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MSK > 9 - Anatomy of the Hand > Flashcards

9 - Anatomy of the Hand Flashcards

1
Q

What are the three parts of the hand?

A

Carpus (Wrist)
Metacarpus
Digits (Fingers and thumb)

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2
Q
A
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3
Q
A
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4
Q

How many carpal bones are there?

A

8

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5
Q

How many metacarpal bones are there?

A

5

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6
Q

How many phalanges are there?

A

14
3 in each finger
2 in thumb

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7
Q
A

Proximal Row
Scaphoid - S
Lunate - L
Triquetral - Tr
Pisiform - P

Distal Row
Trapezium - Tm
Trapezoid - Td
Capitate - C
Hamate - H

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8
Q

Which carpal bones make up the proximal row?

A

Scaphoid
Lunate
Triquetral
Pisiform

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9
Q

Which carpal bones make up the distal row?

A

Trapezium
Trapezoid
Capitate
Hamate

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10
Q

Which carpal bones articulate with the distal radius?

A

Scaphoid & Lunate

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11
Q

Which is the most commonly injured carpal bone?

A

Scaphoid

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12
Q

What is important about a fracture to the scaphoid bone?

A

Part of the radial artery enters the scaphoid bone - if you fracture the bone you can cut off its blood supply causing necrosis.

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13
Q

What mnemonic helps you remember the order of the carpal bones?

A

Some Lovers Try Positions That They Cant Handle

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14
Q

What type of bone is the pisiform? What inserts into it?

A

Sesamoid bone
Flexor Carpi Ulnaris inserts into it

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15
Q

What are the four parts of a metacarpal?

A

Head
Neck
Shaft
Base

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16
Q

How many metacarpals are there?

A

5

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17
Q

What are the three types of a phalange?

A

Proximal
Intermediate (not in the thumb)
Distal

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18
Q
A
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19
Q

Name 5 joints of the hand

A

Wrist
Carpal (midcarpal)
Carpometacarpal
Metacarpophalangeal
Interphalangeal

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20
Q

What is the name of the joints between the carpal bones?

A

Carpal / Midcarpal / Intercarpal

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21
Q

What is the name of the joint between the carpel bones and the metacarpals?

A

Carpometacarpal joints

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22
Q

What’s the name of the joint between the metacarpals and the phalanges?

A

Metacarpophalangeal joints. (MCP joints)

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23
Q

What is the name of the joints between the phalanges?

A

Interphalangeal joints

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24
Q
A
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25
Q
A
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26
Q

What type of joint is found between the carpals?

A

Synovial plane joints

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27
Q

Why is there limited intra-carpal movement?

A

Because the carpals are in a capsule which is reinforced by several ligaments.

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28
Q

What type of joint are the carpometacarpal joints?

A

Synovial planar joints

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29
Q

Which are the most mobile of the carpometacarpal joints?

A

Little finger and thumb

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30
Q

What is special about the carpometacarpal joint of the thumb?

A

It is a saddle joint which allows a wide range of mobility, including opposition of the thumb.

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31
Q
A
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32
Q

What type of joint is the metacarpophalangeal joint?

A

Condylar synovial joint

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33
Q

What movement is permitted by the MCP Joints?

A

Everything except rotation is limited.

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34
Q

What are the MCP joints reinforced by?

A

Palmar ligaments
Deep transverse metacarpal ligaments
Collateral ligaments

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35
Q

Which MCP joint is reinforced differently to the others?

A

The thumb

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36
Q

How is the thumb MCP joint reinforced?

A

By ulnar and radial collateral ligaments

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37
Q

What is another term for the MCP joint?

A

The knuckles

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38
Q

Which finger is deemed to be the axis for adduction and abduction of the fingers?

A

The middle finger

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39
Q

Abduction and adduction of the fingers occurs at which joint?

A

The MCP joints

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40
Q

Which muscle is responsible for abduction of the fingers?

A

Dorsal interosseous

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41
Q

Which muscle is responsible for adduction of the fingers?

A

Palmar interosseous

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42
Q

What is the mnemonic to remember which muscles abduct and adduct the fingers?

A

PAD DAB

Palmar Adduct
Dorsal Abduct

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43
Q
A
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44
Q

What type of joint are in the interphalangeal joints?

A

Hinge synovial joints

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45
Q

What reinforces the interphalangeal joints?

A

Collateral and volar (palmar) ligaments

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46
Q

What movement is permitted at the interphalangeal joints?

A

Flexion & extension only

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47
Q
A
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48
Q

How many interphalangeal joints are found in the thumb?

A

1

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49
Q

Which muscles are responsible for flexion of the fingers at the metacarpophalangeal joints?

