Hand and Fascial Spaces

Question 0

Abductus pollicis brevis:

Answer 0

O: Flexor retinaculum, scaphoid, trapezium
I: Sesamoid bone, proximal phalanx, and extensor expansion
A: Abduction and flexion of proximal phalanx
I: recurrent nerve of median (supplied by radial artery)

Question 1

Thenar compartment muscles:

Answer 1

1. Abductor pollicis brevis
2. Flexor pollicis brevis
3. Oppenens pollicis

Question 2

Flexor pollicis brevis:

Answer 2

O: Flexor retinaculum, trapezium
I: Sesamoid, proximal phalanx, and extensor expansion
A: Flexion of proximal phalanx
I: recurrent nerve of median (supplied by radial artery)

Question 3

Opponens pollicis:

Answer 3

O: Flexor retinaculum and trapezium
I: First metacarpal (lateral side)
A: Rotation of metacarpal during opposition
I: recurrent nerve of median (supplied by radial artery)

Question 4

_______ of the median n. enters the thenar compartment and supplies all of the thenar muscles.

Answer 4

Recurrent branch

Question 5

Two branches of the radial a, _______ a. and _______ a. supply the thenar compartment and lateral side of the index finger.

Answer 5

Princeps pollicis; Radialis indicis

Question 6

The two branches of the radial a. supplying the thenar compartment descend between the _______ m. and oblique head of the _________ near the base of the first phalanx.

Answer 6

First dorsal interosseous m; adductor pollicis m. (Supply skin and subcutaneous tissue of the thumb)

Question 7

The ________ arises from the radial a. just proximal to the wrist; it passes through the thenar eminence, which it supplies.

Answer 7

Superficial palmar branch (and branches of this)

Question 8

Hypothenar compartment muscles:

Answer 8

1. Palmaris brevis
2. Abductor digiti minimi
3. Flexor digiti minimi
4. Opponens digiti minimi

Question 9

Palmaris brevis:

Answer 9

(Hypothenar)
O: Palmar aponeurosis and flexor retinaculum
I: Skin on the ulnar border of the palm
N: Superficial branch of ulnar n.
A: Draws the skin at the ulnar side of the palm towards the middle of the palm
**the palmaris Brevis is located just below the skin of the ulnar side of the hand (very superficial)

Question 10

Abductor digiti minimi:

Answer 10

(Hypothenar)
O: Pisiform
I: Proximal phalanx of digit 5
N: Deep branch of ulnar n.
A: Abduction of digit 5

Question 11

Flexor digiti minimi:

Answer 11

(Hypothenar)
O: Hamate
I: Proximal phalanx of digit 5
N: Deep branch of ulnar n.
A: Flexion of proximal phalanx, digit 5

Question 12

Opponens digiti minimi:

Answer 12

(Hypothenar)
O: Hamate
I: 5th metacarpal
N: Ulnar n.
A: Draws 5th metacarpal anteriorly thus bringing digit 5 into contact with the thumb during opposition (only the thumb can oppose other fingers)

Question 13

All the muscles of the _______ compartment of the hand are supplied by the ulnar n.

Answer 13

Hypothenar. The deep branch of the ulnar nerve.

Question 14

_______ a. forms the superficial palmar arch.

Answer 14

Ulnar

Question 15

Anterior boundary of the Midpalmar compartment:

Answer 15

Palmar aponeurosis

Question 16

Posterior boundary of the midpalmar compartment:

Answer 16

Interosseous fascia (covers the interossei m)

Question 17

Lateral boundary of the midpalmar compartment:

Answer 17

Thenar fascia and compartment

Question 18

Medial border of the midpalmar compartment:

Answer 18

Hypothenar fascia and compartment

Question 19

Tendons of the midpalmar compartment:

Answer 19

1. Four tendons of flexor digitorum superficialis
2. Four tendons of flexor digitorum profundus
3. Tendon of flexor pollicis longus
   (These are all of the tendons that go thru the carpal tunnel)

Question 20

Synovial sheaths in the midpalmar compartment:

Answer 20

1. Radial bursa - covers the tendon of flexor pollicis longus
2. Ulnar bursa - covers tendons of flexor digitorum superficialis and flexor digitorum profundus

Question 21

Muscles of the midpalmar compartment:

Answer 21

1. Lumbricals

2. Adductor pollicis

Question 22

Lumbricals (4) are muscles that arise from tendons of ______.

