Forearm Anatomy Review
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Questions and Answers

Which artery is NOT a direct branch of the brachial artery in the forearm?

  • Radial artery
  • Ulnar artery
  • Anterior interosseous artery (correct)
  • Common interosseous artery

What region of the forearm is supplied by the posterior interosseous artery?

  • Lateral compartment
  • Posterior compartment (correct)
  • Medial compartment
  • Anterior compartment

Which nerve innervates the coracobrachialis muscle?

  • Axillary nerve
  • Radial nerve
  • Musculocutaneous nerve (correct)
  • Ulnar nerve

If a patient has lost sensation on the lateral half of the palm, which nerve is most likely injured?

<p>Median nerve (C)</p> Signup and view all the answers

Which muscle is innervated by the axillary nerve?

<p>Deltoid (C)</p> Signup and view all the answers

Which nerve provides sensory innervation to the posterior forearm?

<p>Radial nerve (C)</p> Signup and view all the answers

Which of the following muscles is innervated by the ulnar nerve?

<p>Flexor carpi ulnaris (C)</p> Signup and view all the answers

Which nerve innervates most of the anterior forearm muscles?

<p>Median nerve (C)</p> Signup and view all the answers

What sensory region is associated with the musculocutaneous nerve?

<p>Lateral forearm (A)</p> Signup and view all the answers

A patient presents with an inability to extend their wrist and fingers. Which nerve is MOST likely affected?

<p>Radial nerve (A)</p> Signup and view all the answers

Which muscle is innervated by the ulnar nerve in the superficial anterior compartment of the forearm?

<p>Flexor carpi ulnaris (D)</p> Signup and view all the answers

What action would be MOST affected by damage to the median nerve in the deep anterior compartment of the forearm?

<p>Flexion of the thumb (D)</p> Signup and view all the answers

Which of the following muscles is NOT located in the posterior compartment of the forearm?

<p>Flexor digitorum profundus (A)</p> Signup and view all the answers

A patient has difficulty tightening their palmar aponeurosis. Which muscle might be affected?

<p>Palmaris longus (A)</p> Signup and view all the answers

Which of the following muscles in the posterior compartment of the forearm assists in flexing the forearm at the elbow?

<p>Brachioradialis (B)</p> Signup and view all the answers

Damage to the radial nerve at the elbow would MOST directly affect the function of which of the following muscles?

<p>Extensor pollicis longus (B)</p> Signup and view all the answers

If a patient is unable to pronate their forearm regardless of elbow angle, which muscle is MOST likely damaged?

<p>Pronator quadratus (A)</p> Signup and view all the answers

Which of the following muscles inserts onto the styloid process of the radius?

<p>Brachioradialis (C)</p> Signup and view all the answers

Which of the following muscles is responsible for flexing the hand at the wrist and adducting the hand?

<p>Flexor carpi ulnaris (C)</p> Signup and view all the answers

Concerning arterial supply to the deep flexor muscles of the forearm, a compromise to the patency of the anterior interosseous artery at its origin would MOST significantly jeopardize perfusion to which structure?

<p>The distal portion of flexor pollicis longus near its insertion on the distal phalanx of the thumb. (B)</p> Signup and view all the answers

Following a penetrating injury to the posterior forearm resulting in verifiable damage to the posterior interosseous nerve distal to the supinator muscle, which precise motor deficit is MOST likely observed?

<p>Inability to extend the index finger at the metacarpophalangeal joint due to paralysis of the extensor indicis proprius. (B)</p> Signup and view all the answers

In a complex reconstruction of the proximal forearm, a surgeon inadvertently severs a nerve subsequently confirmed to exclusively carry motor efferents to the brachialis muscle. Which functional deficit would be MOST anticipated postoperatively?

<p>Marked reduction in elbow flexion strength, irrespective of forearm position (pronation vs. supination). (A)</p> Signup and view all the answers

A patient presents with isolated sensory loss confined to the thenar eminence (excluding the fingertips) and sparing the central palm. Compression of which specific neural structure is MOST suspected?

