Brachial plexus and extemities
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| What are the two soft tissue compartments of the brachium, and what do they do? | anterior (flexor) and posterior (extensor)
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| What separates the compartments of the brachium? | intermuscular septum
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| What is the purpose for body compartments? | prevents the spead of disease and allows for some function in case of an injury
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| Posterior compartment muscles | Triceps brachii (long, lateral, and medial heads)
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| Which of the triceps muscles crosses 2 joints, and what are those joints? | Long head, crosses the shoulder and elbow joints
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| In relation to the radial nerve where do the triceps muscles lie? | lateral lies above the nerve, and the medial lies below it
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| What kind of muscle are the triceps muscles? | Pennate muscles
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| Attachements of Triceps muscles | infraglenoid tubercle (long); humeral shaft (lateral and medial); insert: olecranon process of ulna (all)
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| Triceps functions | extension of the shoulder, extension of the elbow, stabilize inferior part of the shoulder joint in full abduction
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| What exercises can work the triceps muscles? | push-ups and push-downs
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| What is the function of the triceps if you reverse the attachment points? | movement of the trunk around a fixed point, in this case, the arm.
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| Anterior compartment muscles | Biceps brachii (long and short head), brachialis, and coracobrachialis
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| Which of the anterior compartment muscles cross two joints, and what are those joints? | Biceps (long and short heads) cross the elbow and ahoulder joints
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| What 3 muscles attach to the coracoid process? | pec minor, coracobrachialis, and short head of the biceps
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| Biceps attachments | O: supraglenoid tubercle and coracoid (short) I: radial tuberosity and fascia of medial forearm
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| The biceps act as an antagonist to what muscle? | triceps
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| Biceps Functions | flexion of the shoulder(short head), flexion of the elbow (forearm supinated), supination of forearm, stabilizes anterior portion of shoulder joint (tendon of the long head)
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| Supination | moiving the hand into the palm up position, radius and ulna are parallel
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| Pronation | moving of the hand into a palm down position, crossing the radius and ulna
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| Brachialis Attachments | O: anterior humeral shaft I: ulnar tuberosity
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| Brachialis lies deep to what muscle? | biceps
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| Brachialis Functions | flexion of the elbow (all positions of the forearm)
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| What exercises work the brachialis and biceps muscles? | Biceps: palm up curls Brachialis: palm down curls
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| Corachobrachialis attachments | O:coracoid of scapula I:humeral shaft
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| Coracobrachialis functions | flexion of the shoulder, elevation of the humerus
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| When flexing the shoulder, what muscle does coracobrachialis act as a synergist with? | short head of biceps
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| When elevating the humerus, the coracobrachialis acts as a synergist with what muscle? | deltoid (to prevent anterior translation of the humeral head)
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| Musculocutaneous nerve innervates__________ | the anterior brachial muscles (biceps, brachialis and coracobrachialis)
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| When the musculocutaneous nerve crosses the elbow joint it becomes the ___________ | lateral antebrachial cutaneous nerve
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| Extensor muscle origins | common extensor tendon, lateral supercondylar crest of humerus, posterior surfaces of radial and ulnar shafts, posterior surface of interosseous membrane
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| Extensor muscle insertions | MC's, phalanges, radial shaft, proximal ulna
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| Supinator and brachioradialis insertions | radial shaft
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| Anconeus insertion | proximal ulna
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| What innervates the extensor muscles? | radial nerve
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| True or False: Forearm flexors and extensors are major movers of the elbow | FALSE: forearm flexors and extensors are NOT able to move the elbow, even though they corss it
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| What is the major effect of forearm flexors and extensors on the elbow? | Stabilizers
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| Why is the brachial plexus important to OT | Because it innervates the entire upper extremity
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| What is the brachial plexus made of? | Ventral rami
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| What is the brachial plexus? | it is an intersection of cross-trading fibers of multiple spinal levels that lies deep to BOTH pec. mm. and exits between than anterior and middle scalenes
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| What structures run with the brachial plexus? | axillary a. and v.
