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Anatomy EXAM 1 > 10-2 HAND > Flashcards

10-2 HAND Flashcards

1
Q

Out of the 8 HAND Carpal Bones Point out AND Describe:

*Scaphoid [3]

A

1) boat shaped bone in proximal row most commonly FRACTURED—(1-15%)—>avascular necrosis
2) related to FOOSH injury [Fall On Out-Stretched Hand]
3) Articulates the radius

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2
Q

A: Out of the 8 HAND Carpal Bones Point out AND Describe:

  1. Lunate
  2. Triquetrum
  3. Pisiform

B: These HAND Carpal Bones are found in which row?

A

  1. pyramid bone articulating distal radioulnar joint disc
    ———————————————————————————-
  2. ## Pea shaped bone sitting on top of TriquetrumB: ALL OF THESE ARE PROXIMAL ROW
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3
Q

Out of the 8 HAND Carpal Bones Point out AND Describe::

  1. Hamate
  2. Capitate
  3. Trapezoid
  4. Trapezium

B: These HAND Carpal Bones are in which row?

A
  1. Has a hook/hamulus projecting anteriorly / articulates 4th&5th metacarpals
    - ————————————————————————————–
  2. LARGEST carpal bone & articulates 3rd metacarpal
    - ————————————————————————————-
  3. wedge shaped / articulates 2nd metacarpal
    - ———————————————————————————–
  4. Scallop shaped articulating 1st &2nd metacarpals

B: THESE ARE DISTAL ROW!

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4
Q

A: What makes the Phalanges on digit 1 (___) different than the others?

B: What are the types of Phalanges?

A

A: Digit 1(THUMB) only has 2 Phalanges [Proximal & Distal] while all the others have 3!

B: PP vs. MP vs. DP (proximal/middle/distal PHALANX)

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5
Q

In the HAND Extensor Compartment Deep fascia is continuous with _____ _____ and Extensor tendons (with ____ sheaths) pass underneath the _____ _____ __

A

Deep fascia is continuous with ANTEBRACHIAL FASCIA and Extensor tendons (with SYNOVIAL SHEATHS) pass underneath the EXTENSOR RETINACULUM BAND

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6
Q

Extensor Retinaculum Band [4]

A
  1. Overheads & Prevents bow-stringing of extensor tendons
  2. Thickening of antebrachial fascia
  3. Segregates extensor tendons into 6 compartments
  4. Laterally attached to radius but Medially attached to pisiform & triquetrum
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7
Q

A: What are the boundaries of the Carpal Tunnel?
B: What 10 things are housed within the Carpal Tunnel?

C: What tendon lies JUST OUTSIDE this Carpal TunneL?

A

A: Carpal BONES Posteriorly &////
[ Flexor Retinaculum transverse carpal ligament] Anteriorly

B: 
4 Flexor Digitorum superficialis tendons
4 DF-UDP tendons 
1 DF-RPL tendon 
1 MEDIAL NERVE

C:[ flexor carpi radialis] Tendon lies superficial to
[Flexor retinaculum transverse carpal ligament]
——————————————————-

DF-UDP=Deep Flexor Ulnar Digitorum Profundus
DF-RPL=Deep Flexor Radial Pollicis Longus

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8
Q

A: What is Carpal Tunnel Syndrome caused by?
B: Name 2 Common sx of this syndrome

C: Is thumb ADDuction affected by this syndrome?

A

A: Tendons/synovial sheath Swelling WITHIN the tunnel 2º to fluid retention, excessive exercise/motion or Infection
–>Median nerve compression

B:
1-Paresthesia/hypoesthesia/anesthesia of lateral 3.5 fingers

C- thumb Adduction is spared because ADDuctor pollicis is innervated by [Ulnar nerve deep branch] (which is housed in CANAL OF GUYON along with Ulnar artery )

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9
Q

1: What muscles are in the Thenar compartment of the Hand? [3]
2: Muscles in the Hand HYPOthenar compartment [3]
3: Muscles in Hand ADDuctor compartment [1]

A

Thenar= •Abductor Pollicis brevis •Flexor Pollicis brevis
•Opponens pollicis
————————————————————————————–
HYPOthenar= ºAbductor digiti minimi
ºFlexor digiti minimi brevis ºOpponens digiti minimi
————————————————————————————–
ADDuctor= ADDuctor pollicis

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10
Q

Abductor Pollicis brevis [4]

fact, nerve, function, location

A
  • 1out3 muscle inside Hand THENAR compartment
  • innervated by recurrent median n.
  • ABducts thumb
  • lies Anteriorly & laterally superficially
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11
Q

Flexor Pollicis brevis [4]

fact, nerve, function, location

A

º2out3 muscle inside Hand THENAR compartment
ºinnervated by recurrent median n.

