Hand Flashcards
Carpal tunnel contents
9 tendons , 1 nerve
Flexor pollicis longus, flexor digitorum superficialis, and flexor digitorum profundus.
Carpal tunnel formed by…
Passageway deep to the flexor retinaculum between tubercles of the scaphoid and the trapezoid bones on the lateral side. And the pisiform and hook of hamate medially.
Radial nerve
Terminal branches, superficial and deep arise in the cubital fossa
Superficial branch of radial nerve
Is entirely sensory
It pierces the deep fascia near the dorsum of the wrist to supply the skin and fascia over the lateral 2/3 of the dorsum of the hand, the dorsum of the thumb, and the proximal parts of the lateral one and a half digits.
Augmenting movement at the wrist joint
The two rows of carpals glide on each other; in addition, each bone glides on those adjacent to it
Proximal phalanges articulate with
Metacarpal bones at the metacarpophalangeal joints
The joint between proximal and middle phalanx is the
Proximal interphalangeal joint
Ulnar nerve and artery travel through what canal to get to the wrist?
Guyons canal
Anterior to the flexor retinaculum between the pisiform and the hook of hamate
Fibrous digital sheaths
Synovial sheaths that enclose the flexor tendons as they pass along the palmar aspect of each digit. Fiction similar to retinaculum
What kind of joint is Metacarpophalangeal ?
Condyloid synovial
Metacarpophalangeal joint reinforced posteriorly by? Anteriorly?
Posteriorly by dorsal hood
Anteriorly by volar plates
Mcp joint collateral ligaments
Pass posterior to joint axis for flexion and extension
Relaxed when in flexion… If immobilized for long cant make fist
Blood supply for metacarpophalangeal joint
Deep digital arteries arising from superficial palmar arches
Interphalangeal joint is a ____ joint
Hinge synovial joint
Ip joint ligaments
Volar plate
Lateral and accessory collateral ligs
Taut in 25 degrees flexion
Joint blood supply via digital arteries
Thumb carpometacarpal joint is a ____ joint
Synovial Saddle joint
Lots of mobility …little stability
5 ligaments of the cmc thumb joint
Radial and ulnar collaterals
Anterior and posterior obliques
Intermetacarpal
Thumb mcp joint is a _____ joint and what ligaments
Hinge joint
Collateral and palmar ligaments
Ulnar artery enters wrist where?
Guyons canal lateral to ulnar nerve
Anterior to flexor retinaculum
Ulnar artery gives rise to …
Deep and superficial palmar branch
Superficial portion contributes to superficial palmar arch
Radial artery enters wrist?
By curving dorsally around scaphoid and trapezium in the floor of anatomy snuff box
Extensor mechanism
Complex network of ligamentous and muscular units that coordinate to produce extension of the digits
Oblique retinacular ligament
Is taut during flexion of dip…hence it pulls pip into flexion
Part of extensor mechanism
Mallet finger
Basketball jam finger example
Torn extensor ligaments so dip is stuck in flexion
Dupuytren contracture
Palmar fascia thickens and pulls finger into flexion
Digital tenovaginitis stenosans (trigger finger)
Thickened annular lig of fibrous digital sheath due to repetitive overuse
Can flex but have to manually extend it
Palmar aponeurosis
Part of deep fascia of palm
Covers the soft tissue and overlies the long flexor tendons
The proximal end is continuous with flexor retinaculum and palmaris longus tendon
Distally it forms four longitudinal digital bands which attach to bases of proximal phalanges, where they become continuous with the fibrous digital sheaths
Acting together the dorsal and palmar interossei and lumbricals produce
Flexion at the metacarpophalangeal joint and extension of the ip joints….. L
The common flexor and digital sheaths enable the tendons
To slide freely past each other during movements of the fingers
Ulnar artery of palm
Gives rise to the deep (palmar branch) and then continues superficial to the long flexor tendons, where it is the main contributor to the superficial palmar arch
Superficial palmar arch gives rise
To three common palmar digital arteries
Each common palmar d.a. Divides into a pair of proper palmar digital arteries
The radial artery curves dorsally
Around the scaphoid and trapezium in the floor of the a.s.b. and enters palm by passing the heads of the first interossei muscle
The radial artery ends by anastomosing with the deep branch of the ulnar artery to form the …
The Deep palmar arch….formed chiefly by the radial artery
Extensor expansion or hood is a…
Triangular tendinosis aponeurosis wrapping around dorsum and sides of met heads and base proximal phalanx
ED is forming hood splits
Into median band( base of middle phalanx) and 2 lateral bands (base distal phalanx)
Hood is anchored on the side by…
Palmar ligament
Tendons of interossei and lumbricals join
Lateral bands
ORL is taut during flexion of ___ and this pulls the ____ into flexion.
DIP
PIP
Extending the ____ joint pulls ____ via ORL into extension
PIP
DIP
