Podcast
Questions and Answers
Which of the following statements accurately describes the articulation at the superior radio-ulnar joint?
Which of the following statements accurately describes the articulation at the superior radio-ulnar joint?
- The head of the radius articulates with the ulnar notch of the ulna.
- The head of the radius articulates with the radial notch of the ulna and annular ligament. (correct)
- The interosseous border of the ulna articulates with the interosseous border of the radius.
- The head of the ulna articulates with the radial notch of the radius and annular ligament.
What type of joint is the middle radio-ulnar joint, and how does it contribute to forearm movement?
What type of joint is the middle radio-ulnar joint, and how does it contribute to forearm movement?
- Synovial pivot joint; allows for rotation of the radius around the ulna.
- Fibrous syndesmosis; allows for limited movement and stability between the radius and ulna. (correct)
- Synovial ellipsoid joint; allows for flexion, extension, abduction, and adduction.
- Cartilaginous joint; provides cushioning and shock absorption between the radius and ulna.
Which muscles are primarily involved in the movement of supination?
Which muscles are primarily involved in the movement of supination?
- Brachioradialis, biceps, and supinator (correct)
- Pronator quadratus and brachioradialis
- Brachioradialis and pronator teres
- Pronator teres and pronator quadratus
Which carpal bones articulate with the radius at the wrist joint?
Which carpal bones articulate with the radius at the wrist joint?
What type of joint is the wrist (radio-carpal) joint, and what movements does it primarily facilitate?
What type of joint is the wrist (radio-carpal) joint, and what movements does it primarily facilitate?
Which of the following muscles contributes to wrist flexion?
Which of the following muscles contributes to wrist flexion?
Which type of joint is the metacarpophalangeal joint, and what movements does it allow?
Which type of joint is the metacarpophalangeal joint, and what movements does it allow?
With the exception of the thumb, what type of joint is the carpometacarpal joint?
With the exception of the thumb, what type of joint is the carpometacarpal joint?
What is the primary action of the brachioradialis muscle, and what nerve innervates it?
What is the primary action of the brachioradialis muscle, and what nerve innervates it?
What are the actions of the extensor carpi radialis longus and brevis muscles?
What are the actions of the extensor carpi radialis longus and brevis muscles?
Which nerve innervates the extensor carpi ulnaris muscle, and what is its primary action?
Which nerve innervates the extensor carpi ulnaris muscle, and what is its primary action?
What is the origin and action of the anconeus muscle?
What is the origin and action of the anconeus muscle?
Which nerve is responsible for innervating all the muscles in the deep group of the posterior forearm?
Which nerve is responsible for innervating all the muscles in the deep group of the posterior forearm?
What is the origin and action of the abductor pollicis longus (APL) muscle?
What is the origin and action of the abductor pollicis longus (APL) muscle?
What are the terminal branches of the radial nerve at the level of the lateral epicondyle?
What are the terminal branches of the radial nerve at the level of the lateral epicondyle?
Which condition is most likely indicated by swelling in the anatomical snuffbox?
Which condition is most likely indicated by swelling in the anatomical snuffbox?
What structures form the boundaries of the anatomical snuffbox?
What structures form the boundaries of the anatomical snuffbox?
Which of the following structures would NOT be found passing deep to the extensor retinaculum?
Which of the following structures would NOT be found passing deep to the extensor retinaculum?
In which compartment of the extensor retinaculum is the tendon of the extensor carpi ulnaris located?
In which compartment of the extensor retinaculum is the tendon of the extensor carpi ulnaris located?
Which muscles would be affected, resulting in the inability to extend the elbow, wrist and all joints of medial 4 fingers?
Which muscles would be affected, resulting in the inability to extend the elbow, wrist and all joints of medial 4 fingers?
How does the middle radio-ulnar joint primarily achieve stability, considering its classification as a fibrous syndesmosis?
How does the middle radio-ulnar joint primarily achieve stability, considering its classification as a fibrous syndesmosis?
During pronation of the forearm, what is the combined action of the brachioradialis, pronator teres, and pronator quadratus muscles?
During pronation of the forearm, what is the combined action of the brachioradialis, pronator teres, and pronator quadratus muscles?
Considering the articulations at the wrist joint, how does the arrangement of the radius, scaphoid, lunate, and triquetrum contribute to its ellipsoid nature?
Considering the articulations at the wrist joint, how does the arrangement of the radius, scaphoid, lunate, and triquetrum contribute to its ellipsoid nature?
