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Year 2 Medicine > Anatomy of the Hand > Flashcards

Anatomy of the Hand Flashcards

1
Q

Skeleton of the Hand

  • Label the diagram
A
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2
Q

Carpal bones

  • The carpal bones are a group of eight, irregularly shaped bones. They are organised into two rows: proximal and distal.
    • Proximal (Lateral to medial): …, Lunate, …, Pisiform (a … bone, formed within the tendon of the flexor carpi ulnaris)
    • Distal (Lateral to medial): Trapezium, Trapezoid, Capitate, Hamate (has a projection on its palmar surface, known as the ‘hook of hamate’
A
  • The carpal bones are a group of eight, irregularly shaped bones. They are organised into two rows: proximal and distal.
    • Proximal (Lateral to medial): Scaphoid, Lunate, Triquetrum, Pisiform (a sesamoid bone, formed within the tendon of the flexor carpi ulnaris)
    • Distal (Lateral to medial): Trapezium, Trapezoid, Capitate, Hamate (has a projection on its palmar surface, known as the ‘hook of hamate’
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3
Q

Carpal bones

  • The carpal bones are a group of eight, irregularly shaped bones. They are organised into two rows: proximal and distal.
    • Proximal (Lateral to medial): Scaphoid, …, Triquetrum, … (a sesamoid bone, formed within the tendon of the flexor carpi ulnaris)
    • Distal (Lateral to medial): …, Trapezoid, Capitate, Hamate (has a projection on its palmar surface, known as the ‘hook of hamate’)
A
  • The carpal bones are a group of eight, irregularly shaped bones. They are organised into two rows: proximal and distal.
    • Proximal (Lateral to medial): Scaphoid, Lunate, Triquetrum, Pisiform (a sesamoid bone, formed within the tendon of the flexor carpi ulnaris)
    • Distal (Lateral to medial): Trapezium, Trapezoid, Capitate, Hamate (has a projection on its palmar surface, known as the ‘hook of hamate’)
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4
Q

Carpal bones

  • The carpal bones are a group of eight, irregularly shaped bones. They are organised into two rows: proximal and distal.
    • Proximal (Lateral to medial): Scaphoid, Lunate, Triquetrum, Pisiform (a sesamoid bone, formed within the tendon of the flexor carpi ulnaris)
    • Distal (Lateral to medial): Trapezium, …, Capitate, … (has a projection on its palmar surface, known as the ‘hook of hamate’
A
  • The carpal bones are a group of eight, irregularly shaped bones. They are organised into two rows: proximal and distal.
    • Proximal (Lateral to medial): Scaphoid, Lunate, Triquetrum, Pisiform (a sesamoid bone, formed within the tendon of the flexor carpi ulnaris)
    • Distal (Lateral to medial): Trapezium, Trapezoid, Capitate, Hamate (has a projection on its palmar surface, known as the ‘hook of hamate’
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5
Q

Carpal bones

  • The carpal bones are a group of eight, irregularly shaped bones. They are organised into two rows: … and ….
    • … (Lateral to medial): Scaphoid, Lunate, Triquetrum, Pisiform (a sesamoid bone, formed within the tendon of the flexor carpi ulnaris)
    • … (Lateral to medial): Trapezium, Trapezoid, Capitate, Hamate (has a projection on its palmar surface, known as the ‘hook of hamate’
A
  • The carpal bones are a group of eight, irregularly shaped bones. They are organised into two rows: proximal and distal.
    • Proximal (Lateral to medial): Scaphoid, Lunate, Triquetrum, Pisiform (a sesamoid bone, formed within the tendon of the flexor carpi ulnaris)
    • Distal (Lateral to medial): Trapezium, Trapezoid, Capitate, Hamate (has a projection on its palmar surface, known as the ‘hook of hamate’
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6
Q

Label the carpal bones

A
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7
Q

Label the carpal bones

A
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8
Q

Label the carpal bones

A
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9
Q

Label the carpal bones

A
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10
Q

What is the most commonly fractured carpal bone?

A

Scaphoid bone - slow recovery - poor blood supply to proximal part: avascular necrosis

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11
Q

Clinical: Fracture of … bone (Carpal bone) is common (slow recovery - poor blood supply to proximal part: avascular necrosis)

A

Clinical: Fracture of scaphoid bone is common (slow recovery - poor blood supply to proximal part: avascular necrosis)

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12
Q

Joints of the hand

  • … (wrist joint)
  • Midcarpal/Intercarpal
  • … (between distal carpal and metacarpal)
    • Most prominent - between trapezium and first metacarpal - … joint
  • Metacarpophalangeal - between metacarpals and proximal phalanges
  • Interphalangeal - between phalanges
A
  • Radiocarpal (wrist joint)
  • Midcarpal/Intercarpal
  • Carpometacarpal (between distal carpal and metacarpal)
    • Most prominent - between trapezium and first metacarpal - saddle joint
  • Metacarpophalangeal - between metacarpals and proximal phalanges
  • Interphalangeal - between phalanges
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13
Q

Name the carpal bones (proximal vs distal)

A
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14
Q

Label the carpal bones

A
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15
Q

Proximally, the … and … articulate with the radius to form the wrist joint (also known as the ‘radio-carpal joint’). In the distal row, all of the carpal bones articulate with the metacarpals.​

A

Proximally, the scaphoid and lunate articulate with the radius to form the wrist joint (also known as the ‘radio-carpal joint’). In the distal row, all of the carpal bones articulate with the metacarpals.​

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16
Q

Collectively, the carpal bones form an … in the coronal plane. A membranous band, the flexor …, spans between the medial and lateral edges of the arch, forming the carpal tunnel.

A

Collectively, the carpal bones form an arch in the coronal plane. A membranous band, the flexor retinaculum, spans between the medial and lateral edges of the arch, forming the carpal tunnel.

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17
Q

Joints of the hand

  • Radiocarpal (wrist joint)
  • Midcarpal/Intercarpal
  • Carpometacarpal (between distal carpal and metacarpal)
    • Most prominent - between … and first metacarpal - saddle joint
  • … - between metacarpals and proximal phalanges
  • … - between phalanges
A
  • Radiocarpal (wrist joint)
  • Midcarpal/Intercarpal
  • Carpometacarpal (between distal carpal and metacarpal)
    • Most prominent - between trapezium and first metacarpal - saddle joint
  • Metacarpophalangeal - between metacarpals and proximal phalanges
  • Interphalangeal - between phalanges
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18
Q

Wrist (Radiocarpal) Joint

  • ​… joint between radius + disc and first carpal row
  • Reinforced by ligaments
    • Ulnar and radial … ligaments (limits abduction/adduction)
    • Ligaments on the palmar/dorsal surfaces (limits extension/flexion)
  • … ligaments originate from styloid processes (radial or ulnar) and extent to either scaphoid tubercle (Radial) or triquetral (ulnar), ligaments on palmar/dorsal also originate from styloid processes
  • We can flex, extend, abduct, adduct at wrist joint (all together - circumduction)
A
  • ​Synovial joint between radius + disc and first carpal row
  • Reinforced by ligaments
    • Ulnar and radial collateral ligaments (limits abduction/adduction)
    • Ligaments on the palmar/dorsal surfaces (limits extension/flexion)
  • Collateral ligaments originate from styloid processes (radial or ulnar) and extent to either scaphoid tubercle (Radial) or triquetral (ulnar), ligaments on palmar/dorsal also originate from styloid processes
  • We can flex, extend, abduct, adduct at wrist joint (all together - circumduction)
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19
Q

