The radial nerve
contains fibers derived from only the sixth, seventh and eighth cervical spinal nerves
passes in front of the humerus from the medial to the lateral side
supplies the muscles on the posterior aspect of the upper arm and forearm
supplies sensory branches to the nail beds of the index and middle fingers
is the only nerve supplying the triceps muscle.
The flexor digitorum profundus muscle
has an attachment to the ulna and not the radius
is supplied only by the ulnar nerve
can flex the distal, middle and proximal phalanges of the hand
is deep to the flexor digitorum superficialis (sublimis) muscle and tendons along its whole course
has only three of the four lumbrical muscles attached to its tendons in the hand
If the ulnar nerve is cut at the elbow
part of the flexor digitorum superficialis (sublimis) is paralysed
there is a loss of sensation in the back of the index finger
flexion at the metacarpophalangeal joints of the ring and little finger is lost if their interphalarlgeal joints are kept extended
the distal phalanges of all the fingers are extended at the distal interphalangeal joints
the movement of opposition of the thumb is usually lost
If the median nerve is cut at the wrist
sensation in the skin over the hack of the whole of the index finger is lost
adduction of the thumb is lost
flexion at the metacarpophalangeal joint of the thumb is impossible
extension at the interphalangeal joints of the index finger is lost
With regard to movements of the medial four digits
movement of the index finger in a radial direction is due to the first dorsal interosseous muscle
flexion at the distal interphalangeal joints of all the digits is lost if the ulnar nerve is cut at the elbow
flexion at the metacarpophalangeal joints while there is extension at the interphalangeal joints is due to the lumbrical muscles
movement of the ring finger in a radial direction is due to the third dorsal interosseous muscle
extension at the metacarpophalangeal joints is effected by the dorsal interosseous muscles
The palmar aponeurosis
is attached to the skin of the palm by fibrous septa
is attached distally to the fibrous flexor sheaths
protects the underlying tendons
receives tendon of palmaris longus
apex is attached to flexor retinaculum
The ulnar nerve
supplies the adductor pollicis muscle
lies medial to the hook of the hamate
supplies all the interossei muscles
is deep to the flexor retinaculum
contains fibers from only the first thoracic spinal nerve
If the median nerve is cut at the level of the elbow joint
there is a loss of sensation in the tips of all the fingers
there is usually a loss of opposition of the thumb
there is a complete loss of flexion at the wrist
there is a loss of adduction of the thumb
there is a loss of flexion at the interphalangeal joint of the thumb
If the radial nerve is cut in the axilla
the hand cannot be extended at the wrist
there is widespread sensory loss over the back of the forearm
the fingers cannot be extended at the metacarpophalangeal joints
the flexed forearm cannot be actively extended at the elbow
the forearm cannot be pronated
The median nerve
arises by two roots, one from the lateral cord and the other from the medial cord of the brachial plexus
does not contain fibers originating in the first thoracic spinal nerve
lies medial to the axillary artery in the axilla
supplies all the flexor muscles in the front of the forearm
is commonly the motor nerve to the abductor pollicis brevis muscle
In the hand
the superficial palmar arch is deep to the branches of the median nerve
the second palmar interosseous muscle is attached to the third metacarpal bone
the second dorsal interosseous muscle pulls the middle finger in a radial direction
the four dorsal interossei muscles are supplied by the radial nerve
the deep palmar arch is formed mainly by the radial artery
The radius
has its growing end proximally
has the tendon of the biceps muscle attached to the whole of the radial tuberosity
has the pronator teres muscle attached to its lateral border
has the extensor pollicis longus muscle attached to it
has the tendon of the abductor pollicis longus muscle on the lateral side of its styloid process
The flexor digitorum superlicialis (sublimis) muscle
has attachments to the humerus, radius and ulna
has only two tendons just above the flexor retinaculum
is supplied only by the median nerve
is attached to the base of the middle phalanx of the medial four digits
is superficial to the ulnar artery in the upper part of the forearm
is deep to the triceps muscle in part of its course
is posterior to the medial epicondyle of the humerus
arises from the medial cord of the brachial plexus
is medial to the ulnar artery in the forearm
contains fibers which supply the skin of the medial part of the front of the palm of the hand
is lateral to the axillary vein in the with
crosses in front of the brachial artery from the medial to the lateral side in the upper arm
gives a branch to the elbow joint
is lateral to the tendon of the biceps brachii muscle in the cubital fossa
is superficial to the flexor retinaculum
The ulna
has the flexor digitorum profundus muscle attached to its anterior surface
has the flexor digitorum superficialis (sublimis) muscle attached to the medial side of its coronoid process
may have the flexor pollicis longus muscle attached to it
has the abductor pollicis longus muscle attached to its posterior surface
has the flexor carpi ulnaris muscle attached to it
The great (long) saphenous vein
is anterior to the lateral malleolus
is anterior to the saphenous nerve in the leg
has no valves in its course in the leg
is connected to the deep veins of the lower limb by channels which have no valves
after passing through the saphenous opening receives the superficial epigastric and external pudendal veins
none of these
The semimembranosus muscle
