Forearm Anatomy Exam on Monday!!!

Do you need a little help on the forearm? Here are some mnemonics to help you out.

For Carpal Bones, there are many mnemonics out there. I only posted in the two I found that is easy to memorize and is widely used. Other mnemonics (as they usually are) are for parental guidance. This is from lateral to medial. There are eight bones. In each row there are four bones.

Here are menmonics that I know:

Secret            Stop                    Scaphoid

Lovers            Letting                Lunate

Try                 Those                 Triquetral

Positions         People                Pisiform

That                Touch                Trapezium

They               The                    Trapezoid    

Can't               Cadavers           Capitate

Handle            Hand                 Hamate

The first four(Scaphoid, Lunate, Triquetrum and Pisiform) represents the proximal row.

The last four (Trapezium, Trapezoid, Capitate and Hamate.) are part of the distal row.

The trapezium is the most lateral bone in the distal row. It is at the thumb.
The Trapezoid is inside or in its side.

Now that you know the names of the carpal bones and their sequence, you also need to identify them. Remember this: “The boat sailed to the moon with 3 pEas in a rOw, at the wheel was Captain Hook”.
        Boat is scaphoid.
        Moon is lunate. 
        3 is triquetral. 
        Peas is pisiform (stressing the E sound for trapezium). 
        Row is trapezoid (stressing the O for trapezOid). 
        Captain is capitate. 
        Hook is hamate (hamate has the hook).


I remember mine by imagining a scaffold (scaphoid) going up to the moon (lunate). The moon has a pyramid(triquetral) and from it came out four pisi which is waray waray for piglets i think (pisiform). To get t
down I needed to use a trapeze and I hold on to it using my legs forming a letter m(trapezium) and then I flew to the other trapeze where I was rewarded a doughnut (trapezoid). By doing these stunts I was decapitated (capitate) and my thighs were made into hams(hamate). This sounds complicated so ditch it!

The Extensor Muscles of The Forearm follow the Rule of Three (reminds me of the Wiccan Law of Three that whatever energy a person puts out into the world, be it positive or negative, will be returned to that person three times).

3 muscles for wrist extension

• Extensor carpi radialis brevis
• Extensor carpi radialis longus
• Extensor carpi ulnaris

3 muscles for finger extension

• Extensor digitorum ( for all four fingers)
• Extensor indicis
• Extensor digiti minimi

3 muscles for thumb

• Extensor pollicis longus
• Extensor policis brevis
• Abductor pollicis longus

All extensor muscles of forearm are supplied by the radial nerve. Injury to radial nerve caused the classical wrist drop due to unopposed flexor muscles.

For the Flexor Muscles of the Forearm, here is an interesting way on how to memorize it:

There are five (five digits of your hand). Place your thumb into your palm, then lay that hand palm down on your other arm. Place it 

at your medial epicondyle with your middle finger pointing towards the thumb distally. The forearm must be in supine position.

Your thumb will be below the palm. This shows the muscle which is deep to the four: Flexor digitorum superficialis. The four fingers will be pointing towards the hand. This represents the layers in flexor muscles in the forearm.

Your 4 fingers now show distribution: spells PFPF (pass/fail, pass/fail)

           Pronator teres - represented by the index finger

           Flexor carpi radialis - 

the middle finger point pointing towards radial bone, hence radialis

                       

           Palmaris longus

           Flexor carpi ulnaris

There are 3 layers in the flexor compartment. The muscles in the deep layer are flexor digitorum profundus (FDP), flexor pollicis longus and pronator quadratus.

All flexor muscles of forearm are supplied by median nerve except one and half. They are flexor carpi ulnaris and half of flexor digitorum profundus.

For the Muscles of the Hand:

       PAD DAB - palmar hand muscles adduct, dorsal hand muscles abduct

For Thenar and hypothenar muscles:(medial to lateral)

All              Abductor digiti minimi

For            Flexor digiti minimi 

One           Opponens digiti minimi

And           Adductor pollicis

One           Opponens Pollicis

For            Flexor Pollicis Brevis

All             Abductor pollicis brevis

All intrinsic muscles of the hand are innervated by ulnar nerve except these muscles which are innervated by the median nerve.

The LOAF muscles:

Lateral 2 lumbricals, Opponens pollicis, Abductor pollicis brevis, Flexor pollicis brevis

Carpal tunnel syndrome causes MEDIAN TRAP :
          Myxoedema                                      
          Edema premenstrually                        
          Diabetes
          Idiopathic
          Agromegaly
          Neoplasm
          Trauma (occupational)
          Rheumatoid arthritis
          Amyloidosis
          Pregnancy
This mnemonic fits nicely since median nerve is really trapped in a restricted space in betweent he flexor digitorum superficialis and flexor carpi radialis muscles.

