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Gross > Carpal Tunnel and Hand > Flashcards

Carpal Tunnel and Hand Flashcards

1
Q

How many bones are in each hand (including the wrist)

A

27

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2
Q

What are the components of each metacarpal

A

Proximal base, shaft, distal head

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3
Q

What types of bones are the metacarpals?

A

Long bones

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4
Q

How many phalanges does each digit have?

A

Digits 2-5 have proximal, middle, and distal phalanges

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5
Q

How many phalanges does the first digit have?

A

2 phalanges- proximal and distal

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6
Q

What are the parts of the phalanges?

A
  • Proximal
  • Shaft
  • Distal heads
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7
Q

Describe the carpometacarpal joints

A

Synovial–> Plane

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8
Q

What is the one exception to the carpometacarpal joint?

A

The first digit is a saddle joint (trapezium and first metacarpal)

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9
Q

Describe the intermetacarpal joint

A

Synovial–> Planar

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10
Q

Describe metacarpophalangeal joint

A

Synovial –> Condyloid

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11
Q

Describe the interphalangeal joint

A

Synovial –> Hinge

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12
Q

What do the MCP and IP joints have to support the fibrous capsule?

A

Collateral ligaments

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13
Q

This is the main osseofibrous tunnel of the hand

A

Carpal Tunnel

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14
Q

What are the proximal row structures that create the carpal tunnel?

A
  • Triquetrum
  • Lunate
  • Scaphoid
  • Flexor retinaculum
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15
Q

Where does the flexor retinaculum span from (proximal row)?

A

Pisiform to the tubercle of the scaphoid

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16
Q

What are the distal row structures that make up the carpal tunnel

A

Hamate, capitate, trapezoid, trapezium, and flexor retinaculum

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17
Q

What is another name for the flexor retinaculum?

A

Transverse carpal ligament

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18
Q

Where does the flexor retinaculum span from (distal row)

A

The hoot of the hamate to the tubercle of the trapezium

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19
Q

How many tendons of the flexor digitorum superficialis are there?

A

4 (more superficial)

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20
Q

How many tendons of the flexor digitorum profundas are there?

A

4 (deeper)

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21
Q

What is the most superficial structure of the carpal tunnel?

A

The median nerve

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22
Q

What structure lies laterally to the median nerve?

A

Flexor pollicis longus

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23
Q

What structure lies superficially to flexor digitorum profundus but inferiorly to median nerve

A

Flexor digitorum superficialis

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24
Q

What structure superficial and medial to the flexor retinaculum?

A

Ulnar nerve and artery

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25
Q

Where is the radial artery located?

A

The anatomical snuff box

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26
Q

Where does the tendon of the flexor carpi radialis lie?

A

Between (NOT THROUGH) the tunnel and the trapezium on its way to attach to the base of the second metacarpal

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27
Q

Describe carpal tunnel syndrome

A

-Inflammation and swelling of the carpal tunnel due to overuse and repetitive motion that compress the MEDIAN nerve

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28
Q

What are some symptoms of carpal tunnel syndrome

A
  • Always effect the median nerve
  • paresthesis
  • atrophy of thenar muscles
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29
Q

What is a nick name for the groove formed by the ulnar canal?

A

Guyon canal

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30
Q

The palmar fascia is a continuation of what?

A

The antebrachial fascia

31
Q

What does the palmar fascia thicken into?

A

Palmar aponeourosis

32
Q

Is the apex of the palmar aponeourosis proximal or distal?

A

Proximal

33
Q

What does the apex fuse with?

A

The tendon of the palmaris longus muscle

34
Q

What does the base of the palmar aponeosis do?

A

Sends 4 projections to the medial 4 digits

-Blend with fibrous tendon sheaths of the digits

35
Q

What is the purpose for the sheaths?

A

They incase the bones and tendons of each finger and form more osseofibrous tunnels

36
Q

These structures are continuous with the fascia

A

Fibrous septa

37
Q

What is the purpose of the fibrous septa?

A

Compartmentalize the palm

38
Q

What secure the skin of the palm to the palmar fascia and aponeuroisis?

A

Ligaments called retinacula cutis (they are very strong and prevent sliping of the skin of the palm

39
Q

What does the hypothenar compartment contain?

