Anatomy Test 3

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What movements occur at the MP joints of digits 2-5

Flexion & extension; abduction & adduction; circumduction

Clinical presentation of and reason for mallet finger

Flexion of the DIP joint - avulsion of long extensor tendon from its insertion on the distal phalanx

Which of the following muscles is innervated by the ulnar nerve? Flexor carpi ulnaris Flexor carpi radialis Palmaris longus Flexor pollicis longus

Flexor carpi ulnaris

What condition is due to avulsion of the long extensor tendon from its insertion on the distal phalanx.

Mallet finger

What are the contents of The central compartment of the hand

Long finger flexor tendons of FDS & FDP, Short muscles associated with these tendons, Arterial arches (supply structures of the hand), and Digital branches of the median & ulnar nerves

Which of the following muscles insert on the extensor expansion? Select all that apply. -Lumbricals -Dorsal Interossei -Palmar Interossei -Flexor pollicis brevis

Lumbricals, Dorsal Interossei, and Palmar Interossei

The motion that occurs at both the proximal and distal radioulnar joints

Supination & Pronation

What part of the extensor expansion runs from the proximal phalanx & fibrous digital sheaths obliquely across the middle phalanx and IP joints.

Retinacular ligament

The location where the brachial artery divides and the terminal branches

Cubital Fossa Divides into Radial Artery and Ulnar Artery

The ulnar nerve (and artery) pass from the wrist and enter the hand via what?

Ulnar (Guyon's) Canal

What are the main actions of the Palmar Interossei muscles

adducts the MP joints of 2nd, 4th, and 5th digits (reference is the middle finger), & assists the lumbricals with flexion of the MP joints & extension of the IP joints via the extensor expansion.

What are the main actions of the Adductor Pollicis muscle

adducts the thumb

The hand is capable of which of the following functions -the sensory function of touch -the functions of grasp -prehension -manipulation

all of the above

Which of the following muscles is innervated by the deep branch of the ulnar nerve? Select all that apply. -Opponens digiti minimi -Abductor digiti minimi -Dorsal Interossei -3rd and 4th lumbricals -Adductor pollicis

all of the above

Where does the flexor pollicis longus insert

base of distal phalanx of thumb

What articulates at the intercarpal joints

between adjacent carpal bones with in the proximal & distal rows

Where does the flexor digitorum superficialis insert?

bodies of the middle phalanges of medial four digits

What forms the floor of the carpal tunnel

carpal bones

Which of the following is considered a function of the hand? Select all that apply. -grasp and maniuplation of objects -expression through gestures -sexual functions -orienting objects in space

grasp and maniuplation of objects, expression through gestures, and sexual functions

What forms the medial border of the carpal tunnel

hamate & pisiform

what articulates at the proximal radioulnar joint

head of radius and radial notch of the ulna

What type of joint it is IP joints

hinge type

What is the floor of the radial tunnel

joint capsule of humero-radial joint & deep layer of supinator

What movements occur at the MP joint of the thumb

just flexion/extension

What part of the extensor expansion is formed by the ED tendon inserting into the base of the middle phalanx

central band

Which ligament becomes tight when the MP joints are in flexion limiting abduction of the joints. -palmar ligaments -collateral ligaments -transverse metacarpal ligaments

collateral ligaments

Which of the following muscles has an origin point from the lateral epicondyle of the humerus? Select all that apply. -extensor carpi radialis longus -extensor carpi radialis brevis -extensor digiti minimi -abductor pollicis longus -extensor digitorum

extensor carpi radialis brevis, extensor digiti minimi, and extensor digitorum

True or False: An anastomosis between the deep palmar branch of the ulnar artery and the radial artery form the deep palmar arterial arch

false

True or False: The median nerve travels through the cubital tunnel.

false

true or false: The ulnar nerve will provide motor innervation to the majority of the muscles of the anterior compartment of the forearm.

false

What are the main actions of the flexor carpi radialis

flexes & abducts (radial deviation) the wrist joint.

What movements occur at the IP joints

flexion and extension

What is the origin of the Opponens Digiti Minimi muscle

flexor retinaculum & hook of the hamate

What is the origins of the Flexor Digiti Minimi Brevis muscle

flexor retinaculum & hook of the hamate

What is the origin of the Abductor Digiti Minimi muscle

flexor retinaculum & pisiform

What forms the cubital anastomosis

formed by branches of the brachial artery & ulnar and radial arteries

True or False: During the movement of pronation the radius will cross over the ulna.

true

True or False: The radial nerve will divide into a superficial and deep branch at the level of the cubital fossa.

true

true or false: The radius is the laterally located long bone of the forearm

true

Hypothenar muscles have action on what structure

pinky

What bone sits of the palmar surface of the triquetrum

pisiform

What forms the ulnar border of Guyon's canal

pisiform and pisohamate ligament

Which of the following carpal bones forms the medial (ulnar) boundary of the ulnar canal? -pisiform and pisohamate ligament -hook of the hamate -palmar carpal ligament -transverse carpal ligament

pisiform and pisohamate ligament

Where does the flexor carpi ulnaris insert?

pisiform, hook of hamate, base of 5th metacarpal

What type of joints are the radioulnar joints

pivot types of synovial joint

What is the function of anular ligaments

prevents displacement of the radial head during pronation/ supination

Which muscles are supplied by the recurrent branch of the median nerve? Select all that apply. -Opponens pollicis -Abductor pollicis brevis -Dorsal Interossei -Adductor pollicisis -1st and 2nd lumbricals

Opponens pollicis andAbductor pollicis brevis

Which of the following muscles is considered a muscle of the thenar muscle? Select all that apply. -Opponens pollicis -Opponens digiti minimi -Lumbricals -Flexor pollicis brevis -Adductor pollicis