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| Redundancy allows for__________ | continued function if there is an injury at one or more spinal levels
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| Ventral rami also form ________ | intercostal nerves
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| What causes costoclavicular Syndromes? | A depression or compression of the clavicle toward the first rib that may impinge the nerves against the rib
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| What are some effects of costoclavicular syndromes? | possible motor and sensory deficits
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| What is a common cause of costoclavicular syndromes? | heavy backpacks that compress the clavicle to the first rib
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| Ventral rami innervate: | limbs, front and side of trunk
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| Dosal rami innervate | back of trunk (erector spinae and skin)q
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| Parts of the brachial plexus | Roots, trunks, divisions, cords, and branches
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| Roots=_________ | Ventral ramiof C5-T1 (sometimes C4 & T2 are included)
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| Trunks | "1st plexus," formed by the intersection of roots: superior, middle, inferior
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| What roots make up the superior trunk? | C5+C6
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| What roots make up the middle trunk? | C7
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| What roots make up the inferior trunk? | C8+T1
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| What trunk lies on rib 1? | inferior trunk
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| Which trunk is most likely to be affected by costoclavicular impingement? | Inferior trunk
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| Divisions | formed by the splitting of each trunk, forming 1 anterior and 1 posterior divisions for a total of 6 divisions (3 ant. & 3 post.)
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| When referring to divisions, their positons are relative to | their position to the axillary a.
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| Cords | formed by merger of divisions and are named due to their position around the axillary a.
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| Lateral cords | most superior, from 2 upper ant. divisions
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| Posterior Cords | behind axillary a. and formed from all 3 posterior divisions
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| Medial cords | most inferior, anterior division of lower division only
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| Branches | Named nerves, 5 major branches: musculocutaneous, median, ulnar, radial, axillary
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| Which branches for the "M" of the brachial plexus? | Musculocutaneous, median, and ulnar
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| Where is the antebrachium located? | forearm: from elbow to wrist
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| What are the soft tissue compartments of the antebrachium and what do they do? | anterior (flexor)& posterior (extensor)
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| What separeates the compartments of the antebrachium? | radius, ulna, and interosseus membrane
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| Antebrachial fascia is located_________ | below the skin but above the mm. and envelopes the entire forearm
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| What are the functions of the antebrachial fascia? | assist in venous return of blood to the heart; helps to direct/ contain muscle tendons and actions
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| How many muscles are there in the flexor compartment of the antebrchium? | 8 total
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| what are the flexor compartment muscles of the antebrachium responsible for? | flexion of the wrist and fingers; 2 pronate the forearm
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| True or False: Flexor compartment muscles have multiple tendons. | True!
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| How many forearm flexor compartment muscles cross the wrist? | 12 (6mm)
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| How many forearm flexor tendons go through the carpal tunnel? | 10 tendons (4 mm)
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| Why are the muscle bellies of the forearm extensors closer to the elbow than the wrist? | allows for more power because the bulk of the m. is close to the fulcrum (elbow) allowing for less NGR usage
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| Forearm flexor muscle origins (as a group) | common flexor tendon, medial epicondyle of humerus; ant. surfaces of radial and ulnar shafts; ant. surface of interosseus membrane
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| Forearm flexor muscle insertions (as a group) | carpals, MCs, phalanges; radial shaft
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| Innervation of the forearm flexors | median and ulnar nn
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| What are the forearm extensor compartment muscles responsible for? | extension of the wrist and fingers; supination of the forearm, flexion of the elbow, deviation of the ulna
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| Which extensor muscle supinates the forearm? | Supinator
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| Which forearm extensor flexes the elbow? | brachioradialis
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| Which forearm extensor deviates the ulna? | anconeus
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| How many forearm extensor muscles are there? | 12
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| How many forearm extensor tendons cross the wrist? | 9mm = 12 tendons
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| What 3 forearm extensor mm. do not cross the wrist? | supinator, anconeus, and brachioradialis
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| Forearm extensor muscle origins | common extensor tendon, lateral epicondyle of the humerus; lateral supracondylar crest of humerus; post. surfaces of radial and ulnar shafts; post. surface of interosseous membrane
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| Forearm extensor muscle insertions | MCs, radial shaft (supinator & brachioradialis); proximal ulna (anconeus)
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| Innervation of the forearm extensors | radial n
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| True of False: Most forearm extensors cross the elbow, but they do not move it. | True; at most they serve as stabilizers; Exceptions: brachioradialis, anconeus(?), extensor carpi radialis longus
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| Extensor carpi radialis longus is responsible for________ | flexion of the elbow because it crosses in front of the elbow
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| Anconeus functions | extension of the elbow; radial deviation of the ulna in pronations
