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Anatomy > B1W3: Hand and Forearm > Flashcards

B1W3: Hand and Forearm Flashcards

1
Q

The three elbow joint articulations

A

Humeroulnar

Humeroradial

Proximal radioulnar

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2
Q

Humeroulnar articulation

A

hinge with coronoid process and trochlea/olecranon fossa and olecranon; flexion/extension (ulna=pinkie side)

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3
Q

Humeroradial articulation

A

modified hinge with capitulum and head; flexion/extension and supination/pronation (radius=thumb side)

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4
Q

Proximal Radioulnar Joint

A

pivot between radius and ulna; supination and pronation

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5
Q

Anular ligament

A

Round ligament that wraps around head of radius, allows for rotation

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6
Q

Nursemaid’s Elbow

A

if radius is dislocated, annular ligament would be broken; radial head in children isn’t that big yet, so radius can actually be pulled out of anular ligament and displaced

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7
Q

Radial collateral ligament

A

holds radius in place and works with ulnar collateral

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8
Q

Ulnar collateral ligament

A

holds ulna in place and works with radial collateral

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9
Q

The three ligaments of the elbow joint

A

Anular ligament
Radial collateral ligament
Ulnar collateral ligament (baseball players tear this one)

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10
Q

Components of long bones

A

Epiphysis: end of long bone
Metaphysis: where epiphysis, diaphysis meet; growth center
Diaphysis: shaft

Head of radius is proximal while head of ulna is distant

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11
Q

Proximal/distal radioulnar joints

A

How pronation/supination occurs; radius moves around the stationary ulna

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12
Q

Distal radioulnar joint

A

Pivot/synovial joint responsible for supination/pronation

Separated from joint space by articular disc (i.e. triangular fibrocartilage complex)

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13
Q

Articulations of the wrist (3)

A

Midcarpal joint: full extension

Radiocarpal joint: majority of movement

Articular disc: helps elaborate articular surface of radius so bones can slide on top of each other without articulating the ulna directly

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14
Q

Wrist bones

A

PROXIMAL ROW (palmar, thumb to pinkie): scaphoid lunate triquetrum pistiform

DISTAL ROW: trapezium, trapezoid, capitate, hamate

Scaphoid/lunate make direct connections to the radius, so a fall on the hand will break the scaphoid bone

No bones made articulation directly with ulna

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15
Q

Carpometacarpal joint (CMC)

A

Thumb=saddle joint (great range of motion, only other saddle joint is sternum)

digits=plane

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16
Q

Metacarpophalangeal (MCP or MP)

A

Thumb=hinge (only goes to front and back)

Digits=condyloid (can spread fingers apart, and use as hinge); flexion/extension/abduction/adduction

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17
Q

Proximal Interphalangeal (PIP) joint

A

Hinge

No thumb
flexion/extension only

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18
Q

Distal Interphalangeal (DIP) joint

A

Hinge

No thumb

flexion/extension only

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19
Q

Ligaments of fingers

A

Collateral ligaments: two per each MC/IP joint capsule; stabilizes and guards against too much lateral deviation

Palmar ligaments/plates: thicken joint capsule and aid in centering tendons and guard against hyperextension

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20
Q

Elbow movements

A

Flexion: biceps brachii, brachialis

Extension: triceps brachii

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21
Q

Forearm movements

A

Protonation: pronator teres and pronator quadranis

Supination: biceps brachii, supinator

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22
Q

Wrist movements

A

Flexion: “oh no he didn’t”
Extension: “as if”
Adduction: deviating medially
Abduction: deviating laterally

Radial deviation: moving thumb side
Ulnar deviation: moving pinkie side

23
Q

Thumb movements: adduction/abduction

A

Occurs at CMC

Thumb coming straight up=abduction

Thumb coming down=adduction

Perpendicular to plane of palm

24
Q

Thumb movements: flexion/extension

A

Occurs at CMC/MP joint

Flexion=bringing thumb into palm
In coronal plane, parallel to plane of palm

25
Q

Thumb movements: opposition

A

At CMC joint

Thumb opposes little fingers

26
Q

MCP Movements

A

Done by ulnar nerve

Abduction=spreading fingers out
Adduction=bringing fingers back together

27
Q

Musculature of hand generalities

A

Flexor/pronators=medial epicondyle, in anterior compartment; always radial nerve

Extensors/supinators=lateral epicondyle, in dorsal compartment

Hand intrinsics: originate and insert in wrist and hand; no dorsal muscles and only do fine movement

28
Q

Superficial layer of extensor muscles, lateral to medial on dorsal side of hand

A 
Extensor carpi radialis longus
Extensor carpi radialis brevis
Extensor digitorum
Extensor digiti minimi
Extensor carpi ulnaris
29
Q

Trifurcation of extensor digitorum tendon

A

Central slip and two lateral bands that attach to distal phalanes

if you tear one, can’t flex fingers!

