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Hand+ Wrist Anatomy Flashcards

1
Q

What are the 4 components of the wrist joint?

A
  • Distal radius
  • Triangular fibrocartilage complex
  • Scaphoid
  • Lunate

(Ulna is not part of wrist joint, articulates with radius at distal radioulnar joint)

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2
Q

The wrist is an ellipsoid type of synovial joint. What does this mean?

A

Allows movement in 2 planes (Flexion/ extension and Adduction/abduction)

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3
Q

What ligaments stabilise the wrist joint?

A
  1. Radiocarpal ligaments that attach radius to carpal bones on Dorsal + Palmar surfaces
  2. Ulnar and radial collateral ligaments (On ulnar and radial aspects of the joint)
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4
Q

Other than stabilising the wrist joint, what isthe function of the Radiocarpal ligaments

A

Ensure that the hand follows the radius during pronation and supination

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5
Q

How many bones are there in the hand

A

27

8 carpal bones
5 metacarpals
14 phalanges

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6
Q

Identify the carpal bones in the proximal row of the wrist, Radially to Medially

(Sam Likes To Push The Toy Car Hard)

A
  • Scaphoid
  • Lunate
  • Triquetrum
  • Pisiform

(Sam Likes To Push)

(Scaphoid and Lunate articulate with radius to form wrist joint)

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7
Q

Identify the carpal bones in the distal row of the wrist, Radially to Medially

(Sam Likes To Push The Toy Car Hard)

A
  • Trapezium
  • Trapezoid
  • Capitate
  • Hamate (Has a projection on its palmar surface, the ‘hook’)

(The Toy Car Hard)

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8
Q

Describe the blood supply to the Scaphoid bone of the wrist

A
  • A dorsal carpal branch of radial artery
  • enters the dorsal surface of the scaphoid distally
  • supplies proximal 80% of scaphoid
  • by retrograde flow (flow towards wrist)
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9
Q

State the Proximal and Distal articulations of Metacarpal I

A

Proximal articulation: Trapezium
Distal articulation: Proximal phalanx of thumb

(Trapezium is under the thumb)

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10
Q

State the Proximal and Distal articulations of Metacarpal II

A

Proximal articulation: Trapezoid mainly

Distal articulation: Proximal phalanx of index finger

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11
Q

State the Proximal and Distal articulations of Metacarpal III

A

Proximal articulation: Capitate

Distal articulation: Proximal phalanx of middle finger

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12
Q

State the Proximal and Distal articulations of Metacarpal IV

A

Proximal articulation: Hamate

Distal articulation: Proximal phalanx of ring finger

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13
Q

State the Proximal and Distal articulations of Metacarpal V

A

Proximal articulation: Hamate

Distal articulation: Proximal phalanx of little finger

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14
Q

What are the 3 parts of a metacarpal

A

Base
Shaft
Head

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15
Q

Compare the 2 types of hand muscles

A

Intrinsic: Originate within hand and insert within hand

Extrinsic: Originate within forearm and insert within hand (Covered in muscles of forearm)

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16
Q

Intrinsic hand muscles can be divided into 4 compartments.

Identify the muscles in each compartment (3,1,3,3)

A

Thenar (thumb) component; (OAF)

  • Opponens pollicis (Most lateral)
  • Abductor pollicis brevis
  • Flexor pollicis brevis (Most medial)

Adductor component;
- Adductor pollicis

Hypothenar (little finger) component; (OAF)

  • Abductor digiti minimi
  • Flexor digiti minimi brevis
  • Opponens digiti minimi

Central compartment;

  • Lumbricals (4)
  • Interossei (Palmar and dorsal)
  • Palmaris Brevis
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17
Q

Which structure are the Thenar muscles responsible for?

A

Thenar eminence (Muscular prominence on radial aspect of palm)

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18
Q

State the Origins and Insertion of Opponens pollicis

A

Origins: Trapezium and Flexor retinaculum

Insertion: Lateral border of metacarpal 1

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19
Q

State the Innervation and Action of Opponens pollicis

A

Innervation: Median nerve

Action: Thumb opposition (medially rotating and flexing metacarpal 1)

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20
Q

State the Origins and Insertion of Abductor pollicis brevis

A

Origins: Scaphoid, Trapezium and Flexor retinaculum

Insertion: Lateral border of proximal phalanx of thumb

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21
Q

State the Innervation and Action of Abductor pollicis brevis

A

Innervation: Median nerve

Action: Palmar abduction of thumb (Perp. to thumb)

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22
Q

State the Origins (2 heads) and Insertion of Flexor pollicis brevis

A

Origins;

