Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 2 LCRS > Anatomy of the Limbs 4 - The Hand > Flashcards

Anatomy of the Limbs 4 - The Hand Flashcards

1
Q

List the types of grip

A
  • Power grip (fingers are flexed around an object with counter pressure from the thumb)
  • Precision grip (the object is gripped between the tips of the fingers and the thumb, with the intrinsic muscle of the hand carrying out the fine movements needed)
  • Hook grip (little energy, involves long flexor digits, e. carrying a shopping bag)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

List the muscle groups activated in power grip

A
  • Long flexors of the fingers and thumb
  • Intrinsic muscles of the palm
  • Extensors of the wrist joint (to give more power to long flexors)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

List the muscles typically used in precision grip

A
  • Long flexors and extensors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the palmar fascia?

A
  • The fascia of the hand that lies in the palm
  • Anatomically continuous with the forearm
  • Specilisations of the palmar fascia form the palmar aponeurosis and fibrous digital sheaths
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the palmar aponeurosis?

A
  • A well defined region of palmar fascia that overlies the long flexor tendons of the hand
  • Proximal end of the palmar apponeurosis is continuous with the flexor retinaculum and the palmaris longus tendon (although still there when palmaris longus tendon is absent)
  • Distal end forms four bands, which are continuous with the fibrous digital sheaths of each finger
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the fibrous digital sheaths?

A

Tubes which contain the flexor tendons and their sheaths

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

List the compartments of the space between the palmar apponeurosis and the bones of the hand

A
  • Separated by septa
  • Medial septum (to the little finger metacarpal) and a lateral septum (to the middle finger metacarpal) divide the space into:
    • Hypothenar compartment (for the little finger)
    • Central compartment
    • Thenar compartment (part of the palm closes to the thumb - small intrinsic muscles of the thumb)
  • Deep to the thenar compartment there is a fourth adductor compartment, containing the adductor pollicis muscle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

List the bones of the wrist and hand

A
  • Radius
  • Ulna
  • Carpal bones (medial to lateral):
    • Proximal row (pisiform, triquetum, lunate, scaphoid)
    • Distal row (hamate, capitate, trapezoid, trapezium)
  • Metacarpal bones
  • Phalanges
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

List the thenar muscles

A
  • Abductor pollicis brevis
  • Flexor pollicis brevis
  • Opponens pollicis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

List the adductor muscles of the hand

A

Adductor pollicis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

List the hypothenar muscles of the hand

A
  • Abductor digiti minimi
  • Flexor digiti minimi
  • Opponens digiti minimi
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

List the interossei and lumbricals. What are their functions?

A
  • Lumbricals - flex at MCP’s, extend at the IPJ’s
  • Palmar interossei adduct the digits (PAD)
  • Dorsal interossei abduct the digits (DAB)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the other muscle of the intrinsic hand muscles (not including the compartments, interossei and lumbricals)?

A

Palmaris brevis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the attachment, function and innervation of the palmaris brevis?

A
  • From palmar aponeurosis and flexor retinaculum to dermis of skin on the medial margin of the hand
  • Superficial branch of ulnar nerve
  • Improves grip
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the attachment, function and innervation of the dorsal interossei?

A
  • 4 muscles
  • Adjacent sides of metacarpals to extensor hood and base of proximal phalanges of index, middle and ring fingers
  • Deep branch of ulnar nerve
  • Abduction of the index, middle and ring fingers at the metacarpophalangial joins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the attachment, function and innervation of the palmar interossei?

A
  • Three or four muscles
  • Sides of metacarpals to extensor hoods of the thumb, index, ring and little fingers, and the proximal phalanx of the thumb
  • Deep branch of ulnar nerve
  • Adduction of the thumb, index, ring and little fingers at the metacarpophalangeal joints
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the attachment, function and innervation of the adductor pollicis?

A
  • Transverse head attaches to metacarpal III
  • Oblique head to capitate and bases of metacarpals II and III
  • From heads to the base of proximal phalanx and extensor hood of thumb
  • Deep branch of ulnar nerve
  • Adducts the thumb
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the attachment, function and innervation of the lumbricals?

A
  • 4 muscles
  • Tendons of flexor digitorum profundus to the extensor hoods of the index, ring, middle and little fingers as a tendon, forming the extensor expansion
  • Medial two by the deep branch of the ulnar nerve, lateral two by digital branches of median nerve
  • Flex metacarpophalangeal joints while extending interphalangeal joints
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the attachment, function and innervation of the opponens pollicis?

A
  • Tubercle of trapezium and flexor retinaculum to lateral margin and adjacent palmar surface of metacarpal I
  • Recurrent branch of median nerve
  • Medially rotates the thumb
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the attachment, function and innervation of the abductor pollicis brevis?

A
  • Tubercles of scaphoid and trapezium and adjacent flexor retinaculum to the proximal phalanx and extensor hood of the thumb
  • Recurrent branch of median nerve
  • Abducts thumb at metacarpophalangeal joint
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the attachment, function and innervation of the flexor pollicis brevis?

