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82 Cards in this Set
- Front
- Back
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What's the difference between superficial and deep forearm flexors? How many of each?
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Superficial cross the elbow joint; deep do not. There are 5 superficial and 3 deep muscles.
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Where is the common flexor origin?
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Medical epicondyle, anterior surface
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If the opposite hand is laid palm down on the volar forearm, which superficial flexor muscle do each of the fingers relate to?
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Thumb: pronator teres
Index: FCR MIddle: FDS Ring: PL Little: FCU |
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What are the five muscles of the superficial forearm flexor group?
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Pronator teres
FCR FCU FDS PL |
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What is the origin and insertion of pronator teres?
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O: Superficial belly from CFT, deep head from coronoid process of ulna
I: Lateral shaft of radius |
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What lies between the two heads of pronator teres?
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Median nerve; ulnar artery passes deep to the deep head
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Innervation of pronator teres?
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Median nerve, first branch (C6,7)
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Action of pronator teres?
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Forearm pronation, weak flexor of the elbow
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Origin and insertion of FCR?
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Origin: CFT
Insertion: Passes through groove of trapezium and inserts into bases of 2nd and 3rd MC |
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Innervation of FCR?
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Median nerve (C6,7)
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Action of FCR?
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Flexor and radial abductor of the wrist; stabilizer of wrist in finger and thumb movements
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What two structures surround the tendon of FCR at the wrist?
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Radial artery laterally, median nerve medially
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Origin and insertion of FDS?
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O: CFT, medial ligament of elbow, coronoid process of ulna (humeroulnar head)
Anterior oblique line of radius (radial head) I: Middle phalanges of digits 2, 3, 4, 5 |
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Innervation of FDS?
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Median nerve (C6,7)
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Action of FDS?
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Flexes PIPJ, secondarily the MCP and wrist joints
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What is adherent to the deep surface of FDS?
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Median nerve
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Origin and insertion of palmaris longus?
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O: CFT
I: flexor retinaculum |
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Innervation of PL?
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Median nerve (C7,8)
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Action of PL?
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Weak flexor of wrist
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Test for presence of PL?
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Press thumb and little finger together, flex wrist
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Origin and insertion of FCU?
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O: CFT (humeral head), ulna (ulnar head)
I: Pisiform, hamate, 5th MC |
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Innervation of FCU?
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Ulnar nerve (C7,8)
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Action of FCU?
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Flexor and ulnar adductor of the wrist
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What are the boundaries of the cubital fossa?
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Brachioradialis (lateral), pronator teres (medial), line joining epicondyles of humerus
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What are the contents of the cubital fossa?
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From medial to lateral:
1. Median n 2. Brachial artery 3. Tendon of biceps 4. Radial nerve 5. PIN branch of radial n. |
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What is the course of the radial nerve within the cubital fossa?
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Gives branches to brachioradialis, brachialis, ECRL before dividing into the superficial branch and the PIN. PIN gives branches to ECRB and supinator then disappears between origins of supinator; suprficial branch travels down arm under cover of the brachioradialis
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What are the deep flexor muscles of the forearm?
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FDP, FPL, PQ
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Origin and insertion of FDP?
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O: Upper 3/4 of ulna and interosseous membrane
I: Middle phalanges of digits 2, 3, 4, 5 |
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Where in the FDP do the tendons to the digits separate from one another?
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Tendon to index separates in forearm, but others stay stuck to each other until they reach the palm.
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Innervation of FDP?
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AIN branch of median nerve (index, middle)
Ulnar nerve (ring, little) **This is not consistent (only 60% of individuals), may also be 3:1 or 1:3 median to ulnar |
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What attaches to the FDP in the palm?
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The lumbricals. Each lumbrical shares the innervation of its parent FDP.
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Action of FDP?
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Flexes DIPJ and in turn the MCPJ and the wrist
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Origin and insertion of FPL?
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O: Anterior surface of radius above insertion of PQ
I: Base of distal phalanx of thumb |
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What is the distinctive feature of the FPL in the forearm that aids its identification?
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Unipennate muscle, tendon forms on ulnar side down to just above the wrist
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Innervation of FPL?
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AIN of median nerve (C7,8)
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Action of FPL?
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Flexor of IP joint of thumb, also flexes MCP and CMC joints of thumb and wrist
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Origin and insertion of pronator quadratus?
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O: distal ulna
I: distal radius |
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Innervation of pronator quadratus?
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AIN branch of median nerve (C7,8)
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What are the muscles of the flexors of the forearm supplied by ulnar nerve?
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ulnar two FDP, FCU
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What is the space of Parona?
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Superficial to PQ and deep to long flexor tendons of fingers; can be invovled in proximal extensiosn of synovial sheath infections
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What is the chief arterial supply of the forearm?
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Anterior interosseous artery, from the ulnar. (Posterior is lesser)
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Do the AIN or PIN nerves reach the skin?
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No. They remain in their own compartments down to the wrist, supplying muscles.
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Which nerves share the supply of the forearm musculature? WHat do they each pass between?
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Median: between two heads of pronator teres
Ulnar: between two heads of FCU PIN: between two layers of supinator |
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What is the course of the radial artery in the forearm?
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Passes medial to biceps tendon, across supinator, over pronator teres, FPL, PQ, radius; then disappears beneath APL and EPB to cross anatomic snuff box.
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What is the course of the ulnar artery in the forearm?
