Anatomy of the hand Flashcards

1
Q

What forms the roof of the carpal tunnel?

A

Flexor retinaculum

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2
Q

What structures lie deep to the flexor retinaculum?

A

-Flexor digitorum superficialis and profundus muscle tendons
- Flexor pollicis longus muscle tendons
- Median nerve

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3
Q

What structure passes through the flexor retinaculum?

A

Tendon of the flexor carpi radialis muscle

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4
Q

What is the name of the triangular fascial layer on the palm, and what is its function?

A

Palmar aponeurosis

-Protects structures of the palm
-It is the point of insertion for the palmaris longus muscle.

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5
Q

Describe the lumbricals in terms of their origin, insertion, innervation and action

A

Origin: tendons of the flexor digitorum profundus muscle

Insertion: Lateral sides of the extensor hoods

Innervation:
- Lateral two lumbricals by the median nerve
- Medial two lumbricals by the ulnar nerve

Action:
Flexion at the metacarpophalangeal joints
- Extends the dorsal interphalangeal joints

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6
Q

Describe the abductor pollicis brevis muscle in terms of its origin, insertion, innervation and action

A

Origin:
Tubercle of the trapezium and scaphoid
- Adjacent flexor retinaculum

Insertion:
Proximal phalanx and extensor hood of thumb

Innervation:
- Recurrent branch of the median nerve

Action:
Abduction of the thumb at the metacarpophalangeal joint

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7
Q

Describe the opponens pollicis muscle in terms of its origin, insertion, innervation and action

A

Origin
- Tubercle of the trapezium and the flexor retinaculum

Insertion
- Lateral margin and palmar surface of the 1st metacarpal

Innervation
- Recurrent branch of the median nerve

Action
Medially rotates the thumb

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8
Q

Describe the adductor pollicis muscle in terms of its origin, insertion, innervation and action

A

Origin
Oblique head: Capitate and Bases of 2nd and 3rd metacarpals
Transverse head: Anterior surface of the shaft of the 3rd metacarpal

Insertion:
Base of the proximal phalanx of the thumb
Extensor hood of the thumb

Innervation
- Deep branch of the ulnar nerve

Action
Adducts the thumb

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9
Q

Describe the abductor digiti minimi muscle in terms of its origin, insertion, innervation and action

A

Origin
- Pisiform and the pisohamate ligament
- Tendon of the flexor carpi ulnaris muscle
Insertion
- Proximal phalanx of the little finger
Action
- Abducts little finger at metacarpophalangeal joint
Innervation by the Deep branch of the ulnar nerve

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10
Q

Describe the flexor digiti minimi muscle in terms of its origin, insertion, innervation and action

A

Origin
- Hook of the hamate and the flexor retinaculum
Insertion
- Proximal phalanx of the little finger
Action
- Flexes little finger at the metacarpophalangeal joint
Innervation
- Deep branch of the ulnar nerve

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11
Q

Describe the opponens digiti minimi muscle in terms of its origin, insertion, innervation and action

A

Origin
- Hook of the hamate and the flexor retinaculum
Insertion
- Medial aspect of the 5th metacarpal
Action
- Laterally rotates of the 5th metacarpal
Innervation
- Deep branch of the ulnar nerve

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12
Q

How many interosseous muscle does the hand have? how are they positioned?

A

There are 7 interosseous muscles.
-3 on the palmer side (2nd, 4th and 5th fingers), 4 on the dorsal side (2nd, 3rd and 4th fingers)

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13
Q

Describe the palmer interosseous muscles in terms of their origin, insertion, innervation and action

A
  • Origin
  • Sides of the metacarpals
  • Insertion
  • Extensor hoods of the index, ring and little fingers
  • Proximal phalanx of the index, ring and little fingers
  • Action
  • Adduction of the index, ring and little fingers
  • Extension at the dorsal interphalangeal joints
  • Innervation
  • Deep branch of the ulnar nerve
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14
Q

What is the name of the structure that lies over the tendons of the posterior compartment?

A

Extensor retinaculum

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15
Q

Which muscle tendons are found in compartment 1?

A

Abductor pollicis longus muscle
- Extensor pollicis brevis muscle

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16
Q

Which muscle tendons are found in compartment 2?

A

Extensor carpi radialis longus muscle
Extensor carpi radialis brevis muscle

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17
Q

Which muscle tendons are found in compartment 3?

A
  • Extensor pollicis longus muscle
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18
Q

Which muscle tendons are found in compartment 4?

A
  • Extensor digitorum muscle
  • Extensor indicis muscle
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19
Q

Which muscle tendons are found in compartment 5?

A
  • Extensor digiti minimi muscle
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20
Q

Which muscle tendons are found in compartment 6?

A

Extensor carpi ulnaris muscle

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21
Q

Describe the dorsal interosseous muscles in terms of its origin, insertion, innervation and action

A
  • Origin
  • Adjacent metacarpals
  • Insertion
  • Extensor hoods of the index, ring and middle fingers
  • Proximal phalanx of the index, ring and middle fingers
    Action
  • Abduction of the index, ring and middle fingers
  • Extension at the dorsal interphalangeal joints
  • Innervation
  • Deep branch of the ulnar nerve
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22
Q

What is an extensor hood?

