10: Musculo-neuro-vascular systems of the hand and carpal tunnel Flashcards

1
Q

What type of joint is the DIP joint and what are its actions

A

Synovial hinge joint
Flexion + extension

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2
Q

What type of joint is the PIP joint and what are its actions

A

Synovial hinge joint
Flexion & extension

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3
Q

What type of joint is the MCP joint?

A

Synovial condyloid joint

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4
Q

What type of joint is the MCP joint?

A

Synovial condyloid joint

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5
Q

Lateral eminence of palmar surface

A

Thenar eminence

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6
Q

Medial eminence of palmar surface

A

Hypothenar eminence

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7
Q

What separates the two eminences

A

The central concavity

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8
Q

Compartments of the hand (5)

A

Thenar compartment
Adductor compartment
Hypothenar compartment
Central compartment
Interosseous compartment

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9
Q

Compartments of the hand are separated by

A

Fibrous septa

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10
Q

Muscles of thenar compartment (3)

A

Abductor pollicis breves
Flexor pollicis breves
Opponens pollicis

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11
Q

Origin of abductor pollicis brevis

A

Tubercle of scaphoid
Flexor retinaculum

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12
Q

Innervation of abductor pollicis brevis

A

Lateral branch of median nerve

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13
Q

Insertion of abductor pollicis brevis

A

Proximal phalanx of thumb, lateral surface of base

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14
Q

Actions of abductor pollicis brevis

A

Abducts thumb and assists in opposition at CMC joint

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15
Q

Origin of flexor pollicis brevis

A

Trapezium and adjacent flexor retinaculum

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16
Q

Insertion of flexor pollicis brevis

A

Proximal phalanx of thumb

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17
Q

Innervation of flexor pollicis brevis

A

Recurrent branch of median nerve

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18
Q

Actions of flexor pollicis brevis

A

Flexes thumb at cmc/mcp joint

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19
Q

Origin of opponens pollicis

A

Trapezium and adjacent flexor retinaculum

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20
Q

Insertion of opponens pollicis

A

Lateral border of first metacarpal

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21
Q

Innervation of opponens pollicis

A

Lateral branch of median nerve

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22
Q

Actions of opponens pollicis

A

Assists with opposition of thumb
Flexion, adduction + medial rotation at first CMC joint

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23
Q

Muscle of adductor compartment

A

Adductor pollicis

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24
Q

Origin of Adductor pollicis

A

Transverse head: anterior surface of body of third metacarpal
Oblique head: bases of metacarpals 2 and 3, capitate and trapezoid

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25
Q

Insertion of Adductor pollicis

A

Medial side of proximal phalanx of thumb

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26
Q

Innervation of Adductor pollicis

A

Deep branch of ulnar nerve

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27
Q

Actions of Adductor pollicis

A

Adducts thumb at first CMC joint

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28
Q

Muscles of hypothenar compartment (3)

