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hand anatomy > Flexor Tendon Injuries > Flashcards

Flexor Tendon Injuries Flashcards

1
Q

Tendon composed of

A

70% Water

30% Dry mass - tenocytes and EC matrix (mainly collagen)

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2
Q

Collagen allows for

A

tensile strength and loading strength

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3
Q

How many tendons from forearm to hand?

A

9 flexor tendons

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4
Q

How many wrist flexors?

A

2 flexor tendons

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5
Q

Why is the flexor digitorum superficialis named vs flexor digitorum profundus

A

The muscle belly of the FDS is superficial to the FDP in the forearm

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6
Q

Where does the FDS split into two slips?

A

Metacarpal phalangeal joint

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7
Q

Where does the FDS attach?

A

Middle phalanx

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8
Q

Where does the FDP attach?

A

Distal phalanx

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9
Q

What is Camper’s chiasm?

A

Where FDS decussates/intersects around the FDP

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10
Q

What is the function of the pulley system?

A

Holds the flexor tendons down and prevents bowstringing when flexion occurs to allow for improved flexion.

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11
Q

What does a pulley stand for?

A

Annular pulley

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12
Q

How many A pulleys?

A

A1-A5

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13
Q

How are pulleys labeled?

A

Proximal to distal

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14
Q

What is the blood supply to the flexor tendons of the finger?

A

Relatively avascular, but receive blood from digital arteries dorsal blood supply to tendons
1) Branch to long vinculum (proximal)
2) Branch to short vinculum (distal)
Retinaculums also provide blood supply

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15
Q

What are the layers of the tendon sheaths?

A

Visceral

Parietal

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16
Q

How does the tendon receive its nutritional supply?

A

Synovial sheath, not directly from blood supply

17
Q

How does the tendon receive its nutritional supply?

A

Some from the blood supply from vincular circulation

Synovial sheath and synovial fluid

18
Q

Which flexor tendon does not have a vincular blood supply network?

A

Flexor Pollicis Longus - meaning that it can tolerate more advancement without disturbing blood supply

19
Q

How many flexor tendon injury zones are there?

A

Zone 1-5

20
Q

What constitutes Zone 1 for flexor tendon injury?

A

Distal to flexor digitorum superficialis tendon insertion

21
Q

What constitutes Zone 2 for flexor tendon injury?

A

Fibrosseous tunnel, A1 pulley through Zone 1

22
Q

What constitutes Zone 3 for flexor tendon injury?

A

Carpal tunel to A1 pulley

23
Q

What constitutes Zone 4 for flexor tendon injury?

A

Carpal Tunnel

24
Q

What constitutes Zone 5 for flexor tendon injury?

A

Proximal to Carpal tunnel

25
Q

What do you call a Flexor Digitorum Profundus tendon avulsion and where does the avulsion occur?

A

Jersey finger

From the distal phalanx

26
Q

Name the levels of Jersey finger and where they occur?

A

Zone 1/Type 1: Tendon retraction into the palm
Zone 2/Type 2: Tendon retraction to the PIP level
Zone 3/Type 3: large bony fragment blocks proximal retraction of FDP at A4 pulley

27
Q

What is considered no man’s land with Jersey Finger tendon injury?

A

Zone 2/Type 2

28
Q

What type of injury causes jersey finger?

A

Forced hyperextension usually from a flexed position

29
Q

How many flexor tendons are there of the thumb?

A

Only one

Flexor pollicis longus

30
Q

Which annular pulleys cover/cross joints?

A

A1, A3, A5

MCP, PIP and DIP respectively

31
Q

How many cruciate pulleys?

A

C1-C3

32
Q

Which pulleys are the most important for proper flexion tendon function?

A

A2 and A4

A2 and A4 proximal and middle phalanx

33
Q

What is unique about the thumb pulley system?

A

Thumb only has 2 annular pulleys (A1 and A2) and an oblique pulley

34
Q

Why is it recommended to theoretically repair flexor tendons volarly instead of dorsally?

A

Vincula blood supplies tendon on the dorsal aspect

35
Q

What is considered no man’s land?

A

Zone 2 (A1 pulley to FDS)

36
Q

When assessing for flexor FDS tendon injuries, why do you need to hold down the other fingers?

A

Because FDS tendons all share the same muscle belly

hand anatomy (3 decks)

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