Hand and Wrist

Question 1

What are the bones of the hand

Answer 1

Phalanx - distal, middle and proximal

Metacarpal

Trapezoid

Trapezium

Scaphoid

Capitate

Hamate

Triquetrum

Pisifrom

Lunate

Question 2

Which carpal bones are in the proximal row

Answer 2

Scaphoid

Lunate

Triquetrum

Pisiform

Question 3

Which carpal bones are in the distal row

Answer 3

Trapezium

Trapezoid

Capitate

Hamate

Question 4

Number the metacarpals from radial to distal and what they articulate with

Answer 4

I - trapezium proximally, proximal phalanx of thumb distallly

II - trapeziod proximally, proximal phalanx of index finger distally

III - capitate proximally, proximal phalanx of middle finger distally

IV - hamate proximally, proximal phalanx of ring finger distally

V - hamate proximally, proximal phalanx of little finger distally

Question 5

What are the movements of the thumb

Answer 5

Extension

Flexion

Opposition

Retroposition

Palmar abduction

Radial abduction

Question 6

What are the four muscle compartments in the hand

Answer 6

Thenar compartment

Adductor compartment

Hypothenar compartment

Central compartment

Question 7

What are the muscles in the thenar compartment of the thumb, what nerve innervates them and what are their functions

Answer 7

Median nerve

Opponens pollicis - opposes thumb

Abductor pollicis brevis - palmar abduction of thumb

Flexor pollicis brevis - flexes metacarpophalangeal joint of thumb

Question 8

What muscle is in the adductor compartment of the hand, what nerve innervates it and what action does it perform

Answer 8

Adductor pollicis

Ulnar nerve

Thumb adduction - both in radial (coronal) and palmar (sagittal) planes

Question 9

What muscles are in the hypothenar compartment of the hand, what nerve supplies them and what are their actions

Answer 9

Ulnar nerve

Opponens digiti minimi - rotates 5th metacarpal towards the palm

Abductor digiti minimi - abducts finger (only in coronal plane)

Flexor digiti minimi brevis - flexes metacarpophalangeal joint of little finger

Question 10

What muscles are in the central compartment, what are their innervations and what are their actions

Answer 10

Palmaris brevis - ulnar nerve, it wrinkles the skin of hypothenar eminence to deepen the curvature of the palm and improve grip

Lumbricals - radial two: median nerve, ulnar two: ulnar nerve. Act to flex the metacarpophalangeal joint and extend the interphalangeal joint

Dorsal interossei - ulnar nerve, abduct the fingers away from the axis of the third metacarpal

Palmar interossei - ulnar nerve, adduct the fingers towards the axis of the middle finger and third metacarpal

Question 11

Name the origin and insertion of the four lumbricles and whether they are unipennate or bipennate

Answer 11

I - origin: FDP to index, insert: ED to index. Unipennate

II - origin: FDP to middle, insert: ED to middle. Unipennate

III - origin: FDP to middle and ring, insert: ED to ring. Bipennate

IV - origin: FDP to ring and little, insert: ED to little. Bipennate

Question 12

Name the origin and insertion of the dorsal interossei

Answer 12

I - shaft of 1st and 2nd metacarpals, insert into radial aspect of proximal phalanx base of index and extensor expansion

II - shaft of 2nd and 3rd metacarpals, inserts into radial aspect of proximal phalanx base of middle and extensor expansion

III - shaft of 3rd and 4th metacarpals, inserts into ulnar aspect of proximal phalanx base of middle and extensor expansion

IV - shaft of 4th and 5th metacarpals, inserts into ulnar aspect of proximal phalanx base of ring

Question 13

What are the actions of the dorsal interossei

Answer 13

I - abducts index and assists in flexing MCPJ and extending IPJs

II - radially abducts/deviates middle and assists in flexing MCPJ and extending IPJs

III - ulnar abducts/deviates middle and assists in flexing MCPJ and extending IPJs

IV - abducts ring and assits in flexing MCPJ and extending IPJs

Question 14

What are the functions of the palmar interossei

Answer 14

Index - adducts index towards middle

Ring - adducts ring towards middle

Little - adducts little towards middle and ring fingers

Question 15

What are the extrinsic muscles of the hand

Answer 15

Extensor digitorum

Flexor digitorum profundus

Flexor digitorum superficialis

Question 16

Where does the extensor digitorum originate and insert into

Answer 16

Originates from lateral epidcondyles of humerus

Divides to insert into index, middle, ring and little fingers. Tendons divide into central slip, inserting into base of middle phalanx, and two lateral slips which converge to insert into base of distal phalanx

Question 17

Where does the flexor digitorum profundus originate and insert

Answer 17

From proximal ulna and adjacent interosseous membrane

Divides into four at wrist and inserts into base of distal phalanx of the four fingers

Question 18

Where does the flexor digitorum superficialis originate and insert

Answer 18

From medial epicondyle of humerus and superior half of radius

Divides into four tendons at wrist, each inserting into base of middle phalanx of four fingers

Question 19

What are the borders of the carpal tunnel

Answer 19

Deep border - carpal bones

Superficial border - flexor retinaculum: lateral attachments are scaphoid and trapezium, medial attachments are hook of hamate and pisiform

Question 20

What structures pass through the carpal tunnel

Answer 20

Flexor pollicis longus

Flexor digitorum superificialis tendons

Flexor digitorum profundus tendons

Median nerve

Question 21

What is the Guyon’s canal

Answer 21

Semi-rigid longitudinal canal in the wrist that allows the passage of the ulnar nerve and artery into the hand

It is superficial to the flexor retinaculum

Question 22

What is the anatomical snuffbox and what does it contain

Answer 22

Triangular depression on radial aspect on dorsum of the hand containing radial artery, superifical branch of radial nerve and cephalic vein

Question 23

What are the borders of the anatomical snuffbox

Answer 23

Radial border - adductor pollicis longus and extensor pollicis brevis tendons

Medial border - extensor pollicis longus tendon

Proximal border - styloid process of radius

Floor - scaphoid and trapezium

Roof - skin

Question 24

What is the blood supply of the hand - arteries and arterial supply of hand

Answer 24

Ulnar and radial arteries

Superficial palmar arch and deep palmar arch

Superficial palmar arch gives off common palmar digital arteries