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Questions Answered: 238

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200
38

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Anatomy

Upper Limb

Question 67 of 239

A 39 year old man presents to ED complaining of pain over the lateral epicondyle of the right arm. You suspect lateral epicondylitis, which of the following findings would you most likely see on examination:

Answer:

The common extensor tendon originates from the lateral epicondyle and therefore extension of the wrist against resistance will exacerbate the pain of lateral epicondylitis - this is called 'tennis elbow'. 'Golfer's elbow' describes medial epicondylitis, the medial epicondyle is the site of origin of the common flexor tendon, and thus in this case, flexion of the wrist against resistance will exacerbate symptoms.

Posterior Forearm Muscles

Anatomy / Upper Limb / Posterior Forearm

Last Updated: 10th April 2019

The posterior forearm is divided into the superficial and deep groups:

  • The superficial group is made up of:
    • the brachioradialis
    • the extensor carpi radialis longus and brevis
    • the extensor digitorum
    • the extensor digiti mini
    • the anconeus
    • the extensor carpi ulnaris
  • The deep group is made up of:
    • the supinator
    • the abductor pollicis longus
    • the extensor pollicis longus and brevis
    • the extensor indicis

The muscles of the posterior forearm are all innervated by the radial nerve.

Muscles of the Posterior Forearm (Superficial). (Image by Henry Vandyke Carter [Public domain], via Wikimedia Commons)

By Henry Vandyke Carter [Public domain], via Wikimedia Commons

Muscles of the Posterior Forearm (Deep). (Image by Henry Vandyke Carter [Public domain], via Wikimedia Commons)

Function

Table: Function and Innervation of the Posterior Forearm Muscles

Muscle Function Innervation
Brachioradialis Flexion of elbow Radial nerve
Extensor carpi radialis longus Extension and abduction of wrist Radial nerve
Extensor carpi radialis brevis Extension and abduction of wrist Radial nerve
Extensor digitorum Extension of all four fingers, extension of wrist Radial nerve
Extensor digiti minimi Extension of little finger Radial nerve
Extensor carpi ulnaris Extension and adduction of wrist Radial nerve
Supinator Supination of forearm Radial nerve
Abductor pollicis longus Abduction and extension of thumb Radial nerve
Extensor pollicis longus Extension of thumb (CMCJ, MCPJ, IPJ) Radial nerve
Extensor pollicis brevis Extension of thumb (CMCJ and MCPJ) Radial nerve
Extensor indicis Extension of index finger Radial nerve

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  • Biochemistry
  • Blood Gases
  • Haematology
Biochemistry Normal Value
Sodium 135 – 145 mmol/l
Potassium 3.0 – 4.5 mmol/l
Urea 2.5 – 7.5 mmol/l
Glucose 3.5 – 5.0 mmol/l
Creatinine 35 – 135 μmol/l
Alanine Aminotransferase (ALT) 5 – 35 U/l
Gamma-glutamyl Transferase (GGT) < 65 U/l
Alkaline Phosphatase (ALP) 30 – 135 U/l
Aspartate Aminotransferase (AST) < 40 U/l
Total Protein 60 – 80 g/l
Albumin 35 – 50 g/l
Globulin 2.4 – 3.5 g/dl
Amylase < 70 U/l
Total Bilirubin 3 – 17 μmol/l
Calcium 2.1 – 2.5 mmol/l
Chloride 95 – 105 mmol/l
Phosphate 0.8 – 1.4 mmol/l
Haematology Normal Value
Haemoglobin 11.5 – 16.6 g/dl
White Blood Cells 4.0 – 11.0 x 109/l
Platelets 150 – 450 x 109/l
MCV 80 – 96 fl
MCHC 32 – 36 g/dl
Neutrophils 2.0 – 7.5 x 109/l
Lymphocytes 1.5 – 4.0 x 109/l
Monocytes 0.3 – 1.0 x 109/l
Eosinophils 0.1 – 0.5 x 109/l
Basophils < 0.2 x 109/l
Reticulocytes < 2%
Haematocrit 0.35 – 0.49
Red Cell Distribution Width 11 – 15%
Blood Gases Normal Value
pH 7.35 – 7.45
pO2 11 – 14 kPa
pCO2 4.5 – 6.0 kPa
Base Excess -2 – +2 mmol/l
Bicarbonate 24 – 30 mmol/l
Lactate < 2 mmol/l

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