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limbs anatomy > hand > Flashcards

hand Flashcards

1
Q

function of upper limb

A

entirely devoted to hand- allows remote control of hand to manipulate objects

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2
Q

DIAGRAM bones of region

A

carpal bones metacarpals (5) phalanges (thumb has 3, rest have 3)

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3
Q

unique difference of thumb

A

trapezium (carpal bone of thumb) and metacarpal 1 are very mobile, so thumb can OPPOSE well to other finger, whereas carpals/metacarpals of other digits act as one unit as connected to each other

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4
Q

DIAGRAM carpal tunnel- function, borders, whats inside, what goes above and below

A

pathway from forearm into hand- formed by the carpal arch (carpal bones) and flexor retinaculum (roof of tunnel)- has ten structures: 4 tendons of flexor digitorum profundus/superficialis each, one tendon for flexor policis longus, and median nerve ulnar nerve/artery and palmaris longus go above (nerve medial), superficial veins go underneath

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5
Q

DIAGRAM carpal arch

A

from lateral to medial, trapezium, trapezoid, capitate, hamate, triquetrum, pisiform

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6
Q

DIAGRAM bones that flexor retinaculum attaches to

A

lateral- tubercle of scaphoid, then tubercle of trapezium medially- pisiform and hamate hook

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7
Q

scaphoid fractures

A

most common carpal injury- diagnosed through pain in anatomical snuff box most patient’s scaphoid solely from the retrograde radial artery, so fracture easily= avascular necrosis= bone dysfunctional

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8
Q

components of metacarpals

A

has base, body and head (form the knuckles)

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9
Q

joints of hand

A

distal radio-ulnar joint radiocarpal joint ie wrist joint intercarpal joint (between carpal bones, and between proximal and distal row ie midcarpal joint) carpo-metacarpal joints metacarpophalangeal joints proximal and distal interphalangeal joints

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10
Q

DIAGRAM articular disc- function+ shape

A

separates distal radio-ulnar joint from radio-carpal joint- is triangular shaped

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11
Q

radiocarpal joint movements

A

flexion/extension, abduction/adduction (adduction greater as radial styloid process longer), and circumduction

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12
Q

DIAGRAM function of intercapal joints

A

gliding movement to allow other movements of hand

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13
Q

carpo-metacarpal joints- what is it, thumb vs rest + clinical significance

A

between distal carpal bones and heads of metacarpals 1st joint is between metacarpal 1 and TRAPEZIUM- saddle joint to allow ALL movements of thumb, often becoming osteoarthritic 2nd to 5th are less mobile

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14
Q

intermetacarpals

A

only between 2-5- not really joint as formed by DEEP TRANSVERSE METACARPAL LIGAMENTS

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15
Q

DIAGRAM metacarpo-phalangeal joints- what are they, ligament + movements

A

between heads of metacarpals+ base of proximal phalanges reinforced by palamar ligament- allows flexion/extension and abduction/adduction

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16
Q

interphalangeal joints- what is it , thumb difference, and movements

A

between phalanges- thumb only has one, and only flexion/extension

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17
Q

DIAGRAM fascia of palm

A

palmar aponeurosis is above flexor tendons of hand- continuous with flexor retinaculum, THEN fibrous digital sheaths

18
Q

DIAGRAM osseo-fibrous tunnels- borders, whats inside, and fibrous digital sheaths

A

on palmar aspect of hand- formed by fibrous digital sheaths on top, and bone underneath eg phalanges within them is the long flexor tendon and their digital synovial sheaths the fibrous digital sheaths condense into annular (A) and cruciate (C) ligaments/pulleys

19
Q

path of a tendon and attachments of FDP/S

A

goes under flexor retinaculum, enters its synovial sheath and goes into osseofibrous tunnel, FDS SPLITS around FDP at proximal phalanx, and attaches to middle phalanx, but FDP attaches to distal phalanx

20
Q

DIAGRAM dorsal tendinous anatomy

A

extensor tendons go under extensor retinaculum, connected by intertendinous bands- also in synovial sheats

21
Q

DIAGRAM extensor hoods

A

extensor tendons expand over proximal phalanges to form extensor hoods

22
Q

tendon injuries

A

mallet finger- extensor tendor at tip is torn= can’t straighten fingertrip trigger finger- inflammation of tendon= tendon difficult to go through fully= catch and release ie trigger sensation skier/gamekeepers thumb- ulnar collaterla ligament /medial CL joint of thumb torn= difficult to pinch/grasp