 Three B's bend or flex the elbow:
          Brachialis
          Biceps
          Brachioradialis

 The superficial group of the  anterior forearm muscles, uses this mnemonic :

          “Pimps F*ck Prostitutes For Fun”:

            Pronator teres

            Flexor carpi radialis

            Palmaris longous

            Flexor carpi ulnaris

            Flexor digitorum superficialis

The attachments of muscles near the bicipital groove uses this: 

            “The lady between two majors”

              Teres major attaches to medial lip of groove.

              Pectoralis major to lateral lip of groove.

              Latissimus (Lady) is on floor of groove, between the 2 majors.
Cubital fossa contents uses this 

             "Really Need Booze To Be At My Nicest” (lateral to medial) or RBBM:

                     Radial nerve

                     Biceps Tendon

                     Brachial Artery

                     Median nerve

The muscles supplied by the radial nerve are the (simplified) “BEST muscles”:

            Brachioradialis

            Extensors

            Supinator

            Triceps

The Palmaris longus is between two Palmars:

       Palmar cutaneous branch of Ulnar nerve

       Palmar cutaneous branch of Median nerve

For the elbow: which side has common flexor origin
           FM (as in FM Radio): Flexor Medial, so Common Flexor Origin is on the medial

Which is powerful between supination (cup your hands ) and pronation? Supination. 

Why? Screws were designed to be tightened well by majority of people. “Righty tighty”.Majority of people are right-handed. To tighten screws you turn to the right.Turning right-hand to the right is supination. 

Common features of the Median and ulnar nerves:

          Each supply 1/2 of flexor digitorum profundus

          Each supplies 2 lumbricals. 

          Each has a palmar cutaneous nerve that pops off prematurely.

          Each supplies an eminence group of muscles

                  ulnar: hypothenar

                  median: thenar 

          Each enters forearm through two heads 

                  ulnar: heads of flexor carpi ulnaris

                  median: heads of pronator teres

          Each has no branches in upper arm. 

          Each makes two fingers claw when cut at wrist. 

          Each supplies a palmaris 

                  ulnar: palmaris brevis

                  median: palmaris longus 

How to quickly recognize an Ulnar bone: 
    The Ulnar bone has a “U” at the end where it goes over the trochlea.

It is my fervent prayer that these things will help you pass your exams!

Blood Supply of the Brain

Saw Netter's illustration of the Circle of Willis a while ago. It looked quite easy but the drawing is not the prob. My prob is memorizing the parts. As usual, I ran some searches regarding this problem and ta-da..here are some things to help improve that early memory loss of yours!

This looks like a spider, right? A very scary looking spider. It has a face, 8 legs and a Willis.

Now lets compare that to the scholarly version of the Circle of Willis.

Which do you like best?

Who was Willis anyway? Thomas Willis was an English physician in the 17th century. He did a lot of research on the brain and the nervous system. Some of this were done on public execution victims.In 1861, Anne Green was hanged. Willis dissected her. The procedure was cut short when Anne came back to life. From then on, Willis became a sought after physician.

Nosy you! You want the dirt? Anne Green is a 22 year old housemaid. She was hanged at Oxford's Cattle Yard for murdering her newborn. Some say the father of the baby was the grandson of her employer. He was a nobleman and she was just a commoner. The baby was born prematurely and may have died of complications from childbirth.

Interesting right?

 

The book  Neuroanatomy Made Ridiculously Simple is a highly recommended read. It has illustrations and mnemonics that could help you with neuroanatomy.

Pump Up the Blood Flow

My new dilemma today is memorizing the blood flow of the heart.



Since I have a poor memory, I researched some tips and tricks that might help you:
1. Remember that vein has the word "in" in it, meaning it carries blood into the heart!
2. Arteries starts with letter A symbolizing away. It pumps blood away from the heart.
3. Try before you Buy = tricuspid before bicuspid (mitral) valve.
4. Just as veins bring blood into the heart, so does the Vena Cava ( inf.& sup.)
5. Just as arteries take blood away from the heart, so does the Aorta.
6. Pulmonary refers to the lungs, so pulmonary artery takes blood away from heart to lungs and pulmonary veins bring blood into the heart from lungs.
7. A comes before V in the alphabet so I always knew that the Atria came before the ventricles, and the Arteries came before the Veins.
8. As go with the Vs and Vs go with the As.Veins always enter the Atria (or go toward the atria).Arteries always arise from Ventricles.
9. Atrium/ventricles separated by valves.
10. more people are RIGHT handed than left handed so the TRIcuspid valve is on the RIGHT
11. less people are LEFT handed the BICUSPID is on the left
12.TRIcuspid is on the RIGHT side ~ same side as the lung that has three lobes... BIcuspid is on the same side of the lung that has two lobes.
13. TOILET PAPER MY ASS. Tricuspid, Pulmonary, Mitral, Aortic

There is also a song I found at you tube that is helpful with memorizing the blood flow.It is kindda fast but it gives the gist.

But this video is even better.

If you have any corrections or if you want to add something, please leave a comment so I can update this post. Thank you! I do hope this material can help you in your anatomy or physiology exams.