4 UE Wrist + Hand Flashcards
radiocarpal joint (wrist) articulations
(1) distal radius (and articular disc) w/ scaphoid, lunate, triquetrum
(2) condyloid synovial
(3) at proximal wrist crease
ligaments of the radiocarpal joint
dorsal radiocarpal ligament
palmar radiocarpal ligament
radial collateral ligament
ulnar collateral ligament
importance of dorsal/palmar radiocarpal ligaments
very strong
- allows hand to move w/ radius during supination/pronation
flexor retinaculum
extends from pisiform/hamate (medial) to scaphoid/trapezium (lateral)
- creates carpal tunnel
- bracelet
**aka transverse carpal ligament
fascia of the palm
deep connective tissue
- continuous w/ antebrachial fasica
- thickened at center of palm (palmar aponeurosis)
- triangle points towards radius/ulna
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digital fibrous sheaths
(fascia of the palm) fascia that wraps the digits
- further wrapped in synovial sheaths, which are wrapped in fibrous tendon sheaths
hypothenar
refers to the pinky
thenar
refers to the thumb
synovial sheath
membrane that covers tendon
- beneath digitial fibrous sheat
- above fibrous tendon sheath
bursae
fluid-filled sacs that protect y lubricate long tendons
- anchored by retinaculae
compartments of flexors
3
compartments of extensors
6
dorsum tendons
long extensor tendons
extensor expansions
palmar tendons
flexor digitorum superficialis tendon
flexor digitorum profundus tendon
flexor digitorum superficialis tendon
splits b/c it inserts sooner + flexor digitorum profundus tendon needs to insert into distal phalanx
- inserts on middle phalanx
flexor digitorum profundus tendon
“threads the needle”
inserts on distal phalanx
- attached by vincula
vincula
pieces of connective tissue that anchors flexor digitorum profundus tendon (FDST)
- serves as attachment of flexor digitorum superficialis tendon to phalanx
- 2 types
types of vincula
vincula brevia
vincula longum
joints of the hand
(1) intercarpal (IC) joints
(2) carpometacarpal (CMC) joints
(3) intermetacarpal (IM) joints
(4) metacarpaphalangeal (MP) joints
(5) proximal interphalangeal (PIP) joints
intercapal (IC) joint type
plane synovial
carpometacarpal (CMC) joint type
saddle joint
**this is the thumb joint
intermetacarpal (IM) joint type
plane synovial
ligaments of the hand
(1) anterior (palmar) ligaments
(2) posterior (dorsal) ligaments
(3) interosseus ligaments
(4) transverse metacarpal ligaments
(5) collateral ligaments
(6) palmar ligaments
types of transverse metacarpal ligaments
- deep transverse metacarpal ligament
- superficial transverse metacarpal ligament
metacarpophalangeal (MP) joint type
condyloid synovial
- abduct/adduct + flex/extend
proximal interphalangeal (PIP) joint type
hinge synovial
- flex + extend
distal interphalangeal (DIP) joint type
hinge synovial
- flex + extend
hypothenar muscles (3 + 1)
located on medial (pinky) side
- (3) abductor digiti minimi
- (3) flexor digiti minimi brevis
- (3) opponens digiti minimi
- (1) palmaris brevis
3 muscles in compartment + 1 that lies on top
abductor digiti minimi
hypothernar muscle
O: pisiform
I: proximal phalanx digit #5
A: abduct 5th digit
N: ulnar nerve
- *meaty part of palm on medial side
- *more pinky
flexor digiti minimi brevis
hypothenar muscle
O: flexor retinaculum hamate I: promximal phalanx digit #5 A: flex 5th digit N: ulnar nerve
**more pinky
opponens digiti minimi
hypothenar muscle
O: flexor retinaculum + hamate
I: metacarpal #5
A: rotate & draw metacarpal #5 forward (to bring into OPPOSITION w/ thumb)
N: ulnar nerve
- *opponens = wrap around
- *smallest
palmaris brevis
**covers + protects ulnar artery y ulnar nerve
thenar muscles
lateral (thumb) side
- abductor pollicis brevis
- flexor pollicis brevis
- opponens pollicis
abductor pollicis brevis
thenar muscle
O: flexor retinaculum
I: proximal phalanx of thumb
A: abduct thumb
N: median nerve
**big meaty piece of thumb side
flexor pollicis brevis
thenar muscle
O: flexor retinaculum
I: proximal phalanx of thumb
A: flex thumb
N: median nerve + ulnar nerve
opponens pollicis
thenar muscle
O: flexor retinaculum
I: metacarpal #1
A: opposition of thumb
N: median nerve
brevis
start / end in hand
longus
start in arm
OR
end in hand
movements of thumb
abduction adduction extension flexion opposition reposition
abduction
moving thumb away from palm
adduction
returning thumb to palm
extension
hand flat w/ thumb away from palm
flexion
thumb to base of pinky
**very similar to opposition
opposition
thumb to tip of pinky
**very similar to flexion
reposition
fingers touching, thumb touching side of palm
carpal tunnel syndrome
decrease side of carpal tunnel, compression of median nerve
- atrophy of thumb, causes thumb to be adducted/extended
- inability to oppose thumb (thumb to tip of pinky)
- problems w/ flexion + opposition
- loss of sensation on lateral palm + lateral digits
- numbness tingling
**must wear brace to decrease movement
central compartment
- extrinsic flexor tendon + sheaths
- superficial palmar arterial arch
- median nerve branches
- ulnar nerve branches
- lumbricals #1-4
lumbricals #1 - 4
central compartment muscle
O: FDP tendons I: extensor digitorum tendons A: extend fingers @ IP joints + flex metacarpal joints N: median nerve (1-2) ulnar nerve (3-4)
**short muscles of the hand btwn tendons
adductor compartment
deep to thenar compartment
- adductor pollicis
adductor pollicis
adductor compartment muscle
O: metacarpal #2 – 3 + capitate + trapezoid
I: proximal phalanx of thumb
A: adduct thumb (bring thumb back to side of palm)
N: ulnar nerve
interosseous compartment
located btwn metacarpals (short muscles of hand)
- dorsal interossei (DAB)
- palmar interossei (PAD)
**assist lumbricals
dorsal interossei
interosseous compartment muscle
O: adjacent sides of metacarpals
I: proximal phalanges #2 – 4
A: abduct fingers
N: ulnar nerve
**assist lumbricals
DAB
palmar interossei
interosseous compartment muscle
O: metacarpal #2, 4 - 5
I: proximal phalanges #2, 4 - 5
A: adduct fingers
N: ulnar nerve
- *assist lumbricals
- *none on middle finger
PAD
significance of 3rd digit (middle finger)
acts as central point
- does not move
- no palmar interossei muscle on middle finger
