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MSS - MSK Exam 2 > Hand > Flashcards

Hand Flashcards

1
Q

lots of pressure on digit 3 does what?

A

dislocates lunate

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2
Q

lots of pressure on digit 1 does what?

A

fracture of scaphoid

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3
Q

palmar surface

A

hairless, many sweat glads, transverse and longitudinal flexion creases

fingerprints - non-skid tread

looser skin

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4
Q

dorsal surface

A

loose skin with hair

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5
Q

superficial palmar fascia

A

thin layer
highly fibrous
bound tight to deep fascia

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6
Q

deep palmar fascia

A

continuous with deep fascia of antebrachium

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7
Q

webs in fingers?

A

important bc its the location of blood vessels and nerve

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8
Q

fascia distal to wrist?

A

becomes palmar carpal ligament (thicker)

-which is continuous to the transverse carpal ligament (flexor retinaculum)

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9
Q

what muscles attaches to palmar aponeurosis?

A

palmaris longus

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10
Q

superficial palmar aponeurosis

A

longitudinal orientation
-continuous proximally with the flexor retinaculum
and palmaris longus tendon

distally extends onto four lesser digits to attach to base of proximal phalanges and fuse with fibrous digital sheaths

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11
Q

dupuytrens contracture

A

thickening and contracture of longitudinal bands of palmar aponeurosis

fingers force to flexion

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12
Q

deep layer of palmar aponeurosis

A

transverse fibers continuous with thenar and hypothenar fascias, thicker distally

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13
Q

superficial transverse metacarpal ligament

A

unites longitudinal bands distal on their anterior surfaces assist in strengthening region of interdigital webs

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14
Q

fibrous digital sheaths

A

specializations of deep fascia anchored to margins of phalanges

form a fibro-osseous canal for passage of digital flexor tendons

prevent bowstringing of flexor tendons

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15
Q

synovial digital sheaths

A

located between fibrous sheath and accompanying tendon

-lubricate the fibrous digital sheath

fluid filled connective tissue bursa wrapped around tendons

each digit has own sheath

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16
Q

radial bursa

A

aka bursa of flexor pollicis longus tendon

extends from proximal to flexor retinaculum to distal attachment of flexor pollicis longus

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17
Q

ulnar bursa

A

aka common flexor bursa

surrounds tendons of long digital flexors
-flexor digitorum superficialis and profundus

extends from proximal to flexor retinaculum distally to tip of 5th digit

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18
Q

connective tissue septa?

A

from palmar neurosis to shafts of metacarpals delineating three compartments:
thenar, central, hypothenar

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19
Q

deeper transverse fascal plane?

A

fourth compartment:

-adductor inter-osseous compartment

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20
Q

plane of reference in hand?

A

digit 3

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21
Q

deep palmar space

A

between opposing fascias of central and adductor-interosseous compartment

extension of palmar aponeurosis to shaft of thid metacarpal divids this space into lateral palmar space and medial (mid-palmar space)

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22
Q

compartments of hand

A

thenar, hypothenar, central, adductor interosseous

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23
Q

in plane of palm?

A

adducted

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24
Q

out of plane of palm

A

abducted

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25
Q

opposition what is moved?

A

metacarpals moving toward midline of hand

-opponins muscles

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26
Q

hypothenar

A

digit 5

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27
Q

thenar

A

digit 1

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28
Q

muscles of thenar compartment

A

abductor pollicic brevis

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29
Q

attachments of abductor pollicis brevis

A

origin:
flexor retinaculum, scaphoid, trapeqium

insertion:
ventral base of proximal phalanx of thumb laterally

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30
Q

action of abductor pollicis brevis

A

abducts thumb (with slight flexion of carpometacarpal joint)

out of plane of thumb**

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31
Q

innervation of abductor pollicis brevis

A

median nerve (recurrent)

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32
Q

attachments of flexor pollicis brevis

A

origin:
flexor retinaculum, trapezium

insertion:
lateral base of proximal phalanx of thumb

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33
Q

action of flexor pollicis brevis

A

flexion of thumb at carpometacarpal metacarpophalangeal joints

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34
Q

innervation of flexor pollicis brevis

A

superficial head - median nerve recurrent

deep head - deep branch ulnar nerve

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35
Q

order of muscles in thenar and hypothenar

-superficial to deep?

