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medicine > Forearm/hand > Flashcards

Forearm/hand Flashcards

Anatomy

1
Q

What’s the difference between the extrinsic and intrinsic muscles of the hand?

A

Extrinsic - the muscle originates from outside of the hand and inserts in the hand.

Intrinsic - the muscle originates inside the hand and insert in the hand

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2
Q

What are the 8 Carpal bone?

A

Lateral to medial -
“Some Lovers Try Positions…
That They Cannot Handle”

Scaphoid, Lunate, Triquetrum, Pisiform

Trapezium, Trapezoid, Capitate, Hamate

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3
Q

What are the wrist joints?

A 
Radiocarpal joint
Intercarpal joints
Metacarpophalangeal
Carpometacarpal joint
Interphalangeal joints
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4
Q

How many phalanges in the hand?

A
  • 2 phalanges in thumb (distal and proximal)

- 3 phalanges in digit 2-5 (proximal, intermediate, and distal)

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5
Q

What are the fascial compartments of the forearm?

A

1) interosseous membrane
- Anterior (flexors)
- Posterior
2) Antebrachial fascia - prevents bowstringing

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6
Q

What is the function of the flexor retinaculum (transverse carpal ligament)?

A

Prevents bowstringing of tendons. The Flexor retinaculum converts the concavity formed by the carpal bones into the carpal tunnel.

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7
Q

What are the contents of the carpal tunnel?

A

Median Nerve!!!! Flexor digitorum superficialis/profundus, Flexor pollicis longus

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8
Q

What is the palmar aponeurosis

A

Strong covering of the soft tissue and overlies the long tendons. Contributes to the flexor tendon sheaths distally.

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9
Q

Which four superficial muscles attach to the common flexor tendon (attached to the medial epicondyle of humerus)?

A

1) Pronator teres
2) Flexor Carpi radialis (FCR)
3) Palmaris longus
4) Flexor carpi ulnaris (FCU) - ulnar nerve !!!

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10
Q

What is the intermediate flexor muscle of the forearm?

A

Flexor Digitorum Superficialis

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11
Q

What are the deep flexor muscles of the forearm?

A

1) Flexor Pollicis longus (FPL)
2) Flexor digitorum profundus (FDP) - digit 4-5 ulnar nerve, digit 2-3 ant. Interosseous
3) Pronator quadratus
* * Innervated by anterior interosseus nerve (a branch of the median nerve)

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12
Q

What muscles from the posterior compartment of the forearm originates from the lateral epicondyle ?

A

1) Extensor Carpi radialis brevis
2) extensor digitorum
3) extensor digiti minimi
4) extensor carpi ulnaris
5) supinator

** all are innervated by the deep branch of the radial nerve

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13
Q

What muscles from the posterior compartment of the forearm originates form the supracondylar ridge of humerus?

A

1) Brachioradialis
2) Extensor carpi radialis longus
* *innervated by radial nerve

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14
Q

Which 4 muscles from the posterior compartment of the forearm originates from the interosseous membrane and innervated by the posterior interosseous nerve?

A

Abductor pollicis longus (origin: proximal 1/2 of ulna, radius)

Extensor pollicis brevis (Distal 1/3 posterior radius)

Extensor pollicis longus (Mid 1/3 of posterior ulna)

Extensor indicis (Distal 1/3 posterior ulna)

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15
Q

What are the 3 thenar muscles?

A

1) Abductor pollicis brevis
2) Flexor pollicis brevis
3) Opponens pollicis

  • *origin: flexor retinaculum and tubercles of scaphoid/trapezium
    • innervations: recurrent branch of median nerve
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16
Q

What are the 3 hypothenar muscles that are innervated by the deep branch of the ulnar nerve?

A

1) abductor digiti minimi (from pisiform)
2) flexor digiti minimi brevis (hamate/flexor retinac..)
3) opponens digiti minimi (hamate/flexor retinac..)

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17
Q

what are the interosseous muscles, which are innervated by the deep branch of ulnar nerve?

A

1) Palmar Interossei (adduct digit 2, 4, 5) P..Ad

2) Dorsal Interossei (abduct digit 2-4) D..Ab

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18
Q

Origin, insertion, innervation, action of the Lumbricals.

A

Origin: tendons of flexor digitorum profundus
insert: lateral sides of extensor expansions, digits 2-5.
Nerves: Lumbrical 1-2 - branch of median
Lumbrical 3-4 branch of ulnar

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19
Q

What are the compartments of the hand?

A

thenar, hypthenar, adductor, central, and inteosseous

20
Q

what are the 3 digitorum muscles (muscles that goes to the digits)?

A

1) Flexor digitorum superficialis
2) flexor digitorum profundus
3) extensor digitorum

21
Q

What are the 3 supination or pronation muscles?

A

1) supinator
2) pronator teres
3) Pronator quadratus

22
Q

What are the 4 extrinsic “Pollicis” muscles?

A

1) extensor pollicis longus
2) abductor pollicis
3) Extensor pollicis brevis
4) flexor pollicis longus

23
Q

What is the only pollicis muscle innervated by the ulnar nerve? what are the Origin, insertion, innervation, action?

