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Phase 1 - Anatomy > Anatomy - The Hand > Flashcards

Anatomy - The Hand Flashcards

1
Q

What does the radial nerve give motor innervation to?

A

Triceps brachii, responsible for extension at the elbow. It also innervates extensor muscles in the posterior compartment of the forearm.

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2
Q

What does the radial nerve give sensory innervation to?

A

Skin on the posterior side of the forearm and the posterior aspect of the hand.

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3
Q

What would be the effect of damage to the radial nerve?

A

Unable to extend the forearm, wrist and fingers. Unopposed flexion of the wrist: ‘wrist drop’. Loss of sensation over the posterior forearm and hand.

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4
Q

What would be the effect of damage to the ulnar nerve?

A
  • Unable to abduct and adduct the fingers.
  • Movement of the little and ring fingers is reduced.
  • A hand deformity called ‘ulnar claw’ will develop long term.
  • Loss of sensation to the medial 1.5 fingers and medial palm.
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5
Q

What does the ulnar nerve give sensory innervation to?

A

Medial 1.5 fingers and the medial palm.

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6
Q

What does the ulnar nerve give motor innervation to?

A

Muscles of the hand, flexor carpi ulnaris (flexes and adducts the hand at the wrist) and medial half of the flexor digitorum profundus (flexes the fingers).

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7
Q

What bone does flexor digitorum profundus originate from?

A

The ulna bone.

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8
Q

What is the innervation to flexor digitorum profundus?

A
  • Medial half (little and ring fingers) - ulnar nerve. - Lateral half (middle and index fingers) - median nerve.
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9
Q

What is the action of flexor digitorum profundus?

A

It flexes the interphalangeal joints and the metacarphophalangeal joints.

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10
Q

What bone does flexor pollicis longus originate from?

A

The anterius radius.

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11
Q

What is the insertion of flexor pollicis longus?

A

The thumb.

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12
Q

What is the innervation of flexor pollicis longus?

A

Median nerve.

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13
Q

What is the action of flexor pollicis longus?

A

It flexes the interphalangeal joints and the metacarphophalangeal joints of the thumb.

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14
Q

What is the action of pronator quadratus?

A

It pronates the forearm.

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15
Q

Name 3 forearm muscles that are not supplied the median nerve.

A
  1. Flexor carpi ulnaris. 2. The medial half of flexor digitorum profundus. 3. Brachioradialis.
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16
Q

What are the 3 main groups of bones in the hand?

A
  1. Carpal bones. 2. Metacarpals. 3. Phalanges.
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17
Q

How many phalanges does each finger have?

A

3.

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18
Q

How many phalanges does the thumb have?

A

2.

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19
Q

How many carpel bones are there?

A

8.

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20
Q

Why is the skin of the palm adherent to the underlying connective tissue?

A

To prevent the skin from slipping off the hand whilst gripping.

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21
Q

What is the carpal tunnel?

A

A space between the flexor retinaculum and the carpal bones.

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22
Q

What structures pass through the carpal tunnel?

A

Flexor tendons entering the hand and the median nerve.

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23
Q

What is the cause of carpal tunnel syndrome?

A

Swelling of the tendons increases the pressure in the tunnel and compresses on the median nerve.

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24
Q

What are the symptoms of carpal tunnel syndrome?

A

Pain, diminished sensation the hand and weakness of the thenar muscles.

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25
Q

What arteries form the superficial palmar arch?

A

The ulnar artery and a small contribution from the radial artery.

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26
Q

What is the superficial palmar arch?

A

An arterial arcade formed mainly by the ulnar artery that gives off 4 digital branches to the fingers.

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27
Q

What nerve branch arises from the median nerve in the forearm?

A

Palmar cutaneous nerve.

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28
Q

What does the palmar cutaneous branch of the median nerve innervate?

A

The skin of the lateral palm.

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29
Q

What are the two terminal branches of the median nerve?

A
  1. Recurrent branch. 2. Palmar digital branch.
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30
Q

What does the palmar digital branch of the median nerve innervate?

A

The palmar surface and fingertips of the lateral 3.5 digits. It also gives motor innervation to the lateral 2 lumbricles.

31
Q

What are the 3 main nerve branches of the ulnar nerve?

A
  1. Palmar cutaneous branch. 2. Dorsal cutaneous branch. 3. Superficial branch.
32
Q

What does the palmar cutaneous branch of the ulnar nerve innervate?

A

The skin on the medial half of the palm.

33
Q

What does the dorsal cutaneous branch of the ulnar nerve innervate?

A

Skin of the medial 1.5 digits and the associated dorsal hand area.

34
Q

What does the superficial branch of the ulnar nerve innervate?

A

The palmar surface of the medial 1.5 fingers.

35
Q

What nerve and artery lie superficial to the flexor retinaculum?

