Anatomy- wrist and hand Flashcards
1
Q
- Concerning the palmar spaces
a. The hypothenar space contains the long flexor tendons to the 5th digit b. The septum from the radial border of the palmar aponeurosis attaches to the 2nd metacarpal c. The thenar space is bounded posteriorly by adductor pollicis d. The midpalmar space is continuous proximally with anterior compartment of the forearm e. All of the above
A
- Concerning the palmar spaces
a. The hypothenar space contains the long flexor tendons to the 5th digit – midplamar space contains the lond tendons
b. The septum from the radial border of the palmar aponeurosis attaches to the 2nd metacarpal – 3rd
c. The thenar space is bounded posteriorly by adductor pollicis – adductor pollicis is deep to the thenar in the adductor compartment, with the thenar space between
d. The midpalmar space is continuous proximally with anterior compartment of the forearm <= correct, via the carpal tunnel
e. All of the above
2
Q
- Regarding flexion of the fingers
a. Flexor digitorum superficialis inserts at the base of the distal phalanx b. Flexor digitorum profundus enters the fibrous sheath superficial to the flexor digitorum superficialis tendon c. When palmar and dorsal interossei contract together, flexion of the metacarpophalangeal joints results d. The lumbricals are attached to the extensor expansions and to the proximal phalanges e. In the flexor sheath, the tendons of flexor digitorum profundus and flexor digitorum superficialis are invested by separate synovial sheaths
A
- Regarding flexion of the fingers
a. Flexor digitorum superficialis inserts at the base of the distal phalanx - middle
b. Flexor digitorum profundus enters the fibrous sheath superficial to the flexor digitorum superficialis tendon - deep
c. When palmar and dorsal interossei contract together, flexion of the metacarpophalangeal joints results <=
d. The lumbricals are attached to the extensor expansions and to the proximal phalanges – no boney attachment, lateral 2 are unipennate, from FDP to extensor expansion
e. In the flexor sheath, the tendons of flexor digitorum profundus and flexor digitorum superficialis are invested by separate synovial sheaths – common, FPL is exception
3
Q
- Concerning the blood supply of the hand
a. The radial artery crosses the anatomical snuffbox over trapezoid b. The superficial palmar arch is a direct continuation of the radial artery c. The superficial palmar arch is usually a complete arch d. The superficial palmar arch supplies the thumb e. The radial artery gives off the radialis indicis artery and the princeps pollicis artery
A
- Concerning the blood supply of the hand
a. The radial artery crosses the anatomical snuffbox over trapezoid – scaphoid and trapezium
b. The superficial palmar arch is a direct continuation of the radial artery - ulna
c. The superficial palmar arch is usually a complete arch
4
Q
- Regarding tendons across the wrist
a. Flexor carpi ulnaris passes deep to the flexor retinaculum b. Extensor carpi radialis brevis inserts into the base of the 3rd metacarpal c. Flexor digitorum profundus tendons insert into the base of the proximal phalanx d. Extensor carpi radialis longus passes through the carpal tunnel e. Flexor carpi radialis lies superficial to the flexor retinaculum
A
- Regarding tendons across the wrist
a. Flexor carpi ulnaris passes deep to the flexor retinaculum – no attaches to the pisiform (and thus to hook of hamate and base of 5th
b. Extensor carpi radialis brevis inserts into the base of the 3rd metacarpal <= correct
c. Flexor digitorum profundus tendons insert into the base of the proximal phalanx - distal
d. Extensor carpi radialis longus passes through the carpal tunnel - extensor
e. Flexor carpi radialis lies superficial to the flexor retinaculum – all flexors beneath
5
Q
- Movements of the thumb include
a. Radial abduction by abductor pollicis brevis and extensor pollicis brevis b. Opposition by opponens pollicis c. Palmar abduction by abductor pollicis longus d. Adduction by flexor pollicis longus e. Opposition is not important in the power grip
A
- Movements of the thumb include
a. Radial abduction by abductor pollicis brevis and extensor pollicis brevis