A

Tendons of the Extensor digitorum and extensor pollicis longus expand over the proximal phalanges to form a hood. This is called the extensor hood.

23
Q

Which muscles insert on the extensor hood?

A
  • Middle 4 fingers
  • Interossei and lumbricals

In the thumb
- The adductor pollicis and abductor pollicis brevis muscles insert

24
Q

Which muscles are innervated by the deep branch of the ulnar nerve? (5)

A

-Adductor pollicis muscle
-Abductor digiti minimi
-Flexor digiti minimi
-Opponens digiti minimi
-Interosseus muslces (both palmar and dorsal)
Two median lumbricals

25
Q

Which muscles are innervated by the recurrent branch of the median nerve? (3)

A

Abductor pollicis brevis muscle
Flexor pollicis brevis muscle
Opponens pollicis muscle
Two lateral lumbricals

26
Q

Describe the brachial artery

A

It is the continuation of the axillary artery.
It spans from the inferior border of the teres major muscle to the cubital fossa.

Not superficial

27
Q

What branches does the brachial artery gives off?

A

Muscular branches
- Deep artery of the arm
- Superior and inferior ulnar collateral
- Terminates as the radial and ulnar artery

28
Q

List the branches of the ulnar artery

A

Common interosseus
- Anterior and posterior interosseus

Anastomotic branches
- Anterior and posterior ulnar recurrent collateral

29
Q

List the branches of the radial artery

A

Muscular branches
- Anastomotic branches
- Radial recurrent artery

30
Q

Describe the superficial palmar arch

A

Superficial palmar arch
- Joining of ulnar and radial arteries
- Contribution mainly by the ulnar artery

31
Q

Describe the deep palmar arch

A

Deep palmar arch
- Joining of ulnar and radial arteries
- Contribution mainly by the radial artery

32
Q

Describe the palmar digital arteries that arise from the superficial palmar arch

A

Superficial palmar arch
- Gives off common palmar digital arteries
- They terminate as proper palmar digital arteries
- Palmar digital artery to medial side of the little finger

33
Q

Describe the palmar digital arteries that arise from the deep palmar arch

A

Deep palmar arch
- Gives off palmar metacarpal arteries
- Radialis indicis artery to the index finger
- Princeps pollicis artery to the thumb

34
Q

Describe the dorsal digital arteries

A

Dorsal carpal arch is formed by the dorsal branches of
radial and ulnar arteries
- Gives off dorsal metacarpal arteries which terminate
as dorsal digital arteries

35
Q

Where do the dorsal superficial veins commence?

A

They commence at the dorsal venous network

36
Q

What is formed from the dorsal venous network?

A

Basilic and cephalic veins

37
Q

Describe the cephalic vein

A
  • Lies laterally
  • Lies superficial
  • Disappears in deltopectoral triangle
  • Drains into subclavian vein
38
Q

Where do the basilic and cephalic veins join? What joins them?

A

They join at the cubital fossa.
Median cubital vein joins them

39
Q

Describe the deep veins

A

Have same names as arteries
* From digital veins to palmar venous arches
* Radial and ulnar
* Brachial
* Axillary
* Subclavian
* Brachiocephalic vein (With jugulars)
* Superior vena cava

40
Q

What nerve does the median nerve give off in the cubital fossa?

A

Anterior interosseus nerve

41
Q

Which muscles are innervated by the anterior interosseus nerve?

A

Deep flexors
- Flexor pollicis longus
- Lateral half of Flexor digitorum profundus
- Pronator quadratus

42
Q

The median nerve enters the palm via the____________________

A

carpal tunnel

43
Q

Which muscles of the hand are supplied by the median nerve?

A

Supplies thenar group and lateral 2 lumbricals

44
Q

The median nerve gives sensory innervation to ____________________

A

lateral 3 ½ fingers

45
Q

The __________ nerve runs over the flexor retinaculum at the wrist

A

Ulnar

46
Q

Explain the division of the ulnar nerve and what they innervate

A

Superficial branch
- Skin on medial 1 ½ fingers on both surfaces
* Deep branch innervates
- Hypothenar
- 2 medial lumbricals
- All interossei
- Adductor pollicis muscle

47
Q

What is innervated by the deep branch of the radial nerve? (post. interosseus nerve)

A
  • Extensor carpi radialis brevis muscle
  • Supinator muscle
  • Extensor digitorum muscle
  • Extensor digiti minimi muscle
  • Extensor carpi ulnaris muscle
  • Extensor pollicis longus and brevis muscles
  • Extensor indicis muscle
48
Q

What is innervated by the superficial branch of the radial nerve?

A

Superficial innervates lateral 3 ½ of dorsum

49
Q

Intrinsic hand muscles

A

Thenar
Hypothenar
Lumbricals
Adductor pollicis
Palmar interosseous
Dorsal interosseous

50
Q

Thenar muscles

A

AFO
-Abductor pollicis brevis
-Flexor pollicis brevis
-Opponens pollicis

51
Q

Hypothenar mucsles

A

AFO
Abductor digiti minimi
Flexor digiti minimi
Opponens digiti minimi

52
Q

Where do lumbricals arise from?

A

FDP (flexor digitorum profundus) tendon

53
Q

Palmar interosseous

A

PAD
(adduct)

54
Q

Dorsal interosseous

A

DAB
(abduct)