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95 Cards in this Set
- Front
- Back
What are the general actions of the muscles of the anterior compartment of the forearm? |
Flexion at the wrist and fingers Pronation |
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Name the superficial muscles of the anterior compartment of the forearm |
Flexor carpi ulnaris Palmaris longus Flexor carpi radialis Pronator teres
NB: All originate from a common tendon, arising from the medial epicondyle of the humerus |
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What are the attachments of flexor carpi ulnaris? |
Origin: Medial epicondyle of the humerus, posterior border of the proximal ulna
Insertion: Pisiform, hook of hamate, base of 5th metacarpal |
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What are the actions of flexor carpi ulnaris? |
Flexion and adduction at the wrist |
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What is the innervation of flexor carpi ulnaris? |
Ulnar Nerve (C7-T1) |
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What is the arterial supply of flexor carpi ulnaris? |
Ulnar artery |
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What are the attachments of palmaris longus? |
Origin: medial epicondyle of the humerus
Insertion: Flexor retinaculum of the wrist
NB: Absent in 15% |
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What are the actions of palmaris longus? |
Flexion at the wrist Weak flexion at the elbow |
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What is the innervation of palmaris longus? |
Median Nerve (C7-8) |
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What is the arterial supply of palmaris longus? |
Ulnar Artery |
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What are the attachments of flexor carpi radialis? |
Origin: Medial epicondyle of the humerus
Insertion: Base of metacarpals II and III |
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What are the actions of flexor carpi radialis? |
Flexion and abduction at the wrist |
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What is the innervation of flexor carpi radialis? |
Median Nerve (C6-C7) |
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What is the arterial supply of flexor carpi radialis? |
Ulnar Artery |
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What are the attachments of pronator teres? |
Origin: Medial epicondyle of the humerus, coronoid process of the ulna
Insertion: lateral radial mid-shaft |
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What are the actions of pronator teres? |
Pronation of the forearm |
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What is the innervation of pronator teres? |
Median Nerve (C6-C7) |
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What is the arterial supply of pronator teres? |
Ulnar Artery Anterior Ulnar Recurrent Artery |
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Name the intermediate muscles of the anterior compartment of the forearm |
Flexor Digitorum Superficialis |
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What are the attachments of the flexor digitorum superficialis? |
Origin: Humeroulnar Head: Medial epicondyle of the humerus Radial head: Middle third of the radius
Splits into four tendons at the wrist, which travel through the carpal tunnel
Insertion: Middle phalanges of the four fingers |
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What are the actions of the flexor digitorum superficialis? |
Flexion of the MCPJs and PIPJs of the 4 fingers Flexes of the wrist |
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What is the innervation of the flexor digitorum superficialis? |
Median Nerve (C8-T1) |
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What is the arterial supply of the flexor digitorum superficialis? |
Ulnar Artery |
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Why is the flexor digitorum superficialis a good landmark? |
The median nerve and ulnar artery pass between its two heads before travelling posteriorly |
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Name the deep muscles of the anterior compartment of the forearm |
Flexor Digitorum Profundus Flexor Pollicis Longus Pronator Quadratus |
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What are the attachments of the flexor digitorum profundus? |
Origin: Posteromedial ulna and associated interosseous membrane
Splits into four tendons at the wrist, which pass through the carpal tunnel
Insertion: Distal phalanges of the four fingers |
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What are the actions of the flexor digitorum profundus? |
Flexion of the DIPJs of the 4 fingers (sole muscle) Flexion of the MCPJs of the 4 fingers Flexion of the wrist |
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What is the innervation of the flexor digitorum profundus? |
Median Nerve - lateral half (index and middle) Ulnar Nerve - medial half (little & ring fingers) |
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What is the arterial supply of the flexor digitorum profundus? |
Ulnar Artery Anterior Interosseus Artery |
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What are the attachments of the flexor pollicis longus? |
Origin: Anterior surface of the radius and surrounding interosseous membrane
Insertion: Base of the distal phalanx of the thumb on the palmar surface |
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What are the actions of the flexor pollicis longus? |
Flexes the interphalangeal joint and metacarpophalangeal joint of the thumb |
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What is the innervation of the flexor pollicis longus? |
Median Nerve |
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What is the arterial supply of the flexor pollicis longus? |
Anterior Interosseus Artery |
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What are the attachments of the pronator quadratus? |
Origin: Anterior surface of the distal ulna
Insertion: Anterior surface of the distal radius |
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What are the actions of the pronator quadratus? |
Pronates the forearm |
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What is the innervation of the pronator quadratus? |
