Hand Antomy And Hand Injuries

Question 1

What are the main functions of the hand?

Answer 1

Gross and precise functions, essential for daily living.

Question 2

What are the main structures of the hand?

Answer 2

Skin, subcutaneous tissue, tendons, muscles, neurovascular bundles, bones.

Question 3

How does the palmar skin differ from the dorsal skin?

Answer 3

Palmar skin is thick, glabrous, and non-pliable; dorsal skin is thin, pliable, and more prone to avulsion injuries.

Question 4

What are the components of the nail unit?

Answer 4

Germinal matrix, sterile matrix, hyponychium.

Question 5

What is the function of the palmar fascia?

Answer 5

Provides structural support and forms fibrous tunnels for tendons.

Question 6

What are the two important ligaments around the neurovascular bundles of each digit?

Answer 6

Grayson’s and Cleland’s ligaments.

Question 7

What are the intrinsic muscles of the hand?

Answer 7

Thenar, hypothenar, lumbricals, and interossei muscles.

Question 8

Which muscles form the thenar eminence?

Answer 8

Abductor pollicis brevis, flexor pollicis brevis, opponens pollicis, adductor pollicis.

Question 9

Which nerve supplies the thenar muscles?

Answer 9

Median nerve.

Question 10

Which nerve supplies the hypothenar muscles?

Answer 10

Ulnar nerve.

Question 11

What is the function of lumbrical muscles?

Answer 11

MCP flexion and IP extension.

Question 12

What are the extrinsic flexor tendons of the hand?

Answer 12

Flexor Digitorum Superficialis, Flexor Digitorum Profundus, Flexor Pollicis Longus.

Question 13

What are the extrinsic extensor tendons of the hand?

Answer 13

Extensor Digitorum, Extensor Indicis, Extensor Pollicis Longus, Extensor Pollicis Brevis, Abductor Pollicis Longus, Extensor Digiti Minimi.

Question 14

How many phalanges are in the hand?

Answer 14

14; three per finger and two for the thumb.

Question 15

How many metacarpal bones are in the hand?

Answer 15

Five.

Question 16

How many carpal bones are there and how are they arranged?

Answer 16

Eight carpal bones arranged in two rows.

Question 17

Which bones form the proximal row of carpal bones?

Answer 17

Scaphoid, Lunate, Triquetrum, Pisiform.

Question 18

Which bones form the distal row of carpal bones?

Answer 18

Trapezium, Trapezoid, Capitate, Hamate.

Question 19

What movements occur at the wrist joint?

Answer 19

Flexion, extension, circumduction, radial and ulnar deviation.

Question 20

What is the function of the volar plates in interphalangeal joints?

Answer 20

Prevent hyperextension and provide joint stability.

Question 21

What are the most important annular pulleys in the hand?

Answer 21

A2 and A4 pulleys.

Question 22

Which arteries mainly supply the hand?

Answer 22

Radial and ulnar arteries.

Question 23

What are the major venous drainage systems of the hand?

Answer 23

Cephalic and basilic veins (superficial), venae comitantes (deep).

Question 24

Which nerve provides sensory innervation to the radial two lumbricals?

Answer 24

Median nerve.

Question 25

Which nerve provides sensory innervation to the ulnar two lumbricals?

Answer 25

Ulnar nerve.

Question 26

What are common causes of hand injuries?

Answer 26

Domestic, work-related, assaults, motor vehicle accidents, repetitive strain.

Question 27

What are key aspects of taking history in hand injuries?

Answer 27

Hand dominance, mechanism of injury, time of injury, previous treatments.

Question 28

What structures must be assessed in hand injury examination?

Answer 28

Skin, tendons, nerves, blood vessels, bones.

Question 29

What imaging techniques are useful for hand injuries?

Answer 29

X-rays, MRI.

Question 30

What are the basic principles of hand injury treatment?

Answer 30

Hemostasis, debridement, stabilization, analgesia, antibiotics, elevation.

Question 31

Why is early physiotherapy important in hand injuries?

Answer 31

Prevents stiffness and contractures.

Question 32

What is the initial step in treating open hand injuries?

Answer 32

Meticulous debridement to determine functional outcome.

Question 33

Why is vascular repair important in hand injuries?

Answer 33

Ensures adequate blood supply, especially in cases with fractures.

Question 34

What is the management of fingertip injuries with exposed distal phalanx?

Answer 34

Flap coverage (e.g., hypothenar graft).

Question 35

What is the treatment of subungual hematoma?

Answer 35

Drainage by drilling the nail with a hot paperclip.

Question 36

What are the key principles of tendon repair?

Answer 36

Primary repair, delayed primary repair, or secondary repair.

Question 37

Which pulleys are crucial for flexor tendon function?

Answer 37

A2 and A4 pulleys.

Question 38

What is the goal of nerve repair in hand injuries?

Answer 38

Re-innervation for sensitivity and function restoration.

Question 39

What is a common method of nerve repair?

Answer 39

Direct nerve repair or nerve grafting.

Question 40

What are common complications of hand injuries?

Answer 40

Stiffness, contractures, osteomyelitis, deformities, arthritis.

Question 41

What is the importance of post-operative hand elevation?

Answer 41

Minimizes edema and prevents fibrosis.

Question 42

What is the function of Cleland’s ligament?

Answer 42

Provides stability around the neurovascular bundle of each digit.

Question 43

What is the function of Grayson’s ligament?

Answer 43

Stabilizes neurovascular structures in the fingers.

Question 44

Which artery mainly supplies the thumb and index finger?

Answer 44

Deep palmar arch from the radial artery.

Question 45

What structure is affected in a mallet finger injury?

Answer 45

Extensor tendon at the distal interphalangeal joint.

Question 46

What is the function of the anatomical snuffbox?

Answer 46

Passage of the radial artery into the deep palmar arch.

Question 47

What is the primary stabilizer of the thumb’s MCP joint?

Answer 47

Ulnar collateral ligament.

Question 48

What is the most common site of scaphoid fracture?

Answer 48

Waist of the scaphoid.

Question 49

What is the common presentation of carpal tunnel syndrome?

Answer 49

Numbness, tingling in the median nerve distribution, night pain.

Question 50

What is the clinical significance of the Guyon’s canal?

Answer 50

Passage of the ulnar nerve and artery; site of ulnar nerve entrapment.

Question 51

What is the purpose of a volar plate repair?

Answer 51

Prevents hyperextension at the PIP joint.

Question 52

Which hand structure is most commonly injured in boxer's fractures?

Answer 52

Fifth metacarpal neck.

Question 53

What is the best treatment for metacarpal fractures?

Answer 53

Early fixation with K-wire, mini plates, or lag screws if necessary.

Question 54

Why is meticulous handling of tissues important in hand surgery?

Answer 54

Prevents fibrosis and ensures optimal functional recovery.

Question 55

Why is flap coverage indicated in hand injuries?

Answer 55

To cover exposed bone, tendons, or neurovascular structures.

Question 56

What is the main cause of flexor tenosynovitis?

Answer 56

Infection of the flexor tendon sheath, commonly due to puncture wounds.

Question 57

Which flexor tendon zone has the worst prognosis for repair?

Answer 57

Zone II (no-man’s land).

Question 58

What is the importance of the digital arteries?

Answer 58

They provide blood supply to the fingers through the proper digital arteries.

Question 59

Which nerve injury causes claw hand deformity?

Answer 59

Ulnar nerve injury.

Question 60

What is the main goal of rehabilitation in hand injuries?

Answer 60

Restoring function and preventing stiffness and contractures.