A

Flexor Digitorum Profundus
Flexor Digitorum Superficialis
Interossei

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50
Q

Which muscles are responsible for flexion of the fingers at the proximal interphalangeal joints? (PIPJs)

A

Flexor Digitorum superficialis

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51
Q

Which muscles are responsible for flexion of the fingers at the distal interphalangeal joints? (DIPJs)

A

Flexor Digitorum Profundus

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52
Q

What is the function of the lumbricals?

A

Flexion of MCPJs and extension of PIPJ & DIPJs.

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53
Q
A
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54
Q

Which are the main muscles which allow extension of the fingers at the MCPJ, PIPJ and DIPJs?

A

Extensor Digitorum
Interossei

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55
Q

Which are the accessory muscles which allow extension of the fingers?

A

Extensor Indicis (Index finger)
Extensor Digiti Minimi

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56
Q

Which muscles are responsible for flexion of the thumb?

A

Flexor Pollicis Brevis - allows flexion at the MCPJ.

Flexor Pollicis Longus - allows flexion at the IPJ.

58
Q

Which muscles are responsible for extension of the thumb?

A

Extensor Pollicis Brevis (proximal joint = MCPJ)

Extensor Pollicis Longus (distal joint = IPJ)

61
Q

Which muscles are responsible for abduction of the thumb?

A

Abductor Pollicis Longus (APL)
Abductor Pollicis Brevis (APB)

64
Q

Which muscle is responsible for adduction off the thumb?

A

Adductor Pollicis

66
Q

What muscle is responsible for opposition of the thumb?

A

Opponens Pollicis

68
Q

How many compartments are there in the hand?

69
Q

Name the compartments of the hand

A

Central
Hypothenar
Thenar (Thumb)
Adductor
Interosseous

70
Q

In this diagram what colour are the following?
- Central compartment
- Hypothenar compartment
- Thenar compartment
- Adductor compartment
- Interosseous compartment

A

Central = Pink
Hypothenar = Blue
Thenar = Orange
Adductor = Purple
Interosseous = Red

71
Q

What are the intrinsic muscles of the hand?

What are they responsible for?

A

Intrinsics = muscles that start and finish in the hand (dont start in the forearm)

Responsible for = precision movement

72
Q

What nerve supplies the intrinsic muscles of the hand? Which are the exceptions to this?

A

Deep branch of ulnar nerve supplies

EXCEPT

Palmaris brevis (superficial ulnar nerve)
&
Thenar Eminence
Lateral 2 Lumbricals (Median nerve)

73
Q

What are the thenar muscles of the hand?

A

Abductor Pollicis Brevis
Flexor Pollicis Brevis
Opponens Pollicis

74
Q

Which nerve supplies the thenar muscles?

A

The median nerve

75
Q

How does the median nerve enter the hand?

A

Through the carpal tunnel

77
Q

What is the thenar eminence?

A

The mound formed at the base of the thumb on the palm of the hand by the intrinsic group of muscles of the thumb.

78
Q

What happens if the median nerve is squashed by carpal tunnel syndrome?

A

Can get wasting of the median eminence due to lack of innervation.

79
Q

What are the muscles of the Hypothenar compartment?

A

Abductor Digiti Minimi
Flexor Digiti Minimi
Opponens Digiti Minimi

80
Q

What is the nerve supply to the Hypothenar muscles?

A

Ulnar nerve

82
Q

What is found in the central compartment of the hand?

A

Long flexor tendons
- Flexor digitorum superficialis
- Flexor digitorum profundus
- Flexor Policis longus

83
Q

What happens to the flexor digitorum superficialis in regards to the flexor digitorum profundus?

A

The FDS is on top - and is shorter - than FDP. FDS splits to allow FDP to pass through it and insert on the distal phalange.

84
Q

Where do the
- Flexor digitiorum superficialis
- Flexor digitorum profundus
Insert?

A

FDS - inserts on the middle phalanx.

FDP insertes on the distal phalanx.

85
Q

Which tendon flexes the distal phalanx?

Which tendon flexes the proximal phalanx?

A

Distal = Flexor digitorum profundus

Proximal = Flexor digitorum superficialis

86
Q

What do FDS, FDP & FPL enter the hand has?

Which compartment do they all originate in?

A

They enter as fibrous sheaths.

Originate from the anterior compartment of the forearm.

88
Q

How many lumbricals do you have in each finger?

89
Q

What is the function of the lumbricals?

A

To flex the metacarpophalangeal joint and to extend the interphalangeal joint.

90
Q

What is the nerve supply of the lumbricals?

A

Medial 2 = Ulnar nerve
Lateral 2 = Median nerve

91
Q

What do lumbricals join?

A

They are the only muscle that doesn’t join a bone (is a tendon to tendon attachment).

Instead they join a flexor tendon from the back of the finger to the extensor tensor.

