05a: Hand Flashcards
How many hinge joints in hand?
10
“Boxer fracture” is:
fracture of fifth metacarpal
CMC joint in digits 2-5 is what type of joint?
Plane (gliding)
CMC joint in thumb is what type of joint?
Saddle
MCP joint in digits 2-5 is what type of joint?
Condyloid
MCP joint in thumb is what type of joint?
Hinge
PIP joint in digits 2-5 is what type of joint?
Hinge
IP joint in thumb is what type of joint?
Hinge
DIP joint in digits 2-5 is what type of joint?
Hinge
Making a tight fist involves which motion(s) at which joint(s) for digits 2-5?
Flexion;
MCP, PIP, DIP
Abduction and adduction of digits 2-5 occurs at which joint(s)?
MCP
Abd/add of thumb occurs (parallel/perpendicular) to plane of palm.
Perpendicular
Abd/add of thumb occurs at which joint(s)?
CMC
F/E of thumb occurs (parallel/perpendicular) to plane of palm.
Parallel
F/E of thumb occurs at which joint(s)?
CMC, MCP, IP
Opposition of thumb occurs at which joint(s)?
CMC
Collateral ligaments are found on which surface(s) of (MCP/IP) joints? They protect against which motion(s)?
Both MCP and IP joints;
Medial and lateral;
Protect against excessive lateral deviation
The (dorsal/palmar) thickening of the joint capsule on MCP/IP joints serves which function(s)?
Palmar;
- Centers flexor tendons
- Guards against hyperextention
What are the components of the flexor sheath?
- Membranous portion
2. Retinacular portion
(X) portion of the flexor sheath is between the tendon and (Y). It serves to:
X = membranous Y = Retinacular portion
Promotes tendon gliding
(X) portion of the flexor sheath is continuous with (Y) and serves to:
X = retinacular Y = periosteum
Forms pulley, stabilizing the tendon
Bowstringing of tendon occurs when:
Retinacular portion of flexor sheath (“pulley”) ruptures
Juncturae Tendinum are (X) located on (dorsal/palmar) surface, proximal to (Y) joints. What’s the function?
X = intertendinous connections
Dorsal; Y = MCP
Link EDC tendons, restricting independent extension of fingers (couple action of digits 2-5)
The extensor expansion (hood) is an elaboration of (X) structure.
X = ED tendon
Patient can’t make a round OK sign (collapsed circle). Which muscle(s)/nerve(s) are dysfunctional?
Anterior Interosseous nerve; FPL and FDP muscles
Anatomical snuffbox includes (X) tendons and contains (Y) vessel(s). What’s the floor?
X = EPL, EPB, Abd pollicis longus Y = radial artery
Scaphoid bone
Finklestein’s Test is used to assess presence of (X). What are the steps of the test?
X = De Quervain’s Tenosynovitis
- Make tight fist
- Ulnar deviate
- Sharp pain over radial styloid means positive test
What is De Quervain’s Tenosynovitis?
Inflammation of EPB and Abd pollicis longus tendons as they glide over radial styloid process
Which tendon(s) pass through carpal tunnel?
FDS, FDP and FPL
T/F: Ulnar artery doesn’t pass through carpal tunnel.
True (same with ulnar nerve)
T/F: All branches of median nerve pass through carpal tunnel.
False - cutaneous branch does not.
T/F: Palmaris brevis is in the hypothenar compartment.
False (superficial to it)
What are some functions of palmaris brevis?
- Deepens hollow of palm (aids palmar grip)
2. Covers/protects ulnar nerve and artery
List the compartments of the intrinsic hand.
- Thenar
- Hypothenar
- Adductor
- Central
Simian (ape) hand is a symptom that is due to (X), which results from damage to (Y).
X = thenar wasting Y = median nerve (carpal tunnel syndrome)
There are (X) number of lumbricals, and they pass on the (anterior/posterior) side of the (Y) joints, just before attachment on (Z).
X = 4
Anterior
Y = MCP
Z = Extensor hood
If IP flexion is okay with MCP extension, but tight in MCP flexion, there is tightness in (intrinsic muscles/extrinsic muscles/joint capsule).
Extrinsic muscles
If IP flexion is tight with MCP extension and tight in MCP flexion, there is tightness in (intrinsic muscles/extrinsic muscles/joint capsule).
IP joint capsule
If IP flexion is tight with MCP extension, but okay in MCP flexion, there is tightness in (intrinsic muscles/extrinsic muscles/joint capsule).
Intrinsic muscles
There are (X) number of dorsal interossei and (Y) number of palmar interossei.
X = 4 Y = 3
(X) deformity: Laxity of the volar plate causes slippage of (Y). This causes which action(s) at which joint(s)?
X = swan neck Y = collateral ligaments
Hyperextention at PIP; flexion at DIP
(X) deformity: rupture of central tendon, through which (Y) protrudes. This causes which action(s) at which joint(s)?
X = boutonniere Y = PIP joint
PIP flexion; DIP extension
(X) deformity: extensor tendon laxity, resulting in decreased efficiency of (Y). This causes which action(s) at which joint(s)?
X = mallet Y = extensor hood
Inability to extend DIP
Tenodesis refers to:
Increase in grasp strength when wrist is extended, due to increase in distance over which flexors act
Patients with (X) injury rely on tenodesis grasp for functional activity.
X = C6 SC
