Anatomy of the Hand and Wrist

Question 1

Which nerve is associated with wrist drop?

Answer 1

Radial nerve

Question 2

What type of joint is the wrist joint?

Answer 2

It is a condyloid joint

Question 3

What type of joint is the carpo metacarpal of the first digit (trapezium and first metacarpal)

Answer 3

Synovial saddle joint

Question 4

What type of joint exist between the carpo-metacarpal of the 2nd - 5th digits?

Answer 4

Condyloid

Question 5

What type of joint is the proximal metacarpo-phalyngeal?

Answer 5

Synovial condyloid

Question 6

What type of joints are interphalyngeal joints?

Answer 6

Hinge

Question 7

Subclavian becomes axillary at lateral border of 1st rib

Axillary becomes brachial at inferior border of teres major m.

Brachial divides into radial and ulnar in cubital fossa

Radial and ulnar form palmar arches in palm of hand which give off digital aa (run either side of digits).

The ulnar artery is the main contributor to the more distal superficial palmar arch.

The radial artery is the main contributor to the more proximal deep palmar arch.

Question 8

Superficial veins arise from the dorsal venous arch on the back of the hand

Cephalic vein travels up the limb on lateral side. Drains into axillary vein below clavicle

Basilic vein travels up the limb on medial side. Becomes continuous with brachial veins (deep veins accompanying brachial a.)

Median cubital vein connects cephalic and basilic across cubital fossa

Answer 8

Question 9

What drains the lymph from the upper limb?

Answer 9

Upper right quarter of the body = right lymphatic duct

everything else = thoracic duct

Question 10

How many flexor and extensor muscles are there?

Answer 10

•Flexor-pronators

8 muscles

•Extensor

11 muscles

•Brachioradialis

(Exception: does flexion of forearm but muscle of the posterior compartment and supplied by the radial nerve)

Question 11

Forearm flexors

Question 12

Forearm flexors

Question 13

Forearm extensors

Answer 13

Question 14

Forearm extensors

Answer 14

Question 15

Forearm flexors

Answer 15

Question 16

What artery lies in the anatomical snuff box?

Answer 16

Radial artery

Question 17

What runs in the carpal tunnel?

Answer 17

9 tendons of FDS, FDP and FPL together with the median nerve

Question 18

What are the flexors of the arm and the forearm innervated by?

Answer 18

Arm = musculocutaneous nerve

Forearm = median nerve and ulnar nerve

Brachioradialis is innervated by the radial nerve which is the large exception

Question 19

What innervates the extensors of the arm and the forearm?

Answer 19

Radial nerve

Question 20

How many of the following muscles exist?

Thenar

Hypothenar

Palmar interossei

Dorsal interossei

Answer 20

• Thenar M (x4)
• Hypothenar (x3)
• Lumbricals (x4)
• Palmer interossei (x3)
• Dorsal interossei (x4)

Question 21

What nerves in the hand are supplied by the median nerve?

Answer 21

Abductor pollicis brevis, flexor pollicis brevis, flexor, opponens pollicis brevis

Flexor pollicis longus is also innervated by the median nerve although I think this may be classified as a muscle of the forearm

Question 22

Thenar muscles

Answer 22

Question 23

What are the hypothenar muscles?

Answer 23

Flexor digiti minimi

Abductor digiti minimi

Opponens digiti minimi

Question 24

Function: Thenar & Hypothenar

Answer 24

Question 25

Functions: Interossei

Answer 25

Question 26

Where do lumbricals arise from?

Answer 26

They originate from the FDP tendons

Question 27

What is the action of lumbricals?

Answer 27

Simultaneously flex the MCP joint and extend the PIP joint

Question 28

What is the distal attachment of lumbrical muscles?

Answer 28

distal attachments of these muscle is on to the dorsal expansions of the phalanges.

Question 29

What are the features of a median nerve injury?

Answer 29

First two lumbrical muscles are paralysed

Question 30

What does an ulnar nerve injury look like?

Answer 30

Loss of flexion of terminal phalynges of little and ring fingers due to loss of flexor digitorum profundus.

There is also hypothenar and interosseous wasting