A

abductor, flexor, opponens

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36
Q

attachments of opponens pollicis

A

origin:
flexor retinaculum, trapezium

insertion:
most of radial palmar border of first metacarpal

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37
Q

action of opponens pollicis

A

opposition of thumb

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38
Q

innervation of opponens pollicis

A

median nerve recurrent

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39
Q

what else is in thenar compartment?

A

tendon of flexor pollicis longus with radial bursa

40
Q

muscles of the hypothenar compartment

A

abductor digiti minimi, flexor digiti minimi, opponens digiti minimi

41
Q

attachments of abductor digiti minimi

A

origin:
pisiform

insertion:
medial base of proximal phalanx of digiti minimi

42
Q

action of abductor digiti minimi

A

abducts and flexes metacarpophalangeal joint of digiti minimi

43
Q

innervation of abductor digiti minimi

A

ulnar nerve (deep branch)

44
Q

attachments of flexor digiti minimi

A

origin:
hamulus of hamate and flexor retinaculum

insertion:
medial base of proximal phalanx of digiti minimi (with abductor digiti minimi)

45
Q

action of flexor digiti minimi

A

flexes digiti minimi at metacarpophalangeal joint

46
Q

innervation of flexor digiti minimi

A

ulnar nerve (deep branch)

47
Q

attachments of opponens digiti minimi

A

origin:
hamulus of hamate

insertion:
medial border of fifth metacarpal

48
Q

action of opponens digiti minimi

A

pulls fifth petacarpal towards thumb during opposition

49
Q

innervation of opponens digiti minimi

A

ulnar nerve (deep branch)

50
Q

contents of central compartment

A

**structures beneath the palmar aponeurosis

superficial palmar arterial arch
branches of ulnar/median nerve
tendons and synovial linings of long flexors
lumbricals

51
Q

attachments of lumbricals?

A

origin:
radial sides of flexor digitorum profundus tendons

insertion:
extensor expansion of extensor digitorum tendons

52
Q

action of lumbricals?

A

flexes metacarpophalangeal joints and extends interphalangeal joints

MP joint - on palmar side
IP joint - on dorsal side

53
Q

innervation of lumbricals?

A

median - 1 and 2

ulnar - 3 and 4

54
Q

lumbricals 1 and 2?

A

unipennate

55
Q

lumbricals 3 and 4?

A

bipennate stronger

56
Q

contents of adductor-interosseous compartment?

A

deep palmar arterial arch
adductor pollicis
palmar and dorsal interossei
deep branch of ulnar arch

metacarpals 2 3 4

57
Q

attachments of adductor pollicis

A

origin:
oblique head - capitate and bases of second and third metacarpals
transverse head - palmar surface, shaft of third metacarpal

insertion:
ulnar surface, base of proximal phalanx of thumb

58
Q

action of adductor pollicis

A

adducts thumb

59
Q

innervation of adductor pollicis?

A

ulnar deep branch

60
Q

attachments of palmar interossei

A

origin:
interosseous surface of ulnar sides of 1st and 2nd metacarpal and radial side of metacarpal 4 and 5

insertion:
sides of base of proximal phalanx and extensor expansion of digits 1, 2, 4, 5

61
Q

actions of palmar interossesi

A

adducts 1, 2, 4, 5

flex MP joint and extend IP joint of digit 1, 2, 4, 5

62
Q

innervation of palmar interossei

A

ulnar nerve deep branch

63
Q

deep head of flexor pollicis brevis?

