Anatomy of hand and wrist Flashcards
What is the only metacarpal with no distal or proximal IP joint?
1st - thumb
main contributor of superficial palmar arch
ulnar artery
Main contributor of deep palmar arch
radial artery
Where do the superficial veins arise from in the arm?
dorsal venous arch
Cephalic and basilic - median or lateral side
cephalic lateral
basilic median
What vein connects the basilic and cephalic vein across the cubital fossa?
median cubital vein
Lymph nodes which drain the upper limb
axillary
8 flexor muscles of the forearm
pronator teres, FCR, Palmaris longus and FCU
FDS
FDP, FPL and pronator quadratus
nerve supply of brachioradialis
radial nerve
action of the forearm flexors
flex wrist
FCU action on wrist
adducts
FCR action on wrist
abduction
2 muscles responsible for wrist pronation
pronator teres
pronator quadratus
Where does FDS attach?
middle phalanges of digits 2-5
Where does FDP and FPL attach?
distal phalanges
FDS, FDP and FPL action
flex proximal and distal IP joint
forearm flexors actions
extend wrist and digits
ECU action
adducts
ECRL and ECRB action
abduction
supination of wrist
biceps brachii and supinator
extensor digiti minimi and extensor digitorum action
extend fingers, elbow and wrist
3 tendons comprising anatomical snuffbox
EPL
EPB
APL
5 things felt in anatomical snuffbox
radial styloid process radial artery trapezium scaphoid base of 1st metacarpal
what runs in the carpal tunnel?
9 tendons of FDS,FDP and FPL and median nerve
Innervation of hand muscles and exception
ulnar nerve
median nerve - APB, FPB, OPB and lumbricals 1-2
Name the 4 thenar muscles
flexor pollicis brevis
abductor pollicis brevis
adductor pollicis
opponens pollicis
Name the 3 hypothenar muscles
flexor digiti minimi
abductor digiti minimi
opponens digiti minimi
Where do the lumbricals originate?
FDP tendons
Action of lumbricals
flex MCP joint
extend PIP joint
Importance of scaphoid blood supply
retrograde - distal to proximal
more proximal a fracture the more likely AVN
What is used as a landmark for the approach to radius?
FCR
How is palmaris longus tendon and the importance
wrist slightly flexed and oppose thumb to little finger
tendon transfer - autografts
Test FDP
isolate DIPJ in that finger
How to test FDS
take out FDP
hold other fingers down as FDP has common muscle belly
Allens tests
occlude both arteries at wrist and clench until blanched
release ulnar nerve - reperfuse in 15s
When is it useful to do allens test?
before radial artery for repeated ABG or arterial lines
