Please enable JavaScript.
Coggle requires JavaScript to display documents.
Arm, Flexor Forearm, and Palmar Hand (Clinical Implications (ARM - way to…
Arm, Flexor Forearm, and Palmar Hand
-
-
Nerves
-
-
Median Nerve in Forearm
passes by arm, only forearm , supplies superficial flexors of forearm (except FCU - flexor carpi radials), , supplies thumb and first two and a half digits
Ulnar Nerve in Forearm
Passes by medial arm, under Flexor carpi radials, supplies all of the flexor carpi ulnaris and half of the flexor digitorum profundus
crosses writs in Ulnar (Guyon's tunnell)
Vasculature
Axillary Artery
Brachial Artery
-
Brachial Artery
Ulnar Artery (deep)
Common, posterior, and anterior interosseous arteries - vascular of forearm
-
-
Clinical Implications
radial head dislocation in kids - annual ligament isn't yet mature so if you pull hard on their arm they can dislocate their radius from their humeroradial joint
Olecranon bursitis - olecranon is the bump on the superior end of the ulna, if its broken it can swell up and get messy
-
-
-
-
-
Single palmar (Simean) crease can be normal or it can indicate a number of disorders (like down syndrome or fetal alcohol syndrome
Dupuytren's Contracture - disease, palmar aponeurosis becomes progressively fibrotic and short, often bilateral, causes hand to flex, surgical release required
Test palmar interossei (ulnar nerve) - squeeze a popsicle stick in-between second and third digits, see if they can hold on
-
Evaluate Flexor Digitorum Superficialis - see if they can flex only their third digit, holding others back
-
Synovial sheaths in digits will confine infections to either palm and little finger, other fingers, or thumb
palmar branch of median nerve innervates a small sensory patch on the palm, it is the only nerve that doesn't pass through the carpal tunnell, so if there's carpal tunnell syndrom it does not affect this small patch of skin
Median nerve severed near elbow - test flexion of distal interphalangyl joint of index finger,
Median nerve lesion to only anterior interosseous nerve - Anterior Interosseous Syndrome - can't make an ok sign, they do a pinched ok sign, from paralysis of flexor digitorum profundus and flexor pollicis longus
-
Guyon's Canal Syndrome - compression of ulnar nerve, cyclists and weight lifters, pins and needles in ring and little finger
-
Allen Test - check presence of arch before removing artery for grafting elsewhere or placing a catheter in the artery
Radial Nerve damage - can't raise hand when elbow elevated, called wrist drop
-
Crutches size - too long- damage posterior cord, too short - damage long thoracic nerve, hyperextended wrist - compress ulnar nerve
-
Hand
-
-
Palmar Aponeurosis - deep fascia of hand, continuous with flexor retinaculum and palmaris longus tendon, forms 4 rays that go to bases of proximal phalanges
5 Compartments of Hand
-
Adductor Compartment
deep to thenar compartment, houses thumb's adductor
-
-
-
Muscles
palmaris brevis - wrinkles kin of hypothenar eminence, deeps and hollows palm for good grip, protects ulnar nerve and artery
Thenar muscles
-
-
opponens pollici
opposes thumb toward center of palm, rotate thumb medially
-
-
-
Short Hand Muscles
-
-
Palmar interossei
-
adducts digits 2,4,5 to third digit
-
Fibrous Digital Sheath - strong ligaments holding tendons
Synovial sheaths - under fibrous digital sheaths
Nerves
Palmar branch of median nerve - small sensory patch of palm - only one that travels superficial to flexor retinaculum, usually functional during carpal tunnel syndrom because it passes superificial to it
Recurrent branch of median nerve - through carpal tunnel, innervates muscles of thenar compartment
median nerve in hand - also innervates first and second lumbercles, gives rise to 3 common palmar digital nerves, which then split into two palmar digital nerves each
Ulnar Nerve Track
-
Deep branch
supplies hypothenar muscles, medial two lumbricals, adductor policies, deep head of FPB
-
Blood Supply
-
radial artery
dorsal carpal arch -0 goes with dorsal branch of ulnar artery #
risses to dorsal dorsal metacarpal arteries, those go to dorsal digital arteries
Deep palmar arch - most contribution form radial, less from ulnar artery
-