Opponens pollicis, Flexor pollicis brevis, and Adductor pollicis

What are the branches of the ulnar nerve provide sensory information in the hand

Palmar cutaneous, Dorsal cutaneous - digital branches, and Superficial branch - digital branches

What are the key ligaments of the IP joints

Palmar ligaments (volar plates) and Collateral ligaments

What are the key ligaments of the MP joint

Palmar ligaments (volar plates), Collateral ligaments, and Transverse metacarpal ligaments

1. The arteries that form the palmar and dorsal carpal arches

Palmar: Palmar carpal branch of the radial artery, palmar carpal branch of the ulnar artery, anterior interosseous artery Dorsal: dorsal carpal branch of radial artery, dorsal carpal branch of ulnar artery, posterior interosseous artery

What is the cubital fossa?

a triangular depression on the anterior aspect of the elbow

The antebrachial fascia distally stretches across the carpal groove becoming the flexor retinaculum (anterior surface) creating what?

carpal tunnel

What condition causes Progressive loss of coordination and strength in the thumb - wasting of the thenareminence

carpal tunnel syndrome

Which of the following structures of the extensor expansion is important for producing PIP extension? -central band -lateral band -terminal tendon

central band

Which of the following muscles will insert onto a metacarpal bone? Select all that apply. flexor carpi radialis flexor digitorum superficialis pronator quadratus flexor carpi ulnaris pronator teres

flexor carpi radialis and flexor carpi ulnaris

Which of the following muscles originate from the medial epicondyle of the humerus? Select all that apply. flexor carpi radialis flexor carpi ulnaris flexor digitorum profundus flexor pollicis longus palmaris longus

flexor carpi radialis, flexor carpi ulnaris, and palmaris longus

Which tendons are easily palpated as they cross the anterior aspect of the wrist? Select all that apply. flexor carpi radialis flexor digitorum profundus palmaris Longus pronator teres flexor carpi ulnaris

flexor carpi radialis, palmaris longus, and flexor carpi ulnaris

Which of the following muscles will flex the digits of the hand? pronator teres flexor carpi ulnaris flexor digitorium superficialis flexor carpi radialis

flexor digitorium superficialis

The median nerve travels between which two muscles in the anterior compartment of the forearm? pronator teres and flexor pollicis longus flexor digitorium superficialis and profundus flexor digitorium profundus and flexor pollicis longus

flexor digitorium superficialis and profundus

What is the origin of the Opponens Pollicis muscle

flexor retinaculum; tubercle of trapezium

What is the origin of the Abductor Pollicis Brevis muscle

flexor retinaculum; tubercles of scaphoid & trapezium

Which of the following structures articulate to form the proximal radioulnar joint? -head of the ulna & the ulnar notch of the radius -head of the radius & the radial notch of the ulna -distal end of the radius & articular disc with the proximal row of carpal bones

head of the radius & the radial notch of the ulna

What articulates at the distal radioulnar joint

head of ulna and ulnar notch of radius

Which of the following are considered important bony landmarks of the radius? Select all that apply. head trochlear notch styloid process carpal articular surfaces radial notch ulnar notch

head, styloid process, carpal articular surfaces, and ulnar notch

What are the barriers of the cubital fossa?

superior: imaginary line between the epicondyles lateral: brachioradialis medial: pronator teres floor: brachialis and supinator roof: fascia and skin

What occurs in the colles fracture

- fracture of the *distal radius*, possibly also involving the ulnar styloid - wrist and hand is displaced *dorsally and radially* (remember that this is the "dinner fork" or "bayonet" fracture, curves the wrist like a fork or bayonet attached to a musket) - usually caused by a fall onto an outstretched hand by an elderly patient

The muscles innervated by the posterior interosseous nerve

-Extensor Digitorium -Extensor Digiti minimi -Extensor Carpi Ulnaris -Abductor pollicis longus -Extensor pollicis brevis -Extensor pollicis longus -Extensor indicis

1. The muscles innervated by the deep branch of the ulnar nerve

-Flexor pollicis brevis (Recurrent branch Median & DBUN) -Adductor pollicis -Opponens digiti minimi -Abductor digiti minimi -Flexor digiti minimi brevis -Dorsal Interossei -Palmar Interossei -Lumbricals 3 & 4 2LOAF.5 -> Median Nerve Everything else DBUN

1. Cutaneous nerves that provide sensation to the anterior aspect of the forearm

-Lateral antebrachial cutaneous nerve (continuation of musculocutaneous) -Medial antebrachial cutaneous nerve (arises from medial cord of brachial plexus)

What innervates the Abductor Pollicis Brevis muscle

RBMN

what innervates the Opponens Pollicis muscle

RBMN

What provides motor innervation to the muscles in the hand

RBMN and DBUN

what can you use to remember what intrinsic muscles of the hand are innervated by the median nerve

2 LOAF.5

How many types of grasp taxonomies have been identified

33 types

Which compartment contains the tendons of extensor digitorium and extensor indicis? -2nd -4th -6th

4th

How many dorsal compartments are there

6

Which of the following muscles originates from the both the trapezium & scaphoid? -Opponens pollicis -Abductor pollicis brevis -Flexor pollicis brevis -Adductor pollicis

Abductor pollicis brevis and Flexor pollicis brevis

What muscles are included in the first dorsal compartment

Abductor pollicis longus and Extensor pollicis brevis

The articulations that form the radiocarpal joint and the motions that occur at this joint

Articulation: distal end of the radios & articular disc with the proximal row of carpal bones (excluding the pisiform). Motions: flexion/extension, abduction/adduction (radial dev/ulnar dev), circumduction.

Which of the following muscles originates from the pisiform? -Opponens digiti minimi -Abductor digiti minimi -Flexor digiti minimi brevis

Abductor digiti minimi

The borders of the anatomical snuff box

Anterior border: -Abductor pollicis longus -Extensor pollicis brevis Posterior border: -Extensor pollicis longus

what are the borders of the anatomical snuff box

Anterior border: Abductor pollicis longus and Extensor pollicis brevis Posterior border: Extensor pollicis longus

Where does the flexor pollicis longus originate

Anterior surface of radius & interosseous membrane.

Where does the flexor carpi ulnaris originate?

Humeral head: medial epicondyle of the humerus; Ulnar head: posterior border of ulna & olecranon

What are the main actions of the Abductor Pollicis Brevis muscle

abducts thumb; assists with opposition.

The arteries that form the cubical anastomoses

Brachial Artery: superior & inferior ulnar collateral, radial collateral, middle collateral Ulnar Artery: anterior & posterior ulnar recurrent, recurrent interosseous Radial Artery: radial recurrent

What are the specific branches that supply the cubital anastomosis

Brachial: Ulnar collaterals (superior & inferior), Radial collateral, Middle collateral Ulnar: Anterior & posterior ulnar recurrent, Recurrent interosseous Radial: Radial recurrent

These two muscles of the posterior compartment of the forearm that are not extrinsic muscles of the hand.

Brachioradialis: action on the elbow (flexion) Supinator: action on the forearm (supination)

1. The clinical manifestation (and cause) for carpal tunnel syndrome

Cause: entrapment of the median nerve in the carpal tunnel - pressure in the tunnel increases with power grip and wrist flexion/extension when tendons glide into the tunnel (FPL, FDS, FDP) Sensory (appears first): lateral 3 ½ digits (NO loss in palm because palmar cutaneous branch is before the tunnel) Motor: wasting of the thenar eminence leading to loss of coordination and strength (recurrent branch of the median nerve)

Where does the flexor digitorum superficialis originate

Humero-ulnar head: medial epicondyle of humerus & coronoid process of ulna; Radial head: superior half of anterior surface of the radius

What innervates lumbricals 3 and 4

DBUN

What innervates the Abductor Digiti Minimi muscle

DBUN

What innervates the Adductor Pollicis muscle

DBUN

What innervates the Dorsal Interossei muscles

DBUN

What innervates the Flexor Digiti Minimi Brevis muscle

DBUN

What innervates the Opponens Digiti Minimi muscle

DBUN

What innervates the Palmar Interossei muscles

DBUN

The superficial palmar arch receives contribution from what artery

Digital arteries

What are the branches of the superficial branch of the radial nerve that provide sensory information in the hand

Digital branches

What condition causes the Digits are pulled into partial flexion at the MP and PIP joints - most often impacts the 4th & 5th digits.

Dupuytren's contracture:

What condition is a disease of the palmar fascia resulting in progressive thickening of the fascia.

Dupuytren's contracture:

What tendons fan our over the dorsum of the hand and adjacent tendons are linked via intertendinous connections just proximal to MP joints

ED

What tendons cross the wrist deep to the extensor retinaculum to reach their respective insertions on the extensor expansion.

ED, EDM, & EI

What is the triangular tendinous aponeurosis that wraps around the dorsum & sides of the MP joint

Extensor Expansion

What muscles are included in the second dorsal compartment

Extensor carpi radialislongus/brevis

What muscles are included in the sixth dorsal compartment

Extensor carpi ulnaris

What muscles are included in the fifth dorsal compartment

Extensor digiti minimi

What muscles are included in the fourth dorsal compartment

Extensor digitorum and Extensor indicis

What muscles are included in the third dorsal compartment

Extensor pollicis longus

What tendons are included in the flexor tendon sheath

FDS, FDP, & FPL

What are the Ligamentous tubes that enclose the flexor tendons in their synovial sheaths from the metacarpal heads to the distal phalanx creating a "fibro-osseous tunnel"

Fibrous sheath aka the pulleys in the flexor tendon sheath

Where does the ulnar nerve divide into superficial and deep branches

Guyon's canal

Where does the pronator teres originate from

Humeral head: medial epicondyle of the humerus; Ulnar head: coronoid process of ulna.

What nerve is arising from the medial cord of the brachial plexus; supplies the skin on the medial aspect of the forearm.

Medial antebrachial cutaneous nerve

1. Compare and contrast medial epicondylitis and lateral epicondylitis

Medial: "Golfer's", flexor/Pronator group of muscles, common origin medial epicondyle, numbness and tingling over ulnar nerve distribution Lateral: "Tennis", extensor group of muscles, common origin lateral epicondyle, weak grip Both: repetitive use injuries, pain/tenderness at insertion point, radiating pain

The sensory nerve distribution in the hand

Median nerve: central palm, majority of the thenar eminence, volar aspects of index, middle, lateral ½ of ring finger & dorsal surface: distal aspects of the thumb, index, middle and ½ of ring finger.-Ulnar nerve: hypothenar eminence, and the palmar and dorsal surfaces of medial ½ of ring finger and whole pinky. -Radial nerve: lateral 2/3rd of the dorsum of the hand, the dorsum of the thumb, and the proximal parts of the dorsum of the index, middle ½ of the ring finger.

