The Flexor Tgitorum Equilibrium

Background: The forearm is the most common site for compartment syndrome in the upper extremity. The compartments of the forearm include the volar (anterior or flexor), and the dorsal (posterior or exterior). Both bone forearm fractures and distal radius fractures are common initial injuries that lead to acute forearm compartment syndrome. The flexor digitorum profundus and flexor pollicis longus are among the most severely affected muscles because of their deep location, closest to the bone.

The left metatarsophalangeal and interphalangeal (great and lesser toes) joints are held at slight flexion pressed against the ground by a concentric contraction of the flexor halluces longus, flexor digitorum longus, flexor digitorum longus. The left talocrural (ankle) is plantar flexed using a concentric contraction of the gastrocnemius and the soleus. The right talocrural (ankle) is plantar flexed by a concentric contraction of the tibialis anterior, extensor digitorum longus, peroneus tertius. The left tibiofermoral (knee) joints are being extended by a concentric contraction of the quadriceps muscles (rectus femoris, vastus lateralis, vastus medialis, vastus intermedius). The right metatarsophalangeal and interphalangeal (great and lesser toes) are being held plantar flexed due to an isometric contraction of the flexor halluces longus, flexor digtorum longus. The right tibiofermoral (knee) joints are flexed at a 90-degree angle by a concentric contraction of the biceps femoris, semitendinous, semimembranosus. During this phase the left acetabular fermoral (hip) joint is flexed due to an eccentric contraction of the rectus femoris, pectineus, iliacus, and psoas. The right acetabular fermoral (hip) joint is at slight extension due to a concentric contraction of the biceps femoris, semitendinosus, semimembranosus, and the gluteus

Being that Jim was severed above the elbow, the specific muscles are biceps brachii, tricep brachii, brachialis, anconeus, and brachioradialis. Located on the upper region of the arm the triceps brachii controls the flexing, twisting, and supination which is the upward turning of the palm. Just in the back of the arm is the biceps brachii which stabilizes the elbow and is receptive to extension of the arm as well. Muscles need assistance to extend the forearm at the elbow and this is where the anconeus muscle comes into play. In comparison, the brachialis is also an aid or assistant in muscle but instead of extending it flexes the elbow inwards toward the body. The brachioradialis can be identified on the forearm and responsible for flexing the arm at the elbow. The major bone that was severed by the shark bite is the humerus bone, the long bone of the upper arm, which bonds the elbow and the shoulder correspondingly to the ulna and

PROCEDURE: The patient was placed in the supine position on the operating room table, where her right hand and forearm were prepped with Betadine and draped in a sterile fashion. We infiltrated the thenar crease area with 1% Xylocaine, and once adequate anesthesia had been achieved, we exsanguinated the hand and forearm with an Esmarch bandage. We then created a longitudinal incision just at the ulnar aspect of the thenar crease and carried the dissection down through the subcutaneous tissue. We identified the transverse carpal ligament and incised this

Flexor Digitorum Profundus - It's attachments are the medial epicondyle. When it contracts it causes flexion in fingers 2-5.

PROCEDURE: The patient was placed in the supine position on the operating room table, where her right hand and forearm were prepped with Betadine and draped in a sterile fashion. We infiltrated the thenar crease area with 1% Xylocaine, and once adequate anesthesia had been achieved, we exsanguinated the hand and forearm with an Esmarch bandage. We then created a longitudinal incision just at the ulnar aspect of the thenar crease and carried the dissection down through the subcutaneous tissue. We identified the transverse carpal

Some of the injuries that can occur in the hand are Cubital Tunnel Syndrome and Carpal Tunnel Syndrome along with many more. Cubital Tunnel Syndrome causes pain or numbness in the ring and little fingers, but could also go to the arm (Types of RSI, 2010). Occurs when the ulnar nerve is pinched along the elbow’s edge (“funny bone”), and has tingling or painful feeling (Types of RSI, 2010). Cubital Tunnel Syndrome can be treated by avoiding putting pressure on the “funny bone” (Types of RSI, 2010). Cubital could lead to surgery if the nerve needs to be relieved. Carpal Tunnel Syndrome is similar to Cubital but occurs in the three first fingers. A major nerve is compressed which passes over the carpal bones through the front of the wrist (ASSH, 2015). When the nerve is compressed it causes painful, tingling and numbness in the first three fingers (ASSH, 2015). Carpal Tunnel Syndrome can be treated without surgery by changing the patterns of hand use and/or wearing wrist splints at night (ASSH, 2015). If severe then surgery can take place to make the nerve have more

1. Place your index and middle fingers in the groove on the inside of the wrist. Just slide your fingers across the tendons until they slip into soft tissue.

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The median nerve and several tendons run from your forearm to your hand through a small space in your wrist called the carpal tunnel camera.gif. The median nerve controls movement and feeling camera.gif

and finger ability to flex and bend is due to the anterior muscles while the posterior muscles work to

Dupuytren’s contracture (DC) involves pathologic myofibroblast forming cords due to deposition of collagen into the digitopalmar fascia, which can result in fixed flexion deformity of the affected finger impairing normal hand function. Depending on the degree of contracture, the patient´s daily activities may become significantly affected as well as their health-related quality of life, at which time they often seek treatment1,2.

Nine tiny but tough tendons, each in its lubricating lining or sheath, slide back and forth through the tunnel as the muscles of the hand and fingers move. These tendons are called the Flexor tendons; these tendons are the structures that let you bend your fingers, or flex, your fingers. They are long smooth cords that arise in the muscles of the forearm and end on the fingers. They work like a bicycle brake cable to flex your fingers, sliding in and out as the fingers bend and straighten. The median nerve is the only nerve that travels through the tunnel along with the tendons.

The obturator internus muscles had two main areas of origin, one is from the rami surrounding the obturator foramen and other from the quadrilateral plate. This muscle fibers were directed in transverse plane and leave pelvis through lesser sciatic notch. The tendon of piriformis and obturator internus joined to form a conjoined tendon before their insertion on the prox. Femur. The length of conjoint tendon is defined as the distance between the point at which two tendons united to the junction between the posterior and superior margins of the greater trochanter approx. 0.5cm and 2cm. The conjoint tendon flattened and inserted on the superior margin and the entire medial surface of the greater trochanter as far as proximal part of the intertrochanteric

After seeing how close to the humerus the radial nerve ran, it was easy to understand how mid shaft injuries can lead to radial nerve damage. Not only this, but although we had learnt about the passing of Flexor Digitorum Profundus through Flexor Digitorum Superficialis, it was amazing to see it in real life, it was actually one of the highlights of this dissection for me.