Wrist (Radiocarpal) Joint

  • ​… joint between radius + disc and first carpal row
  • Reinforced by ligaments
    • Ulnar and radial collateral ligaments (limits …/…)
    • Ligaments on the palmar/dorsal surfaces (limits …/…)
  • Collateral ligaments originate from styloid processes (radial or ulnar) and extent to either scaphoid tubercle (Radial) or triquetral (ulnar), ligaments on palmar/dorsal also originate from styloid processes
  • We can flex, extend, abduct, adduct at wrist joint (all together - circumduction)
A
  • ​Synovial joint between radius + disc and first carpal row
  • Reinforced by ligaments
    • Ulnar and radial collateral ligaments (limits abduction/adduction)
    • Ligaments on the palmar/dorsal surfaces (limits extension/flexion)
  • Collateral ligaments originate from styloid processes (radial or ulnar) and extent to either scaphoid tubercle (Radial) or triquetral (ulnar), ligaments on palmar/dorsal also originate from styloid processes
  • We can flex, extend, abduct, adduct at wrist joint (all together - circumduction)
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20
Q

Wrist (Radiocarpal) Joint

  • ​… joint between radius + disc and first carpal row
  • Reinforced by ligaments
    • Ulnar and radial collateral ligaments (limits abduction/adduction)
    • Ligaments on the palmar/dorsal surfaces (limits extension/flexion)
  • Collateral ligaments originate from … processes (radial or ulnar) and extent to either scaphoid tubercle (Radial) or triquetral (ulnar), ligaments on palmar/dorsal also originate from … processes
  • We can flex, extend, abduct, adduct at wrist joint (all together - …)
A
  • ​Synovial joint between radius + disc and first carpal row
  • Reinforced by ligaments
    • Ulnar and radial collateral ligaments (limits abduction/adduction)
    • Ligaments on the palmar/dorsal surfaces (limits extension/flexion)
  • Collateral ligaments originate from styloid processes (radial or ulnar) and extent to either scaphoid tubercle (Radial) or triquetral (ulnar), ligaments on palmar/dorsal also originate from styloid processes
  • We can flex, extend, abduct, adduct at wrist joint (all together - circumduction)
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21
Q

What movements can the wrist (radiocarpal) joint make?

A

flexion/extension, abduction/adduction, circumduction

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22
Q

Carpometacarpal joints

  • … joints - Limited movement
  • Except for the … joint (between trapezium and metacarpal of d1)
    • Enables opposition
  • Movements of the thumb: extension, flexion, abduction, adduction, opposition, reposition
A
  • Plane joints - Limited movement
  • Except for the saddle joint (between trapezium and metacarpal of d1)
    • Enables opposition
  • Movements of the thumb: extension, flexion, abduction, adduction, opposition, reposition
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23
Q

Carpometacarpal joints

  • Plane joints - Limited movement
  • Except for the saddle joint (between … and metacarpal of d1)
    • Enables …
  • Movements of the thumb: extension, flexion, abduction, adduction, opposition, reposition
A
  • Plane joints - Limited movement
  • Except for the saddle joint (between trapezium and metacarpal of d1)
    • Enables opposition
  • Movements of the thumb: extension, flexion, abduction, adduction, opposition, reposition
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24
Q

Carpometacarpal joints

  • Plane joints - Limited movement
  • Except for the saddle joint (between trapezium and metacarpal of …)
    • Enables opposition
  • Movements of the thumb: (6)
A
  • Plane joints - Limited movement
  • Except for the saddle joint (between trapezium and metacarpal of d1)
    • Enables opposition
  • Movements of the thumb: extension, flexion, abduction, adduction, opposition, reposition
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25
Q

Movements of the thumb (6)

A

Movements of the thumb: extension, flexion, abduction, adduction, opposition, reposition

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26
Q

Metacarpophalangeal joints

  • … joints
  • Between metacarpals and proximal phalanges
  • Movements:
    • Flexion/extension
    • Abduction/adduction - all relative to digit 3
  • Deep transverse metacarpal ligaments - unifies metacarpals (holds them together) but not between D1 and D2
A
  • Condylar joints
  • Between metacarpals and proximal phalanges
  • Movements:
    • Flexion/extension
    • Abduction/adduction - all relative to digit 3
  • Deep transverse metacarpal ligaments - unifies metacarpals (holds them together) but not between D1 and D2 - allows opposition
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27
Q

Metacarpophalangeal joints

  • Condylar joints
  • Between … and … phalanges
  • Movements:
    • Flexion/extension
    • Abduction/adduction - all relative to digit …
  • Deep transverse metacarpal ligaments - unifies metacarpals (holds them together) but not between D1 and D2
A
  • Condylar joints
  • Between metacarpals and proximal phalanges
  • Movements:
    • Flexion/extension
    • Abduction/adduction - all relative to digit 3
  • Deep transverse metacarpal ligaments - unifies metacarpals (holds them together) but not between D1 and D2 - allows opposition
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28
Q

Metacarpophalangeal joints

  • Condylar joints
  • Between metacarpals and proximal phalanges
  • Movements:
    • Flexion/extension
    • Abduction/adduction - all relative to digit 3
  • … … metacarpal ligaments - unifies metacarpals (holds them together) but not between D1 and D2
A
  • Condylar joints
  • Between metacarpals and proximal phalanges
  • Movements:
    • Flexion/extension
    • Abduction/adduction - all relative to digit 3
  • Deep transverse metacarpal ligaments - unifies metacarpals (holds them together) but not between D1 and D2 - allows opposition
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29
Q

Metacarpophalangeal joints

  • … joints
  • Between metacarpals and proximal phalanges
  • Movements:
    • Flexion/extension
    • Abduction/adduction - all relative to digit 3
  • Deep transverse metacarpal ligaments - unifies metacarpals (holds them together) but not between … and ….
A
  • Condylar joints
  • Between metacarpals and proximal phalanges
  • Movements:
    • Flexion/extension
    • Abduction/adduction - all relative to digit 3
  • Deep transverse metacarpal ligaments - unifies metacarpals (holds them together) but not between D1 and D2 - allows opposition of thumb
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30
Q

Interphalangeal joints

  • … joints
  • Between …
  • Only one in thumb, two in digits 2,3,4,5
    • PIPs - proximal interphalangeal joints
    • DIPs - distal interphalangeal joints
A
  • Hinge joints
  • Between phalanges
  • Only one in thumb, two in digits 2,3,4,5
    • PIPs - proximal interphalangeal joints
    • DIPs - distal interphalangeal joints
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31
Q

Interphalangeal joints

  • Hinge joints
  • Between phalanges
  • Only one in …, two in …
    • PIPs - proximal interphalangeal joints
    • DIPs - distal interphalangeal joints
A
  • Hinge joints
  • Between phalanges
  • Only one in thumb, two in digits 2,3,4,5
    • PIPs - proximal interphalangeal joints
    • DIPs - distal interphalangeal joints
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32
Q

Interphalangeal joints

  • Hinge joints
  • Between phalanges
  • Only one in thumb, two in digits 2,3,4,5
    • PIPs - … interphalangeal joints
    • DIPs - … interphalangeal joints
A
  • Hinge joints
  • Between phalanges
  • Only one in thumb, two in digits 2,3,4,5
    • PIPs - proximal interphalangeal joints
    • DIPs - distal interphalangeal joints
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33
Q

Palmar aponeurosis

  • … deep fascia
  • Triangular shape
  • Continuous with palmaris longus
A
  • Thickened deep fascia
  • Triangular shape
  • Continuous with palmaris longus
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34
Q

Palmar aponeurosis

  • … deep fascia
  • Triangular shape
  • Continuous with … …
A
  • Thickened deep fascia
  • Triangular shape
  • Continuous with palmaris longus
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35
Q

What is Dupuytren’s contracture?

