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anatomy - physio > carpus and hand > Flashcards

carpus and hand Flashcards

1
Q

what are the different movements of the wrist?

A
  • abduction (radial deviation)
  • adduction (ulnar deviation)
  • flexion
  • extension
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2
Q

what are the different movements of the hands and fingers?

A
  • flexion and extension of the metacarpal-phalanges joints
  • adduction of fingers
  • abduction (spreading) of fingers
  • flexion and extension of thumb
  • opposition of thumb
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3
Q

what is the IP joint?

A
  • interphalangeal joint
  • joint at the tip of the finger
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4
Q

describe the **1st carpometacarpal joint **

A
  • synovial joint - between the carpal bone and the metacarpal bone of the thumb
  • wide range of mvts - most out of all CMC joints
  • flexion and extension
  • abduction and adduction
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5
Q

what is a fracture of the 1st carometacarpal joint called?

A

a bennetts fracture

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6
Q

what is the mmemonic for remembering the carpal bones of the hand?

A
  • She Likes To Play Try To Catch Her
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7
Q

what are the carpal bones in the hand - proximal row, distal row - lateral to medial?

She Likes To Play Try To Catch Her

A
  • Scaphoid
  • Lunate
  • Triquetral
  • Pisiform
  • Trapezium
  • Trapezoid
  • Capitate
  • Hamate
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8
Q

Describe the radiocarpal joint (the wrist)

A
  • synovial joint
  • distal radius articulating with the scaphoid, lunate and triquetral bone
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9
Q

what is the** function of the triangular fibrocartilaginous disc **in the wrist joint?

A
  • load bearing structure between the lunate, triquetrum and the ulnar head
  • act as a stabiliser for the ulnar aspect of the wrist
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10
Q

what is the mid carpal joint?

A
  • the articulation between the proximal and distal row of the carpal bones
  • synovial joint
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11
Q

which carpal bone is most commonly fractured? And how does this happen?

A
  • scaphoid bone
  • MOI - falling on an outstretched hand - fractures are usually along the axis and may fail to unite
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12
Q

what is a complication of a spaphoid fracture?

A
  • the scaphoid bone recieves a lot of blood supply - a fracture in this bone could lead to** avascular necrosis **
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13
Q

In which direction could the lunate bone dislocate and what nerve could be damaged as a result?

A
  • may dislocate anteriorly
  • effects the median nerve
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14
Q

what are the different layers of the hand?

A
  1. skin
  2. **deep fascia **and **palmar aponeurosis **
  3. superficial muscle layer - ie thenar and hypothenar muscles
    4.** intermediate muscle layer** - lumbrical and long flexor tendons from forearm muscles
  4. deep muscle layer - interossei (palmar and dorsal) and adductor pollicis muscle
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15
Q

what is the** palmar aponeurosis**?

A
  • central part of the deep fascia in the hand
  • highly specialised and thickened structure
  • triangular in shape - anchored to the flexor retinaculum
  • divides into slips for insertion
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16
Q

what is the flexor retinaculum?

A
  • fibrous band on the palmar side of the hand near the wrist, it arches over the carpal bones on the hand
  • important structure involved in the carpal tunnel
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17
Q

what is the carpal tunnel?

A
  • narrow passageway found on the anterior portion of the wrist which allows the entrance of several tendons and the median nerve from the forearm into the hand
  • formed by 2 layers - deep carpal arch and the flexor retinaculum
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18
Q

what are the contents of the carpal tunnel?

A
  • tendon of flexor pollucis longus
  • four tendons of flexor digitorum profundus
  • four tendons of flexor digitorum superficialis
  • median nerve
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19
Q

once the median nerve passes through the carpal tunnel, what does it brancch into?

A
  • divides into 2 branches
  • the recurrent branch
  • palmar digital nerve
20
Q

what is carpal tunnel syndrome?

what is it and what are symptoms?

A
  • compression of the median nerve
  • pins and needles in the hand which become worse at night
  • patient complains of weakness in the hand and dropping things
  • overtime, they can develop wasting of the thenar muscles
21
Q

what might be potential causes of carpal tunnel syndrome?

A
  • fluid retention - eg pregnancy etc
  • arthritis
22
Q

what are the 4 thenar muscles in the hand?

