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MSK > Anatomy- Hand and Wrist > Flashcards

Anatomy- Hand and Wrist Flashcards

1
Q

what type of joint is the 1st CMC

A

saddle type

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2
Q

what type of joint are the MCPs

A

condyloid

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3
Q

what is flexion, extension, abduction and adduction of the thumb

A

Extension of thumb= thumbs up, flexion back towards fingers. Abducting thumb palms flat facing ceiling, thumb up to ceiling

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4
Q

what muscles are in the thenar eminence

A

abductor pollicis brevis
flexor pollicis brevis
opponens pollicis

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5
Q

what is the innervation of the thenar eminence

A

recurrent branch of the median nerve (affected by carpal tunnel)

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6
Q

what muscles are in the hypothenar eminence

A

abductor digiti minimi
flexor digiti minimi brevis
opponens digiti minimi

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7
Q

what is the innervation of the hypothenar eminence

A

deep branch of the ulnar nerve

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8
Q

what are the muscle groups of the hand

A

lumbricals and interossei

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9
Q

what do the lumbricals do

A

attached to tendons of flexor digitorum profundus

cause flexion of MCP joints and extension of PIP joints

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10
Q

what do the interossei do

A

dorsal- abduction of digits
palmar- adduction of digits
(DAB and PAD)

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11
Q

what is the innervation of the lumbricals

A

lateral 2 = median nerve

medial 2 = ulnar nerve

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12
Q

what is the innervation of the interossei

A

all ulnar nerve

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13
Q

what forms the carpal tunnel

A 
flexor retinaculum (anteriorly) 
carpals (posteriorly)
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14
Q

what are the contents of the carpal tunnel

A

long tendons of the forearm flexor muscles (flexor digitorum superficialis (x4)
flexor digitorum profundus (x4)
flexor pollicis longus (x1))
median nerve

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15
Q

describe the features of carpal tunnel syndrome

A

compression of the median nerve due to swelling in the tunnel

weakness in the thenar muscles
numbness in digits 1-3 and lateral half of digit 4

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16
Q

what is the volar surface

A

the anterior wrists

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17
Q

what are the compartments of the hand

A

central, thenar, hypothenar, adductor, interosseous

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18
Q

what are the spaces of the hand

A 
midpalmar space (posterior to the central compartment)
thenar space (posterior to thenar compartment)
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19
Q

how might deep hand infections spread to the forearm

A

via the midpalmar space into the anterior compartment of the forearm via the carpal tunnel

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20
Q

what is the superficial fascia of the hand

A

ligaments within connecting skin to deep fascia

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21
Q

what are the movements of the thumb

A

flexion, extension, abduction, adduction, opposition

22
Q

what are the different grips of the hand

A

power (fist)
precision (opposition of thumb and index fingers)
hook (carrying bag in fingers)

23
Q

when does optimal power grip occur

A

with wrist joint extended

24
Q

what type of arteries are digital arteries

A

end arteries

25
Q

how does lymph drain from the hands

A

via cubital and axillary nodes

26
Q

what forms the flexor retinaculum

A

the antebrachial (deep) fascia of the anterior forearm thickens distally- firstly as the palmar carpal ligament (at wrist joint) then distally and deeper as the flexor retinaculum

27
Q

what is the transverse carpal ligament

A

the flexor retinaculum

28
Q

where does the flexor retinaculum attach

A

to the scaphoid/ trapezoid laterally and the pisiform and hamate medially

29
Q

what is the role of the flexor retinaculum

A

prevents bowstringing of the tendons during flexion which would reduce muscle efficiency

30
Q

what fuses with and strengthens the flexor retinaculum

A

the distal tendon of palmaris longus

31
Q

why is the centre of the palm unaffected by carpal tunnel syndrome

A

as the palmar cutaneous branch of the median nerve is given off proximal to the tunnel and travels superficially to reach the skin of the palm

32
Q

what are the two branches of the radial nerve

A

superficial and deep

33
Q

how is the superficial palmar arch formed and where

A

The superficial palmar branch of the ulnar artery anastomoses with the superficial palmar branch of the radial artery

immediately deep to the palmar aponeurosis

34
Q

what does the deep branch of the radial artery do

A

forms the deep palmar arch by anastomosing with the deep branch of the unlar artery

35
Q

where does the deep palmar arch gi

A

runs across the anterior aspects of the bases of the metacarpals

36
Q

what is dupuytrens contracture

A

pathology affecting the palmar fascia. It causes thickening and shortening (contracture) leading to fixed flexion deformities of, in particular, the ring and little fingers.

37
Q

what does each finger have nerve supply wise

A

4 neurovascular bundles: medial palmar, lateral palmar, medial dorsal, lateral dorsal

38
Q

what is ring block

A

involves depositing local anaesthetic in a “ring” around the base of the finger to anaesthetise all four proper digital nerves. Suturing or minor surgery can then be performed painlessly distal to the block.

39
Q

what does the ulnar nerve supply in the palmar aspect

A

medial part of palm
little finger
medial half of ring finger

40
Q

what does the median nerve supply in the palmar aspect

A

central/ lateral palm
lateral half of the ring finger
middle and index finger
thumb (excluding skin over the base)

41
Q

what does the radial nerve supply in the palmar aspect

A

skin over the base of the thummb

42
Q

what are the fibrous digital sheaths continuous with

A

the longitudinal digital bands of the palmar aponeurosis

43
Q

where do the fibrous digital sheaths attach

A

to both sides of the phalanges

44
Q

what is the role of the fibrous digital sheaths

A

from a secure tunnel through which the FDS, FDP, FPL and their synovial sheaths travel distally

45
Q

where do the tendons of FDS, FDP and FPL attach

A

FDS middle phalanges

FDP and FPL distal phalages

46
Q

what does tenderness in the floor of the anatomical snuffbox following trauma suggest

A

scaphoid fracture

47
Q

what does the median nerve supply in the dorsal aspect

A

skin over distal phalanges/ nail beds of thumb, index, middle and ring finger

48
Q

what does the ulnar nerve supply in the dorsal aspect

A

medial part of the dorsum of the hand
little finger
medial half of ring finger

49
Q

how many lumbricals are there

A

4- one for each finger

50
Q

where do the lumbricals attach

A

between the FDP tendon and the extensor expansion of the same digit

51
Q

what do the lumbricals span

A

the anterior aspect of the 2nd to 5th MCP joints and then the posterior aspect of the 2nd to 5th PIP joints

52
Q

what is the median plane of the hand

A

runs through the midline of the middle finger (fingers abd/ adduct from/ to this)

MSK (71 decks)

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