A

Can’t straighten (usually) D4 and D5 - fibrosis of longitudinal fibres of palmar aponeurosis

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36
Q

Long flexor tendons to digits

  • From muscles in … forearm
  • Pass through … tunnel
A
  • From muscles in anterior forearm
  • Pass through carpal tunnel
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37
Q

Long flexor tendons to digits

  • From muscles in anterior forearm
  • Pass through … tunnel
  • Flexor … (Transverse carpal ligament - prevents bowing of tendons)
    • Flexor digitorum superficialis (D2-D5)
    • Flexor digitorum profundus (D2-5)
    • Flexor pollicis longus (D1)
A
  • From muscles in anterior forearm
  • Pass through carpal tunnel
  • Flexor retinaculum (Transverse carpal ligament - prevents bowing of tendons)​
    • Flexor digitorum superficialis (D2-D5)
    • Flexor digitorum profundus (D2-5)
    • Flexor pollicis longus (D1)
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38
Q

Long flexor tendons to digits

  • From muscles in anterior forearm
  • Pass through … tunnel
  • Flexor … (Transverse carpal ligament - prevents bowing of tendons)
    • Flexor digitorum superficialis (D…-D…)
    • Flexor digitorum profundus (D…-…)
    • Flexor pollicis longus (D…)
A
  • From muscles in anterior forearm
  • Pass through carpal tunnel
  • Flexor retinaculum (Transverse carpal ligament - prevents bowing of tendons)​
    • Flexor digitorum superficialis (D2-D5)
    • Flexor digitorum profundus (D2-5)
    • Flexor pollicis longus (D1)
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39
Q

What passes through the carpal tunnel? (tendons and nerve)

A

The carpal tunnel contains nine tendons: the flexor pollicis longus, the four flexor digitorum superficialis and the four flexor digitorum profundus as well as the median nerve.

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40
Q

These are showing the … tendons to digits

A

long flexor tendons to digits

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41
Q

Long flexor tendons to digits

  • Label the diagram
A
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42
Q

Long flexor tendons to digits

  • Label the diagram
A
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43
Q

Long flexor tendons to digits

  • Label the diagram
A
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44
Q

Flexor tendon insertions

  • The long flexor tendons of the fingers arise from the flexor digitorum superficialis (FDS) and flexor digitorum profundus (FDP) forearm muscles
  • These tendons enter the hand via the carpal tunnel, enclosed in a common … sheath.
  • Within the hand, the tendons fan out and enter their respective … flexor sheaths. These sheaths are strong ligamentous tunnels, each associated with a digit.
  • At the base of the proximal phalanx, the FDS tendon splits into two – with the FDP tendon passing between them. The split FDS tendons attach to the base of the middle phalanx, whilst the FDP tendon attaches to the base of the distal phalanx
A
  • The long flexor tendons of the fingers arise from the flexor digitorum superficialis (FDS) and flexor digitorum profundus (FDP) forearm muscles
  • These tendons enter the hand via the carpal tunnel, enclosed in a common synovial sheath.
  • Within the hand, the tendons fan out and enter their respective fibrous flexor sheaths. These sheaths are strong ligamentous tunnels, each associated with a digit.
  • At the base of the proximal phalanx, the FDS tendon splits into two – with the FDP tendon passing between them. The split FDS tendons attach to the base of the middle phalanx, whilst the FDP tendon attaches to the base of the distal phalanx
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45
Q

Flexor tendon insertions

  • The long flexor tendons of the fingers arise from the flexor digitorum superficialis (FDS) and flexor digitorum profundus (FDP) forearm muscles
  • These tendons enter the hand via the carpal tunnel, enclosed in a common synovial sheath.
  • Within the hand, the tendons fan out and enter their respective fibrous flexor sheaths. These sheaths are strong ligamentous tunnels, each associated with a digit.
  • At the base of the proximal phalanx, the FDS tendon splits into two – with the FDP tendon passing between them. The split FDS tendons attach to the base of the … phalanx, whilst the FDP tendon attaches to the base of the … phalanx
A
  • The long flexor tendons of the fingers arise from the flexor digitorum superficialis (FDS) and flexor digitorum profundus (FDP) forearm muscles
  • These tendons enter the hand via the carpal tunnel, enclosed in a common synovial sheath.
  • Within the hand, the tendons fan out and enter their respective fibrous flexor sheaths. These sheaths are strong ligamentous tunnels, each associated with a digit.
  • At the base of the proximal phalanx, the FDS tendon splits into two – with the FDP tendon passing between them. The split FDS tendons attach to the base of the middle phalanx, whilst the FDP tendon attaches to the base of the distal phalanx
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46
Q

Flexor tendon insertions

  • The long flexor tendons of the fingers arise from the flexor digitorum superficialis (FDS) and flexor digitorum profundus (FDP) forearm muscles
  • These tendons enter the hand via the carpal tunnel, enclosed in a common synovial sheath.
  • Within the hand, the tendons fan out and enter their respective fibrous flexor sheaths. These sheaths are strong ligamentous tunnels, each associated with a digit.
  • At the base of the proximal phalanx, the FDS tendon splits into two – with the FDP tendon passing between them. The split FDS tendons attach to the base of the middle phalanx, whilst the FDP tendon attaches to the base of the distal phalanx
A
  • The long flexor tendons of the fingers arise from the flexor digitorum superficialis (FDS) and flexor digitorum profundus (FDP) forearm muscles
  • These tendons enter the hand via the carpal tunnel, enclosed in a common synovial sheath.
  • Within the hand, the tendons fan out and enter their respective fibrous flexor sheaths. These sheaths are strong ligamentous tunnels, each associated with a digit.
  • At the base of the proximal phalanx, the FDS tendon splits into two – with the FDP tendon passing between them. The split FDS tendons attach to the base of the middle phalanx, whilst the FDP tendon attaches to the base of the distal phalanx
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47
Q

Fibrous digitial sheath is formed of alternating fibrous … ligaments and … ligaments

A

Fibrous digitial sheath is formed of alternating fibrous annular ligaments and cruciate ligaments

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48
Q

Annular ligaments within fibrous digital sheath are also referred to as …

A

Annular ligaments within fibrous digital sheath are also referred to as A1-A5 pulley’s

49
Q

Long extensor tendons to digits

  • From muscles in … forearm
  • Extensor digitorum
  • Extensor indicis
  • Extensor digit minimi
    • All to D…-D…
  • Extensor pollicis longus
  • Extensor pollicis brevis
  • Abductor pollicis longus
    • All to D…
A
  • From muscles in posterior forearm
  • Extensor digitorum
  • Extensor indicis
  • Extensor digit minimi
    • All to D2-D5
  • Extensor pollicis longus
  • Extensor pollicis brevis
  • Abductor pollicis longus
    • All to D1
50
Q

Extensor digitorum tendons - as they pass over the metacarpopharyngeal joints they form triangular aponeurotic slips (… hood/dorsal digital expansions) - some … muscles attach onto these

A

Extensor digitorum tendons - as they pass over the metacarpopharyngeal joints they form triangular aponeurotic slips (extensor hood/dorsal digital expansions) - some intrinsic muscles attach onto these

51
Q

Extensor Hoods are an elaboration of the extensor … comunis (EDC) tendon on the dorsum of each phalanx. The extensor … (EI) and the extensor digiti … (EDM) insert into the extensor hoods of the … and … digits, respectively.

A

Extensor Hoods are an elaboration of the extensor digitorum comunis (EDC) tendon on the dorsum of each phalanx. The extensor indicis (EI) and the extensor digiti minimi (EDM) insert into the extensor hoods of the second and fifth digits, respectively.

52
Q

… … are an elaboration of the extensor digitorum comunis (EDC) tendon on the dorsum of each phalanx. The extensor indicis (EI) and the extensor digiti minimi (EDM) insert into the extensor hoods of the second and fifth digits, respectively.

A

Extensor Hoods are an elaboration of the extensor digitorum comunis (EDC) tendon on the dorsum of each phalanx. The extensor indicis (EI) and the extensor digiti minimi (EDM) insert into the extensor hoods of the second and fifth digits, respectively.

