Download Antebrachium, Hand, and Joints

5
L A B O R A T O R Y
Antebrachium, Hand,
and Joints
ELBOW JOINT
Classify the elbow joint according to structural and functional criteria –
Hinge, synovial (diarthrotic) joint
Identify the bony articulations.
Humeroradial: (radial collateral) capitulum of humerus articulates with the head of the radius
Humeroulnar: (ulnar collateral) trochlea of humerus articulates with the trochlear notch of
the ulna olecranon process of the ulna articulates with the olecranon fossa of the humerus
Proximal radioulnar: Head of radius articulates with the radial notch of the ulna
Held in place by the annular ligament
Identify the ligaments associated with the elbow joint.
radial collateral ligament
ulnar collateral ligament
annular ligament
Identify the primary sources of vascularization to the elbow joint.
superior/inferior ulnar collateral arteries
anterior/posterior interosseous arteries
Identify the primary innervation sources to the elbow and radioulnar joints.
Elbow – musculocutaneous, radial, ulnar nerves
Radioulnar – musculocutaneous, median, radial nerves
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Laboratory 5 • Antebrachium, Hand, and Joints
Identify the structures associated with the cubital fossa.
brachial artery
median nerve
median cubital vein
biceps brachii tendon
Discuss the venous return from the brachial region.
cephalic vein
basilic vein
median cubital vein
axillary vein
RADIOULNAR JOINTS
Proximal radioulnar: Head of radius articulates with the radial notch of the ulna
Distal radioulnar:
Head of the ulna articulates with the ulnar notch on the radius
Allows radius to move anteriorly across the ulna during pronation
Classify the radioulnar joints according to structural and functional criteria, and
identify the associated ligaments.
Proximal – pivot, synovial diarthrotic joint
Distal – pivot, synovial diarthrotic joint
annular ligament
triangular ligament (articular disc)
radial/ulnar collateral ligaments
(fibrocartilage complex)
radial/ulnar collateral ligaments
WRIST JOINT
Classify the wrist joint according to structural and functional criteria –
diarthrotic, synovial condyloid.
Identify the ligaments associated with the wrist joint.
radial collateral ligament
ulnar collateral ligament
palmar carpal ligament
dorsal carpal ligament
triangular ligament (fibrocartilage complex)
flexor retinaculum
extensor retinaculum
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Laboratory 5 • Antebrachium, Hand, and Joints
ANTERIOR ANTEBRACHIUM
Identify the superficial and deep muscles located in the anterior compartment of the antebrachium.
Describe the attachment points of all of the anterior antebrachial muscles.
Describe the primary action of each of these muscles.
Identify the primary source of innervation of ALL of these muscles.
Identify the primary source of vascularization for all of these muscles.
Anterior Antebrachium Muscles
Layer 1
Muscle
Origin
Insertion
Pronator Teres
Medial
Mid-lateral
epicondyle of
Radius
Humerus
coranoid
process of Ulna
Flexor Carpi
Radialis
Medial
epicondyle of
Humerus
Innervation
Blood Supply
Action
Median N
(C6-C7)
Ulnar A
Pronate
forearm
weak forearm
flexor
2nd Metacarpal Median N
(C6-C7)
Ulnar A
Flex and abduct
hand at wrist
Palmaris Longus Medial
epicondyle of
Humerus
Palmar
aponeurosis
Median N
(C7-C8)
Ulnar A
Flex hand at
wrist and
Tighten palm
Flexor Carpi
Ulnaris
Pisiform bone
Hook of
Hamate
5th Metacarpal
Ulnar N
(C7-C8)
Ulnar A
Flex and adduct
hand at wrist
Humeral:
medial
epicondyle of
Humerus
Ulnar:
olecranon and
posterior Ulna
Layer 2
Muscle
Flexor
Digitorum
Superficialis
Origin
Insertion
Medial
Middle
epicondyle of
phalanges of
Humerus,
medial 4 digits
coronoid process
of Ulna and
superoanterior
Radius
Innervation
Median N
(C7-T1)
Blood Supply
Ulnar A
Action
Flex wrist,
interphalangeal,
and metacarpophalangeal
joints
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Laboratory 5 • Antebrachium, Hand, and Joints
Layer 3
Muscle
Origin
Flexor
Digitorum
Profundus
Flexor Pollicis
Longus
Insertion
Innervation
Blood Supply
Action
Proximal,
Distal phalanges
medial, anterior of medial
Ulna and
4 digits
interosseus
membrane
Medial –
Ulnar N
(C8-T1)
Lateral –
Median N
(C8-T1)
Ulnar A
Anterior
Interosseus A
Flex wrist, distal
interphalangeal
and metacarpophalangeal
joints
Anterior Radius Base of distal
and interosseus phalanx of
membrane
thumb
Median N
(C8-T1)
(anterior
interosseous)
Radial A
Anterior
Interosseus A
Flex distal
thumb
phalanges
Layer 4
Muscle
Pronator
Quadratus
Origin
Distal anteromedial Ulna
(proximal
attach)
Insertion
Innervation
Distal anteroMedian N
lateral Radius
(C8-T1)
(distal attach) (anterior
interosseous)
Blood Supply
Radial A
Anterior
Interosseus A
Action
Pronate forearm
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Laboratory 5 • Antebrachium, Hand, and Joints
POSTERIOR ANTEBRACHIUM
Identify the superficial and deep muscles located in the posterior compartment of the forearm.
