Hand & Wrist Anatomy Flashcards
State the carpal bones of the hand
She looks too pretty, try to catch her
Scaphoid, lunate, triquetrum, pisiform, trapezium, trapezoid, capitate, hamate
Describe the boundaries of the carpal tunnel
Superior boundary - flexor retinaculum (attaches to scaphoid, pisiform, trapezium, hamate)
Inferior boundary - carpal bones
State the contents of the carpal tunnel
4 flexor digitorum superficialis tendons
4 flexor digitirum profundus tendons
Flexor pollicis longus
Medial nerve
State the thenar eminence muscles
Opponens pollicis, abductor pollicis brevis, flexor pollicis brevis
Opponens pollicis - AFI
Attachments - originates from trapezium and flexor retinaculum and inserts into metacarpals
Actions - thumb opposition
Innervation - median nerve
Abductor pollicis brevis - AFI
Attachments - originates from scaphoid, trapezium and flexor retinaculum and inserts into proximal phalanx and extensor hood
Actions - thumb abduction
Innervation - median nerve
Flexor pollicis brevis - AFI
Attachments - originates from trapezium and flexor retinaculum and inserts into proximal phalanx
Actions - thumb flexion
Innervation - median nerve
State the hypothenars muscles
Opponens digiti minimi, abductor digiti minimi, flexor digiti minimi
Opponens digiti minimi - AFI
Attachments - originate from hamate and flexor retinaculum inserts into metacarpals
Actions - opposition of 5th metatarsal
Innervation - ulnar nerve
Abductor digiti minimi - AFI
Attachments - originates from pisiform and inserts into proximal phalanx
Actions - abduction of 5th metatarsal
Innervation - ulnar nerve
Flexor digiti minimi - AFI
Attachments - originates from hamate and flexor retinaculum and inserts into proximal phalanx
Actions - flexion of 5th metatarsal
Innervation - ulnar nerve
Lumbricals - AFI
Attachments - originates from flexor digitorum profundus and insert into extensor hood
Function - flexion of MCP joint and extension at IP joints
Innervation - medial two lumbricles innervated by ulnar nerve
Lateral two lumbricles innervated by median nerve
Interossei muscles - AFI
Attachments - originate from metacarpals and insert into extensor hood 3/4 in the palmar, 4 in the dorsal Function - PAD DAB Palmar interossei cause adduction Dorsal interossei cause abduction Innervation - ulnar nerve
Palmaris brevis - AFI
Attachments - originates from palmar aponeurosis and flexor retinaculum and inserts into skin
Action - improves grip
Innervation - ulnar nerve
Adductor pollicis - AFI
Attachments - originates from metacarpal II, III and capitate and inserts into proximal phalanx and extensor hood of thumb
Action - adducts thumb
Innervation - ulnar nerve
Describe the blood supply of the hand
- The radial and ulnar arteries enter the hand and split into the superficial and deep palmar arches
- They anastomose with the corresponding branches from the other artery
- Superficial palmar arch gives off the common palmar digital arteries which supply the fingers
Describe the Allen’s test
Pressing the ulnar or radial artery and then releasing
For normal blood flow, hand quickly becomes warm and returns to its normal colour
One artery alone enough to supply entire hand
For abnormal flow, hand remains cold and pale
What does the median nerve supply in the hand
Supplies radial 3 and a half of digits - thumb to half of ring finger
Superficial to tendons
LOAF - lateral two lumbricals
Opponens pollicis
Abductor pollicis brevis
Flexor pollicis brevisWhat does the ulnar nerve supply in the hand
Covered by flexor carpi ulnarus
Supplies little finger and half of ring fingers
Innervates all muscles apart form LOAF
What does the radial nerve supply in the hand
Supplies back of hand with sensation
State the borders and contents of the anatomical snuffbox
Lateral Border= tendons of abductor pollicis longus and extensor pollicis brevis
Medial Border= tendon of extensor pollicis longus
Floor= scaphoid bone
Roof= skin
Proximal border= styloid process of radius
Contents= radial artery, superficial branch of radial nerve, cephalic vein
