Hand and Wrist Flashcards
radius and ulna are attached the entire extent of the forearm by way of an ____
interosseus membrane
distal radioulnar joint has an articular joint with the ________ rolling on the ulna
ulnar notch of the radius
what finder does the longitudinal axis run in the hand
through the 2nd finger
Finger rotations is technically _____, a movement that outlines a cone, since the ______ joint only has ____ degrees of freedom
circumduction, MCP, 2
O of abductor pollicis brevis
flexor retinaculum and tubercles of scaphoid and trapezium bone
I of abductor pollicis brevis
lateral side of base of proximal phalanx of thumb
action of abductor pollicis brevis
abducts thumb and helps oppose it
innervation of both abductor pollicis brevis and opponens pollicis
recurrent branch of median n. (C8-T1)
What is the wrist joint?
radiocarpal joint (ulna does not articulate w the carpal bones, but has a fibrocartilaginous disk to the ulna
O of flexor pollicis brevis
superficial head - flexor retinaculum and tubercle of trapezium
deep head - floor or carpal tunnel
I of flexor pollicis brevis
lateral side of base of proximal phalanx of thumb
Action of flexor pollicis brevis
flex thumb
Segments of ALL hand mucscles
C8-T1
innervation of flexor pollicis brevis
sup. head - recurrent branch of median n. C8-T1
deep head - deep branch of ulnar n. C8-T1
O of opponens pollicis
flexor retinaculum and tubercle of trapezium
I of opponens pollicis
lateral side of base of proximal phalanx of thumb
A of opponens pollicis
opposes thumb toward center of palm and rotates it medially
Innervation of opponens pollicis
recurrent branch of median n. C8-T1
O of adductor pollicis
oblique head - bases of metacarpal 2-3, capitate and adjacent carpal bones
transverse head - anterior surface of 3rd metacarpal
I of adductor pollicis
medial side of base of proximal phalanx of thumb
action of adductor pollicis
adducts thumb toward middle digit
innervation of adductor pollicis
deep branch of ulnar n. C8-T1
O of abductor digiti minimi
pisiform bone
i of abductor digiti minimi
medial side of base of proximal phalanx of digit 5
action of abductor digiti minimi
abducts digit 5
innervation of abductor digiti minimi
deep branch of ulnar n. C8-T1
O of flexor digiti minimi brevis
hook of hamate bone and flexor retinaculum
i of flexor digiti minimi brevis
medial side of base of proxmial phalanx of digit 5
action of flexor digiti minimi brevis
flexes proximal phalanx of digit 5
innervation of all digiti minimi muscles
deep branch of ulnar n. C8T1
O of opponens digiti minimi
hook of hamate bone and flexor retinaculum
i of opponens digiti minimi
medial border of 5th metacarpal
action of opponens digiti minimi
draws 5th metacarpal bone anteriorly and rotates it bringing digit 5 into opposition to thumb
innervation of opponens digiti minimi
deep branch of ulnar n. C8T1
O of lumbricals 1 and 2
lateral two tendons of flexor digitorum profundus (index and middle finger)
I of lumbricals 1 and 2
Lateral sides of extensor expansions of digits 2 and 3
Action of lumbricals 1 and 2
flex digits at metacarpophalangeal joint and extend interphalangeal joints
innervation of lumbricals 1 & 2
median n. C8-T1
O of lumbricals 3 and 4
medial two tendons of flexor digitorum profundus (ring and little finger)
I of lumbricals 3 and 4
lateral sides of extensor expansions of digits 4 and 5
action of lumbricals 3-4
flex digits at metacarpophalangeal joint and extend interphalangeal joints
innervation of lumbricals 3 and 4
deep branch of ulnar n. C8T1
o of dorsal interosseus 1-4
adjacent sides of two metacarpal bones
i of dorsal interosseus 1-4
extensor expansions and bases of proximal phalanges of digits 2-4
middle finger has two insertions
action of dorsal interosseus 1-4
abducts digits and assist lumbricals in extension at the IP joints
innervation of dorsal interosseus 1-4
deep branch of ulnar n. C8-T1
O of palmar interosseus 1-3
palmar surfaces of 2nd, 4th and 5th metacarpal bones
I of palmar interosseus 1-3
extensor expansions and bases of proximal phalanges of digits 2,4,5
action of palmar interosseus
adducts digits and assist lumbricals in flexion at the mcp joints
innervation of palmar interosseus 1-3
deep branch of ulnar n. C8-T1
flexor retinaculum is on the _____ side of the forearme
anterior
extensor retinaculum is on the _____ side of the forearm
posterior
The flexor retinaculum closes off the carpal groove (sulcus) for the formation of the __________
carpal tunnel
The deep fascia of the palm is thickened along __________
the middle of the palm as the palmar aponeurosis
What mark the lateral and medial boundaries of the central compartment?
