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UdeM PS questions > Anatomie 3 (membre supérieur) > Flashcards

Anatomie 3 (membre supérieur) Flashcards

1
Q

Retaining ligaments of fingers and position

A

Grayson: Volar and transverse, palmar to neurovasc bundle (brevents bowstringing during flexion)

Cleland: dorsal, passes from junction of periosteum and flexor tendon sheath to skin

Transverse retinacular ligament: radial and ulnar to PIP, superficial to collateral ligaments, prevents dorsal displacement of lateral bands

Oblique retinacular ligament (Of Landsmeer): from volar P2 to dorsal P3, coordinates PIP and DIP joint motion

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2
Q

Deep fascial spaces of hand

A

Midpalmar space
Thenar space
Hypothenar space
Interdigital web space
Parona’s space (at wrist)

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3
Q

Extensor compart of wrist

A

1: APL, EPB
2: ECRL, ECRB
3: EPL
4: EDC and EIP
5: EDM
6: ECU

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4
Q

Position of EPL in at the level of the extensor retinaculum

A

Ulnar to Listers tubercule

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5
Q

Position of EIP and EDM relative to EDC

A

Both ulnar to EDC

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6
Q

Name of connections between EDC tendons

A

Juncturae tendinum

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7
Q

Extensor zones

A

1: DIP
2: P2
3: PIP
4: P1
5: MCP
6: MC
7: wrist
8: distal 1/3 forearm
9: proximal 2/3 forearm

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8
Q

Thumb extensor zones

A

1: over IP
2: over P1
3: over MCP
4: over MC
5: over carpal bones

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9
Q

Flexor tendon zones

A

Zone 1: distal to FDS insertion
Zone 2: distal to A1
Zone 3: distal to carpal tunnel
Zone 4: above carpal tunnel
Zone 5: proximal to carpal tunnel

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10
Q

Zones of thumb flexor tendon

A

Zone T1: Distal to IP joint
Zone T2: distal to A1 pulley
T3: Over thenar eminence
T4: Carpal tunnel
T5: Proximal to carpal tunnel

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11
Q

Thumb pulleys

A

A1 and A2 over MCP and IP
Oblique pulley is between both/P1 (most important to prevent bowstringing) run proximal ulnar to distal radial

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12
Q

Which is the most important pulley in the thumb

A

Oblique pulley

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13
Q

Name the two pathway of tendon healing and identify which one causes adhesions

A

Intrinsic pathway (proliferation of tenocytes)
Extrinsic pathway (invasion of cells from tendon sheath)(adhesions)

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14
Q

Anomalous interconnections in forearm

A

Martin-Gruber anastomosis
Riche Cannieu anastomosis

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15
Q

Describ Martin-Gruber anastomosis
Prevalence
Relevance clinically

A

Motor fiber connection between medial to ulnar nerve in forearm

Affects 10-25% population

Can cause preserved ulnar nerve motor function in the hand after high ulnar injury

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16
Q

Describ RicHe-Cannieu anastomosis

Relevance clinically

A

Motor fiber connection from ulnar to median nerve in Hand

Common

Can result in preserved thenar motor function after median nerve injury

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17
Q

Describe Marinacci anastomoses

A

Rare anomalous intercommunication from the ulnar nerve to the median nerve in the forearm

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18
Q

What are the dominant arteries for each finger

A

D1: UDA
D2: UDA
D3: UDA
D4: RDA
D5: RDA

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19
Q

Define Vincula

A

Fold of mesotenon in tendon sheath that anchors tendon to bone and contains receive direct blood supply from transverse digital arteries

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20
Q

Name and identify the location of the three volar communicating branch of the digital arteries and the associated vinculum

A

Proximal transverse palmar arch, proximal to PIP, gives vineculum longum profundus and vineculum brevis superficialis

Middle transverse palmar arch, proximal to DIP, gives vineculum brevis profondus

Distal transverse palmar arch at the level of the lanula

There is also a vinculum longus superficialis proximal P1 from direct branch of proper digital artery

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21
Q

Name a specialized neuromyoarterial receptor in fingertip and its clinical application

