Hand and Wrist 1 Flashcards
Palmar aspect of hand
Hypothenar Eminence
3 Muscles
Flexor digiti minimi
Abductor digiti minimi
Opponens digiti minimi
Palmaris brevis
Opponens pollicis
Origin: flexor retinaculum
scaphoid and trapezium
Insertion: 1st metacarpal
Axns: oppose thumb
medially rotate 1st metacarpal
Blood: radial artery
Nerve: recurrent branch of median nerve
Abductor pollicis brevis
Origin: flexor retinaculum
scaphoid and trapezium
Insertion: base of proximal phalanx of thumb
Axns: abduct thumb
opposition
Blood: radial artery
Nerve: recurrent branch of median nerve
Flexor pollicis brevis
Origin: flexor retinac.
scaphoid and trapezium
Insertion: base of prox. phalanx of thumb
Axn: flex thumb
Blood: radial artery
Nerve: recurrent branch of median nerve (superficial head)
Deep branch of ulnar nerve (deep head)
Adductor pollicis (not in thenar eminence)
Origin: 2nd and 3rd metacarpal base
capitate and adjacent carpals
Insertion: base of prox. phalanx of thumb
Axns: adducts thumb toward lateral border of palm
Blood: radial artery
Nerve: deep branch of ulnar nerve
Abductor digiti minimi
Origin: pisiform
Insertion: base of prox. phalanx of 5th digit
Axns: abducts 5th digit
flexion of 5th prox. phalanx
Blood: ulnar artery
Nerve: ulnar artery
Flexor digiti minimi brevis
Origin: hook of hamate
flexor retinac
Insertion: prox. phalanx of 5th digit
Axns: flexes prox. phalanx of digit 5
Blood: ulnar artery
Nerve: deep branch of the ulnar nerve
Opponens digiti minimi
Origin: hook of hamate
flexor retinac.
Insertion: 5th metacarpal
Axns: opposition of 5th digit to thumb
(anterior pull, rotates)
Blood: ulnar artery
Nerve: deep branch of ulnar artery
Intrinsic (short) muscles
Lumbricals
Palmar interossei
Dorsal interossei
1st and 2nd Lumbricals
attached to lateral 2 tendons of FDP
Median nerve
Blood: radialis indicis artery
Superficial palmar arch (ulnar ar)
3rd and 4th lumbricals
attach to medial 3 tendons of FDP
Deep branch of ulnar nerve
Blood: superficial palmar arch (ulnar artery)
dorsal carpal arch ( ulnar and radial artery)
Insert on lateral sides of the extensor expansions of digits 2-5
Flex MCP joint
Extend IP joint
Extensor hood
Palmar Interossei
3 muscles
Origin: palmar surface of 2, 4, 5 metacarpals
Insertion: base of prox. phalanges/extensor hoods of digits 2, 4, 5
PAD: adduct 2, 4, 5 fingers toward axial line: assist lumbricals
Blood supply from radial and ulnar artery
Innervated by deep branch of ulnar nerve
Dorsal Interossei
4
Origin: adjacent sides of 2 metacarpals
Insertion: bases of prox. phalanges and exensor hood of 2-4 digits
DAB: abduct 2-4th fingers toward axial line: assist lumbricals
Blood: radial a mainly: some ulnar
Nerve: deep branch of ulnar nerve
Dupuytren’s Contracture
Progressive shortening and thickening of palmar fascia
pulls 4th and 5th digit into partial flexion
hereditary
Fascial compartments of Hand and Wrist
Hypothenar
Thenar
Central
Adductor
Interosseous
Long Flexor Tendons & Synovial Sheaths:
Long tendons of:
Flexor Digitorum superficialis
Flexor Digitorum Profundus
enter common flexor sheath (ulnar bursa) beneath flexor retinaculum
4 tendons of each enter individual synovial sheath
synovial sheath for digit 5 continuous w/ ulnar bursa
long tendon of flexor pollicis longus has a synovial sheath separate from ulnar bursa
Tensosynovitis
Infections in digital synovial sheath
Inflammation of tendon and sheath
5th digit infection can spread to carpal tunnel and forearm (sheath continuous w/ ulnar bursa)
Abduction & Adduction of fingers and thumb
toward the middle digit
Palmar aspect of Hand:
Thenar Eminence
Abductor pollicis brevis
Flexor pollicis brevis : deep and superficial head
Opponens pollicis
Adductor pollicis: transverse and oblique head
Power grip
Flexor digitorum profundus
Movements of the thumb
Abduction
Adduction
Extension
Flexion
Opposition
Reposition
Innervation of the Hand (motor)
Superficial branch of Ulnar Nerve
Hypothenar muscles (5th digit)
3rd and 4th lumbricals
Palmar interosseous muscles (1-4)
Dorsal interosseous muscles (1-3)
Some pollicis brevis
Innervation (motor)
Deep branch of the Ulnar Nerve
Adductor pollicis (transverse and oblique head)
Deep portion of flexor pollicis brevis
Innervation:
Recurrent Branch of Median Nerve
Thenar muscles (1st digit)
(except deep portion of flexor pollicis brevis)
1st and 2nd lumbrical muscles
Innervation of the Hand (sensory distribution)
INSERT PIC on website
Median Nerve
Deep to palmar aponeurosis
Recurrent branch: very superficial = easily injured
innervates thenar eminence AND
Palmar aspect of 1-3 digits and palm
Carpal Tunnel Syndrom
Transverse carpal ligament medial to thenar eminence
pinches down on median nerve
released by cutting transverse carpal ligament
Blood supply to forearm and hand (review)
Anterior Forearm:
Ulnar artery
Anterior interosseous artery
Blood Supply: Posterior Forearm
Radial artery
recurrent interosseous artery
posterior interosseous artery
ulnar artery
Superficial Palmar Arch
Ulnar artery
gives rise to common digital arteries
which become proper palmar digital arteries
Deep Palmar Arch
Radial artery
gives rise to pinceps pollicis artery
which gives rise to radialis indics artery
Dorsal Carpal Arch
Dorsal aspect of hand
Gives rise to dorsal metacarpal arteries
normally has contribution from anterior interosseous artery
Thenar Eminence (thumb)
3 muscles
abductor pollicis brevis
flexor pollicis brevis (superficial and deep head)
Opponens pollicis
also adductor pollicis oblique and transverse head
Hypothenar Eminence (under pinky)
3 muscles
flexor digiti minimi
abductor digiti minimi
opponens digiti minimi
palmaris brevis is superficial