How do the actions of the Flexor Carpi Radialis (FCR) and Flexor Carpi Ulnaris (FCU) work in synergy with the Palmaris Longus to achieve wrist flexion effectively?
How do the actions of the Flexor Carpi Radialis (FCR) and Flexor Carpi Ulnaris (FCU) work in synergy with the Palmaris Longus to achieve wrist flexion effectively?
Considering the structure and function of the hand joints, how does the unique synovial saddle joint of the thumb's carpometacarpal joint differ from the other carpo-metacarpal joints?
Considering the structure and function of the hand joints, how does the unique synovial saddle joint of the thumb's carpometacarpal joint differ from the other carpo-metacarpal joints?
What functional consequence would result from damage to the radial nerve affecting the brachioradialis muscle, relative to its role in forearm positioning and elbow flexion?
What functional consequence would result from damage to the radial nerve affecting the brachioradialis muscle, relative to its role in forearm positioning and elbow flexion?
How does the coordinated action of the Extensor Carpi Radialis Longus (ECRL) and Brevis (ECRB) contribute to the movements of the wrist and hand?
How does the coordinated action of the Extensor Carpi Radialis Longus (ECRL) and Brevis (ECRB) contribute to the movements of the wrist and hand?
What specific loss of function would be expected following damage to the posterior interosseous nerve, concerning its innervation of the digital extensor muscles?
What specific loss of function would be expected following damage to the posterior interosseous nerve, concerning its innervation of the digital extensor muscles?
What functional deficit would be most apparent following an injury that selectively impairs the abductor pollicis longus (APL) muscle?
What functional deficit would be most apparent following an injury that selectively impairs the abductor pollicis longus (APL) muscle?
Following a fracture at the mid-shaft of the humerus, which results in wrist drop and finger drop, what nerve is most likely compromised?
Following a fracture at the mid-shaft of the humerus, which results in wrist drop and finger drop, what nerve is most likely compromised?
In the event of radial nerve damage proximal to the elbow, which of the following muscles would retain its normal function?
In the event of radial nerve damage proximal to the elbow, which of the following muscles would retain its normal function?
What specific anatomical feature makes the scaphoid bone vulnerable to avascular necrosis following a fracture in the anatomical snuffbox?
What specific anatomical feature makes the scaphoid bone vulnerable to avascular necrosis following a fracture in the anatomical snuffbox?
What critical maneuver might be used to assess the integrity of the radial artery within the anatomical snuffbox?
What critical maneuver might be used to assess the integrity of the radial artery within the anatomical snuffbox?
What key distinctions exist between structures superficial and deep to the extensor retinaculum at the wrist?
What key distinctions exist between structures superficial and deep to the extensor retinaculum at the wrist?
Following a laceration over the 5th compartment of the extensor retinaculum, which specific movement of the hand and wrist would be most compromised?
Following a laceration over the 5th compartment of the extensor retinaculum, which specific movement of the hand and wrist would be most compromised?
If a patient exhibits limited supination of the forearm following an injury, but pronation remains largely unaffected, which combination of muscle impairments is least likely to be the primary cause?
If a patient exhibits limited supination of the forearm following an injury, but pronation remains largely unaffected, which combination of muscle impairments is least likely to be the primary cause?
What is the consequence of a complete transection of the posterior interosseous nerve regarding the function of the wrist and fingers?
What is the consequence of a complete transection of the posterior interosseous nerve regarding the function of the wrist and fingers?
Considering the anatomical arrangement at the wrist, what is the most likely consequence of significant swelling within the anatomical snuffbox?
Considering the anatomical arrangement at the wrist, what is the most likely consequence of significant swelling within the anatomical snuffbox?
Following a forceful impact to the anterior aspect of the wrist, a patient reports pain and reduced range of motion, particularly during wrist extension and abduction. Imaging reveals no fractures, but significant swelling is noted around the tendons on the radial side of the wrist. Which compartment of the extensor retinaculum is most likely affected?
Following a forceful impact to the anterior aspect of the wrist, a patient reports pain and reduced range of motion, particularly during wrist extension and abduction. Imaging reveals no fractures, but significant swelling is noted around the tendons on the radial side of the wrist. Which compartment of the extensor retinaculum is most likely affected?
A surgeon is planning an approach to the radial artery at the wrist. What is the most important consideration regarding the location of the superficial branch of the radial nerve?
A surgeon is planning an approach to the radial artery at the wrist. What is the most important consideration regarding the location of the superficial branch of the radial nerve?
