Hand and Wrist Flashcards
what does the antebrachial (deep) fascia of the anterior forearm thicken distally to
palmar carpal ligament at the wrist
then flexor retinaculum (transverse carpal ligament)
where does the flexor retinaculum attach
to scaphoid/trapezoid laterally
pisiform and hamate medially
what does the flexor retinanculum prevent during flexion
bowstringing of the tendons
what tendon fuses with and strengthens the flexor retinaculum
palmaris longus
what is the carpal tunnel composed of
carpal bones and flexer retinaculum
what is the contents of the carpal tunnel
the long tendons of the forearm flexor muscles and the median nerve
carpal tunnel syndrome
result of compression of the median nerve due to swelling in the tunnel
palmar cutaneous branch of the median nerve is given off before the tunnel to travel superficially to reach the skin of the palm, therefore spared in carpal tunnel syndrome so sensation of centre palm is unaffected
what do the radial and ulnar arteries form in the hand
the superficial palmar branch of the radius and the ulna form the superficial palmar arch
the deep branch of the radial and ulnar artery form the deep palmar arch
dupuytren’s contracture
thickening and shortening of the palmar fascia - flexed finger deformities of, in particuar, ring and little fingers
what is the innervation of the dorsal aspect of the hand
what is the innervation of the palmar aspect of the hand
ring block technique
used to anaesthetise a finger
local anaesthetic deposited in a ring around the base of the finger to anaesthetise all 4 proper digital nerves
what must not be used to anaesthetise the proper digital arteries
adrenaline
they are end arteries
fibrous digital sheaths
continuous with digital bands of the palmar aponeurosis
the sheaths attach to both sides of the phalanges and form a secure tunnel through which the FDS, FDP and FPL (int and deep) tendons and their synovial sheaths travel distally
anatomical snuff box
- pain
tenderness in the floor of it following trauma is suggestive of a scaphoid fracture
what are your lumbricals supplied by
lateral - median nerve
medial - ulnar nerve
what are your interossei innervated by
ulnar nerve
what is the action of the lumbricals
attach to FDP tendon
flex MCP (anterior aspect) and extend PIP (posterior aspect)
action of the interossei
palmar - adduct digits
dorsal - abduct digits
adductor pollicus innervation
ulnar nerve
what test is used for the adductor pollicus
Froment’s test
what is the action of the interossei
anterior and posterior for abduction/adduction of the fingers
what is the action of the lumbricals
flex MCP/extend PIP
name the intrinsic muscles of the hand
interossei
lumbricals
palmaris brevis
thenar and hypothenar eminence