A
  • Tubercle of the trapezium and flexor retinaculum
  • Proximal phalanx of the thumb
  • Recurrent branch of median nerve
  • Flexes thumb at metacarpophalangeal joint
22
Q

What is the attachment, function and innervation of the opponens digiti minimi?

A
  • Hook of hamate and flexor retinaculum to the medial aspect of metacarpal V
  • Deep branch of ulnar nerve
  • Laterally rotates metacarpal V
23
Q

What is the attachment, function and innervation of the abductor digiti minimi?

A
  • Pisiform, pisohamate ligament, and tendon of flexor carpi ulnaris to the proximal phalanx of the little finger
  • Deep branch of ulnar nerve
  • Abducts little finger at metacarpophalangeal joints
24
Q

What is the attachment, function and innervation of the flexor digiti minimi brevis?

A
  • Hook of the hamate and flexor retinaculum to the proximal phalanx of the little finger
  • Deep branch of ulnar nerve
  • Flexes the little finger at the metacarpophalangeal joint
25
Q

Describe the anterior tendinous anatomy of the hand

A
  • Fibrous digital sheaths from the level of the metacarpal head to the base of the distal phalanx in each digit
  • Form osseo-fibrous tunnels with underlying bone, through which the long flexor tends and their synovial sheaths run
  • Parts of the digital sheath form the annular and cruciform pulleys
  • Tendons of flexor digitorum profundus and superficialis past deep to the flexor retinaculum to enter a common synovial sheath, They pass to their respective digit via a digital synovial sheath contained within the fibrous digital sheath (usually, those of the index, middle and ring fingers are separate from the common synovial sheath)
  • FDS splits around the FDP and attaches to the middle phalanx, while the FDP attaches to the distal phalanx
  • The flexor pollicis longus has its own synovial sheath at the flexor retinaculum, and then runs to the distal phalanx of the thumb
26
Q

What is the function of the annular and cruciform pulleys?

A
  • Allow more functional use of the long flexor tendons

- Hold the tendons down to prevent bowing

27
Q

Describe the posterior tendinous anatomy of the hand

A
  • All extensor tendons are held to the dorsum of the wrist region by the extensor retinaculum
  • Synovial tendon sheaths surround the tendons to allow free movement
  • Long extensor tendons are joined by inter-tendinous bands, which prevent movement of one extensor tendon independently of the others
  • At the level of metacarpals, long extensor tendons form extensor expansions which form a hood on the back of the digit. The lumbricals and interossei attach to this extensor expansion.
  • Extensor expansions are intricately involved in movement of the digits
28
Q

What is the function of the extensor digitorum?

A
  • Extensor digitorum extends the MCP joint and IP joints
  • Extends the wrist joint after maximal extension of the digits
  • Index finger and little finger have their own individual long extensors
29
Q

List the joints of the region

A
  • Distal radio-ulnar joint
  • Wrist joint
  • Intercarpal joints
  • Carpo-metacarpal and inter-metacarpal joints
  • Metacarpo-phalangeal joints
  • Interphalangeal joints
30
Q

List the intercarpal joints

A
  • All synovial
  • Joints between proximal row of carpal bones
  • Joints between the distal row of carpal bones
  • Joints between the proximal and distal row of carpal bones (midcarpal joint)
31
Q

List the movements of the intercarpal joints

A

Gliding, augmenting the movement occurring in the wrist joint itself, especially flexion and radial deviation of the wrist

32
Q

What is the carpo-metacarpol joint of the thumb and why is it significant?

A
  • Articulation between the trapezium and the thumb metacarpal
  • Often becomes osteoarthritic
  • Synovial joint of the saddle variety
33
Q

What type of joint are the other carpo-metacarpal joints, not including the thumb?

A
  • Synovial ellipsoid joints between the trapezoid, capitate and hamate with the metacarpals of the digits
  • Index and middle finger CMC’s are very rijit, the ring finger is less rigid and the little finger is very mobile
34
Q

Where are the plane synovial intermetacarpal joints?

A

Between the metacarpals and their bases

35
Q

List the movements that occur at the C-MC and IMC joints

A
  • Flexion and extension
  • Radial deviation and ulnar deviation
  • Circumduction
36
Q

What are the metacarpophalangeal joints? What are their movements?

A
  • Condylar synovial joints between the metacarpal heads and the proximal phalanges
  • Flexion and extension
  • Abduction and adduction
  • Ulnar collateral ligament of the thumb
37
Q

What are the interphalangeal joints?

A
  • Hinge synovial joints, allow for flexion and extension
  • Proximal and distal joint for each digit
  • The thumb has only one
38
Q

List the important ligaments holding the MCP and IP joints together

A

Collateral ligaments (radial and ulnar - ulnar is clinically significant as it is frequently injured skiing when falling onto the outstretched thumb)

39
Q

What is the volar plate of the hand?

