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Diogo Script for Hand, Forearm I and II > Hand-Script Diogo > Flashcards

Hand-Script Diogo Flashcards

1
Q

The cutaneous innervation of the hand is derived from what nerves?

A

Median Nerve
Ulnar Nerve
Superficial branch of the Radial Nerve

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2
Q

What is the sole prime mover of the opposition of the thumb?

A

opponens pollicis

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3
Q

Most of the intrinsic hand muscle innervated by what nerve?

A

deep branch of the ulnar nerve

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4
Q

What are the prime movers of reposition of the thumb?

A

abductor pollicis longus

extensor pollicis longus

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5
Q

The opposition and reposition of the thumb is largely dependent upon the freedom of movement in what joint?

A

carpometacarpal joint

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6
Q

What is the action of the lumbricals and what are they innervated by?

A

flexion at the metacarpophalangeal joints and extension at the interphalangeal joints of digits 2, 3, 4, and 5

lumbricals 1 and 2 innervated by median nerve
lumbricals 3 and 4 innervated by the deep branch of the ulnar nerve

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7
Q

The combined extensor activity of these 3 posterior muscles is counterbalanced by the combined flexor activity of the lumbricals and the 2 anterior forearm muscles (flexor digitorum profundus and superficialis).

A

extensor digitorum
extensor indicis
extensor digit minimi

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8
Q

What is the function of the dorsal and palmar interossei respectively?

A

dorsal interossei: abduction of finger (DAB)

palmar interossei: adduction of finger (PAD)

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9
Q

Where are the 4 dorsal interossei located in the hands with respect to the anatomical position?

A

1st DI: lateral side of the index finger
2nd and 3rd DI: lateral and medial side of the middle finger
4th DI: medial side of the ring finger

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10
Q

What is the result of a paralysis of the dorsal interossei?

A

inability to spread apart the index, middle and ring fingers

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11
Q

Where are the 3 palmar interossei located with respect to the anatomical position?

A

1st PI: medial side of the index finger
2nd PI: lateral side of the ring finger
3rd PI: lateral side of the little finger

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12
Q

What is the result of a paralysis of the palmar interossei?

A

inability to squeeze the fingers together along their sides

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13
Q

What are the 6 intrinsic hand muscles that are the exception with respect to their innervation? What are they innervated by?

A 
MEDIAN NERVE 
-3 thenar eminence muscle 
abductor pollicis brevis 
opponens pollicis 
flexor pollicis brevis
-1st and 2nd lumbricals

SUPERFICIAL BRANCH OF THE ULNAR NERVE
-Palmar brevis

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14
Q

What specific branch of the median nerve innervates the muscles of the thenar eminence?

A

recurrent branch of the median nerve

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15
Q

Paralysis of what muscles will produce an ape hand?

A

thenar eminence muscles

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16
Q

The 3 thenar eminence muscles are:

  • adductor pollicis
  • opponens pollicis
  • flexor pollicis brevis

True or false?

A

FALSE

ABductor pollicis brevis
NOT ADductor pollicis

Adductor pollicis is not considered to be a thenar muscle and is innervated by the deep branch of the ulnar nerve. It can both flex and abduct the thumb.

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17
Q

What are the 3 muscles of the hypothenar eminence?

A

abductor digiti minimi
opponens digiti minimi
flexor digiti minimi

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18
Q

Which muscle can wrinkle the skin covering the hypothenar eminence?

A

palmaris brevis

which is one of the exceptions as it is innervated by the superficial branch of the ulnar nerve

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19
Q

Which spinal nerve provides most of the nerve fibers that control abduction and adduction of the fingers at their metacarpophalangeal joints?

A

T1

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20
Q

The paralysis of what intrinsic hand muscles innervated by what nerve produces the claw hand?

A

intrinsic hand muscle innervated by the deep branch of the ulnar nerve

21
Q

The motor deficits which result from a severe injury to the C8 and T1 roots, lower trunk, or the divisions of the lower trunk of the brachial plexus are referred to as what?

A

Klumpke’s palsy

which is due to excessive traction on the lower parts of the brachial plexus

22
Q

Which muscles are significantly compromised if both the C8 and T1 nerve fibers sustain significant damage?

A

intrinsic hand muscles

C8 and T1 are the only spinal nerves that provide innervation for not only the intrinsic hand innervated by the deep branch of the ulnar nerve but also intrinsic hand muscle innervated by the median nerve.

23
Q

The loss of action of the intrinsic hand muscles innervated by the deep branch of the ulnar nerve and the median nerve produce a combination of a claw hand an ape hand named what?

A

Klumpke’s palsy

24
Q

The paralysis of what muscles produces hyperextension of the fingers at their metacarpophalangeal joints and full flexion at their interphalangeal joints?

