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MSK Exam II > Hand > Flashcards

Hand Flashcards

1
Q

What side of the hand is the skin thicker

A

palmar surface

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2
Q

describe the superficial palmar fascia

A

thin layer highly fibrous in composition, bound tightly to deep fascia

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3
Q

describe the deep palmar fascia

A

continuous with deep fascia of the antebrachium

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4
Q

What does the deep palmar fascia form

A

palmar carpal ligament and flexor retinaculum, palmar aponeurosis and the fibrous digital sheaths

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5
Q

Describe the superficial layer of the palmar aponeurosis

A

longitudinally oriented fibers ocntinuous with flexor retinaculum and palmaris longus tendon,

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6
Q

where does the superficial layer of palmar aponeurosis attach?

A

distal on 4 lesser digits at base of proximal phalanges and fuses with digital sheaths

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7
Q

what is Dupuytren’s contracture

A

thickening and contracture of longitudinal bands- forces fingers to remain in state of severe flexion

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8
Q

describe the deep layer of the palmar aponeurosis

A

transversely oriented fibers continuous with thenar and hypothenar fascias; becomes thicker distally

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9
Q

what structure unites the longitudinal bands distally

A

superficial transverse metacarpal lig to strengthen webs

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10
Q

What prevent “bowstringing” of tendons when flexing fingers

A

fibrous digital sheaths that form canals

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11
Q

what lays between the fibrous digital sheaths and the actual tendon

A

synovial digital sheaths

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12
Q

Describe the radial bursa

A

bursa of flexor pollicis longus tendon that extends from proximal retinaculum to distal attachment

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13
Q

describe the ulnar bursa

A

common flexor bursa, surrounds tendons of long digital flexors and extends distally to tip of fifth digit

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14
Q

Connective tissue septae split the hand into how many compartments, what are they?

A

3

thenar, central and hypothenar

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15
Q

what creates the fourth compartment of the hand

A

deeper transverese fascial plane which makes the adductor-interosseous compartments

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16
Q

the aponeurosis to shaft of third metacarpa divides spaces into what

A

lateral palmar (thenar) and medial (mid palmar)

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17
Q

What structures are in the thenar compartment

A

abductor pollicis brevis, flexor pollicis brevis, opponens pollicis, tendon of flexor pollicis longus, branches of median n, branches of radial a and 1st metacarpal

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18
Q

origin and insertion of abductor pollicis brevis

A

origin: flexor retinaculum, scaphoid and trapezium
insertion: ventral base of proximal phalanx of thumb

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19
Q

action of abductor pollicis brevis

A

abducts thumb with slight flexion of carpometacarpal joint

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20
Q

what innervates abductor pollicis brevis

A

median n (recurrent)

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21
Q

origin and insertion of flexor pollicis brevis

A

origin: flexor retinaculum and trapezium
insertion: lateral base of proximal phalanx of thumb

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22
Q

action of flexor pollicis brevis

A

flexion of thumb at carpometacarpal and metacarpophalangeal joint

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23
Q

what innervates flexor pollicis brevis

A

superficial head: median n (recurrent)

deep head: deep branch ulnar n

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24
Q

origin and insertion of opponens pollicis

A

origin: flexor retinaculum and trapezium
insertion: most radial palmar border of first metacarpal

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25
Q

action of opponens pollicis

A

opposition

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26
Q

innervation of opponens pollicis

A

median n (recurrent)

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27
Q

what structures are within hypothenar compartment

A

abductor digiti minimi, flexor digiti minimi, opponens digiti minimi, branches of ulnar n, branches of ulnar a and 5th metacarpal

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28
Q

origin and insertion of abductor digiti minimi

A

origin: pisiform
insertion: medial base of proximal phalanx of digiti minimi

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29
Q

what is the action of abductor digit minimi

A

abducts and flexes metacarpophalangeal joint of digiti minimi

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30
Q

what innervates abductor digiti minimi

A

ulnar n (deep branch)

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31
Q

origin and insertion of flexor digiti minimi

A

origin: hamulus of hamate and flexor retinaculum
insertion: medial base of proximal phalanx of digiti minimi (with abductor digiti minima)

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32
Q

What is the action of flexor digiti minimi

A

flexes digiti minimi at metacarpophalangeal joint

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33
Q

What innervates flexor digiti minimi

A

ulnar n (deep branch)

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34
Q

origin and insertion of opponens digiti minimi

A

origin: hamulus of hamate
insertion: medial border of fifth metacarpal

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35
Q

what is the action of opponens digiti minimi

A

opposition or grasping

36
Q

what innervates opponens digit minimi

A

ulnar n (deep branch)

37
Q

What structures are found in the central compartment of the hand

A

superficial palmar arterial arch and branches
branches of the median and ulnar nn
tendons and synovial linings of long digital flexors and lumbricals

38
Q

where does flexor digitorum superficialis attach

A

sides of middle phalanx of digits 2-5

39
Q

where does flexor digitorum profundus attach

A

palmar surface, base of distal phalanx, digits 2-5

40
Q

origin and insertion of lumbricals

A

origin: radial side of flexor digitorum profundus tendons
insertion: extensor expansion of extensor digitorum tendons

