1.4.2 Hand

Question 1

A continuation from the antebrachial fascia and the fascia of the dorsal hand, thin on thenar and hypothenar regions, thick in the center to form the ____.

Answer 1

Palmar aponeurosis

Question 2

What is blended by the palmar aponeurosis? (Hint: a tendon and ligament)

Answer 2

Palmar carpal ligament and the palmar longus tendon

Question 3

What are the two different orientations of the fibrous digital sheath?

Answer 3

Annular (ring-like) and cruciform parts

Question 4

Lies deep to the palmar aponeurosis and palmaris longus tendon. It is also part of the palmar fascia.

Answer 4

Flexor Retinaculum

Question 5

What forms the “roof” of the “Carpal tunnel”?

Answer 5

Flexor retinaculum

Question 6

Where are the carpal tunnel and Guyon’s canal in relation to one another?

Answer 6

Question 7

What side of the hand is typically affected by Dupuytren’s Contracture?

Answer 7

Medial side - 4th and 5th fingers

Question 8

What is the classic population to get Dupuytren’s contracture?

Answer 8

Bilateral, male, over 50

Question 9

What is Dupuytren’s contracture?

Answer 9

Progressive shortening, thickening, and fibrosis of the palmar fascia and aponeurosis.

Question 10

What is the treatment for dupuytren’s?

Answer 10

Collagenase injections; surgical if injections don’t reduce enough of the fibrosis

Question 11

What seperates the hypothenar compartment from the potential midpalmar space?

Answer 11

Medial fibrous septum

Question 12

What seperates the thenar compartment from the potential thenar space?

Answer 12

lateral fibrous septum

Question 13

What are the five compartments of the hand and their location?

Answer 13

Thenar, Hypothenar, Central, Adductor, Interosseus

Question 14

What are the five compartments of the hand that house the intrinsic muscles?

Answer 14

Thenar, hypothenar, central, interosseus, and adductor

Question 15

Which muscle in the hand is not within any of the compartments of the hand?

Answer 15

Palmaris brevis; runs superficially above the hypothenar

Question 16

What helps form the thenar eminence and chief function is to oppose the thumb?

Answer 16

Thenar muscles?

Question 17

What are the three thenar muscles?

Answer 17

Abductor policis brevis, flexor policis brevis, and opponens policis

Question 18

Which thenar muscle is responsible for a little abduction of the thumb and assisting in the early stages of opposition?

Answer 18

Abductor policis brevis

Question 19

What innervates the majority of the thenar muscles? What is the exception?

Answer 19

Median nerve;

the deep head of the flexor policis brevis is innervated by the ulnar nerve

Question 20

Name the thenar muscles from superficial to deep?

Answer 20

Abductor pollicis brevis, flexor pollicis brevis, opponens pollicis

Question 21

Identify these origins and insertions

Answer 21

Question 22

What are the three hypothenar muscles?

Answer 22

abductor digiti minimi, flexor digiti minimi brevis, opponens digiti minimi

Question 23

Which hypothenar muscle is the most superficial and ulnar (medial)?

Answer 23

abductor digiti minimi

Question 24

What is the function of the abductor digiti minimi?

Answer 24

Abduction of the 5th digit

Question 25

Which muscle lies lateral to the abductor digiti minimi? Its function?

Answer 25

The flexor digiti minimi; Flexes the 5th digit

Question 26

Which hypothenar muscle lies the deepest? It's function?

Answer 26

Opponens digiti minimi; allows for opposition of the 5th digit

Question 27

Which group of muscles is responsible for the "L" or "Z" movement?

Answer 27

Lumbricals

Question 28

Describe the innervation of the lumbricals?

Answer 28

1 & 2nd: Median nerve 3 & 4: Ulnar Nerve

Question 29

What are the origins and insertions of the lumbricals?

Answer 29

**Originate from the tendon of the flexor digitorum profundus tendon** Insert on lateral sides of extensor expansion

Question 30

What is the two 1 1/2s and two 3 1/2s rule?

Answer 30

Question 31

If the ulnar nerve is injured, how would the "z" move look? (hint: lumbricals)

Answer 31

The claw hand (The lumbricals are dual innervated - with the 4th and 5th digits being innervated by the ulnar nerve)

Question 32

Name this muscle

Answer 32

Adductor Pollicis

Question 33

What innervates adductor pollicis?

Answer 33

Ulnar nerve

Question 34

What function is mediated by the dorsal interossei?

Answer 34

Abduct the digits Dorsal ABducts (DAB)

Question 35

What innervates the dorsal interossei?

Answer 35

All are innervated by the ulnar nerve

Question 36

What function is mediated by the palmar interossei?

Answer 36

Adducts the digits **P**almar **AD**duct **(PAD)**

Question 37

Give a summary of all the intrinsic muscles of the hand and their compartment.

Answer 37

Question 38

The tendons of these two extrinsic hand muscles are enclosed in a **common flexor synovial sheath?**

Answer 38

FDS and FDP

Question 39

Compare the insertions of the flexors vs. extensors.

Answer 39

Question 40

What type of injury could lead to tenosynovitis?

Answer 40

Puncture wound (ie. rusty nail)

Question 41

Name this condition.

Answer 41

Tenosynovitis: infection of the synovial sheaths

Question 42

Name this condition.

Answer 42

De Quervain's Tenovaginitis Stenosans | (covered word is stenosis)

Question 43

Name this condition.

Answer 43

Digital Tenovaginitis Stenosans (Trigger finger or snapping finger)

Question 44

Where does the ulnar nerve enter the hand?

Answer 44

Guyon's (Ulnar) canal

Question 45

Name this branch of the ulnar artery?

Answer 45

Superficial palmar arch

Question 46

Name this branch of the radial artery (anastamose with ulnar).

Answer 46

Deep palmar arch

Question 47

What artery crosses the anatomical snuff box?

Answer 47

The radial artery

Question 48

Why might profuse bleeding occur when one of the palmar arterial arches is lacerated?

Answer 48

Extensive anastomoses

Question 49

What are the nine tendons that run through the carpal tunnel?

Answer 49

Four FDS, Four FDP, and one flexor pollicis longus

Question 50

Name this nerve.

Answer 50

Median nerve at hand

Question 51

Which branch of the median nerve innervates the thenar muscles?

Answer 51

Recurrent branch of the median nerve

Question 52

This branch of the median nerve enters the hand superficially to the carpal tunnel?

Answer 52

Palmar branch of the median nerve

Question 53

What is the treatment for carpal tunnel?

Answer 53

Question 54

Trauma to the median can cause what appearance in the hand?

Answer 54

Ape hand (loss of ability to abduct and oppose thumb)

Question 55

What provides innervation to the 5th digit and 1/2 of the 4th?

Answer 55

Superficial branch of the ulnar nerve

Question 56

Name this nerve

Answer 56

Palmar cutaneous branch

Question 57

Name this nerve.

Answer 57

Deep branch of ulnar nerve

Question 58

Name the two 3 1/2s and 1 1/2s for the median and ulnar nerve

Answer 58

Question 59

Name the four locations of ulnar nerve injury? Possible causes? Appearance?

Answer 59

Question 60

What does the radial nerve innervate in the hand?

Answer 60

Question 61

Name the muscles involved in each of these movements? Are these muscles intrinsic or extrinsic? What is their innervation?

Answer 61