APB is A Friend Of Police

A
  • abductor pollis brevis
  • adductor pollucis
  • Flexor pollucis brevis
  • Opponens Pollucis
23
Q

what is the thenar eminence?

A

the ball or fleshy part of the thumb

24
Q

what nerve innervates the thenar muscles?

A

the median nerve

25
Q

what are the thenar muscles attached to?

A
  • they are attached to the radial side of flexor retinaculum and the adjacent carpal bones
26
Q

what is the hypothenar eminence?

A
  • fleshy region on the palmar side of the little finger
27
Q

what are the 4 hypothenar muscles?

A
  • abductor digiti minimi
  • flexor digiti minimi
  • opponens digiti minimi
  • palmaris brevis
28
Q

what is the hypothenar eminence attached to?

A
  • the ulnar side of flexor retinaculum and the adjacent carpal bones
29
Q

what nerve innervates the hypothenar muscles?

A

the ulnar nerve

30
Q

what are the 3 long flexor tendons of the hand?

note the flexor tendons are on the palmar surface of hand - flex wrist

A
  • Flexor digitorum superficialis
  • Flexor digitorum profundus
  • flecxor pollicis longus
31
Q

what is the flexor pulley system of the hand?

A
  • complex system of the hand that co-ordinates the flexion of the digits (ie fingers)
  • consists of the long flexor tendons and their associated flexor tendon synovial sheaths, annular pulleys, cruciate pulleys and oblique pulleys
  • main role of this system is to hold the tendons against the phalanges preventing them from pulling away and bowstringing
32
Q

what are the palmar spaces of the hand?

A
  • spaces that lie **between the flexor tendons and the fascia **covering the deep muscles in the floor of the palm
  • midpalmar space, thenar space, medial fibrous septum and lateral fibrous septum
33
Q

what are the lumbrical muscles and why are they important?

A
  • lumbricals are muscles in the hand
  • they are critical for finger mvt and they link the extensors to the flexor tendons
34
Q

what does each lumbrical muscle originate and insert onto?

A
  • each lumbrical muscle originates from a tendon of the flexor digitorum profundus and they pass laterally round each finger and insert onto the extensor hood of the finger
35
Q

what is the action of the lumbrical muscles?

A

flex MCP joints and extend IP joints

36
Q

what are the radial or lateral lumbrical muscles innervated by?

A

the median nerve - the digital branch

37
Q

what are the medial (ulnar) lumbrical muscles innervated by?

A

ulnar nerve - deep branch

38
Q

what are the interossei muscles of the hand?

A
  • muscles located between the metacarpal bones of the hand
  • divided into 2 groups - palmar and dorsal
39
Q

in addition to adduction and abduction of the fingers, what do the interosseus muscles also assist with?

A

they also assist the lumbricals in flexion at the MCP joints and IP joint extension

40
Q

Describe the palmar interossei muscles - what are they, attachments and function

A
  • muscles located anteriorly on the hand - ie the palm
  • 3 palmar interossei muscles
  • each muscle arises from a medial or lateral side of a metacarpal and attaches onto the extensor hood & proximal phalanx of the finger
  • palmar = PAD - they adduct the fingers
41
Q

what nerve innervates the palmar interossei muscles?

A

the ulnar nerve- deep branch

42
Q

describe the dorsal interossei muscles - what are they, attachments and function

A
  • located on the dorsum of the hand
  • there are 4 of them
  • each muscle originates from medial or lateral side of MC (2 adjacent MC’s) and insert onto the extensor expansions of 2nd,3rd and 4th digits
  • they abduct the digits
43
Q

what nerve innervates the dorsal interossei muscles?

A

the ulnar nerve - deep branch

44
Q

what 3 nerves innervate the hand?

A
  • median
  • ulnar
  • radial
45
Q

what two arteries does the blood supply of the hand originate from?

A
  • radial and ulnar arteries
  • important branches - are the superficial palmar arch and the deep palmar arch
46
Q

what muscles would be affected by an ulnar nerve injury & therefore what mvts might be affected?

A
  • interossei muscles - ie extension of MCP’s and flexion of IPs
  • 2 medial lumbricals
  • hypothenar muscles
47
Q
A

anatomy - physio (17 decks)

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