochlear – tight integration)
RADIAL NOTCH
[ULNAR] TUBEROSITY (brachialis)
radius
-head
-neck
-tuberosity
-styloid process
-ulnar notch
tuberosity-biceps brachii
wrist and hand
-carpals
-metacarpals
-phalanges
CARPALS (8)
METACARPALS (5)
PHALANGES (2+3+3+3+3) Distal, middle, and proximal. Note middle not medial; thumb is #1.
glenohumeral
-type of joint
-glenoid labrum-
-3 glenohumeral
-coracohumeral
-transverse humeral-
-multiaxial synovial jt
-ring-like structure that deepens the glenoid cavity
-bridges over intertubercular groove
cubital (elbow) joint
-type
-humeroulner
-humeroradial
-prox. radioulnar joint
Ligaments
-ulnar (med)collateral-
-radial (lat)collateral-
-annular-
-compound synovial joint
-ulnar m.c.-running same direction
-radial l.c.-radial "cuital"
-annular-"ring" ulna around radius back to ulna
radius and ulna
-proximal
-distal
-middle
---interosseous membrane
-UNIAXIAL, ROTATION
CAPSULE IS PART OF CUBITAL JOINT CAPSULE
ANNULAR LIGAMENT
OBLIQUE CORD (CHECK LIGAMENT)
-UNIAXIAL, SYNOVIAL JOINT, PIVOT
-SYNDESMOSIS
INTEROSSEOUS MEMBRANE- serves as muscle attachment, serves to transfer impact from hand and from the radius to the ulna.

-stress directed from radius to ulna is more sturdy
Compartments:
-Anterior-? type of muscles?
-Posterior-? type of muscles?
GENERAL RULE:
ANTERIOR COMPARTMENT: FLEXORS (May have other duties and there might be exceptions but all perform flexion)
POSTERIOR COMPARTMENT: EXTENSORS

Nerve and vascular is by compartment too. Compartments divided by tissue evolving from the bone.
anterior compartment:
which muscles belong?
-biceps brachii
-brachialis
-coraco-brachialis
-musculocutaneous nerve
bbc flexors
Biceps brachii – whole length of arm (shoulder to forearm (radius))
Coracobrachialis – upper half of arm (shoulder to mid humerus)
Brachialis – lower half of arm (mid humerus to forearm (ulnar))
biceps brachii
ORIGIN
SHORT HEAD: CORACOID PROCESS OF SCAPULA
LONG HEAD: SUPRAGLENOID TUBERCLE (on the scapula)
INSERTION: RADIAL TUBEROSITY AND FASCIA OF FOREARM BY BICIPITAL APONEUROSIS- bicipital aponeurosis merges into the fascia of the forearm
ACTION: SUPINATES FOREARM (1st) AND [then] FLEXES AT ELBOW WHEN FOREARM IS SUPINE, ASSISTS WITH FLEXION OF THE SHOULDER
INNERVATION (compartment wide): MUSCULOCUTANEOUS NERVE

