Muscles, clinical correlation, etc.
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What is Colles fracture? | caused by doriflexion of wrist, "dinner fork deformity"
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What happens during colles fraction | -complete transverse fracture of distal radius
-distal radial fragment is displaced dorsally
-ulnar styloid process may be avulsed
Associated injuries: medial and ulnar n. injury, carpal fracture, dislocation of radioulnar joint
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What is the cause, presentation, and associated injury of the smith fracture? | Cased by falling on flexed wrist,
complete transverse fracture of distal radius, distal radial fragemnt is displaced ventrally, ulnar styloid process maybe avulsed
acoociated injure: acute carpal tunnel syndrome, compressive neuropathy, ishemia
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What are the 8 carpal bones of the wrist? | Scapoid, lunate, triquetrium, pisimform, trapezium, trapezoid, capitate, and hamat
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What happens w/ scaphoid fracture? | pain and tenderness in the anatomial suffbox, could get avascular necrosis: damage to the palmar carpal branch of radial artery
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What happens w/ hamate fracture? | Hamat fracture can compress the ulnar nerve, leading to loss of sensation in the medial half of digit 4 and digit 5
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What's so special bout the capometacarparl joint of digit 1? | saddle-type of synovial joint b/w trapezium and 1st base of metacarpal. Has a separate joint cavity--allows for movement in multiple planes
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Difference b/w MCP and PIP/DIP? | MCP: synovial joint, condyloid type, allows flexion/extension, and abduction/adduction
PIP/DIP: synocial joints, hinge type, allow only flexion/extension
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What is mallet finger and how does it present? | "baseball finger", long extensor tendon avulsion
presentation: hyperflexion at the DIP, inability to extend DIP
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Interosseous membrane separates forearm into anterior and posterior compartments, what are contents of each of compartment? | Anterior: flexors and pronators, largely median and some ulnar nerve innervation
Posterior: extensors and supinators, radial nerve innervation
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What is antebrachial fascia? | thickens around wrist,
anteriorly as the palmar carpal ligament and felxor retinaculum
posteriorly as extensor retinculum
prevents bowstringing of muscle tendons
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flexor retinacular (transverse carpal ligament) converts the concavity formed by carpal bones into the carpal tunnel, what are the contents of tunnel and fxn of tendon? | Contents: Median N. Flexor difitorum superficialis, flexor pollicis longus, flexor digitorum profundus
Fxn: prevents bowstringing of tendon
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What is palmar aponeurosis? | strong covering of the soft tissues, overlies the long tendons, contributes to the flexor tendon sheaths distally
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What is dpuytren contracture? | Fascial thickening causes shortening on the medial side of hand
You get Flexion at metacarpophalangeal and proximal interphalangeal joints
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What are the anterior muscles of the forearm? | Superfical: Pronator tere, flexor carpi radialis, palmaris longus, flexor carpi ulnaris
intermediate: flexor digitorum superficialis
deep: flexor pollicis longus, flexor digitorum profundus, pronator quadratus
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What do the superficial muscles of forearm orginate from? | common flexor tendon--attached to the emdial epicondyle of humerrus
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What is the origin, insertion, action, and innervation of the pronator teres? | Origin
Humeal head: Medial epicondyle (via common flexor tendon)
Ulnar head: coronoid process
Insertion
Middle portion of lateral radius