<p>The palmar cutaneous branch of the median nerve proximal to the carpal tunnel. (B)</p> Signup and view all the answers

During a surgical exploration of the axilla, a lesion is identified affecting the nerve supply to teres minor, but surprisingly sparing the deltoid. Topographically, where is the MOST probable location of this isolated neural compromise?

<p>Within the quadrangular space, affecting the posterior branch of the axillary nerve before it innervates the deltoid. (B)</p> Signup and view all the answers

A patient reports paresthesia along the dorsal radial aspect of the hand AND weakness in thumb abduction in the plane of the palm. This constellation of findings MOST strongly implicates injury to which structure?

<p>The superficial branch of the radial nerve proximal to the anatomical snuffbox, with concurrent involvement of the abductor pollicis brevis. (D)</p> Signup and view all the answers

Surgical transection of the ulnar nerve at the wrist level would spare the motor function of which of the following muscles?

<p>The palmaris brevis muscle, responsible for wrinkling the skin of the hypothenar eminence. (B)</p> Signup and view all the answers

A patient exhibits selective paralysis of forearm pronation, coupled with impaired flexion of digits II and III at the distal interphalangeal joints and sensory loss at the median-innervated palm. Which anatomical structure is MOST likely compromised?

<p>The anterior interosseous nerve, sparing the pronator teres but impacting flexor digitorum profundus and pronator quadratus. (A)</p> Signup and view all the answers

Following a high radial nerve injury proximal to the spiral groove, which compensatory mechanism would MOST likely contribute to a degree of wrist extension, albeit significantly weakened?

<p>Recruitment of the flexor carpi ulnaris to provide wrist extension through eccentric contraction. (B)</p> Signup and view all the answers

A patient presents with an inability to abduct the small finger against resistance, accompanied by sensory loss over the medial aspect of the hand. Which surgical intervention would MOST directly address the underlying pathology?

<p>Decompression of Guyon's canal to release pressure on the ulnar nerve. (B)</p> Signup and view all the answers

A surgeon is performing a delicate exploration of the cubital fossa and encounters a bifurcating nerve, one branch coursing deep to the pronator teres muscle's two heads, the other remaining superficial. Which nerve and its respective branches are most likely being observed?

<p>Median nerve; anterior interosseous nerve and palmar cutaneous branch. (B)</p> Signup and view all the answers

Following a penetrating injury to the distal forearm, a patient exhibits a selective loss of motor function: specifically impaired flexion of the distal interphalangeal joints of the 2nd and 3rd digits, but intact flexion of the 4th and 5th digits. Sensation is unaffected. Which specific neural structure is MOST likely compromised?

<p>The anterior interosseous nerve. (B)</p> Signup and view all the answers

A high-performance cellist reports experiencing progressive weakness and diminished fine motor control in their left hand. Clinical examination reveals atrophy of the thenar eminence and impaired pronation, but normal wrist flexion and adduction. Nerve conduction studies indicate a lesion affecting a specific branch as it passes between the two heads of pronator teres. Which neural element is MOST implicated?

<p>The recurrent branch of the median nerve. (B)</p> Signup and view all the answers

During a complex surgical reconstruction involving the distal radius and ulna, meticulous dissection is required to identify and protect key neurovascular structures. Which of the following neurovascular bundles, defined by their anatomical relationship to forearm muscles, is MOST vulnerable during volar plate fixation of a distal radius fracture?

<p>The anterior interosseous artery and nerve, running on the interosseous membrane between flexor pollicis longus and flexor digitorum profundus. (A)</p> Signup and view all the answers

A patient presents with paralysis of the extensor carpi ulnaris, extensor digiti minimi, and the ulnar portion of the extensor digitorum. Sensation is intact. Electrophysiological studies reveal a lesion affecting a nerve as it courses around the radial head. Which of the following is the MOST likely diagnosis?

