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Anatomy, muscles and ligaments for elbow, wrist and hand

Terms in this set (41)

brachialis
Action = flex the elbow (humeroulnar joint)
Origin = distal half of anterior surface of hmerus
Insertion = tuberosity and coronoid process of ulna
Nerve = musulocutaneous, small branch from radial C5,6

Use your brachialis when you bring food from plate to your mouth, picking up a load of anatomy books, carrying a baby car seat
Brachioradialis
Action - flex the elbow (humeroulnar joint), assists to pronate and supinate the forearm when these movements are resisted
Origin - proximal two-thirds of the lateral supracondylar ridge of humerus
Insertion - Styloid process of radius
Nerve - Radial C5,6

Use your brachioradialis when turning a door handle or screw driver, bringing a beer stein up to your mouth, whisking cream in a bowl, hoisting a toddler out of her crib
Extensor carpi radialis longus
A - extend the wrist (radiocarpal joint), abduct the wrist (radiocarpal joint), assist to flex the elbow (humeroulnar joint)
O - distal one-third of the lateral supracondylar ridge of humerus
I - base of second metacarpal
N - Radial, C5,6,7,8

Use them to stabilse the wrist while gripping (opening a jar), washing the dishes, turning off a facuet
Extensor carpi radialis brevis
A - extend the wrist (radiocarpal joint), abduct the wirst, assist to flex the elbow (humeroulnar joint)
O - Common extensor tendon from the lateral epicondyle of humerus
I - Base of third metacarpal
N - C6,7,8

Use them to stabilse the wrist while gripping (opening a jar), washing the dishes, turning off a facuet
Extensor carpi ulnaris
A - extend the wrist (radiocarpal joint)
O - common extensor tendon from the lateral epicondyle of humerus
I - Base of fifth metcarpal
N - Radial C6,7,8

Use it when shaping soft clay for an art project, pulling a book off a tall ilbrary shelf, reaching into the backseat of your car.
Extensor digitorum
A - Extend the second thoruhg fifth fingers (metacarpophalangeal and interphalangeal joints)
Assists to extend the wrist (radiocarpal joint)
O - Common extensor tendon from the lateral epicondyle of humerus
I - Bases of middle and distal phalanges of second through fifth fingers
N - radial C6,7,8

Playing the piano or trumpet, holding your hand up to give the vulcan hand greeting, releasing a hand shake
Anconeus
A - extend the elbow (humeroulnar joint)
O - Lateral epicondyle of the humerus
I - olecranon process and posterior, proximal surface of ulna
N - Radial C7,8
Extensor Indicis
A - Extend the second finger (matcarpophlangeal joint)
Adduct the second finger. May assist to extend the wrist (radiocarpal joint)
O - Posterior surface of distal shaft of ulna and interosseous membrane
I - tendon of the extensor digitorum at the level of the second metacarpal
N - Radial C6,7,8
Flexor carpi radialis
A - Flex the wrist (radiocarpal joint), abduct the wrist, may assist to flex the elbow
O - Common flexor tendon from medial epicondyle of humerus
I - Bases of second and third metacarpals
N - Median C6,7,8
Palmaris Longus
A - Tense the palmar fascia, flex the wrist, may assist to flex the elbow
O - common flexor tendon from medial epicondyle of humerus
I - Flexor retinaculum and palmar aponeuorosis
N - Median C5(6) 7,8, T1
Flexor carpia ulnaris
A - Flex the wrist , adduct the wirst, assist to flex the elbow
O - Humeral head: Common flexor tendon from medial epicondyle of humerus. Ulnar head: Posterior surface of proximal two-thirds of ulna
I - Pisiform, hook of the hamate and base of fifth metacarpal
N - Ulnar, C7,8,T1
Flexor digitorum superficialis
A - Flex the second through fifth fingers (metcarpophalangeal and proximal interphalangeal joints). Flex the wrist.
O - Common flexor tendon from medial epicondyle of humerus, ulnar collateral ligament, coronoid process of ulna, interosseous membrane and proximal shaft of radius.
I - Sides of middle phalanges of second through fifth fingers
N - Median C7,8,T1
Flexor digitorum profundus
A - Flex the second through fifth fingers (metcarpophalangeal and distal interphalangeal joints)
Assist to flex the wrist
O - Anterior and medial surfaces of proximal three-quarters of ulna
I - Bases of distal phalanges, palmar surface of second through fifth fingers
N - First and second: Meidla C7.8.T1
Third and fourth: Ulnar: C7,8,T1
Pronator teres
A - pronate the forearm (radioulnar joints), assists to flex the elbow (humeroulnar joint)
O - Common flexor tendon from medial epicondyle of humerus and coronoid process of the ulna
I - Middle of lateral surface of the radius
N - Median C6,7
Pronator Quadratus
A - Pronate the forearm (radioulnar joints)
O - Medial, anterior surface of distal ulna
I - Lateral, anterior surface of distal radius
N - Median, C7,8,T1
Supinator
A - supinate the forearm (radioulnar joints)
O - lateral epicondyle of humerus, radial colalteral ligamnet, annular ligament and supinator crest of the ulna
I - Anterior, lateral surface of proximal one-third of radial shaft
N - Radial C5,6 (7)