Considering the actions of the muscles acting on the wrist, what would be the functional outcome of simultaneous paralysis of the flexor carpi ulnaris and extensor carpi radialis longus?
Considering the actions of the muscles acting on the wrist, what would be the functional outcome of simultaneous paralysis of the flexor carpi ulnaris and extensor carpi radialis longus?
A patient presents with weakness in wrist extension and an inability to abduct the thumb. Which specific nerve impairment is most likely responsible for these deficits?
A patient presents with weakness in wrist extension and an inability to abduct the thumb. Which specific nerve impairment is most likely responsible for these deficits?
During a complex surgical repair involving the distal radius and ulna, there is iatrogenic damage affecting the interosseous membrane. How would this compromise the biomechanics of the forearm?
During a complex surgical repair involving the distal radius and ulna, there is iatrogenic damage affecting the interosseous membrane. How would this compromise the biomechanics of the forearm?
In a scenario involving a stab wound to the anterior forearm, a patient exhibits paralysis of the flexor digitorum profundus of the index and middle fingers, as well as the flexor pollicis longus, but maintains normal function of the flexor carpi ulnaris. Which nerve is likely affected?
In a scenario involving a stab wound to the anterior forearm, a patient exhibits paralysis of the flexor digitorum profundus of the index and middle fingers, as well as the flexor pollicis longus, but maintains normal function of the flexor carpi ulnaris. Which nerve is likely affected?
If a patient has difficulty with both wrist flexion and adduction, which combination of muscle impairments is most likely present?
If a patient has difficulty with both wrist flexion and adduction, which combination of muscle impairments is most likely present?
What would be the most expected outcome of a surgical error during carpal tunnel release that severs the recurrent branch of the median nerve?
What would be the most expected outcome of a surgical error during carpal tunnel release that severs the recurrent branch of the median nerve?
Following a fall onto an outstretched hand, a patient experiences persistent pain and tenderness in the anatomical snuffbox, but initial radiographs are negative. If avascular necrosis of the scaphoid bone is suspected, what imaging modality would be most appropriate to confirm this diagnosis?
Following a fall onto an outstretched hand, a patient experiences persistent pain and tenderness in the anatomical snuffbox, but initial radiographs are negative. If avascular necrosis of the scaphoid bone is suspected, what imaging modality would be most appropriate to confirm this diagnosis?
A patient presents with pain and weakness in the hand following a deep laceration on the ulnar side of the anterior forearm. Examination reveals weakened flexion of the wrist and impaired adduction. Which of the following structures is most likely injured?
A patient presents with pain and weakness in the hand following a deep laceration on the ulnar side of the anterior forearm. Examination reveals weakened flexion of the wrist and impaired adduction. Which of the following structures is most likely injured?
A patient is diagnosed with compression of the radial nerve in the spiral groove of the humerus. Which of the following muscles would retain its normal function?
A patient is diagnosed with compression of the radial nerve in the spiral groove of the humerus. Which of the following muscles would retain its normal function?
If there is damage to the interosseous membrane, how does this affect force transmission between the radius and ulna during weight-bearing activities such as performing a push-up?
If there is damage to the interosseous membrane, how does this affect force transmission between the radius and ulna during weight-bearing activities such as performing a push-up?
Flashcards
Radio-ulnar Joint
Radio-ulnar Joint
A joint that allows for pronation and supination movements in the forearm.
Superior Radio-Ulnar Joint
Superior Radio-Ulnar Joint
Synovial pivot joint where the head of the radius articulates with radial notch of ulna & annular ligament.
Inferior Radio-Ulnar Joint
Inferior Radio-Ulnar Joint
Synovial pivot joint where the head of the ulna articulates with & ulnar notch of radius.