Action
Pronates and flexes forearm (at elbow)
Innervation
Median nerve
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What is the origin, insertion, action, and innervation of the flexor carpi radialis? | Origin
Medial epicondyle (via common flexor tendon)
Insertion
Base of 2nd metacarpal
Action
Flexes and abducts hand at wrist
Innervation
Median nerve
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What is the origin, insertion, action, and innervation of the palmaris longus? | Origin
Medial epicondyle (via common flexor tendon)
Insertion
Palmar aponeurosis (apex) and flexor retinaculum
Action
Flexes hand (at wrist); tenses palmar aponeurosis
Innervation
Median nerve
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What is the origin, insertion, action, and innervation of the flexor carpi ulnaris | Origin
Humeral head: Medial epicondyle (via common flexor tendon), Ulnar head: Olecranon process
Insertion
Pisiform, hook of hamate, 5th metacarpal
Action
Flexes and adducts (ulnar deviation) hand (at wrist)
Innervation
Ulnar nerve
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What is the origin, insertion, action, and innervation of the Flexor digitorum superficialis? | Origin
Humeroulnar head: Medial epicondyle, coronoid process
Radial head: Superior portion of radius
Insertion
Intermediate phalanx, digits 2-5
Action
Flexes middle phalanges at the PIP of digits 2-5; may assist flexion of proximal phalanges at
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What is the origin, insertion, action, and innervation of the Felxor digitorum profundus? | Origin
Proximal ulna and interosseous membrane
Insertion
Bases of distal phalanx of digits 2-5
Action
Flexes distal phalanges at the DIP of digits 2-5
Innervation
Digits 2-3: Anterior interosseous nerve (branch of median nerve)
Digits 4-5: U
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What is the origin, insertion, action, and innervation of the Flexor pollicis longus? | Origin
Radius, interosseous membrane
Insertion
Base of distal phalanx of digit 1 (pollex)
Action
Flexes phalanges of digit 1
Innervation
Anterior interosseous nerve (a branch of the median nerve)
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What is the origin, insertion, action, and innervation of the pronator quadratus? | Origin
Distal ulna
Insertion
Distal radius
Action
Pronates forearm; bind radius and ulna together
Innervation
Anterior interosseous nerve (a branch of the median nerve)
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What are muscles of the Posterior comparment innervated by? | radial n.
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What is the origin, insertion, action, and innervation of the Brachioradialis | Origin
Supracondylar ridge of humerus
Insertion
Distal lateral radius
Action
Flexes (weakly) forearm at elbow, but strong in mid-pronated position
Innervation
Radial nerve
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What is the origin, insertion, action, and innervation of the extensor carpi radialis longus | Origin
Supracondylar ridge of humerus
Insertion
Base of 2nd metacarpal
Action
Extend and abduct (radial deviation) the hand at the wrist, also active during fist clenching
Innervation
Radial nerve
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What is the origin, insertion, action, and innervation of the brachioradialis? | Origin
Lateral epicondyle
Insertion
Base of 3rd metacarpal
Action
Extend and abduct (radial deviation) the hand at the wrist
Innervation
Deep branch of radial nerve
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What is the origin, insertion, action, and innervation of the Extensor digitorum | Origin
Lateral epicondyle
Insertion
Extensor expansion of digits 2-5
Action
Primary extension at metacarpophalangeal joint digits 2-5
Secondary extension at interphalangeal joints (distal, middle and proximal phalanges)
innerva: deep branch
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What is the origin, insertion, action, and innervation of the Extensor digiti minimi | Origin
Lateral epicondyle
Insertion
Extensor expansion of digit 5
Action
Primary extension at metacarpophalangeal joint digit 5
Secondary extension at interphalangeal joints for digit 5
inv: deep branch radial n.
