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WEEK 24:
Extensor compartment upper limb:
| Question | Answer |
|---|---|
| muscles that move the scapula (4) | trapezius, levator scapulae, rhomboid minor and rhomboid major |
| trapezius muscle | innervated by CNXI with three parts (descending, ascending and horizontal) to move the scapula |
| levator scapulae muscle | innervated by dorsal scapula nerve and elevates the scapula |
| rhomboid major and minor muscles | innervated by dorsal scapular nerve and retract the scapula |
| descending part of the trapezius muscle | elevate scapula |
| ascending part of the trapezius muscle | depress scapula |
| horizontal part of the trapezius muscle | retracts scapula |
| trapezius muscles attaches where on scapula | along spine and acromial process |
| quadrangular space boundaries | medial (long head of triceps), lateral (surgical neck of humerus), superior (teres minor), and inferior (teres major) |
| function of the quadrangular space | space in posterior axilla which allows the posterior circumflex humeral artery and vein and axillary artery to pass into the posterior compartment of the upper arm |
| medial boundary of quadrangular space | long head of triceps |
| lateral boundary of quadrangular space | surgical neck of humerus |
| superior boundary of quadrangular space | teres minor |
| inferior boundary of quadrangular space | teres major |
| contents of the quadrangular space (3- APP) | axillary nerve, posterior circumflex humeral artery, |
| triceps spinal roots | C6, C7, C8 |
| long head of triceps origin | from infraglenoid tubercle of scapula |
| lateral head of triceps origin | posterior aspect of humerus above radial groove |
| medial head of triceps origin | posterior aspect of humerus below radial groove |
| insertion of all heads of triceps | olecranon process of ulna |
| anconeous spinal roots | C7, C8, T1 |
| innervation of triceps and anconeous | radial nerve |
| anconeous origin | from lateral epicondyle of humerus to olecranon process and supero-posterior surface of ulna |
| brachioradialis action | weak elbow flexion which is maximal when arm is midpronated (rock paper scissors) |
| extensor carpi radialis brevis action | wrist extension and abduction |
| extensor carpi radialis longus action | wrist extension and abduction |
| extensor carpi ulnaris action | wrist extension and adduction |
| extensor digiti minimi action | wrist extension and 5th digit extension at MCP and IP joints |
| extensor digitorum action | wrist extension and medial 4 digits extension at their MCP and IP joints |
| muscles in the superficial layer of the posterior compartment of the forearm (5- BEEEE) | brachioradialis, extensor carpi radialis longus, extensor carpi radialis brevis, extensor carpi ulnaris, extensor digiti minimi and extensor digitorum |
| muscles in the deep layer of the posterior compartment of the forearm (5- SEEEA) | supinator, extensor indicis, extensor pollicis brevis, extensor pollicis longus, and abductor pollicis longus |
| supinator action | forearm supination and radius rotation |
| extensor indicis action | 2nd digit extension and wrist extension |
| extensor pollicis brevis action | 1st MCP and CMC joints extension |
| extensor pollicis longus action | 1st IP and MCP and CMC joints extension |
| abductor pollicis longus action | CMC joint abduction and extension |
| innervation of the supinator | deep branch of radial nerve (C7, 8) |
| innervation of all muscles in the deep layer of the posterior compartment of the forearm (except the supinator) | posterior interosseous nerve (C7, 8) which is a continuation of deep branch of radial nerve |
| intrinsic muscles important in extending IP joints and flexing MCP joints (4) | lumbricals 1-2, lumbricals 3-4, dorsal interossei, and palmar interossei |
| innervation of lumbricals 1-2 | medial nerve (C8-T1) |
| innervation of lumbricals 3-4, dorsal and palmar interossei | deep branch of ulnar nerve (C8-T1) |
| joint involved in supination and pronation | radioulnar joint in forearm |
| muscles involved in supination (2) | biceps brachii and supinator |
| muscles involved in pronation (2) | pronator teres and pronator quadratus |
| anatomical snuff box boundaries (3) | tendon of extensor pollicis longus (ulnar) and tendons of extensor pollicis brevis and abductor pollicis longus (radial) |
| contents of the anatomical snuff box (6) | scaphoid bone, trapezium, styloid process of radius, radial artery, superficial branch of radial nerve, and cephalic vein |
