DR4: Hand

Question 1

What tendons border the anatomical snuff box?

Answer 1

Abductor pollicis longus
Extensor pollicis brevis
Extensor pollicis longus

Question 2

What muscles make up the thenar eminence?

Answer 2

Abductor pollicis brevis
Flexor pollicis brevis
Opponens pollicis

Question 3

What is the origin, insertion and function of abductor pollicis brevis?

Answer 3

Origin: flexor retinaculum and tubercle of scaphoid and trapezium
Insertion: Proximal phalanx of thumb
Function: abduct thumb

Question 4

What is the origin, insertion and function of flexor pollicis brevis?

Answer 4

Origin: flexor retinaculum and tubercle of trapezium
Insertion: proximal phalanx of thumb
function: flex thumb

Question 5

What is the origin, insertion and function of opponens pollicis?

Answer 5

Origin: flexor retinaculum and tubercle of trapezium
Insertion: metacarpal I
Function: opposition

Question 6

What muscles make up the hypothenar eminence?

Answer 6

Abductor digiti minimi
Flexor digiti minimi
Opponens digiti minimi

Question 7

What is the origin, insertion and function of abductor digiti minimi?

Answer 7

Origin: flexor retinaculum and pisiform
Insertion: proximal phalanx of D5
Function: abduct digit 5

Question 8

What is the origin, insertion and function of flexor digiti minimi?

Answer 8

Origin: flexor retinaculum and hook of hamate
Insertion: Base proximal phalanx digit 5
Function: flex digit 5

Question 9

What is the origin, insertion and function of opponens digiti minimi?

Answer 9

Origin: flexor retinaculum and hook of hamate
Insertion: Metacarpal 5
Function: opposition

Question 10

What muscles are in the central palmar area?

Answer 10

Lumbricals
Dorsal interossei
Palmar interossei
Adductor pollicis

Question 11

What is the origin, insertion and function of the lumbricals?

Answer 11

Origin: flexor digitorum profundus
Insertion: dorsal Digital expansion
Function: extend interphalangeal joints, flex metacarpophalangeal joints

Question 12

What is the origin, insertion and function of dorsal interossei?

Answer 12

Origin: sides of metacarpal bones
Insertion: dorsal digital expansion
function: abduct MCP joints

Question 13

What is the origin, insertion and function of palmar interossei?

Answer 13

Origin: 2, 4, 5th metacarpal
Insertion: dorsal digital expansions
Function: adduct MCP joints

Question 14

What is the origin, insertion and function of adductor pollicis?

Answer 14

Origin: metacarpal III (transverse head), base metacarpal II, III and carpal bones (oblique head)
Insertion: base proximal phalanx of thumb
Function: adduction

Question 15

What forms the main part of the superficial palmar arch?

Answer 15

Ulnar artery

Question 16

What forms the main part of the deep palmar arch?

Answer 16

Radial artery

Question 17

Describe the path of the median nerve

Answer 17

Travels through carpal tunnel

Divides into digital nerves which supply skin over D1, D2, 1/2 D3

Question 18

What nerve supplies the thenar muscles?

Answer 18

Recurrent branch of the median nerve

Question 19

Where is the ulnar nerve in the hand?

Answer 19

On lateral side of pisiform bone

Question 20

What movements does flexor carpi radialis perform?

Answer 20

flexion and abduction of wrist

Question 21

What movements does flexor carpi ulnaris perform?

Answer 21

Flexion and adduction of wrist

Question 22

What is the function of the flexor retinaculum?

Answer 22

Prevent bowing of flexor tendons

Question 23

What is the function of the five carpi muscles when they contract together?

Answer 23

To form a stable wrist base, which is important for performing fine finger movements, such as during typing or writing.

Question 24

Which digits have accessory tendons and what are the names of the accessory muscles?

Answer 24

Digit 2 (index finger) – extensor indicis
Digit five – extensor digiti minimi

Question 25

Which muscles insert into the dorsal digital expansion?

Answer 25

The lumbricals and interossei muscles insert into the dorsal digital expansions

Question 26

What is the clinical significance of the palmer aponeurosis?

Answer 26

Clinically significant because of the common condition which affects it – Dupuytren’s contracture.
A dense fibrosis occurs in the aponeurosis, affecting especially fibres, to, and of, the ring and little fingers. Thickening of the fibrous tissue occurs and a flexion contracture of the metacarpophalangeal joint and proximal interphalangeal joint follow.
Eventually severe deformity may result.
The thickened, contracted aponeurosis has to be surgically released.

Question 27

What is the nerve supply to the hypothenar muscles?

Answer 27

Ulnar nerve

Question 28

What is the function of the lumbricals?

Answer 28

On contraction, they put the hand into a precision grip (as in holding a pencil) – they flex at the metacarpophalangeal joint and extend at the interphalangeal joints.

Question 29

Which structures does the deep branch of the ulnar nerve supply?

Answer 29

Hypothenar muscles
Medial two lumbricals
Dorsal and palmar interossei
Adductor pollicis.

Question 30

What would be the consequence of an injury to the superficial branch of the ulnar nerve?

Answer 30

Loss of sensation over digits 4 and 5.

Question 31

What would be the consequence of an injury to the superficial branch of the radial nerve?

Answer 31

Loss of sensation over the dorsolateral aspect of the hand.

Question 32

Which four carpal bones give attachment to the flexor retinaculum?

Answer 32

On the medial side these are the pisiform and hamate (specifically the hook of the hamate) and on the lateral side these are the scaphoid and trapezium.

Question 33

The pisiform bone is a sesamoid bone. Which tendon does it sit within?

Answer 33

Flexor carpi ulnaris