Which of the following muscles inserts on the 5th metacarpal bone? -Abductor digiti minimi -Flexor digiti minimi brevis -Opponens digiti minimi

Opponens digiti minimi

Which of the following muscles inserts on the 1st metacarpal bone? -Abductor pollicis brevis -Flexor pollicis brevis -Opponens pollicis -Adductor pollicis

Opponens pollicis

What important branch of the deep branch of the radial nerve in the forearm

PIN

What innervates the Abductor Pollicis Longus muscle

PIN

What innervates the Extensor Carpi Ulnaris muscle

PIN

What innervates the Extensor Digiti Minimi muscle

PIN

What innervates the Extensor Digitorum muscle

PIN

What innervates the Extensor Indicis muscle

PIN

What nerve is a branch of the radial nerve: supplies the skin along the midline of the forearm.

Posterior antebrachial cutaneous

What is the origin of the Extensor Pollicis Brevis muscle

Posterior surface of the distal 1/3 of the radius and the interosseous membrane.

Function of the volar plates

Prevent excessive extension of MP and IP joints

The superficial layer of the anterior compartment muscles of the forearm

Pronator Teres Flexor Carpi Radialis Palmaris Longus Flexor Carpi Ulnaris

These five muscles of the posterior compartment of the forearm have a common origin point on the lateral epicondyle of the humerus.

Pronator Teres Flexor Carpi Radialis Palmaris Longus Flexor Carpi Ulnaris Supinator

What are some syndromes caused by the Proximal median nerve injury or entrapments

Pronator teres syndrome and Anterior interosseous syndrome

The proximal and distal carpal bones of the wrist from lateral to medial.

Proximal row: Scaphoid, Lunate, Triquetrum, Pisiform Distal Row: Trapezium, Trapezoid, Capitate, Hamate

1. The clinical manifestation of an injury to the AIN nerve and the anatomical space involved

Purely Motor (3 muscles): inability to make the OK sign (loss of innervation to flexor Pollicis longus and ½ flexor Digitorum Profundus), pronation weakness (loss of Pronator quadratics)

What is the condition where sensory & motor impairments impacting the distribution of the radial nerve

Radial nerve injury or entrapments

What passes through the carpal tunnel

Tendons of FDP, FDS, and FPL and Median nerve

Which structures travel through the carpal tunnel? Select all that apply -Tendons of flexor digitorium superficialis -Tendons of flexor digitorium profundus -Tendon of flexor carpi radials -Tendon of flexor pollicis longus -Median nerve -Ulnar nerve

Tendons of flexor digitorium superficialis, tendons of flexor digitorium profundus, Tendon of flexor pollicis longus, and Median nerve

What structure is a fibro-osseous tunnel that is formed by the carpal bones posteriorly and the transverse carpal ligament anteriorly.

The carpal tunnel

What structures of the hand is located in the center of the palm. It is bordered laterally and medially by the thenar and hypothenar eminences, respectively.

The central compartment of the hand

True or False: The movements that are possible at the radiocarpal joint include: flexion/extension; radial and ulnar deviation; and circumduction.

True

Which of the following muscles inserts onto the base of the first metacarpal bone? -abductor pollicis longus -extensor pollicis longus -extensor pollicis brevis

abductor pollicis longus

Which tendons form the anterior border of the anatomical snuff box? Select all that apply. -abductor pollicis longus -extensor pollicis longus -extensor pollicis brevis -extensor Digitorium -Extensor Indicis

abductor pollicis longus and extensor pollicis brevis

Which of the following muscles is a muscle of the deep layer of the forearm? Select all that apply. -extensor carpi radialis longus -abductor pollicis longus -extensor pollicis brevis -extensor pollicis longus -extensor carpi ulnaris

abductor pollicis longus, extensor pollicis brevis, and extensor pollicis longus

What are the main actions of the Abductor Pollicis Longus muscle

abducts & extends the CM joint of the thumb; assists with extension of the wrist

What are the main actions of the Abductor Digiti Minimi muscle

abducts the 5th digit; assists with flexion of 5th digit.

What are the main actions of the Dorsal Interossei muscles

abducts the MP joints of 2nd - 4th digits, & assists the lumbricals with flexion at MP joints & extension of IP joints via the extensor expansion.

what is the key ligament of the proximal radioulnar joint

annular ligament

What structure encloses the muscles of the forearm & forms a complete sheath around the forearm; penetrated by deep nerves & vessels.

antebrachial fascia

the palmar carpal arch receives contribution from what artery

anterior interosseous artery

What innervates the flexor pollicis longus

anterior interosseous nerve

What innervates the pronator quadratus

anterior interosseous nerve

What structure gives off the medial antebrachial cutaneous nerve

arises from the medial cord of the brachial plexus;

The ulnar nerve is traveling through the cubital tunnel when transitioning from what 2 structures

arm to forearm

What joint of the forearm has an articular disk

articular disc

Cubital anastomosis: formed by branches of what arteries

brachial artery & ulnar and radial arteries

Which of the following structures forms the lateral border of the cubital fossa? imaginary line between the epicondyles brachioradialis pronator teres

brachioradialis

What is the lateral boundary of the radial tunnel

brachioradialis, ECRL and ECRB

Which of the following muscles forms part of the lateral boundary of the radial tunnel? Select all that apply. -brachioradialis -biceps -extensor carpi radialis longus -supinator -extensor carpi radialis brevis

brachioradialis, extensor carpi radialis longus, and extensor carpi radialis brevis

What are the two major divisions of the radial nerve in the forearm

deep and superficial branch

What innervates the Supinator muscle

deep branch of the radial nerve

What is the cause of Cubital tunnel syndrome

entrapment of the ulnar nerve in the cubital tunnel.

What is the main actions of the Extensor Carpi Radialis Brevis muscle

extends & abducts (radial deviation) the wrist joint.

What forms the radial border of Guyon's canal

hook of the hamate

These muscles are apart of what group of hand muscles Opponens digiti minimi, Abductor digiti minimi, and Flexor digiti minimi brevis

hypothenar muscle

The ED tendons limit what motion

independent extension of the digits.

