Forearm & Hand (W/ wrist joint)

What are the muscles in the Hypothenar Compartment?

1. Abductor Digiti Minimi 2. Flexor Digiti Minimi (Brevis) 3. Opponens Digiti Minimi

What are the muscles in the Thenar Compartment?

1. Abductor Pollicis Brevis 2. Flexor Pollicis Brevis 3. Opponens Pollicis

List the Superficial Extensors of the Forearm?

1. Anconeus 2. Brachioradialis 3. Extensor Carpi Radialis Longus 4. Extensor Carpi Radialis Brevis 5. Extensor Digitorum 6. Extensor Digit Minimi 7. Extensor Carpi Ulnaris *Innerv = radial nerve

The wrist joint is covered by a single synovial capsule forming a joint that allows what 2 motions?

1. Flex/Ext. 2. Adduct/Abd.

The wrist joint is made up of many __________________ b/w the radius, ulna, and carpal bones

1. Flex/Ext. 2. Adduct/Abd.

Describe the 2 Main Functional Compartments of the Forearm?

1. Flexor (Anterior) Compartment 1. Superficial Section - 4 2. Medial Section - 2 3. Central Deep Section - 3 2. Extensor (Posterior) Compartment 1. Superficial Extensors - 7 2. Deep Extensors - 5

Name the 2 Ligaments of the Carpal Tunnel

1. Flexor Retinaculum (Transverse Carpal Ligament = Roof Runs from hamate & pisiform --> scaphoid & trapezium Function: Prevents "bowstringing" of flexor tendons 2. Palmar Carpal Ligament = Floor Function = Binds the wrist bones together

Name the 3 ligaments of the Carpometacarpal Joint?

1. Palmar Carpometacarpal Ligaments 2. Dorsal Carpometacarpal Ligaments 3. Intermetacarpal Ligament (Reinforce the Intermetacarpal Joints)

The Deep Palmar Arch gives rise to

1. Palmar metacarpal arteries 2. Princeps pollicis A. 3. Radialis Indicis A.

What are the muscles in the Central Compartment?

1. Palmaris Brevis 2. Lumbricals 1-4 3. Adductor Pollicis

What 2 carpal bones form the floor of the anatomical snuff box?

1. Scaphoid 2. Trapezium

List the Deep Extensors of the Forearm?

1. Supinator 2. Abductor Pollicis Longus 3. Extensor Pollicis Brevis 4. Extensor Pollicis Longus 5. Extensor Indicis

Superficial Palmar Arch is primarily a continuation of the ________ Deep Palmar Arch is primarily a continuation of the _____________

1. Ulnar A. 2. Radial A.

What 5 muscles of the hand are innervated by the median nerve?

3 muscles of the Thenar Compartment 1. Abductor Pollicis Brevis 2. Flexor Pollicis Brevis 3. Opponens Pollicis 4. Lumbrical 1 (digit 2) 5. Lumbrical 2 (digit 3) & 2 of digits 2 & 3 EVERY other muscle in the hand is innervated by ULNAR N.

What are the muscles in the Interosseus Compartment?

7 Total Interossei Muscles 3 PADs - 3 Palmar Interosseous --> ADDuct 4DABs - 4 Dorsal Interosseous --> ABDuct digits Mnemonic (Lateral --> Medial) Dr. Pepper Diet Dr. Pepper Dr. Pepper

Movements of the Thumb

A. extension B. Flexion C. Radial Abduction D. Adduction E. Opposition

Abductor Pollicis Brevis vs Abductor Pollicis Longus

Abductor Pollicis Brevis = Thumb Abductor Pollicis Longus = Forearm

What is the only muscle in the hand that will ADDUCT the thumb?

Adductor Pollicis Innervation: Ulnar *Remember only 5 muscles in the hand are innerv. by median (thenar group & lumbricals 1-2) Everything in the hand is Ulnar.

