Hand Antomy And Hand Injuries Flashcards
What are the main functions of the hand?
Gross and precise functions, essential for daily living.
What are the main structures of the hand?
Skin, subcutaneous tissue, tendons, muscles, neurovascular bundles, bones.
How does the palmar skin differ from the dorsal skin?
Palmar skin is thick, glabrous, and non-pliable; dorsal skin is thin, pliable, and more prone to avulsion injuries.
What are the components of the nail unit?
Germinal matrix, sterile matrix, hyponychium.
What is the function of the palmar fascia?
Provides structural support and forms fibrous tunnels for tendons.
What are the two important ligaments around the neurovascular bundles of each digit?
Grayson’s and Cleland’s ligaments.
What are the intrinsic muscles of the hand?
Thenar, hypothenar, lumbricals, and interossei muscles.
Which muscles form the thenar eminence?
Abductor pollicis brevis, flexor pollicis brevis, opponens pollicis, adductor pollicis.
Which nerve supplies the thenar muscles?
Median nerve.
Which nerve supplies the hypothenar muscles?
Ulnar nerve.
What is the function of lumbrical muscles?
MCP flexion and IP extension.
What are the extrinsic flexor tendons of the hand?
Flexor Digitorum Superficialis, Flexor Digitorum Profundus, Flexor Pollicis Longus.
What are the extrinsic extensor tendons of the hand?
Extensor Digitorum, Extensor Indicis, Extensor Pollicis Longus, Extensor Pollicis Brevis, Abductor Pollicis Longus, Extensor Digiti Minimi.
How many phalanges are in the hand?
14; three per finger and two for the thumb.
How many metacarpal bones are in the hand?
Five.
How many carpal bones are there and how are they arranged?
Eight carpal bones arranged in two rows.
Which bones form the proximal row of carpal bones?
Scaphoid, Lunate, Triquetrum, Pisiform.
Which bones form the distal row of carpal bones?
Trapezium, Trapezoid, Capitate, Hamate.
What movements occur at the wrist joint?
Flexion, extension, circumduction, radial and ulnar deviation.
What is the function of the volar plates in interphalangeal joints?
Prevent hyperextension and provide joint stability.
What are the most important annular pulleys in the hand?
A2 and A4 pulleys.
Which arteries mainly supply the hand?
Radial and ulnar arteries.
What are the major venous drainage systems of the hand?
Cephalic and basilic veins (superficial), venae comitantes (deep).
Which nerve provides sensory innervation to the radial two lumbricals?
Median nerve.
Which nerve provides sensory innervation to the ulnar two lumbricals?
Ulnar nerve.
What are common causes of hand injuries?
Domestic, work-related, assaults, motor vehicle accidents, repetitive strain.
What are key aspects of taking history in hand injuries?
Hand dominance, mechanism of injury, time of injury, previous treatments.
What structures must be assessed in hand injury examination?
Skin, tendons, nerves, blood vessels, bones.
What imaging techniques are useful for hand injuries?
X-rays, MRI.
What are the basic principles of hand injury treatment?
Hemostasis, debridement, stabilization, analgesia, antibiotics, elevation.
Why is early physiotherapy important in hand injuries?
Prevents stiffness and contractures.
What is the initial step in treating open hand injuries?
Meticulous debridement to determine functional outcome.
Why is vascular repair important in hand injuries?
Ensures adequate blood supply, especially in cases with fractures.
What is the management of fingertip injuries with exposed distal phalanx?
Flap coverage (e.g., hypothenar graft).
What is the treatment of subungual hematoma?
Drainage by drilling the nail with a hot paperclip.
What are the key principles of tendon repair?
Primary repair, delayed primary repair, or secondary repair.
Which pulleys are crucial for flexor tendon function?
A2 and A4 pulleys.
What is the goal of nerve repair in hand injuries?
Re-innervation for sensitivity and function restoration.
What is a common method of nerve repair?
Direct nerve repair or nerve grafting.
What are common complications of hand injuries?
Stiffness, contractures, osteomyelitis, deformities, arthritis.
What is the importance of post-operative hand elevation?
Minimizes edema and prevents fibrosis.
What is the function of Cleland’s ligament?
Provides stability around the neurovascular bundle of each digit.
What is the function of Grayson’s ligament?
Stabilizes neurovascular structures in the fingers.
Which artery mainly supplies the thumb and index finger?
Deep palmar arch from the radial artery.
What structure is affected in a mallet finger injury?
Extensor tendon at the distal interphalangeal joint.
What is the function of the anatomical snuffbox?
Passage of the radial artery into the deep palmar arch.
What is the primary stabilizer of the thumb’s MCP joint?
Ulnar collateral ligament.
What is the most common site of scaphoid fracture?
Waist of the scaphoid.
What is the common presentation of carpal tunnel syndrome?
Numbness, tingling in the median nerve distribution, night pain.
What is the clinical significance of the Guyon’s canal?
Passage of the ulnar nerve and artery; site of ulnar nerve entrapment.
What is the purpose of a volar plate repair?
Prevents hyperextension at the PIP joint.
Which hand structure is most commonly injured in boxer’s fractures?
Fifth metacarpal neck.
What is the best treatment for metacarpal fractures?
Early fixation with K-wire, mini plates, or lag screws if necessary.
Why is meticulous handling of tissues important in hand surgery?
Prevents fibrosis and ensures optimal functional recovery.
Why is flap coverage indicated in hand injuries?
To cover exposed bone, tendons, or neurovascular structures.
What is the main cause of flexor tenosynovitis?
Infection of the flexor tendon sheath, commonly due to puncture wounds.
Which flexor tendon zone has the worst prognosis for repair?
Zone II (no-man’s land).
What is the importance of the digital arteries?
They provide blood supply to the fingers through the proper digital arteries.
Which nerve injury causes claw hand deformity?
Ulnar nerve injury.
What is the main goal of rehabilitation in hand injuries?
Restoring function and preventing stiffness and contractures.
