Hand

Question 1

What are the bones of the hand and wrist?

Answer 1

Proximal row: scaphoid, lunate, triquetrum, pisiform

Distal row: hamate, capitate, trapezoid, trapezium

Question 2

What bone articulates with the wrist and hand bones?

Answer 2

The radius articulates with the scaphoid and lunate

Question 3

Which bone in the hand is most commonly broken?

Answer 3

The scaphoid, because all the force is transferred there during a fall

Question 4

What are the attachment sites for the carpal tunnel ligaments?

Answer 4

Hook of hamate, tubercle of the trapezium, scaphoid, and pisiform

Question 5

What bone in the hand is most commonly dislocated?

Answer 5

The lunate

Question 6

What are the metacarpals?

Answer 6

5 bones, one per finger, that all have a base that articulates with the carpal bones, they have a linear shaft and a rounded head

Question 7

What are the phalanges?

Answer 7

They are bones that attach to the metacarpals, each with a base, a shaft, and a head. There are 2 phalanges in the thumb (proximal and distal) and 3 in every other digit (proximal, middle, and distal)

Question 8

What are the cutaneous innervations of the palmar side of the hand?

Answer 8

The thumb, index, middle finger, and half of the ring finger are done by the median nerve. The rest of the ring finger and the pinky are done by the ulnar nerve

Question 9

What are the cutaneous innervations of the dorsal side of the hand?

Answer 9

The pinky half of the hand is done by the ulnar nerve and the thumb half of the hand is done by the radial nerve

Question 10

What is the palmar aponeurosis?

Answer 10

It is deep palmar fascia that has a strong, heavy, dense, well-defined triangular layer of deep fascia in the middle of the palm

Question 11

What is Dupuytren’s Contracture?

Answer 11

It is a progressive fibrosus, which produces abnormal bands of tissue that extend from the aponeurosis to the bases of the phalanges. This pulls the digit(s) into flexion at the metacarpophalangeal joints so that they can’t be straightened.

Question 12

What are synovial sheaths?

Answer 12

They are spaces filled with fluid to allow tendons to slide easily

Question 13

What is found in the carpal tunnel?

Answer 13

The median nerve, the flexor pollicis longus (1 tendon), the flexor digitorum superficialis (4 tendons), and the flexor digitorum profundus (4 tendons)

Question 14

What is the anterior boundary of the carpal tunnel?

Answer 14

The flexor retinaculum

Question 15

What is carpal tunnel syndrome?

Answer 15

It is due to repetitive movements that impinge the median nerve. It decreases the size of the carpal tunnel, specifically wasting of the thenar muscles

Question 16

What is the thenar compartment of the hand?

Answer 16

It consists of three muscles - the opponens pollicis, the abductor pollicis brevis, and the flexor pollicis brevis.

Question 17

What is the reccurrent median nerve?

Answer 17

It innervates the opponens pollicis and is known as the million dollar nerve because if injured, will prevent someone from opposing their thumb.

Question 18

In the thenar compartment of the hand, where are the OAF muscles?

Answer 18

Opponens pollicis runs across the longitudinal length of the thumb.
Abductor pollicis brevis is the most superficial muscle that covers the other two muscles.
Flexor pollicis brevis is the smallest of the three muscles and is the most medial.

Question 19

What is the hypothenar compartment of the hand?

Answer 19

It consists of the opponens digiti minimi, the abductor digiti minimi, and the flexor digiti minimi

Question 20

In the hypothenar compartment of the hand, where are the OAF muscles?

Answer 20

Abductor digiti minimi is the most prominent and superficial.
Flexor digiti minimi is lateral to the abductor and the most medial.
Opponens digiti minimi is deep to all the muscles.

Question 21

What nerve innervates the thenar side?

Answer 21

Recurrent branch of the median nerve

Question 22

What nerve innervates the hypothenar side?

Answer 22

Ulnar nerve

Question 23

Where do the lumbricals originate from?

Answer 23

The flexor digitorum profundus tendons

Question 24

What nerve innervates the lumbricals?

Answer 24

Lumbricals 1 and 2 are innervated by the median nerve. Lumbricals 3 and 4 are innervated by the ulnar nerve.

Question 25

What are the dorsal interossei?

Answer 25

They are 4 bipennate muscles that abduct the fingers. It is found between the bones in the hand.

Question 26

What nerve innervates the dorsal interossei?

Answer 26

The ulnar nerve

Question 27

Where do the dorsal interossei originate from?

Answer 27

The metacarpals

Question 28

What are the palmar interossei?

Answer 28

They are 3 unipennate muscles that adduct the fingers.

Question 29

What is the arterial supply for the muscles of the hand?

Answer 29

The ulnar artery supplies superficial muscles and the radial artery supplies deep muscles. (USRD)

Question 30

What does the superficial branch of the ulnar artery become?

Answer 30

The superficial palmar arch which anastamoses with the superficial branch of the radial artery

Question 31

What are the branches of the radial artery in the hand?

Answer 31

The princeps pollicis (which supplies the medial side of the thumb) and the radialis indicis (which supplies the lateral side of the index finger).

Question 32

What are the branches of the median nerve in the hand?

Answer 32

The recurrent (thenar) branch, common palmar digital nerves, and the proper palmar digital nerves

Question 33

What are the branches of the ulnar nerve in the hand?

Answer 33

The palmar cutaneous branch, dorsal cutaneous branch, superficial branch, and distal branch

Question 34

What are the branches of the radial nerve in the hand?

Answer 34

The superficial branch and the dorsal digital nerves.

Question 35

What is claw hand?

Answer 35

It is also known as ulnar claw and it is due to ulnar nerve palsy usually at the wrist. It leads to weakness of the intrinsic muscles of the hand (such as the lumbricals). There will be hyperextension of the 4th and 5th metacarpophalangeal joints. There is also the loss of ability to spread fingers because the loss of the interossei.

Question 36

What is ape hand?

Answer 36

This is due to median nerve palsy and it causes the wasting of thenar muscles, specifically the inability to oppose the thumb. This can occur with an injury of the median nerve either at the elbow or at the wrist.

Question 37

What is Hand of Benediction?

Answer 37

This is due to median nerve palsy and results from prolonged compression or injury of the median nerve at the level of the elbow or upper arm. The deformity is visible when trying to making a fist. It is caused by the inability to flex the first 3.5 fingers.

Question 38

What is wrist drop?

Answer 38

It is palsy of the radial nerve and causes loss of motor innervation to the wrist extensors in the forearm.