A

Glomus body

Functions to control blood pressure and thermoregulation

Can give rise to painful glomus body tumor

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22
Q

Structure comprise dans la perionychium (4)

A

Nail fold
Nail plate
Nail bed
Hyponychium

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23
Q

Define Hyponychium

A

Junction sterile matrix of nail bed and skin beneath distal nail margin

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24
Q

Define paronychium

A

skin on each side of the nail/lateral nail fold

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25
Q

Define eponychium

A

Skin proximal to nail that covers nail fold

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26
Q

Why is the lanula white

A

due to persistance of nail cell nuclei in the germinal matrix

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27
Q

Difference between germinal and sterile matrix and specific localisation of each

A

Germinal: proximal to lanula, distal to extensor tendon, reponsible for 90% of nail production

Sterile: nail bed distal to lanula, responsible for nail plate adherence, secondary site of nail production

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28
Q

3 location of nail growth

A

1) germinal matrix
2) sterile matrix
3) dorsal roof of nail fold

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29
Q

How/through which machanism does the germinal matrix produce the nail

A

gradient parakeratosis

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30
Q

Rate of nail growth and time to grow a complete nail

A

Rate: 3-4mm/month

100 days

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31
Q

4 conditions that increase speed of nail growth

A

Longer digit
Summer months
Young person
Nail bitters

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32
Q

2 components of nail fold

A

1) ventral floor: germinal matrix
2) dorsal roof: host cells that cause nail shine

33
Q

quel % de la population a une arcade palmaire superficielle provenant seulement de l’artère ulnaire

34
Q

quel % de la population a une arcade palmaire superficielle parfaitement communicante radiale-ulnaire

35
Q

quel % de la population a une arcade palmaire superficielle provenant de l’artère ulnaire + médiane + radiale

36
Q

quel % de la population n’a pas de communication entre art radiale et ulnaire au niveau de l’arcade palmaire superficielle (vascularisation des doigts séparément, PAS d’arcade proprement dite)

37
Q

quel % de la population a les 3 artères (R + U + M) qui vascularise les doigts séparément SANS communication en arcade palmaire superficielle

38
Q

quel % de la population a:
-communication radio-ulnaire typique de l’arcade palmaire profonde

39
Q

Différence des muscles bellies of FDS and FDP

A

FDP: common muscle belly (except D2 which is separated)

FDS: individual muscle belly

40
Q

Arrangement of flexor tendons in carpal tunnel

A

FDS: D3 and D4 at superficial to D2 and D5
FDP is deep

41
Q

Innervation of FDP tendon

A

D2 and D3: AIN
D4 and D5: Ulnar nerve

42
Q

Configeration, origin, insertion, innervation and action of lumbricals

A

D2 and D3: unipennate, origin from radial side FDP, insert extensor expansion hood (radial lateral band), median nerve

D4 and D5: bipennate, origin from radial and ulnar side FDP, insert extensor expansion hood (radial lateral band), ulnar nerve

Action: main extensor of IP, weak flexor of MCP

43
Q

Name structure of extensor hood

A

Proximal: sagital bands, lateral bands

Central slip

Distal: oblique retinacular ligament, triangular ligament

44
Q

Accessory head of FPL name, origin and associated complication

A

Gantzer muscle

Origin: medial epicondyle and coronoid process of ulna

AIN compressive neuropathy

45
Q

Explain location or annular and cruciate pulleys

A

A1: MCP
A2: P1
C1: proximal to PIP
A3: PIP
C2: distal to PIP
A4: P2
C3: proximal to DIP
A5: DIP

46
Q

Most important pulleys and why

A

A2 and A4 pulleys

Prevents bowstringing the most

47
Q

What makes up the A0 pulley (2)

A

Transverse fibers of palmar aponeurosis

Vertical septa of Legeu and Juvara

48
Q

3 structure the makes a tendon

A

Endotenon (inner)
Epitenon (outer)
Paratenon (most outer)

49
Q

2 mechanism for tendon vascular supply, which is dominant

A

1: Direct vascular supply
2. Synovial diffusion (dominant)