A

considered an adductor of thumb by virtue of its deep position and by the fact that it is innervated by deep branch of ulnar nerve

64
Q

attachments of dorsal interossei?

A

origin:
adjacent sides of all metacarpals

insertion:
extensor expansions and sides of bases of phalanges 2, 3, 4

65
Q

action of dorsal interossei?

A

abduct digit 2, 3, 4

flex MP joint and extend IP joint digit 2, 3, 4

66
Q

innervation of dorsal interossei?

A

ulnar nerve deep branch

67
Q

two major arteries of arm

A

radial and ulnar

enter palm and anastomose

68
Q

anastomosis of radial and ulnar arteries?

A

superficial and deep palmar arch

69
Q

superficial palmar arterial arch

A

anastomose of:
superficial branch of radial artery
ulnar artery (chief contributor)

  • under palmar aponeurosis
  • over flexor tendons
  • more distal and larger than deep arch

at risk to get cut

70
Q

deep palmar arterial arch

A

major contributor is radial artery (dorsal side of thumb)

  • sits on bones deep to flexor tendons on top of interossei muscles
  • continuous with deep branch of ulnar artery
71
Q

how many arteries on glomus of fingers?

A

4

**why you bleed alot on your fingers

72
Q

radial artery

A

courses through snuff box and goes to dorsum of carpal bones

gives off dorsal carpal arch
-then dives deep to first interossei muscle two heads

73
Q

dorsal carpal arch

A

of radial artery

-anastomoses with dorsal carpal branch of ulnar artery

**won’t see on body

give rise to dorsal metacarpal arteries

74
Q

dorsal metacarpal arteries

A

from dorsal carpal arch
-two for every finger

form proper dorsal digital arteries

75
Q

deep palmar arterial arch

A

small, proximal, deep to tendons
on the metacarpals and interossei muscles

forms from radial artery continuation
-branches princeps pollicis and radialis indicis

anastomose with deep branch of ulnar artery

76
Q

princeps pollicis

A

arises from radial artery

77
Q

radialis indicis

A

variable - sometimes from radial artery (distal to princeps pollicis) or from princeps pollicis

78
Q

branches from deep palmar arterial arch?

A

palmar metacarpal arteries (usually 3)

anastomose with common palmar digital branches
-from superficial palmar arterial arch

79
Q

perforating branches

A

connect dorsal metacarpal arteries with palmar metacarpal arteries

80
Q

ulnar artery

A

goes over flexor retinaculum lateral to pisiform

forms the superficial palmar arterial arch

81
Q

superficial palmar arterial arch

A

continuation of ulnar artery

  • gives rise to common palmar digital arteries
  • in webs branches to proper digital arteries
82
Q

common palmar digital arteries

A

branch of superficial palmar arterial arch (3)

83
Q

each finger receives how many arteries?

A

4

84
Q

veins of fingers?

A

vena comitantes that accompany branches of radial and ulnar arteries in hand

85
Q

cutaneous innervation of hand?

A

from C678

86
Q

ulnar nerve

A

on top of bones next to ulnar artery

passes under pisohamate ligament

87
Q

median nerve

A

cutaneous - 1, 2, 3, lateral 4

88
Q

ulnar nerve

A

cutaneous - medial 4, 5

89
Q

median motor innervation?

A

**recurrent branch

thenar and 1 2 lumbricals

90
Q

ulnar nerve motor innervation

A

hypothenar muscles
3 4 lumbricals
dorsal and palmar interossei
ends at adductor pollicis and deep head of flexor pollicis brevis

91
Q

branches of ulnar nerve

A

superficial - cutaneous (and palmaris brevis)

deep - follow deep palmar arterial arch

92
Q

major innervation of forearm?

A

median

93
Q

ulnar nerve

A

C8 T1

94
Q

carpal tunnel what nerve?

A

median nerve

95
Q

guyans tunnel

A

for ulnar nerve

MSS - MSK Exam 2 (13 decks)

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