A

Adductor pollicis

Origin: oblique head bases of 2-3 metacarpals, capitate and adjacent carpals. Transverse head is in the anterior surgace of 3rd metacarpal.

Insert: medial site of base of digit 1’s proximal phalanx.

Nerve: deep branch of ulna

Action: adduct thumb, duh!!!

24
Q

What is Guyon’s canal

A

AKA ulnar canal. It’s a a band of tissue the ulnar nerve passes through.

25
Q

What are the borders of the anatomical snuff box?

A

anterior - abductor pollicis longus/extensor pollicis brevis tendons

posterior - extensor pollicis

floor - scaphoid and radial artery

roof - superficial branch of radial nerve and cephalic vein

26
Q

What is smith fracture?

A

Fracture of distal radius caused by falling on flexed wrist (impact on dorsum of hand). Presents as a complete transverse fracture of distal radius. Distal radial fragment is displaced ventrally. Ulnar styloid process avulsed. Associated injuries: Carpal tunnel syndrome, neuropathy, ischemia.

27
Q

What is colles fracture?

A

Fracture of distal radius caused by falling on an extended pronated wrist (force dorsiflexion). Presents as a “dinner fork” deformity - transverse fracture of distal radius, radial fragment displaced dorsally, ulnar styloid avulsed. Associated injuries: median and ulnar nerve injury/carpal fractures/dislocation of radioulnar joint

28
Q

What is the most common fractured carpal?

A

Scaphoid bone. Present with pain/tender anatomical snuff box. Complications: avascular necrosis - damage to the palmar carpal branch of the radial artery

29
Q

what is a complication of a hamate fracture?

A

Compression of ulnar nerve as it pass through the Guyon’s canal. symptoms: loss of sensation in the medial half of digit 4 and whole digit 5

30
Q

What is a Mallet Finger?

A

AKA Baseball finger. An avulsion of long extensor tendon. s/s: hyperflexion and inability to extend the distal interphalangeal joint

31
Q

Give 2 examples of repetitive stress injuries of the elbow.

A

Lateral epicondylitis - tennis elbow

Medial Epicondylitis - golfer’s elbow

32
Q

What is the Dupuytren Contracture?

A

Disease of palmar fascia and aponeurosis. Fascial thickening causes shortening on the medial side of hand. Genetic?

33
Q

What is a claw hand?

A

An example of an ulnar nerve neuropathy (C8-T1 damage).

34
Q

what are the five carpi muscles?

A

1) Flexor Carpi ulnaris
2) Flexor carpi radialis
3) Extensor carpi ulnaris
4) extensor carpi radialis longus
5) exterson carpi radialis brevis

35
Q

what are the 3 specialist muscles?

A

1) brachioradialis - beer drinkers hand
2) extensor indicis - point your index finger
3) extensor digiti minimi - to pick your nose =)

36
Q

what are the 3 “sock puppet” muscles?

A

4 lumbricals, 3 palmar interossei, 4 dorsal interossei

37
Q

What would an avulsion fracture of the medial epicondyle cause?

A

“Claw Hand” deformity, paresthes in forearm and 4th and 5th digit from ulnar nerve injury

38
Q

What are the clinical implications of supracondylar fracture of humerus caused by fall onto outstretched hand?

A

1) Limb shortening from the distal shaft fragment displaced
2) Risk of brachial artery laceration (Volkmann’s contracture)
3) “Hand of benediction” when making a fist- median nerve damage cause motor and sensory loss

39
Q

What is the pronator syndrome?

A

Median nerve entrapment caused by compression between head of pronator teres. S/s pain and tenderness in proximal anterior forearm and hypoesthesia/hypesthesia in palmar part of lateral 3 1/2 digits

40
Q

what causes “Ape hand”?

A

Damage to median nerve at the wrist will lose innervation to abductor pollicis brevis, flexor pollicis brevis, opponens pollicis, and lateral two lumbricals. Presents with loss of opposition from digit 1 and weakened digit 1 flexion and abduction.

41
Q

What is carpal tunnel syndrome?

A

Damage to median nerve due to compression of the carpal tunnel. S/s: sensory and motor deficit

42
Q

What causes wrist drop?

A

Damage to radian nerve, usually at the radial groove. s/s inability to extend wrist and fingers, wrist flexed d/t unopposed flexor tone and gravity

43
Q

What are sign and symptoms of injury to the deep branch of the radial nerve cause by deep penetrating wounds of the posterior forearm?

A
  • inability to extend thumb and fingers (mcp joint)

- no loss of sensation

44
Q

Name the forearm and hand arteries

A

Ulnar, common interosseous, posterior interosseous, recurrent interosseous, anterior interosseous, Palmar carpal branch of radialulnar, Dorsal carpal branch of radial ulnar

proper palmar artery
3 common palmar digital arteries
superficial branch of radial artery
princeps pollicis artery
3-4 palmar metacarpal arteries
deer palmar branch of ulnar artery
45
Q

Where does the superficial lymphatic vessels and lymphatic plexus of the palm drain to?

A

The dorsum of the hand, which eventually drains to the lymph nodes in the axilla.

medicine (7 decks)

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