Glossary of GA8-11-06

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Clinical Implications for Veins
2. Cardiac puncture
3. Arteriovenous fistula for hemodialysis
4. Antihypertensive drugs
-drawing bood from a vein
-can use any vein that is large enough to insert a catheter into
Cardiac Puncture
-inserting a catheter into the heart to measure pressures
-usually go through subclavian but can use vein in forearm if the person is too fat to go through the neck
Arteriovenous fistula for hemodialysis
-need a big vein to draw blood from, clean it out, and return it back to the body for dialysis
-achieved by cutting cephalic vein and either ulnar or radial artery and creating a loop from them
-PROBLEM: arterial blood enters venous blood flow so the patient gets huge veins that pulsate strongly
Antihypertensive drugs
-dilate veins of upper and lower limbs to reduce pressure in arteries and heart
-red wine can have this same effect by dilating veins
Proximal and Distal Radioulnar Joints
-together with the interosseus membrane, these joints pronate and supinate the forearm
Radiocarpal joint
-articulation of distal part of radius with scaphoid and carpal bones of wrist
Line of Weight and Line of Rotation
-important to biomechanics
-when placing a cast, you must consider both lines so that the arm won't rotate inside the cast
Joints of the Wrist/Hand
1. Intercarpal
2. Carpometacarpal
3. Metacarpophalangeal
4. Interphalangeal
Intercarpal Joints
-Joints between carpals
Carpometacarpal Joints
-joint between carpal bones and metacarpals
Metacarpophalangeal Joints
-joint between metacarpals and phalanges
Interphalangeal Joints
-joints between the bones of the phalanges
Carpal Bones (proximal row-distal row, lateral to medial)
1. Scaphoid
2. Lunate
3. Triquetrium
4. Pisiform
5. Trapezium
6. Trapezoid
7. Capitate
8. Hamate
Which carpal bone has a small hook on the side?
Hamate --> Hook of Hamate
Hook of Hamate
-small hook on side of hamate carpal bone
Pneumonic for carpal bones
"Some Lovers Tri Positions That They Can't Handle"
What type of joint is the wrist?
-condyloid type synovial
What carpal bone in the proximal row does the distal end of the radius NOT articulate with?
-pisiform (sesamoid)
What do ligaments inside the wrist joint do?
-reinforce articulation of carpal bones and distal end of radius
Ligaments inside the wrist joint
1. Palmar Radiocarpal
2. Dorsal Radiocarpal
3. Ulnar Collateral
4. Radial Collateral
Colles Fracture
-distal end of radius displaced posteriorly
Reverse Colles Fracture
-distal end of radius displaced anteriorly
Fracture of Scaphoid
-commonly occurs when one extends the palms to brace the body against a fall
-when this happens, the entire weight of the body is transmitted through the scaphoid bone
What two carpal bones articulate with the radius?
Scaphoid and Lunate
Pronator Teres
-runs from medial epicondyle to upper 1/3 of radius
-pronates forearm
-supplied by median nerve
Flexor Carpi Ulnaris (FCU)
-flexes the wrist at the ulnar side
-runs from medial epicondyle to pisiform and Hook of Hamate
Palmaris Longus
-absent in 15-20% of pop.
-median nerve is posterior and medial to this muscle
-Iatrogenic injuries happen when median nerve is cut under the assumption that the patient has a palmaris longus muscle to shield it
-distal attachment is palmar aponeurosis
Flexor Digitorum Superficialis
-flexes the fingers
-has 4 tendons that go to the middle phalanges
-responsible for a strong grip
Flexor Carpi Radialis
-flexes wrist on radial side
-attaches from second metacarpal
Flexor Digitorum Profundis (FDP)
-attaches to distal phalanges
-responsible for slow motion of distal parts of finger
Flexor Pollicis Longus (FPL)
-flexes thumb
Pronator Quadratus
-responsible for pronation of forearm
-supplied by median nerve via anterior interosseus nerve
4 Muscles of Pronation and Supination of Forearm
1. Pronator Teres (pronates)
2. Pronator quadratus (pronates)
3. Biceps brachii (supinates)
4. Supinator (supinates)
Biceps brachii
-supplied by musculocutaneous nerve
-major supinator during flexion
-if biceps are lost, you can still flex forearm using brachialis and brachialradialis
-supplied by deep radial nerve
-supinates forearm
Antebrachial Fascia
-strong connective tissue that creates anterior and posterior compartments of forearm and encircles the muscles
Interosseus Membrane
connective tissue connecting radius and ulna
Median Nerve in Forearm
-has lateral and medial cords
-no branches in arm
-crosses anterior to elbow
Anterior Interosseus Branch of Median Nerve
-supplies pronator quadratus, Flexor Pollicis Longus, Flexor Digitorum Profundis 1st and 2nd
Ulnar Nerve in Forearm
-extends from medial cord
-crosses behind elbow
-runs under Flexor Carpi Ulnaris and ulnar half of Flexor Digitorum Profundis
What nerve innervates the extensors of the forearm?
Radial nerve
What condition is seen if the radial nerve is damaged?
Wrist drop
Three groups of muscles that extend, abduct, and adduct the forearm
1. Extensor Carpi Radialis Longus
2. Extensor Carpi Radialis Brevis
3. Extensor Carpi Ulnaris
Where does Extensor Carpi Radialis Brevis attach?
second metacarpal
Muscles of the Forearm that Extend the medial four fingers
1. Extensor Digitorum
2. Extensor Indicis
3. Extensor Digiti Minimi
Extensor Digitorum
-extends the medial 4 fingers
Extensor Indicis
-deep extensor
-used for pointing and extension of the index finger
-located at deep surface of compartment
Extensor Digiti Minimi
-gives pinky free rotation similar to index finger
Muscles that Extend of Abduct the Thumb
1. Abductor Pollicis Longus
2. Extensor Pollicis Brevis
3. Extensor Pollicis Longus
The brachioradialis belongs to the ______ compartment but is really a _______ muscle.
extensor, flexor
Extensor Reticulum and Flexor Reticulum
-connective tissue band that goes around tendons of wrist joint
-keeps the tendons from pulling out during times of weighted stress
Synovial Sheath
-covers tendons and keeps them moving smoothly through extensor/flexor reticulum
-infection of synovial sheath
-often caused by trauma, animal bites
-treated by antibiotics and small incision for drainage
-use Finkelstein's test for diagnosing
Anatomical Snuff Box
-triangular area bounded by APL, EPB, and EPL
-radial artery passes through here
Cutaneous Innervation of Forearm
-important for cases involving trauma
-see what areas of skin have parasthesia to determine which nerves have been damaged
-also important for nerve blocks prior to sutures or surgery
What artery is the common interosseus artery a branch of?
From which artery of the forearm are bypass grafts often taken?
-Radial artery
-ulnar artery has a lot of small branches and is sufficient to supply forearm with blood
-procedure that cuts away fascia to releive tension
Volkmann's Ischemic Contracture
-compression of arteries, nerves, muscles, and tendons
-when blood supply is cut, it necroses
-treatment involves fasciotomy

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