Use it to dig out a scoop of ice cream, swirling water in bath tub, folding your clothes
abductor pollicis longus
A - Abduct the thumb (carpometacarpal joint)
Extend the thumb (carpometacarpal joint)
Abduct the wrist (radiocarpal joint)
O - Posterior surface of radius and ulna, and interosseous membrane
I - base of first metacarpal
N - radial C6,7,8
Extensor pollicis longus
A - Extend the thumb (interphalangeal joint)
Extend the thumb (Metacarpophalangeal and carpometacarpal joints)
Abduct the wrist (radiocarpal joint)
O - Posterior surface of ulna and interosseous membrane
I - Base of distal phalanx of thumb
N - radial C6,7,8
Extensor pollicis brevis
A - Extend the thumb (interphalangeal joint)
Extend the thumb (Metacarpophalangeal and carpometacarpal joints)
Abduct the wrist (radiocarpal joint)
O - Posterior surface of radius and interosseous membrane
I - Base of proximal phalanx of thumb
N - RAdial C6,7,8
Flexor pollicis longus
A - Flex the thumb (interphalangeal joint)
Flex the thumb (metcarpophalangeal and carpometacarpal joints)
Assist to flex the wrist (radiocarpal joints)
O - anterior surface of radius and interosseous membrane
I - base of distal phalanx of thumb
N - median C(6), 7,8,T1
Abductor pollicis brevis
A - Abduct the thumb (Carpometacarpal and metacarpophalangeal joints)
O - flexor retinaculum, trapezium and scaphoid tubercles
I - Base of proximal phalanx of thumb
N - Median C6,7,8,T1
Flexor pollicis brevis
A - flex the thumb (carpometacarpal and metacarpophlangeal joints), assists in opposition of the thumb
O - Superficial head: Flexor retinaculum
Deep head: Trapezium, trapezoid and capitate
I - Base of proximal phalanx of thub
N - Superficial head: Median C6,7,8,t1
Deep head: Ulnar C8,T1
Opponens pollicis
A - Opposition of the thumb at the carpometacarpal joint (bringing the pads of the thumb and fifth finger together)
O - Flexor retinaculum and tubercle of the trapezium
I - Entire length of first metacparal bone, radial surface
N - median c6,7,8, T1
Adductor pollicis
A - Adduct the thumb (carpometacarpal and metacarpophalangeal joints), assist to flex the thumb (metacarpophalangeal joint)
O - capitate, second and third metacarpals
I - base of proximal phalanx of thumb
N - Ulnar C8.T1
Lumbricals of the hand
A - extend the second through fifth fingers at the interphalangeal joints, flex the second through fifth fingers at the metacarpophalangeal joints
O - surfaces of the flexor digitorum profundus tendons
I - Extensor oponeurosis on dorsal surface of phalanges
N - Second and third fnigers : Median C(6), 7, 8, T1
fourth and fifth fingers: Ulnar C(7), 8, T1
Palmar Interossei
A: Adduct the thumb, second, fourth and fifth fingers towards the third finger
Assist to flex the thumb, second, fourth and fifth fingers at the metacarpophalaangeal joints
Assist to extend the thumb, second, fourth, and fifth fingers at the interphalangeal joints
Dorsal interossei
A - Abduct the second, third and fourth fingers at the metacarpophalangeal joints
Assist to flex of the second, third and fourth fingers the metacarpophalangeal joints
Assist to extend the second, third and fourth fingers at the interphalangeal joints
O - Adjacent sides of all metacarpals
I - Base of the proximal phlanax of the second, third and fourth fingers and the extensor aponeurosis
N - Ulnar C8, T1
What muscles make up the hypothenar eminence and their O+I's
Abductor digit minimi
A - Abduct the fifth finger (metacarophalangeal joint)
Assist in opposition of the fifth finger toward the thumb (metacarophalangeal joint)
O - Pisiform and tendon of flexor carpi ulnaris
I - Base of proximal phalanx of fifth finger, ulna surface
N - Ulnar C(7).8, T1

Flexor digiti minimi brevis
A - flex the fifth finger (metacarpophalangeal joint)
Assist in opposition of the fifth finger toward the thumb
O - hook of hamate and flexor retinaculum
I - Base of proximal proximal phalanx of fifth finger, palmar surface
N - Ulnar C (7), 8, T1

