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Anatomy Module III > Forearm, Wrist and Hand (+ UE Blood Supply) > Flashcards

Forearm, Wrist and Hand (+ UE Blood Supply) Flashcards

1
Q

arterial supply to the upper extremity

A

brachial artery and brachial profunda

at level of the elbow = radial artery and ulnar artery

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2
Q

where does it turn from axillary artery to brachial artery

A

at the inferior border of the teres major –> axillary–> brachial artery

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3
Q

brachial profunda artery

A

deep artery of the arm is a major branch from the brachial artery

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4
Q

what does the brachial artery divide into

A

radial (lateral side) and ulnar (medial side) artery

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5
Q

major branches of the ulnar artery

A

anterior interosseous artery

posterior interosseous artery

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6
Q

ulnar supply into the hand

A

superficial palmar arch

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7
Q

radial artery into the hand

A

deep palmar arch

makes sense that it is deep because the radial artery is supplying the posterior aspect of the arm

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8
Q

cephalic vein drainage

A

superficial to the metacarpals - lateral side

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9
Q

dorsal venous network in hand

A

drains the superficial and deep venous palmar arches

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10
Q

median cubital vein

A

communication between the basilic and cephalic veins in the cubital fossa

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11
Q

cephalic vein ends?

A

termination of the axillary vein

more proximal - when it becomes subclavian basically

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12
Q

basiclic vein ends when?

A

origin of the axillary vein - inferior border of the teres major - when the axillary starts going towards the heart

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13
Q

T/F the ulna is articulating with the carpel bones

A

FALSE - just the radius is because it widens out in the distal hand

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14
Q

mnemonic for carpel bones and the orientation

A 
STARTS AT THE THUMB 
Proximal row = lateral to medial 
Second Row (Distal) = medial to lateral 
"So long to pinky" 
"Here comes the thumb"
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15
Q

How do you know you’re looking at the dorsal hand?

A

cannot see the pisiform bone

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16
Q

name proximal bone in carpels

A 
so long to pinky 
Scaphoid 
Lunate
Triquetrum
Pisiform
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17
Q

name distal carpel bones

A 
Here comes the thumb
Hamate
Capitate
Trapezoid
Trapezium
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18
Q

radiocarpel articulation
type
function

A

between the distal radius and the proximal row of the carpels
condyloid
wrist flexion and extension
wrist abduction and adduction

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19
Q

midcarpal
articulation
type
function

A

between the proximal and distal row of carpel bones
PLANE SYNOVIAL JOINT
gliding motions between the carpels

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20
Q

distal radioulnar joint

A

pivot synovial joint
pronation and supination
- ulnar not moving

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21
Q

ulnar deviation aka

A

ADduction

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22
Q

radial deviation

A

ABduction

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23
Q

distal radius fractures

aka

A

Colle’s Fracture - FRACTURE OF THE DISTAL RADIUS
‘FOOSH’
70% of these fractures occur in post-menopausal woman
usually a fall from an outstretched arm
DORSAL DISPLACEMENT OF DISTAL FRAGMENT

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24
Q

stabalizing ligaments in the hand

A

extensor retinaculum

flexor retinaculum

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25
Q

extensor retinaculum

A

posterior stabalizing ligament in the carpels

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26
Q

flexor retinaculum

A

anterior stablizing ligament in the carpel

THIS IS ARCHED IN THE CARPEL REGION
also called the transverse carpal ligament

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27
Q

function of the retinaculum in hands

A

stabalize the tendons going into the hand

can feel the muscles in forearms move when you wingle your fingers - muscle bellies in arm then tendons into hand

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28
Q

carpel tunnel

A

formed by the flexor retinaculum or the transverse carpel ligament

versus the extensor retinaculum is right up against the bones of the carpels

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29
Q

extensors
Attachment
Action
Innervation

A

muscles acting on the wrists

Attachment - lateral epicondyle of humerus to base of metacarpels

Action - wrist extension

Innervation
- radial nerve

30
Q

lateral epicondylitis

A

repeated forceful flexion and extension of the wrist may strain the attachment at the lateral epicondyle of the - producing inflammation at the periosteum - irritating at the elbow joint (tennis elbow?)