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Passes deep to deep head of pronator teres, beneath FDS and median nerve; runs on FDP; lies on top of flexor retinaculum and runs into palm as superifical palmar arch
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What is the main branch of the ulnar artery in the forearm?
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Anterior interosseous artery. Lies deep on IO membrane between FDP and FPL, supplying each; branches supply extensor muscles, nutrient vessels to radius and ulna
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What branches of arteries are located surrounding the elbow joint?
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Recurrent branches (sometimes double) from ulnar, radial, and common IO arteries run anterior and posterior to joint, anastomose with profunda brachii and ulnar collaterals
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What arteries supply the carpal area?
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Both radial and ulnar arteries give off palmar and dorsal carpal branches which form a dorsal and palmar carpal arch
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What is the venous drainage of the forearm? Hand?
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Forearm: venae comitantes
Hand: most passes to superficial venous network on dorsum; radially the cephalic vein begins in roof of snuffbox and runs along lateral border. Ulnar side, basilic vein become axillary vein. |
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Which cutaneous nerves supply the forearm?
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Laterallly: lateral cutaneous nerve of forearm (continuation of musculocutaneous nerve)
Medially: medial cutaneous nerve of forearm (branch of brachial plexus) |
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What is the course of the radial nerve in the forearm?
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Radial nerve splits into PIN and terminal superficial branch, which runs under brachioradialis on lateral surface of forearm; leaves flexor compartment and breaks up into branches which can be rolled on surface of EPL tendon
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What does the capitulum articulate with? The trochlea?
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Capitulum: lateral, spherical, articulates with head of radius
Trochlea: medial, grooved surface; articulates with trochlear notch of ulna |
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What is the course of the median nerve in the forearm?
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Leaves cubital fossa between two heads of pronator teres, adherent to FDS; travels deep to PL in tunnel into hand. Gives off palmar branch to skin over thenar muscles
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What muscles does the AIN supply?
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FDP, FPL, PQ and wrist/radioulnar/carpal joints
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What is the course of the ulnar nerve in the forearm?
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Passes behind medial epicondyle, enters in extensor compartment between heads of FCU, lies on FDP. Branches to FCU and ulnar half of FDP. Dorsal branch splits off between FCU and ulna; supplies dorsum of hand. Palmar cutaneous branch goes superficial over flexor retinaculum to supply skin of hypothenar eminence.
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How many muscles occupy the extensor compartment?
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12.
Upper: anconeus, supinator (2) From lateral humerus: 6 Deep origin to thumb: 3 One for the index: 1 |
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Origin/insertion of brachioradialis?
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O: upper 2/3 of lateral supracondylar ridge
I: base of radial styloid |
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Innervation of brachioradialis?
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Radial nerve
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Action of brachioradialis?
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Flex elbow joint
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Origin and insertion of ECRL?
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O: LOwer third of lateral supracondylar ridge
I: Base of 2nd metacarpal |
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Nerve supply of ECRL?
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Radial nerve (C6,7)
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Action of ECRL?
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Extensor and abductor of wrist; assists in flexion of elbow
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What tendons arise from the common extensor origin?
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Four.
ECRB, ED, EDM, ECU |
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Origin and insertion of ECRB?
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O: CEO
I: Base of 3rd metacarpal |
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Innervation of ECRB?
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PIN
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Action of ECRB?
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Wrist extensor
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Origin and insertion of ED?
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O: CEO
I: extensor expansions |
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Innervation of ED?
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PIN
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Action of ED?
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Extensor of wrist, MCP, IP joints
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Origin and insertion of ECU?
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O: CEO and ulna (with FCU)
I: base of 5th MC |
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Origin and insertion of anconeus?
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O: posterior surface of lateral epicondyle
I: lateral side of olecranon and shaft of ulna |
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Innervation of anconeus?
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Radial nerve
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Origin and insertion of supinator?
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O: Lateral epicondyle, annular ligament of radius, ulan
I: lateral surface of radius |
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Origin and insertion of APL?
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O: back of radius and ulna, IO
I: two slips, one to base of first MC, other to trapezium - forms at radial side of snuffbox |
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Innervation of APL?
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PIN
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Action of APL?
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Extends thumb at CMC joint, displacing it laterally in plane of palm; can assist in abducting and flexing the wrist
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Origin and insertion of EPB?
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O: Radius and IO membrane below APL
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What three muscles make up the thenar eminence?
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From radial to ulnar:
1. Abductor pollicis brevis 2. Flexor pollicis brevis 3. Opponens pollicis (deep to APB and FPB) |
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Origin, insertion, and innervation of abductor pollicis brevis?
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O: flexor retinaculum, tubercle of scaphoid
I: radial side of base of proximal phalanx, tendon of EPL Inn: Recurrent branch of median nerve |
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Origin, insertion, innervation of FPB?
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O: superficial head from flexor retinaculum and trapezium; deep head from trapezoid and capitate
I: Radial sesamoid of thumb and radial side of base of proximal phalanx Inn: Recurrent branch of median nerve (highly variable! also deep branch of ulnar nerve) |
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Origin, insertion, innervation of OP?
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O: flexor retinaculum, trapezium
I: radial border of MC of thumb Inn: Recurrent branch of median nerve |
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Origin, insertion, innervation of adductor pollicis?
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O: transverse head (palmar border of third metacarpal) and oblique head (bases of 2nd and 3rd metacarpals, capitate)
I: ulnar sesamoid of thumb, ulnar side of base of proximal phalanx, tendon of EPL Inn: Deep branch of ulnar nerve |