Middle Radio-Ulnar Joint
Middle Radio-Ulnar Joint
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Pronation
Pronation
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Supination
Supination
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Radio-carpal Joint
Radio-carpal Joint
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Wrist (Radio-carpal) Joint
Wrist (Radio-carpal) Joint
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Inter-carpal Joints
Inter-carpal Joints
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Carpo-metacarpal Joints
Carpo-metacarpal Joints
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Metacarpo-phalangeal Joints
Metacarpo-phalangeal Joints
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Inter-phalangeal Joints
Inter-phalangeal Joints
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Brachio-radialis
Brachio-radialis
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Extensor Carpi Radialis Longus
Extensor Carpi Radialis Longus
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Extensor Carpi Radialis Brevis
Extensor Carpi Radialis Brevis
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Extensor Digitorum
Extensor Digitorum
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Extensor Digiti Minimi
Extensor Digiti Minimi
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Extensor Carpi Ulnaris
Extensor Carpi Ulnaris
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Anconeus
Anconeus
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Abductor Pollicis Longus
Abductor Pollicis Longus
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Supinator Muscle
Supinator Muscle
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Extensor Pollicis Longus
Extensor Pollicis Longus
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Extensor Indicis
Extensor Indicis
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Radial Nerve
Radial Nerve
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Superficial Branch (Radial Nerve)
Superficial Branch (Radial Nerve)
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Posterior Interosseous Nerve
Posterior Interosseous Nerve
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Crutch Palsy
Crutch Palsy
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Anatomical Snuff Box
Anatomical Snuff Box
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Anterior (Lateral) Boundary
Anterior (Lateral) Boundary
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Posterior (Medial) Boundary
Posterior (Medial) Boundary
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Floor
Floor
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Posterior Interosseous Nerve Supply
Posterior Interosseous Nerve Supply
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Origin of ECRL
Origin of ECRL
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Wrist Flexion
Wrist Flexion
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Wrist & Finger Drop
Wrist & Finger Drop
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Radial Artery
Radial Artery
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Injury of Superficial Branch
Injury of Superficial Branch
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Saturday Night Palsy
Saturday Night Palsy
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Superficial branch supply
Superficial branch supply
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Brachioradialis Action
Brachioradialis Action
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ECU Muscle Action
ECU Muscle Action
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Study Notes
Radio-ulnar Joint
- Connects the radius and ulna bones in the forearm.
- Includes the superior, inferior, and middle radio-ulnar joints.
Superior Radio-ulnar Joint
- Type: Synovial pivot joint
- Articulation: The head of the radius articulates with the radial notch of the ulna and the annular ligament.
Inferior Radio-ulnar Joint
- Type: Synovial pivot joint
- Articulation: The head of the ulna articulates with the ulnar notch of the radius.
Middle Radio-ulnar Joint
- Type: Fibrous syndesmosis joint.
- Articulation: Occurs along the interosseous border of the ulna and radius.
Movement of Radio-ulnar Joints
- Pronation: Involves the brachioradialis, pronator teres, and pronator quadratus muscles.
- Supination: Involves the brachioradialis, biceps brachii, and supinator muscles.
Wrist "Radio-carpal" Joint
- Type: Synovial ellipsoid joint
- Articulation:
- Superior: The lower end of the radius.
- Inferior: The scaphoid, lunate, and triquetrum bones.
Movement
- Flexion: Achieved by the flexor carpi radialis, flexor carpi ulnaris, and palmaris longus muscles.
- Extension: Achieved by the extensor carpi radialis longus (ECRL), extensor carpi radialis brevis (ECRB), and extensor carpi ulnaris muscles.
- Abduction: Achieved by the ECRL, ECRB, and flexor carpi radialis muscles.
- Adduction: Achieved by the extensor carpi ulnaris and flexor carpi ulnaris muscles.
Hand Joints
- Inter-carpal: Synovial plane joint.
- Carpo-metacarpal: Synovial plane joint, except for the thumb, which is a synovial saddle joint.
- Metacarpo-phalangeal: Synovial condylar joint.
- Inter-phalangeal: Synovial hinge joint.
Muscles of the Back of Forearm (Superficial Group)
Brachio-radialis
- Origin: Upper 2/3 of the lateral supra-condylar line of the humerus.
- Insertion: Styloid process of the radius.
- Nerve Supply: Radial nerve
- Action: Puts the forearm in a mid-prone position and flexes the elbow in a mid-prone position.
Extensor Carpi Radialis Longus
- Origin: Lower 1/3 of the lateral supra-condylar line and common extensor origin.
- Insertion: 2nd metacarpal bone.
- Nerve Supply: Radial nerve.
- Action: Extends the elbow and extends and abducts the wrist.
Extensor Carpi Radialis Brevis
- Origin: Common extensor origin.
- Insertion: 3rd metacarpal bone.
- Nerve Supply: Posterior interosseous nerve.
- Action: Extends the elbow and extends and abducts the wrist.
Extensor Digitorum
- Origin: Common extensor origin.
- Insertion: Middle and distal phalanges of the medial four fingers.
- Nerve Supply: Posterior interosseous nerve.
- Action: Extends the elbow, wrist, and all joints of the medial four fingers.