31
Q

flexors
Attachment
Action
Innervation

A

Attachment - medial epicondyle of the humerus to the base of the metacarpals

Action - wrist flexion

Innervation - median + ulnar nerve

32
Q

Palmaris Longus
Attachment
Action
Innervation

A

Attachment - medial epicondyle of the humerus to the fascia in the palm of the hand

Action - tense the fascia in the palm of the hand and known to weakly flex the wrist (as it has a similar attachement with the wrist flexors)

Innervation- median nerve

may be absent in 10-15% of the population because known to bring out the claws in animals

33
Q

non-manipulative prehension patterns

A

cylindrical grip
hook grip
spherical grip

EXTRINSIC MUSCLES INVOLVED IN THE MOVEMENT (from muscles in the forearm)

34
Q

cylindrical grip

A

holding onto something like a cylinder - beer can?

a non-manipulative prehension pattern

35
Q

hook grip

A

a non- manipulative prehension pattern

dont need to useyour thumb - using the other digits

36
Q

spherical grip

A

a non-manipulative prehension pattern
where your thumb comes across more
holding a ball

37
Q

manipulative prehension patterns

A

using INTRINISC HAND MUSCLES - FINE MOTOR MOVEMENTS
palmar pinch **
lateral pinch
tip-to-tip pinch

38
Q

palmar pinch

A

a manipulative prehension pattern
distal phaylnx of 2 and 3 with the thumb
- pad to pad between first (thumb) digit and second digit

39
Q

lateral pinch

A

manipulative prehension pattern where the thumb (1st digit is being used) with the SIDE OF THE PROXIMAL PHALYNX

example = holding a key

40
Q

Tip-to-tip

A

manipulative prehension pattern
not as powerful but more fine tuned
tip of 1st - thumb with tip of second
distal of the phaylnx

41
Q

articulations of digits and thumb

A

name with thumb in own group then usually digits 3-5 in another

42
Q

carpometacarpal joints

location and action

A

distal of carpels with metacarpals
adduction and abduction at the thumb
flexion and extension with thumb
opposition with thumb

43
Q

first IP joint?

A

what we call the thumb because no 3rd phalange so we have ONE interphalange joint

44
Q

Metacarpophalangeal Joints

location and action

A

Between distal of metacarpels and the first phalange

Flexion and Extension AND ABduction and ADduction
aka MCP or MP joint

45
Q

Proximal Interphalangeal Joints

action and location

A

between the distal proximal phalange and the second phalange
aka PIP

Action - flexion and extension

46
Q

Distal Interphalangeal Joints

location and action

A

located at the distal part of the second phalange with the third distal phalange

Action - extension and flexion

47
Q

opposition movement

A

bringing the thumb towards your pinky - using the CMC joint

48
Q

extrinisic digit flexors
name and
action
innervation

A

flexor digatorum superficialis and flexor digitorum profundus

Action - Flex PIP
Flex DIIP = the digatorum profundus

innervation:
median and ulnar nerves

49
Q

carpel tunnel syndrome

A

because the flexor retinaculum forms a tunnel on the anterior side - we have a lot of tendons/muscles/ and MEDIAN NERVE going through - if we have inflammed or irritated muscles or tendons this can COMPRESS THE MEDIAN NERVE and can then suffer from carpel tunnel syndrome

  • because the carpal tunnel contains the extrinsic tendons of the digit flexors as well as the main branch of the MEDIAN NERVE
  • likely will see ATROPHY of the thenar muscles - in the thumb - because supplied by the median
50
Q

Digit Extensors
Name w/ action
innervation

A

Extensor Digitorum Communis - all 2-5 digits

Extensor indicis proprius - extensor for digit number 2

extensor digiti minimi - specific for the 5th digit

innervation - all by the radial nerve

51
Q

flexor pollicis longus

extensor pollicis longus and brevis

abductor pollicis longus

A

all are EXTRINSIC TO THE THUMB

  • flexion
  • extension
  • abduction

FORMING THE ANATOMICAL SNUFF BOX

52
Q

pollicis refers to?