Describe the components of the Superficial Section of the Anterior Forearm

All Arise from Medial Epicondyle of the Humerus Weak elbow flexors Innervation = Median Nerve Muscles 1. Pronator Teres 2. Flexor Carpi Radialis 3. Palmaris Longus 4. Flexor Digitorum Superficialities

Describe the Components of the Deep Central Deep Section of the Forearm

All arise from the shafts of the Ulna & Radius Innervation: Anterior Interosseus Nerve Muscles 1. Flexor Digitorum Profundis (Lateral Half) 2. Flexor Pollicis Longus 3. Pronator Quadratus

The cubital fossa is covered (roof) by the __________ The cubital fossa is lined (floor) by the ___________ Deep the Cubital is the ____________________

Bicipital aponeurosis separates superficial from deep structures in the fossa. Brachialis Muscle Distal Humerus & Elbow Joint

Joints b/w the 5 metacarpals and the 4 distal carpal bones which are considered all plane synovial joints and all have articular capsules joined to the wrist capsule

Carpometacarpal Joint

Superficial Veins to the Cubital Fossa

Cephalic V. - Laterally Basilic V. - Medially Cephalic + Basilic = Median Cubital V *Linking of cephalic and basilic vein to form median cubital v is common but not always *Median Cubital V - superficial to cubital fossa

Palmar Aponeurosis

Dense Fascia covering most of the palm, just deep to the skin Continuous with the Flexor Retinaculum Divides into four slips for the fingers Main Insertion of the Palmaris Longus

Official name of each digit

Digit 1 = pollex Digit 2 = indicus Digit 3 = impudius Digit 4 = annularis Digit 5 = minimi, or digiti minimi Midline (median plane) of the hand divides digit 3

What motion do Metacarpophalangeal (MCP) Joints produce?

Digits 2-5 produce Flexion/Extension & Adduction/abduction Digit 3 can only ABduction - (medial/ulnar) or lateral (radial) Digit 1 can only Flexion/Extension

Necrosis of the Carpal Bones would be indicative of damage to the __________, which comes off the radial artery near the anatomical snuff box.

Dorsal Carpal Branch.

Describe the compartments of the Ulnar Tunnel (of Guyon) (Roof, floor, and contents)

Entry of Ulnar Nerve, Artery, & Vein Boundaries Flexor Retinaculum - Floor Tendon of Flexor Carpi Ulnaris - Roof Pisiform & Hamate - Walls *Guyons Canal Syndrome - compression of ulnar nerve. Affects areas of all things supplied by the ulnar nerve distal to the tunnel

The _____________ is a common tendinous band that allows simultaneous extension of the IP joints

Extensor Hood (aka Dorsal Digital Expansion Sheath)

What motion do Interphalangeal (IP) Joints produce?

Flexion & Extension ONLY

Describe the Components of the Medial Section of the Forearm

Innervation= Ulnar Nerve Muscles 1. Flexor Carpi Ulnaris 2. Flexor Digitorum Profundis (medial half)

Describe the Components of the Anatomical Snuff Box. What tendons, artery, and bone(s) surround this region?

Lateral Border: EPB & APL Medial Border: EPL Contains radial artery, which can be palpated inside the snuffbox.bone deep t Scaphoid bone is located deep to Snuffbox. (Tenderness in snuffbox may indicate injury to scaphoid)

Describe the Palmaris Brevis Muscle?

Located in the skin, attached to palmar aponeurosis Innervation = ulnar nerve. Help cup the hand

Lumbricals

Lumbricals 1-4 go to digits 2-5 Action Flexion at MCP joint Extension at IP joint Innervation Lumbricals 1 & 2 of digits 2 & 3 - Median N. Lumbricals 3 & 4 of digits 4 & 5 - Ulnar N

Define the Boarders of the Cubital Fossa?

Medial - Pronator Teres Lateral- Brachioradialis Superior - Line passing through humeral epicondyles

List the nearby Structures of the Cubital Fossa *Hint- if the Medial Nerve runs through the cubital fossa, what other common surrounding structures would be present?

Medially & Posteriorly - Ulnar nerve & artery Lateral & Anterior - Radial nerve & artery

List the contents of the Cubital Fossa

Median Nerve Brachial Artery & Vein -Possibly the beginning of the Ulnar & Radial Arteries - Possibly the exiting of Basilic Vein Biceps Branchii Tendon

__________joints are b/w the heads of the metacarpals and proximal phalanges. They are synovial joints that allow 2 types of motion

Metacarpophalangeal Joints

What are the actions of the Finger Joints?

PIP, DIP = Flexion/Ext MCP = Flex/Ext, Add/Abd

This structure is the main insertion of the palmaris longus and is continuous with the flexor retinaculum. Functionally it divides into 4 slips for fingers and consists of a deep fascia covering most of the palm, just deep to the skin

Palmar Aponeurosis

What is the thick fascia that covers the central palm of the hand?