93
Q

What is the action of the interossei muscles?

A

Adduction and abduction of digits.

Palmar Adduct (PAD)
Dorsal Abduct (DAB)

94
Q

Where are the interossei muscles found?

A

In compartments between the metacarpals.

95
Q

How many interosseous compartments are there?

A

4 Anterior
4 Posterior

96
Q

Which joint do the interosseous muscles act on?

A

The metacarpophalangeal joints

97
Q

What is the nerve supply of the interosseous muscles?

A

Deep branch of the ulnar nerve

99
Q

What is the deepest compartment of the hand?

A

Adductor compartment

100
Q

Which muscle is found in the adductor compartment?

A

Adductor Pollicis

101
Q

What is the action of adductor pollicis?

A

Adducts the thumb &
Aids opposition of the thumb

102
Q

What is the nerve supply of the adductor pollicis muscle?

A

Deep branch of the ulnar nerve

103
Q

Where do the extensor tendons of the hand originate?

A

In the posterior compartment of the forearm

104
Q

What do the extensor tendons pass under as they enter the hand?

A

The extensor retinaculum

105
Q

What is the function of the extensor retinaculum?

A

It is an elastic band across the back of the hand that holds the extensor tendons in place - it stops them bowstringing with extension of the wrist or fingers.

106
Q

Why is it difficult to extend different parts of the finger individually?

A

Due to the extensor hood = travels down the back of the finger attaching to each phalanx - means is difficult to straighten individual parts of the finger.

107
Q

What is the extensor hood made of?

A

Extensor digitorum
Extensor Pollicis Longus
Form triangular aponeurosis over the back of the proximal phalanges

109
Q

What are the boundaries of the anatomical snuffbox?

A

Lateral/anterior = Extensor pollicis brevis & Abductor pollicis longus
Medial/posterior = Extensor pollicis longus

110
Q

What passes through the anatomical snuffbox?

A

The radial artery

113
Q

Which arteries supply the blood to the hand?

A

Radial and ulnar arteries

114
Q

What arches are formed in the hand
- Mainly by the radial artery?
- Mainly by the ulnar artery?

A

Deep palmar arch = radial main supply

Superficial palmar arch = ulnar main supply

116
Q

Which digits are supplied by the ulnar artery?

A

The little, ring, middle & medial 1/2 of the index finger

117
Q

Which digits are supplied by the radial artery?

A

Thumb and lateral 1/2 of the index finger

118
Q

What provides superficial venous drainage to the hand?

A

Dorsal venous network
Cephalic and basilic veins

119
Q

What provides deep venous drainage to the hand?

A

Deep veins = venae commitantes

121
Q

Which nerves innervate the forearm?

A

Radial
Ulnar
Median
Superficial cutaneous

122
Q

Name the following cutaneous nerves of the forearm

123
Q

Where is the ulnar nerve found?

A

Lateral to the pisiform
Medial to the ulnar artery

124
Q

What are the branches of the ulnar nerve?

A

Deep
Superficial

125
Q

What does the deep branch of the ulnar nerve innervate?

A

Motor innervation to -

Adductor pollicis
Interossei
Medial 2 lumbricals

126
Q

What does the superficial branch of the ulnar nerve innervate?

A

Palmaris brevis (motor)

Palmar surface - medial 1.5 digits (sensory)

127
Q

How does the ulnar nerve enter the hand?

A

Through Guyon’s canal - which is next to the ulnar artery, in front of the carpal tunnel

128
Q

What does the superficial nerve provide in terms of innervation?

A

Motor supply for most of the intrinsics of the hand.

130
Q

In which compartment is the median nerve found in the hand?

A

Anterior compartment

131
Q

What are the branches of the median nerve?

A

Recurrent
Palmar digital

132
Q

What does the recurrent branch of the median nerve innervate?

A

Thenar muscles (motor)

133
Q

What does the palmar digital branch of the median nerve innervate?

A

Skin of the lateral 3.5 digits (sensory)
Lateral two lumbricals (motor)

135
Q

Where is the carpal tunnel?

A

The anterior wrist

136
Q

What travels through the carpal tunnel?

A

9 tendons with synovial sheaths
inc
Tendon of flexor pollicis longus
Four tendons of flexor digitorum profundus
Four tendons of flexor digitorum superficialis

Median nerve

137
Q

What are the boundaries of the carpal tunnel?

A

Base (posterior) = Arch of carpal bones

Lateral = Tubercles of scaphoid & trapezium

Medial = Pisiform and hook of hamate

Roof (anterior wall) = Flexor retinaculum

138
Q

What is anterior / superficial to the carpal tunnel?

A

Tendon of flexor carpal radialis (within separate sheath)
Ulnar nerve
Ulnar artery
Tendon of Palmaris Longus

MSK (21 decks)

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