Describe the attachment points of all of the posterior antebrachial muscles.
Describe the primary action of each of these muscles.
Identify the primary source of innervation and vascularization of all of these muscles.
Identify the flexor and extensor retinaculums and be able to describe their anatomical significance.
Identify the basilic and cephalic veins, which originate in the antebrachial region.
Posterior Antebrachium Muscles
Superficial - Layer 1
Muscle
Brachioradialis
Origin
Lateral supracondylar ridge
of Humerus
Insertion
Blood Supply
Action
Radial N
(C5-C7)
Deep A of Arm Flex forearm at
(profunda
elbow
brachii)
Extensor Carpi Lateral supraRadialis Longus condylar ridge
of Humerus
2nd Metacarpal Radial N
(C6-C7)
Deep A of Arm Extend and
(profunda
Abduct hand at
brachii)
wrist
Extensor Carpi
Radialis Brevis
Lateral
epicondyle of
Humerus
3rd Metacarpal
Radial N
(C7-C8)
(posterior
interosseous)
Deep A of Arm Extend and
(profunda
Abduct hand at
brachii)
wrist
Extensor
Digitorum
Lateral
epicondyle of
Humerus
Medial 4 digits
extensor
expansion
Radial N
(C7-C8)
(posterior
interosseous)
Posterior
Interosseus A
Extend
phalangeal
joints & extend
wrist
Extensor Digiti Lateral
Minimi
epicondyle of
Humerus
5th digit
extensor
expansion
Radial N
(C7-C8)
(posterior
interosseous)
Posterior
Interosseus A
Extend 5th digit
at metacarpophalangeal/
interphalangeal
joint
Extensor Carpi
Ulnaris
5th Metacarpal
Radial N
(C7-C8)
(posterior
interosseous)
Posterior
Interosseus A
Extend and
Adduct hand at
wrist
Lateral
epicondyle of
Humerus,
posterior Ulna
Lateral distal
Radius
Innervation
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Laboratory 5 • Antebrachium, Hand, and Joints
Deep - Layer 2
Muscle
Origin
Insertion
Innervation
Blood Supply
Action
Supinator
Lateral
epicondyle of
Humerus,
elbow ligaments, Ulnar
crest
Proximal
Posterolateral
Radius
Radial N
(C5-C6)
(posterior
interosseous)
Radial A
Supinate
Deep A of Arm forearm
(profunda
brachii)
Abductor
Pollicis Longus
Posterior Ulna,
Radius and
Interosseous
membrane
1st Metacarpal
Radial N
(C7-C8)
(posterior
interosseous)
Posterior
Interosseus A
Extensor
Pollicis Brevis
Posterior Radius Proximal
and interosseous Phalanx of
membrane
thumb
Radial N
(C7-C8)
(posterior
interosseous)
Posterior
Interosseus A
Extensor
Pollicis Longus
Posterior midUlna and
interosseous
membrane
Radial N
(C7-C8)
(posterior
interosseous)
Posterior
Interosseus A
Extend distal
thumb phalanx
at carpometacarpal &
interphalangeal
joints
Radial N
(C7-C8)
(posterior
interosseous)
Posterior
Interosseus A
Extend 2nd
digit, extend
hand at wrist
Distal Phalanx
of thumb
Extensor Indicis Posterior Ulna 2nd digit
and interosseous extensor
membrane
expansion
Abduct, Extend
thumb at
carpometacarpal
joint
Extend
proximal thumb
phalanx at
carpometacarpal
joint
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Laboratory 5 • Antebrachium, Hand, and Joints
MUSCLES OF THE HAND
Describe the carpal tunnel.
Identify the muscles associated with the thenar, hypothenar, lumbricals, and interossei muscles.
Attachment points do NOT have to be identified for specific muscles within the hand.
Identify the actions of the hand muscles.
Identify the primary innervation source for the hand muscles.
Describe the blood flow in the hand, including the superficial, deep palmar, and dorsal carpal arches.
