Chapter 13 - Hand Flashcards
CMC joint of the thumb
made up of the trapezium bone, which articulates with the base of the 1st metacarpal
What type of movement does the MCP joint allow?
hinge joint that allows for flexion and extension (uniaxial)
IP joint
only phalangeal joint of the thumb, also allows only flexion and extension
CMC joint of the fingers
nonaxial, plane-shaped synovial joints that provide slight gliding motion (provide more stability than mobility)
MCP joints of the fingers
formed by concave-shaped bases of the proximal phalanges articulating with convex, rounded heads of the metacarpals
Flexor retinaculum
a fibrous band of connective tissue that spans the anterior surface of the wrist in a mediolateral direction
- attaches to the styloid processes of the radius and ulna and crosses over the flexor muscle tendons
Palmar carpal ligament
more proximal and superficial than the transverse carpal ligament
- attaches to the styloid processes of the radius and ulna and crosses over the flexor muscle tendons
Transverse carpal ligament
lies deeper and more distally
- attaches to the pisiform and hook of the hamate on the medial side and to the scaphoid and trapezium bones laterally
Extensor retinaculum ligament
fibrous band traversing the posterior side of the wrist in a horizontal mediolateral direction
- attaches medially to the styloid process of the ulna and to the triquetrum, pisiform, and lateral side of the radius
Extensor expansion ligament
“extensor hood” is a small, triangular, flat aponeurosis covering the dorsum and sides of the proximal phalanx of each finger
Proximal carpal arch
formed by the proximal end of the metacarpals and carpal bones and is maintained by the flexor retinaculum
Distal carpal arch
shallower, made up of the metacarpal heads
Longitudinal arch
begins at the wrist and runs the length of the metacarpal
and phalanges for each digit
- perpendicular to the other two arches
Flexor digitorum superficialis origin
common flexor tendon on the medial epicondyle, coronoid process, radius
Flexor digitorum superficialis insertion
sides of the middle phalanx of the four fingers
Flexor digitorum superficialis action
flexes PIP and MCP joints of the fingers
Flexor digitorum superficialis nerve
median nerve
Flexor digitorum profundus origin
upper 3/4 of the ulna
Flexor digitorum profundus insertion
distal phalax of the 4 fingers
Flexor digitorum profundus action
flexes all 3 joints of the fingers
Flexor digitorum profundus nerve
median and ulnar nerves
Flexor pollicus longus origin
radius, anterior surface
Flexor pollicus longus insertion
distal phalanx of thumb
Flexor pollicus longus action
flexes all 3 joints of the thumb
Flexor pollicus longus nerve
median
Abductor pollicus longus origin
posterior radius, interosseus membrane, middle ulna
Abductor pollicus longus insertion
base of the 5th metacarpal
Abductor pollicus longus action
abducts thumb
Abductor pollicus longus nerve
radial
Extensor pollicus brevis origin
posterior distal radius
Extensor pollicus brevis insertion
base of the proximal phalanx of thumb
Extensor pollicus brevis action
extends MCP and CMC joints of thumb
Extensor pollicus brevis nerve
radial
Extensor pollicus longus origin
middle posterior ulna and interosseus membrane
Extensor pollicus longus insertion
base of distal phalanx of thumb
Extensor pollicus longus action
extends all 3 joints of thumb
Extensor pollicus longus nerve
radial
Extensor digitorum origin
lateral epicondyle of the humerus
Extensor digitorum insertion
base of distal phalanx of the second through fifth fingers
Extensor digitorum action
extends all 3 joints of the fingers
Extensor digitorum nerve
radial nerve
Extensor indicis origin
distal ulna
Extensor indicis insertion
base of distal phalanx of the second finger
Extensor indicis action
extends all 3 joints of the second finger
Extensor indicis nerve
radial
Extensor digiti minimi origin
lateral epicondyle of humerus
Extensor digiti minimi insertion
base of distal phalanx of 5th finger
Extensor digiti minimi action
extends all 3 joints of 5th finger
Extensor digiti minimi nerve
radial nerve
Flexor pollicis brevis origin
trapezium and flexor retinaculum
Flexor pollicis brevis insertion
proximal phalanx of the thumb
Flexor pollicis brevis action
flexes the MCP and CMC joints of the thumb
Flexor pollicis brevis nerve
median
Abductor pollicis brevis origin
scaphoid, trapezium, and flexor retinaculum
Abductor pollicis brevis insertion
abducts the thumb
Abductor pollicis brevis nerve
median
Opponenes pollicis origin
trapezium and flexor retinaculum
Opponenes pollicis insertion
1st metacarpal
Opponenes pollicis action
opposes the thumb
Opponenes pollicis nerve
median
Adductor pollicis origin
capitate, base of the 2nd and 3rd metacarpal, and distal 2/3 of the palamar surface of the 3rd metacarpal
Adductor pollicis insertion
base of proximal phalanx of thumb
Adductor pollicis action
adducts thumb
Adductor pollicis nerve
ulnar nerve
Dorsal interossei origin
adjacent metacarpals
Dorsal interossei insertion
