Fascia, Compartments, Synovial Sheaths and Clefts

Question 1

Palmar Carpal Ligament: Def

Answer 1

Where the deep fascia of the palm of the hand is continuous with the antebrachial fascia at the wrist

Question 2

What are the deep fascias?

Answer 2

Thenar Fascia
Hypothenar Fascia
Palmar Aponeurosis

Question 3

What are the osteofascial compartments?

Answer 3

Thenar Compartment
Hypothenar Compartment
Central Compartment
Adductor-Interosseous Compartment

Question 4

Thenar Compartment: Muscles (origin and Insertion)

Answer 4

Abductor Pollicis Brevis Muscle (O: Lateral End of Flexor Retinaculum, I: Lateral side of bas of proximal phalanx)

Opponens Pollicis Muscle (O: Lateral end of flexor retinaculum, I: Shaft of 1st metacarpal)

Flexor Pollicis Brevis (O: Lateral End of flexor retinaculum, I: Abductor Pollicis Brevis)

Question 5

Thenar Compartment: Innervations and Blood Supply

Answer 5

Recurrent branch of median nerve innervates all 3 muscles

Vascular Supply from Superficial Palmar Branch of Radial ARtery

Question 6

Hypothenar Compartment: O & I of Muscles

Answer 6

Origin for all is Medial end of Flexor Retinaculum

Abductor Digiti Minimi (I: Medial Side of base of proximal phalanx)

Opponens Digiti Minimi (I: Medial Side of entire 5th Metacarpal)

Flexor Digiti Minimi Brevis (I: WIth abductor Digiti Minimi)

Question 7

Hypothenar Compartment Muscles: Innervation and Blood Supply

Answer 7

Innervation by deep branch of ulnar nerve

Vascular Supply by superficial and deep branches of ulnar artery

Question 8

Central Compartment: Muscles O & I

Answer 8

4 Lumbrical Muscles
O: From tendons of flexor digitorum profundus muscle and pass to lateral side of digit they serve
I: Radial side of extensor tendons

Question 9

Central Compartment Muscles: Action

Answer 9

Helps to flex the metacarpophalangeal joints and extend the interphalangeal joints

Question 10

Central Compartment Muscles: Innervation

Answer 10

Lateral 2 lumbricals: Median Nerve

Medial 2 lumbricals: Ulnar Nerve

Question 11

Central Compartment: Extra Contents

Answer 11

Flexor Tendons and their synovial sheaths

Superficial Palmar Arch

Digital and Muscular Branches of Superficial Palmar Arch

Ulnar and Median Nerve

Question 12

Adductor- Interosseous Compartment: Adductor Pollicis Muscle: O&I

Answer 12

O: By transverse (from 2nd-4th metacarpals) and oblique eads (from capitate)

I: On medial side of 1st phalanx of thumb

Question 13

Palmar Interosseous Muscles: Action, # , and O&I

Answer 13

Adduction
3 muscles
O: From metacarpal bone
I: on base of proximal phalanx and extensor tendon of digit acted upon

Question 14

Dorsal Interosseous Muscles: Action, #, O&I

Answer 14

Abduction
4 Muscles
O: From adjacent metacarpal bones
I: On base of proximal phalanx and extensor tendon

Question 15

Adductor Interosseous Compartment: Extra Contents

Answer 15

Deep Palmar Arterial Arch and its branches

Question 16

Adductor- Interosseous Muscles: Innervation

Answer 16

All muscles in this compartment are innervated by the deep branch of the ulnar nerve

Question 17

Synovial Sheaths: Purpose

Answer 17

As flexor tendons pass under the flexor retinaculum, they are enclosed in synovial sheaths to reduce friction

Question 18

Ulnar Bursa: Def and Pathway

Answer 18

Complex synovial sheath for the 8 tendons of the 2 flexor muscles of the fingers

Continues into the little finger, but not into the 2nd, 3rd, and 4th fingers

Question 19

Radial Bursa: Def and Pathway

Answer 19

Synovial Sheath for the tendon of the flexor pollicis longus muscle

Continues into thumb

Question 20

What is unique about the distal tendons to the index, middle, and ring fingers?

Answer 20

Separate from the ulnar bursa

Question 21

Fascial Clefts: Def

Answer 21

Potential spaces which act as planes of cleavage between fascial membranes

May occur inside compartments or lie between compartments

Question 22

Major Fascial Cleft: Location

Answer 22

Between central and adductor-interosseous compartments

Divided by an oblique septum extending from palmar aponeurosis to the shaft of the middle metacarpal bone

Forms Midpalmar Cleft medially and Thenar Cleft laterally