What completes the separation between the anterior and posterior surface of the forearm

interosseous membrane

What condition is Characterized by MP flexion coupled with PIP and DIP extension

intrinsic plus hand

What condition is caused by imbalances between strong (or short) intrinsic and weak extrinsic muscles of the hand.

intrinsic plus hand

What is the origin of lumbricals 1 and 2

lateral 2 tendons of FDP as unipennate muscles.

Carpal tunnel syndrome causes Sensory impairments of what structure

lateral 3 ½ digits

What cords of the brachial plexus contribute to the median nerve

lateral and medial cords

What part of the extensor expansion pass to the base of the distal phalanx; tendons of the short muscles of the hand join the ED tendon over the middle phalanx.

lateral bands

What is the origin of lumbricals 3 and 4

medial 3 tendons of FDP as bipennatemuscles.

Where does the flexor digitorum profundus orignate

medial and anterior surfaces of proximal 3/4 of the ulna & interosseous membrane

Which of the following nerves supply the skin of the anterior aspect of the forearm? Select all that apply medial antebrachial cutaneous ulnar median lateral antebrachial cutaneous

medial antebrachial cutaneous and lateral antebrachial cutaneous

Where is the cubital tunnel located

medial aspect of the elbow

What cords of the brachial plexus contribute to the ulnar nerve

medial cord

What type of joint are the intercarpal joints

plane

What type of joint is a Carpometacarpal joints

plane type

the dorsal carpal arch receives contribution from what artery

posterior interosseous artery

What is the origin of the Extensor Indicis muscle

posterior surface of the distal 1/3 of the ulna and the interosseous membrane

What is the origin of the Extensor Pollicis Longus muscle

posterior surface of the middle 1/3 of the ulna and the interosseous membrane

What is the origin of the Abductor Pollicis Longus muscle

posterior surface of the ulna, radius, and interosseous membrane

What are the main actions of the pronator teres

pronates forearm & flexes elbow

What are the main actions of the pronator quadratus

pronates forearm; deep fibers bind radius & ulna together

Which muscles are contained in the superficial layer of the anterior compartment of the forearm? Select all that apply. flexor digitorum profundus pronator quadratus pronator teres palmaris longus flexor digitorum superficialis

pronator teres and palmaris longus

What is the origin of the Brachioradialis muscle

proximal 2/3rds of the lateral supracondylar ridge of humerus.

What innervates the Brachioradialis muscle

radial nerve proper

What innervates the Extensor Carpi Radialis Longus muscle

radial nerve proper

Which of the following are considered important bony landmarks of the ulna? Select all that apply. ulnar notch radial notch coronoid process greater tubercle tuberosity styloid

radial notch, coronoid process, tuberosity, and styloid

What are the key branches of the radial artery

radial recurrent artery and carpal branches

What are some symptoms of Proximal median nerve injury or entrapments

sensory & motor impairments impacting the distribution of the median nerve

What are some of the symptoms of Cubital tunnel syndrome

sensory & motor impairments in the distribution of the ulnar nerve.

These muscles are apart of what group of hand muscles Lumbricals, Dorsal Interossei, and Palmar Interossei

short muscles

What does the Lateral antebrachial cutaneous nerve supply

skin on the lateral aspect of the forearm.

What does the medial antebrachial cutaneous nerve supply

skin on the medial aspect of the forearm.

What is the medial boundary of the radial tunnel

tendon of the biceps & brachialis

Which structures are contained in the central compartment of the hand? Select all that apply. -tendons of flexor digitorium superficialis and profundus -Radial nerve -Superficial and deep palmar arterial arches -Digital branches of the median and ulnar nerves -Tendon of flexor pollicis longus

tendons of flexor digitorium superficialis and profundus, Superficial and deep palmar arterial arches, and Digital branches of the median and ulnar nerves

What part of the extensor expansion inserts into base of distal phalanx -important extension of DIP joint.

terminal tendon

The cubital fossa is a transition zone for neurovascular structures traveling between what 2 structures

the arm & forearm

These muscles are apart of what group of hand muscles Opponens pollicis, Abductor pollicis brevis, Flexor pollicis brevis, and Adductor pollicis

thenar muscles

Thenar muscles have action on what structure

thumb

Which of the following arteries contributes to the formation of the cubital anastomosis? Select all that apply. ulnar collaterals (superior and inferior) radial and middle collaterals recurrent interosseous anterior intereosseous radial recurrent

ulnar collaterals (superior and inferior), radial and middle collaterals, recurrent interosseous, and radial recurrent

What innervates the flexor carpi ulnaris

ulnar nerve

What structure travels through the cubital tunnel

ulnar nerve

What is contained within Guyon's canal

ulnar nerve and ulnar artery

What is the insertion of the Extensor Carpi Ulnaris muscle

base of the 5th metacarpal

What is the insertion of the Extensor Pollicis Longus muscle

base of the distal phalanx of thumb (dorsal aspect)

What is the insertion of the Extensor Pollicis Brevis muscle

base of the proximal phalanx of thumb (dorsal aspect)

Where does the flexor digitorum profundus insert

bases of distal phalanges of medial four digits

What structure gives off the Lateral antebrachial cutaneous nerve

continuation of the musculocutaneous nerve

Articulations between proximal & distal row of carpal bones is known as what type of joint

midcarpal joint

The location you would palpate to feel the radial pulse

Antero-Lateral Wrist between flexor carpi Radialis and the 1st dorsal compartment

What condition is Characterized by MP hyperextension coupled with PIP and DIP flexion

Intrinsic minus hand

What condition is caused by imbalances between strong extrinsic (or short) and weak intrinsic muscles of the hand

Intrinsic minus hand

What nerve is the continuation of the musculocutaneous nerve; supplies the skin on the lateral aspect of the forearm.