b. Opposition by opponens pollicis <=
c. Palmar abduction by abductor pollicis longus
d. Adduction by flexor pollicis longus
e. Opposition is not important in the power grip
6
Q
- The anatomical snuffbox
a. Has the extensor pollicis longus on its ulnar side b. Lies between extensor pollicis longus and abductor pollicis longus c. Has the trapezoid palpable in its base d. Is most obvious with the thumb fully abducted e. Contains the posterior interosseous artery
A
- The anatomical snuffbox
a. Has the extensor pollicis longus on its ulnar side <= and EPB w/ AbdPL on radial side
b. Lies between extensor pollicis longus and abductor pollicis longus – true, but EPB also
c. Has the trapezoid palpable in its base – radial styloid, scaphoid, trapezium and base of 1st MC
d. Is most obvious with the thumb fully abducted - extended
e. Contains the posterior interosseous artery – radial
7
Q
- The flexor retinaculum attaches to all of the following bones except
a. Scaphoid b. Hamate c. Trapezium d. Pisiform e. Capitate
A
- The flexor retinaculum attaches to all of the following bones except
a. Scaphoid
b. Hamate
c. Trapezium
d. Pisiform
e. Capitate <=
8
Q
- Compression of structures in the carpal tunnel usually results in
a. Weakness of forearm flexors b. Weakness of flexion of the terminal phalanx of the thumb c. Weakness of the interossei muscles d. Unaffected sensation on the palmar surface of the little finger e. Weakness of all the lumbrical muscles
A
- Compression of structures in the carpal tunnel usually results in
a. Weakness of forearm flexors
b. Weakness of flexion of the terminal phalanx of the thumb – FPL is a forearm muscle
c. Weakness of the interossei muscles – deep branch ulnar
d. Unaffected sensation on the palmar surface of the little finger <= ulnar distribution
e. Weakness of all the lumbrical muscles – medial 2
9
Q
- With respect to the thenar muscles
a. Abductor pollicis brevis inserts into the base of the distal phalanx of the thumb b. All arise from the flexor retinaculum c. Flexor pollicis is usually supplied by a branch from the ulnar nerve d. Abductor pollicis brevis has no role in opposition of the thumb e. Opponens pollicis is the most superficial muscle of the group
A
- With respect to the thenar muscles
a. Abductor pollicis brevis inserts into the base of the distal phalanx of the thumb – prox phalanx
b. All arise from the flexor retinaculum <= depends if you count adductor pollicis
c. Flexor pollicis is usually supplied by a branch from the ulnar nerve – usually median (recurrent muscular)
d. Abductor pollicis brevis has no role in opposition of the thumb - helps
e. Opponens pollicis is the most superficial muscle of the group – deep to FPB (it’s in the web)
10
Q
- With respect to the flexor retinaculum
a. It attaches to the scaphoid, hamate, pisiform and trapezium b. The tendons of palmaris longus passes deep to it c. The median nerve passes superficial to it d. The ulnar artery passes deep to it e. It is pierced by the tendon of flexor carpi ulnaris
A
- With respect to the flexor retinaculum
a. It attaches to the scaphoid, hamate, pisiform and trapezium <=
b. The tendons of palmaris longus passes deep to it – inserts into it
c. The median nerve passes superficial to it – deep (but is shallow)
d. The ulnar artery passes deep to it – in own canal of Guyon
e. It is pierced by the tendon of flexor carpi ulnaris
11
Q
- In the hand, the deep palmar arch
a. Is normally incomplete b. Is formed by the superficial branch of the ulnar artery c. Crosses the palm 1cm distal to the superficial arch d. Gives off 3 metacarpal arteries e. Does not anastomose with the anterior carpal arch
A
- In the hand, the deep palmar arch
a. Is normally incomplete
b. Is formed by the superficial branch of the ulnar artery – dorsal branch of the radial
c. Crosses the palm 1cm distal to the superficial arch – proximal
d. Gives off 3 metacarpal arteries <= correct
e. Does not anastomose with the anterior carpal arch – does via the metacarpals -> common digitals
12
Q
- Regarding digital nerves
a. Common digital nerves lie superficial to the superficial arch b. Palmar nerves only supply palmar surface c. Digital nerves are only sensory d. Digital nerve lie posterior to digital artery e. ?
