Hand

Question 1

deep and superficial transverse metacarpal ligaments

Answer 1

connect the heads on the metacarpals at the MP joints
restrict the movement of the bones relative to each other

Question 2

scaphoid fracture: mechanism and risks

Answer 2

FOOSH
waist of scaphoid can fracture
blood supply from distal to proximal from radial artery, if fractured proximal portion loses blood supply

Question 3

palmar radiocarpal ligament

Answer 3

distal radius and scaphoid, lunate, triquetrum
palmar aspect

Question 4

radial collateral ligament

Answer 4

radial styloid process to scaphoid
limit ulnar deviation

Question 5

ulnar collateral ligament

Answer 5

ulnar styloid process to triquetrum and pisiform
limit radial deviation

Question 6

dorsal radiocarpal ligament

Answer 6

distal radius to scaphoid, lunate, triquetrum
dorsal aspect

Question 7

distal radioulnar ligament

Answer 7

palmar and dorsal
wraps around distal ulna to connect to radius

Question 8

flexor retinaculum

Answer 8

aka transverse carpal ligament
attach to pisiform, hook of hamate; scaphoid, trapezium
covers carpal tunnel

Question 9

extensor retinaculum

Answer 9

radius, pisiform, triquetrum
hold extensor tendons in place
can be removed to use as a surgical graft

Question 10

palmar aponeurosis

Answer 10

from flexor retinaculum and palmaris longus
insert base of MP joint into transverse metacarpal ligament
muscle attachment, grip, protect deep tendons

Question 11

carpal tunnel

Answer 11

made by flexor retinaculum and deep arch of carpal bones
contains tendons of: flexor digitorum profundis, flexor pollicis longus, flexor digitorum superficialis, median nerve

Question 12

carpal tunnel syndrome

Answer 12

entrapment of median nerve within carpal tunnel
numbness, tingling, pain in hand and forearm
pregnancy, work, systemic health

Question 13

fibrous digital sheath

Answer 13

cruciate, annular ligaments and distal extensions of palmar aponeurosis
sheaths continuous with carpal tunnel to hold tendons to bony plane and prevent bowing

Question 14

extensor hoods

Answer 14

tendons of ext digitorum and extensor pollicis longus form these on proximal phalanges
attachments for many intrinsic muscles
allow MP joint to flex while extending IP joints

Question 15

What muscles of the forearm or hand are involved in a power grip? precision?

Answer 15

power: forearm, extrinsic hand muscles
precision: hand, intrinsic hand muscles

Question 15

palmaris brevis

Answer 15

origin: flexor retinaculum
insertion: dermis on ulnar border
innervation: ulnar n
action: wrinkle skin on side of palm

Question 16

adductor pollicis

Answer 16

oblique head and transverse head
origin: oblique, 2 and 3 metacarpals and capitate
transverse:3rd metacarpal
insertion: proximal 1st phalanx
innervation: ulnar n
action: adduction of thumb

Question 17

lumbricals

Answer 17

origin:
1 and 2: lateral tendons of flex dig profundus
3 and 4: medial tendons of flex dig profundus
insertion: lateral side dorsal expansion 2-5
innervation: 1-2 median, 3-4 ulnar
action: flex MCP, extend DIP PIP

Question 18

dorsal interossei

Answer 18

origin: adjacent side of metacarpals (lateral to midline, middle finger, so they can abduct, not pinky or thumb)
insertion: dorsal expansion, base of 2-4 proximal phalanges
innervation: ulnar
action: abduct digits, flex MP, extend IP

Question 19

palmar interossei

Answer 19

origin: palmar surface 2, 4, 5 metacarpals
insertion: dorsal expansion, base of 2, 4, 5 proximal phalange
innervation: ulnar
action: adduct digit to center of hand, flex MP, extend IP
none on 3rd digit bc midline of hand

Question 20

flexor pollicis brevis

Answer 20

origin: deep - trapezium, flexor retinaculum; superficial - trapezoid, capitate
insertion: proximal phalange 1st digit
innervation: median
action: flex thumb

Question 21

opponens pollicis

Answer 21

origin: trapezium and flexor retinaculum
insertion: lateral side first metacarpal
innervation: median
action: bring 1st digit to center of palm

Question 22

abductor pollicis brevis

Answer 22

origin: flexor retinaculum, scaphoid, trapezium
insertion: proximal 1st phalanx
innervation: median
action: abduct thumb

Question 23

opponens digiti minimi

Answer 23

origin: hook of hamate, flexor retinaculum
insertion: 5th metacarpal
innervation: ulnar
action: lateral rotation of 5th metacarpal to center of palm (opposition)

Question 24

abductor digiti minimi

Answer 24

origin: pisiform, tendon flexor carpi ulnaris
insertion: proximal 5th phalange
innervation: ulnar
action: abduct 5

Question 25

flexor digiti minimi brevis

Answer 25

origin: hook hamate, flexor retinaculum
insertion: proximal 5th phalange
innervation: ulnar
action: flex 5th MCP joint

Question 26

blood supply to the hand

Answer 26

radial and ulnar artery frorm two interconnected vascular branches in palm
radial artery supplies thumb mainly, ulnar supplies remaining digits

Question 27

veins of the hand

Answer 27

basilic and cephalic veins continue to form venous palmar arches along arterial arches

Question 28

What muscles in the hand are supplied by the ulnar n?

Answer 28

all but the thenar and two lateral lumbricals
these are innervated by the median n

Question 29

median n sensory distribution in the hand

Answer 29

skin of thumb, index, middle, and lateral side of ring finger
sensory and allows precision grip

Question 30

guyon’s canal

Answer 30

thickening of antebrachial fascia from palmar carpal ligament connected to hypothenar and flexor retinaculum
pisiform and hook of hamate form walls
entrapment of the ulnar n can occur here in medial anterior wrist

Question 31

What hand position signals ulnar nerve lesions?

Answer 31

clawing of hand, especially medial 2 fingers
hyperextended MP and IP flexed due to lost intrinsic hand m function