A

the thumb

53
Q

Anatomical snuff box

A

formed by the extrinsic muscles of the thumb - extensor pollicis longus (on dorsal side)
extensor pollicis brevis on palmar side and abductor pollicis longus

GOING OVER THE DISTAL END OF THE RADIUS AND THE STYLOID PROCESS

base is formed by the scaphoid bone of the carpel at the base

54
Q

thenar group of muscles

A

INTRINSIC TO THE HAND - on the thumb side and innervated by the median nerve

55
Q

hypothenar group of muscles

A

INTRINSIC TO THE HAND - on the pinky side of the hand and innervated by the ulnar nerve

56
Q

lumbricals
Attachment
Action *
Innervation

A

Attachment - flexor tendons in palm to dorsum of proximal phalanges

Action - flex at MP and extend at PIP and DIP joints

Innervation - median and ulnar nerve

these are INTRINSIC CENTRAL HAND MUSCLES

57
Q

course of fibers of the lumbricals

A

cross on the ANTERIOR side of the MP joint

58
Q

DORSAL AND PALMAR INTEROSSEI
attachment
action
innervation

A

THESE ARE CENTRAL INTRINISC HAND MUSCLES

Attachment - metacarpals to proximal phalanges

ALL ULNAR INNERVATION

‘PAD AND DAB’ mnemonic
Dorsal = ABduction - 4 muscles

Palmar = ADduction - 3 muscles

59
Q

which nerves give Cutaneous Innervation to the Hand

A

Radial, Median and Ulnar nerves

60
Q

radial innervation to hand

A

the rest of the back part of the hand

makes sense - as the radial nerve is doing a lot of the posterior aspect

61
Q

ulnar innervation to hand

A

cutaneous innervation to the front and back of all of digit 5 and the half of the front and back of digit 4

hit funny bone? why we have tingling in out pinky a lot

62
Q

median innervation in hand

A

the rest of the anterior part of the hand - palm

63
Q

CUBITAL TUNNEL SYNDROME

A
  • stretching and pressure on ulnar nerve
  • ulnar nerve traveling under medial condyle - inner side of elbow - numbness or tingling in the RING AND SMALL FINGERS, pain in the forearm, and or weakness in the hand
64
Q

causes of cubital tunnel syndrome

A
  • pressure - nerve doesn’t have pad on it - causing numbness potentially
  • keeping elbow bent for a long period of time
  • ulnar nerve may not stay in place - move back and forth

pressure, stretching (bending too long), and anatomy

65
Q

sustained grips and long awakawrd postures

A

contributing to the incidence of hand, wrist, and arm pain

66
Q

T/F 40-70% of dental professionals experience chronic hand and wrist pain

A

True

67
Q

dental professionals and hygienists experience four times the prevalence found in the general working public?

A

true - between 23-40% professionls and 75 % of hygienists

most common between 30-60 years of age

more common in female than male

exercise can decrease risk

68
Q

prevention posture

A

between 60 degrees and 90 degrees
stay away from too much flexion and extension
neutral forearm position - keep forearms parallel to floor

69
Q

difference between carpel tunnel and cubital tunnel syndrome

A

carpel = position of wrist and compression of the median nerve

cubital syndrome = position of the elbow - mainly in prolonged flexion and compression or irritation of the ulnar nerve

70
Q

borders of the anatomical snuff box

A 
proximal = styloid process of radius 
base = scaphoid bone of carpel 
lateral = extensor pollicus brevis 
medial = extensor pollicis longus
71
Q

De Quervain’s Tenosynovitis

A

chronic irritation of tendons connecting extrinsic muscles of the thumb

swelling of synovial, tendons, and sheath

pain and swelling at base of thumb

mostly in the extensor pollicis brevis and abdutor pollicus longus

72
Q

‘wrist drop’

A

radial innervation is lost in the wrist because of loss of the innervatoin in a higher area of the arm
loss of a wrist extensor muscle

Anatomy Module III (7 decks)

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