Lateral antebrachial cutaneous nerve

What nerves supply the skin over the anterior aspect of the forearm

Lateral antebrachial cutaneous nerve and Medial antebrachial cutaneous nerve

The deep palmar arch receives contribution from what artery

Metacarpal arteries

Which of the following joints is formed by the articulation of the the head of the metacarpal bones with the bases of the proximal phalanges. -Metacarpophalangeal joints -Interphalangeal joints -Carpometacarpal joints

Metacarpophalangeal joints

What innervates the Extensor Pollicis Brevis muscle

PIN

what innervates the Extensor Pollicis Longus muscle

PIN

What are the branches of the median nerve provide sensory information in the hand

Palmar cutaneous and Digital branches

Which branch of the median nerve arises prior to the median nerve entering the carpal tunnel? -Recurrent branch -Digital branches -Palmar cutaneous branch

Palmar cutaneous branch

What condition causes Weakness of the intrinsic muscles of the hand - clawing of 4 & 5th digits - wasting of the hypothenar eminence and over the area of the 1st dorsal interosseous

Ulnar canal syndrome

Which of the following structures pass through the ulnar canal? Select all that apply. -Ulnar nerve -Median nerve -Radial artery -Ulnar artery

Ulnar nerve and Ulnar artery

What is the origin of the Dorsal Interossei muscles

adjacent sides of two metacarpal bones (bipennate muscles)

Which of the following muscles is supplied by the PIN? Select all that apply. -extensor pollicis longus -extensor digitorium -extensor digiti minimi -extensor indicis -abductor pollicis longus

all of the above

Where does the flexor carpi radialis insert?

base of 2nd and 3rd metacarpals

What is the insertion of the Abductor Pollicis Longus muscle

base of the 1st metacarpal (lateral aspect)

What is the insertion of the Extensor Carpi Radialis Longus muscle

base of the 2nd metacarpal

What is the insertion of the Extensor Carpi Radialis Brevis muscle

base of the 3rd metacarpal

Which of the following muscles receives its blood supply from the radial recurrent artery? Select all that apply. -brachioradialis -extensor carpi radialis longus -extensor digiti minimi -extensor pollicis longus -extensor carpi radialis brevis

brachioradialis, extensor carpi radialis longus, and extensor carpi radialis brevis

What type of joint is the radiocarpal joint

condyloid joint

What type of joint is the MP joint

condyloid type

What innervates the Extensor Carpi Radialis Brevis muscle

deep branch of the radialnerve

What are the movements of the wrist

flexion/extension, radial/ulnar deviation, and circumduction

Which fingers have DIP and PIP joints

digits 2-5

Where does the pronator quadratus originate

distal 1/4 of anterior surface of ulna

what articulates at the radiocarpal joint

distal end of the radius & articular disc with the proximal row of carpal bones (excluding pisiform)

Where does the pronator quadratus insert

distal ¼ of anterior surface of radius

true or false: The common interosseous artery is a branch of the radial artery

false

What is the main actions of the Extensor Carpi Radialis Longus muscle

extends & abducts (radial deviation) the wrist joint.

What are the main actions of the Extensor Carpi Ulnaris muscle

extends & adducts (ulnar deviation) the wrist joint.

What are the main actions of the Extensor Pollicis Brevis muscle

extends the CM & MP joints of the thumb; assists with extension of the wrist

what are the main actions of the Extensor Indicis muscle

extends the MP & IP joints of the index finger; assists with extension of the wrist

what are the main actions of the Extensor Pollicis Longus muscle

extends the MP & IP joints of the thumb; assists with extension of the wrist

What are the main actions of the Extensor Digiti Minimi muscle

extends the MP joints of digits & secondarily extends IP joint of the 5th digit, & extends the wrist joint

What are the main actions of the Extensor Digitorum muscle

extends the MP joints of the digits & secondarily extends IP joints, & extends the wrist joint.

Which of the following muscles will extend and radial deviate the wrist joint? -supinator -brachioradialis -extensor carpi ulnaris -extensor carpi radialis longus

extensor carpi radialis longus

What is the insertion of the Extensor Indicis muscle

extensor expansion of the 2nd digit (index finger)

What is the insertion of the Extensor Digiti Minimi muscle

extensor expansion of the 5thdigit (pinky).

What is the insertion of the Palmar Interossei muscles

extensor expansions and the bases of the proximal phalanges of digits 2, 4, & 5.

What is the insertion of the Dorsal Interossei muscles

extensor expansions and the bases of the proximal phalanges of digits 2-4

What is the insertion of the Extensor Digitorum muscle

extensor expansions of the medial four digits

Which of the following muscles inserts into the extensor expansion of the 2nd digit (index finger)? -extensor indicis -extensor digitorium -extensor digiti minimi -extensor pollicis longus

extensor indicis

Which of the following tendons is contained in the 3rd dorsal compartment? -extensor pollicis brevis -extensor digiti minimi -extensor pollicis longus

extensor pollicis longus

True or False: An infection in the tendon sheath of the thumb often presents with redness and swelling at the wrist because of the continuity of the ulnar bursa.

false

True or False: Drinking from a water bottle requires use of a precision grasp while holding a pen to write requires use of a power grasp

false

True or False: The posterior interosseous artery is a branch of the radial artery.

false

True or False: The radiocarpal joint is a condyloid joint that allows one degree of freedom: flexion/extension.

false

True or False: The superficial branch of the radial nerve is a mixed motor and sensory nerve.

false

True or False: Upon passing through the ulnar canal, the ulnar nerve divides into a superficial motor branch and a deep sensory branch.

false

What are the main actions of the flexor carpi ulnaris

flexes & adducts (ulnar deviation) the wrist joint.

