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What holds down the tendons in the wrist
Flexor Retinaculum
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Colles Fracture is
- Mechanism of Injury:
- • Fall on outstretched, pronated hands
- Clinical Implications:
- Complete transverse fracture of distal radius
- Dorsal displacement of hand relative to wrist (Dinner Fork Deformity)
- • Ulnar styloid process may also be avulsed
- • Risk of injury to median nerve (may mimic Carpal Tunnel Syndrome)
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Interosseous Membrane
Is the seperation of the anterior and posterior muscles of the upper arm between the radius and ulna
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Flexor Carpi Radialis action and innervation
- Action
- Flex and abduct hand at wrist
Innervation Median n. (C6, C7)
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Flexor Carpi Ulnaris action and innervation
Action Flex and adduct hand at wrist
Innervation Ulnar n. (C7, C8)
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Palmaris Longus action and innervation
(absent ~14% of population)
Action Flex hand at wrist, tenses palmar aponeurosis
Innervation Median n. (C7, C8)
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Pronator Teres action and innervation
- Action Pronate and flex forearm at elbow
- Innervation Median n. (C6, C7)
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Flexor Digitorum Superficialis
- Action: Flex middle and proximal phalanges (digits II-V)
- Innervation Median n. (C7, C8, T1)
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Flexor Digitorum Profundus action and innervation
Action Flex distal phalanges (digits II-V)
Innervation Lateral half: Median n. (C7, C8, T1)Medial half: Ulnar n. (C8, T1)
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Flexor Pollicis Longus action and innervation
Action Flex distal and proximal phalanx of pollex (digit I = thumb)
Innervation Median n. (C8, T1)
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The brachial radialis action gives it an alternative name of
The drinking muscle, because it is used to raise a glass
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Pronator Quadratus
Action Pronate forearm, bind radius and ulna together
Innervation Median n. (C8, T1)
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Supracondylar Fracture (distal humerus) Clinicle implications
- Clinical Implications:
- • Distal shaft fragment displaced (posteriorly)
- Limb shortening
- • Risk of brachial a. laceration
- • Risk of median n. damage
- Motor & sensory loss
- “Hand of Benediction” (when making a fist)
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Pronator Syndrome caused by
- Mechanism of Injury:
- • Median n. compressed between ulnar & humeral heads of pronator teres m.
- • Trauma, muscle hypertrophy, fibrous bands
- Clinical Implications:
- • Symptoms present after provacative test
- Pronation against resistance
- Pain in forearm, paresthesia of hand
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Fracture & Avulsion of the Medial Epicondyle
- Clinical Implications:
- • High risk of ulnar n. injury
- Motor & sensory loss
- Claw Hand deformity (when making a fist)
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Brachioradialis action and innervation
- Action
- Flex forearm at elbow
- Innervation
- Radial n. (C5, C6, C7)
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Extensor carpi ulnaris action and innervation
Action Extend and adduct hand at wrist Innervation Radial n. deep branch (C7, C8)
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Extensor carpi radialis longus & brevis Action and innervation
Extend and abduct hand at wrist
Innervation ECRL: Radial n. ( C6, C7); ECRB: Radial n. deep branch (C7, C8)
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Extensor digitorum (+ ext. digiti minimi & ext. indicis) action and innervation
Action Extend distal, middle and proximal phalanges (digits II-V)
Innervation Radial n. deep branch (C7, C8)
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Supinator innervation
Innervation Radial n. deep branch (C7, C8)
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Extensor pollicis longus
Innervation Radial n. deep branch (C7, C8)
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Extensor pollicis brevis innervation
Innervation Radial n. deep branch (C7, C8)
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Abductor pollicis longus innervation
Innervation Radial n. deep branch (C7, C8)
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“Wrist Drop” is due to
Damage to radial n., usually at humerus mid-shaft (radial groove
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Medial Epicondylitis is also known as
- “golfer’s elbow”
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Lateral Epicondylitis is also known as
Tennis elbow
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