Thenar Muscles
Muscle
Origin
Insertion
Innervation
Blood Supply
Palmar Arches
(superfic/deep)
Action
Abductor
Pollicis Brevis
Flexor
retinaculum,
Scaphoid &
Trapezium
Lateral proximal Recurrent
Phalanx of
branch of
thumb
Median N
(C8-T1)
Flexor Pollicis
Brevis
Flexor
retinaculum,
Scaphoid &
Trapezium
Lateral proximal Recurrent branch Palmar Arches
Phalanx of
of Median N
(superfic/deep)
thumb
(C8-T1)
Flex thumb at
interphalangeal
joint
Opponens
Pollicis
Flexor
retinaculum,
Scaphoid &
Trapezium
Lateral
1st Metacarpal
Oppose thumb
(toward palm)
Recurrent branch Palmar Arches
of Median N
(superfic/deep)
(C8-T1)
Abduct and
Oppose thumb
(toward palm)
Hypothenar Muscles
Muscle
Origin
Insertion
Innervation
Blood Supply
Action
Abductor
Digiti Minimi
Pisiform
Medial proximal Deep branch of Palmar Arches
Phalanx of
Ulnar N
(superfic/deep)
th
(C8-T1)
5 digit
Abduct 5th digit
Flexor Digiti
Minimi Brevis
Hook of
Hamate
Flexor
Retinaculum
Medial proximal Deep branch of Palmar Arches
Phalanx of
Ulnar N
(superfic/deep)
(C8-T1)
5th digit
Flex proximal
phalanx of
5th digit
Opponens
Digiti Minimi
Hook of
Hamate
Flexor
Retinaculum
Medial
5th Metacarpal
Oppose
5th digit
(toward palm)
Deep branch of Palmar Arches
Ulnar N
(superfic/deep)
(C8-T1)
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Laboratory 5 • Antebrachium, Hand, and Joints
Adductor Muscles
Muscle
Adductor
Pollicis
Origin
Oblique:
2-3 Metacarpal
& Capitate
Trans: 3rd
Metacarpal
Insertion
Innervation
Blood Supply
Medial proximal Deep branch of Palmar Arches
Phalanx of
Ulnar N
(superfic/deep)
thumb
(C8-T1)
Action
Adduct thumb
toward middle
digit
Central Muscles
Muscle
Origin
Insertion
Innervation
Blood Supply
Action
Lumbricals
1&2
Lateral 2
Lateral extensor Median N
tendons of
expansions of
(C8-T1)
flexor digitorum digits 2-5
profundus
Palmar Arches
(superfic/deep)
Flex at
metacarpophalangeal
joints;
Extend at interphalangeal
joints
Lumbricals
3&4
Medial 3
Lateral extensor Deep branch of Palmar Arches
tendons of
expansions of
Ulnar N
(superfic/deep)
flexor digitorum digits 2-5
(C8-T1)
profundus
Flex at
metacarpophalangeal
joints;
Extend at interphalangeal
joints
Palmar
interossei
PAD 3
2, 4, 5
Extensor
Metacarpals
expansions &
(palmar surface) proximal
phalanx of
digits 2, 4, 5
Adduct digits
2, 4, 5 & Assist
lumbricals
Dorsal
interossei
DAB 4
Metacarpal sides Extensor
Deep branch of Deep Palmar &
expansions &
Ulnar N
Dorsal Carpal
proximal
(C8-T1)
Arches
phalanx of
digits 2, 3, 3, 4
Deep branch of Deep Palmar
Ulnar N
Arch
(C8-T1)
Abduct digits
2, 3, 3, 4 &
Assist
lumbricals
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Laboratory 5 • Antebrachium, Hand, and Joints
UPPER EXTREMITY REVIEW (SELF STUDY)
SHOULDER
List the muscles of the back that connect the upper limb to the axial skeleton.
Describe the muscles of the back and
discuss their attachment points, action, blood supply, and innervation.
List the pectoral muscles.
Describe the pectoral muscles and
discuss their attachment points, action, blood supply, and innervation.
List the rotator cuff muscles.
Describe the muscles of the shoulder,
including their attachment points, blood supply, actions, and innervation.
Classify the joints of the pectoral girdle according to structural/functional criteria and
describe the ligaments.
Identify bony landmarks on real bone, models, and x-rays.
BRACHIUM
Identify the muscles of the brachial region and
discuss their attachment points, actions, blood supply, and innervation.
Locate and describe the anatomical significance of the bicipital aponeurosis.
Identify the trunks, cords, and branches of the brachial plexus and
discuss the targets of the nerves.
Discuss the blood vessels of the arm, including both superficial and deep vessels.
Identify bony landmarks on real bone, models, and x-rays.
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Laboratory 5 • Antebrachium, Hand, and Joints
ANTEBRACHIUM
Identify the muscles located in the forearm and
discuss their attachment points, action, blood supply, and innervation.
Identify the retinacula and be able to describe their anatomical significance.
Classify the elbow and radioulnar joints according to structural/functional criteria and
describe ligaments.
Discuss the blood vessels of the forearm, including both superficial and deep vessels.
Identify bony landmarks on real bone, models, and x-rays.
HAND
Describe the carpal tunnel.
Identify the muscles associated with the thenar, hypothenar, lumbricals, and interossei muscles.
Attachment points do NOT have to be identified for specific muscles within the hand.
Identify the actions, innervation, and blood supply of the hand muscles.
Discuss the blood vessels of the hand, including both superficial and deep vessels.
Identify bony landmarks on real bone, models, and x-rays.
Laboratory 5 • Antebrachium, Hand, and Joints
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Laboratory 5 • Antebrachium, Hand, and Joints