A

The ulnar nerve and artery.

36
Q

True or false: the ulnar nerve and artery pass through the carpal tunnel.

A

False. They lies superficial to the flexor retinaculum and so outside of the carpal tunnel.

37
Q

What intrinsic hand muscles are innervated by the median nerve?

A

The 3 thenar muscles and the lateral 2 lumbricles.

38
Q

Where are the thenar muscles located?

A

At the base of the thumb.

39
Q

What is the action of the thenar muscles?

A

Fine movements of the thumb.

40
Q

Name the 3 thenar muscles.

A
  1. Abductors pollicis brevis. 2. Flexor pollicis brevis. 3. Opponens pollicis.
41
Q

Where do the abductors pollicis brevis and flexor pollicis brevis insert?

A

The lateral aspect of the 1st phalanx of the thumb.

42
Q

What is the action of opponens pollicis?

A

It opposes the thumb by medially rotating and flexing the metacarpal.

43
Q

Where are the hypothenar muscles attached?

A

The little finger. They are mirror images of the thenar muscles.

44
Q

What nerve innervates the hypothenar muscles?

A

The deep branch of the ulnar nerve.

45
Q

Name the 3 hypothenar muscles.

A
  1. Abductor digiti minimi. 2. Flexor digiti minimi. 3. Opponens digiti minimi.
46
Q

How many lumbrical muscles are there in each hand?

A

4 - each associated with a finger.

47
Q

What is the innervation to the lumbrical muscles.

A
  • The medial 2 = deep branch of ulnar nerve. - The lateral 2 = median nerve.
48
Q

What is the origin of the lumbricals?

A

The flexor digitorum profundus tendon.

49
Q

What is the action of the lumbricals?

A

Flexion of the metacarphophalangeal joint and extension of the interphalangeal joints.

50
Q

What covers the flexor tendons?

A

A fibrous flexor sheet that fans out into synovial sheaths.

51
Q

What is the importance of the synovial sheath that covers the flexor tendons?

A

It reduces friction in flexion and extension.

52
Q

What is the innervation to the interossei muscles?

A

The deep branch of the ulnar nerve.

53
Q

What is the action of the dorsal interossei muscles?

A

Abduction.

DAB

54
Q

What is the action of the palmar interossei muscles?

A

Adduction.

PAD

55
Q

What carpal bones are most prone to injury?

A

The scaphoid is most prone to fracture and the lunate is most prone to dislocation.

56
Q

What is the complication of a scaphoid fracture?

A

The artery supplying the scaphoid bone is often affected and so the bone can be without blood supply: avascular necrosis.

57
Q

The ulnar artery and nerve lie superficially to the flexor retinaculum. Which lies medially?

A

The ulnar nerve lies medial and the artery lateral.

58
Q

What is the cutaneous distribution of the median nerve?

A

The lateral palm of the hand and the palmar surface of the lateral 3.5 digits.

59
Q

What is the cutaneous distribution of the ulnar nerve?

A

The medial palm of the hand and the palmar and dorsal surfaces of the medial 1.5 digits.

60
Q

List the hand muscles supplied by the deep branch of the ulnar nerve.

A
  1. Hypothenar muscles. 2. Medial 2 lumbricles. 3. Interossei muscles.
61
Q

What are the 2 location where the ulnar nerve is often damaged?

A

At the elbow and at the wrist.

62
Q

What is the mnemonic to help learn the carpal bones?

A

Some Lovers Try Positions That They Cannot Handle

63
Q

Name the Carpal bones?

A

Proximal row starting nearest the thumb:

  1. Scaphoid
  2. lunate
  3. triquetral
  4. pisiform

Distal row starting at the base of the thumb:

  1. trapezium
  2. trapezoid
  3. capitate
  4. hamate
64
Q

Why is blood supply in the scaphoid bone unusual? What is the clinical relevance?

A
  • retrograde blood supply due to the fusion of 2 embryological bones and therefore blood supplies (radial artery branch)
  • most common fractured carpal bone
    • at risk of avascular necrosis of proximal part of the scaphoid
65
Q

Describe LLOAF?

A

The mnemonic to remember the muscles innervated by the median nerve

LL - lateral 2 lubricals (middle and index finger)

O - opponens pollicis (thumb)

A - abductor pollicis brevis (thumb)

F - flexor pollicis brevis (thumb)

The rest of the motor supply is via the ulnar nerve

66
Q
A
67
Q
A
68
Q
A

sensory palm:

Green - median nerve

Yellow - ulnar

Red - radial

69
Q
A

sensory dorsal:

Red - radial

Green - median

Yellow - ulnar

70
Q
A
71
Q
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72
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A
73
Q
A
74
Q
A

Phase 1 - Anatomy (29 decks)

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