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Gross Anatomy > functional anatomy of the hand > Flashcards

functional anatomy of the hand Flashcards

1
Q

proximal row of carpal bones

A

scaphoid, lunate, triquetrium, pisiform

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2
Q

distal row of carpal bones

A

trapezium, trapezoid, capitate, hamate

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3
Q

radial nerve supply of the hand

A

cutaneous innervation from the region along the dorsal of the hand and thumb. component of the C6 dermatome

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4
Q

median nerve supply of the hand

A

sensory innervation from the palmar surface of the first 3.5 digits. Motor innervation to thenar muscles and first 2 lumbricals

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5
Q

ulnar nerve supply of the hand

A

divides into superficial and deep branches near the wrist. Superficial: cutaneous innervation from the medial (ulnar) 1.5 digits and the ulnar potion of the hand. C8 dermatome
deep: hypothenar mucles, all interossei, adductor policies and medial 2 lumbricals

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6
Q

blood supply to the hand and digits

A

radial and ulnar arteries

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7
Q

carpometacarpal joints

A

the base of each metacarpal articulates with the distal row of carpal bones connecting the wrist to the hand

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8
Q

metacarpophalangeal joints

A

the distal portion of the metacarpal bones articulating with the proximal phalanx of of each digit

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9
Q

thenar eminence

A

fleshy, muscular area on the lateral side of the thumb formed by the thinner muscles

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10
Q

hypothenar eminence

A

fleshly area on the medial side of the 5th digit

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11
Q

proximal crease of the wrist

A

indicates the location of the articulation between the distal radius and the proximal row of the carpal bones

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12
Q

distal crease of the wrist

A

site of the articulations between the distal row of carpals and the base of the metacarpals

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13
Q

proximal digital crease

A

location of the metacarpophalangeal joints on the fingers

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14
Q

proximal interphalangeal crease

A

location of the proximal interphalangeal joint (middle knuckle)

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15
Q

distal interphalangeal joint

A

location of the distal interphalangeal joint on each finger (distal knuckle)

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16
Q

common synovial sheath

A

surround the tendons of the flexor digitorum superficialis and profundus. start just proximal to the carpal tunnel and conducts the tendons from there through the middle of the palm.

17
Q

digital synovial sheath

A

surrounds the combined tendons to each finger and continue to the base of the distal phalanx.

provides lubrication to help the tendons move without resulting in pain and inflammation

the digital synovial sheath in the 5th digit is continuous with the common synovial sheath of all 4 fingers in the palm forming the ulnar bursar

18
Q

tendon sheaths

A

kept applied to the bones of the fingers by fibrous digital sheaths. made up of:
-dense annular and weaker cruciate ligaments extending from the synovial sheaths to the base of the distal phalanx of each finger that are attached at the IP and MP joints to fibrocartilage palmar plates

the tendon of the flexor policies longs is surrounded by its own digital sheath, sometimes referred to as the radial bursa

19
Q

extrinsic extensor muscles of the fingers

A

arise in the extensor region of the forearm, pass though the extensor retinaculum on the dorsum of the wrist.

exert their primary action on the MP joints of the fingers

  1. extensor digitorum
  2. extensor indicis
  3. extensor digiti minimi
20
Q

extrinsic muscles of the thumb

A
  1. extensor pollicis longus
  2. extensor pollicis brevis
  3. adbuctor pollicis longus

posterior interosseous branch of the radial nerve

21
Q

intrinsic thenar muscles

A
  1. flexor pollicis brevis
  2. abductor pollicis brevis
  3. opponens pollicis
  4. adductor pollicis (ulnar nerve)

recurrent (thenar) branch of the median nerve

22
Q

thumb opposition steps (3)

A
  1. abductor pollocis brevis abducts MP joint & unlocks it
  2. flexor pollicis brevis brings the thumb across the palm by flexing the MP joint
  3. opponens pollicis rotates 1st metacarpal on the trapezium, enabled the pad of the thumb to touch the the pad of the other fingers
23
Q

intrinsic hypothenar muscles (3)

