Hand Anatomy Flashcards
Flexor Tendon Zones
I: Distal to FDS insertion II: Finger flexor retinaculum III: Palm IV: Carpal tunnel V: Wrist and forearm Thumb 1: distal to FPL Thumb 2: Thumb flexor retinaculum Thumb 3: Thenar eminence
Extensor Tendon Zones
I: DIP II: Middle phalanx III: PIP IV: proximal phalanx V: MCP joint VI: Metacarpal VII: Dorsal retinaculum VIII: Distal forearm IX: Proximal forearm
What type of joint is carpometacarpal joint?
Thumb CMC: Saddle joint
Finger CMC: Gliding joints
What type of joint is metacarpophalangeal joint?
Diarthrodial joint
What type of joints are proximal interphalangeal and distal interphalangeal joints?
Hinge joints
Ligament involved in Dupuytren’s disease/nodules
Grayson’s ligament
Space in the hand between flexor tendon and adductor pollicis
Thenar space
Space in the hand between flexor tendon and metacarpals
Midpalmar space
Space in the hand that is the proximal extension of FPL sheath
radial bursa
Space in the hand that communicates with small finger FDS/FDP flexor tendon sheath
ulnar bursa
Hand findings in rheumatoid arthritis
Boutonniere deformity, swan neck deformity, ulnar drift
Hand findings in osteoarthritis
Heberden’s nodes - DIP
Bouchard’s nodes - PIP
Disease where patient is unable to extend affected finger. Can be extended passively and extension occurs with distinct and painful snapping action
Stenosing tenosynovitis (trigger finger)
Most commonly involve flexion contracture of 4th and 5th finger, with palpable fascial nodules near flexion crease of palm at base of involved fingers with cordlike formations extending to proximal palm
Dupuytren’s contractures
What nerve is weak when Froment’s sign is tested positive?
Ulnar nerve
Froment’s test - pinch a piece of paper between the thumb and index finger
Primary muscle in opposition of the fingers
Abductor pollicis brevis
Muscles of the thenar compartment
Abductor pollicis brevis, flexor pollicis brevis, opponens pollicis
Muscles of the hypothenar conp
Palmaris brevis
Abductor digiti minimi
Flexor digiti minimi brevis
Opponens digiti minimi
Only muscles in the body to insert on their own antagonist
Lumbricals (connects to the flexor digitorum profundus versus its action of extension)
Interossei involved in abduction and is bipennate (each belly has separate insertion)
Dorsal interossei
Interossei involved in adduction and is unipennate
Palmar interossei
Arterial palmar arch mainly supplying the hands/fingers. Dominant 2/3 of the time. Complete 80% of the time
Superficial palmar arch
Relationship of arteries and nerves in the palms and fingers
Palm: Artery volar to the nerves
Fingers: Artery dorsal to the nerves
Failure of differentiation of finger tissue
Syndactyly
Congenital finger flexion anomaly, usually involving PIP joint of little finger
Camptodactyly
Deviation of finger in coronal plane with radial deviation of small finger
Classic finding: delta shaped middle phalanx
Clinodactyly
Syndrome where constrictive bands lead to digit necrosis or diminished growht/development
Constriction band syndrome
Idiopathic condition characterized by intermittent bilateral attacks of ischemia of the fingers with cyanosis, paresthesia, and pain
Raynaud phenomenon
Venous network that gives rise to cephalic and basilic vein
Dorsal venous network
Venous network that gives rise to median antebrachial vein
Palmar venous network
Thenar muscles
Abductor pollicis brevis
Flexor pollicis brevis
Opponens pollicis
Hypothenar muscles
Opponens digiti minimi
Flexor digiti minimi
Abductor digiti minimi
Classic finding of median nerve lesion when hand is at rest
Ape hand
Branch of the median nerve usually affected in superficial laceration of the hand, causing immobilized thumb but normal sensation
Recurrent branch of the medial nerve