lateral and medial septa
This compartment is the palmar extension of the carpal tunnel and carries the tendons of the superficial and deep digital flexor muscles.
central
The wrist is made up of which joints
radiocarpal, distal radial ulnar
does not atrticulate with the carpals, but is attached via fibrocartilaginous disc
ulna
which carpal articulates via the fibrocartilaginous disc
triquetrum
the distal radioulnar joint has an articulation with the _____ of the radius rolling on the ulna
ulnar notch
What ligaments are involved in the radiocarpal joints and the MCP, PIP, DIP
radial and ulnar collateral ligaments
What actions occur at the CMC jt of the thumb
ext,flex, abd,add, opp
which retinaculum closes off the carpal groove for the formation of the carpal tunnel
flexor
what is the flexor retinaculum a continuum of
antebrachial fascia
what is the transverse carpal ligament attached to?
radially-tubercles of scaphoid and trapezium
ulnar - pisiform and hook of hamate
the cephalic vein enters which side of the wrist
lateral
What creases mark the levels of the MCP PIP DIP
proximal digital crease
middle ‘’ ‘’
distal ‘’ ‘’
What two nerves control the short muscles of the hand
ulnar and median
which nerve is entirely sensory over the dorsolateral part of the hand and thumb
radial
what are the motor innervations for the median n? sensory?
lumbricals 1and2
radial half of palm & dorsal surface of thumb to lateral 2.5 digits & the distal end of dorsal side of digits 2 to half of 4
What 3 muscles travel w/ median n. through carpal tunnel
FDS FDP FPL
Where does the recurrent branch of the median n. branch and what does it innervate?
just distal to the flexor retinaculum
thenar eminence muscles ( except adductor pollicis)
Which nerve is responsible for fine movement of the hand
ulnar
what 3 branches are a part of the sensory branch of the ulnar n
superficial branch
dorsal cutaneus branch
palmar branch
what does the superficial branch of the ulnar n innervate
ulnar palmar 1.5 digits
what does the dorsal cutaneus branch of the ulnar nerve innervate
ulnar dorsal 1.5 digits
what does the palmar branch of the ulnar n innervate
medial half of palm
Which branch innervates the hypothenar mm., lumbricals 3,4, adductor pollicis, and all the dorsal and palmar interosseus (fine motor control)
deep branch of ulnar (C8-T1)
What nerve innervates the distal ends of the fingers
median 2-1/2 of 4
ulnar 5-1/2 of 4
does radial nerve have any motor control of the hand
no, but can control hand movement due to the innervation of the extensor comp
the superficial branch of the radial n is _____ and covers _____________
sensory
radial 1/2 of dorsum of hand & thumb. extending only to proximal half of digits 2-4
radial artery is located
anterior and lateral part of forearm
what branch of the radial a comes off befor it enters the extensor compartement through the anatomical snuff box?
what does it anastomose with
superficial palmar branch
superficial palmar arterial arch of ulnar a
the radial artery continues around the dorsal side of the thumb through the snuff box to enter the palm as what? what will it anastomose with
deep palmar arterial arch, ulnar artery
what branches come off the deep palmar arterial arches
princeps pollicis a, radialis indicis a, digital a
the ulnar artery travels through the pisiform and hook of hamate and braches into the superficial and deep branch, what does each anastomose with
superficial-superficial palmar a
deep-deep palmar a of radius
what forms the superficial palmar arterial arch
superficial branch of ulnar a (located mid metacarpal)
T/F suprficial palmar arterial arch is deep to palmar aponeurosis
T
What forms the deep palmar arterial a
deep branch of radial a ( located near proximal ends of metacarpals)
With carpal tunnel syndrom, the swelling decreases the space in the carpal tunnel and increases the pressure on which n and which tendons
median n.
forearm flexors
carpal tunnel sensory limitations, motor?
pain, anesthesia over median n sensory map of hand
weakness/atrophy of the thenar muscles
what 2 muscles might also be weak due to pressure on the synovial sheaths
FDS, FDP
Ulnar n damage
sensory - ulnar n sensory map of hand
motor - fine motor control (lumbricals 34 and interossei)
ulnar n damage. how will it affect the thumb
weak adduction
wrist drop sign of damage to what n
radial
where can damage to radial n occur
as high as the post humerus, lateral epi
what muscles will be affected if radial n is damaged, actions?
ED,ECU,ECRL,ECRB
wrist ext, finger ext, thumb ext and abd
4 muslces of thenar eminence
abductor pollicis brevis
flexor pollicis brevis
obterator pollicis
adductor pollicis
what are the 3 muscles of the hypothenar eminence
abductor digiti minimi
flexor digit minimi brevis
opponens digiti mini
flex digits at CMP and ext IP
lumbricals
which short muscles of the hand abduct digits. add?
dorsal interosseus DAB
palmar interosseus PAD
what are the only short muscles of the hand not innervated by the deep branch of the ulnar n.
lumbricals 1.2