Anterior Interosseus Nerve (from the median nerve) |
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What is the arterial supply of the pronator quadratus? |
Anterior Interosseus Artery |
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What is the general function and innervation of the muscles of the posterior compartment of the forearm as a group? |
Action: Extension at the wrist and fingers
Innervation: Radial nerve |
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Name the superficial muscles of the posterior compartment of the forearm |
Brachioradialis Extensor carpi radialis longus Extensor carpi radialis brevis Extensor digitorum Extensor carpi ulnaris Extensor digiti minimi Anconius |
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What are the attachments of the brachioradialis? |
Origin: Supraepicondylar ridge of the humerus
Insertion: Distal radius, just before the styloid process |
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What are the actions of the brachioradialis? |
Elbow flexion (paradoxical as in posterior compartment) |
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What is the innervation of the brachioradialis? |
Radial Nerve (C5-C6) |
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What is the arterial supply of the brachioradialis? |
Radial recurrent artery |
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What are the attachments of the extensor carpi radialis longus? |
Origin: Lateral supracondylar ridge of the distal humerus
Insertion: Base of 2nd metacarpal on the dorsal surface |
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What are the actions of the extensor carpi radialis longus? |
Extension and abduction of the wrist |
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What is the innervation of the extensor carpi radialis longus? |
Radial Nerve (C6-C7) |
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What is the arterial supply of the extensor carpi radialis longus? |
Radial Artery |
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What are the attachments of the extensor carpi radialis brevis? |
Origin: Lateral epicondyle of the humerus
Insertion: Base of 3rd metacarpal on the dorsal surface |
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What are the actions of the extensor carpi radialis brevis? |
Extension and abduction of the wrist |
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What is the innervation of the extensor carpi radialis brevis? |
Deep radial nerve (C7-C8) |
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What is the arterial supply of the extensor carpi radialis brevis? |
Radial Artery |
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What are the attachments of the extensor digitorum? |
Origin: Lateral epicondyle of the humerus
Tendon continues into in the distal forearm, where it splits into four
Insertion: Extensor hood of each of the four fingers on the dorsal surface |
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What are the actions of the extensor digitorum? |
Extends the four fingers at the MCPJs and IPJs |
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What is the innervation of the extensor digitorum? |
Deep Radial Nerve (C7-C8) |
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What is the arterial supply of the extensor digitorum? |
Interosseus Recurrent Artery Posterior Interosseus Artery |
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What are the attachments of the extensor carpi ulnaris? |
Origin: Lateral epicondyle of the humerus
Insertion: Base of the 5th metacarpal |
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What are the actions of the extensor carpi ulnaris? |
Extension and adduction of wrist |
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What is the innervation of the extensor carpi ulnaris? |
Deep Radial Nerve (C7-C8) |
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What is the arterial supply of the extensor carpi ulnaris? |
Ulnar Artery |
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What are the attachments of the extensor digiti minimi? |
Origin: Lateral epicondyle of the humerus
Insertion: Extensor hood of the little finger with the extensor digitorum tendon |
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What are the actions of the extensor digiti minimi? |
Extends the little finger (MCPJ, IPJs) Contributes to extension at the wrist |
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What is the innervation of the extensor digiti minimi? |
Deep Radial Nerve (C7-C8) |
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What is the arterial supply of the extensor digiti minimi? |
Interosseus Recurrent Artery |
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What are the attachments of anconeus? |
Origin: Lateral epicondyle of the humerus
Insertion: Posterolateral olecrannon |
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What are the actions of anconeus? |
Moves the ulna during pronation Extension of the forearm |
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What is the innervation of anconeus? |
Radial Nerve |
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What is the arterial supply of anconeus? |
Interosseus Recurrent Artery |
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Name the deep muscles in the posterior compartment of the forearm |
Supinator Abductor Pollicis Longus Extensor Pollicis Brevis Extensor Pollicis Longus Extensor indicis |
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What are the attachments of the supinator? |
Two heads of origin: - Lateral epicondyle of the humerus - Posterior surface of the ulna
Insertion: Proximal third of radius |
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What are the actions of the supinator? |
Supination of the forearm at the radioulnar joints |
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What is the innervatin of the supinator? |
Deep Radial Nerve (C6-C7) |
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What is the arterial supply of the supinator? |
Recurrent Interosseous Artery |
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What are the attachments of the abductor pollicis longus? |
