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Neuromuscular/Anatomy > Hand > Flashcards

Hand Flashcards

1
Q

What are the four types of joints in the hand?

A

Carpometacarpal joint

Metacarpal phalangeal joint

proximal interphalangeal joint

Distal interphalangeal joint

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2
Q

Which digit only has 2 phalanges?

A

Thumb (1st digit)

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3
Q

What is the most commonly fractured carpal bone?

A

scaphoid

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4
Q

where does a scaphoid commonly fracture?

A

along the long axis

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5
Q

Describe the 1st carpmetacarpal joint

A

synovial joint - saddle type

wide range of movements here including flexion, extension, abduction, adduction, opposition -

this joint is involved in the Bennet’s fracture

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6
Q

What muscles compose the long flexors of the finger?

A

Flexor digitorum profundus

Flexor digitorum superficialis

*both median nerve*

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7
Q

What joints does flexor digitorum profundus act on?

A

EVERY joint in the hand!

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8
Q

What are the Thenar muscles?

A

OAF

O= opponens pollicis

A= abductor pollicis brevis

F= flexor pollicis brevis

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9
Q

What are the two heads of adductor pollicis called?

A
  • Transverse head of adductor pollicis
  • Oblique head of adductor pollicis
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10
Q

What is the nerve supply to the thenar muscles?

A

Remember thenar muscles = opponens pollicis, abductor pollicis brevis, and flexor pollicis brevis - nerve suppy = median nerve

Deep to these thenar muscles is adductor pollicis whos nerve supply is the ulnar nerve!

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11
Q

What are the hypothenar muscles? What is their nerve supply?

A

Abductor digiti minimi

flexor digiti minimi

opponens digiti minimi

(ulnar nerve)

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12
Q

What are the roots of the ulnar nerve?

A

C8 and T1

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13
Q
A
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14
Q

What tendon do the lumbricals arise from?

A

They arise from the flexor digitorum profundus tendons

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15
Q

What is the function of the lumbricals?

What are their innervations?

A

flex the metacarpal phalangeal joint and extend the interphalangeal joints

innervated by median nerve on radial side

innervated by ulnar nerve on ulnar side

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16
Q

What are the inerossei muscles? What action are they responsible for? What is their nerve supply?

A

They are responsible for the adduction/abduction of your fingers

you have dorsal interossei and palmar interossei (PAD and DAB)

nerve supply = ulnar nerve (C8 T1)

17
Q

What lies under the carpal tunnel?

A

Flexor digitorum superficialis

flexor digitorum profundus

median nerve

flexor pollicis longus tendon

18
Q

What structures pass over the flexor retinaculum?

A

ulnar artery

ulnar nerve

palmar cutaneous branch of ulnar nerve

tendon of palmaris longus

palmar cutaneous branch of median nerve

19
Q

What are the clinical symptoms of carpal tunnel syndrome?

A

tingling/numbness of the first 3 and half digits -

wasting of the thenar eminence due to inability of OAF

opponens pollicis, abductor pollicis brevis, flexor pollicis brevis

20
Q

What is the purpose of the finger synovial sheath?

what are the implications?

A

the synovial sheaths reduce friction in your fingers - but they can also spread infection

21
Q

what structure overlies the long flexor tendons in the palm?

A

the palmar aponeurosis

22
Q

Where does the palmar aponeurosis spred from?

A

it spreads from the flexor retinaculum and the palmaris longus tendon to the bases of the proximal phalances

23
Q

With is Dupuytren’s contracture?

A

common problem that results in fibrosis of the palmar aponeurosis- leading to shortening/thickening of the digital bands that pull the digits (4th and 5th especially) to varying degrees of flexion. Surgery is required to correct this deformity

24
Q

How does the ulnar artery enter the hand?

A

it ents anterior to the flexor retinaculum between pisiform and hook of hamate (Guyon’s canal)

It divides into superficial and deep branches

it is the man contributor to the superficial arch

25
Q

How does the radial artery enter the hand?

A

It curves around scaphoid and trapezium, passes between the heads of 1st dorsal interosseous muscle then between heads of adductor pollicis

Forms an anastomosis with deep branch of ulnar artery (deep palmar arch)

26
Q

what is the allen’s test?

A

place fingers on the radial artery and ulnar artery in the wrist cutting off blood supply to the hand- then release one of them to test the profusion of the anatomoses. If there is a true anatomosis, one artery should be sufficient to profuse the entire hand

27
Q

Describe the path of the ulnar nerve

A

After arising from the brachial plexus, the ulnar nerve descends down the medial side of the upper arm. At the elbow, it passes posterior to the medial epicondyle of the humerus, entering the forearm. At the medial epicondyle, the nerve is easily palpable and vulnerable to injury.

In the forearm, the ulnar nerve pierces the two heads of the flexor carpi ulnaris, and travels alongside the ulna. Three branches arise in the forearm:

Muscular branch: innervates some muscles in the anterior compartment of the forearm.

Palmar cutaneous branch: innervates the skin of the medial half of the palm.

Dorsal cutaneous branch: innervates the skin of the medial 1 and 1/2 fingers, and the associated palm area.

28
Q

Where does the ulnar nerve give off the dorsal cutaneous nerve?

A

Aprox. 5cm proximal to the wrist, the dorsal cutaneous nerve passes deep to flexor carpi ulnaris to supply the dorsal aspect of the hand.

29
Q

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

flexor carpi ulnaris

ulnar half of flexor digitorum profundus

hypthenar muscles

Interossei

3rd and 4th lumbricals

adductor pollicis

A

Everything but LOAF is supplied by the ulnar nerve in the hand

30
Q
A
31
Q

Name the structures at the wrist from lateral to medial

A

Tendon of brachioradialis

radial artery

flexor carpi radialis

median nerve (palmaris longis superficial to this)

Flexor digitorum superficialis

ulnar artery

ulnary nerve

flexor carpi ulnaris

32
Q

What is the tendon that 15% of population doesn’t have at the wrist?

A

palmaris longus

33
Q

Describe the myotomes of the arm

A

Shoulder extension and abduction = C5

shoulder flexion and adduction = C6,7,8

Elbow flexion = C5,6

Elbow Extension = C7,8

Radioulnar supination/pronation = C6

Fingers flextion/extension = C7,8

Fingers abduction/adduction/small muscles = T1

Neuromuscular/Anatomy (37 decks)

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