Class of 2016
Extensor compartment of forearm
Demonstration
Date: 12-03-12
Learning objectives:
a. Identify the muscles of extensor compartment of forearm
and state their attachment, nerve supply, action and
method of testing.
Superficial Muscles
i)
ii)
iii)
iv)
v)
vi)
vii)
Anconeus
Brachioradialis
Extensor carpi radialis longus
Extensor carpi radialis brevis
Extensor Digitorum
Extensor digiti minimi
Extensor carpi ulnaris
Deep Muscles
i)
ii)
iii)
iv)
v)
Supinator
Extensor indicis
Abductor pollicis longus
Extensor pollicis brevis
Extensor policis longus
b. Identify posterior interosseous nerve and artery.
c. Describe the course, relation ship and branches of Posterior
interosseous
nerve and posterior interosseous artery
d. Define mallet or base ball finger and give reason for this
deformity
1
Elbow and Radioulnar joint
Demonstration
Date: 13-03-12
1) Identify, classify and describe the movements available at the:
i) elbow joint
ii) radioulnar articulations
- proximal (superior) radioulnar joint
- distal (inferior) radioulnar joint
2) Identify and describe the articular surfaces of the:
i) elbow joint
- trochlea of humerus
- trochlear notch of ulna
- capitulum of humerus
- head of radius
ii) radioulnar articulations
a) proximal (superior) radioulnar joint
- radial notch of ulna
- head of radius
b) distal (inferior) radioulnar joint
- head of ulna
- ulnar notch of radius
3) Identify bony projections providing attachment for joint capsules,
ligaments and muscles
i) elbow region
- medial and lateral epicondyle of humerus
- medial and lateral supracondylar ridges of humerus
- olecranon process of ulna
- coronoid process of ulna
- supinator crest of ulna
- ulnar tuberosity of ulna
- radial tuberosity of radius
ii) mid forearm
- impression for pronator teres on radius
4) Identify / describe the functions of:
i) joint capsules and synovial membranes of the elbow and
radioulnar joints
ii) olecranon, coronoid and radial fossae
2
iii) ligaments of the elbow and proximal radioulnar joints
- ulnar (medial) collateral
- radial (lateral) collateral
- annular
iv) interosseous membrane
v) articular disc of the distal radioulnar joint
5) Describe the relationship between the elbow joint and the
superior radioulnar Joint.
6) Describe the functional relationship between the radius and ulna
during pronation and supination.
7) Identify the bony features listed above on x-rays of the elbow
region
8) Identify/ list the attachments of, and deduce the actions of the
muscles which move the elbow and radioulnar joints:
i) biceps brachii
ii) brachialis
iii) brachioradialis
iv) triceps brachii
v) anconeus
vi) pronator teres
vii) pronator quadratus
viii) supinator
9) Define carrying angle and its difference in man and woman
10) Desribe blood supply and nerve supply of elbow joint
11) Define Colles fracture, sublauxation and dislocation of radial
head
Hand and (Fascial Spaces and Muscles)
Demonstration
Date: 15-03-12
HAND
1) Grips
2) Fascia
I)
Retinacula
3
II)
Palmar aponeurosis
III) Fibrous flexor sheath
IV)
Compartments
V)
Spaces
a) Thenar & mid palmar
b) Space of perona
c) Web space
d) Pulp space
3) Dupuytren contracture
a) Hand infections
b) Felon
c) Carpel Tunnel Syndrome
4) Thenar and Hypothenar Muscles
CASE
23:
Basketballer
with
painful
swollen wrist
SGD
Date: 16-03-12
A 27-year-old-male basketball player presents to the emergency room
following an awkward landing after a rebound in which he landed on his right
hand. He was unable to carry on playing and reports that his right wrist
became immediately swollen. On examination, the patient's right wrist is
swollen with marked "dinner fork" deformity. There is tenderness over the
distal radius and hypoesthesia in the distribution of the medial nerve.
4
CRITICAL QUESTION
1. What is the basis of this injury?
2. Why is it called a dinner fork deformity?
3. How is wrist joint formed?
4. What is Colle’s fracture and how does Colle’s fracture
differ in children?
5. What difference would you see in a normal X-ray of
arm taken from a 51 year old man and a ten year old
boy?
6. Why is his wrist swollen?
7. How does the healing occur in bone?
8. What cells are involved in healing?
9. What factors influence bone formation?
10. What is mallet finger?
5
Wrist Joint (Radiocarpel joint)
SGD
Date: 16-03-12
1. Mention the type of joint
2. Demonstrate movements possible at this joint and mention the
muscles involved in action
3. Identify the articulating bones and their articular surfaces
4. Explain fibrous capsule and ligaments of the wrist joint
5. Mention anterior and posterior relations of wrist joint
6. Describe arterial and nerve supply of wrist joint
7. Define “ganglion” and mention the structure involved in forming this
localized swelling
8. Describe clinical conditions: “Colles” fracture, scaphoid fracture,
anterior dislocation of lunate and fracture separation of distal radial
epiphysis in children.
6