base of proximal phalanx
Dorsal interossei action
abducts fingers at MCP joint
Dorsal interossei nerve
ulnar nerve
Palmar interossei origin
2nd, 4th, and 5th metacarpals
Palmar interossei insertion
base of respective proximal phalanx
Palmar interossei action
adducts fingers at MCP joint
Palmar interossei nerve
ulnar
Lumbrical origin
tendon of the flexor digitorum profundus muscle
Lumbrical insertion
tendon of the extensor digitorum muscle
Lumbrical action
flex the MCP joint while extending the PIP and DIP joints
Lumbrical nerve - 1st and 2nd
median
Lumbrical nerve - 3rd and 4th
ulnar
Flexor digiti minimi origin
hamate and flexor retinaculum
Flexor digiti minimi insertion
base of proximal phalanx of 5th finger
Flexor digiti minimi action
flexes MCP and CMC joints of 5th finger
Flexor digiti minimi nerve
ulnar
Abductor digiti minimi origin
pisiform and tendon of flexor carpi ulnaris
Abductor digiti minimi insertion
proximal phalanx of 5th finger
Abductor digiti minimi action
abducts the MCP joint of 5th finger
Abductor digiti minimi nerve
ulnar
Opponens digiti minimi origin
hamate and flexor retinaculum
Opponens digiti minimi insertion
5th metacarpal
Opponens digiti minimi action
opposes 5th finger (CMC joint)
Opponens digiti minimi nerve
ulnar
Carpal tunnel syndrome
an extremely common condition caused by compression of the median nerve with the carpal tunnel
De Quervain’s disease
cause by inflammation and thickening of the sheath containing the extensor pollicis brevis and abductor pollicis longus, resulting in pain on the radial side of the wrist
Tenosynovitis
inflammation of tendons and their surrounding sheaths
Dupuytren’s contracture
occurs when the palmar aponeurosis undergoes a nodular thickening - most common in the area of the palm in line with the ring and little finger
Stenosing tenosynovitis (trigger finger)
a problem with the sliding mechanism of a tendon in its sheath
Skier’s thumb
common hand injury among athletes and involves an acute tear of the ulnar collateral ligament of the thumb
Gamekeeper’s thumb
old term referring to a stretching injury of this same ligament developed over time by English gamekeepers as they twisted the necks of small game
Swam neck deformity
characterized by flexion of MCP joint, hyperextension of the PIP joint, and flexion of the DIP joint
Boutonniere deformity
the deformity is in the opposite direction - extension of the MCP joint, flexion of the PIP joint, and extension of the DIP joint
Ulnar drift
results in ulnar deviation of the fingers at the MCP joints
Mallet finger
caused by disruption of the extensor mechanism of the DIP joint, either because the tendon was severed or because the portion of bone where the tendon attached has avulsed from the distal phalanx
Scaphoid fracture
usually results from a fall on the outstretched hand of a younger person
Kienbock’s disease
refers to the necrosis of the lunate, which may develop after trauma
Power grip
used when an object must be held forcefully while being moved about by more proximal joint muscles (holding a hammer or doorknob)
Precision grip
used when an object must be manipulated in a finer type of movement (holding a pen or threading a needle)
Cylindrical grip
has all the fingers flexed around the object, which usually lies at a right angle to the forearm (holding a hammer, a racquet, or a wheelbarrow handle)
Spherical grip
has all the fingers and thumb abducted around an object and the fingers are spread apart (holding an apple or a doorknob or picking up a glass by its top)
Hook grip
involved the 2nd through 5th fingers flexed around an object in a hooklike manner, MCP joints extended, PIP and DIP joints are in some degree of flexion (holding on to a handle like a suitcase, wagon, or bucket)
Pad-to-pad grip
MCP and PIP joints of the fingers are flexed, the thumb is abducted and opposed, and the distal joints of bother are extended, bring the pads of the finger(s) and thumb together
Pinch grip
Pad-to-pad grip that also involves the thumb and one finger, usually the index finger (holding a coin between thumb and index finger)
Three-jaw chuck (tripod grasp)
Pad-to-pad grip that also involves the thumb and two fingers, usually the index and middle fingers (holding a pen or pencil)
Tip-to-tip grip
involves bringing the tip of the thumb up against the tip of another digit, usually the index finger, to pick up, a small object such as a coin or pin
Tip-to-tip/pincer grip
involves bringing the tip of the thumb up against the tip of another digit, usually the index finger, to pick up, a small object such as a coin or pin
Pad-to-side grip (lateral prehension)
has the pad of the extended thumb pressing an object against the radial side of the index finger - strong grip but it allows less fine movements
Side-to-side
required adduction of the index finger and abduction of the middle finger - weak grip and does not permit much precision
Lumbrical/plate grip
MCP flexed and the PIP and DIP joints extended - thumb opposes the fingers holding an object horizontal (plate or tray)
