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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
action of opponens pollicis
opposition
26
innervation of opponens pollicis
median n (recurrent)
27
what structures are within hypothenar compartment
abductor digiti minimi, flexor digiti minimi, opponens digiti minimi, branches of ulnar n, branches of ulnar a and 5th metacarpal
28
origin and insertion of abductor digiti minimi
origin: pisiform insertion: medial base of proximal phalanx of digiti minimi
29
what is the action of abductor digit minimi
abducts and flexes metacarpophalangeal joint of digiti minimi
30
what innervates abductor digiti minimi
ulnar n (deep branch)
31
origin and insertion of flexor digiti minimi
origin: hamulus of hamate and flexor retinaculum insertion: medial base of proximal phalanx of digiti minimi (with abductor digiti minima)
32
What is the action of flexor digiti minimi
flexes digiti minimi at metacarpophalangeal joint
33
What innervates flexor digiti minimi
ulnar n (deep branch)
34
origin and insertion of opponens digiti minimi
origin: hamulus of hamate insertion: medial border of fifth metacarpal
35
what is the action of opponens digiti minimi
opposition or grasping
36
what innervates opponens digit minimi
ulnar n (deep branch)
37
What structures are found in the central compartment of the hand
superficial palmar arterial arch and branches branches of the median and ulnar nn tendons and synovial linings of long digital flexors and lumbricals
38
where does flexor digitorum superficialis attach
sides of middle phalanx of digits 2-5
39
where does flexor digitorum profundus attach
palmar surface, base of distal phalanx, digits 2-5
40
origin and insertion of lumbricals
origin: radial side of flexor digitorum profundus tendons insertion: extensor expansion of extensor digitorum tendons
41
action of lumbricals
flexes metacarpophalangeal joints and extends interphalangeal joints
42
what innervates the lumbricals
lumbricals 1 and 2- median | lumbricals 3 and 4- ulnar
43
what structures are in the adductor-interosseous compartment
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
origins of adductor pollicis
origin: oblique head- capitate and bases of 2nd and 3rd metacarpal transverse head- palmar surface, shaft of 3rd metacarpal
45
insertion of adductor pollicis
ulnar surface, base of proximal phalanx of thumb
46
action of adductor pollicis
adducts thumb
47
inn of adductor pollicis
ulnar (deep branch)
48
origin and insertion of palmar interossei
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
action of palmar interossei
adduct digits 1,2,4,5 flexes MP joints and extends IP joints of digits 1,2,4,5
50
inn of palmar interossei
ulnar (deep branch)
51
what portion of flexor pollicis brevis is considered an adductor
deep head
52
origin and insertion of dorsal interossei
origin: adjacent sides of all metacarpals insertion: extensor expansions and sides of bases of phalanges 2,3,4
53
Action of dorsal interossei
abduct digits 2,3,4 flex MP joints and extend IP joints of digits 2,3,4
54
inn of dorsal interossei
ulnar (deep branch)
55
what is the chief contributer to the superficial palmar arterial arch
ulnar artery
56
where is the superficial palmar arterial arch located
between palmar aponeurosis and long digital flexor tendons
57
what is the chief contributor to the deep palmar arterial arch
radial a
58
where is the deep palmar arterial arch located
in adductor-interosseous compartment deep to the long flexor tendons and adductor pollicis m
59
which arterial branch is more distal than the other
superficial. also its larger
60
branches of radial a
superficial palmar branch, dorsal carpal branch, princeps pollicis and radials indicis
61
where does the 1st dorsal metacarpal a spring from
radial a just prior to passing between 2 heads of 1st dorsal interosseous m
62
where does the 5th dorsal metacarpal a spring from
dorsal carpal branch of the ulnar a just prior to its anastomosis with dorsal carpal branch of radial a
63
where is princeps pollicis a located
ulnar side of thumb and divides into two branches- palmar surface of thumb
64
where is radialis indicis a
distal or in common with princeps pollicis and in courses along radial palmar side of index finger
65
what are the branches of the deep palmar arterial arch
palmar metacarpal aa
66
how are dorsal metacarpal aa connected with palmar metacarpal aa
perforating branches
67
Where does ulnar a enter hand
lateral to pisiform and superficial to flexor retinaculum
68
branches of ulnar's superficial palmar arterial arch
common palmar digital aa (3 of them) | distall on surface of long flexor tendons
69
what aa supply the 2 proper digital aa
short arterial trunk from palmar metacarpal, common palmar digital and distal perfortating aa
70
Each finger receives how many aa input
4 aa each finger
71
what are the branches of median n in the hand
recurrent or motor common palmar digital nn palmar cutaneous branch
72
what innervates thenar compartment mm
recurrent branch of median n
73
how many common palmar digital nn from median are there and they go where
three, cutaneous inn to thumb, 2nd and 3rd (radial side of 4th) digits
74
what does the palmar cutaneous branch of median n inn
the central area of palm- cutaneous
75
where does the ulnar n split
base of hypothenar eminence
76
what does the superficial branch of ulnar n inn
common and proper digital branches of 5th and ulnar side 4th
77
Where is there usually a communicating branch n in the hand
between the fourth digit (ulnar) and 3rd (median
78
where does deep branch ulnar n course
superfical and proximal to the deep palmar arterial arch
79
what does the deep branch of ulnar a inn
hypothenar mm, lumbricals 3&4, all interossei and adductor pollicis muscle
80
where do cutaneous branches of ulnar n arise
forearm
81
where does the cutaneous palmar branch of ulnar n go to inn
central palm (same as the median)
82
Where does the dorsal cutaneous branch of ulnar n go
dorsal to ulnar styoid and divides into 3 dorsal digital n (skin medial dorsum of hand)
83
Does the radial n inn hand at all
superficial branch with a medial and lateral branc
84
what does the medial branch of superficial branch of radial n inn
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
what does the lateral branch of superficial branch of radial n inn
base of thumb

MSK Exam II (10 decks)

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