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Hand Flashcards

1
Q

What lives in the ulnar notch of the radius to ulnar styloid and separates the ulnar head from carpals while sliding across ulnar head during pronation/supination?

A

Triangular Fibrocartilage (TFC)

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2
Q

What are the 4 proximal carpals?

A

Scaphoid, lunate, triquetrum, pisiform

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3
Q

What are the 4 distal carpals?

A

Trapezium, trapezoid, capitate, hamate

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4
Q

Describe the scaphoid

A

Largest proximal carpal, most frequently fractured

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5
Q

Describe the lunate

A

Most common dislocated

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6
Q

Describe the triquetrum

A

Connects to the triangular fibrocartilage

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7
Q

Describe the pisiform

A

Embedded in flexor carpi ulnaris tendon

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8
Q

Describe the trapezium

A

Thumb side

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9
Q

Describe the trapezoid

A

Connects to second metacarpal

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10
Q

Describe the capitate

A

Largest of all carpal bones

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11
Q

Describe the hamate

A

Hook projects anteriorly

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12
Q

Radius + proximal carpals

A

Radiocarpal joint

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13
Q

Proximal row of carpals+distal row of carpals

A

Midcarpal joint

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14
Q

Distal carpal + metacarpals

A

Carpometacarpal (CMC) joints

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15
Q

What is special about the first CMC joint?

A

It is a saddle joint, allowing the thumb a wide range of movement

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16
Q

Metacarpals + proximal phalanges

A

Metacarpophalangeal joints

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17
Q

Proximal phalanx + middle phalanx

A

Proximal Interphalangeal Joints (PIP)

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18
Q

Middle phalanx + distal phalanx

A

Distal Interphalangeal Joints (DIP)

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19
Q

Does the thumb have PIP or DIP joints?

A

No, only IP joint

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20
Q

What 4 ligaments surround the wrist?

A

Palmar radiocarpal, dorsal radiocarpal, ulnar collateral, radial collateral

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21
Q

What is the job for palmar and dorsal radiocarpal?

A

Keep hand connected to radius (allows hand to rotate with radius when pronating/supinating)

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22
Q

What is the jobs of ulnar and radial collateral?

A

RC= Strengthen medial parts of joint capsule; UC= Strengthen lateral parts of joint capsule

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23
Q

Where do the palmar and dorsal radiocarpal attach to?

A

Radius to both rows of carpals

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24
Q

Where does the ulnar collateral attach to?

A

Ulna to the triquetrum

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25
Q

Where does the radial collateral attach to?

A

Radius to the scaphoid

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26
Q

Myotome for wrist flexion

A

C7

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27
Q

Myotome for wrist extension

A

C6

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28
Q

Myotome for finger abduction/adduction

A

T1

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29
Q

Myotome for thumb extension

A

C8

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30
Q

Describe Palmar Ligaments (Plates)

A

Plates that connect to fan-like portion of collateral ligaments and prevent hyper extension of finger (specifically flexor tendon)

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31
Q

What is palmar aponeurosis?

A

Fascia that is a continuation of palmaris longus tendon, it connects to flexor retinaculum and is continued by fibrous digital sheaths

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32
Q

What is palmar aponeurosis?

A

Fascia that is a continuation of palmaris longus tendon, it connects to flexor retinaculum and is continued by fibrous digital sheaths

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33
Q

What is fibrous digital sheaths (pulleys)?

A

Tubes that enclose synovial sheaths and long fiber flexors within them; they keep tendons from bowstringing away from nones

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34
Q

What is fibrous digital sheaths (pulleys)?

A

Tubes that enclose synovial sheaths and long fiber flexors within them; they keep tendons from bowstringing away from bones

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35
Q

How many fibrous digital sheaths are there?

A

5 anular (rounded) and 3 cruciform (cross)

36
Q

What allows infection to spread from hand to forearm?

A

The mid palmar space due to being continuous from hand to anterior compartment of forearm through the carpal tunnel

37
Q

What are the boundaries of the carpal tunnel?

A

Roof= Flexor retinaculum; walls= scaphoid/trapezoid and pisiform/hook of hamate; floor= carpals between walls and their ligaments

38
Q

What are the contents of the carpal tunnel?

A

9 tendons (4 FDS, 4 FDP, 1 FPL) and 1 nerve (median nerve)

39
Q

Tunnel of guyon vs carpal tunnel

A

Tunnel of guyon has ulnar nerve pass through while carpal tunnel has median nerve pass through

40
Q

How many compartments does the extensor retinaculum have?

41
Q

ER Compartment 1 muscles

A

Abductor Pollicis Longus (APL) and Extensor Pollicis Brevis (EPB)

42
Q

ER Compartment 2 muscles

A

Extensor carpi radialis longus (ECRL) and extensor carpi radialis brevis (ECRB)

43
Q

ER Compartment 3 muscles

A

Extensor Pollicis longus (EPL)

44
Q

ER Compartment 4 muscles

A

Tendon sheath for extensor digitorum (ED) and extensor indicis (EI)

45
Q

ER Compartment 5 muscles

A

Extensor digiti minimi (EDM)

46
Q

ER Compartment 6 muscles

A

Extensor carpi ulnaris (ECU)

47
Q

What bones and tendons make up the anatomical snuff box?

A

Bone= scaphoid; tendons= abductor Pollicis longus, extensor Pollicis brevis, and extensor pollicis longus

48
Q

What muscles perform thumb flexion?