ºFlexes Proximal Thumb phalanx
ºlies medial to ABductor pollicis brevis

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12
Q

Opponens Pollicis [4]

fact, nerve, function, location

A
  1. 3out3 muscle inside Hand THENAR compartment
  2. innervated by recurrent median n.
  3. Medially rotates AND Opposes thumb to center of palm
  4. lies DEEP to ABductor pollicis brevis
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13
Q

abductor digiti minimi [3]

fact, nerve, location

A
  1. 1out3 muscle inside Hand HYPOthenar compartment
  2. innervated by Ulnar n. deep branch
  3. MOST superficial HYPOthenar muscle and originates from pisiform bone
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14
Q

flexor digiti minimi brevis [3]

fact, nerve, location

A

º2out3 muscle inside HYPOthenar compartment
ºinnervated by Ulnar n. deep branch

ºlies lateral to abductor digit minimi and originates from hamulus

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15
Q

[T or F] The [flexor digiti minimi Longus] lies lateral to flexor digiti minimi brevis

A

FALSE! THERE IS NO [flexor digiti minimi LONGUS]

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16
Q

[opponens digiti minimi]

fact, nerve, function, location

A
  • 3out3 muscle inside HYPOthenar compartment
  • innervated by Ulnar n. deep branch
  • Draws 5th pinky metacarpal anteriorly and rotates center of palm to meet thumb
  • lies DEEP to abductor digiti minimi
17
Q

ADDuctor Pollicis [5]

A
  • Fan shaped muscle in adductor compartment of hand
  • ADDucts thumb toward middle finger
  • innervated by Ulnar n. deep branch

*Has 2 HEAD ORIGINS = Oblique head
& Transverse head(3rd metacarpal) origin

*perfused by Deep palmar arterial arch

18
Q

Lumbricals [4]

A
  1. Lumbricals 1&2 originate from lateral 2 tendons of
    DF-UDP and innervated by median n.
    ——————————————————————————
  2. Lumbricals 3&4 DOUBLE-sided originating from 3 medial tendons of
    DF-UDP and innervated by [[Ulnar n. deep branch]]
    —————————————————————————-
  3. Worm-looking muscles tht insert on lateral sides of extensor expansions digits 2-5
  4. Flexes digits at MCP joints and extends IP joints allowing pulp of finger to oppose thumb and not just thumb fingertip= “pinch” feature
19
Q

Palmar interosseous muscles [3]

function vs. location vs. nerve

A

(3 PAD) –>on PALM side

1–P: ADDucts fingers back toward 3rd midline middle finger

2–originates from side of M 2nd, L 4th & 5th metacarpals and attaches to bottom of PP{proximal phalanx}

3–innervated by Ulnar n. deep branch

20
Q

Dorsal interosseous muscles [3]

function vs. location vs. nerve

A

(4 DABS)–>on hand DORSAL side
A–ABducts fingers away from 3rd midline middle finger

B–Found at the L 2nd/3rd metacarpals AND M 3rd/4th = 3RD METACRPL HAS 2 INSERTIONS/quadruple sided

C–innervated by Ulnar n. deep branch

21
Q

How does the Ulnar Artery enter the hand and what happens once it gets in?

A

Enters via Ulnar Canal of Guyon and divides into Superficial Palmar Arch and Deep Branch once its in

22
Q

Describe the [Ulnar artery SUPerFiciAL Palmar Arch] [4]

A

Ulnar artery Superficial Palmar Arch

a: anastamoses w/superficial Radial artery branch
b: extends across palm and perfuses finger digital branches
c: Common palm digital artery daughters pass INBETWEEN METACRPLS

d: Proper palm digital artery daughters run on either side of digits 2-5

23
Q

Describe the [Ulnar artery DEEP Branch]

A

Ulnar artery DEEP branch

ºPasses inbetween [abductor digiti minimi] &
[ flexor digiti minimi]
ºAnastomoses with Radial artery Deep Palmar Arch

24
Q

In regards to Palmar Arches..which artery branch [Radial vs. Ulnar] is DEEP?