Answer 22

Flexor digitorum profundus

Question 23

Lumbricals course on the ________ side of each digit and are inserted on the __________ of digits 2-5.

Answer 23

Lateral; extensor expansions

Question 24

______ n. supplies the two lateral lumbricals.

Answer 24

Median

Question 25

______ n. supplies the two medial lumbricals.

Answer 25

Ulnar

Question 26

The two lateral lumbricals have __ head(s) and the two medial lumbricals have __ head(s).

Answer 26

1; 2

Question 27

What is the action of the lumbricals?

Answer 27

Flexion of digits at metacarpo-phalangeal joints and extension of interphalangeal joints.

Question 28

Adductor pollicis (2 heads):

Answer 28

``` Oblique head: O: Capitate and 2nd metacarpal Transverse head: O: 3rd metacarpal I: Sesamoid bone, base of proximal phalanx, and extensor expansion of the thumb N: DEEP BRANCH OF ULNAR N. A: Adduction of thumb, aids in opposition ```

Question 29

For deep muscles of the hand, extension and flexion are in relation to the ____, whereas abduction and adduction is expressed in relation to the ____.

Answer 29

Palm; middle finger

Question 30

Deep muscles of the hand include:

Answer 30

1. Palmar interossei | 2. Dorsal interossei

Question 31

Palmar interossei m. arise from the entire length of one ______ bone and is inserted into the side of the base of the _______ of the same finger and into the _______ on the dorsum of the finger.

Answer 31

Metacarpal; Proximal phalanx; Extensor expansion

Question 32

First Palmar interossei:

Answer 32

O: Medial side of 2nd metacarpal I: Medial side proximal phalanx digit 2, and extensor expansion N: Deep branch of ulnar n A: ADDUCT the fingers toward the middle finger

Question 33

Second palmar interossei:

Answer 33

O: Lateral side of 4th metacarpal I: Lateral side proximal phalanx of digit 4 and extensor expansion N: Deep branch of the ulnar n. A: ADDUCT fingers toward the middle finger

Question 34

Third palmar interossei:

Answer 34

O: Lateral side of 5th metacarpal I: Lateral proximal phalanx of digit 5 and extensor expansion N: Deep branch of ulnar n. A: ADDUCT the fingers toward the middle finger

Question 35

Dorsal interossei:

Answer 35

There are 4 and each arises by two heads from the adjacent metacarpal bones and inserts into the base of the proximal phalanx and extensor expansion

Question 36

1st dorsal interossei:

Answer 36

Most prominent and largest, flat, triangular m. originating from 1st and 2nd metacarpals and inserting into the lateral side of the proximal phalanx of the index finger N: Deep branch of ulnar n. A: ABDUCTION of digits 2-4 away from longitudinal axis thru the center of the middle finger (also flex metacarpophalangeal joints and extend interphalangeal joints of digits 2-5)

Question 37

2nd and 3rd dorsal interossei:

Answer 37

Both insert into the middle finger, 2nd on the lateral side and 3rd on the medial side N: Deep branch of ulnar n. A: ABDUCTION of digits 2-4 away from longitudinal axis thru the center of the middle finger (also flex metacarpophalangeal joints and extend interphalangeal joints of digits 2-5)

Question 38

4th dorsal interossei:

Answer 38

Inserts into the medial side of the ring finger N: Deep branch of ulnar n. A: ABDUCTION of digits 2-4 away from longitudinal axis thru the center of the middle finger (also flex metacarpophalangeal joints and extend interphalangeal joints of digits 2-5)

Question 39

Extensor expansion:

Answer 39

Aponeurotic or tendinous fusion of the digital extensors, lumbricals, and interossei tendons on the dorsal aspects of the digits

Question 40

Before going thru the carpal tunnel, the median n. gives off the _________ which runs anterior to the flexor retinaculum and supplies the skin of the _______.

Answer 40

Palmar cutaneous branch; thenar compartment

Question 41

At the distal border of the flexor retinaculum, the median n. divides into 2 branches:

Answer 41

Motor (recurrent median) | Sensory

Question 42

Motor (recurrent median) n. goes to:

