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Limbs > Hand > Flashcards

Hand Flashcards

1
Q

Describe the surface anatomy of the hand

  • tendons
  • creases and associated joint
  • ligaments
A

Extensor digitorum on fingers
EPL, EPB and APL tendon around anatomical snuffbox

Distal radioulnar crease => midcarpal joint
Proximal radioulnar crease => radiocarpal joint

Distal phalangeal crease => DIP joint
Middle phalangeal crease => PIP joint
Under proximal phalangeal crease => MCP joint

Phalangeal crease on thumb => IP joint

MCP, PIP, DIP have collateral ligaments

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2
Q

Name the 4 proximal carpal bones
Name the 4 distal carpal bones
Name the bones in the mid hand
Name the bones in the forehand

A 
From thumb => little finger
Scaphoid
Lunate
Triquetrum
Pisiform (under triquetrum

Trapezium
Trapezoid
Capitate
Hamate (hook)

5 metacarpals

Thumbs
-proximal, distal phalanges

Fingers
-proximal, medial, distal phalanges

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3
Q

Name the wrist bones and their articulations

A

Radius
Proximal row of carpals

NOT THE ULNA

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4
Q

What movements is the thumb capable of

A

Abduction, adduction
Extension, flexion
Opposition, reposition

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5
Q

Name the 5 extrinsic hand flexors

A 
Flexor carpi radialis (ant sup)
Flexor carpi ulnaris (ant sup)
Flexor digitorum superficialis (ant int)
Flexor digitorum profundus (ant deep)
Palmaris longus (ant sup)

All arise from med epicondyle

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6
Q

Describe the location of the median and ulnar nerve in the wrist

A

Radius <=> ulnar
FCR Median PL

     Ulnar FCU (the most medial tendon)
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7
Q

Name the 2 extrinsic muscles involved in finger flexion

A

Flexor digitorum profundus

Flexor digitorum superficialis

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8
Q

What are the

  • attachments
  • innervations
  • actions of the finger flexors
  • flexor digitorum profundus
  • flexor digitorum superficialis
A

Flexor digitorum profundus

  • Ulna, IOM => DP fingers
  • MCP, DIP, wrist flexors
  • Medial half => ulnar
  • Lateral half => median

Flexor digitorum superficialis

  • Med epicondyle => MP of fingers
  • MCP, PIP, wrist flex
  • Median
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9
Q

Name the 5 posterior superficial extrinsic hand extensors

Name the 4 posterior deep extrinsic hand extensors

A 
Extensor digitorum (4 fingers)
Extensor digiti minimi (little finger)
Extensor carpi ulnaris (MB5)
Extensor carpi radialis longus (MB2)
Extensor carpi radialis brevis (MB3)

Abductor pollicis longus
Extensor pollicis longus
Extensor pollicis brevis
Extensor indicis

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10
Q

Name the 5 hand compartments and the muscles associated with them

A 
Central (lumbricals)
Hypothecate
Interosseous (between metacarpals)
Adductor comp (adductor pollicis)
Thenar (base of thumb)
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11
Q

Name the 3 thenar muscles

A

Opponens pollicis
Abductor pollicis brevis
Flexor pollicis brevis

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12
Q

What are the

  • attachments
  • innervations
  • actions of the thenars
  • opponens pollicis
  • Abductor pollicis brevis
  • flexor pollicis brevis
A

Opponens pollicis

  • Trapezium => MI
  • Opposition
  • Median

Abductor pollicis brevis

  • Scaphoid, trapezium => PPI
  • Abduction
  • Median

Flexor pollicis brevis

  • Trapezium => PPI
  • MCPI flexion
  • Median
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13
Q

Name the 3 hypothenar muscles

A

Opponens digiti minimi
Abductor digiti minimi
Flexor digiti minimi brevis

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14
Q

What are the

  • attachments
  • actions
  • innervations of the hypothenars
  • opponens digiti minimi
  • abductor digiti minimi
  • flexor digiti minimi brevis
A

Opponens digiti minimi

  • Hamate => MP5
  • Opposition
  • Ulnar

Abductor digiti minimi

  • Pisiform => PP5
  • Abducts
  • Ulnar

Flexor digiti minimi brevis

  • Hamate => PP5
  • MCP flex
  • Ulnar
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15
Q

Describe the

  • attachments
  • innervation
  • actions of the

-lumbricals

A
  • FDP tendon => PP of fingers
  • MCP flex, IP extension
  • F2, 3=> median
  • F4, 5 => ulnar
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16
Q

Name the 2 interossei muscles

A

Dorsal interossei

Palmar interossei

17
Q

Describe the

  • attachment
  • actions
  • innervations of the interossei
  • dorsal interossei
  • palmar interossei
A

Dorsal interossei

  • Lat and med MC => PP of fingers
  • Abduct fingers at MCP
  • Ulnar

Palmar interossei

  • Lat and med MC => PP of fingers
  • Adduct fingers at MCP
  • Ulnar
18
Q

How would you test the palmar interossei and dorsal interossei
Why would you do this

A

Palmar

  • Place a piece of paper between the fingers
  • Ask them to adduct as they try to pull the paper

Dorsal
-Ask them to abduct their fingers between theirs

Test the ulnar nerve

19
Q

Describe the pathway of the

  • median nerve
  • ulnar nerve
  • radial nerve
A

Median
-Carpal tunnel => thenar and finger II, III

Ulnar
-Guyon’s canal => hypothenar, finger IV, V, interosseous

Radius
-Radial side of wrist => dorsal sensory

20
Q

Describe the arterial pathway from the forearm to the fingers

A

Radial, ulnar
Superficial and deep palmar arches
Digital arteries

21
Q

Describe the superficial venous drainage

Describe the deep venous drainage from the hand

A

Superficial palmar arch => median and cephalic
Median => basilic => subclavian
Cephalic => Median cubital => basilic => subclavian
Cephalic => subclavian

Superficial and deep palmar arch => radial, ulnar => brachial

22
Q

Describe the flexor tendons of the hand
What are they surrounded by
What does this allow for

A

FDP goes deeper in finger than FDS
Tendons surrounded by synovial sheath
Synovial sheath surrounded by angular fibrous digital sheath and crucial fibrous digital sheath

Synovial membrane and covering, covers tendon

Each one moves on synovial membrane
Tendons move independently within synovium

23
Q

Describe the main types of injuries to the hand

A

Trauma

  • avocado hand
  • Friday night fracture (M5 fracture)

Wear and tear

24
Q

Describe skiers thumb
What happens
What are the consequences of this

A

Ulnar collateral ligament of MCP I
-supports thumb in pinching and gripping

Damage => chronic instability

25
Q

Describe the consequences of mallet finger

A

Tendon that straightens end joint of finger

  • torn
  • pull off fragment off bone
26
Q

Describe trigger finger
What happens in trigger finger
What is it associated with

A

Finger, thumb clicks/locks as its bent towards the palm

Tendon tunnel mouth thickens => catches in mouth
Can be associated with rheumatoid arthritis

27
Q

Describe Dupuytren’s contracture
How does it occur
Which fingers are most commonly affected
How would you treat it

A

Palmar fascia thickens and fibroses
4th, 5th finger most commonly affected

Often bilateral

Surgical excision of fibrotic tissue

28
Q

What occurs in osteoarthritis

A

Loss of smooth cartilage surface covering ends of the bones in joints

Thin, rough cartilage => ends rub
Often affects M and trapezium

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