is a flexor of the leg at the knee
forms the upper medial boundary of the popliteal fossa
is innervated by the medial popliteal (tibial) part of the sciatic nerve
forms the oblique popliteal ligament of the knee joint
has deep to its tibial attachment a bursa which never communicates with the knee joint
The longitudinal plantar (tarsal) arch is supported and maintained by the
tibialis anterior muscle
peroneus longus muscle
tibialis posterior muscle
calcaneouavicular ligament
popliteus muscle
The peroneus longus muscle
is paralyzed if the sciatic nerve is cut
is an evertor of the foot
is attached to the fifth metatarsal bone
is an important muscle in maintaining the transverse arch of the foot
is attached to the medial surface of the fibula
With regard to the tibia
the flexor hallucis longus muscle is attached to its posterior surface
the extensor hallucis longus muscle is attached to its anterolateral surface
its articulations with the fibula are both synovial
The soleus muscle
is attached to only the soleal line ofthe tibia
is active while walking upstairs
is active while walking downstairs
has a tendon which begins at a higher level than that of the gastrocnemius muscle
is a plantar flexor of the foot at the ankle joint
The calcaneus
has the tendo calcaneus (Achillis) attached to the middle of its posterior surface
has the tendon of flexor hallucis longus passing inferior to the sustentaculum tali
has the flexor digitorum accessorius muscle attached to its inferior and medial surfaces
has the long plantar ligament attached to its inferior surface
has the inferior extensor retinaculum attached to its upper surface anteriorly
The common peroneal nerve (or its branches)
innervates the skin between the third and fourth toes
innervates the knee joint
innervates the peroneus tertius muscle
innervates all the muscles producing inversion of the foot
innervates all the muscles producing evasion of the foot
Fibers of the fourth lumbar spinal nerve
supply skin on the medial side of the leg
are found in the inferior gluteal nerve
are found in the femoral nerve
are found in the tibial nerve
are found in the common peroneal nerve.
The superficial peroneal nerve supplies
peroneus Iongus and brevis
peroneus tertius
tibialis anterior
extensor digitorum longus
flexor digitorum longus
begins on the medial side of the ankle
is anterior to the tibial (medial) malleolus
is anterior to the medial femoral condyle
receives the termination of the small (short) saphenous vein
has no connexions with the deep veins of the leg
has a common origin from the ischial tuberosity with the semitendinosus
is deep to the semitendinosus muscle
can act as a lateral rotator of the leg on the thigh
is an extensor of the thigh on the trunk
is innervated by the common peroneal (lateral popliteal) nerve
The tibialis anterior muscle
is a dorsiflexor of the foot at the ankle joint
is active during the whole of the stance phase of the step in walking
is attached to the navicular bone
helps to maintain the medial longitudinal arch
is innervated by the deep pertinent (anterior tibial) nerve
The medial plantar nerve
has cutaneous branches which supply the media! three and a half toes
arises from the tibial (pusterior tibial) nerve deep to the flexor retinaculum
innervates the abductor hallucis muscle
intervates the flexor digitorum brevis muscle
innervates the medial two plantar interossei muscles
If the common peroneal (lateral popliteal) nerve is cut
aversion of the foot is lost
inversion of the foot is lost
dorsiflexion of the foot is lost
plantar flexion of the foot is lost
there is no loss of cutaneous sensation
The tibial(medial popliteal) nerve
is superficial to the popliteal vessels in the popliteal fossa
is lateral to the popliteal and posterior tibial vessels along the whole of its course down the back of the knee and leg
gives off the sural nerve to the medial side of the leg and foot
gives branches to the muscles which plantar flex the foot
gives branches to the knee and ankle joints
The flexor hallucis longus muscle
is attached to the tibia
has a tendon which in the sole is superficial to the tendon of the flexor digitorum longus muscle
has a tendon which is medial to the posterior tibial vessels and nerves deep to the flexor retinaculum
is attached to the proximal phalanx of the great toe
receives a slip from the flexor digitorum accessories muscle
The tiblalis posterior muscle
is attached to both bones of the leg
has a tendon which passes deep to the tendon of the flexor digitorum longus muscle
is an invertor of the foot
is attached by a fibrous slip to the sustentaculum tali
has a tendon which lies in a groove on the posterior aspect of the medial malleolus
The radial nerve:
arises from lateral cord of the brachial plexus
supplies brachioradialis
divides near the elbow into muscular and cutaneous components
innervates most of the dorsal skin of the hand
when injured, gives rise to-the condition known as wrist drop
The ulnar nerve:
supplies skin on medial side of arm and forearm
passes behind medial epicondyle of humerus
supplies first dorsal interosseous muscle
when injured, thenar muscles are wasted
The median nerve:
arises directly from trunks of the brachial plexus
crosses the axillary artery from lateral to medial side
enters the forearm through pronator quadratus
enters the hand by passing through carpal tunnel
when injured gives rise to the condition known as ‘claw hand’
The carpal tunnel:
is a fibro-osseous tunnel formed by carpal bones and palmar apaneurosis
contains the tendons of flexor digitorum superficialis
both the radial and ulnar arteries
compression of nerve in tunnel causes sensory loss in index finger (palmar surface)
contains portion of ulnar bursa
The palmar aponeurosis:
sensation in the skin over the back of the whole of the index finger is lost
flexion at the metacarpophalangeal joint of the thumbs impossible