What are the main actions of the flexor digitorum profundus

flexes DIP joints of digits; assists with flexion of the wrist joint

What are the main actions of the flexor pollicis longus

flexes IP (primarily) & MP joints of thumb; can assist with flexion of wrist joint

What are the main actions of the flexor digitorum superficialis

flexes PIP & MCP joints of digits; assists with flexion of the wrist joint

What is the main action of the Brachioradialis muscle

flexes elbow weakly - maximum action when the forearm is in mid-position.

What is the main actions of lumbricals 1 and 2

flexes the MP joints & extends IP joints (via extensor expansion) of digits 2 & 3

What are the main actions of lumbricals 3 and 4

flexes the MP joints & extends IP joints (via extensor expansion) of digits 4 & 5

What are the main actions of the Flexor Digiti Minimi Brevis muscle

flexes the proximal phalanx ofthe 5th digit

What are the main actions of the palmaris longus

flexes the wrist joint & tightens the palmar aponeurosis

What are the main actions of the Flexor Pollicis Brevis muscle

flexes thumb

What movements occur at the CM joint of the thumb

flexion & extension; abduction & adduction; opposition & reposition.

What movements occur at the Radiocarpal joint

flexion & extension; abduction (radialdeviation) & adduction (ulnar deviation); circumduction

what motion is the central band of the extensor expansion important for

important for extension of the PIP joint

Which of the following nerves supplies the skin of the posterolateral aspects of the forearm? -medial antebrachial cutaneous nerve -lateral antebrachial cutaneous nerve -posterior antebrachial cutaneous nerve

lateral antebrachial cutaneous nerve

What is the origin of the Extensor Carpi Ulnaris muscle

lateral epicondyle of humerus & posterior border of the ulna.

What is the origin of the Extensor Carpi Radialis Brevis muscle

lateral epicondyle of the humerus

What is the origin of the Extensor Digiti Minimi muscle

lateral epicondyle of the humerus

What is the origin of the Supinator muscle

lateral epicondyle of the humerus; "supinator ridge"

What is the origin of the Extensor Digitorum muscle

lateral epicondyle of the humerusand deep fascia of forearm.

What is the insertion of the Opponens Pollicis muscle

lateral side of the first metacarpal

What is the insertion of lumbricals 3 and 4

lateral sides of the extensor expansions of digits 4 & 5.

What is the insertion of lumbricals 1 and 2

lateral sides of the extensorexpansions of digits 2 & 3

What is the origin of the Extensor Carpi Radialis Longus muscle

lateral supracondylar ridge of the humerus.

What is the insertion of the Brachioradialis muscle

lateral surface of distal end of the radius just proximal to the radial styloid

What is the insertion of the Supinator muscle

lateral, posterior, and anterior surfaces of the proximal 1/3rd of the radius

Which of the following structures forms the medial boundary of the cubital tunnel? cubital retinaculum medial epicondyle olecranon

medial epicondyle

Where does the palmaris longus originate?

medial epicondyle of humerus

Where does the flexor carpi radialis originate from

medial epicondyle of the humerus

What innervates the flexor digitorum profundus

medial half: ulnar nerve lateral half: anterior interosseous nerve

What is the insertion of the Abductor Digiti Minimi muscle

medial side of base of the proximal phalanx of digit 5 (pinky).

What is the insertion of the Flexor Digiti Minimi Brevis muscle

medial side of base of the proximal phalanx of digit 5 (pinky).

What is the insertion of the Adductor Pollicis muscle

medial side of the base of the proximal phalanx of the thumb.

What innervates lumbricals 1 and 2

median nerve

What innervates the flexor carpi radialis

median nerve

What innervates the flexor digitorum superficialis

median nerve

What innervates the palmaris longus

median nerve

What innervates the pronator teres

median nerve

What are the three nerves that supply the skin of the hand.

median nerve, ulnar nerve, and superficial branches of the radial nerve

Where does the pronator teres insert

midway along the lateral surface. of radius

What is the origin of the Adductor Pollicis muscle

oblique head: trapezoid, capitate & bases of 2nd/3rd metacarpals; transverse head: shaft of 3rd metacarpal

Which of the following movements is possible at the carpometacarpal (CM) joint of the thumb? Select all that apply. -radial and ulnar deviation -opposition and reposition -flexion and extension -abduction and adduction -internal and external rotation

opposition and reposition, flexion and extension, and abduction and adduction

What are the key ligaments of the CM joints

palmar & dorsal carpal-metacarpal ligaments

Your patient had an injury to the ulnar nerve. Where do you anticipate your patient will have sensory loss? -central palm and the majority of the thenar eminence -palmar and dorsal surfaces of the 4th and 5th digits -lateral 2/3rds of the dorsum of the hand

palmar and dorsal surfaces of the 4th and 5th digits

Where does the palmaris longus insert?

palmar aponeurosis

What forms the roof of Guyon's canal

palmar carpal ligament

What does the antebrachial fascia continue into the hand as?

palmar fascia

The extensor expansion is Anchored on the sides to the

palmar ligaments

Which of the following ligaments provides support to the distal radioulnar joint? -palmar radio-ulnar ligaments -radial collateral ligament -dorsal radiocarpal ligaments

palmar radio-ulnar ligaments

Which of the following ligaments will prevent excessive wrist extension? Select all that apply. -ulnar collateral -dorsal radiocarpal -palmar radiocarpal -dorsal ulnocarpal -palmar ulnocarpal

palmar radiocarpal and palmar ulnocarpal

What is the insertion of the Opponens Digiti Minimi muscle

palmar surface of the 5th metacarpal

What does the pisiform sit on

palmar surface of the triquetrum

What is the origin of the Palmar Interossei muscles

palmar surfaces of 2nd, 4th, & 5th metacarpals

What is the roof of the radial tunnel

radial recurrent vessels (leash of Henry) & superficial layer of supinator.