53
Q

Extensor digitorum insertion

  • Passes over knuckle - forms extensor …
    • Medial band - into middle phalanx
    • 2 lateral bands - into distal phalanx
  • Tendons of extensor digitorum extend the wrist, metacarpopharyngeal joints of D2-D5 and proximal and distal interphalangeal joints of D2-D5
A
  • Passes over knuckle - forms extensor hood
    • Medial band - into middle phalanx
    • 2 lateral bands - into distal phalanx
  • Tendons of extensor digitorum extend the wrist, metacarpopharyngeal joints of D2-D5 and proximal and distal interphalangeal joints of D2-D5
54
Q

Extensor digitorum insertion

  • Passes over knuckle - forms extensor …
    • … band - into middle phalanx
    • … … bands - into distal phalanx
  • Tendons of extensor digitorum extend the wrist, metacarpopharyngeal joints of D2-D5 and proximal and distal interphalangeal joints of D2-D5
A
  • Passes over knuckle - forms extensor hood
    • Medial band - into middle phalanx
    • 2 lateral bands - into distal phalanx
  • Tendons of extensor digitorum extend the wrist, metacarpopharyngeal joints of D2-D5 and proximal and distal interphalangeal joints of D2-D5
55
Q

Unlike long flexor tendons (with flexor digitorum superficialis and profundus), with long extensor tendons you have one tendon for each joint (one tendon splits into … band into middle phalanx and … band into distal phalanx)

A

Unlike long flexor tendons (with flexor digitorum superficialis and profundus), with long extensor tendons you have one tendon for each joint (one tendon splits into medial band into middle phalanx and lateral band into distal phalanx)

56
Q

… … for attachment for intrinsic muscles

A

Extensor hoods for attachment for intrinsic muscles

57
Q

Anatomical Snuff Box

  • As the snuffbox is triangularly shaped, it has three borders, a floor, and a roof:
    • Ulnar (medial) border: Tendon of the extensor pollicis …
    • Radial (lateral) border: Tendons of the extensor pollicis … and abductor pollicis …
    • Proximal border: Styloid process of the radius.
    • Floor: Carpal bones; scaphoid and trapezium.
    • Roof: Skin.
A
  • As the snuffbox is triangularly shaped, it has three borders, a floor, and a roof:
    • Ulnar (medial) border: Tendon of the extensor pollicis longus.
    • Radial (lateral) border: Tendons of the extensor pollicis brevis and abductor pollicis longus.
    • Proximal border: Styloid process of the radius.
    • Floor: Carpal bones; scaphoid and trapezium.
    • Roof: Skin.
58
Q

Anatomical Snuff Box

  • As the snuffbox is triangularly shaped, it has three borders, a floor, and a roof:
    • Ulnar (medial) border: Tendon of the extensor pollicis longus.
    • Radial (lateral) border: Tendons of the extensor pollicis brevis and abductor pollicis longus.
    • Proximal border: styloid process of the radius
    • Floor: Carpal bones; … bone and … bone.
    • Roof: Skin.
A
  • As the snuffbox is triangularly shaped, it has three borders, a floor, and a roof:
    • Ulnar (medial) border: Tendon of the extensor pollicis longus.
    • Radial (lateral) border: Tendons of the extensor pollicis brevis and abductor pollicis longus.
    • Proximal border: Styloid process of the radius.
    • Floor: Carpal bones; scaphoid and trapezium.
    • Roof: Skin.
59
Q

Anatomical Snuff Box

  • As the snuffbox is triangularly shaped, it has three borders, a floor, and a roof:
    • Ulnar (medial) border: Tendon of the extensor pollicis longus.
    • Radial (lateral) border: Tendons of the extensor pollicis brevis and abductor pollicis longus.
    • Proximal border: … process of the …
    • Floor: Carpal bones; scaphoid and trapezium.
    • Roof: Skin.
A
  • As the snuffbox is triangularly shaped, it has three borders, a floor, and a roof:
    • Ulnar (medial) border: Tendon of the extensor pollicis longus.
    • Radial (lateral) border: Tendons of the extensor pollicis brevis and abductor pollicis longus.
    • Proximal border: Styloid process of the radius.
    • Floor: Carpal bones; scaphoid and trapezium.
    • Roof: Skin.
60
Q

The anatomical snuff box is important clinically - … pulse can be taken here and also can palpate scaphoid - check for fracture

A

The anatomical snuff box is important clinically - Radial pulse can be taken here and also can palpate scaphoid - check for fracture

61
Q

The anatomical snuff box is important clinically - Radial pulse can be taken here and also can palpate … - check for fracture

A

The anatomical snuff box is important clinically - Radial pulse can be taken here and also can palpate scaphoid - check for fracture

62
Q

Extensor hoods

  • Extensor Hoods are an elaboration of the … … tendon on the dorsum of each phalanx.
  • Lumbricals and interossei muscles insert into the extensor hoods
A
  • Extensor Hoods are an elaboration of the extensor digitorum tendon on the dorsum of each phalanx.
  • Lumbricals and interossei muscles insert into the extensor hoods
63
Q

Extensor hoods

  • Extensor Hoods are an elaboration of the extensor digitorum tendon on the dorsum of each phalanx.
  • … and … muscles insert into the extensor hoods
A
  • Extensor Hoods are an elaboration of the extensor digitorum tendon on the dorsum of each phalanx.
  • Lumbricals and interossei muscles insert into the extensor hoods
64
Q

Lumbricals

  • Link flexor to extensor tendons
  • There are … lumbricals
  • They originate at tendon and insert into tendon
    • Come from flexor digitorum profundus and insert into extensor hood of respective tendon (D2-D5)
  • Lateral two muscles are unipennate, medial two muscles are bipennate
  • Extend interphalangeal joints and flex metacarpopharyngeal joints - precision grip (hold pen / pinch)
A
  • Link flexor to extensor tendons
  • There are 4 lumbricals
  • They originate at tendon and insert into tendon
    • Come from flexor digitorum profundus and insert into extensor hood of respective tendon (D2-D5)
  • Lateral two muscles are unipennate, medial two muscles are bipennate
  • Extend interphalangeal joints and flex metacarpopharyngeal joints - precision grip (hold pen / pinch)
65
Q

Lumbricals

  • Link flexor to extensor tendons
  • There are … lumbricals
  • They originate at tendon and insert into tendon
    • Come from flexor … … and insert into … hood of respective tendon (D2-D5)
  • Lateral two muscles are unipennate, medial two muscles are bipennate
  • Extend interphalangeal joints and flex metacarpopharyngeal joints - precision grip (hold pen / pinch)
A
  • Link flexor to extensor tendons
  • There are 4 lumbricals
  • They originate at tendon and insert into tendon
    • Come from flexor digitorum profundus and insert into extensor hood of respective tendon (D2-D5)
  • Lateral two muscles are unipennate, medial two muscles are bipennate
  • Extend interphalangeal joints and flex metacarpopharyngeal joints - precision grip (hold pen / pinch)
66
Q

Lumbricals

  • Link flexor to extensor tendons
  • There are … lumbricals
  • They originate at tendon and insert into tendon
    • Come from flexor digitorum profundus and insert into extensor hood of respective tendon (D2-D5)
  • Lateral two muscles are …pennate, medial two muscles are …pennate
  • Extend interphalangeal joints and flex metacarpopharyngeal joints - precision grip (hold pen / pinch)
A
  • Link flexor to extensor tendons
  • There are 4 lumbricals
  • They originate at tendon and insert into tendon
    • Come from flexor digitorum profundus and insert into extensor hood of respective tendon (D2-D5)
  • Lateral two muscles are unipennate, medial two muscles are bipennate
  • Extend interphalangeal joints and flex metacarpopharyngeal joints - precision grip (hold pen / pinch)
67
Q

The Lumbrical Muscles

  • The lumbrical muscles, which get their name due to their worm-like appearance (lumbricidae - Latin = earthworm), are … short intrinsic muscles of the hand located between the … bones, deep to the palmar fascia.
  • The lumbrical muscles of the hand … the fingers at the metacarpophalangeal (MCP) joints, and … them at the interphalangeal (IP) joints (Hold pen/pinch)
A
  • The lumbrical muscles, which get their name due to their worm-like appearance (lumbricidae - Latin = earthworm), are four short intrinsic muscles of the hand located between the metacarpal bones, deep to the palmar fascia.
  • The lumbrical muscles of the hand flex the fingers at the metacarpophalangeal (MCP) joints, and extend them at the interphalangeal (IP) joints (Hold pen/pinch)
68
Q

