19 - MSK Hand & Hip Flashcards
which arteries form anastomoses in the hand
radial and ulnar arteries
(deep and superficial in the hand)
What are the two arches in the hand
superficial palmer arch
deep palmar arch
What are tests to ensure anastomosis are functional
allen’s test
squeezing radial artery or on the ulnar artery
hand goes white
What is the anatomical snuff box
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)
What prevents the tendons from buldging from the surface of the carpals
extensor retinaculum
Which are the extensors and abductors of the digits and thumb
Where are they found
What are they innervated by
abductor pollicis
extensor pollicis (brevis & longus)
extensor digitorum
posterior extensor compartment of the forearm
radial nerve
What are the intrinsic muscles of the hand
What is it innervated by
lumbricals to flex the metacarpophalangeal (MCP) joints
ulnar and median nerves
interossei muscles
- dorsal interossei (DAB)
- palmar interossei (PAD)
ulnar nerve
Where do the lumbricals extend from
from the tendons of flexor digitorum profundus to the digital extensor tendons
Which muscles make up the thenar eminence
What are they innervated by
- abductor pollicis - superficial (median nerve)
- opponens pollicis - deep & lateral (median nerve)
- flexor pollicis brevis - deep & medial (median & ulnar nerve)
What muscle make up the hypothenar eminences
What is it innervated by
opponens digiti minimi (ulnar nerve)
Where does the adductor pollicis extend from
What is it innervated by
from third metacarpal and carpals to proximal phalanx of thumb
What would happen if there was a median nerve injury
hand of benediction
- thenar wasting
proximal to the elbow
What would happen if there was an ulnar nerve injury
ulnar claw hand or hand of benediction
- hypothenar wasting
proximal to the carpals
What would happen if there was an injury to the radial nerve
waiter’s tip
proximal to elbow
Which are the superficial veins
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)
What are the three thigh muscle compartments
What are they innervated by
extensors of knee (quads - femoral nerve)
adductors of the hip (adductor group - obturator nerve)
flexors of the knee (hamstrings - tibial nerve)
What forms the openings for peripheral nerves that innervates muscles of the hip and pelvic floor
sacrospinus and sacrotuberus ligaments
What openings do the sacrospinus and sacrotuberus ligaments form
greater sciatic foramen
- sciatic and gluteal nerves
lesser sciatic foramen
- pudendal nerve
What are the structures of the femoro-acetabular (hip) joint
articular cartilage
acetabular labrum
ligamentum teres
synovium
joint capsule (ligaments)
femoral artery
What type of joint is the hip
What can it do
ball and socket
circumduction
What are the main muscle groups that affect circumduction of the hip
flexors - illiopsoas and sartorius
adductors - adductor group and gracilis
extensors - gluteal
abductors - gluteus maximus and tensor fascia lata
What innervates the flexor muscles of the pelvis and hip
ventral ramus of lumbar spinal nerves
What are the flexors and stabilizers of the pelvis and hip
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)
what does the iliacus muscle do
flexion of femoral-acetabular joint (hip flexion)
Works with psoas major
Where does the ilacus muscle extend from
iliac bone to shaft of femus (corssing hip joint)
What does the psoas muscle do
flexion of femoral-acetabular joint (hip flexion)
Works with iliacus muscle
Where does the psoas muscle extend from
transverse process of lumbar vertebrae to shaft of femus (crossing hip joint)
What does the iliopsoas muscle do
flexion of lumbar vertebrae
What are the gluteal muscles
What do they do
What innervates
gluteus maximus - inf gluteal nerves
- extensor
- abductor
- lateral rotator
gluteus medius - sup gluteal nerves
- abductor
- hip stabilizer
Which muscles help to stabalize the pelvis when walking
How are they engaged
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)
What would happen if there were injury to the gluteus medius
trendelenburg gait
- unstable pelvis
(damage to glut medius or superior gluteal nerve)