Answer 42

The 3 thenar muscles - abductor pollicis brevis, flexor pollicis brevis, and opponens pollicis AND the 1st and 2nd lumbricals

Question 43

Sensory median n. goes to:

Answer 43

Lateral palmar surface, the palmar surface of digits 1-3, and the lateral half of 4, these nerves are also sensory to the dorsum of the distal halves of digits 2-4

Question 44

Superficial branch of the ulnar n. supplies:

Answer 44

Palmaris brevis and divides into digital nerves which are sensory to the palmar surface and sides of the little finger and medial half of the ring finger

Question 45

Deep branch of the ulnar n. supplies:

Answer 45

All 3 muscles of the hypothenar compartment - adductor digiti minimi, flexor digiti minimi, and opponens digiti minimi, the 3rd and 4th lumbricals, ALL interossei, and ADDUCTOR POLLICIS

Question 46

Dorsal branch of the ulnar n.:

Answer 46

Arises in the lower third of the forearm and gives off dorsal digital n. that are SENSORY to the dorsal surface of the medial 1 and 1/2 digits

Question 47

Superficial radial n. supplies:

Answer 47

Skin of the posterior surface of the thumb, index, and half of the middle finger (except the distal phalanges of these digits which are supplied by the median n.)

Question 48

Deep palmar arch of the hand:

Answer 48

Formed by the radial a. which enters the hand after coursing through the snuff box, and between the 2 heads of the 1st dorsal interosseous (radial a. also gives off the princeps pollicis a. to the thumb and radialis indicis to the index finger)

Question 49

What does the palmar branch of the median nerve supply?

Answer 49

Anterior digits I-III and half (lateral) of IV. | Posterior distal portion of digits I-III and half (lateral) of IV.

Question 50

What does the superficial branch of the ulnar nerve in the hand distribute over?

Answer 50

Anterior digit V and medial IV | Dorsal digit V and IV (except the distal lateral half of IV)

Question 51

What supplies the thenar compartment?

Answer 51

The radial artery: 1. Princeps pollicus and radicalism indicis: thenar compartment + lateral side of index finger. Supplies the skin + subcutaneous tissue of the thumb 2. Superficial Palmar branch: thenar eminence 3. Branches of the Superficial Palmar branch

Question 52

What artery supplies the hypothenar compartment?

Answer 52

Deep branches of the ulnar artery (deep palmar artery, superficial palmar artery)

Question 53

Blood supplies to the hand in general: what does the radial art supply? What does the ulnar art supply?

Answer 53

Radial: thumb+ lateral half of index ... Thenar compartment Ulnar: everything else (medial index-pinky) ...hypothenar compartment ** these locations include anterior and posteriors!

Question 54

What makes up the palmar aponeurosis

Answer 54

1. thick superficial part of longitudinal fibers continuous with the palmaris longus tendon 2. Thinner layer of transverse fibers

Question 55

What does the radial bursa cover?

Answer 55

covers the tendon of flexor pollicis longus

Question 56

What des the ulnar bursa cover?

Answer 56

covers tendons of flexor digitorum superficialis and flexor digitorum profundus

Question 57

The third and fourth lumbricals are_________ while the first and second Lumbricals re _________

Answer 57

Bipennate; unipennate

Question 58

what are anastosomes? Where are they prevalent?

Answer 58

collateral blood network; prevalent in the superficial/deep palmar arches, the scapula (via circumflex scapular artery)

Question 59

where are the palmar spaces located?

Answer 59

mid-palmar, posterior to the radial and palmar bursae and the adductor pollicis muscle. There are two spaces and they are separated by the oblique palmar septum (anterior border of MC III to palmar aponeurosis) INFECTION IN THESE AREAS CAN ONLY MOVE PROXIMALLY BUT NOT LATERALLY OR MEDIALLY

Question 60

lateral palmar space

Answer 60

lateral to oblique palmar septum

Question 61

medial palmar space

Answer 61

medial to oblique palmar septum