Anatomy of the hand

Question 1

Skeleton

Answer 1

Carpals

Metacarpals

Phalanges

Question 2

Carpal bones

Answer 2

Lunate

Scaphoid

Trapezium

Trapezoid

Triquetral/ triquetrium

Pisiform

Hamate

Capitate

Question 3

Clinical: carpal bones

Answer 3

Fracture of scaphoid common

Question 4

Joints of the hand

Answer 4

Wrist (radiocarpal)

Saddle joint

Midcarpal/ intercarpal

Carpometacarpal

Metacarpophalangeal

Interphalangeal

Question 5

Wrist joint (radiocarpal)

Answer 5

Between radius/ disc and first carpal row

Reinforced by ligaments

• ulnar and radial collateral ligaments
• ligaments on the palmar/ dorsal surfaces

Question 6

Carpometacarpal joints

Answer 6

Plane joints- limited movement

Except for the saddle joint
- enables opposition

Question 7

Metacarpophalangeal joints

Answer 7

Condylar joints

Flexion/ extension

Abduction/ adduction

Question 8

Deep transverse metacarpal ligaments

Answer 8

Unifies metacarpal

Not between digit 1 and 2

Question 9

Interphalangeal joints

Answer 9

Hing joints

Flexion/ extension

Proximal interphalangeal joints

Distal interphalangeal joints

Question 10

Palmar aponeurosis

Answer 10

Thickened deep fascia

Triangular

Continuous with palmaris longus

Question 11

Clinical: palmar aponeurosis

Answer 11

Dupuytren’s contracture

Question 12

Long flexor tendons to digits

Answer 12

From muscles in anterior forearm

Pass through carpal tunnel

Flexor digitorum superficialis (d2-5)

Flexor digitorum profundus (d2-5)

Flexor pollicis longus (d1)

Flexor retinaculum

Question 13

Long extensor tendons to digits

Answer 13

Extensor digitorum 2-5

Extensor indicis 2

Extensor digit minimi 5

Extensor pollicis longus 1

Extensor pollicis brevis 1

Abductor pollicis longus 1

Question 14

Anatomical snuff box

Answer 14

Abductor pollicis longus
- to base of 1st metacarpal

Extensor pollicis brevis
- to base of proximal phalanx

Extensor pollicis longus
- to base of distal phalanx

Question 15

Extensor hoods

Answer 15

Lumbricals and interossei insert into the extensor hoods

Question 16

Lumbricals

Answer 16

Link flexor to extensor tendons

Extend interphalangeal joints and flex MCP joints

Precision grip (hold pen/ pinch)

Question 17

Palmar interossei

Answer 17

Sit between the metacarpals

3 palmar interossei

Adduct MCP joints

Question 18

Dorsal interossei

Answer 18

4 dorsal interossei

Abduct MCP joints

Question 19

Thenar muscles

Answer 19

Fine movements of the thumb (d1)

Three muscles

• opponens pollicis
• abductor pollicis brevis
• flexor pollicis brevis

Question 20

Hypothenar muscles

Answer 20

Fine movements of the little finger

Three muscles

• opponens digiti minimi
• abductor digiti minimi
• flexor digiti minimi

Question 21

Blood supply

Answer 21

Radial artery, towards dorsal surface

Ulnar artery

Form complex anastomosis in hand

Question 22

Deep palmar arch

Answer 22

Below long flexor tendons

Question 23

Superficial palar arch

Answer 23

Above long flexor tendons

Question 24

Median nerve

Answer 24

Passes through carpal tunnel

Becomes recurrent branch
- thenar muscles

Becomes digital nerves

• lateral 2 lumbricals
• sensory d1 to 1/2 d4

Question 25

Clinical: median nerve

Answer 25

Carpal tunnel syndrome

Question 26

Ulnar nerve

Answer 26

Becomes deep branch

• hypothenar muscles
• interossei
• medial 2 lumbricals
• adductor pollicis

Superficial branch
- sensory 1/2 d4 and d5

Question 27

Clinical: ulnar nerve

Answer 27

Clawed hand