Anatomy - Wrist & Hand - Flexors Flashcards
Attachments of the Transverse Carpal Ligament
Pisiform, hook of hamate, tubercle of scaphoid, & Ridge of trapezium
Contents of Carpal Tunnel
FPL, median nerve, & FDS & FDP (last 2 share common synovial sheath)
Thumb movements: Concave on convex
Flexion/extension
Thumb movements: Convex on concave
Abduction/adduction
Dupurtren’s Disease/Contracture
Slow onset & contracture of palmar fascia; pull fingers into flexion (MCP and PIP); usually seen in ring &/or little finger; skin adherent to fascia; seen in men more
Camper’s Chiasma
FDP passing through split of FDS (distal attachments on MPs of digits 2-5) to distal attachment of DPs of digits 2-5
Trigger Finger
Sheath swelling does not allow finger to extend then it suddenly give way
The synovial sheath of which 2 digits would allow the spread of infection to the wrist?
1st (thumb) & 5th (pinky)
Flexor Tendon Injury Zone 1
FDP only
Flexor Tendon Injury Zone 2
FDP & FDS (No Man’s Land) w/scar adhesion problems
Flexor Tendon Injury Zone 3
Palm w/lumbrical injury
Flexor Tendon Injury Zone 4
Carpal Tunnel w/median nerve injury & scar adhesion problems
Flexor Tendon Injury Zone 5
Forearm w/faster healing, but adhesion between tendons & nerve/vascular injury
Superficial Intrinsic Hand Muscles
Thenar Compartment (ABductor Pollicis Brevis, Flexor Pollicis Brevis, Opponens Pollicis)
Central Intrinsic Hand Muscles
Hypothenar Compartment (ABductor Digiti Minimi, Flexor Digiti Minimi, Oppenens Digiti Minimi)
Deep Intrinsic Hand Muscles
Adductor & Interosseous Compartments (ADductor Pollicis & Palmar/Dorsal Interossei)
ABductor Pollicis Brevis - Proximal Attachment(s)
Flexor retinaculum & tubercles of the scaphoid & trapezium
ABductor Pollicis Brevis - Distal Attachment(s)
Lateral base of P1 of 1st digit
ABductor Pollicis Brevis - Innervation
Thenar recurrent branch (of median n.) C8, T1
ABductor Pollicis Brevis - Action
ABduct the thumb at the CMC & assist opposition
Flexor Pollicis Brevis - Proximal Attachment(s)
Flexor retinaculum & tubercle of the trapezium
Flexor Pollicis Brevis - Distal Attachment(s)
Lateral base of P1 of the 1st digit
Flexor Pollicis Brevis - Innervation
Thenar recurrent branch (of the median n.) & deep branch ulnar nerve C8, T1
Flexor Pollicis Brevis - Action
Flex thumb at MCP
Opponens Pollicis - Proximal Attachment(s)
Flexor retinaculum & tubercle of the trapezium
Opponens Pollicis - Distal Attachment(s)
Lateral side of 1st MC
Opponens Pollicis - Innervation
Thenar recurrent branch (of the median n.) C8, T1
Opponens Pollicis - Action
Opposition of the thumb
ABductor Digiti Minimi - Proximal Attachment
Pisiform
ABductor Digiti Minimi - Distal Attachment
Medial base of P1 of 5th digit
ABductor Digiti Minimi - Innervation
Deep branch ulnar nerve C8, T1
ABductor Digiti Minimi - Action
ABduct the 5th digit
Flexor Digiti Minimi - Proximal Attachment(s)
Flexor retinaculum & hook of hamate
Flexor Digiti Minimi - Distal Attachment(s)
Medial side of P1 of 5th digit
Flexor Digiti Minimi - Innervation
Deep branch ulnar nerve C8, T1
Flexor Digiti Minimi - Action
Flex 5th MCP
Opponens Digiti Minimi - Proximal Attachment(s)
Flexor retinaculum & hook of hamate
Opponens Digiti Minimi - Distal Attachment(s)
Medial side of 5th MC
Opponens Digiti Minimi - Innervation
Deep branch ulnar nerve C8, T1
Opponens Digiti Minimi - Action
Draws 5th MC anteriorly & supinates it; OPPOSES to thumb
4 Lumbrical Muscles - Proximal Attachment(s)
Tendons of FDP
4 Lumbrical Muscles - Distal Attachment(s)
Radial side of extensor mechanism (lateral bands) of digits 2-5 (tendons pass palmar to transverse inter metacarpal ligament)
4 Lumbrical Muscles - Innervation
Medial 2: Median nerve C8, T1
4 Lumbrical Muscles - Action
Flex MCPs & extend IPs of digits 2-5
ADductor Pollicis - Proximal Attachment(s)
Transverse Head: Anterior surface of body of 3rd MC
ADductor Pollicis - Distal Attachment(s)
Medial side of base of P1 of 1st digit
ADductor Pollicis - Innervation
Deep branch ulnar nerve C8, T1
ADductor Pollicis - Action
Adduct the thumb (moves towards 3rd digit); IMPORTANT in pinch grasp
Dorsal Interossei - Proximal Attachment(s)
Adjacent sides of 2 MCs
Dorsal Interossei - Distal Attachment(s)
P1s & lateral bands of extensor hood of digits 2-4 (Tendons of interossei pass dorsal to transverse inter metacarpal ligament)
Dorsal Interossei - Innervation
Deep branch ulnar nerve C8, T1
Dorsal Interossei - Actions
ABduct the digits to midline (3rd digit); Flex the MCPs & extend the IPs
Palmar Interossei - Proximal Attachment(s)
Palmar surfaces of 2nd, 4th, & 5th MCs
Palmar Interossei - Distal Attachment(s)
Bases of P1s & lateral bands of extensor hood of 2nd, 4th, & 5th digits
Palmar Interossei - Innervation
Deep branch ulnar nerve C8, T1
Palmar Interossei - Actions
ADduct the fingers to midline (3rd digit); Flex the MCPs & extend the IPs (Tendons of interossei pass dorsal to transverse inter metacarpal ligament)