unit 15- posterior forearm and hand

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dorsal metacarpal arteries

- branches of the dorsal carpal arch to carry blood to the fingers

first dorsal metacarpal artery

- directly from the radial artery before it crosses through the two heads of the first dorsal interosseous muscle

deep radial nerve

- supplies the extensor carpi radialis brevis and supinator muscles

no- some people only have 3 because not everyone has one going to their pinky finger

does every single person have 4 tendons from their extensor digitorum? explain.

no it inserts on the upper ulna (aka doesn't cross the wrist joint) so it only works on the elbow joint

does the anconeus muscle work on the wrist?

no

does the brachioradialis cross the wrist?

no it only works on the elbow joint (to flex it) because it inserts on the styloid process of the radius which is above the wrist joint (since it doesn't cross the joint it cant work on it)

does the brachioradialis work on the wrist joint?

no! it is purely cutaneous (but that means it does have some visceral efferents aka postganglionic sympathetics for those sweat glands)

does the superficial radial nerve have somatic motor fibers?

anatomical snuff box

edges are tendons of muscles related to the thumb -tendons of abductor pollicis longus and extensor pollicis brevis -tendon of extensor pollicis longus

when it enters the extensor retinaculum it is one tendon but as it emerges from the distal side of the extensor retinaculum and heads towards the pinky finger it is typically 2 separate tendons next to each other

explain the tendons of the extensor digiti minimi

6

how many osteofibrous comparments under the extensor retinaculum are there?

O: lateral epicondyle and ulna, wraps around radius I: lateral surface of the radius A: supinates the forearm N: deep branch of radial nerve

origin, insertion, action, and innervation of the supinator muscle

superficial radial nerve

purely cutaneous to posterolateral surface of the hand

dorsal branch of the ulnar nerve

serves the medial aspect of the digits of the dorsal side

dorsal carpal arch

supplied by the dorsal carpal branches of the radial and ulnar arteries and anterior and posterior interosseous arteries

first compartment

the abductor pollicis longus passes through the ________ ________under extensor retinaculum

medial

the dorsal branch of the ulnar nerve supplies the _____ aspect of the digits of the dorsal side

2nd 3rd

the extensor carpi radialis LONGUS inserts on the base of the _____ metacarpal while the extensor carpi radialis BREVIS inserts on the base of the _______ metacarpal

second compartment

the extensor carpi radialis brevis passes through the ______ ______ under the extensor retinaculum

second compartment

the extensor carpi radialis longus passes through the _________ _______ under extensor retinaculum

extensor retinaculum

the extensor carpi radialis longus passes through the second comparment under the ______ _______

sixth comparment

the extensor carpi ulnaris passes through the _______ _______under extensor retinaculum

medial/ulnar side

the extensor digiti minimi inserts on what side of the extensor digitorum tendon to the pinky finger?

fifth comparment

the extensor digiti minimi passes through the ______ compartment under the extensor retinaculum

fourth compartment

the extensor digitorum passes through the _______ ______ under the extensor retinaculum

medial/ulnar

the extensor indicis inserts on the ______ side of the extensor digitorum tendon to the index finger

fourth compartment

the extensor indicis passes through the______ ______under extensor retinaculum

first comparment

the extensor pollicis brevis passes through the ______ ________ under extensor retinaculum

third compartment

the extensor pollicis longus passes through the _______ _________ and changes direction at the dorsal radial tubercle (Lister's tubercle)

radial artery (before it crosses through the two heads of the first dorsal interosseous muscle)

the first dorsal metacarpal artery comes directly from what?

anconeus muscle

the interosseous recurrent artery remains deep to what muscle?

anconeus (branch from the arm not in cubital fossa) extensor carpi radialis longus brachioradialis muscles

the main trunk of the radial nerve supplies what 3 muscles before it divides?

above the wrist

the posterior branch of the anterior interosseous artery appears where?

supinator

the posterior interosseous artery enters the compartment deep to what muscle?

deep radial nerve

the posterior interosseous nerve is a continuation of what nerve?

anterior aspect

the radial nerve divides on the _______ aspect of the elbow

scaphoid bone

What is the most frequently fractured carpal bone?