A

Abductor digiti minimi
Flexor digiti minimi brevis
Opponens digiti minimi

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29
Q

Origin of Abductor digiti minimi

A

Pisiform and flexor retinaculum

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30
Q

Insertion of Abductor digiti minimi

A

Medial base of proximal phalanx of little finger

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31
Q

Innervation of Abductor digiti minimi

A

Deep branch of ulnar nerve

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32
Q

Actions of Abductor digiti minimi

A

Abducts little finger

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33
Q

Origin of flexor digiti minimi brevis

A

Hook of hamate and flexor retinaculum

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34
Q

Insertion of flexor digiti minimi brevis

A

Medial surface of base of proximal phalanx

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35
Q

Innervation of flexor digiti minimi brevis

A

Deep branch of ulnar nerve

36
Q

Actions of flexor digiti minimi brevis

A

Flexes little finger at CMC/MCP joint

37
Q

Origin of opponens digiti minimi

A

Hook of hamate and flexor retinaculum

38
Q

Insertion of opponens digiti minimi

A

Medial border of fifth metacarpal

39
Q

Innervation of opponens digiti minimi

A

Deep branch of ulnar nerve

40
Q

Actions of opponens digiti minimi

A

Rotates fifth metacarpal to oppose little finger to thumb

41
Q

Location of palmaris brevis

A

Superficial to the hypothenar compartment

42
Q

Origin of palmaris brevis

A

Proximal border of palmar aponeurosis

43
Q

Insertion of palmaris brevis

A

Skin over hypothenar eminence

44
Q

Innervation of palmaris brevis

A

Superficial branch of ulnar nerve

45
Q

Actions of palmaris brevis

A

Wrinkles skin of hypothenar eminence - aids in palmar gripping

46
Q

Central muscles of the hand

A

4 lumbricals

47
Q

What lumbricals are unipennate

A

1 and 2

48
Q

What lumbricals are bipennate

A

3 and 4

49
Q

1st lumbrical is attached to

A

Lateral 1st FDP tendon

50
Q

2nd lumbrical is attached to

A

Lateral 2nd FDP tendon

51
Q

3rd lumbrical is attached to

A

Medial 2nd FDP and lateral 3rd FDP tendon

52
Q

4th lumbrical is attached to

A

Medial 3rd FDP and lateral 4th FDP tendon

53
Q

Insertion of lumbricals

A

Insert into the posterior regions of digit 2-5 into their respective extensor expansion

54
Q

Innervation of lumbricals 1 and 2

A

Median nerve

55
Q

Innervation of lumbricals 3 and 4

A

Ulnar nerve

56
Q

Actions of lumbricals

A

Flex digits 2-5 at MCP joints
Extend digits 2-5 at IP joints

57
Q

How many palmar interosseous muscles are there?

A

3

58
Q

How many dorsal interosseous muscles are there?

A

4

59
Q

What are the interosseous muscles of the hand innervated by?

A

Deep branch of ulnar nerve

60
Q

Origin of palmar interossei

A

Palmar surface of metacarpals 2,4,5

61
Q

Insertion of palmar interossei (3)

A

Medial base of proximal phalanx of index finger
Lateral surface of base of 4th proximal phalanx
Lateral surface of base of 5th proximal phalanx

62
Q

Action of palmar interossei

A

Palmar adduction and adduction of index ring and little fingers

63
Q

Origin of dorsal interossei

A

Bipennate muscles, originate on adjacent sides of metacarpals

64
Q

Insertion of dorsal interossei (4)

A

Lateral base of index proximal phalanx + DDE
Lateral base of middle finger proximal phalanx + DDE
Medial base of middle finger proximal phalanx + DDE
Medial base of 4th finger proximal phalanx + DDE

65
Q

DDE

A

Dorsal digital expansion

66
Q

Action of dorsal interossei

A

Dorsal abduction (digits 2-4)

67
Q

Course of anterior interosseous nerve

A

Runs distally along the anterior part of interosseous membrane and innervates the anterior compartment muscles

68
Q

Where does the medial cutaneous nerve of the forearm come from

A

Direct from medial cord of brachial plexus

69
Q

Where does the lateral cutaneous nerve of the forearm come from

A

Continuation of musculocutaneous nerve

70
Q

Where does the posterior cutaneous nerve of the forearm

A

Branch of radial nerve

71
Q

Motor innervation of thenar muscles

A

Median nerve branches

72
Q

Motor innervation of adductor pollicis

A

Ulnar nerve

73
Q

Motor innervation of hypothenar muscles

A

Ulnar nerve

74
Q

Where is the superficial palmar arch?

A

Located between palmar aponeurosis and tendons of flexor digitorum superficialis

75
Q

What is the superficial palmar arch made of

A

Terminal branch of ulnar artery
Superficial palmar branch of radial artery

76
Q

Location of deep palmar arch

A

Between metacarpals and deep flexor tendons

77
Q

What is the deep palmar arch made of

A

Deep palmar branch of ulnar artery
Branch of radial artery

78
Q

Arterial supply to hand

A

superficial palmar arch
deep palmar arc
Common palmar digital arteries
Proper palmar digital arteries

79
Q

Arterial supply to dorsal surface of hand

A

Dorsal carpal arch
Dorsal metacarpal arteries
Dorsal digital arteries

80
Q

Floor of anatomical snuffbox

A

styloid process of radius
scaphoid proximally
trapezium distally
base of 1st metacarpal

81
Q

Boundaries of anatomical snuffbox

A

Extensor pollicis longus
Extensor pollicis brevis
Abductor pollicis longus

82
Q

Roof of anatomical snuffbox

A

Skin
Superficial brand of radial nerve

83
Q

Carpal tunnel contents

A

Flexor digitorum profundus tendons (4)
Flexor digitorum superficialis tendons (4)
Flexor pollicis longus tendon
Median nerve
Flexor carpi radialis tendon

84
Q

Sensory symptoms of carpal tunnel syndrome

A

Paraesthesia
Hypoesthesis
Anaesthesia

85
Q

Motor symptoms of carpa tunnel syndrome

A

Reduced power in abductor pollicis brevis
and opponens pollicis muscles and atrophy over time

86
Q

Simian hand

A

Median nerve injury that causes paralysis of the thenar muscles
Results in thumb fixed in the same plane as other fingers