What structure is is located from the humero-radial joint & extends distally past the proximal edge of the supinator muscle

radial tunnel

the deep branch of the radialtravels through what structure when transitioning from the cubital fossa to the forearm

radial tunnel

the interosseous membrane is located between which 2 structures

radius and ulna

What are the borders of the cubital tunnel

roof: cubital retinaculum floor: ulnar/medial collateral ligament and elbow joint capsule medial: medial epicondyle lateral: olecranon

What is the main action of the Opponens Pollicis muscle

rotates first meta-carpal to oppose the thumb.

What are the main actions of the Opponens Digiti Minimi muscle

rotates the 5th metacarpal drawing it toward the thumb in opposition

What type of joint is the CM joint of the thumb

saddle joint

What forms the lateral border of the carpal tunnel

scaphoid & trapezium

Which of the following bones are found in the proximal row of carpal bones? Select all that apply. scaphoid trapezium lunate pisiform capitate

scaphoid, lunate, and pisiform

What are the bones in the proximal row of the carpal bones from lateral to medial

scaphoid, lunate, triquetral bone, and pisiform

What occurs during accommodation

structure of the hand conforms to the structure of a surface allowing movement over surfaces.

What innervates the Flexor Pollicis Brevis muscle

superficial head = RBMN & deep head = DBUN

What is the origin of the Flexor Pollicis Brevis muscle

superficial head:flexor retinaculum & tubercle of the trapezium; deep head: tubercle of the scaphoid.

What does the superficial fascia of the forearm contain?

superficial nerves and vessels

What is the main actions of the supinator muscles

supinates the forearm

What movements occur at the Distal radioulnar joint

supination & pronation

What movements occur at the joint of the forearm

supination and pronation

The deep branch of the radial nerve supplies which of the following muscles? Select all that apply. -brachioradialis -supinator muscle -extensor carpi radialis longus -extensor carpi radialis brevis -extensor carpi ulnari

supinator muscle and extensor carpi radialis brevis

What structures travel through the cubital fossa? Select all that apply. terminal end of the brachial artery ulnar nerve proximal parts of the ulna and radial arteries biceps tendon

terminal end of the brachial artery, median nerve, proximal parts of the ulna and radial arteries, and biceps tendon

What articulates at the CM joints

the distal row of carpal bones & the bases of the metacarpal bones

antebrachial fascia of the forearm is continuous with what?

the fascia of the palm and the dorsum of the hand

What articulates at the MP joint

the head of the metacarpal bones with the bases of the proximal phalanges.

What articulates at the IP joints

the head of the phalanges with the bases of the more distal. phalanges.

What is the insertion of the Abductor Pollicis Brevis muscle

the lateral side of the base of the proximal phalanx of the thumb

What is the insertion of the Flexor Pollicis Brevis muscle

the lateral side of the base of the proximal phalanx of the thumb.

Ulnar canal syndrome causes Sensory impairments of what structure

the medial1 ½ digits

During pronation, which bone in the forearm rotates over the other

the radius rotates over the fixed ulna

What forms the floor of Guyon's canal

transverse carpal ligament

What forms the roof of the carpal tunnel

transverse carpal ligament

Which of the following structures forms the roof of the carpal tunnel? -transverse carpal ligament -extensor retinaculum -the palmar carpal ligament -palmar aponeurosis

transverse carpal ligament

The CM joint of the thumb is formed by the articulation of the base of the1st metacarpal bone with the __________. -lunate -pisiform -trapezoid -trapezium

trapezium

What articulates at the CM joint of the thumb

trapezium and the 1stmetacarpal bone.

What are the bones in the distal row of the carpal bones from lateral to medial

trapezium, trapezoid, capitate, and hamate

This function of the fibrous layer of the flexor tendon sheaths is to prevent bowstringing of the tendons as they cross multiple joints.

true

True or False: The CM joint of the thumb is a saddle joint that allows for three degrees of freedom: flexion/extension; abduction/adduction; and opposition/reposition.

true

True or False: The ability of the hand to conform to the characteristics of object surfaces is called accommodation.

true

True or False: The radioulnar joints are pivot joints that allow 1 degree of freedom: pronation/supination.

true

True or False: The tendons of the FPL, FDS, and FDP are contained in flexor tendon sheaths that consist of both a synovial layer and fibrous layer.

true

True or False: The thickening of the antebrachial fascia across the anterior aspect of the wrist forms the flexor retinaculum.

true

true or false: The cubital anastomosis is formed by the branches of the brachial, ulnar and radial arteries

true

true or flase: the median nerve gives off a deep branch called the anterior interosseous nerve.

true

Blood supply to the hand arises from multiple arches formed by the anastomoses between what arteries

ulnar and radial

Blood supply to the forearm arises from multiple branches of what arteries

ulnar and radial arteries

What is contained in the cubital fossa

ulnar artery, radial artery, accompanying veins, median nerve, divisions of radial nerve, and biceps tendon

Which of the following ligaments prevents excessive radial deviation? -radial collateral ligament -ulnar collateral ligament -palmar radiocarpal ligament

ulnar collateral ligament

What are the key branches of the ulnar artery

ulnar recurrent arteries, common interosseous artery, anterior, posterior, and recurrent interosseous artery, and carpal branches


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