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| What is radial deviation? | moving toward the radius
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| What is ulnar deviation? | moving toward the ulna
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| The elbow joint is made up of the intersection of _____ bones | 3
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| In the elbow, the radius has free rotary motion on the _________, and is restricted to ___ degree of freedom on its ________ | capitulum, 1, long axis
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| In the elbow, the articulation between the ulna and the trochlea is what kind of joint? | Condylar or hinge joint
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| The articulation of the radius on the capitulum is what kind of joint? | ball and socket
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| When are hinge joints in close-packed positions? | full stability
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| Elbow ligaments | joint capsule, ulnar lig., radial collateral lig., annular lig.
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| Where is the annular ligament located? | surronding the head of the radius , keeping it on the head of the capitulum
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| When is the radial collateral ligament slack? | in the flexed position
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| Where is the radial collateral lig. located? | on the outside of the hinge joint
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| In general, collateral ligaments___________ | are found at hinge joints in the limbs, are normally tightest in extension, stabilize the joint whe it's subjected to greatest loads
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| What are the elbow bursae? | Subtendinous bursa and subcutaneous bursa
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| The subtendinous bursa___________ | us below the tendon of the triceps and allows the radius to move easily
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| The subcutaneous bursa_____________ | act as a buffer between the humerus, radius and ulna whe the elbo is in full flexion
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| The shafts of the radius and ulna form what kind of joint along their lengths? | syndemosis joint
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| The interosseous membrane fibers are _______, and run primarily in what 2 directions? | oblique, distally toward the radius and distally toward the ulna
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| The interosseous membrane fibers are tightest in the ___________ | anatomical position
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| In the interosseous membrane, the fibers running distally to the radius are called | oblique cord (proximally)
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| The oblique cord prevents what? | traction of the radius/hand
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| When does dislocation of the radius occur during a traction injury? | when there is an impingement of the annular ligament between the radius and capitulum
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| In the interosseous membrane, the firbers running distally toward the ulna________ | make up the bulk of the membrane, prevent compression of the radius against the humerus
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| Compression of the radius occurs when | the radius is driven in front of or to the side of the humerus
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| What 2 "linked" elements comrise the forearm? | (humerus + ulna) + (radius+manus)
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| Pronation/supination is | the movementof the RM around the HU
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| What are the major grips of the hand? | power and precision
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| When would you use a power grip? | when holding/using a hammer or squeezing an object
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| When is a precision grip most often used? | writing
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| When does the strongest power grip occur? | when the wrist is slightly extended (extensor tendons are loose, flexor tendons are tight)
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| True or false: forced flexion of the wrist weakens the power grip | True
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| When is full extension of the fingers possible? | when the wrist is slightly flexed
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| How many carpals are in the wrist? | 8; 4 in the proximal row & 4 in the distal row
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| The proximal row of carpals attach to | the radius
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| The distal of the carpals ________ | supports finger
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| Proximal row carpals | scaphoid, lunate, triangular, pisiform
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| Distal row of carpals | trapezium, trapezoid, capitate, hamate
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| How many articulations are there between the carpals and metacarpals? | 4- digits 4 and 5 both articulate with the hamate
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| What are the arches of the hand? | longitudinal and transverse
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| The longitudinal arch is | the natural curve from the wrist to the fingers; concave palm; conforms to objects graspes
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| The transverse arch is | concave on the palm side, protects the nerves and vessels; runs transversely to longitudinal arch
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| What makes up the transverse arch? | wedge shaped carpals (proximal and distal)
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| Without soft tissue, what will happen to the transverse arch? | it will fall apart ("fallen arches")
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| What structure maintains the transverse arch? | flexor retinaculum
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| Attachment points of the flexor retinaculum | scaphoid tubercle, pisiform, trapezium tubercle, hook of the hamate
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| What structures are part of the radiocarpal joint? | the radius, lunate, scaphoid, triangular fibrocartilage, and triangular
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| Separates the ulna from the triangular bone | triangular fibrocartilage
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| The ulna articulates with the radius at __________ | the radius at the distal radioulnar joint
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| What kind of joint is the wrist? | Condylar (hinge)
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| Motions of the radiocarpal joint | flexion/ extension (primary), radial/ulnar deviation, circumductions
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| Which has more movement, radial or ulnar deviation? | ULNAR
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| Ligaments of the wrist | Flexor retinaculum, extensor retinaculum, collateral lig., radiocarpal lig., ulnocarpal lig., intercarpal lig.