<p>Posterior interosseous nerve entrapment at the supinator. (B)</p> Signup and view all the answers

A highly skilled pianist develops an insidious onset of pain and weakness in their forearm, specifically noting difficulty with rapid, alternating pronation and supination movements. On examination, resisted pronation is weak with the elbow flexed at 90 degrees. There is no sensory loss. Imaging reveals no structural abnormalities. Where is the MOST likely site of pathology?

<p>The origin of the pronator teres from the medial epicondyle. (D)</p> Signup and view all the answers

A researcher is investigating the biomechanics of wrist stabilization during forceful gripping. They selectively paralyze specific forearm muscles to assess their individual contributions. If the flexor carpi ulnaris is completely inhibited, what specific compensatory adaptation would MOST likely be observed to maintain grip strength and wrist stability?

<p>Increased activation of the flexor carpi radialis to prevent radial deviation. (A)</p> Signup and view all the answers

A patient presents with impaired thumb abduction in the plane of the palm alongside weakened wrist extension, but normal thumb extension. Which of the following represents the MOST likely lesion involving the deep posterior compartment muscles of the forearm?

<p>Selective radial nerve injury proximal to the supinator affecting the abductor pollicis longus but sparing the extensor pollicis longus. (C)</p> Signup and view all the answers

In a study investigating the comparative effectiveness of surgical approaches for decompressing the radial nerve in patients with recalcitrant radial tunnel syndrome, one approach involves releasing the arcade of Frohse. What anatomical structure is directly released by this procedure?

<p>The proximal aspect of the supinator muscle. (B)</p> Signup and view all the answers

A research team is developing a novel prosthetic hand controlled by electromyographic (EMG) signals from spared forearm muscles following a high median nerve injury at the elbow. Which combination of muscles would be the MOST effective for generating proportional control of both wrist flexion/extension and pronation/supination?

<p>Extensor carpi radialis longus and brevis for flexion/extension; supinator and brachioradialis for pronation/supination. (A)</p> Signup and view all the answers

Flashcards

Musculocutaneous nerve

Innervates the anterior arm muscles.

Radial nerve

Innervates the posterior arm muscles.

Median nerve

Innervates most of the anterior forearm muscles.

Ulnar nerve

Important for wrist flexion and adduction; innervates flexor carpi ulnaris.

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Pronator teres

Movement: Pronates forearm, helps flex forearm at elbow. Innervation: Median nerve.

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Flexor carpi radialis

Movement: Flexes hand at wrist, abducts hand. Innervation: Median nerve.

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Palmaris longus

Movement: Tightens palmar aponeurosis. Innervation: Median nerve.

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Flexor carpi ulnaris

Movement: Flexes hand at wrist, adducts hand. Innervation: Ulnar nerve.

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Extensor digitorum

Movement: Extend phalanges of the digital fingers (2nd - 5th). Innervation: Radial nerve.

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Supinator

Movement: Supinates forearm. Innervation: Radial nerve.

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Common interosseous artery

Artery that branches off the brachial artery in the forearm, splitting into radial and ulnar arteries.

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Anterior interosseous artery

Supplies the deep flexor muscles in the anterior forearm.

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Posterior interosseous artery

Supplies the extensor muscles of the forearm.

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Axillary nerve

Innervates the deltoid and teres minor muscles, providing sensory to the deltoid region.

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Deltoid innervation

Axillary nerve

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Radial artery

Artery in the forearm that is a branch of the brachial artery and travels down the thumb side of the forearm.

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Posterior arm nerve

The main nerve of the posterior arm compartment.

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Styloid process of radius

Distal end of the radius, near the wrist.

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Olecranon

Bony prominence on the ulna, forming the elbow.

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Anterior forearm compartment

Compartment containing flexors of wrist and fingers.

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Pronator quadratus

Deep muscle in the anterior forearm that pronates the forearm.

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Posterior forearm compartment

Compartment containing extensors of wrist and fingers.

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Abductor pollicis longus

Deep posterior muscle responsible for thumb abduction.