23
Q

superficial muscles of anterior forearm

A

FCR, palmaris longus and FCU- all attach to metacarpals apart of PL (ends at palmar aponeurosis- wrist flexion also pronator teres

24
Q

intermediate muscle of anterior forearm

A

FDS- wrist, metacarpo-phalangeal joint and proximal interphalangeal flexion

25
Q

deep muscles of foream

A

FDP, FPL (flexes thumb interphalangeal joint) also pronator quadratus

26
Q

posterior forearm muscles with innnervation

A

wrist exntesion- ECRL, ECRB, ECU digit extension- extensor digitorum (all 4), extensor indicis, extensor digit minimi all by posterior interosseous nerve- deep branch of radial nerve extension of thumb- EPB, EPL, ABDUCTOR pollicis longus

27
Q

intrinsic muscles of hand

A

anterior- thenar (thumb) and hypothenar (little finger) muscles, 4 lumbricals, 4 palmar interosseuous muscles, ADDUCTOR pollicis, palmaris brevis posteiro- 3 dorsal interosseous muscles

28
Q

innervation of intrinsic muscles+ hypothenar/thenar muscles

A

ulnar nerve supplies most muscles of hand including hypothenar median nerve supplies the thenar and lateral 2 lumbrical (LOAF) L- lateral lumbrical O- opponens pollicis A- abductor pollicis brevis F- flexor pollicis brevis hypothenar- oppones digiti minim, abductor digiti minim, flexor digiti minim thus both have flexor, opponents and abductor (OAF)

29
Q

functions of thenar/hypothenar muscles

A

A- abduction of MCP of both O- opposition of both F- flexion of MCP of both

30
Q

lumbricals origin and function with innervation

A

side of FDP, inserts at lateral sides of extensor hoods flexion at MCP, BUT extension at interphalangeal joint- thus they LINK FLEXOR and EXTENSOR muscles innervation- medial 2 ulnar nerve, lateral 2 median nerve

31
Q

dorsal and palmar interosseous muscles

A

sides of 2 metacarapals, inserts at sides of extensor hoods- causes abduction/adduction at MCP ulnar nerve PAD (palmar= add) and DAB (dorsal= abduction)

32
Q

types of grips with muscles involved and examples of actions

A

power grips= grasping a rod (fingers flexed around obect)- involves LONG FOREARM FLEXORS+ INTRINSIC MUSCLES, stabilised by extensors precision grip- unbutton shirt (object between finger tips): involves INTRINSIC MUSCLES hook grip- carrying shopping bag (fingers flexed around handle): involves LONG FLEXORS OF DIGITS

33
Q

DIAGRAM blood supply of hand- branches, connection, part of hand supplied

A

medial ulnar artery goes above flexor ret . through GUYONS CANAL- forms superficial palmar arch (at level of end of thumb) and deep palmar arch: lateral to ulnar artery AND FCU radial artery also forms the 2 branches- deep arch of radial artery connected to superficial branch of ulnar artery radial artery supplies lateral 1 and a half fingers including thumb, ulnar supplies medial bit

34
Q

pathway of radial artery with relations to other structures

A

starts in cubital fossa, goes lateral to FDS, under the brachiradialis, on trapezium

35
Q

pathway of ulnar artery

A

starts in cubital fossa, goes under pronator teres, onto FDP

36
Q

superficial drainage of posterior/anterior

A

posterior drainage of hand superficial- dorsal digital veins drain to dorsal venous arch, which form cephalic/basilic veins in forearm anterior part comprised of venae comitantes of superficial/deep palmar arches, which drain into venae comitantes of radial/ulnar arteries (ie the pair of veins running along with these arteries)

37
Q

deep drainage of forearm

A

arterial palmar arches have venae comitantes, which drain into venae comitantes of radial/ulnar arteries, which drain into venae comitantes of brachial artery (brachial veins)

38
Q

role of median nerve

A

supplies thenar muscles, lateral two lumbricles, and sensation LATERAL 3 and a half fingers

39
Q

role of ulnar nerve

A

forms superficial branch- sensory to little finger and half of ring finger deep branch- motor to hypothenar muscles, adductior pollicis, medial 3rd and 4th lumbricles, and ALL interosseous muscles ie controls most FINE MOVEMENT of hand: also palmaris brevis, so most muscles of hand, and 2 of forearm (medial part of FDP, and FCU (ULNARIS)

40
Q

DIAGRAM radial nerve and sensory innervation

A

no hand muscles- sensory to most back of hand ulnar front and back of medial 1 and half fingers, median mainly front of hand

limbs anatomy (8 decks)

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