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| True or False: Since the wrist is a hinge joint, it has the same limited movement as other hinge joints such as the knee. | FALSE: it has more movement
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| Collateral Ligaments | usually found at hinge joints
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| Collateral ligaments of the wrist | radial and ulnar collateral ligaments and run from each bones' styloid processes to the carpals
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| Function of collateral ligaments_ | prevents excessive deviation of the wrist.
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| Deep palmar ligaments | palmar radiocarpal lig., palmar ulnocarpal lig., prevents hyperEXTENSION of the wrist
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| During supination of the hand, the _________ligament tightens | radiocarpal
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| What ligaments are most frequently injured when you fall? | palmar ligaments
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| Deep Dorsal ligaments | dorsal radiocarpal, dorsal ulnocarpal, prevent hyperFLEXION of the wrist
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| When the wrist is in pronation, what ligament is the tightest? | dorsal radiocarpal lig.
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| Intercarpal ligaments | bind together adjacent carpal bones to maintain stability of the wrist
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| Fractures of the wrist | Colle's (radius), Smith's (radius), scaphoid, lunate dislocation (palmar)
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| In a Colle's fracture______ | the wrist hyperEXTENDS and the fractured fragment moves dorsally
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| In a Smith's fracture______ | the wrist hyperFLEXES and the fractures fragment moves palmarly
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| Also called a dinner fork fracture: | Colle's fracture
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| This fracture usually coincides with a Colle's fracture. | Scaphoid, usually at its narrow center. Can lead to necrosis in the upper half of the bone and must be surgically removed
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| Lunate dislocation | the lunate "pops" out of position in a hyperFLEXION injury. The ligament tears, causing an anterior dislocation into the carpal tunnel. If both ligaments tear, it can lead to necrosis and must be surgically removed
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| Joints of the fingers: | CM, MP (ball & socket), PIP (hinge), DIP (hinge), IP
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| Which joint of the hand is a saddle-shape? | Between the trapezium and MC1 (thumb)
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| The saddle shaped joint allows | the thumb the ability to oppose
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| Motions of the thumb | extension, flexion, abduction, adduction, opposition, reposition
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| Extension of the thumb | hitch-hiking
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| Flexion of the thumb | Thumb across palm
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| abduction of the thumb | thumb away from palm in plane of the index finger
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| adduction of the thumb | thumb toward the base of the index finger
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| Opposition of the thumb | pads of thumb and finger come together
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| Reposition of thumb | moves thumb back to anatomical position
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| Motions of the metacarpals | MC1: highly mobile, MC2 & 3: fixed, MC4: slight opposition, MC5: moderate opposition
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| Structural center of the hand | MC 2 &3
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| Ligaments of the fingers | carpometacarpal, (inter)metacarpal, palmar, and collateral
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| Carpometacarpal ligaments | at palmar and dorsal CM joints
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| Intermetacarpal ligaments | between MC bases
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| Palmar ligaments | at MP & IP joints
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| Collateral ligaments | fan-like at volar plates, cord-like into bone
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| MP collateral lig. | Tightest in FLEXION, preventing abduction in power grip
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| PIP and DIP collateral lig. | tightest in EXTENSION, prevents collapse when using finger as a probe
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| Fracture of the finger | Boxer's fracture (MC4 or 5)
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| What is Boxer's fracture? | When MC 4 and/or 5 hit something off center and are fractured, bones will heal curved toward the palmar side of hand, and there will be no nerve damage
