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204- MSK > Anatomy of the hand > Flashcards

Anatomy of the hand Flashcards

1
Q

Starting most laterally, state the names of the proximal carpal bones

A

Scaphoid
Lunate
Triquetral
Pisiform

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2
Q

Starting most laterally, state the names of the distal carpal bones

A

Trapezium
Trapezoid
Capitate
Hamate

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3
Q

Which bone in the proximal carpal bone is prone to francture?

A

Scaphoid

  • slow recovery due to poor blood supply to proximal part –> avascular necrosis
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4
Q

State the joints of hands

A

Wrist (radiocarpal)
Midcarpal/intercarpal
Carpometacarpal (saddle joint)

Metacarpophalangeal
Interphalangeal

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5
Q

Describe the wrist joint

A

Between radius/disc and first carpal row

Reinforced by ligaments

  • Ulnar and radial collateral ligaments
  • Ligaments on the palmar/dorsal surfaces

Facilitates flexion/extension, abduction/adduction and circumduction

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6
Q

State the functions of the ligaments which stabilise the wrist

A

Ulnar and radial collateral ligaments
- limits abduction/adduction

Ligaments on the palmar/dorsal surfaces
- limits extension/flexion

Radial styloid process
- limits range of abduction

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7
Q

Describe the carpometacarpal joinits

A
  • Plane joints which limit movement

EXCEPT for the saddle joint (between trapezium and d1) which enables opposition

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8
Q

State the movements of the thumb

A

Extension, flexion, abduction, adduction, opposition, reposition

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9
Q

Describe the metacarpophalangeal joints

A

Condylar joints

Facilitate flexion/extension, abduction/adduction

The deep transverse metacarpal ligaments unifies metacarpals but not between d1 and d2

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10
Q

Describe the interphalangeal joints

A

Hinge joints

Facilitate flexion/extension

Proximal interphalangeal joints (PIPs) AND Distal interphalangeal joints (DIPs)

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11
Q

Describe the palmar aponseurosis and its clinical relevance

A

Thickened deep fascia in a triangular shape which is continuous with palmaris longus. Contains longitudinal and transverse fibres

Dupuytren’s contracture is fibrosis of it

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12
Q

Describe the long flexor tendons to digits

A

From muscles in anterior forearm and pass through carpal tunnel

Paired tendons enter fibrous digital sheaths –> synovial sheath

Alternating fibrous annular (a1-5 pulleys) and cruciate ligaments

The vinculae attaches tendons to phalanges

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13
Q

Which muscles from the posterior forearm serve d2-5?

A

Extensor digitorum

Extensor indicis

Extensor digit minimi

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14
Q

Which muscles from the posterior forearm serve d1?

A

Extensor pollicis longus

Extensor pollicis brevis

Abductor pollicis longus

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15
Q

How can you detect fracture in scaphoid bone?

A

Scaphoid fracture = pain in anatomical snuff box

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16
Q

State the borders of the anatomical snuff box and give their insetions

A

Abductor pollicis longus
-To base of 1st metacarpal

Extensor pollicis brevis
- To base of proximal phalanx

Extensor pollicis longus
- To base of distal phalanx

17
Q

State the insertion of the medial and lateral bands of the extensor digitorum

A

Medial band
- into middle phalanx

Lateral band
- into distal phalanx

18
Q

Which muscles insert into the extensor hoods

A

lumbricals and interossei

19
Q

What is the function of the lumbricals?

A
  • Link flexor to extensor tendons
  • Extend interphalangeal joints and flex MCP joints
  • Precision grip
20
Q

State the location and innervation of the lumbricals

A

Lateral to d2-5 (intrinsic muscles)

Median nerve supple lateral 2

Ulnar nerve supplies medial two

21
Q

Describe the palmar interossei muscles

A
  • Three of them which sit between the metacarpals
  • Insert into extensor hoods (d2,4,5)
  • They ADDUCT MCP joints (relative to middle finger)
22
Q

Which muscle causes adduction of D1?

Which muscle causes abduction of D1 and 5

A

adductor pollicis muscle

thenar and hypothenar muscles

23
Q

Describe the dorsal interossei muscles

A
  • Four of them which originate at metacarpals and insert into extensor hoods of d2, d3 (x2) and d4
  • They ABducT MCP joints
24
Q

State the function and origin of the thenar and hypothenar muscles

A

Thenar muscles - fine movement of d1

Hypothenar muscles- fine movement sof d5

Originate at flexor retinaculum and adjacent carpal bones

25
Q

Describe the thenar muscles

A

Composed of three muscles
- Opponens pollicis (deepest) inserts into first metacarpal

  • Abductor pollicis brevis
  • Flexor pollicis brevis
    (both insert into proximal phalanx)
26
Q

Describe the hypothenar muscles

A

Composed of three muscles
- Opponens digiti minimi (deepest) inserts into fifth metacarpal

  • Abductor digiti minimi
  • Flexor digiti minimi
    (both insert into proximal phalanx)
27
Q

Describe the muscle responsible for adduction of the thumb

A

Adductor pollicis (deep to thenar muscles)

Oblique head
- base 2nd and 3rd metarcarpal and carpal bones

Transverse head
- ased 3rd metacarpal

Insert onto proximal phalanx\

28
Q

How is the hand anastomosis made? Why is it important?

A

Radial artery (towards dorsal surface) and ulnar artery

So that blood can reach all parts in all hand positions

D1 and 1/2 D2 mainly radial artery

29
Q

Describe the deep palmar arch

A
  • BELOW long flexor tendons
  • ## forms floor of anatomical snuff box
30
Q

State the arterial supply to d1 and d2

A

D1 and 1/2 D2 mainly radial artery

The branches are:

  • princeps pollicis artery
  • radialis indicis artery
31
Q

Describe the superficial palmar arch

A
  • ABOVE long flexor tendons
  • three common palmar digital arteries and proper palmer digital arteries

1/2 d2 -d5 = ulnar artery

32
Q

Describe the median nerve in the hand

A
  • Passes through carpal tunnel and gives off recurrent branch (to thenar muscles)
  • Digital nerve supplies lateral 2 lumbricals and sensory d1 to 1/2 d4
  • Clinically responsible for carpal tunnel syndrome
33
Q

Describe the ulnar nerve in the hand

A

Superficial branch
- sensory to 1/2 d4 and d5

Deep branch
- to hypothenar muscles, interossei, medial two lumbricals and adductor pollicis

  • Clinically responsible for ‘clawed hand’

204- MSK (16 decks)

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