19 - MSK Hand & Hip

Question 1

which arteries form anastomoses in the hand

Answer 1

radial and ulnar arteries
(deep and superficial in the hand)

Question 2

What are the two arches in the hand

Answer 2

superficial palmer arch
deep palmar arch

Question 3

What are tests to ensure anastomosis are functional

Answer 3

allen’s test
squeezing radial artery or on the ulnar artery
hand goes white

Question 4

What is the anatomical snuff box

Answer 4

located at the base of the dorsal surface of the thumb

Borders are formed by the tendons of muscles from the posterior (extensor) compartment of the forearm

• medial border: extensor pollicis (longus)
• lateral border: extensor pollicis (brevis) & abductor pollicis
• proximal border: styloid process of the radius

(pollicis = thumb)

Question 5

What prevents the tendons from buldging from the surface of the carpals

Answer 5

extensor retinaculum

Question 6

Which are the extensors and abductors of the digits and thumb
Where are they found
What are they innervated by

Answer 6

abductor pollicis
extensor pollicis (brevis & longus)
extensor digitorum

posterior extensor compartment of the forearm

radial nerve

Question 7

What are the intrinsic muscles of the hand
What is it innervated by

Answer 7

lumbricals to flex the metacarpophalangeal (MCP) joints
ulnar and median nerves

interossei muscles
- dorsal interossei (DAB)
- palmar interossei (PAD)
ulnar nerve

Question 8

Where do the lumbricals extend from

Answer 8

from the tendons of flexor digitorum profundus to the digital extensor tendons

Question 9

Which muscles make up the thenar eminence
What are they innervated by

Answer 9

• abductor pollicis - superficial (median nerve)
• opponens pollicis - deep & lateral (median nerve)
• flexor pollicis brevis - deep & medial (median & ulnar nerve)

Question 10

What muscle make up the hypothenar eminences
What is it innervated by

Answer 10

opponens digiti minimi (ulnar nerve)

Question 11

Where does the adductor pollicis extend from
What is it innervated by

Answer 11

from third metacarpal and carpals to proximal phalanx of thumb

Question 12

What would happen if there was a median nerve injury

Answer 12

hand of benediction
- thenar wasting
proximal to the elbow

Question 13

What would happen if there was an ulnar nerve injury

Answer 13

ulnar claw hand or hand of benediction
- hypothenar wasting
proximal to the carpals

Question 14

What would happen if there was an injury to the radial nerve

Answer 14

waiter’s tip
proximal to elbow

Question 15

Which are the superficial veins

Answer 15

dorsal venous plexus - random pattern

cephalic vein - lateral aspect of arm, toward head

basilic vein - medial aspect of arm

median cubital vein - in cubital fossa (convenient for blood sampling)

Question 16

What are the three thigh muscle compartments
What are they innervated by

Answer 16

extensors of knee (quads - femoral nerve)
adductors of the hip (adductor group - obturator nerve)
flexors of the knee (hamstrings - tibial nerve)

Question 17

What forms the openings for peripheral nerves that innervates muscles of the hip and pelvic floor

Answer 17

sacrospinus and sacrotuberus ligaments

Question 18

What openings do the sacrospinus and sacrotuberus ligaments form

Answer 18

greater sciatic foramen
- sciatic and gluteal nerves
lesser sciatic foramen
- pudendal nerve

Question 19

What are the structures of the femoro-acetabular (hip) joint

Answer 19

articular cartilage
acetabular labrum
ligamentum teres
synovium
joint capsule (ligaments)
femoral artery

Question 20

What type of joint is the hip
What can it do

Answer 20

ball and socket
circumduction

Question 21

What are the main muscle groups that affect circumduction of the hip

Answer 21

flexors - illiopsoas and sartorius
adductors - adductor group and gracilis
extensors - gluteal
abductors - gluteus maximus and tensor fascia lata

Question 22

What innervates the flexor muscles of the pelvis and hip

Answer 22

ventral ramus of lumbar spinal nerves

Question 23

What are the flexors and stabilizers of the pelvis and hip

Answer 23

quadratus lumborum - from transverse process of lumbar vertebrae to iliac crest
- stablizer of pelvis

iliopsoas - from transverse process of lumbar vertebrae and iliac bone to shaft of femus (crossing hip joint)

Question 24

what does the iliacus muscle do

Answer 24

flexion of femoral-acetabular joint (hip flexion)
Works with psoas major

Question 25

Where does the ilacus muscle extend from

Answer 25

iliac bone to shaft of femus (corssing hip joint)

Question 26

What does the psoas muscle do

Answer 26

flexion of femoral-acetabular joint (hip flexion)
Works with iliacus muscle

Question 27

Where does the psoas muscle extend from

Answer 27

transverse process of lumbar vertebrae to shaft of femus (crossing hip joint)

Question 28

What does the iliopsoas muscle do

Answer 28

flexion of lumbar vertebrae

Question 29

What are the gluteal muscles
What do they do
What innervates

Answer 29

gluteus maximus - inf gluteal nerves
- extensor
- abductor
- lateral rotator
gluteus medius - sup gluteal nerves
- abductor
- hip stabilizer

Question 30

Which muscles help to stabalize the pelvis when walking
How are they engaged

Answer 30

quadratus lumborum and gluteus medius

engaged in an alternating fashion
- QL: on the unsupported side (non-wt bearing)
- GM: on the supported side (wt bearing)

Question 31

What would happen if there were injury to the gluteus medius

Answer 31

trendelenburg gait
- unstable pelvis
(damage to glut medius or superior gluteal nerve)