Palmar Aponeurosis Provides protection and structural support to fingers moving together as a unit

What muscle attatches the the palmar aponeurosis

Palmaris Brevis & Palmaris Longus *Which does NOT go through the carpal tunnel. Its superficial to the tunnel and inserts directly onto the P.A Palmaris Longus = superficial flexor

The radial and ulnar artery join together to form the __________

Radial A -->Superficial Palmar Branch of Radial A Ulnar A -->Superficial Palmar Branch of Ulnar A Superficial Palmar Branch of Radial + Ulnar A = Superficial Palmar Arch Superficial Palmar Arch gives rise to Common Palmar Digital A ----> which splits into 2 separate proper palmar digit arteries.

Describe the compartments of the Carpal Tunnel (Roof, floor, and contents)

Roof: Flexor Retinaculum (Transverse Carpal Ligament) *Runs from Hamate & Pisiform to Scaphoid & Trapezium "Prevents bowstringing" of the flexor tendons Floor: Palmar Carpal Ligament Contents Median Nerve 4 Tendons of Flexor Digitiform Superficialis 4 Tendons of Flexor Digitiform Profundis Tendon of Flexor Pollicis Longus

Radial Artery of the hand gives rise to ______________

Splits into Superficial and Deep sections Superficial Radial A --> Superficial Palmar Branch (radial a) --> Superficial Palmar Arch Deep Radial A --> Deep Palmar Arch *Radial A terminal @ deep palmar arch Gives off the Princeps Pollicis Artery Radialis Indicis Artery

Ulnar Artery of the Hand gives rise to _________

Superficial Ulnar A. --> Superficial Ulnar Branch (ulnar a.) --> Superficial Palmar Arch *Ulnar A terminate @ superficial palmar arch Deep Ulnar A --> Deep Ulnar Branch --> Deep Palmar Arch

What is Opposition?

The ability to turn and rotate Digit 1 so that it can touch each fingertip Digit 1 needs help to touch the tip of digit 5 so that help comes from opposition of digit 5

What are the deepest muscles in the thenar & hypothenar compartment?

Thenar = Opponens Pollicis - Innervation: recurrent branch of median nerve Hypothenar = Opponens Digiti Minimi - Innervation: ulnar nerve "Oppenens is on the Bonens:

Name the 3 borders of the snuffbox

Ulnar (medial) border: Tendon of the extensor pollicis longus. Radial (lateral) border: Tendons of the extensor pollicis brevis and abductor pollicis longus. Proximal border: Styloid process of the radius. Floor: Carpal bones; scaphoid and trapezium. Roof: Skin.

Where does the Ulnar A terminate? Where does the Radial A. terminate?

Ulnar A terminates as the Superficial Palmar Arch Radial A. terminates as the Deep Palmar Arch

Nerve Artery Associations In the Hand

Ulnar Artery - Ulnar Nerve Common Palmar Digital & Proper Palmar Digital Arteries - Common Palmar Digital & Proper Palmar Digital Nerves of the Medial 1 1 /2 fingers (Note that the nerves divide earlier than the arteries) Deep Palmar Arch - Deep Branch of the Ulnar Nerve Median Nerve - NO ARTERY Common Palmar Digital & Proper Palmar Digital Arteries - Common Palmar Digital & Proper Palmar Digital Nerves of the Lateral 3 1 /2 fingers

List the Nerve Associated with the following arteries Ulnar Artery --> ____________ Common Palmar Digital & Proper Digital Arteries --> _______________ Deep Palmar Arch --> ___________________ Median Nerve --> ____________________ Common Palmar Digital & Proper Digital Arteries --> ________________

Ulnar Nerve Common Palmar Digital & Proper Digital Nerves of Medial 1.5 fingers Deep Branch of Ulnar Nerve No Artery Common Palmar Digital & Proper Digital Nerves of Lateral 3/5 fingers

Abduction/Adduction of digit 1 occurs at the _______________

carpometacarpal joint

interphalangeal joints

distal and proximal (DIP &PIP Joints) on digits 2-5 Only 1 IP joint on digit 1 (thumb) synovial joint that permits only 1 motion: Flexion/Extension.

The main joint of the wrist is b/w the radius, scaphoid, and lunate to form the _________________ joint

radiocarpal joint

What 3 carpal bones make up the "wrist" joint

radius, scaphoid, and lunate = radiocarpal joint

The wrist joint is made up of many __________________ b/w the radius, ulna, and carpal bones

synovial joints