30
Q

Extensor hood

A

Elaboration of this muscle on the dorsum of each proximal phalanx; includes central and lateral components; non contractile, extends IPs when ED contracts and is pulled proximally (can’t extend DIP and flex PIP at same time!)

the interossei and lumbrical attach

31
Q

Deep layer extensor muscles

A

Supinator
Abductor pollics longus
Extensor pollicis longus
Extensor policis brevis

32
Q

What are the outcropping muscles?

A

Make anatomical snuff box

Abductor pollicis longus, extensor pollicis longus, extensor pollicis brevis

33
Q

Anatomical snuff box

A

Dorsal side of hand near thumb

Contains radial nerve, cephalic vein, radial artery and scaphoid bone

34
Q

Superficial layer flexor muscles of hand (lateral to medial when palm side up)

A

Pronator teres
Flexor carpi radialis
Palmaris longus
Flexor carpi ulnaris

35
Q

Intermediate layer of flexor muscles of hand

A

Flexor digitorum superficialis

–major flexor of wrist/fingers, 4 tendons, no movement of thumb

36
Q

Deep layer flexor muscles of hand

A

Flexor digitorum profundus (tendon passes thru Camper’s chiasm)

Flexor pollicis longus
Pronator quadratu

37
Q

Flexor sheath

A

Membrane portion=promotes tendon gliding, allows for good grip

Retinacular portion=forms pulleys which stabilize tendon; cruciate tendons that cross anular ones and go all the way around finers

38
Q

Carpal tunnel

A

Flexor renticulum goes over it

Contains medial nerve, which is compressed during carpel tunnel syndrome

9 tendons go through (flexor policis longus, flexor digitorum profundus, flexor digtorium superficialis)

39
Q

Hand intrinsics: thenar

A

Base of thumb group

Abductor pollicis brevis
Flexor pollicis brevis (2)
Opponens pollicis
Adductor pollicis (2 heads, oblique and transverse)

40
Q

Hand intrinsics: hypothenar

A

Base of little finger

Abductor digiti minimi
Flexor digiti minimi
Opponens digiti minimi
Palmaris brevis

41
Q

Interossei

A

3 palmar adductors, unipennate (PAD); ulnar nerve

4 dorsal abductors, bipenate (DAB); ulnar nerve

Flex MCPs and extend IPs through extensor hood (flexing fingers at 90 degrees)

Metacarpals to proximal phalanx and extensor hood

42
Q

Lumbricals

A

Arise from FDP tendons and go into extensor hood; flex MCPs and extend IPs through extensor hood

Index and middle arise from 1 head
Ring and small arise from two heads

43
Q

What happens if you lose intrinsic hand muscles?

A

Get a claw-shaped hand (i.e. lose the interosseous and lumbrical muscles)

44
Q

Arteries of hand

A

Radial artery=goes to snuffbox
Ulnar artery=goes into hand

Other structures: superficial and deep palmar arches, princeps pollicis, radials indicis, common palmar digital and proper palmar digital

45
Q

Alan’s test

A

See what vasculature in hand is like

Squeeze wrist, watch hand turn white, let go and see where the color returns

46
Q

Venous system of hand

A

Superfical veins: cephaalic, basilic, and median cubital (where you take blood)

Deep veins: perforating eins and Venae Comitantes; usually paired

Once basilic vein joins the venae comitantes of the axillary artery, becomes axillary vein

47
Q

Nursemaid’s Elbow

A

Captiulum to radial head=annular ligament

If radius dislocated, annular ligament breaks or in kids slides up

48
Q

Dorsum of wrist and hand

A

6 dorsal compartments; fibro-osseous tunnels with synovial sheaths

Extensor retinaculum secures tendons and prevents bowstring effect

Juncturae tendinum allows synergistic function of extensor tendons

49
Q

Innervations of forearm/hand

A

Extensor/supinator: radial nerve; sensation to dorsal hand

Flexor/pronator: median nerve except FCU and 1/2 FDB (both ulnar); sensation to prehensile area, goes through carpal tunnel

Hand intrinsics: ulnar except med loaf–2 lateral lumbricals, opponons polilics, abductor policis brevis, superfical head of flexor pollicis breavis

50
Q

Ulnar nerve and hand intrinsics

A

Innervates 4th and 5th fingers, half of middle finger

passes through Guyon’s canal

MED loaf=lumbricals 1 and 2, flexor policis brevis, abductor policis brevis

51
Q

Collateral ligaments

A

Medial and lateral; fibrous layer of the IP and MC

against excessive lateral deviation

52
Q

Palmar ligaments

A

Volar thickening of joint capsule
which aid incentering the long flexortendons and guard against
hyperextension

53
Q

Medial nerve

A

flexor/pronator except for FCU/ 1/2 FDP
MED LOAF
carpal tunnel syndrome when compressed, can’t move thumb, lose strength

Anatomy (8 decks)

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