Damage to nerve means loss of flexion of elbow.
brachialis (deep to biceps)
ORIGIN: DISTAL HALF OF THE ANTERIOR SURFACE OF THE HUMERUS
INSERTION: CORONOID PROCESS AND ULNAR TUBEROSITY
ACTION: FLEXES FOREARM ON ARM (elbow joint)
coracobrachialis
ORIGIN: CORACOID PROCESS OF SCAPULA
INSERTION: MIDDLE, MEDIAL SURFACE OF HUMERUS
ACTION: FLEXION OF SHOULDER AND ADDUCTION OF THE ARM
triceps brachii
ORIGIN:
LONG HEAD: INFRAGLENOID TUBERCLE OF SCAPULA
LATERAL HEAD: POSTERIOR SURFACE OF HUMERUS
MEDIAL HEAD: POSTERIOR SURFACE OF HUMERUS
INSERTION: OLECRANON PROCESS OF ULNA AND FASCIA OF FOREARM
ACTION: EXTENDS THE FOREARM, ASSISTS WITH EXTENSION OF THE SHOULDER AND ADDUCTION OF THE SHOULDER.
INNERVATION: RADIAL NERVE
FLEXOR CARPI RADIALIS (flexor of wrist inserting on radius side)
ORIGIN: MEDIAL EPICONDYLE OF HUMERUS & SUPRACONDYLE RIDGE
INSERTION: BASE OF SECOND METACARPAL (thumb side / radius side)
ACTION: FLEXES AND ABDUCTS HAND
INNERVATION: MEDIAL NERVE
flexor carpi ulnaris
ORIGIN:
HUMERAL HEAD: MEDIAL EPICONDYLE OF HUMERUS
ULNAR HEAD: OLECRANON AND POSTERIOR BORDER OF ULNA
INSERTION: PISIFORM, HOOK OF HAMATE, AND FIFTH METACARPAL BONES
ACTION: FLEXES AND ADDUCTS HAND
INNERVATION: ULNAR NERVE (exception for compartment)
flexor digitorum superficialis
ORIGIN:
HUMEROULNAR HEAD: MEDIAL EPICONDYLE OF HUMERUS, ULNAR COLLATERAL LIGAMENT, CORONOID PROCESS OF ULNA
RADIAL HEAD: SUPERIOR HALF OF THE ANTERIOR BORDER OF THE RADIUS
INSERTION: BODIES OF THE MIDDLE PHALANGES OF DIGITS 2-5.
ACTION: FLEXES MIDDLE PHALANGES, PROXIMAL PHALANGE, AND HAND
INNERVATION: MEDIAL NERVE
palmaris longus
ORIGIN: MEDIAL EPICONDYLE OF THE HUMERUS
INSERTION: DISTAL HALF OF THE FLEXOR RETINACULUM AND THE PALMAR APONEUROSIS
ACTION: FLEXES HAND AND TIGHTENS THE PALMAR APONEUROSIS
INNERVATION: MEDIAL NERVE
pronator teres
ORIGIN: MEDIAL EPICONDYLE OF HUMERUS AND CORONOID PROCESS OF ULNA
INSERTION: MIDDLE OF LATERAL SURFACE OF RADIUS
ACTION: PRONATES FOREARM AND FLEXES AT ELBOW
INNERVATION: MEDIAL NERVE
(round – crosses elbow joint so it’s also a flexor)
flexor digitorum profundus
ORIGIN: MEDIAL AND ANTERIOR SURFACES OF ULNA AND THE INTEROSSEOUS MEMBRANE (muscle attachment without weight of bone)
INSERTION: BASES OF DISTAL PHALANGES OF DIGITS 2-5
ACTION: FLEXES DISTAL PHALANGES OF DIGITS 2-5
INNERVATION: ½ by MEDIAL NERVE & ½ by ULNAR NERVE
flexor pollicis longus
ORIGIN: ANTERIOR SURFACE OF RADIUS AND ADJACENT INTEROSSEOUS MEMBRANE
INSERTION: BASE OF DISTAL PHALANX OF THE 1ST DIGIT (THUMB)
ACTION: FLEXES PHALANGES OF THE FIRST DIGIT (THUMB)
INNERVATION: MEDIAL NERVE
pronator quadratus
ORIGIN: DISTAL FOURTH OF THE ANTERIOR SURFACE OF THE ULNA
INSERTION: DISTAL FOURTH OF THE ANTERIOR SURFACE OF THE RADIUS
ACTION: PRONATES FOREARM AND HOLDS DISTAL ENDS OF RADIUS AND ULNA TOGETHER.
 EXCEPTION TO COMPARTMENT RULE – doesn’t flex anything.
INNERVATION: MEDIAL NERVE
anterior compartment innervation
MEDIAN NERVE EXCEPT FOR 1-½ MUSCLES.
EXCEPTIONS:
FLEXSOR CARPI ULNARIS (1)
MEDIAL HALF OF FLEXOR DIGITORUM PROFUNDUS (½)
EXCEPTIONS: ULNAR NERVE
flexor retinaculum
a strong band of fibrous tissue running 90 degrees across tendons. Function is to prevent bowstringing of tendons. To prevent tendons from fraying they are wrapped in a synovial sheet (a.k.a. a bursa that surrounds something).

STRONG FIBROUS BAND PASSING ACROSS THE WRIST, CONVERTING THE CARPAL CONCAVITY INTO A CARPAL TUNNEL (makes a roof)
 TENDONS, NERVES, AND VESSELS PASS THROUGH THE CARPAL TUNNEL

MEDIAL ATTACHMENT:
PISIFORM BONE
HOOK OF HAMATE

LATERAL ATTACHMENT:
SUPERFICIAL LAMINA: ATTACHED TO THE TUBERCLES OF THE SCAPHOID AND TRAPEZIUM
DEEP LAMINA: MEDIAL LIP OF GROOVE ON TRAPEZIUM

ULNAR VESSELS AND NERVE AND PALMAR CUTANEOUS BRANCHES OF MEDIAN AND ULNAR NERVES PASS SUPERFICIAL TO THE RETINACULUM
superficial retaniculum
SUPERFICIAL PART OF THE FLEXOR RETINACULUM
DIFFERENT FROM SUPERFICIAL LAMINA DESCRIBED IN PREVIOUS SLIDE
THICKENING OF ANTEBRACHIAL FASCIA THAT EXTENDS LATERALLY FROM THE PISIFORM BONE
CROSSES SUPERFICIAL TO THE ULNAR VESSELS AND NERVE AND BLENDS WITH THE FLEXOR RETINACULUM LATERAL TO THEM