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| Intrinsic muscles of the hand arise . . . | from within the hand, but do NOT cross the wrist
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| Intrinsic muscles of the hand - GROUPS | Thenar, hypothenar, lumbricals, interossei
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| How many thenar muscles are there and what are their names? | 4: ABductor pollicus brevis, opponens pollicus, flexor pollicus brevis, ADductor pollicus
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| The thenar muscles form the ________, are responsible for _______, and are innervated by________ | thenar eminence, movement of the thumb, both ulnar and median nerves
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| The hyporthenar muscles form the _______, are responsible for ______ and ________, and are innervated by the ___________. | hypothenar eminence, moving the pinkie and corrugating the skin over the eminence, ulnar nerve
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| How many hypothenar muscles are there, and what are their names? | 4; palmaris brevis, ABductor digiti minimi, flexor digiti minimi, opponens digiti minimi
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| Palmaris brevis functions | corrugates the skin, but does NOT move the pinkie
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| Substitute for ADductor in hyporthenar eminence | palmaris brevis
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| Lumbrical attachments | O: FDP tendons; I: extensor hoods on RADIAL sides of digits 2-5
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| Lumbrical functions | Flex MP joints and Extend IP joints
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| Lumbrical Innervation | #'s 1 and 2 - MEDIAN; #'s 3 and 4 - ULNAR
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| What dance do the lumbricals allow you to do (in part) | the chicken dance (chicken hands!)
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| How many interossei muscles are there? | 7 that are divided into two groups
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| Palmar interossei attachments | O: MC shafts facing the middle digit; I: extensor hood phalanges
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| Palmar inerossei functions | ADduct digits 2,4, and 5, EXTENDS IP joints
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| What muscle is responsible for ADduction of the thumb? | adductor pollicus
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| The middle finger only ________ | ABducts because it is the "midline" of the had
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| Dorsal interossei muscle attachments | O: MC shafts; I: extensor hoods
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| Dorsal interossei functions | ABduct digits 2, 3, and 4, assist in extension of IP joints
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| Which digit has 2 dorsal interossei muscles and why? | the middle finger (digit 3) because it can only ABduct !
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| Innervation of dorsal interossei | ULNAR n.
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| If you damage your Ulnar nerve, how is your hand effected? | loss of fine motor movements
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| Summary of intrinsic hand innervartion | thenar- ulnar and median, hypothenar- ulnar, lumbricals- median, interossei- ulnar
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| What muscle can be considered an honorary dorsal interossei? | abductor digiti minimi
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| What muscles are closest to the extensor hood? | interosseus
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| Which muscle is more powerful in flexing the MP joint? | Lumbicals
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| On the dorsal side of the hand, the extensor digitorum tendon splits into ______, that are called__________ | 3 slips, central (inserts into mid. phalanx) and 2 lateral (inserts into distal phalanx)
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| On the palmar side, what 2 muscles control flexion | flexor digitorum superficialis(mid. phalanx) and flexor digitorum profundus (distal phalanx)
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| Fibrous digital sheaths are : | long tubular ligaments, surrond the long flexor tendons and synovial sheaths, composed of annular and cruciate ligments
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| Where are the fibrous digital sheaths located? | palmar side of fingers
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| Which is stronger, annular or cruciate ligaments? | annular
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| What does the fibrous digital sheath prevent? | Bowstringing of the flexor digitorum superficialis and profundus during flexion
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You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
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Created by:
CoachAmy
Popular Anatomy sets