A

Muscles that act on the 5th finger

-These muscles give rise to the hypothenar eminence on the medial palmar surface

40
Q

What does the thenar compartment contain?

A

Muscles that act on the thumb

to place it in opposition

41
Q

What does the central compartment contain?

A

Long flexor tendons of the digits

  • lumbrical muscles
  • arterial arches of the palm
42
Q

What does the adductor compartment contain

A

-Adductor pollicis muscle

43
Q

What does the interosseous compartment contain

A

The interossei muscle

44
Q

What is the midpalmar space continuous with?

A

Carpal tunnel and the anterior compartment of the forearm

45
Q

Does the third digit always adduct or abduct?

A

Abduct (it cant move to the midline cause it is the midline)

46
Q

What plane are flexion and extension of the thumb in?

A

Coronal

47
Q

What plane are abduction and adduction of the thumb in?

A

Saggital

48
Q

This is continuous with the antebrachial fascia

-thickened to protect the deeper musculotendinous structures

A

Palmar Aponeuroisis

49
Q

This is subcutaneous

  • covers the guyon canal
  • protects the deep branches of the ulnar nerve and artery
A

Palmaris brevis

50
Q

These muscles act on the 1st digit

A

Thenar muscles

51
Q

What are the thenar muscles?

A
  • Abductor pollicis Brevis
  • Flexor pollicis Brevis
  • Opponens pollicis
52
Q

What are the hypothenar eminence muscles?

A
  • Abductor digiti minimi
  • Flexor digiti minimi Brevis
  • Opponens digiti minimi
53
Q

This is a thickening part of the palmar fascia between the tubercles of the scaphoid/trapezium and pisiform/hamate

A

Flexor Retinaculum

54
Q

What do flexor tendons go through?

A

The carpal tunnel

55
Q

Where do flexor tendons insert?

A

Into distal (profundas) and middle phalanges (superficialis)

56
Q

These are on digits 2-5 on the lateral side

A

Lumbricals

57
Q

Are lumbricals 1 & 2 unipennate/bipennate?

A

Unipennate

58
Q

Are lumbricals 3 and 4 unipennate/bipennate?

A

Bipennate

59
Q

What are the 2 heads of the adductor pollicis?

A

Transverse and oblique

60
Q

What structure splits the 2 heads of the adductor pollicis?

A

The radial artery

61
Q

This is an abductor of digits 2, 3, and 4

A

Dorsal Interossei

62
Q

Do digits 1 and 5 have their own abductors?

A

Yes um

63
Q

What is special about abduction of the 3rd digit?

A

Being the midline, digit 3 abducts both laterally and medially so it requires 2 dorsal interossei muscles

64
Q

What muscle adducts digits 2, 4, and 5?

A

Palmar Interossei (the thumb has its own adductor muscle

65
Q

Due to the fibrous sheath, what happens when the extensor digitorum contracts?

A

The IP and MP joints all extend

66
Q

Can the lumbricals flex the MP joints while extending the IP joints?

A

Yes- because…

  • the lumbrical crosses the MP joint anteriorly
  • distally, tension is placed on the sheath when the lumbrical pulls
67
Q

Is the extensor mechanism opposite of the flexor arrangement?

A

Yes

68
Q

Where does the split of the tendon run in an extensor mechanism?

A

To the distal phalanx

69
Q

Where does the center continuation of the tendon run to?

A

The middle phalanx

70
Q

What are the 2 ligaments of the fingers?

A
  • Annular

- Cruciform

71
Q

Describe the annular ligaments?

A
  • Pulleys

- Extend over the flexor digitorum superficialis tendon

72
Q

Describe cruciform ligaments

A
  • They look like “x”

- Extend over the flexor digitorum superficialis tendon

73
Q

Describe trigger finger

A
  • Due to forcefully flexing fingers
  • Thickens fiber sheaths
  • Causes the flexed finger not to be able to extend actively since the tendon sheaths of the FDS and FSP cant return to the osseofibrous tunnel
74
Q

Describe tenosynovitis

A

-inflammation of the sheaths of the flexor tendons
-causes pain and disrups movement
-

Gross (45 decks)

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