A
- Regarding digital nerves
a. Common digital nerves lie superficial to the superficial arch
b. Palmar nerves only supply palmar surface
c. Digital nerves are only sensory <=
d. Digital nerve lie posterior to digital artery – palmar to dorsal: NAV
e. ?
13
Q
- Regarding the interossei of the hand, which is INCORRECT
a. Insert into proximal phalanx b. Insert into the dorsal expansion c. When act together, the dominant action is adduction d. When act together, flex the MCP joint e. ?
A
- Regarding the interossei of the hand, which is INCORRECT
a. Insert into proximal phalanx
b. Insert into the dorsal expansion
c. When act together, the dominant action is adduction <=
d. When act together, flex the MCP joint
e. ?
14
Q
- With regard to the deep spaces of the hand the following are correct EXCEPT:
a. The thenar space always contains the first lumbrical muscle b. The thenar space is overlaid by the flexor tendons to the index finger c. Infection in the midpalmar space can involve the ulnar three lumbricals d. The hypothenar space encloses only the hypothenar muscles e. The thenar space contains the common flexor sheath
A
- With regard to the deep spaces of the hand the following are correct EXCEPT:
a. The thenar space always contains the first lumbrical muscle – lumbricals in the central compartment w/ long flexors, superficial arch, digital nerves and vessels
b. The thenar space is overlaid by the flexor tendons to the index finger
c. Infection in the midpalmar space can involve the ulnar three lumbricals
d. The hypothenar space encloses only the hypothenar muscles <= pg 773
e. The thenar space contains the common flexor sheath
15
Q
- Regarding the carpal tunnel
a. Flexor pollicis longus has its own synovial sheath b. The flexor retinaculum is attached to the scaphoid, trapezium, hamate and triquetrum c. The median nerve lies medial to flexor digitorum superficialis d. Median nerve compression causes paraesthesia of the thenar eminence e. Palmaris longus runs lateral to the median nerve
A
- Regarding the carpal tunnel
a. Flexor pollicis longus has its own synovial sheath <=
b. The flexor retinaculum is attached to the scaphoid, trapezium, hamate and triquetrum
c. The median nerve lies medial to flexor digitorum superficialis - lateral
d. Median nerve compression causes paraesthesia of the thenar eminence – no, the palmar cutaneous branch comes off proximally
e. Palmaris longus runs lateral to the median nerve – inserts into the retinaculum
16
Q
- The palmar carpal arch
a. Supplies the skin of the digits b. Supplies the skin of the thumb c. Does not anastomose radial and ulnar arteries d. Is deep to the long flexor tendons e. Is level with the metacarpal bases
A
- The palmar carpal arch
a. Supplies the skin of the digits
b. Supplies the skin of the thumb
c. Does not anastomose radial and ulnar arteries
d. Is deep to the long flexor tendons <=
e. Is level with the metacarpal bases
17
Q
- Regarding the small muscles of the hand
a. Thenar eminence muscles are supplied mainly by C8 b. Abductor pollicis brevis causes radial abduction c. Lumbricals are supplied by the ulnar nerve only d. Palmar and dorsal interossei cancel the effect of each other out, when acting simultaneously e. Flexor pollicis brevis is inserted into the base of the distal phalanx
A
- Regarding the small muscles of the hand
a. Thenar eminence muscles are supplied mainly by C8 <=
b. Abductor pollicis brevis causes radial abduction
c. Lumbricals are supplied by the ulnar nerve only
d. Palmar and dorsal interossei cancel the effect of each other out, when acting simultaneously
e. Flexor pollicis brevis is inserted into the base of the distal phalanx
18
Q
- The following muscles are involved in ulnar and transpalmar adduction of the thumb
a. Flexor pollicis brevis and flexor pollicis longus b. Opponens pollicis and adductor pollicis c. Flexor pollicis longus and opponens pollicis d. Adductor policis and flexor pollicis breviss e. Opponens pollicis and abductor pollicis brevis
A
- The following muscles are involved in ulnar and transpalmar adduction of the thumb
a. Flexor pollicis brevis and flexor pollicis longus
b. Opponens pollicis and adductor pollicis
c. Flexor pollicis longus and opponens pollicis
d. Adductor policis and flexor pollicis breviss <= i.e. flexion and adduction
e. Opponens pollicis and abductor pollicis brevis