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What is the origin, insertion, action, and innervation of the Extensor carpi ulnaris | Origin
2 heads: Lateral epicondyle, and posterior border of ulna
Insertion
Base of 5th metacarpal
Action
Extends and adducts (ulnar deviation) the hand at wrist
Innervation
Deep branch of radial nerve
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What is the origin, insertion, action, and innervation of the supinator? | Origin
Lateral epicondyle, radial collateral and annular ligament, ulna
Insertion
Proximal 1/3 of the radius
Action
Supinates forearm
Innervation
Deep branch of radial nerve
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What is the origin, insertion, action, and innervation of the abductor pollicis longus | Origin
Proximal ½ of posterior ulna, radius, and interosseous membrane
Insertion
Base of 1st metacarpal
Action
Abducts thumb and extends it at carpometacarpal joint
Innervation
Posterior interosseous nerve (continuation of deep branch of radi
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What is the orgin, insertion, action, and innervation of the extensor pollicis brevis? | Origin
Distal 1/3 of posterior radius and interosseous membrane
Insertion
Base of proximal phalanx of Digit 1
Action
Extends proximal phalanx of thumb at the MCP joint; also extends CMC joint
Innervation
Posterior interosseous nerve (radial
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What is the origin, insertion, action, and innervation of the extensor pollicis longus? | Origin
Middle 1/3 of posterior ulna and interosseous membrane
Insertion
Base of distal phalanx of Digit 1
Action
Extends distal phalanx of thumb at interphalangeal joint; extends CMC and MCP joints
Innervation
Posterior interosseous nerve
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What is the origin, insertion, action, and innervation of the extensor indicis? | Origin
Distal 1/3 of posterior ulna and interosseous membrane
Insertion
Extensor expansion of digit 2
Action
Extends proximal phalanx of digit 2, also extends hand at wrist
Innervation
Posterior interosseous nerve
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3 thenar muscles? | opponens pollicis, abductor pollicis brevis, flexor pollicis brevis
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Abductor pollicis brevis? | Origin
Flexor retinaculum, tubercles of scaphoid and trapezium
Insertion
Lateral side of proximal phalanx of digit 1
Action
Abduction of the thumb
Innervation
Recurrent branch of median nerve
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FLexor pollicis brevis? | Origin
Flexor retinaculum, tubercles of scaphoid and trapezium
Insertion
Lateral side of base of 1st proximal phalanx
Action
Flexes thumb
Innervation
Recurrent branch of median nerve
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pponens pollicis? | Origin
Flexor retinaculum, tubercles of scaphoid and trapezium
Insertion
Lateral side of 1st metacarpal
Action
Opposition towards digit 5
Innervation
Recurrent branch of median nerve
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3 hypothenar muscles? | abductor digiti minimi, flexor digiti minimi brevis, opponens difiti minimi
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Abductor digiti minimi | Origin
Pisiform
Insertion
Medial side of base of 5th proximal phalanx
Action
Abduction of digit 5
Innervation
Deep branch of ulnar nerve
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Flexor digiti minimi brevis | Origin
Hook of hamate and the flexor retinaculum
Insertion
Medial side of base of 5th proximal phalanx
Action
Flexes proximal phalanx of digit 5
Innervation
Deep branch of ulnar nerve
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opponens digiti minimi | Origin
Hook of hamate and the flexor retinaculum
Insertion
Medial border of 5th MC
Action
Opposition towards digit 1
Innervation
Deep branch of ulnar nerve
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Adductor pollicis (adductor muscle) | Origin
Oblique head: bases of 2nd and 3rd MCs, capitate and adjacent carpals
Transverse head: Anterior surface of 3rd MC
Insertion
Medial side of base of digit 1’s proximal phalanx
Action
Adducts thumb towards
ulnar n. innv.
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origin, insertion, action of 4 lumbricals | Origin
Tendons of flexor digitorum profundus
Insertion
Lateral sides of extensor expansions of 2nd-5th digits
Action
Flex metacarpophalangeal joint, extend interphalangeal joints of digits 2-5
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What is the innervationo fthe 4 lumbricals | Lumbricals 1 & 2: Median nerve (medial and lateral branches)
Lumbricals 3 & 4: Deep branch of ulnar nerve
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3 palmar interossei? | Origin
Palmar surfaces of 2nd, 4th, and 5th MCs (unipennate)
Insertion
2nd, 4th, and 5th proximal phalanges and extensor expansions
Action
Adduction of 2nd, 4th, 5th digits and flexion of the MCP joint
Innervation
Deep branch of ulnar nerve
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4 dorsal interossei? | Origin
Adjacent surfaces of MCs
Insertion
Digits 2-4, bases of proximal phalanges & extensor expansion
Action
Abduction of digits 2-4 and flexion at the metacarpophalangeal joint
Innervation
Deep branch of ulnar nerve
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