A

4 lumbricals

1 and 2 are innervated by the median nerve and 3 and 4 are innervated by the deep branch of the ulnar nerve

25
Q

Paralysis of what muscle results in the thumb being laterally rotated excessively at its carpometacarpal joint?

A

opponens pollicis

26
Q

The sensory supply of the hand is derived from what 3 major nerves?

A

ulnar nerve
median nerve
superficial branch of the radial nerve

27
Q

Where on the hand does the ulnar, median, and superficial branch of the radial nerve supply sensory innervation?

A

ulnar nerve: anterior and posterior surfaces of digits 4, 5, and medial half of 3

median nerve: anterior surface of digits 1, 2, and lateral half of 3

superficial branch of the radial nerve: posterior surface of digits 1, 2, and lateral half of 3

28
Q

Why is the median nerve referred to as “the eye of the hand”?

A

the anterior surfaces receiving sensory innervation from the median nerve are the surfaces by which objects are primarily felt by the hand

29
Q

What are the quick test to test for sensory function of the ulnar, median, and superficial branch of the radial nerve using a probe?

A

ulnar nerve: apply the probe to palmar surface of the little finger

median nerve: apply the probe to the palmer surface of the index finger

superficial branch of the radial nerve: apply the probe to the skin surface of the index finger

30
Q

What spinal nerve provides most of the sensory innervation to the skin of the thumb?

A

C6

31
Q

What spinal nerve provides the most sensory innervation to the skin of the index, middle, and ring finger?

A

C7

32
Q

What spinal nerve provides most of the sensory innervation to the skin of the little finger?

A

C8

33
Q

The upper limb median nerve is derived from what spinal nerves?

A

C5, C6–> lateral cord –> lateral branch for the median nerve
C8, T1 –> medial cord –> medial branch for the median nerve

34
Q

Sensory and motor deficits associated with the dysfunction of the muscles of the thenar eminence are collectively referred to as what?

A

carpal tunnel syndrome

recurrent branch of the median nerve is distal to the carpal tunnel

35
Q

The blood supply of the hand is mainly provided by what two arteries?

A

superficial palmer arch of the ulnar artery

deep palmar arch of the radial artery

36
Q

The ulnar artery enters into the hand by passing ________to the flexor retinaculum, and then curves laterally through the palm as the superficial palmar branch.

A

superficial

37
Q

The superficial palmer arch of the ulnar artery generally anastomoses with what?

A

the superficial branch of the radial nerve in the lateral half of the palm

38
Q

The radial artery enters into the dorsal side of the hand coursing through this at the lateral side of the wrist.

A

anatomical snuffbox

39
Q

After passing the anatomical snuffbox the radial artery gives rise to the superficial branch and then curves medially through the palm as what?

A

deep palmar arch of the radial artery

40
Q

The deep palmer arch of the radial artery generally anastomoses with what?

A

the deep branch of the ulnar artery in the medial half of the palm

41
Q

What is the major artery supplying the thumb? What about the index finger?

A

princeps pollicis artery - thumb

radialis indicis- index finger

42
Q

What is the Allen’s used for?

A

to determine whether the ulnar and radial arteries are a chief source of blood supply to a patient’s hand

43
Q

What are the steps of the Allen’s test?

A
  1. Ask patient to make a tight fist : increases the external pressure upon capillary beds within the skin of the palm
  2. Apply pressure to both the ulnar and radial arteris at their palaption sites in the anterior formarm
  3. Ask patient to unclench the fist, exposing the blanched pallor of the palmar surface
  4. Release the pressure on one artery and ascertain whether color is restored to the palmar surface within 2 to 4 seconds (normal); if not abnormal
44
Q

What is the average velocity of blood flow in a capillary?

A

1 mm/sec

45
Q

Most median nerve lesions are in the form of what common brachial plexus injury type?

A

neuropraxia or axonotmesis

46
Q

What is neuropraxia and axonotmesis?

A

Neuropraxia is a neuronal lesion in which local demyelination occurs in the absence of axonal disruption.

Axonotmesis is a neuronal lesion in which disruption of axons and their myelin sheaths occurs in the absence of disruption of the endoneurium and other connective tissue sheaths.

47
Q

What are the typical initial neurological symptoms of neuropraxia?

A

pain and sensory deficits within the distribution of the digital cutaneous branches of the median nerve

48
Q

When do motor deficits associated with dysfunction of the muscles of the thenar eminence occur?

A

subsequent to the onset of sensory deficits

example:
proximal (before) carpal tunnel –>sensory deficits
in the carpal tunnel –> both sensory and motor deficits
distal (after) carpal tunnel –> motor deficits

Diogo Script for Hand, Forearm I and II (3 decks)

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