| scaphoid fracture | due to falling on outstretched hand can lead to pain and tenderness in the snuff box, putting scaphoid at risk of avascular necrosis |
| dorsal digital expansion aka extensor hood/ extensor expansion | triangular structure which covers back and sides of proximal phalanx and head of metacarpal allowing the extensor tendons to attach to phalanges |
| extensor tendons in dorsal digital expansion split into | three slips - central slip inserting into middle phalanx, and two lateral slips inserting into distal phalanx |
| central slip of the extensor tendon in dorsal digital expansion inserts | in middle phalanx |
| lateral slips of the extensor tendon in dorsal digital expansion inserts | onto distal phalanx |
| tendons of extensors pass through | wrist under extensor retinaculum |
| tendons of extensors are linked where | at MCP joints by intertendinous connections (restricting independent extension) |
| tendons of extensors are linked at MCP joints by what | intertendinous connections |
| tendons flatten to form what | extensor expansions |
| lumbricals origin and insertion | originate from palmar side by insert on dorsal side of palm by merging with extensor expansion |
| lumbricals and interosseous muscles run pass | MP joint ventrally |
| lumbricals and interossei attachment to extensor expansion is | dorsal to PIP and DIP joints |
| the way lumbricals and interossei are attached means | flexion at MP joint and extension at PIP and DIP joints (wave bye bye) |
| radial nerve is terminal branch of what cord of brachial plexus | posterior |
| radial nerve travels | behind humerus in radial groove and runs through radial tunnel between brachialis and brachioradialis muscle |
| radial nerve relationship with cubital fossa | most lateral structure |
| as the radial nerve leaves the cubital fossa it splits into (2) | superficial branch and deep branch |
| superficial branch of radial nerve | accompanies radial artery down forearm along brachioradialis, passes to extensor side between radius and brachioradialis in lower third of forearm and terminates as sensory branches supplying the skin of lateral 2-5 digits |
| deep branch of radial nerve | pierces supinator and enters extensor compartment of forearm as posterior interosseous nerve |
| deep branch of radial nerve pierces what | supinator |
| when does the deep branch of the radial nerve become the posterior interosseous nerve | after passing the supinator |
| injury to radial nerve causes (4) | trauma to humerus, pressure on axillary region eg crutches or saturday night palsy, elbow fracture, and fracture of radius |
| injury to radial nerve leads to (4) | paralysis or weakness of extensor muscles, loss of sensation in areas of skin, and wrist drop , and TRICEPS can be spared in some cases |
| the more proximal the lesion of injury to radial nerve the | the greater number of structures affected |
| why are the triceps sometimes spared in radial nerve injury | radial nerve gives off branches before it reaches radial groove of humerus (most common site of injury) |
| elbow joint type of joint | hinge type of synovial joint |
| action of elbow joint | flexion and extension |
| articulation of structures forming elbow joint includes | trochlea and capitulum of humerus with trochlear notch of ulna and head of radius , and olecranon process of ulna with olecranon fossa of humerus |
| the elbow joint is strengthened by | radial and ulnar collateral ligaments and annular ligament of radius |
| proximal and distal RU joints type of join | pivot joint |
| action of proximal and distal RU joints | supination and pronation |
| articulation of structures forming elbow joint includes | articulation between head of radius and radial notch of ulna (proximal), and articulation between head of ulna and ulnar notch of radius (distal) |
| proximal articulation of the RU elbow joint | articulation between head of radius and radial notch of ulna |
| distal articulation of the RU elbow joint | articulation between head of ulna and ulnar notch of radius |
| proximal articulation of the RU elbow joint strengthened by | annular ligament of radius |
| distal articulation of the RU elbow joint strengthed by | articular disc |
| how many muscles in hand | 11 (4 lumbricals, 4 dorsal and 3 palmar interossei) |
| how many dorsal interossei | 4 |
| how many palmar interossei | 3 |
Created by:
kablooey
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