HAND Flashcards
The longitudinal fibres of the palmar fascia extend to the fingers and blend and mix with the fibrous tissue of the fingers. what is the role of this fibrous tissue
support the flexor tendons int he fingers - holds them in place and protects them from trauma
What is the firbosseous tunnel of the fingers made of
both fibrous and bone tissue. Roof is fibrous tissue and floor is bone tissue
Flexor pollicis brevis
O - lateral carpal bones + flexor retinaculum
I - base of middle phalanx of thumb
A - Flexion
NS - Sup: Recurrent median Inf: deep ulnar
Abductor pollicis brevis
O - lateral carpal bones
I - Proximal phalanx and 1st MC bone
A - Abduction of thumb
NS - Recurrent median
Adductor pollicis
O - Distal carpal bones and MC 2 and 3
I - Base of proximal phalanx of thumb
A - Adduction of thumb
NS - Deep ulnar
Opponens pollicis
O - Lateral carpal bones
I - Lateral surface of 1st MC
A - Opposition
NS - Median recurrent
Opposition is considered a combination of what two movements
flexion and adduction
Abductor digiti minimi
O - Medial carpal bones and flexor carpi ulnaris tendon
I - Proximal phalanx of thumb and 5th MC bone
A - Abduction of digiti minimi
NS - Deep ulnar nerve
Palmaris brevis
O - Palmar fascia, tendon of palamaris longus, flexor retinaculum
I - Deep surface of skin on medial side of hand
A - enabled our ancesters to make cup with hands to use tools
NS - Superficial ulnar nerve
Opponens digiti minimi
O- Flexor retinaculun, medial carpal bones
I - Medial side of 5th MC bone
A - Opposition of 5th finger
NS - Deep ulnar
Flexor digiti minimi
O - Medial carpal bones, flexor retinaculum
I - Proximal end of proximal phalanc
A - Flexion of the 5th digit
NS - deep ulnar N.
Palmar interosseous
O - MC bones 2,4,5
I - DDE
A - Adduction of fingers
NS - Deep ulnar
Dorsal interosseous
O - All MC bones
I - DDE
A - Abduction
NS - Deep ulnar
Lumbricals
O - Arise from tendon of flexor digitorum profundus
I - Dorsal digital expansion of corresponding finger
A - Flexion of MC phalangeal, extension of IP joint - byebye
NS - Lateral two: median nerve. medial two: deep ulnar nerve
How many intrinsic muscles of the hand are there
19
What tendons are found in the carpal tunnel
Flexor digitorum superficialis
Flexor digitorum profundus
Flexor pollicis longus
The synovial sheaths of the 1st and 5th finger and continuous with those for the flexors passing through the carpal tunnel, what is the consequence of this
Penetrating wound in the thumb and 5th finger, if they become inflammed or infected it will travel to the carpal tunnel tendons causing carpal tunnel syndrome
What is carpal tunnel syndrome
compression of median nerve
What are the causes of carpal tunnel syndrome
- Overuse of CT tendons
- Penetrating injury to thumb or pinky
- normal consequence of pregnancy
Why does carpal tunnel occur with pregnancy
- Because entire volume of interstitial fluid in the body increases
What are the signs and symptoms of carpal tunnel syndrome
- Sensory deficiency - lateral 3.5 fingers will have number
- Motor deficiencies - fully impaired opposition. Partially impaired: flexion of thumb, abduction of thumb
What forms the superficial palmar arhc
superficial branch of ulnar artery and superficial palmar branch of radial artery
Where does the deep palmar arch sit
deep to all tendons and just superficial to interosseous muscles
what supplies blood to fingers?
Palmar metacarpal artery
Common palmar digital artery
Superficial ulnar nerve is almost all sensory except for…
palmaris brevis
When does the ulnar nerve divide into deep and superficial branches
just after the tunnel of guyon
Where is the radio-carpal joint? what type of joint is it?
between the radial distal end and proximal row of carpal bones
Condylar joint
What are the 2 axis of the radiocarpal joint and where do they pass?
Anteroposterior axis passing through the proximal end capitate
Transverse axis passing through the styloid process of radius and pisiform
What type of joint is the mid-carpal joint
gliding
What type of joint is the intercarpal joint
gliding
What 3 joints make up the articular complex of the wrist
radiocarpal joint
Midcarpal joint
intercarpal joints
What are the collateral ligaments of the wrist
The lateral collateral and the medial collateral carpal ligaments
Where is the lateral collateral carpal ligament attached
to the styloid process of the radius and the scaphoid bone
Where is the medial collateral carpal ligament attached
the styloid process of the ulna and the pisiform and triquetrum bones
what are the 2 anterior posterior ligaments of the wrist
Radio-carpal and the ulno carpal
The radio-carpal ligament has an expansion to the…
pisiform bone
there are ___ set of radiocarpal and ulno-carpal ligaments
2 palmar and dorsal
Where does the inferior radio-ulnar ligament run? what does it do ?
between distal ends of radius and ulna on palmar and dorsal aspect - indirectly stabilizes the wrist complex
Which ligaments control extension of the wrist?
the radio-carpal and ulno-carpal ligaments
Which ligaments control radial and ulnar deviation
the collateral ligaments
What are the 2 groups of mid-carpal ligaments
- The interosseous ligaments
2. The mid-carpal ligaments
Where are the interosseous ligaments found
joining the carpal bones on the same row
What do the mid-carpal ligaments do
joint proximal and distal carpal rows
During flexion what is the range of movement at the radiocarpal joint and the midcarpal joint respectively
RC - 50
MC - 35
During extension what is the range of movement at the radiocarpal joint and the midcarpal joint respectively
RC 35
MC 50
Why is the ROM different for flexion and extension at the radiocarpal and midcarpal joints
Because flexion at the radiocarpal joint is checked later by the anterior margin of the joint which does not extend as far distally as the posterior margin
The __ joint is more important in wrist flexion
radiocarpal
The ___ joint in more important in wrist extension
Midcarpal
The carpometacarpal joints are ___ joints
planar
What ligaments support the CMC joints
CMC ligaments and inter-metacarpal ligaments
The metacarpo-phalangeal joints are ___ joints
condyloid
What are the ligaments supporting the metacarpo-phalangeal joint
Deep transverse metacarpal ligaments
Palmar plates
Collateral ligaments
What type of joint are the interphalangeal joints
hinge joints
What ligaments support the interphalangeal joints
collateral ligaments
smaller palmer plates