Origin: Middle third of posterior surfaces of the radius and ulna and the adjacent interosseous membrane
Insertoin: Radial side of the base of the 1st metacarpal |
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What are the actions of the abductor pollicis longus? |
Abduction of the thumb (radiocarpal and carpometacarpal joints) |
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What is the innervation of the abductor pollicis longus? |
Deep Radial Nerve |
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What is the arterial supply of the abductor pollicis longus? |
Posterior Interosseus Artery |
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What are the attachments of the extensor pollicis brevis? |
Origin: Posterior surface of the distal radius and interosseous membrane
Insertion: Base of the proximal phalanx of the thumb |
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What are the actions of the extensor pollicis brevis? |
Extension at the metacarpophalangeal and carpometacarpal joints of the thumb |
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What is the innervation of the extensor pollicis brevis? |
Deep Radial Nerve |
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What is the arterial supply of the extensor pollicis brevis? |
Posterior Interosseus Artery |
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What are the attachments of the extensor pollicis longus? |
Origin: Posterolateral surface of the ulna and interosseous membrane
Insertion: Base of the distal phalanx of the thumb
Tendon travels medially to the dorsal tubercle at the wrist, using the tubercle as a pulley to increase the force exerted |
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What are the actions of the extensor pollicis longus? |
Extends all joints of the thumb: carpometacarpal, metacarpophalangeal and interphalangeal |
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What is the innervation of the extensor pollicis longus? |
Deep Radial Nerve (C7-C8) |
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What is the arterial supply of the extensor pollicis longus? |
Posterior Interosseus Artery |
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What are the attachments of the extensor indices? |
Origin: Posterolateral surface of the ulna and interosseous membrane(distal to the extensor pollicis longus)
Insertion: Extensor hood of the index finger, with the extensor digitorum tendon |
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What are the actions of the extensor indices? |
Extension of the index finger (MCPJ, PIPJ, DIPJ) |
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What is the innervation of the extensor indices? |
Deep Radial Nerve (C7-C8) |
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What is the arterial supply of the extensor indices? |
Posterior Interosseous Artery |
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What are the common causes and clinical features of radial nerve injury? |
Sites of radial nerve injury: Axilla: Injured via humeral dislocations or fractures of the proximal humerus Radial Groove of the Humerus: Injured via a humeral shaft fracture
Wrist Drop: Radial nerve innervates all extensor muscles. Median nerve innervates all flexor muscles and remains intact - tone causes unapposed flexion |
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What are the borders of the cubital fossa? |
Superior: Line between the epicondyles of the humerus
Medial: Lateral border of pronator teres
Lateral: Medial border of brachioradialis |
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What are the contents of the cubital fossa? |
Lateral to medial:
Radial nerve – divides into its deep and superficial branches as it passes under brachioradialis
Biceps tendon
Brachial artery - bifurcates into the radial and ulnar arteries at the apex of the cubital fossa
Median nerve - leaves the cubital between the two heads of the pronator teres
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What is the clinical relevance of the cubital fossa? |
Palpation of the brachial pulse medial to the biceps tendon
Venepuncture (median cubital vein, connects the basilic and cephalic veins)
Damage to the cubital fossa contents can occur in the context of a supraepicondylar fracture (sustained by falling on a flexed elbow). Disruption to the brachial artery can cause can cause Volkmann’s ischaemic contracture (uncontrolled flexion of the hand) |
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What are the borders of the carpal tunnel? |
Composed of the deep carpal arch forms a concave surface, which is converted into a tunnel by the overlying superficial flexor retinaculum.
Carpal Arch: - Concave on the palmar side - Formed laterally by the scaphoid and trapezium tubercles - Formed medially by the hook of the hamate and the pisiform
Flexor Retinaculum - Thick connective tissue - Turns the carpal arch into the carpal tunnel by bridging the space between the medial and lateral parts of the arch - Originates on the lateral side and inserts on the medial side of the carpal arch |
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What are the contents of the carpal tunnel? |
Median Nerve Tendon of flexor pollicis longus 4 tendons of flexor diditorum profundus 4 tendons of flexor digitorum superficialis
NB: 8 tendons of the flexor digitorum profundus and flexor digitorum superficialis are surrounded by a single synovial sheath
The flexor carpi radialis tendon is located within the flexor retinaculum rather than the carpal tunnel itself |
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What are the symptoms and clinical tests for carpal tunnel syndrome? |
Symptoms: Numbness, tingling and pain in the distribution of the median nerve, which divides once it passes through the carpal tunnel: - Palmar digital nerves: sensory innervation to the palmar skin and dorsal nail beds of the lateral three and a half digits. provide motor innervation to the lateral two lumbricals. - Recurrent branch supplies the thenar muscle group
Clinical Tests: - Tinel's Sign: Tapping the nerve in the carpal tunnel to elicit pain in median nerve distribution - Phalen's Manoeuvre: Holding the wrist in flexion for 60 seconds to elicit numbness/pain in median nerve distribution |