Hand

Question 1

Peripheral nerve innervation of hand

Answer 1

Ulnar n.
- dorsal cutaneous branch of ulnar n.
Median n.
Radial n.
-radial n. superficial branch

Question 2

Dermatomes of the hand

Answer 2

C6
C7
C8

Question 3

Carpal tunnel framework

Answer 3

formed by the arching alignment of the carpal bones and the thick flexor retinaculum (transverse carpal ligament)

Question 4

Carpal tunnel contents

Answer 4

Median n.
1 Flexor pollicis longus tendon
4 flexor digitorum profundus tendons
4 flexor digitorum superficialis tendons

Question 5

Fascia of the hand

Answer 5

Palmar fascia is thin over thenar and hypothenar eminences (thenar fascia, hypothenar fascia)
Thick centrally forming the palmar aponeurosis and in the fingers forming the digital sheaths

Question 6

Dupuytren’s contracture/disease

Answer 6

Palmar node, usually 4th or second digit at the MCP joint then the prox IP joint
nodules in fascia = loss of ROM and some pain
30% sporadic
1-2% of population - more in men
Dupuytren’s diathesis - more aggressive form
Trauma and occupational

Question 7

Intrinsic muscle of the hand

Answer 7

Palmar brevis m.
Thenar eminence mm.
Adductor pollicis m.
Hypothenar eminence mm.
Interossei mm.
Lumbrical mm.

Question 8

Movements of the thumb

Answer 8

extension
flexion
abduction
adduction
opposition

Question 9

Palmar brevis muscle

Answer 9

O: palmar aponeurosis and flexor retinaculum
I: Dermis of skin
Inn: Superficial branch of ulnar n.
Actions: improves grib

Question 10

ABductor pollicis brevis muscle

Answer 10

Inn: reccurent branch of median n.
Actions: ABducts pollex - helps with opposition

Question 11

Flexor pollicis brevis muscle

Answer 11

Inn: recurrent branch of median n.
Actions: flexes pollex
Has two heads

Question 12

Opponens pollicis muscle

Answer 12

Inn: recurrent branch of median n.
Actions: opposes pollex toward center of palm and rotates it medially

Question 13

Abductor digiti minimi muscle

Answer 13

O: pisiform
I: medial side of base of prox. phalanx of digit 5
Inn: deep branch of ulnar n.
Actions: ABducts digit 5 (assists in flexion of proximal phalanx)

Question 14

Flexor digiti minimi brevis muscle

Answer 14

Inn: deep branch of ulnar n.
Actions: flexes digit 5

Question 15

Opponens digiti minimi muscle

Answer 15

Inn: deep branch of ulnar n.
Actions: draws 5th metacarpal anteriorly and rotates it (brings digit 5 into opposition with pollex)

Question 16

Adductor pollicis muscle

Answer 16

O: had two heads that origin from the base of metacarpals
I: medial side of base of proximal phalanx or pollex
Inn: deep branch of ulnar n.
Actions: adducts pollex

Question 17

Lumbrical muscles

Answer 17

O: tendons of flexor digitorum profundus m.
I: Lateral sides of extensor expansion (digits 2-5)
Inn: Median n. (lumbricals 1&2); deep branch of ulnar n. (lumbricals 3&4)
Actions: flexes digits at MCP joint and extends IP joints (digits 2-5)

Question 18

Dorsal interossei muscles

Answer 18

O: Adjacent sides of metacarpals
I: extensor hood and base of prox. phalanges of digits 2-4
Inn: deep branch of ulnar n.
Actions: ABducts digits 2-4
assists lumbrcials in flex MCP and extend IP joints
DAB

Question 19

Palmar interossei muscles

Answer 19

O: sides of metacarpals (digits 2,4,5)
I: Extensor expansion of digits 2,4,5 and base of prox phalanx
Inn: deep branch of ulnar n.
Actions: ADDucts digits 2,4,5
assists lumbricals in flex MCP and extend IP joints
PAD

Question 20

Arteries of the hand

Answer 20

Deep palmar artery
Superficial palmar arch
- Common palmar digital aa.
- Proper palmar digital aa.

Question 21

Anatomical snuff box

Answer 21

Lateral: ABductor pollicis longus tendon and extensor pollicis brevis tendon
Medial: extensor pollicis longus tendon
Floor: scaphoid trapezium
Contents: radial artery

Question 22

Median nerve branches in hand

Answer 22

Palmar branch
Recurrent branch
Common palmar digital nn.
- proper palmar digital nn.

Question 23

Ulnar nerve branches in hand

Answer 23

Palmar branch
Deep branch
Superficial branch
common palmar digital n.
proper palmar digital nn.

Question 24

Radial nerve branches in hand

Answer 24

Superficial branch - all sensory in the hand
Dorsal digital n.
terminal branch of dorsal digital branches

Question 25

Myotome testing

Answer 25

C8 - ulnar deviation (ADduction and thumb extension
T1 - finger abduction

Question 26

Bones of hand

Answer 26

Phalanges: Distal, middle, proximal
Metacarpals: 1-5