Anatomy of Hand and Wrist Flashcards
What is the only joint of pronation and supination in the hand and wrist
Radio-ulnar joint
Arteries in the arm (when do they get a new name?)
Subclavian –> axillary at lat. border of 1st rib
Axillary –> brachial at inf. border of teres minor
Brachial –> divdes into radial and ulnar at cubital fossa
Radial & Ulnar –> forms deep and superficial palmar arches, gives of digital artery branches (run down fingers)
Superficial veins in arm
Superficial veins from dorsal venous arch
Cephalic - travels laterally and drains into axillary below clavicle
Basilic - travels medially and becomes continuous with brachial veins
Median cubital vein - connects cephalic and basilica in cubital fossa
Lymphatic drainage of the arms
Right Arm –> right lymphatic duct
Left Arm –> thoracic duct
Glenohumeral joint type and movement
Synovial ball and socket
Flexion - extension
Abduction - adduction
Circumduction
Elbow joint type and movement
Synovial hinge
Flexion - extension
Proximal and distal radioulnar joint type and movement
Synovial pivot
Pronation - supination
Wrist joint type and movement
Synovial condyloid
Flexion - extension
Abduction - adduction
Circumduction
Carpo-metacarpal (1st) joint type and movement
Synovial saddle Flexion - extension Abduction - adduction Circumduction Opposition
Carpo-metacarpal (2-5th) joint type and movement
Synovial condyloid
Flexion - extension
Interphalangeal joint type and movement
Synovial condyloid
Flexion - extension
What muscles are in the superficial layer of the forearm flexors (lateral - medial) and what are their actions
Pronator teres - pronation
Flexor carpi radialis - abduction
Palmaris longus - tightens palmar aponeurosis (flexion)
Flexor carpi ulnaris - adduction
What muscle is in the intermediate layer of the forearm flexors (lateral - medial) and what is its action
Flexor digitorum superficialis - flexes the PIP, MCP and wrist joints
What muscles are in the deep layer of the forearm flexors and what are their actions
Supinator - supination
Flexor Pollicis Longus - flexes thumb phalanges, assists in flexing the wrist when thumb is fixed
Flexor Digitorum Profundus - flexes DIP, PIP, MCP and wrist joints
What muscle is in the distal deep layer of the forearm flexors and what is its action
Pronator quadratus - pronation
What muscles can be found in the posterior compartment and what are their actions
Extensor carpi ulnaris - adduction
Extensor carpi radialis - abduction
Biceps brachi - supination
Supinator - supination
What muscles can be found in the intermediate posterior compartment of the forearm and what are their actions
Extensor digiti minimi - extension of little finger at MCP and IP joints
Extensor digitorum - extends IP (mostly proximal) and wrist joints
What is the carpal tunnel and what does it contain - what causes carpal tunnel syndrome
The carpal tunnel is bound by the flexor retinaculum and the carpal bones and contains 9 tendons (FDS, FDP, FPL) and the median nerve.
If any of the tendons swell or degenerate, the narrowing of the carpal tunnel can lead to the median nerve becoming compressed causing pain in wrist
What nerves innervate muscles in the upper arm
Musculocutaneous nerve - flexors
Radial nerve - extensors
What nerves innervate muscles in the forearm
Flexors - median and ulnar Extensors - radial Brachioradialis - radial Brachialis - radial FCU & FDP (ulnar half) - ulnar
What are the thenar muscles, what is there actions and what are they innervated by
Flexor Pollicis Brevis - median
Abductor Pollicis Brevis - median
Opponens Pollicis - median
Adductor Pollicis - ulnar
What are the hypothenar muscles, what is there actions and what are they innervated by
Flexor digiti minimi - ulnar
Abductor digiti minimi - ulnar
Opponens digiti minimi - ulnar
Action of Interossei
Palmar - adduction
Dorsal - abduction
Action of lumbricals
Simultaneously flex MCP joints and extend PIP joints
Clinical relevance of trapezium
Common site of arthritis
Clinical relevance of scaphoid
Common fracture site and difficult to heal due to its retrograde blood supply (branch from radial a. comes from distal to proximal), means proximal part is prone to avascular necrosis –> poor healing –> arthritis
Borders and Contents of anatomical snuffbox
Borders - EPL, EPB, APL Contents - radial artery - styloid process of radius - trapezium - scaphoid - base of 1st metacarpal
What muscle is used for a landmark in radial fractures
Flexor carpi radialis
What is the palmaris Longus test
Slightly flex wrist, oppose thumb and little finger
How to test flexor digitorum profundus
Only tendon to act on distal IP joint so flex DIPJ
How to test flexor digitorum superficialis
Hold fingers out straight to isolate FDS (FDP also acts on PIPJ) and flex proximal IP joint
What is Allens test
Done before using radial artery for repeated ABGs or arterial lines - shows ulnar nerve can perfuse hand.
Make fist and occlude radial and ulnar arteries. Release ulnar artery. Hand should reperfuse within 5-15 seconds