A

Flexor Pollicis brevis and flexor Pollicis longus

49
Q

What muscles perform thumb extension?

A

Extensor Pollicis longus and extensor Pollicis brevis

50
Q

What muscles perform thumb abduction?

A

Abductor Pollicis brevis and abductor Pollicis longus

51
Q

What muscles perform thumb adduction?

A

Abductor Pollicis and first dorsal interosseous

52
Q

What muscles perform thumb opposition?

A

Opponens Pollicis

53
Q

What muscles perform finger flexion?

A

Flexor digitorum superficialis, flexor digitorum profundus, flexor digiti minimi brevis (pinky)

54
Q

What muscles perform finger extension?

A

Extensor digitorum, extensor indicis, extensor digiti minimi (pinky)

55
Q

What muscles perform finger abduction?

A

Dorsal interossei and abductor digiti minimi (pinky)

56
Q

What muscles perform finger adduction?

A

Palmar interossei and adductor pollicis

57
Q

What do the lumbricals do?

A

Extend IP’s and flex MCP’s

58
Q

How do extensor expansions (or hoods) work to extend the fingers?

A

They hold tendon in finger for expansion

59
Q

Map the radial artery to the hand

A

——> superficial branch-> superficial palmar arch
|
Radial artery-> dorsal branch -> deep palmar arch

60
Q

Map the ulnar artery to the hand

A

—> superficial palmar arch-> common digital arteries-> proper digital | arteries
|
|
Ulnar artery-> deep palmar arch-> palmar metacarpal arteries

61
Q

Map veins in hand to deep veins of forearm

A

Superficial venous palmar arch-> deep vein of forearm
Deep venous palmar arch-> deep vein of forearm

62
Q

Map the veins in hand to superficial veins in arm

A

Dorsal venous network-> cephalic vein
|
——> basilic vein

63
Q

Dermatome sensory distribution

A

Single nerve root (c6, c7, c8)

64
Q

Peripheral sensory distribution

A

Individual named nerve (superficial branch of radial nerve, ulnar nerve, median nerve)

65
Q

Myotome definition

A

Group of muscles inner step by a single spinal nerve

66
Q

What Myotomes are in the hand and how are they tested?

A

C8-T1, tested through the interossei

67
Q

What 2 thenar muscles are not innervated by the median nerve?

A

Flexor Pollicis brevis and adductor pollicis

68
Q

Why does a scaphoid fracture have trouble healing, what is the consequence of this?

A

It receives little blood supply, this can cause avascular necrosis and degenerative joint disease

69
Q

What is Dupuytren’s Contracture?

A

Disease affecting palmar fascia and aponeurosis, unknown cause (potentially hereditary) affects men over 50 y/o of N. European descent, occurs in bilateral hands (pulls 4th/5th digits into flexion)

70
Q

What is tenosynovitis?

A

Inflammation of synovial sheath of tendon

71
Q

What causes trigger finger?

A

Repetitive, forceful use of pulling the finger; fibrous digital sheath becomes thickened and narrow and keeps finger from flexing/extending

72
Q

What causes De Quervain’s disease?

A

Sheath around abductor Pollicis longus and extensor Pollicis brevis becomes inflamed; usually repetitive use of gripping activities; sheath= thickened/narrow; pain over snuffbox radiating up lateral forearm, tender to touch

73
Q

Carpal tunnel syndrome

A

Median nerve compression caused by decrease tunnel size, enlargement of tunnel contents, fluid retention, infection, or excessive use of finger flexors

74
Q

Signs and symptoms of carpal tunnel syndrome

A

Sensation loss, thenar atrophy/wasting, poor coordination/strength of thumb

75
Q

What is mallet finger

A

Extensor tendon avulsed from distal phalanx during forced hypertension (cannot extend DIP)

76
Q

Jersey finger

A

Distal insertion of FDP avulsed from distal phalanx during loss of forceful grip (cannot flex DIP)

77
Q

Skier’s thumb

A

Tear in ulnar collateral ligament of thumb’s MCP capsule from hyoerabduction

78
Q

What nerve is injured with claw hand?

A

Ulnar nerve in tunnel of guyon

79
Q

What are signs of claw hand?

A

MCP’s are pulled into hypertension by extensor digitorum and medial lumbrical’s cannot overcome the pull due to ulnar nerve injury

80
Q

What nerve is injured in ape hand syndrome?

A

Median nerve in wrist/carpal tunnel

81
Q

Why does ape hand occur?

A

Thenar muscles affected (cannot abduct thumb from palm, thenar atrophy/wasting) but FPL and 1/2 FPB can flex thumb across palm

82
Q

What nerve is injured in hand of benediction?

A

Median nerve in forearm/elbow

83
Q

Why does hand of benediction occur?

A

Thenar muscles are affected and cannot abduct thumb, FDS and 1/2 of FDP also affected (cannot flex PIP or DIP of digits 2-3)

84
Q

What nerve is injured with wrist drop?

A

Radial nerve could be injured all the way up as far as the radial groove

85
Q

Why does wrist drop occur?

A

With radial nerve injured, the wrist extensors cannot extend against gravity

86
Q

What condition in the hand can occur with a humeral fracture?

A

Wrist drop, the radial nerve could be injured in the radial groove in the humeral head

Anatomy (8 decks)

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