Extensor Digiti Minimi
- Origin: Common extensor origin.
- Insertion: Middle and distal phalanges of the little finger.
- Nerve Supply: Posterior interosseous nerve.
- Action: Extends the elbow, wrist, and all joints of the little finger.
Extensor Carpi Ulnaris
- Origin: Common extensor origin and posterior border of the ulna.
- Insertion: 5th metacarpal bone.
- Nerve Supply: Posterior interosseous nerve.
- Action: Extends the elbow and extends and adducts the wrist.
Anconeus
- Origin: Back of the lateral epicondyle.
- Insertion: Back of the upper half of the ulna.
- Nerve Supply: Radial nerve.
- Action: Extends the elbow.
Muscles of the Back of Forearm (Deep Group)
Supinator
- Origin: Lateral epicondyle of the humerus, supinator fossa and crest, and annular ligament.
- Insertion: Upper 1/3 of the radius.
- Action: Supination of the forearm.
Abductor Pollicis Longus
- Origin: Back of the ulna and back of the radius.
- Insertion: Metacarpal bone of the thumb.
- Action: Abducts the wrist and thumb.
Extensor Pollicis Longus
- Origin: Back of the ulna.
- Insertion: Distal phalanges of the thumb.
- Action: Extends the thumb.
Extensor Pollicis Brevis
- Origin: Back of the radius.
- Insertion: Proximal phalanges of the thumb.
- Action: Extends the thumb.
Extensor Indicis
- Origin: Back of the ulna.
- Insertion: Extensor expansion of the index finger.
- Action: Extends the index finger.
- Note: All muscles of the deep group are supplied by the posterior interosseous nerve.
Radial Nerve
- Origin: Continuation of the posterior cord of the brachial plexus.
- Root Value: C5, C6, C7, C8, T1.
- Course: Passes in the lower triangular space with profunda brachii artery, then in the spiral groove.
- End: At the level of the lateral epicondyle, it gives off branches.
Branches
- Superficial: Passes deep to the brachioradialis.
- Posterior inter-osseous: Pierces the supinator.
- Muscular.
- Cutaneous.
Muscular Branches
- Radial nerve itself supplies: Brachialis (lateral ½), Triceps, Brachioradialis, ECRL, and Anconeus.
- Posterior inter-osseous supplies: Muscles of the back of the forearm except brachioradialis and ECRL.
Cutaneous Branches
- Radial nerve itself: Gives the lower lateral cutaneous nerve (LCN) of the arm and the posterior cutaneous nerve (PCN) of the arm and forearm.
- Superficial branch: Supplies the lateral 2/3 of the dorsum of the hand and the dorsal surface of the lateral 3.5 fingers, except for the distal phalanges.
Injury
- Crutch or Saturday night palsy: Causes elbow, wrist, and finger drop.
- Fracture at the mid-shaft of the humerus: Causes wrist and finger drop.
- Fracture of the neck of the radius: Causes finger drop.
- Injury of the superficial branch: No motor affection, only sensory loss of the lateral 2/3 of the dorsum of the hand and the dorsal surface of the lateral 3.5 fingers.
Anatomical Snuff Box
- Definition: A depression on the lateral side of the wrist.
Boundaries
- Anterior (lateral): Tendon of abductor pollicis longus and extensor pollicis brevis.
- Posterior (medial): Tendon of extensor pollicis longus.
- Floor: Styloid process of the radius, scaphoid, and trapezium.
Content
- Radial artery and tendon of ECRL and ECRB.
Clinical Importance
- Any swelling in the anatomical snuff box suggests a scaphoid fracture (the most common fractured carpal bone).
- Site for pulse detection.
Extensor Retinaculum
Attachment
- Medially: To the anterior border of the ulna.
- Laterally: To the anterior border of the radius.
Structures Passing (superficial to it)
- Cephalic vein.
- Superficial branch of the radial nerve.
- Basilic vein.
- Dorsal cutaneous branch of the ulnar nerve.
Structures Passing (deep to it)
- 1st compartment: Contains tendons of abductor pollicis longus and extensor pollicis brevis.
- 2nd compartment: Contains tendons of ECRL and ECRB.
- 3rd compartment: Contains the tendon of extensor pollicis longus.
- 4th compartment: Contains tendons of extensor indicis and extensor digitorum, posterior interosseous nerve and anterior interosseous artery.
- 5th compartment: Contains the tendon of extensor digiti minimi.
- 6th compartment: Contains the tendon of extensor carpi ulnaris.
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