Opponens digiti minimi
A - opposition of the fifth finger at the carpometacarpal joint
O - hook of hamate and flexor retinaculum
I - Shaft of fifth metacarpal, ulnar surface
N - ulnar C(7), 8, T1
Normal ROM for elbow?
Flexion = 0-130/150 degrees - muscle bulk can restrict this
Extension = 0 degrees
Pronation = 0-80/90 degrees
Supination = 0-80/90 degrees
Where is the interoessous membrane situated
Between the radius and ulna
Biceps Brachii
O - Short head = apex of the coronoid process of the scapula
Long head = supraglenoid tubercle of the scapula
I - Short head = posterior aspect of the radial tuberosity
Long head = bicipital aponeurosis: Deep fascia covering origins of the flexor muscles of the forearm
N - Musculocutaneous (C5/6)
A - Elbow flexion, forearm supination
Triceps
is a large muscle occupying the extensor compartment of the arm. It arises from three heads, medial, lateral and long from which it gets its name.
O - The long head of triceps arises from a tendon attached to the infraglenoid tubercle of the scapula. The long head supports the inferior aspect of the shoulder joint capsule when the arm is abducted.
The medial head of triceps arises from the posterior surface of the humerus below the radial groove, as well as from the adjacent medial and lateral intermuscular septum. It is overlapped posteriorly by long and lateral heads.
The lateral head of triceps arises by a flattened tendon from the upper border of the radial groove, from the lateral border of the humerus and lateral intermuscular septum.
I - To the proximal part of the olecranon process of the ulna and via an aponeurosis to the fascia of the posterior aspect of the elbow and forearm. The muscle converges on the common tendon, which inserts on the upper surface of the olecranon.
N - Radial nerve (C6,7,8) with separate branches to each head.
A - powerful extensor of the elbow. In addition, the long head produces weak extension of the shoulder and assists in stabilising the shoulder joint.
The annular ligament
lined with articular cartilage, wraps around the head and neck of the radius, stabilising the proximal radius against the ulna during pronation and supination. It lies deep to the supinator and the extensor muscles of the forearm. Although the annular ligament cannot be palpated separately, its location can be isolated.
Radial collateral ligament
is a cordlike band that stretches from the lateral epicondyle of the humerus to the annular ligament and lateral side of the ulna.
Ulnar collateral ligament
is a strong, triangular shaped ligament that originates on the humerus medial epicondyle. Its fibres spread out and attach to the coronoid process of the ulna and to the olecranon process. The collateral ligament is deep to the common flexor tendon, but superficial to the ulnar nerve.
Olecranon bursa
just distal to the triceps brachii tendon, this small bursa pads the space between the olecranon process and skin of the elbow. Due to its location, the bursa can become inflamed when the elbow is irritated or struck by an external object. This condition, olecranon bursitis is readily observable by the distinct localised ballooning of the elbow.
Steps for palpation
Medial epicondyle - most prominent epicondyle. Commonly see it on people sticking out. On the humerus. Track humerus down medial.
Lateral epicondyle - on the humerus. Track the humerus down until hit bony landmark, don't stick fingers in keep hands nice and soft because if someone has tennis elbow will be very painful.
Olecranon - posterior aspect of ulna, easy to palpate. Swelling suggests bursitis. Located on the ulna - much easier to palpate with elbow in 90 degrees' flexion. Ulna nerve runs close to this area so be careful. Follow olecranon down this is the shaft on the ulna.
Head of radius - find under lateral epicondyle, dip under lateral epicondyle until find next bone, pro + supinate to check on head of radius as this should rotate/pivot under your thumb. During pronation of the forearm the radius crosses over the ulna.
Radial + ulnar styloid - bony prominences of wrist both distal. Much easier to palpate on the posterior aspect of hand. Quite easy to palpate. Can follow shaft of radius down, commonly in line with thumb and can palpate.
Head of ulna - distal end at the bottom
Head of radius - proximal at the top
Describe the humeroradial joint
formed by trochlea of the humerus that is convex anteroposteriorly and articulates with the concave surface of the trochlear notch of the ulna.
Describe the humeroulnar joint
The convex surface of the capitulum of the humerus articulates with the concave proximal aspect of the radial head to form the humeroradial joint.
Both responsible for flexion and extension in the saggital plane with movement occurring around a frontal axis.
Describe the superior radioulnar joint
contained within the capsule of the elbow joint and is a pivot joint formed between the convex surface of the radial head and the concave radial notch on the radial aspect of the proximal ulna. Responsible for pro and supination which happens in the transverse longitudinal plane.
Describe the inferior radioulnar joint
is also a pivot joint in which the concave ulnar notch on the medial aspect of the distal radius articulates with the convex head of the ulna. Responsible for pro and supination which happens in the transverse longitudinal plane.
Supination and pronation movements occur around an oblique axis that passes through the head of the radius proximally and through the head of the ulna distally. With the elbow in an anatomical position, the movements of pronation and supination occur in the transverse plane around a longitudinal axis. In supination, the radius lies alongside the ulna. In pronation, the radius rotates around the relatively stationary ulna.
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