A

U S R D !! {REFERS TO ARCHES ONLY}
Ulnar Palmar Arch = superficial

***RADIAL PALMAR ARCH = DEEP

25
Q

Passage of Radial artery [4]

A

Gives off Superficial Palmar branch–(then)–>
extends across snuff box floor –>
wraps dorsally around 1st thumb metacrpl —>

pierces 1st dorsal interosseous muscle as the Radial artery DEEP Palmar Arch

26
Q

Name the 3 daughter arteries of the

[Radial artery DEEP Palmar ARCH] and their significance

A
  1. princeps pollicis=medial thumb
  2. radialis indicis= lateral 2nd digit
  3. [palmar metacarpal arteries]

…and then ARCH eventually anastomoses with

27
Q

Which fingers receive DUAL Blood supply?

A

ALL FINGERS GET DUAL BLOOD SUPPLY EXCEPT

THUMB (only gets blood from princeps pollicis from Radial artery DEEP ARCH) !

28
Q

What are the 4 Major facts regarding HAND Venous Return

A
  1. Multiple veins (like Venae Comitantes) course with the singular radial and ulnar arteries in the hand
  2. Finger venous return follows superficial palmar Arch to Ulnar Vein–> U S R D
  3. Deep venous arcades follow DEEP palmar arch to RADIAL Vein —> U S R D
  4. Ulnar, Radial and interosseous veins ALL ultimately drain into Brachial Vein
29
Q

A: Median Nerve enters hand under the _____ _____ thru the _____ _____.

B: Describe the 2 Branches that come from Median Nerve [Palmar Cutaneous branch(2) vs.
Recurrent Thenar Branch(4) ]

A

A: Median nerve enters hand under the FLEXOR RETINACULUM thru the CARPAL TUNNEL

B: Palmar Cutaneous BRanch
ºProvides cutaneous sensation to central palm
ºbranches just proximal to carpal tunnel but NOT ACTUALLY IN CARPAL TUNNEL

vs.

Recurrent Thenar Branch = 1/2 LOAF!

  • Innervates 1st and 2nd lumbricals
  • innervates Opp pollicis/ABductor pollicis/Flexor Pollicis brevis
  • 1st branch distal to flexor retinaculum
  • enters the thenar eminence
30
Q

A: The Ulnar nerve enters the hand via ___ __ ______.

B: name the 4 daughter branches of the Ulnar n.

A

A. Ulnar n. enters hand via Canal of Guyon

B:

  1. Palmar cutaneous branch=medial palm
  2. [ dorsal cutaneous branch] passes under FCU tendon, extends distally across hand dorsum
  3. 2 branches come off Distal of Flexor Retinaculum = Superficial branch and Deep Branch
31
Q

Describe the Ulnar nerve Superficial branch

A

“born” from Ulnar n. distal from flexor retinaculum

—>becomes common palmar digital nerves and then proper palmar digital nerves

32
Q

Describe the [ Ulnar nerve DEEP branch ] and name the 6 muscles it innervates {DHAPP3}

A

A: passes between abdDM and FDMB tendons then passes deep to flexor tendons along deep palmar arch path

B: DHAPP3 muscles=Ulnar n. DEEP BRANCH
Dorsal Interossei/HYPOthenar/ADDuctor Pollicis/
Palmar Interossei/ Pollicis Brevis/ 3rd&4th Lumbricals

33
Q

State key features of Radial Nerve IN THE HAND [3]

A
  1. Radial n. STRICTLY CUTANEOUS in hand
  2. Enters hand dorsum after passing over anatomical snuff box
  3. creates dorsal digital nerves on dorsal lateral hand –> cutaneous sensation to dorsal lateral 3.5 digits inferior to DIP joint
34
Q

Dupuytren’s Contracture

A

Progressive Hand fibrosis in which fibrous tissues band palmar aponeurosis to phalange bases
—->pulls digits into marked flexion at Metacrpl joints= can’t straightened out fingers

Anatomy EXAM 1 (14 decks)

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