5 2

_____ superficial layer muscles take origin from a common tendon on the lateral epicondyle while _____ take origin from the supracondylar line above it

posterior interosseous nerve

all of the deep layer muscles (besides the supinator) are innervated by what?

radial nerve and its branches

all of the posterior forearm muscles are innervated by what?

lateral epicondyle supracondylar line/ridge

all superficial layer muscles take partial origin from a common tendon from the ______ _______ (5) or the ________ ________ (2) above it

L: tendons of abductor pollicis longus and extensor pollicis brevis M: tendon of extensor pollicis longus

borders of the anatomical snuff box : lateral border: medial border:

long extensor of the thumb

content of 3rd compartment

tendon of the extensor digiti minimi muscle

content of 5th compartment

tendon of extensor carpi ulnaris muscle

content of 6th compartment

the tendon splits into 3 parts - one central split and then 2 bands on either side.. the central split inserts on the middle phalanx while the 2 lateral slits travel down further to insert on the distal phalanx (looks similar to the FDS splitting and FDP traveling through)

describe what happens to the tendons of the extensor digitorum as they go to insert on the digits

skin and fascia

what forms the roof of the snuff box?

superficial radial nerve deep radial nerve (posterior interosseous nerve - a continuation of the deep radial)

2 branches of the radial nerve when it divides on the anterior aspect of the elbow

two extensor carpi radialis muscles (longus and brevis)dorsa

2 contents of the 2nd compartment

tendons of extensor digitorum and extensor indicis muscles

2 contents of the 4th compartment

long abductor and short extensor of the thumb

2 contents of the first compartment

supinator abductor pollicis longus extensor pollicis brevis extensor pollicis longus extensor indicis

5 muscles of the deep layer of the posterior forearm/hand from most proximal to most distal

brachioradialis extensor carpi radialis longus extensor carpi radialis brevis extensor digitorum extensor digiti minimi extensor carpi ulnaris aconeus

7 muscles of the superficial layer of the posterior forearm/hand

no-- the radial nerve innervates a portion of the back of the hand where the median nerve was on the front (the median nerve only innervates the distal phalanx area of the 3.5 fingers) the ulnar nerve still has about its same 1.5 digit innervation area

is the cutaneous supply of the dorsal aspect of the hand the same as the palmar aspect?

no -- there are insertions on all the other metacarpals though

is there a muscle from the posterior compartment of forearm that inserts on the 4th metacarpal?

extensor carpi radialis longus extensor carpi radialis brevis extensor digitorum extensor digiti minimi extensor carpi ulnaris anconeus (on top)

list the 6 muscles of the superficial layer of the posterior compartment from most lateral to most medial

listers tubercle

name for the dorsal radial tubercle

extensor expansion

name for the four tendons from the extensor digitorum muscle spread out over the metacarpophalangeal joint

O: radius, ulna and interosseous membrane I: base of first metacarpal A: abducts and extends the thumb N: posterior interosseous nerve

origin, insertion, action and innervation of the abductor pollicis longus

O: lateral epicondyle I: on the olecranon and upper one-fourth of ulna A: extends the elbow N: main trunk of the radial nerve (from the ARM not in the cubital fossa)

origin, insertion, action and innervation of the anconeus muscle

O: lateral supracondylar ridge I: distal radius above styloid process A: flexes forearm at elbow N: main trunk of the radial nerve

origin, insertion, action and innervation of the brachioradialis

O: lateral epicondyle I: base of third metacarpal A: extends and abducts the wrist N: deep branch of the radial nerve

origin, insertion, action and innervation of the extensor carpi radialis brevis

O: lateral supracondylar ridge I: base of second metacarpal A: extends and abducts the wrist N: main trunk of the radial nerve

origin, insertion, action and innervation of the extensor carpi radialis longus

O: lateral epicondyle I: on base of fifth metacarpal A: extends and adducts the wrist N: posterior interosseous nerve

origin, insertion, action and innervation of the extensor carpi ulnaris

O: lateral epicondyle I: on extensor expansion of little finger A: extends the little finger N: posterior interosseous nerve

origin, insertion, action and innervation of the extensor digiti minimi

O: lateral epicondyle I: as extensor expansions to middle and distal phalanges of four fingers A: extends the medial four fingers and also extends the wrist N: posterior interosseous nerve

origin, insertion, action and innervation of the extensor digitorum

O: ulna and interosseous membrane I: on extensor expansion of index finger 15-5 A: extends the index finger N: posterior interosseous nerve

origin, insertion, action and innervation of the extensor indicis

O: radius and interosseous membrane I: base of the proximal phalanx of thumb A: extends metacarpophalangeal and carpometacarpal joints of the thumb N: posterior interosseous nerve

origin, insertion, action and innervation of the extensor pollicis brevis

O: ulna and interosseous membrane I: base of the distal phalanx of thumb A: extends interphalangeal, metacarpophalangeal and carpometacarpal joints of the thumb N: posterior interosseous nerve

origin, insertion, action and innervation of the extensor pollicis longus

6 (brachioradialis doesn't really count) 5

there are ____ muscles in the superfiical layer and _____ muscles in the deep layer

2 (superficial and deep)

there are ______ layers of muscles in the posterior forearm and hand

muscular branches

there are numerous ________ _______of radial artery

dorsal digital arteries

there are one of these arteries on each side of each finger

interosseous recurrent artery

this artery remains deep to the anconeus muscle

posterior interosseous artery

this blood vessel enters the compartment deep to the supinator muscle

abductor pollicis longus extensor pollicis brevis

what 2 deep layer muscles pass through the first compartment under the extensor retinaculum?

extensor carpi radialis brevis supinator (then it becomes the posterior interosseous after this)

what 2 muscles are innervated by the deep radial nerve?

extensor carpi radialis longus extensor carpi radialis brevis

what 2 superficial layer muscles pass through the second comparment under the extensor retinaculum

brachioradialis extensor carpi radialis longus anconeus (from the ARM not in the cubital fossa/forearm)

what 3 superficial layer muscles are innervated by the main trunk of the radial nerve?

extensor digitorum extensor digiti minimi extensor carpi ulnaris

what 3 superficial layer muscles are innervated by the posterior interosseous nerve?

radial artery 2 extensor carpi radialis tendons (longus and brevis)

what 3 things pass through the anatomical snuff box?

tendons of abductor pollicis longus extensor pollicis brevis

what are the 2 tendons that from the lateral (radial) border of the snuff box?

styloid process scaphoid bone little bit of the trapezium and 1st metacarpal

what forms the floor of the snuff box?

dorsal carpal branches of the radial and ulnar arteries anterior and posterior interosseous arteries

what is the dorsal carpal arch supplied by?

tendon of extensor pollicis longus

what is the medial (ulnar) border of the snuff box?

supinator (deep branch of radial nerve)

what is the only muscle of the deep layer not innervated by the posterior interosseous nerve?

it WRAPS AROUND the radius from the lateral epicondyle to insert on its lateral surface (this is how it can cause supination)

what is the supinator muscle's relationship to the radius?

it is innervated by the main trunk of the radial nerve but it's innervation comes from the ARM not the forearm (not in the cubital fossa)

what is unique about the innervation of the anconeus muscle?

anconeous

what muscle assists the triceps with elbow extension?

extensor carpi radialis brevis

what superficial layer muscle is innervated by the deep branch of the radial nerve?

it FLEXES the elbow (typically posterior compartment muscles are extensors)

what's unique about the brachioradialis? (one of the reasons it's kind of weird to compartmentalize it into the posterior compartment of the forearm)

the extensor retinaculum is bound down in places along its expansion across the wrist and therefore it creates 6 smaller compartments versus the flexor retinaculum which was not bound down in the middle and only created 1 central compartment aka the carpal tunnel

whats a difference between the extensor retinaculum and flexor retinaculum?

after it passes through the two heads of the supinator muscle and emerges on the posterior side

when does the deep radial nerve changes its name to the posterior interosseous nerve

dorsal radial tubercle (listers tubercle)

where does the extensor pollicis longus change directions?

pinky (extensor digiti minimi- superficial layer) index (extensor indicis - deep layer)

which 2 fingers have their own separate extensors besides the ones from the extensor digitorum? name the extensors

3rd (extensor pollicis longus) 5th (extensor digiti minimi) 6th (extensor carpi ulnaris)

which 3 compartments only have 1 tendon in them? (name the tendon)

extensor pollicis longus

which muscle of the posterior comparment undergoes a change of direction via the dorsal radial tubercle?


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