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Anatomy 2 > Dorsal and Palmar Hand, Injuries, Deformities > Flashcards

Dorsal and Palmar Hand, Injuries, Deformities Flashcards

1
Q

Dermatomes of Hand

A

C4 - shoulder shrug
C5 - shoulder abd
C6 - elbow flex/wrist ext
C7 - elbow ext/wrist flex
C8 - thumb ext
T1 - finger abb/add

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2
Q

Median Nerve Branches

A
  • anterior interosseous nerve (AIN)
  • recurrent branch
  • digital branch
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3
Q

Median nerve innervates …

A

pronator teres, flexor carpi radialis, flexor digitorum superficialis

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4
Q

Median nerve (AIN) innervates …

A

lateral flexor digitorum profundus, flexor pollicis longus, pronator quadratus

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5
Q

Median nerve (recurrent branch) innervates …

A

thenar muscles (abductor pollicis brevis, flexor pollicis brevis, opponens pollicis)

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6
Q

Median nerve (digital branches) innervates …

A

lateral lumbricals (1 + 2)

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7
Q

Radial Nerve Branches

A
  • deep branch
  • posterior interosseous nerve (PIN)
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8
Q

Radial nerve innervates …

A

brachialis, triceps brachii, anconeus, brachioradialis, extensor carpi radialis longus

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9
Q

Radial nerve (deep branch) innervates …

A

extensor carpi radialis brevis

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10
Q

Radial nerve (PIN) innervates …

A

extensor digitorum, extensor digiti minimi, extensor carpi ulnaris, supinator, abductor pollicis longus, extensor pollicis brevis, extensor pollicis longus, extensor indices

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11
Q

Ulnar Nerve Branches

A
  • deep branch
  • *superficial branch (palmaris brevis)
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12
Q

Ulnar nerve innervates …

A

flexor carpi ulnaris, medial flexor digitorum profundus

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13
Q

Ulnar nerve (deep branch) innervates …

A

hypothenar muscles (abductor, flexor, opponens digiti minimi), adductor pollicis, medial lumbricals (3 + 4), dorsal and palmar interossei

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14
Q

Scratch Collapse

A
  • gross manifestation of cutaneous silent period that is an inhibitory spinal reflex in UE
  • latent reflexive collapse of shoulder ER
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15
Q

Carpal Tunnel Syndrome

A
  • entrapment of median nerve in carpal tunnel
  • sensory impairments = pain, numbness, tingling
  • motor impairments = weakness and atrophy of thenar muscles
  • conservative treatment = reduce inflammation, limit aggravating activities, wrist brace, postural correction, nerve gliding
  • surgical treatment = surgical release of transverse carpal ligament, scar management, ROM, strengthening
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16
Q

Median Nerve Palsy

A
  • impaired sensation along palmar aspect of radial hand
  • loss of anterior forearm (proximal), thenar muscles, and lateral lumbricals (distal)
  • ape hand = atrophy of thenar muscles, thumb rests in adduction
  • hand of benediction (bishop’s hand) = extension of digits 1-3 when actively making a fist
17
Q

Radial Nerve Palsy

A
  • impaired sensation along dorsal aspect of thumb and radial hand
  • loss of muscles in posterior arm and forearm
  • decreased wrist strength
  • wrist drop = wrist rests in flexion, inability to extend wrist and fingers
  • treatment = orthosis, ROM, stretching, muscular strengthening, wait for nerve recovery
18
Q

Ulnar Nerve Palsy

A
  • impaired sensation along palmar aspect of digit 5 and ulnar half of digit 4
  • loss of FCU and medial FDP (proximal), intrinsics, adductor pollicis, hypothenar muscles, and medial lumbricals (distal)
  • claw hand = MCP joints are hyperextended and IP joints are flexed
19
Q

DeQuervain’s Syndrome

A
  • overuse injury … repeated lifting or use of thumb
  • inflammation of 1st dorsal compartment (APL, EPB)
  • wrist pain preventing thumb flexion, extension, abduction
  • conservative treatment = thumb spica orthosis, cortisone injection, rest
  • surgical treatment = surgical release of extensor retinaculum, active ROM for wrist and thumb, scar management, nerve gliding
20
Q

Extensor Hood

A
  • composed of tendons and ligaments on dorsal digit
  • extends IP joints, counterbalances flexor forces of extrinsic muscles, facilitates coordinated finger flexion
  • sagittal band, central tendon, lateral band, oblique retinacular ligament, terminal tendon
21
Q

Swan Neck Deformity

A
  • damage to terminal tendon, direct blow to DIP while digit is extended, progressive weakening of DIP
  • PIP joint hyperextension and DIP joint flexion
22
Q

Boutonniere Deformity

A
  • due to direct injury to central slip, volar PIP joint dislocation, or secondary to RA
  • PIP joint flexion and DIP joint hyperextension
23
Q

Pulleys

A
  • 5 annular (transverse), 4 cruciate (oblique)
  • contain FDS and FDP tendons
  • promotes tendon gliding, prevent bowstringing, increase mechanical advantage for finger flexion
  • most important = A2, A4
24
Q

Trigger Finger

A
  • stenosing tenosynovitis
  • fibrosis and tightening of flexor tendon sheath typically due to repetitive gripping activities
  • often at MCP joint (A1)
  • conservative treatment = orthosis, reduce gripping activities
  • surgical treatment = surgical release of affected pulley, scar massage, increase ROM, improve grip strength

Anatomy 2 (11 decks)

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