Lumbricals

  • Link flexor to extensor tendons
  • There are … lumbricals
  • They originate at tendon and insert into tendon
    • Come from flexor digitorum profundus and insert into extensor hood of respective tendon (D2-D5)
  • Lateral two muscles are …pennate, medial two muscles are …pennate
  • Extend … joints and flex … joints - precision grip (hold pen / pinch)
A
  • Link flexor to extensor tendons
  • There are 4 lumbricals
  • They originate at tendon and insert into tendon
    • Come from flexor digitorum profundus and insert into extensor hood of respective tendon (D2-D5)
  • Lateral two muscles are unipennate, medial two muscles are bipennate
  • Extend interphalangeal joints and flex metacarpopharyngeal joints - precision grip (hold pen / pinch)
69
Q

What muscles put the hand into a precision grip? (hold pen/pinch)

A

lumbrical muscles

70
Q

Unipennate lumbricals on lateral side are innervated by the … nerve, whereas the bipennate lumbricals on the medial side are innervated by the … nerve

A

Unipennate lumbricals on lateral side are innervated by the median nerve, whereas the bipennate lumbricals on the medial side are innervated by the ulnar nerve

71
Q

The lumbrical muscles sit on the … side of their respective digit

A

The lumbrical muscles sit on the radial side of their respective digit

72
Q

Palmar interossei

  • Interossei sit between the …
  • Originate from metacarpals and insert into extensor hoods
  • 2 layers - palmar and dorsal
    • 3 Palmar interossei (originate from D2,D4,D5 metacarpal and insert into extensor hood of D2,D4,D5) adduct the digits (towards D3, so do not have palmar interossei to this digit, thumb has it’s own adductor)
A
  • Interossei sit between the metacarpals
  • Originate from metacarpals and insert into extensor hoods
  • 2 layers - palmar and dorsal
    • 3 Palmar interossei (originate from D2,D4,D5 metacarpal and insert into extensor hood of D2,D4,D5) adduct the digits (towards D3, so do not have palmar interossei to this digit, thumb has it’s own adductor)
73
Q

Palmar interossei

  • Interossei sit between the metacarpals
  • Originate from metacarpals and insert into extensor hoods
  • 2 layers - palmar and dorsal
    • 3 Palmar interossei (originate from D2,D4,D5 metacarpal and insert into extensor hood of D2,D4,D5) they … the digits (towards D3, so do not have palmar interossei to this digit, thumb has it’s own adductor)
A
  • Interossei sit between the metacarpals
  • Originate from metacarpals and insert into extensor hoods
  • 2 layers - palmar and dorsal
    • 3 Palmar interossei (originate from D2,D4,D5 metacarpal and insert into extensor hood of D2,D4,D5) they adduct the digits (towards D3, so do not have palmar interossei to this digit, thumb has it’s own adductor)
74
Q

Palmar interossei

  • Interossei sit between the metacarpals
  • Originate from metacarpals and insert into extensor hoods
  • 2 layers - palmar and dorsal
    • … Palmar interossei - adduct the digits
A
  • Interossei sit between the metacarpals
  • Originate from metacarpals and insert into extensor hoods
  • 2 layers - palmar and dorsal
    • 3 Palmar interossei (originate from D2,D4,D5 metacarpal and insert into extensor hood of D2,D4,D5) adduct the digits (towards D3, so do not have palmar interossei to this digit, thumb has it’s own adductor)
75
Q

Palmar interossei

  • Interossei sit between the metacarpals
  • Originate from metacarpals and insert into extensor hoods
  • 2 layers - palmar and dorsal
    • 3 Palmar interossei (originate from … metacarpals and insert into extensor hoods of …) adduct the digits
A
  • Interossei sit between the metacarpals
  • Originate from metacarpals and insert into extensor hoods
  • 2 layers - palmar and dorsal
    • 3 Palmar interossei (originate from D2,D4,D5 metacarpal and insert into extensor hood of D2,D4,D5) adduct the digits (towards D3, so do not have palmar interossei to this digit, thumb has it’s own adductor)
76
Q

What digits do not have palmar interossei?

A

No palmar interossei for D1 (performed by adductor pollicis muscle) or D3

77
Q

… … (PAD) MCP joints

A

Palmar adduct (PAD) MCP joints (palmar interossei muscles)

78
Q

Interossei muscle - Mnemonic: PAD DAB (‘Use your hand to dab with a pad’)

A

Palmar interossei ADduct, Dorsal interossei ABduct

79
Q

Dorsal interossei

  • Interossei sit between the metacarpals
  • There are 4 dorsal interossei
  • Insert into extensor hoods of D2,D3(X2), D4 - all bipennate muscles
  • Their function is to … the D2-D4, as well as to assist in flexion of these fingers at the metacarpophalangeal (MCP) joints and in extension at the interphalangeal (IP) joints.
A
  • Interossei sit between the metacarpals
  • There are 4 dorsal interossei
  • Insert into extensor hoods of D2,D3(X2), D4 - all bipennate muscles
  • Their function is to abduct the D2-D4, as well as to assist in flexion of these fingers at the metacarpophalangeal (MCP) joints and in extension at the interphalangeal (IP) joints.
80
Q

Dorsal interossei

  • Interossei sit between the metacarpals
  • There are 4 dorsal interossei
  • Insert into extensor hoods of digits … - all …pennate muscles
  • Their function is to abduct these digits, as well as to assist in flexion of these fingers at the metacarpophalangeal (MCP) joints and in extension at the interphalangeal (IP) joints.
A
  • Interossei sit between the metacarpals
  • There are 4 dorsal interossei
  • Insert into extensor hoods of D2,D3(X2), D4 - all bipennate muscles
  • Their function is to abduct the D2-D4, as well as to assist in flexion of these fingers at the metacarpophalangeal (MCP) joints and in extension at the interphalangeal (IP) joints.
81
Q

Dorsal interossei

  • Interossei sit between the metacarpals
  • There are … dorsal interossei (Digits…)
  • Insert into extensor hoods of the digits- all bipennate muscles
  • Their function is to … the digits, as well as to assist in flexion of these fingers at the metacarpophalangeal (MCP) joints and in extension at the interphalangeal (IP) joints.
A
  • Interossei sit between the metacarpals
  • There are 4 dorsal interossei
  • Insert into extensor hoods of D2,D3(X2), D4 - all bipennate muscles
  • Their function is to abduct the D2-D4, as well as to assist in flexion of these fingers at the metacarpophalangeal (MCP) joints and in extension at the interphalangeal (IP) joints.
82
Q

There are no dorsal interossei for which digits?