41
Q

action of lumbricals

A

flexes metacarpophalangeal joints and extends interphalangeal joints

42
Q

what innervates the lumbricals

A

lumbricals 1 and 2- median

lumbricals 3 and 4- ulnar

43
Q

what structures are in the adductor-interosseous compartment

A

deep palmar arterial arch and branches, adductor pollicis, palmar and dorsal interossei, deep branch of the ulnar n and metacarpals 2, 3 and 4

44
Q

origins of adductor pollicis

A

origin: oblique head- capitate and bases of 2nd and 3rd metacarpal
transverse head- palmar surface, shaft of 3rd metacarpal

45
Q

insertion of adductor pollicis

A

ulnar surface, base of proximal phalanx of thumb

46
Q

action of adductor pollicis

A

adducts thumb

47
Q

inn of adductor pollicis

A

ulnar (deep branch)

48
Q

origin and insertion of palmar interossei

A

origin: interosseous surface of ulnar sides of 1st and 2nd metacarpal and radial side of 4th and 5th metacarpals
insertion: sides of base of proximal phalanx and extensor expansion of digits 1,2,4,5

49
Q

action of palmar interossei

A

adduct digits 1,2,4,5 flexes MP joints and extends IP joints of digits 1,2,4,5

50
Q

inn of palmar interossei

A

ulnar (deep branch)

51
Q

what portion of flexor pollicis brevis is considered an adductor

A

deep head

52
Q

origin and insertion of dorsal interossei

A

origin: adjacent sides of all metacarpals
insertion: extensor expansions and sides of bases of phalanges 2,3,4

53
Q

Action of dorsal interossei

A

abduct digits 2,3,4 flex MP joints and extend IP joints of digits 2,3,4

54
Q

inn of dorsal interossei

A

ulnar (deep branch)

55
Q

what is the chief contributer to the superficial palmar arterial arch

A

ulnar artery

56
Q

where is the superficial palmar arterial arch located

A

between palmar aponeurosis and long digital flexor tendons

57
Q

what is the chief contributor to the deep palmar arterial arch

A

radial a

58
Q

where is the deep palmar arterial arch located

A

in adductor-interosseous compartment deep to the long flexor tendons and adductor pollicis m

59
Q

which arterial branch is more distal than the other

A

superficial. also its larger

60
Q

branches of radial a

A

superficial palmar branch, dorsal carpal branch, princeps pollicis and radials indicis

61
Q

where does the 1st dorsal metacarpal a spring from

A

radial a just prior to passing between 2 heads of 1st dorsal interosseous m

62
Q

where does the 5th dorsal metacarpal a spring from

A

dorsal carpal branch of the ulnar a just prior to its anastomosis with dorsal carpal branch of radial a

63
Q

where is princeps pollicis a located

A

ulnar side of thumb and divides into two branches- palmar surface of thumb

64
Q

where is radialis indicis a

A

distal or in common with princeps pollicis and in courses along radial palmar side of index finger

65
Q

what are the branches of the deep palmar arterial arch

A

palmar metacarpal aa

66
Q

how are dorsal metacarpal aa connected with palmar metacarpal aa

A

perforating branches

67
Q

Where does ulnar a enter hand

A

lateral to pisiform and superficial to flexor retinaculum

68
Q

branches of ulnar’s superficial palmar arterial arch

A

common palmar digital aa (3 of them)

distall on surface of long flexor tendons

69
Q

what aa supply the 2 proper digital aa

A

short arterial trunk from palmar metacarpal, common palmar digital and distal perfortating aa

70
Q

Each finger receives how many aa input

A

4 aa each finger

71
Q

what are the branches of median n in the hand

A

recurrent or motor
common palmar digital nn
palmar cutaneous branch

72
Q

what innervates thenar compartment mm

A

recurrent branch of median n

73
Q

how many common palmar digital nn from median are there and they go where

A

three, cutaneous inn to thumb, 2nd and 3rd (radial side of 4th) digits

74
Q

what does the palmar cutaneous branch of median n inn

A

the central area of palm- cutaneous

75
Q

where does the ulnar n split

A

base of hypothenar eminence

76
Q

what does the superficial branch of ulnar n inn

A

common and proper digital branches of 5th and ulnar side 4th

77
Q

Where is there usually a communicating branch n in the hand

A

between the fourth digit (ulnar) and 3rd (median

78
Q

where does deep branch ulnar n course

A

superfical and proximal to the deep palmar arterial arch

79
Q

what does the deep branch of ulnar a inn

A

hypothenar mm, lumbricals 3&4, all interossei and adductor pollicis muscle

80
Q

where do cutaneous branches of ulnar n arise

A

forearm

81
Q

where does the cutaneous palmar branch of ulnar n go to inn

A

central palm (same as the median)

82
Q

Where does the dorsal cutaneous branch of ulnar n go

A

dorsal to ulnar styoid and divides into 3 dorsal digital n (skin medial dorsum of hand)

83
Q

Does the radial n inn hand at all

A

superficial branch with a medial and lateral branc

84
Q

what does the medial branch of superficial branch of radial n inn

A

4 dorsal digital nn for lateral dorsum of hand and dorsum and ulnar side of thumb forsum of index finger, and radial halff dorsum middle finger

85
Q

what does the lateral branch of superficial branch of radial n inn

A

base of thumb

MSK Exam II (10 decks)

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