SYNOVIAL TENDON SHEATHS
STRUCTURE:
FUNCTION:

ATTACHMENTS TO THE RETINACULUM
TENDONS OF PALMARIS LONGUS
TENDON OF FLEXOR CARPI ULNARIS
SOME MUSCLES OF THE THENAR AND HYPOTHENAR EMINENCIES
posterior compartment superficial muscles (all radial nerve innervation?)
Aconeus
Brachioradialis
Extensor Carpi Radialis Longus
Extensor Carpi Radialis Brevis
Extensor Digitorum
Extensor Digiti Minimi
Extensor Carpi Ulnaris
all extensors but brachioradialis
-one is a triceps helper-extends elbow joint
post compartment
deep muscles
Abductor Pollicis Longus
Extensor Pollicis Brevis
Extensor Indicus
Supinator
brachioradialis
Origin
Lateral supracondylar ridge of humerus
Insertion
Distal end of radius on lateral surface
Action
Flexes forearm when hand is partially prone
Innervation
Radial Nerve
carpal tunnel
Things are rubbing against one another and that causes inflammation. (Common once electric typewrites came out but not seen in manual typewriters because to use a manual typewriter you have to flex the wrist.) Inflammation causes adhesions which cause more inflammation.
extensor carpi radialis longus
Origin
Lateral supracondylar ridge of humerus
Insertion
Base of 2nd metacarpal
Action
Extend and abduct hand at wrist joint
Innervation
Radial Nerve
extensor carpi radialis brevis
Origin
Lateral epicondyle of the humerus
Insertion
Base of 3rd metacarpal bone
Action
Extend and abduct hand at wrist joint
Innervation
Radial Nerve
extensor digitorum
Origin
Lateral epicondyle of humerus
Insertion
Extensor expansions (hoods) of digits 2-5
Action
Extends digits 2-5 @ metacarpophalangeal jt
Extends hand at the wrist joint
Innervation
Radial Nerve
extensor digiti minimi
Origin
Lateral epicondyle
Insertion
Extensor expansion (hood) of 5th digit
Action
Extend 5th digit at the metacarpophalengeal and interphalangeal joints
Innervation
Radial Nerve
extensor carpi ulnaris
Origin
Lateral epicondyle of the humerus and posterior border of the ulna
Insertion
Base of the 5th metacarpal
Action
Extends and adducts hand at the wrist joint
Innervation
Radial Nerve
anconceus
Origin
Lateral epicondyle of humerus
Insertion
Lateral surface of olecranon process and posterior surface of ulna
Action
Assists triceps in extending the elbow joint, helps stabilize elbow joint
Innervation
Radial Nerve
abductor pollicis longus
Origin
Posterior surfaces of radius, ulna and interosseous membrane
Insertion
Base of first metacarpal
Action
Abducts 1st digit (thumb) and extends it @ the carpometacarpal joint
Innervation
Radial Nerve
extensor pollicis longus
Origin
Posterior surface of ulna and interosseus membrane
Insertion
Base of distal phalanx of 1st digit
Action
Extends the 1st digit at the metacarpophalangeal and interphalangeal jts.
Innervation
Radial Nerve
extensor pollicis brevis
Origin
Posterior surface of radius and interosseous membrane
Insertion
Base of proximal phalanx of 1st digit
Action
Extend 1st digit at carpometacarpal and metacarpophalangeal joints
Innervation
Radial Nerve
extensor indicus
Origin
Posterior surface of the ulna and interosseous membrane
Insertion
Extensor expansion (hood) of 2nd digit
Action
Extends 2nd digit and helps extend hand
Innervation
Radial Nerve
supinator
Origin
Lateral epicondyle of humerus, radial collateral and annular ligaments, supinator fossa and crest of ulna
Insertion
Proximal 1/3 of the radius
Action
Supinates forearm (exception)
Innervation
Radial Nerve
snuff box
FORMED BY THE TENDONS OF:
ABDUCTOR POLLICIS LONGUS AND EXTENSOR POLLICIS BREVIS
EXTENSOR POLLICIS LONGUS
extensor retaniculum
-6 compartments
-attachments: radius ant. br
-medial
-acroos dorsum
-antebrachial fascia
EXTENDS ACROSS THE RADIOCARPAL DORSUM
FORMED OF ANTEBRACHIAL FASCIA
 STRENGTHENED BY OBLIQUE TRANSVERSE FIBERS
ATTACHMENTS:
LATERAL: ANTERIOR BORDER OF RADIUS
MEDIAL: TRIQUETRAL AND PISIFORM BONES AND DORSAL ASPECT OF RADIUS