A

No dorsal interossei for D1 or D5 (performed by thenar and hypothenar muscles)

83
Q

… … (DAB) MCP joints

A

Dorsal abduct (DAB) MCP joints (Dorsal interossei)

84
Q

Thenar and hypothenar muscles

  • The thenar eminence is the fleshy mound at the base of the …
  • The hypothenar eminence is the mound located at the base of the …
A
  • The thenar eminence is the fleshy mound at the base of the thumb.
  • The hypothenar eminence is the mound located at the base of the fifth digit (little finger).
85
Q

Thenar and hypothenar muscles

  • Origin of muscles: flexor … and adjacent … bones
A
  • Origin of muscles: flexor retinaculum and adjacent carpal bones
86
Q

Thenar muscles

  • The … nerve innervates all the thenar muscles.
  • 3 thenar muscles - originate from flexor retinaculum, scaphoid, trapezium
    • Opponens Pollicis (…) - inserts into first metacarpal - draws thumb across little finger in opposition
    • Abductor Pollicis Brevis - inserts into proximal phalanx - abduct thumb
    • Flexor Pollicis Brevis - inserts into proximal phalanx - flexes the thumb
A
  • The median nerve innervates all the thenar muscles.
  • 3 thenar muscles - originate from flexor retinaculum, scaphoid, trapezium
    • Opponens Pollicis (deepest) - inserts into first metacarpal - draws thumb across little finger in opposition
    • Abductor Pollicis Brevis - inserts into proximal phalanx - abduct thumb
    • Flexor Pollicis Brevis - inserts into proximal phalanx - flexes the thumb
87
Q

Thenar muscles

  • The median nerve innervates all the thenar muscles.
  • 3 thenar muscles - originate from flexor …, s.., t…
    • Opponens Pollicis (deepest) - inserts into first metacarpal - draws thumb across little finger in opposition
    • Abductor Pollicis Brevis - inserts into proximal phalanx - abduct thumb
    • Flexor Pollicis Brevis - inserts into proximal phalanx - flexes the thumb
A
  • The median nerve innervates all the thenar muscles.
  • 3 thenar muscles - originate from flexor retinaculum, scaphoid, trapezium
    • Opponens Pollicis (deepest) - inserts into first metacarpal - draws thumb across little finger in opposition
    • Abductor Pollicis Brevis - inserts into proximal phalanx - abduct thumb
    • Flexor Pollicis Brevis - inserts into proximal phalanx - flexes the thumb
88
Q

Thenar muscles

  • The median nerve innervates all the thenar muscles.
  • 3 thenar muscles - originate from flexor retinaculum, scaphoid, trapezium
    • … Pollicis (deepest) - inserts into first metacarpal - draws thumb across little finger in opposition
    • … … … - inserts into proximal phalanx - abduct thumb
    • … … … - inserts into proximal phalanx - flexes the thumb
A
  • The median nerve innervates all the thenar muscles.
  • 3 thenar muscles - originate from flexor retinaculum, scaphoid, trapezium
    • Opponens Pollicis (deepest) - inserts into first metacarpal - draws thumb across little finger in opposition
    • Abductor Pollicis Brevis - inserts into proximal phalanx - abduct thumb
    • Flexor Pollicis Brevis - inserts into proximal phalanx - flexes the thumb
89
Q

Thenar muscles

  • The median nerve innervates all the thenar muscles.
  • 3 thenar muscles - originate from flexor retinaculum, scaphoid, trapezium
    • Opponens Pollicis (deepest) - inserts into … … - draws thumb across little finger in opposition
    • Abductor Pollicis Brevis - inserts into … … - abduct thumb
    • Flexor Pollicis Brevis - inserts into … … - flexes the thumb
A
  • The median nerve innervates all the thenar muscles.
  • 3 thenar muscles - originate from flexor retinaculum, scaphoid, trapezium
    • Opponens Pollicis (deepest) - inserts into first metacarpal - draws thumb across little finger in opposition
    • Abductor Pollicis Brevis - inserts into proximal phalanx - abduct thumb
    • Flexor Pollicis Brevis - inserts into proximal phalanx - flexes the thumb
90
Q

Hypothenar muscles

  • The … nerve innervates the muscles of the hypothenar eminence.
  • 3 Hypothenar muscles:
    • Opponens Digiti Minimi (…) originates from flexor retinaculum and the hamate, inserts into base of 5th metacarpal - draws finger towards thumb in opposition
    • Abductor Digiti Minimi originates from the pisiform and inserts into the base of the proximal phalanx - abduction of little finger
    • Flexor Digiti Minimi Brevis originates from the hamate and flexor retinaculum and inserts into the proximal phalanx - flexes little finger
A
  • The ulnar nerve innervates the muscles of the hypothenar eminence.
  • 3 Hypothenar muscles:
    • Opponens Digiti Minimi (deepest) originates from flexor retinaculum and the hamate, inserts into base of 5th metacarpal - draws finger towards thumb in opposition
    • Abductor Digiti Minimi originates from the pisiform and inserts into the base of the proximal phalanx - abduction of little finger
    • Flexor Digiti Minimi Brevis originates from the hamate and flexor retinaculum and inserts into the proximal phalanx - flexes little finger
91
Q

Hypothenar muscles

  • The ulnar nerve innervates the muscles of the hypothenar eminence.
  • 3 Hypothenar muscles:
    • Opponens Digiti Minimi (deepest) originates from flexor retinaculum and the hamate, inserts into base of 5th metacarpal - draws finger towards thumb in …
    • Abductor Digiti Minimi originates from the pisiform and inserts into the base of the proximal phalanx - … of little finger
    • Flexor Digiti Minimi Brevis originates from the hamate and flexor retinaculum and inserts into the proximal phalanx - … little finger
A
  • The ulnar nerve innervates the muscles of the hypothenar eminence.
  • 3 Hypothenar muscles:
    • Opponens Digiti Minimi (deepest) originates from flexor retinaculum and the hamate, inserts into base of 5th metacarpal - draws finger towards thumb in opposition
    • Abductor Digiti Minimi originates from the pisiform and inserts into the base of the proximal phalanx - abduction of little finger
    • Flexor Digiti Minimi Brevis originates from the hamate and flexor retinaculum and inserts into the proximal phalanx - flexes little finger
92
Q

Hypothenar muscles

  • The ulnar nerve innervates the muscles of the hypothenar eminence.
  • 3 Hypothenar muscles:
    • … Digiti … (deepest) originates from flexor retinaculum and the hamate, inserts into base of 5th metacarpal - draws finger towards thumb in opposition
    • … Digiti … originates from the pisiform and inserts into the base of the proximal phalanx - abduction of little finger
    • … Digiti … Brevis originates from the hamate and flexor retinaculum and inserts into the proximal phalanx - flexes little finger
A
  • The ulnar nerve innervates the muscles of the hypothenar eminence.
  • 3 Hypothenar muscles:
    • Opponens Digiti Minimi (deepest) originates from flexor retinaculum and the hamate, inserts into base of 5th metacarpal - draws finger towards thumb in opposition
    • Abductor Digiti Minimi originates from the pisiform and inserts into the base of the proximal phalanx - abduction of little finger
    • Flexor Digiti Minimi Brevis originates from the hamate and flexor retinaculum and inserts into the proximal phalanx - flexes little finger
93
Q

Hypothenar muscles

  • The ulnar nerve innervates the muscles of the hypothenar eminence.
  • 3 Hypothenar muscles:
    • Opponens Digiti Minimi (deepest) originates from flexor retinaculum and the hamate, inserts into base of … metacarpal - draws finger towards thumb in opposition
    • Abductor Digiti Minimi originates from the pisiform and inserts into the base of the … … - abduction of little finger
    • Flexor Digiti Minimi Brevis originates from the hamate and flexor retinaculum and inserts into the … … - flexes little finger
A
  • The ulnar nerve innervates the muscles of the hypothenar eminence.
  • 3 Hypothenar muscles:
    • Opponens Digiti Minimi (deepest) originates from flexor retinaculum and the hamate, inserts into base of 5th metacarpal - draws finger towards thumb in opposition
    • Abductor Digiti Minimi originates from the pisiform and inserts into the base of the proximal phalanx - abduction of little finger
    • Flexor Digiti Minimi Brevis originates from the hamate and flexor retinaculum and inserts into the proximal phalanx - flexes little finger
94
Q

The … nerve innervates the muscles of the hypothenar eminence, whereas the … nerve innervates the thenar muscles

A

The ulnar nerve innervates the muscles of the hypothenar eminence, whereas the median nerve innervates the thenar muscles

95
Q

Label the Thenar muscles

A
96
Q

The muscles shown are … muscles

A

hypothenar muscles

97
Q

Adduction of the thumb - Adductor pollicis

  • The adductor pollicis muscle is a short and broad, fan-shaped muscle of the palm. It arises by the two muscular heads: oblique and transverse.
    • … head originates from the palmar base of metacarpal bone 3
    • … head arises from the capitate bone and palmar bases of metacarpal bones 2 and 3.
    • From their origins, the muscle heads run laterally, converging into a single muscle belly that inserts onto the medial base of … … 1.
A
  • The adductor pollicis muscle is a short and broad, fan-shaped muscle of the palm. It arises by the two muscular heads: oblique and transverse.
    • Transverse head originates from the palmar base of metacarpal bone 3
    • Oblique head arises from the capitate bone and palmar bases of metacarpal bones 2 and 3.
    • From their origins, the muscle heads run laterally, converging into a single muscle belly that inserts onto the medial base of proximal phalanx 1.
98
Q