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Extensor carpi radialis longus & brevis

Extend and abduct hand at the wrist

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Extensor digiti minimi

Extend phalanges of the pinky

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Brachioradialis

Elbow flexor attaches to radius' styloid process

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Brachial artery

Main artery of the arm that continues into the forearm, branching into the radial and ulnar arteries.

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Musculocutaneous Nerve: Function

Sensory: Lateral forearm. Motor: Anterior arm muscles (Coracobrachialis, Biceps brachii, Brachialis).

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Axillary Nerve: Function

Provides motor function to deltoid and teres minor and sensory to the deltoid region.

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Radial Nerve: Function

Innervates posterior arm and forearm muscles; sensory to posterior arm, forearm, and hand.

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Median Nerve: Function

Innervates most anterior forearm muscles; sensory to the lateral palm.

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Ulnar Nerve: Function

Innervates specific muscles (flexor carpi ulnaris, medial half of flexor digitorum profundus) and provides sensory to medial hand.

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Anterior interosseous artery function

Artery that supplies blood to the deep flexor muscles of the forearm.

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Posterior interosseous artery function

Artery that supplies blood to the extensor muscles of the forearm.

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Flexor Carpi Ulnaris: Action

The ulnar nerve innervates the flexor carpi ulnaris, what movements does this create?

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Study Notes

  • The upper limb includes the forearm

Arteries of the Anterior Forearm

  • The brachial artery splits into the radial and ulnar arteries in the anterior forearm
  • The radial artery is one of the main arteries of the forearm
  • The ulnar artery one of the main arteries of the forearm
  • The common interosseous artery is also located in the anterior forearm
  • The anterior interosseous artery supplies the deep flexor muscles of the forearm

Arteries of the Posterior Forearm

  • The ulna is a bone in the posterior forearm alongside the radius
  • The radius is a bone in the posterior forearm alongside the ulna
  • The interosseous membrane connects the ulna and radius
  • The common interosseous artery is located in the posterior forearm
  • The posterior interosseous artery supplies the extensor muscles of the forearm

Terminal Branches of Brachial Plexus

  • The musculocutaneous nerve branches from the brachial plexus
  • The median nerve branches from the brachial plexus
  • The ulnar nerve branches from the brachial plexus
  • The axillary nerve branches from the brachial plexus
  • The radial nerve branches from the brachial plexus

Musculocutaneous Nerve

  • The musculocutaneous nerve controls motor function for the anterior arm muscles e.g. coracobrachialis, biceps brachii, brachialis
  • The musculocutaneous nerve controls sensory function in the lateral forearm

Axillary Nerve

  • The axillary nerve controls motor function for the deltoid and teres minor
  • The axillary nerve controls sensory function for the deltoid

Radial Nerve

  • The radial nerve controls motor function for posterior arm and forearm muscles
  • The radial nerve controls sensory function for the posterior & inferolateral arm, posterior forearm, and the lateral half of the dorsum of hand

Median Nerve

  • The median nerve controls motor function for most anterior forearm muscles
  • The median nerve controls sensory function for the lateral half of the palm of hand

Ulnar Nerve

  • The ulnar nerve controls motor function for the medial anterior forearm muscles, including the flexor carpi ulnaris, and the medial half of flexor digitorum profundus
  • The ulnar nerve controls sensory function for the medial half of the dorsum & palm of hand

Nerves of the Forearm (Motor)

  • The axillary nerve controls the deltoid
  • The musculocutaneous nerve controls the anterior arm
  • The radial nerve controls the posterior arm
  • The anterior forearm is mainly controlled by the median nerve, and medially by the ulnar nerve

Cutaneous Innervation (Dermatomes)

  • The end of the branch of the axillary nerve provides cutaneous innervation
  • The radial nerve provides cutaneous innervation
  • The lateral antebrachial cutaneous nerve provides cutaneous innervation from the end of the musculocutaneous nerve
  • The median nerve provides cutaneous innervation to a portion of the hand
  • The ulnar nerve provides cutaneous innervation to a portion of the hand

