forearm, wrist, hand and fingers Flashcards
distal radioulnar joint
head of ulna articulates with ulnar notch of radius
tfcc
flexor carpi radialis
O: medial epicondyle of humerus
I: ventral surface of 2 and 3 metacarpals
A: wrist flexion, abduction, elbow flexion and pronation
palmaris longus
O: medial epicondyle of humerus
I: palmaris aponeurosis
A: wrist flexion
N: median
flexor carpi ulnaris
O: medial epicondyle of humerus, olecranon and posterior surface of ulna
I: pisiform and hamate, base of 5th metacarpal
A: flexion of wrist and adduction
N: ulnar
flexor digitorum superficialis
O: medial epicondylitis of humerus, coronoid process of ulna and shaft of radius
I: middle phalanges of digit 2-5
A: flexes hands and middle phalanges of fingers 2-5
N: median
flexor digitorum profundus
O: medial epicondyle and coronoid process of the ulna and the anterior radius
I: ventral surface of the base of the distal phalanges of digits 2-5
A: flexion of wrist and fingers
flexor pollicis longus
O: ventral surface of teh radius and interosseus membrane
I: ventral surface of teh base of the distal phalanx of the thumb
A: flex thumb and aid in wrist flexion and pronation
pronator quadratus
O: distal and anterior ulna
I: distal and anterior radius
A: pronates forearm
N: median
extensor carpi radialis longus
O: lateral supracondylar ridge of humerus
I: base of the metacarpal 2
A: works with other muscles to extend and abduct wrist
extensor carpi radialis brevis
O: lateral epicondyle of humerus
I: base of 3rd metacarpal (dorsal)
A: extend wrist and abduct hand
N: radial
extensor digitorum communis
O: lateral epicondyle
i: distal phalanges digit 2-5
A: extension of digits and wrist
N: radial
extensor digiti minimi
O: tendon of EDC
I: tendon of EDC on the dorsum of little finger
A: extends little finger
extensor carpi ulnaris
O: lateral epicondyle of humerus and posterior ulna
I: base of metacarpal V
A: works with other muscles to extend and adduct hand
N: radial
abductor pollicis longus
O: posterior radius and ulna, interosseous membrane
I: base of metacarpal 1 and trapezium
A: abducts and extension of thumb
wrist adduction
ulnar deviation
wrist abduction
radial deviation
Triangular fibrocartilage complex
dorsal radioulnar ligament, ulnar collateral ligament, ulnocarpal meniscus, sheath of ECU
significant tear of tfcc: immobilization of wrist joint in neutral position for 4-6 weeks
carpal bones
trapezium, trapezoid, capitate, hamate, scaphoid, lunate, triquetrum, pisiform
lumbricles
O: Tendons of flexor digitorum profundus of each finger
I: Lateral sides of tendons of extensor digitorum on proximal phalanges of each finger
A: Flexion of each finger at MCP and extension of each finger at PIP and DIP
N: Median nerve (1st and 2nd) and Ulnar Nerve (3rd and 4th)
dorsal interossei
O: metacarpals adjacents sides
I: proximals phalanx of the 2,3,4 fingers
A: abducts fingers
N: deep branch of ulnar nerve
palmar interossei
O: medial side of the second metacarpal and lateral side of the fourth and fifth metacarpals
I: proximal phalanx of the same finger
A: adducts the finger towards middle finger
N: ulnar
abductor pollicis brevis
O: flexor retinaculum, scaphoid, and trapezium
I: proximal phalanx of the thumb
A: abducts the thumb
N: median
flexor pollicis brevis
O: flexor retinaculum and the trapezium and first metacarpal
I: proximal phalanx of the thumb base
A: flexion and abduction of the thumb
N: median
opponens pollicis
O: flexor retinaculum and trapezium
I: 2 first metacarpal lateral border
A: opposition and flexion of the thumb
N: median
adductor pollicis
O: capitate, base of 2-4 metacarpals
I: proximal phalanx of thumb
A: adducts thumb, helps with opposition
N: ulnar
palmaris brevis
O: flexor retinaculum and palmar aponeurosis
I: skin of ulnar border of hand
A: pulls skin towards the middle of the hand
N: superficial ulnar nerve
abductor digiti minimi
O: pisiform and the tendon of the flexor carpi ulnaris
I: base of the proximal phalanx of the little finger
N: ulnar
flexor digiti minimi brevis
O: flexor retinaculum and hamate
I: base of the proximal phalanx of the little finger
A: flexes the little finger
N: ulnar
opponens digiti minimi
O: flexor retinaculum and hamate
I: metacarpal of the little finger
A: brings the little finger to meet the thumb
N: ulnar
retrograde blood flow
scaphoid #
if proximal- chance of necrosis because blood travels distal first and then proximal
blood supply to fingers
radial and ulnar arteries
superior and deep palmar arches
finkelsteins
DeQuervain’s Tenosynovitis
pt makes a fist and then deviates into ulnar deviation
sharp pain is evidence of stenosing tenosynovitis
pain over carpal tunnel - median nerve
tinel sign (wrist)
carpal tunnel
tapping over the transverse carpal ligament- which causes tingling and parasthesia over the thumb, indea, middle and ring finger - median nerve
phalens test
wrist are bent down with backs of each hand touching
carpal tunnel sufferers feel tingling or pain within 60 seconds
allens test
occlude both ulnar and radial artery until hand blanches then release ulnar. If the
hand pinks up, ulnar artery is good and you can carry on with ABG/radial stick as planned. ABGS
must be put on ice and whisked to the lab.
tfcc injury
MOI: torque or violent twist, foosh
ulnar pain
wrist extension is difficult
clicking or catching and considerable swelling
drop wrist
radial nerve palsy
benediction deformity
wasting of the hypothenar, dorsal interossei, and fourth and fifth lumbrical muscles resulting from ulnar nerve palsy (bishops deformity)
claw hand
ulnar nerve laceration, MCP flexion block splint
ape hand
median nerve palsy
dequervains syndrome
painful condition at the wrist on the side closer to the thumb resulting from tendons trapped beneath a ligament as they travel to the thumb
kienbock disease
avascular necrosis of the lunate
preisers disease
avascular necrosis of the scaphoid
wrist ganglion
herniation of the joint capsule or synovial sheath of a tendon
soft, rubbery, or very hard
boutonniere deformity
flexion of PIP and hyperextension of DIP joint
dupuytrens contracture
thickening and shrinking of the fascia of the palm with fingers being drawn into a flexed position
jersey finger
an injury to the finger resulting in tearing of the flexor tendon in the fingertip
game keeps thumb
injury to thumb that results in tearing or stretching of the MP joint or rupture of the ulnar collateral ligament
swan neck deformity
hyperextension of the PIP and flexion of DIP