Adduction of the thumb - Adductor pollicis

  • The adductor pollicis muscle is a short and broad, fan-shaped muscle of the palm. It arises by the two muscular heads: oblique and transverse.
    • Transverse head originates from the palmar base of metacarpal bone …
    • Oblique head arises from the capitate bone and palmar bases of metacarpal bones … and …
    • From their origins, the muscle heads run laterally, converging into a single muscle belly that inserts onto the medial base of proximal phalanx 1.
A
  • The adductor pollicis muscle is a short and broad, fan-shaped muscle of the palm. It arises by the two muscular heads: oblique and transverse.
    • Transverse head originates from the palmar base of metacarpal bone 3
    • Oblique head arises from the capitate bone and palmar bases of metacarpal bones 2 and 3.
    • From their origins, the muscle heads run laterally, converging into a single muscle belly that inserts onto the medial base of proximal phalanx 1.
99
Q

Adduction of the thumb

  • The … … muscle is a short and broad, fan-shaped muscle of the palm. It arises by the two muscular heads: oblique and transverse.
    • Transverse head originates from the palmar base of metacarpal bone 3
    • Oblique head arises from the capitate bone and palmar bases of metacarpal bones 2 and 3.
    • From their origins, the muscle heads run laterally, converging into a single muscle belly that inserts onto the medial base of proximal phalanx 1.
A
  • The adductor pollicis muscle is a short and broad, fan-shaped muscle of the palm. It arises by the two muscular heads: oblique and transverse.
    • Transverse head originates from the palmar base of metacarpal bone 3
    • Oblique head arises from the capitate bone and palmar bases of metacarpal bones 2 and 3.
    • From their origins, the muscle heads run laterally, converging into a single muscle belly that inserts onto the medial base of proximal phalanx 1.
100
Q

Adduction of the thumb - Adductor pollicis

  • The adductor pollicis muscle is a short and broad, fan-shaped muscle of the palm. It arises by the two muscular heads: … and …
    • … head originates from the palmar base of metacarpal bone 3
    • … head arises from the capitate bone and palmar bases of metacarpal bones 2 and 3.
    • From their origins, the muscle heads run laterally, converging into a single muscle belly that inserts onto the medial base of proximal phalanx 1.
A
  • The adductor pollicis muscle is a short and broad, fan-shaped muscle of the palm. It arises by the two muscular heads: oblique and transverse.
    • Transverse head originates from the palmar base of metacarpal bone 3
    • Oblique head arises from the capitate bone and palmar bases of metacarpal bones 2 and 3.
    • From their origins, the muscle heads run laterally, converging into a single muscle belly that inserts onto the medial base of proximal phalanx 1.
101
Q

What muscle adducts the thumb?

A

Adductor pollicis

102
Q

Blood supply to the Hand

  • Brachial artery enters cubital fossa - divides into radial and ulnar artery
    • Radial artery passes laterally to sit under … muscle - sits beside superficial branch of radial nerve - towards dorsal surface - Radial artery passes through anatomical snuffbox - piercing first dorsal interosseous muscle - forms deep palmar arch - anastomose with ulnar artery on medial side
    • Ulnar artery passes medially - sits beside ulnar nerve and passes towards wrist - under … … … muscle - at wrist, forms superficial palmar arch - above long flexor tendon - anastomose with radial artery
A
  • Brachial artery enters cubital fossa - divides into radial and ulnar artery
    • Radial artery passes laterally to sit under brachioradialis muscle - sits beside superficial branch of radial nerve - towards dorsal surface - Radial artery passes through anatomical snuffbox - piercing first dorsal interosseous muscle - forms deep palmar arch - anastomose with ulnar artery on medial side
    • Ulnar artery passes medially - sits beside ulnar nerve and passes towards wrist - under flexor carpi ulnaris muscle - at wrist, forms superficial palmar arch - above long flexor tendon - anastomose with radial artery
103
Q

Blood supply to the Hand

  • Brachial artery enters cubital fossa - divides into radial and ulnar artery
    • Radial artery passes laterally to sit under brachioradialis muscle - sits beside superficial branch of radial nerve - towards dorsal surface - Radial artery passes through … … - piercing first dorsal interosseous muscle - forms … palmar arch - anastomose with ulnar artery on medial side
    • Ulnar artery passes medially - sits beside ulnar nerve and passes towards wrist - under flexor carpi ulnaris muscle - at wrist, forms … palmar arch - above long flexor tendon - anastomose with radial artery
A
  • Brachial artery enters cubital fossa - divides into radial and ulnar artery
    • Radial artery passes laterally to sit under brachioradialis muscle - sits beside superficial branch of radial nerve - towards dorsal surface - Radial artery passes through anatomical snuffbox - piercing first dorsal interosseous muscle - forms deep palmar arch - anastomose with ulnar artery on medial side
    • Ulnar artery passes medially - sits beside ulnar nerve and passes towards wrist - under flexor carpi ulnaris muscle - at wrist, forms superficial palmar arch - above long flexor tendon - anastomose with radial artery
104
Q

Blood supply to the Hand

  • Brachial artery enters cubital fossa - divides into radial and ulnar artery
    • Radial artery passes … to sit under brachioradialis muscle - sits beside superficial branch of radial nerve - towards dorsal surface - Radial artery passes through anatomical snuffbox - piercing first dorsal interosseous muscle - forms deep palmar arch - anastomose with ulnar artery on medial side
    • Ulnar artery passes … - sits beside ulnar nerve and passes towards wrist - under flexor carpi ulnaris muscle - at wrist, forms superficial palmar arch - above long flexor tendon - anastomose with radial artery
A
  • Brachial artery enters cubital fossa - divides into radial and ulnar artery
    • Radial artery passes laterally to sit under brachioradialis muscle - sits beside superficial branch of radial nerve - towards dorsal surface - Radial artery passes through anatomical snuffbox - piercing first dorsal interosseous muscle - forms deep palmar arch - anastomose with ulnar artery on medial side
    • Ulnar artery passes medially - sits beside ulnar nerve and passes towards wrist - under flexor carpi ulnaris muscle - at wrist, forms superficial palmar arch - above long flexor tendon - anastomose with radial artery
105
Q

Deep palmar arch

  • Below long flexor tendons
  • Radial artery passing across anatomical snuff box and piercing the first dorsal interosseous muscle where it gives off branches to supply D1 and lateral side of D2
    • … … artery - thumb
    • … … artery - lateral half of index finger
  • Radial artery mainly supplies blood to thumb and lateral half of D2
A
  • Below long flexor tendons
  • Radial artery passing across anatomical snuff box and piercing the first dorsal interosseous muscle where it gives off branches to supply D1 and lateral side of D2
    • Princeps pollicis artery - thumb
    • Radialis indicis artery - lateral half of index finger
  • Radial artery mainly supplies blood to thumb and lateral half of D2
106
Q

Deep palmar arch

  • Below long flexor tendons
  • Radial artery passing across anatomical snuff box and piercing the first dorsal interosseous muscle where it gives off branches to supply … and lateral side of …
    • Princeps pollicis artery - …
    • Radialis indicis artery - …
A
  • Below long flexor tendons
  • Radial artery passing across anatomical snuff box and piercing the first dorsal interosseous muscle where it gives off branches to supply D1 and lateral side of D2
    • Princeps pollicis artery - thumb
    • Radialis indicis artery - lateral half of index finger
  • Radial artery mainly supplies blood to thumb and lateral half of D2
108
Q