A

located on the ulnar side of the 5th metacarpal. proximal attachments of all 3 are on the medial side of the flexor retinaculum, the pisiform bone and the hamate bone

  1. abductor digiti minimi
  2. flexor digiti minimi
  3. opponens digiti minimi

deep branch of the ulnar nerve

24
Q

lumbricals

A

worm-like muscles that arise from the flexor digitorum profundus. each muscle crosses anterior to the MP joint to insert onto the dorsal digital expansion

flex the MP joints while extending the IP joints

median (1&2) and ulnar (3&4) nerves

25
Q

interossei

A

arise from the metacarpal bones deep in the palm.
4 dorsal, 3 palmer. flexors of the MP joints

palmer: arise from the palmer surface of MC bones 2,4,5 and inert into dorsal digital expansion and proximal phalanges of 2,4,5. adduct MP joints and flex
dorsal: arise from adjacent surfaces of MC bones and insert into dorsal digital expansion and proximal phalanges of digits 2,3,4. abduct MP joints of digits 2,3,4.

deep branch of the ulnar nerve

26
Q

dorsal digital expansion functions

A
  • enables the extrinsic extensor tendons to strongly extend the MP joints of the fingers
  • extend the IP joints of the fingers only when MP joints are flexed by finger flexors
27
Q

components of the dorsal digital expansion

A
  1. extensor hood:
    - covers MP joint of each finger
    - formed by tissue connecting the tendons of the extensor digitorum, interossei, and the lumbricals of each finger
    - ext. indices tendon joins the hood of the 2nd digit
    - ext digiti minimi joins the hood of the pinky
  2. bands
    - central bands extends the base of the middle phalanx of each finger
    - 2 lateral bands extend to distal phalanx of each finger
28
Q

role of interossei and lumbricals in dorsal digital expansion

A
  1. interossei joins the hood close to MP joint and acts as the primary flexors of them
  2. lumbricals join the expansion distal to interpose and affect the central and lateral bands. Primary extenders of the IP joints when MP joints are flexed
29
Q

ulnar artery

A

large superficial branch, joins the smaller branch of the radial artery to form the superficial palmar arch which supplies skin and superficial structures of the hand

30
Q

radial artery

A

deep branch: larger than superficial, crosses within the anatomical snuff box before passing through the heads of the dorsal interosseous muscles, then crosses over the palmar surface of the MC bones to join the deep branch of the ulnar artery.
superficial branch: courses along the palmar surface of the MC bones in company of the deep branch of the ulnar nerve

31
Q

movement of the MP joints of fingers

A

extension: fingers brought away from palmar surface of hand (extensor digitorum, indices, digit minimi)
flexion: fingers toward palmar surface. (interossei, lumbricals can flex only when they simultaneously extend the IP joints)
abduction: moving 2 and 4 and 5 away from 3 (midline), or moving 3 medially or laterally (dorsal interossei)
adduction: moving toward the midline. (palmar interossei)

32
Q

movement of IP joints of fingers

A

flexion: curling fingers, (flexor digitorum superficialis on procimal IP and profundus on distal IP)

33
Q

movements of the MP joints of the thumb

A

extensor pollicis brevis: extends
flexor pollicis brevis: flexes
adductor pollicis: adducts
abductor pollicis brevis: abducts

34
Q

movements of the IP joints of the thumb

A

extensor pollicis longus

flexor pollicis longus

35
Q

movement of the 1st carpometacarpal joint

A

abductor pollicis longus: abducts
adductor pollicis: adducts along w/ MP joint of thumb
opponens pollicis: rotates

36
Q

opposition of the thumb

A

allows humans to grasp things, 4 steps

  1. abductor pollicis brevis abducts MP joint unlocking it
  2. flexor pollicis brevis flexes MP joint
  3. opponens pollicis rotates 1st MC bone of trapezium
  4. complete opposition also requires flexion of IP joint by flexor pollicis longs and some flexion at 1st CMC joint by adductor pollicis

Gross Anatomy (18 decks)

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