Radius

  • The radius is a bone in the forearm that contains a head
  • Features of the radius include the radial tuberosity (attachment of biceps brachii), shaft (diaphysis), ulnar notch, and styloid process

Ulna

  • The ulna is a bone in the forearm that contains a trochlear notch
  • Features of the ulna include the radial notch, ulnar tuberosity, olecranon (elbow), shaft (diaphysis), and styloid process

Forearm Muscle Compartments

  • The forearm consists of the posterior compartment, superficial anterior compartment, and deep anterior compartment
  • The radius is the lateral bone of the forearm
  • The ulna is the medial bone of the forearm

Anterior Compartment

  • The main action of the anterior compartment is to cause flexion of the wrist and fingers
  • This compartment is located medially

Superficial Anterior Compartment

  • The muscles found in the superficial anterior compartment include the pronator teres, flexor carpi radialis, palmaris longus, flexor carpi ulnaris, and flexor digitorum superficialis
  • The pronator teres attaches to the radius
  • The flexor carpi radialis attaches to MC2
  • The palmaris longus attaches to the palmar aponeurosis
  • The flexor carpi ulnaris attaches to MC5
  • The flexor digitorum superficialis attaches to the middle phalanges of the 2nd to 5th digits
  • These muscles are innervated by the median nerve, except for the flexor carpi ulnaris which is innervated by the ulnar nerve
  • The pronator teres pronates the forearm and helps flex the elbow
  • The flexor carpi radialis flexes and abducts hand at the wrist
  • The palmaris longus tightens the palmar aponeurosis
  • The flexor carpi ulnaris flexes and adducts hand at the wrist
  • The flexor digitorum superficialis flexes phalanges of digital fingers (not thumb)

Deep Anterior Compartment

  • The muscles found in the deep anterior compartment include the flexor digitorum profundus, flexor pollicis longus, and pronator quadratus
  • The flexor digitorum profundus is innervated by the median and ulnar nerves
  • The flexor pollicis longus and pronator quadratus are innervated by the median nerve
  • The flexor digitorum profundus flexes phalanges of digital fingers (not thumb)
  • The flexor pollicis longus flexes pollex (thumb)
  • The pronator quadratus pronates the forearm

Posterior Compartment

  • The main action of the posterior compartment is to cause extension of the wrist and fingers
  • This compartment is located laterally

Muscles of the Posterior Compartment

  • Muscles in posterior compartment include the extensor carpi ulnaris which attaches to MC5, the extensor digitorum which attaches to the 2nd to 5th digits, and the extensor digiti minimi, which attaches to the 5th digit
  • All muscles are innervated by the radial nerve
  • The extensor digitorum extends the phalanges of the digital fingers (2nd to 5th)
  • The extensor carpi ulnaris extends and adducts hand atthe wrist
  • The extensor digiti minimi extends the phalanges of the pinky
  • Muscles in posterior compartment include the extensor carpi radialis longus which attaches to MC2 and the extensor carpi radialis brevis which attaches to MC3
  • Muscles in posterior compartment include the brachioradialis which attaches to styloid process of the radius

Deep Posterior Compartment

  • Muscles in the deep posterior compartment include the supinator (to radius), abductor pollicis longus, extensor pollicis longus, extensor pollicis brevis, and extensor indicis
  • All muscles are innervated by the radial nerve
  • The supinator supinates the forearm
  • The abductor pollicis longus abducts phalanges of pollex (thumb)
  • The extensor pollicis longus & brevis extends phalanges of the pollex (thumb)
  • The extensor inidicis extends phalanges of index finger
  • The brachioradialis helps flex forearm at the elbow
  • The extensor carpi radialis longus & brevis extends and abducts hand at the wrist

Tendons and Ligaments

  • The tendons of the forearm can easily be palpated in the wrist
  • The extensor and flexor retinaculum hold the tendons in place at the wrist
  • Tendon sheaths also surround the tendons in the posterior and anterior hand

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Test your knowledge of forearm anatomy. Questions cover arteries, nerve innervation, and muscle function. Review key concepts for medical and anatomy students.

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