Hand (Exam 1) Flashcards
What type of joints are the carpometacarpals
synovial, plane gliding
What type of joints are the intermetacarpals
synovial plane gliding
What type of joints are the metacarop-phalangeal
synovial, condyloid (proximal and distal)
What type of joints are the interphalangeal
synovial, hinge
What join the fingers will allow abduction and adduction
metacarpo-phalangeal: synovial condyloid joint
What join in the fingers will allow flexion and extension
proximal and distal interphalangeal
What type of joint is the 1st carpometacarpal joint
synvoial saddle
What types of movement are permitted at the 1st carpometacarpal joint
adduction abduction extension flexion opposition reposition
Where does the C7 dermatome go
middle finger
What arterial arches are seen at the radial and ulnar arterial arches
superficial palmar arch at ulnar and deep palmar arch at radial
What are the PAD muscles
the interosseous palmar muscles that adduct
What are the DAB muscles
the interosseous palmar muscles that abduct
What muscles in the hand are innervated by median nerve
(2 Loaf)
2 lumbricals, opponens, abductor, and a flexor
What are the myotomes of the hand
c8-t1
What are the dermatomes of the hand
C6 thumb
C7 Middle finger
C8 pinky
What causes Dupytren’s contracture
fibrotic thickening and shortening of palmar aponeuroses
What occurs during Dupytren’s contracture
pulls digits 5 and 6 into the palm of the hand and you cannot move these digits
Is Dupytren’s contracture a neurologic condition
no, it is dysfunction of CT
Wheres is the midpalmar space found within the hand
found between the deep muscles and central compartment of the hand
What is the clinical correlation regarding the midpalmar space
travels from the hand to the carpal tunnel to the forearm: infection can spread from hand and damage median nerve and travel to forearm
What compartment of the hand are the tendons held within
central compartment
What is the thenar space
thumb space
What is the hypothenar space
pinky
What are the borders of the carpal tunnel
floor: carpal bones
Roof: flexor retinaculum (scaffoid, trapezium)
What will run through the flexor retinaculum
tendon of flexor carpi radialis
What structures run through the carpal tunnel
flexor digitorum profundus tendons (4)
flexor digitorum superficialis tnedons (4)
flexor pollicis longus tendon (1)
median nerve
Will the palmar cutaneous nerve be affected in carpal tunnel syndrome
no as it branches off above the tunnel
Where is Guyon’s canal located
between hamate and pisiform carpal bones
What causes handle bar neuropathy
numbness from compression the ulnar nerve in guyon’s tunnel
What are the main points of compression of the ulnar nerve
palmar carpal ligament
transverse carpal ligament
deep motor ulnar branch
superficial sensory ulnar branch
What synovial digit sheaths are continous with the palm
digits 1-5 are connected to the sheath of the palm
digits 2-4 are continuous with the palm
Name the thenar muscles
abductor pollicis brevis
flexor pollicis brevis
opponens pollicis
What are the thenar muscles innervated by
recurrent branch of the median nerve
What is another name for the recurrent branch of the median nerve
million dollar nerve
What happens if you cut the recurrent branch of the median nerve
you cannot use the thumb
Name the hypothenar muscles
Abductor digiti minimi
Flexor digiti minimi
opponens digiti minimi
What are the interosseous muscles
4 dorsals and 3 palmar muscles
What do the 4 dorsal interosseous muscles do
abduct
What do the 3 palmar interosseous muscles do
adduct
What are the interosseous muscles innervated by
ulnar nerve
Which finger lacks a palmar interossei
middle finger
What are the lumbricale muscles
run along the radial side of each digit and attach to the extensor hood
What is the innervation of lumbricale muscles
digits 2-3 are median nerve
digits 4-5 are ulnar nerve
What is adductor pollicis innervated by
deep branch of ulnar nerve (C8-T1)
What are the actions of the lumbricals
flexes the MP joint and extends the IP joint
What is the function of the dorsal interosseous muscle
abduction of the thumb
What muscles connect to the extensor hood
interosseous muscles and lumbricals
What is ulnar claw
muscles of digits 4 and 5 have lost innervation from the ulnar nerve
What is Klumpke’s palsy
clawing of digits 2-5 due to damage to C8-T1, all lumbricals and interosseous muscles are paralyzed
What is the arterial supply to the hand
superficial palmar arch
What is the superficial palmar arch
direct continuation of ulnar artery on top of digitorum tendons
Where is the radial pulse taken
lateral aspect of hand near the base of the thumb
What arterial arches of the hand are associated with the ulnar and radial arteries
superficial palmar arch and deep palmar arch
Which artery is more involved in the superficial palmar arch
ulnar
Which artery is more involved in the deep palmar arch
radial
Which arch is more distal
superficial palmar arch
Which arterial arch is more proximal
deep palmar arch
Are the arches always a full arch
no, sometimes arches can be incomplete
How is the deep palmar arch related to the interosseous muscles
runs with deep branch of ulnar nerve that supplies all the deep muscles
What are the branches off of the superficial arch
common palmar digital arteries that give rise to proper digital arteries
What are the branches off of the deep palmar arch
- palmar metacarpal arteries x3
- perforating brs (join dorsal metacarpal aa.)
- Recurrent brs (join palmar carpal arch)
Describe the arterial supply to the digits
arteries and nerves on palmar side go to the tip and go back over the top
Do dorsal nerves and arteries supply the tip of phalanges
no, they are too short
What are the borders of the anatomical snuff box
extensor pollicis longus
extensor pollicis brevis
abductor pollicis longus
What is the palmar branch of the median nerve
supplies the skin over the thenar compartment and center of the palm
What is the clinical significance of the palmar branch of the median nerve
Does not go through the carpal tunnel and will not be affected by carpal tunnel syndrome
thus, no loss of sensation with carpal tunnel, if nerve injury is higher sensation can be lost
What is the course of the palmar branch of the ulnar nerve and clinical relevance
travels over guyons tunnel, thus will not be affected when there is compression
will still have sensation over the last 2 digits
What nerve is referred to as the million dollar nerve
recurrent branch of median nerve
Where does the recurrent branch of the median nerve travel
over the top of the carpal tunnel, more superficial
Where would sensory loss occur in a radial nerve injury
dorsum of the hand
palmar surface okay
Where would sensory loss occur if there were damage to C6
both dorsum and palmar surface as it innervates both
