Hand, Carpus 2

Question 1

Describe the pathway of the Ulnar Artery in the Hand

Answer 1

It enters the hand superficial to Flexor Retinaculum, passes between the Pisiform and the Hook of the Hamate, then divides into the Superficial Branch (to Superficial Arch) and Deep Branch (to Deep Arch)

Question 2

Describe the pathway of the Radial Artery in the Hand

Answer 2

It curves around the scaphoid and trapezium, passes between the heads of the 1st dorsal interosseous muscle, then between the heads of Adductor Pollicis Muscle. It then divides into the Superficial Brach (to Superficial Arch) and Deep Branch (Deep Palmar Arch)

Question 3

Which artery is the main contributor to the Superficial Palmar Arch?

Answer 3

Ulnar Artery

Question 4

Which artery is the main contributor to the Deep Palmar Arch?

Answer 4

Radial Artery

Question 5

What is the surface marking of the Superficial Palmar Arch?

Answer 5

Approximately level with the tip of the fully extended thumb

Question 6

What is the surface marking of the Deep Palmar Arch?

Answer 6

Approximately level with the base of the fully extended thumb

Question 7

How do you test the integrity of the Ulnar and Radial Arteries?

Answer 7

Allen’s Test

Question 8

Describe Allen’s Test

Answer 8

1. The 2 arteries are simultaneous occluded while the patient makes a fist
2. the hand is opened and the palm will be pale
3. The Ulnar/Radial Artery is released, and the hand is observed for change in colour back to normal

Question 9

Describe the Venous Drainage of the Hand

Answer 9

The Dorsal Venous Arch on the back of the palm drains into the Cephalic and Basilic Veins

Question 10

Which Roots of the Brachial Plexus does the Ulnar Nerve arise from?

Answer 10

C8 and T1

Question 11

Describe the pathway of the Ulnar Nerve in the Hand

Answer 11

Enters the hand superficial to Flexor Retinaculum with the Ulnar Artery, them gives off the dorsal cutaneous nerve which passes deep to Flexor Carpi Ulnaris to supply the dorsal aspect. It then branches into the superficial (sensory) branch and the deep (motor) branch

Question 12

What parts of the hand does the Ulnar Nerve give Sensory Innervation to?

Answer 12

The Medial 1.5 digits on both dorsal and palmar sides

Question 13

Describe the pathway of the Median Nerve in the Hand

Answer 13

It gives off the palmar cutaneous branch before passing through the Carpal Tunnel. It then gives off the recurrent branch which supplies the Thenar Muscles, then branches into the Palmar and Digital Branches

Question 14

What parts of the hand does the Median Nerve give Sensory Innervation to?

Answer 14

Palmar Aspect: Palmar Skin of the Radial 3.5 Digits and the adjacent Palm
Dorsal Aspect: The tips of the Radial 3.5 Digits

Question 15

What is a Myotome?

Answer 15

A group of muscles innervated by a single spinal nerve

Question 16

Which Myotomes are responsible for Flexion at the elbow?

Answer 16

C5, C6

Question 17

Which Myotomes are responsible for Extension of the Elbow?

Answer 17

C7, C8

Question 18

Which Myotomes are responsible for Abduction and Lateral Rotation of the Shoulder?

Answer 18

C5

Question 19

Which Myotomes are responsible for Adduction and Medial Rotation of the Shoulder?

Answer 19

C6, C7, C8

Question 20

Which Myotomes are responsible for Pronation and Supination at the Radioulnar Joint?

Answer 20

C6

Question 21

Which Myotomes are responsible for Flexion and Extension of the wrist?

Answer 21

C6,C7

Question 22

Which Myotomes are responsible for the Intrinsic Muscles of the Hand?

Answer 22

T1

Question 23

What happens if there is a lesion of the Median Nerve?

Answer 23

Weakness and Wasting of the Thenar Muscles

Question 24

What happens if there is a lesion of the Ulnar Nerve?

Answer 24

Weakness and Wasting of the Hypothenar Muscles

Question 25

What happens if there is weakness and wasting of both Thenar and Hypothenar Muscles?

Answer 25

Lesion of T1 Root–> Klumpke’s Paralysis