50
Q

What are the 3 source of direct vascular supply to tendon, and localisation relative to the tendon

A

Myotendinous junction (proximal tendon)
Osteotendinous junction (distal tendon)
Connective tissues (mid tendon)

51
Q

3 connective tissue structures that vascularise the tendon

A

Paratenon
Mesotenon
Vincula

52
Q

% of population that does not have D5 FDS

53
Q

Name and describe the variant connection between hand flexor tendons and its incidence

A

Linburg-Comstock variant

Between FPL muscle belly/tendon and FDP D2

8-35% of population

54
Q

Palmar interossei, # of units, bi vs unipennate, insertion, action, innervation

A

3 units
unipennate
Inserts on lateral bands
Adducts, flex MCP, extend IP
Ulnar nerve

55
Q

Dorsal interossei, # of units, bi vs unipennate, insertion, action, innervation

A

4 units
bipennate
Inserts on lateral bands
Abducts, flex MCP, extend IP
Ulnar nerve

56
Q

Sagital bands: origin and insertion and function (2)

A

Origin from intermetacarpal plate and insert on dorsal hood above MCP

Prevent lateral subluxation of extensor tendons, prevents MCP joint hyperextension

57
Q

Name 3 anomalous extensor muscle and their implication

A

Extensor carpi radialis intermedius (can be used in tendon transfer)

Extension medii proprius
Independent extensor of middle finger (can be used for sagital bands injuries)

Extensor digitorus, brevis manus, often between 2nd and 3rd metacarpal

58
Q

Structure of nerve from outside to inside (6)

A

Mesoneurium (loose areolar tissue)
Epineurium–> recouvre nerf principal
Perineurium –> recouvre fascicule
Endoneurium–> recouvre axones

59
Q

Blood supply of nerves (3)

A

Vasa nervorum
Extrinsic vessels
Capillary plexus

60
Q

À quoi sert un nœud de Ranvier?

A
  • Gap junctions de Cellules de Schwann
  • Conduction saltatoire
  • Plus rapide
61
Q

Nommer les structures innervées par le AIN

A

FDP D2D3
FPL
PQ
articulation radiocarp et radioulnaire

62
Q

Définir la ligne de Kaplan

A

Ligne reliant le 1er webspace et le crochet de l’hamatum

63
Q

Quelles structures anatomiques retrouve-t-on a/n de la ligne de Kaplan

A

-Arcade palamaire profonde
-Rebord distal du ligament transverse du carpe
- branche récurrente n. médian

64
Q

Comment repérer anatomiquement la branche récurrente du nerf médian

A

Jonction entre la ligne de kaplan et une ligne suivant l’axe du bord radial du majeur

65
Q

Comment localiser anatomiquement l’arcade palmaire superficielle

A

Tout juste proximal à une ligne reliant le distal et proximal transverse palmar crease

66
Q

2 muscles responsables de la rotation externe de l’épaule

A

Infraépineux
Teres minor

67
Q

4 muscles responsables de la rotation interne de l’épaule

A

Teres major
Subscapularis
Latissimus dorsi
Pectoralis major

68
Q

Principal muscle responsable de stabiliser la scapula

A

Serratus antérieur

69
Q

Quel nerf innerve:
serratus antérieur

A

long thoracique

70
Q

Quel nerf innerve: muscle rhomboid major et minor

A

scapulaire dorsal

71
Q

Quel nerf innerve: muscle supra et infra épineux

A

suprascapulaire

72
Q

Quel nerf innerve: muscle subscapularis

A

upper subscapular
lower subscapular

73
Q

Quel nerf innerve: muscle teres major

A

Lower subscapular

74
Q

Quel nerf innerve: latissimus dorsi

A

thoracodorsal

75
Q

Quel nerf innerve: pec major et minor

A

pectoral médial
pectoral latéral

76
Q

Quel nerf innerve: muscle deltoide

77
Q

Quel nerf innerve: muscle teres minor

78
Q

3 muscles innervés par le n. musculocutané

A

Coracobrachialis
Biceps brachial
Brachialis

UdeM PS questions (52 decks)

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