A
  • Important structure on the anterior surface of the proximal interphalangeal joint.
  • Dense condensation of fibrous tissue formed by the collateral ligaments at the front of the proximal IP joint. Frequently damaged
40
Q

List the muscles that move the thumb

A

Abduction

  • Abductor pollicis longus
  • Abductor pollicis brevis

Adduction

  • Adductor pollicis
  • First dorsal interosseous

Extension

  • Extensor pollicis longus
  • Extensor pollicis brevis
  • Abductor pollicis longus

Flexion

  • Flexor pollicis longus
  • Flexor pollicis brevis

Opposition
- Opponens pollicis (carpo-metacarpal joint)

41
Q

Describe the blood supply of the hand via the ulnar artery

A
  • Runs in anterior compartment of the forearm, passes on the ulnar side of the palmar surface of wrist, just lateral to the FCU (FCU, ulnar nerve, ulnar artery)
  • In forearm, forms common anterior and posterior interosseous artery
  • Runs into the hand over the flexor retinaculum, lateral to the pisiform through the semi-rigid ulnar canal with the ulnar nerve
  • Divides to form superficial palmar branch (recieves from superficial palmar branch of radial artery) and the deep palmar branch of the ulnar artery
  • Superficial palmar branch gives off three common palmar digital branches, which divide into palmar digital arteries
42
Q

Describe the blood supply of the hand via the radial artery

A
  • Passes down lateral aspect of the forearm under the brachioradialis muscle
  • Crosses floor of anatomical snuff box to enter the hand between the two heads of the dorsal interosseous muscle
  • Then passes between the two heads of the first adductor pollicis muscle
  • Anastamoses with deep palmar branch of the palmar artery to form the deep palmar arch
  • Deep palmar branch also gives origin to the palmar metacarpal arteries
43
Q

Describe the venous drainage of the hand

A
  • Superficial and deep palmar arterial arches have corresponding palmar venous arches (deep draining)
  • Dorsal digital veins drain into the dorsal venous arch on the dorsum of the hand
  • Gives rise to the cephalic vein laterally and the basilic vein medially
44
Q

List the three main nerves of the hand

A
  • Median nerve
  • Ulnar nerve
  • Radial nerve
45
Q

What are the sensory nerves of the digits?

A
  • Digital nerves (easy damaged - very important)

- All three nerves contribute

46
Q

What does the median nerve supply in the hand? Describe its pathway.

A
  • Lies superficially between FDS and FDP, deep to palmaris longus
  • Enters carpal tunnel, accompanied by 9 flexor tendons where it passes under the flexor retinaculum
  • Motor supply to three thenar muscles (abductor pollicis brevis, flexor pollicis brevis, opponens pollicis)
  • Lateral (first and second) lumbricals
  • Recurrent branch of the median nerve supplies the thenar muscles
  • Sensory supply to the palmar surface of thumb, index, middle fingers and lateral half of ring finger. Supplies some dorsal surface of these digits
47
Q

What does the ulnar nerve supply in the hand? Describe its pathway.

A
  • Proximal to the wrist, it fives off two cutaneous branches (palmar cutaneous branch, which supplies the medial palm of the hand, and the medial portion of flexor difitorum profundus, which supplies the medial half of the dorsum of the hand, and the little and ring fingers)
  • At the wrist lies between FCU (medial) and ulnar artery (lateral)
  • Passes over flexor retinaculum in the ulnar canal with the ulnar artery, lateral to the pisiform bone.
  • Superficial branch of the ulnar nerve is sensory to the palmar surface of little finger and medial side of ring finger
  • Deep branch is motor to hypothenar muscles, adductor pollicis, medial (third and fourth) lumbricals and the interossei
48
Q

What does the radial nerve supply in the hand? Describe its pathway

A
  • Superficial branch of radial nerve is sensory to the lateral two thirds of the dorsum of the hand, the dorsum of the thumb and the proximal portions of the dorsal index and middle fingers
  • Posterior interosseous nerve is the direct continuation of the deep radial nerve as it passes through the heads of the supinator. Does not supply any muscles in the hand.
49
Q

What is in the carpal tunnel?

A
  • Median nerve
  • Tendon of the flexor pollicis longus
  • Four tendons of the flexor digitorum profundus
  • Four tendons of flexor digitorum superficialis from the forearm to the hand
  • Have a synovial sheath around them
50
Q

What are the the borders of the carpal tunnel formed from?

A
  • Base is formed form the bony arch of the carpal bones
  • Palpable bony margins are laterally the scaphoid and trapezoid bones, and medially the pisiform and hamate bones
  • The roof is the flexor retinaculum
51
Q

What is carpal tunnel syndrome?

A
  • Compression of the median nerve in the carpal tunnel

- Results in tingling, loss of sensation and pain in the hand

52
Q

What can the result of fracture of the scaphoid be?

A
  • Avascular necrosis
  • Caused by damage to the blood supply via the radial nerve
  • Supply is retrograde (distal to proximal), so the proximal part will loose its only blood supply and necrose
  • Results in long term disability

Year 2 LCRS (128 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions