BPK 241 - Lecture 10: Upper Extremities

What are the main parts of the humerus

Shaft (with bicepital groove)

Head, neck & tubercles

Condyles and Epicondyles (Medial = trochlea, Lateral = Capitulum)

Coranoid Fossa (anterior)

Olceranon fossa (posterior)

Between the elbow and wrist joints, which bones are firmly attached

Radius if firmly attached to the hand, where the ulnar is firmly attached to the humerus

Which nerve primarily innervates the upper arm

Musculocutaneous nerve

What are the muscles of the anterior compartment, and their insertions/origins/movement

Biceps brachial, o = supraglenoid tubercle, i = radial tuberosity (forearm fascia), forearm flexion at elbow, supination, assists shoulder flexion

Brachialis, o = anterior surface of humerus, i = coranoid of ulna, flexion of forearm at elbow

Coracobrachialis, assists flexion of arm at shoulder

What are the movements of the forearm, and which bone is moving?

Supination and pronation

The radius rotates

What is in the posterior compartment? Including origins/insertions, and movements

Triceps brachial, o = infragelnoid tubercle, upper lateral & lower medial halves, i = olecranon of ulna, extension of forearm at elbow

Anconeus, o = lat epicondyle, i = olecranon of ulnar, assists triceps brachii

What nerve innervates the posterior arm?

The radial nerve

What are the main arteries in the upper arm?

Brachial arteries, medial and moves laterally and anteriorly at elbow to form ulnar and radial artery

Profound a brachii artery (posterior, only upper arm)

What are the 4 nerves in the upper arm?

Musculocutaneous

Median

Ulnar

Radial

What does the radius articulate with?

Capitulum, and radial notch of ulna

What articulates with the ulna

The trochlear notch articulates with trochlea (humerus)

What joint type is the elbow

Synovial and hinge

What are the ligaments at the elbow

Capsular

medial (ulnar) collateral

Lateral (radial) collateral

Annular ligament

Movements with elbow

Flexion and extension

Pronation and supination occur at radioulnar joints

What and where is the cubital fossa

Anteriorly; inverted triangle

Contains median and radial nerve, brachial artery and its derivatives and tendon of biceps brachii

What type of joint is the radioulnar joint? And what movement does it do?

Synovial and pivot

Supination and pronation

What muscles are active during supination

Biceps brachii (supinator magnus)

What muscles are active during pronation

Pronator teres (proximal)

Pronator quadratus (distal)

What muscle is involved in bringing the arm to mid-range of pronation/supination?

Brachioradialis

What are the muscles of the anterior forearm? (8)

Pronator trees

flexor carpi radialis

Palmaris longus

Flexor carpi ulnaris

Flexor digitorum superficialis

Flexor digitorum profundus

Flexor Pollicis longus

Pronator quadratus

Which muscles in the anterior forearm are innervated by the ulnar nerve?

Flexor carpi ulnaris and ½ of Flexor digitorum profundus

What is the common flexor origin?

Medial epicondyle

What are the muscles in the posterior forearm? (12)

Brachioradialis

Extensor carpi radialis longus

Extensor carpi radials brevis

Extensor digitorum

Extensor digits minimize

Extensor carpi ulnaris

Anconeus

Supinator

Abductors pollicis longus

Extensor pollicis brevis

Extensor pollicis longus

Extensor indicis

Where is the common extensor origin

Lateral epicondyle

What muscles in the posterior forearm are innervated by the radial nerve?

All of them

What are the 3 muscles in the posterior forearm that are considered a part of the anatomical snuff box

Abductor pollicis longus

Extensor pollicis brevis

Extensor pollicis longus

What muscles are involved in flexion of the hand at wrist

Flexor carpi radialis, Flexor carpi ulnaris, Flexor digitorum superficialis, Flexor digitorum profundus, Flexor pollicis longus

What muscles are involved in extension of the hand at the wrist

Extensor carpi radialis longus, Extensor carpi radialis brevis, Extensor carpi ulnaris, Extensor digitorum, Extensor digitorum minimi, Extensor indicis, Abductor pollicis longus, Extensor pollicis brevis, Extensor Pollicis longus

What muscles are involved with adduction (ulnar deviation) of the hand?

Flexor carpi ulnaris, Extensor carpi ulnaris

What muscles are involved in abduction of the wrist

Flexor carpi radialis, Extensor carpi radialis longus, Exentosr carpi radialis brevis

What are the proximal carpal bones

Scaphoid, lunate, triquetral, pisiform

What are the distal carpal bones

Trapezium, trapezoid, capitate, hamate

What carpal bone is most commonly dislocated

Lunate

What carpal bone is most commonly fractured

Scaphoid

What are the ligaments of the wrist

Capsular (anterior and posterior)

Collateral (medial and lateral)

Intercarpal

What are the two retinacula and where are they

Extensor, on dorsal wrist

Flexor, palmar wrist (roof of carpal tunnel)

What kind of blood supply does the anatomical snuffbox have? And what kind of complications does this cause

Retrograde

Avascular necrosis is common if untreated scaphoid fracture occurs

What bones are in the hand

Metacarpals I-V

I side references thumb, V side references pinky finger

Phalanges I-V

What is involved in the carpometacarpal joints?

Metacarpals II-V = gliding, minimal movement

1st metacarpal = synvoial, saddle joint, flex/ext, abd/add, opposition

What is involved with the maetacarpophalangeal joints

Primarily flexion/extension

Strong collateral ligaments

Strong flexor/extensor tendons

Some abduction and adduction

What is involved with the Interphalangeal joints

Synovial joints

Flexion and extension

Collateral ligaments Strong

Phalanges II-V have distal and proximal

What are the intrinsic muscles of the hand, on the thumb side

Thenar eminence

Opponens pollicis

Abductor pollicis brevis

Flexor Pollicis brevis

What are the intrinsic muscles of the hand, on the pinky finger side?

Hypothenar eminence

Opponens digiti minimi

Abductor digiti minimi

Flexor digiti minimi

What nerve are the thenar and hypothenar eminence innervated by, respectively

Median, Ulnar

What are the DABS and PADS? What do they do, and what are they innervated by

Dorsal and palmer Interosseus muscles

Dorsal: Abduction

Palmar: Adduction

Both innervated by ulnar nerve

What is the ½ L from ½ LOAF innervation?

Lumbricals, as half is innervated by the median nerve (thumb half)