Superficial palmar arch

  • Above long flexor tendons:
  • … artery passing down towards wrist - forming superficial palmer arch before anastomoses with radial artery
  • Gives off … palmar digital arteries - form … palmar digital arteries - supplies blood to medial half of D2 and D3,D4,D5.
A
  • Above long flexor tendons:
  • Ulnar artery passing down towards wrist - forming superficial palmer arch before anastomoses with radial artery
  • Gives off common palmar digital arteries - form proper palmar digital arteries - supplies blood to medial half of D2 and D3,D4,D5.
109
Q

Superficial palmar arch

  • Above long flexor tendons:
  • Ulnar artery passing down towards wrist - forming superficial palmer arch before anastomoses with radial artery
  • Gives off common palmar digital arteries - form proper palmar digital arteries - supplies blood to what digits?
A
  • Above long flexor tendons:
  • Ulnar artery passing down towards wrist - forming superficial palmer arch before anastomoses with radial artery
  • Gives off common palmar digital arteries - form proper palmar digital arteries - supplies blood to medial half of D2 and D3,D4,D5.
111
Q

Median nerve - Hand

  • As it approaches carpal tunnel - gives off a branch called the … branch which is … in carpal tunnel syndrome
  • As it pops into hand, gives off a recurrent branch which supplies the three thenar muscles (not the adductor pollicis muscle - ulnar nerve)
  • Gives off digital nerves - supply the lateral 2 lumbricals (sensory D1 D2 D3 1/2 D4)
A
  • As it approaches carpal tunnel - gives off a branch called the palmar branch which is spared in carpal tunnel syndrome
  • As it pops into hand, gives off a recurrent branch which supplies the three thenar muscles (not the adductor pollicis muscle - ulnar nerve)
  • Gives off digital nerves - supply the lateral 2 lumbricals (sensory D1 D2 D3 1/2 D4)
115
Q

D1 and 1/2 D2 are mainly supplied by which artery?

A

Radial artery

118
Q

1/2 D2 and D3,D4,D5 are mainly supplied by what artery?

A

Ulnar artery

119
Q

Median nerve - Hand

  • As it approaches carpal tunnel - gives off a branch called the palmar branch which is spared in carpal tunnel syndrome
  • As it pops into hand, gives off a … branch which supplies the three … muscles (not the adductor pollicis muscle - ulnar nerve)
  • Gives off digital nerves - supply the lateral 2 lumbricals (sensory D1 D2 D3 1/2 D4)
A
  • As it approaches carpal tunnel - gives off a branch called the palmar branch which is spared in carpal tunnel syndrome
  • As it pops into hand, gives off a recurrent branch which supplies the three thenar muscles (not the adductor pollicis muscle - ulnar nerve)
  • Gives off digital nerves - supply the lateral 2 lumbricals (sensory D1 D2 D3 1/2 D4)
120
Q

Median nerve - Hand

  • As it approaches carpal tunnel - gives off a branch called the palmar branch which is spared in carpal tunnel syndrome
  • As it pops into hand, gives off a recurrent branch which supplies the three thenar muscles (not the adductor pollicis muscle - ulnar nerve)
  • Gives off … nerves - supply the … 2 lumbricals (sensory D1 D2 D3 1/2 D4)
A
  • As it approaches carpal tunnel - gives off a branch called the palmar branch which is spared in carpal tunnel syndrome
  • As it pops into hand, gives off a recurrent branch which supplies the three thenar muscles (not the adductor pollicis muscle - ulnar nerve)
  • Gives off digital nerves - supply the lateral 2 lumbricals (sensory D1 D2 D3 1/2 D4)
121
Q

Ulnar nerve - Hand

  • Does not pass through carpal tunnel - between … and … to enter hand
  • Enters hand - deep branch and superficial branch
    • Deep branch: Hypothenar muscles, Interossei, Medial 2 lumbricals, Adductor Pollicis muscle
    • Superficial branch: Branches that supply skin over 1/2 D4 and D5 (+ medial side of hand)
  • Clawed hand - damage to ulnar nerve at the wrist - D4 and D5 MCP joint extension, interphalangeal joint flexion
A
  • Does not pass through carpal tunnel - between pisiform and hook of hamate to enter hand
  • Enters hand - deep branch and superficial branch
    • Deep branch: Hypothenar muscles, Interossei, Medial 2 lumbricals, Adductor Pollicis muscle
    • Superficial branch: Branches that supply skin over 1/2 D4 and D5 (+ medial side of hand)
  • Clawed hand - damage to ulnar nerve at the wrist - D4 and D5 MCP joint extension, interphalangeal joint flexion
122
Q

Ulnar nerve - Hand

  • Does not pass through carpal tunnel - between pisiform and hook of hamate to enter hand
  • Enters hand - deep branch and superficial branch
    • Deep branch: Supplying the … muscles, I…, … 2 lumbricals, … … muscle
    • Superficial branch: Branches that supply skin over 1/2 D4 and D5 (+ medial side of hand)
  • Clawed hand - damage to ulnar nerve at the wrist - D4 and D5 MCP joint extension, interphalangeal joint flexion
A
  • Does not pass through carpal tunnel - between pisiform and hook of hamate to enter hand
  • Enters hand - deep branch and superficial branch
    • Deep branch: Hypothenar muscles, Interossei, Medial 2 lumbricals, Adductor Pollicis muscle
    • Superficial branch: Branches that supply skin over 1/2 D4 and D5 (+ medial side of hand)
  • Clawed hand - damage to ulnar nerve at the wrist - D4 and D5 MCP joint extension, interphalangeal joint flexion
123
Q

Ulnar nerve - Hand

  • Does not pass through carpal tunnel - between pisiform and hook of hamate to enter hand
  • Enters hand - deep branch and superficial branch
    • Deep branch: Hypothenar muscles, Interossei, Medial 2 lumbricals, Adductor Pollicis muscle
    • Superficial branch: Branches that supply skin over …
  • Clawed hand - damage to ulnar nerve at the wrist - D4 and D5 MCP joint extension, interphalangeal joint flexion
A
  • Does not pass through carpal tunnel - between pisiform and hook of hamate to enter hand
  • Enters hand - deep branch and superficial branch
    • Deep branch: Hypothenar muscles, Interossei, Medial 2 lumbricals, Adductor Pollicis muscle
    • Superficial branch: Branches that supply skin over 1/2 D4 and D5 (+ medial side of hand)
  • Clawed hand - damage to ulnar nerve at the wrist - D4 and D5 MCP joint extension, interphalangeal joint flexion
124
Q

Ulnar nerve - Hand

  • Does not pass through carpal tunnel - between pisiform and hook of hamate to enter hand
  • Enters hand - deep branch and superficial branch
    • Deep branch: Hypothenar muscles, Interossei, Medial 2 lumbricals, Adductor Pollicis muscle
    • Superficial branch: Branches that supply skin over 1/2 D4 and D5 (+ medial side of hand)
  • … hand - damage to ulnar nerve at the … - D4 and D5 MCP joint extension, interphalangeal joint flexion
A
  • Does not pass through carpal tunnel - between pisiform and hook of hamate to enter hand
  • Enters hand - deep branch and superficial branch
    • Deep branch: Hypothenar muscles, Interossei, Medial 2 lumbricals, Adductor Pollicis muscle
    • Superficial branch: Branches that supply skin over 1/2 D4 and D5 (+ medial side of hand)
  • Clawed hand - damage to ulnar nerve at the wrist - D4 and D5 MCP joint extension, interphalangeal joint flexion
125
Q

Clinical: Clawed hand (Damage to … nerve at wrist –affects digit … and …MCP joint extension, interphalangeal joint flexion)

A

Clinical: Clawed hand (Damage to ulnar nerve at wrist – d4+ d5 MCP joint extension, interphalangeal joint flexion)

126
Q

What are the four muscle groups that make up the intrinsic muscles of the hand?

A

These are the thenar, hypothenar, interossei and the lumbrical muscles.

Year 2 Medicine (162 decks)

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