Hand

Question 1

State the contents of the anatomical snuffbox.

Answer 1

Radial artery
Branch of radial nerve
Cephalic vein

Question 2

Tenderness in the anatomical snuffbox is an indicator of what injury?

Answer 2

Fracture of scaphoid

Question 3

What are the boundaries of the anatomical snuffbox?

Answer 3

Medial border: Tendon of ExtensorPollicis longus

Lateral border: Tendons of Abductor Pollicis Longus and Extensor pollicis brevis

Question 4

State the structures forming the floor of the anatomical snuffbox.

Answer 4

Scaphoid

Trapezium

Question 5

Select the incorrect answer; The skin of the palm

a) is rich in sweat glands
b) is rich in sebaceous glands
c) is immobile
d) Has creases where it is firmly bound to deep fascia

Answer 5

b)

The skin of the palm has NO SEBACEOUS GLANDS

Question 6

Which muscle is found in the superficial fascia of the palm?

Answer 6

Palmaris brevis

Question 7

State the 3 specializations of the deep fascia of the palm.

Answer 7

1. Flexor retinaculum
2. Palmar aponeurosis
3. Flexor sheaths of digits

Question 8

The transverse carpal ligament is another name for which structure in the hand?

Answer 8

The flexor retinaculum

Question 9

State the attachments of the transverse carpal ligament.

Answer 9

Medially (Hook of hamate and pisiform)

Laterally (Scaphoid and Trapezium)

Question 10

What is the name of the superficial slip of the flexor retinaculum?

Answer 10

Volar carpal ligament/Palmar carpal ligament

Question 11

VOLAR CARPAL LIGAMENT is another name for which structure?

Answer 11

Flexor retinaculum superficial slip also called palmar carpal ligament

Question 12

The flexor retinaculum is a thickening of which fascia?

Answer 12

Deep fascia of forearm (antebrachial fascia)

Question 13

State the attachments of the palmar aponeurosis.

Answer 13

apex - blends with flexor retinaculum and palmarus longus tendon
base - splits into 4 before metacarpals, each splits into 2 slips to blend with flexor sheaths of tendons
medial - blends with hypothenar fascia
lateral - blends with thenar fascia

Question 14

State the functions of the palmar aponeurosis.

Answer 14

1. Protects nerves and vessels

2. Improves grip by keeping skin fixed

Question 15

Describe Duputren’s Contracture.

Answer 15

Fibrosis (fibrous tissue buildup) on fascia on palm, causing flexion deformity of DIP and PIP joints of usually little and ring fingers (but can involve other fingers; thumb and fingers not usually affected)
Treatment involves fasciectomy to relieve pressure

Question 16

What is the clinical basis of Trigger finger?

Answer 16

Thickening of long flexor tendon causes finger to get locked in full flexion which can be undone only with assistance from opposite hand; extension occurs suddenly with a click sound

Question 17

What are vincula?

Answer 17

thin connective tissue bands connectinglong flexor sheaths to phalanges

Question 18

Name the 3 major synovial sheaths in the hand.

Answer 18

1. Radial bursa (encloses flexor pollicis longus & blends with synovial sheath of thumb)
2. Ulnar bursa (blends with synovial sheath of little finger)
3. Digital synovial sheaths (of all the digits)

Question 19

What is TENOSYNOVITIS?

Answer 19

Infection and inflammation of long flexor sheaths
Causes; small penetrating wounds ex: pricks
Symptoms; swelling of digits from collection of pus in synovial sheaths, pain in digits when trying to flex

Question 20

Which arteries complete the superficial palmar arch of the ulnar artery?

Answer 20

From radial artery;

1. superficial palmar branch
2. princeps pollicis
3. radialis indicis

Question 21

What are the 5 groups of muscles in the hand?

Answer 21

Thenar
Hypothenar
Adductor pollicis 
Interossei
Lumbricals