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
Which muscles are innervated by the recurrent branch of the median nerve? (3)
Abductor pollicis brevis muscle Flexor pollicis brevis muscle Opponens pollicis muscle Two lateral lumbricals
26
Describe the brachial artery
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
What branches does the brachial artery gives off?
Muscular branches - Deep artery of the arm - Superior and inferior ulnar collateral - Terminates as the radial and ulnar artery
28
List the branches of the ulnar artery
Common interosseus - Anterior and posterior interosseus Anastomotic branches - Anterior and posterior ulnar recurrent collateral
29
List the branches of the radial artery
Muscular branches - Anastomotic branches - Radial recurrent artery
30
Describe the superficial palmar arch
Superficial palmar arch - Joining of ulnar and radial arteries - Contribution mainly by the ulnar artery
31
Describe the deep palmar arch
Deep palmar arch - Joining of ulnar and radial arteries - Contribution mainly by the radial artery
32
Describe the palmar digital arteries that arise from the superficial palmar arch
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
Describe the palmar digital arteries that arise from the deep palmar arch
Deep palmar arch - Gives off palmar metacarpal arteries - Radialis indicis artery to the index finger - Princeps pollicis artery to the thumb
34
Describe the dorsal digital arteries
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
Where do the dorsal superficial veins commence?
They commence at the dorsal venous network
36
What is formed from the dorsal venous network?
Basilic and cephalic veins
37
Describe the cephalic vein
- Lies laterally - Lies superficial - Disappears in deltopectoral triangle - Drains into subclavian vein
38
Where do the basilic and cephalic veins join? What joins them?
They join at the cubital fossa. Median cubital vein joins them
39
Describe the deep veins
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
What nerve does the median nerve give off in the cubital fossa?
Anterior interosseus nerve
41
Which muscles are innervated by the anterior interosseus nerve?
Deep flexors - Flexor pollicis longus - Lateral half of Flexor digitorum profundus - Pronator quadratus
42
The median nerve enters the palm via the____________________
carpal tunnel
43
Which muscles of the hand are supplied by the median nerve?
Supplies thenar group and lateral 2 lumbricals
44
The median nerve gives sensory innervation to ____________________
lateral 3 ½ fingers
45
The __________ nerve runs over the flexor retinaculum at the wrist
Ulnar
46
Explain the division of the ulnar nerve and what they innervate
Superficial branch - Skin on medial 1 ½ fingers on both surfaces * Deep branch innervates - Hypothenar - 2 medial lumbricals - All interossei - Adductor pollicis muscle
47
What is innervated by the deep branch of the radial nerve? (post. interosseus nerve)
- 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
What is innervated by the superficial branch of the radial nerve?
Superficial innervates lateral 3 ½ of dorsum
49
Intrinsic hand muscles
Thenar Hypothenar Lumbricals Adductor pollicis Palmar interosseous Dorsal interosseous
50
Thenar muscles
AFO -Abductor pollicis brevis -Flexor pollicis brevis -Opponens pollicis
51
Hypothenar mucsles
AFO Abductor digiti minimi Flexor digiti minimi Opponens digiti minimi
52
Where do lumbricals arise from?
FDP (flexor digitorum profundus) tendon
53
Palmar interosseous
PAD (adduct)
54
Dorsal interosseous
DAB (abduct)