  • Superficial head: Trapezium, Flexor retinaculum
  • Deep head: Trapezoid, Capitate

Insertion: Medial aspect of base of proximal phalanx of thumb

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23
Q

State the Innervations (2 heads) and Action of Flexor pollicis brevis

A

Innervations;

  • Superficial head: Median nerve
  • Deep head: Ulnar nerve

Action: Flexion of MCPJ of thumb (FPL flexes the IPJ)

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24
Q

What is the largest thenar muscle? Compare its location to the other 2

A

Opponens pollicis is the largest

Is deep to FPB and APB

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25
State the Origins (2 heads) and Insertion of Adductor pollicis
Origins; - Transverse head: Shaft of metacarpal 3 - Oblique head: Capitate and base of metacarpals 2,3 Insertion: Ulnar aspect of base of proximal phalanx of thumb (with FPB)
26
State the Innervation and Action of Adductor pollicis
Innervation: Ulnar nerve Action: Thumb adduction (Both palmar and radial)
27
Which structure are the Hypothenar muscles responsible for? What is the largest Hypothenar muscle? Compare its location to the other 2
Hypothenar Eminence (Muscular prominence on ulnar aspect of palm) Opponens digit minimi Is deeper to other 2 (ADM, FDMB)
28
State the Origins and Insertion of Opponens digiti minimi
Origins: Hamate hook, Flexor retinaculum Insertion: Ulnar aspect of metacarpal 5
29
State the Innervation and Action of Opponens digiti minimi
Innervation: Ulnar nerve Action: Little finger opposition against thumb (rotates metacarpal 5 towards palm)
30
State the Origins and Insertion of Abductor digiti minimi
Origins: Pisiform, tendon o FCU Insertion: Base of proximal phalanx of little finger
31
State the Innervation and Action of Abductor digiti minimi
Innervation: Ulnar nerve Action: Little finger abduction
32
State the Origins and Insertion of Flexor digiti minimi brevis
Origins: Hamate hook, Flexor retinaculum Insertion: Base of proximal phalanx of little finger
33
State the Innervation and Action of Flexor digiti minimi brevis
Innervation: Ulnar nerve Action: Flexion of MCPJ of little finger
34
State the Origins and Insertion of Palmaris Brevis | A small, thin, superficial muscle overlying the hypothenar eminence
Origins: Palmar aponeurosis, Flexor retinaculum Insertion: Dermis of skin on medial margin of hand
35
State the Innervation and Action of Palmaris Brevis
Innervation: Ulnar nerve Action: Wrinkles the skin of the hyothenar eminence (Deepens the curvature of palm, improving grip)
36
Describe the combined actions of the 4 Lumbricals
Flexion at MCPJ | Extension at IPJ
37
State the Origin, Insertion, Innervation of Lumbrical I Is it Unipennate or Bipennate?
Origin: FDP to index finger Insertion: ED to index finger Innervation: Median nerve Unipennate
38
State the Origin, Insertion, Innervation of Lumbrical II Is it Unipennate or Bipennate?
Origin: FDP to middle finger Insertion: ED to middle finger Innervation: Median nerve Unipennate
39
State the Origin, Insertion, Innervation of Lumbrical III Is it Unipennate or Bipennate?
Origin: FDP to middle and ring finger Insertion: ED to ring finger Innervation: Ulnar nerve Bipennate
40
State the Origin, Insertion, Innervation of Lumbrical IV Is it Unipennate or Bipennate?
Origin: FDP to ring and little finger Insertion: ED to little finger Innervation: Ulnar nerve Bipennate
41
Where are the Interossei located? What are the 2 groups?
Between metacarpals, Dorsal and Palmar
42
What do the Palmar and Dorsal Interossei muscles do?
PAD DAB - Palmar ADduct the fingers - Dorsal ABduct the fingers
43
State the Origin and Insertions of Dorsal Interossei I
Origin: Shaft of metacarpals 1,2 Insertions: Radial aspect of base of proximal phalanx of index finger and extensor expansion
44
State the Innervation and Actions of Dorsal Interossei I
Innervation: Ulnar nerve Actions: Index finger abduction + Assist lumbricals
45
State the Origin and Insertions of Dorsal Interossei II
Origin: Shaft of metacarpals 2,3 Insertions: Radial aspect of base of proximal phalanx of middle finger and extensor expansion
46
State the Innervation and Actions of Dorsal Interossei II
Innervation: Ulnar nerve Actions: Middle finger radial abduction + Assist lumbricals
47
State the Origin and Insertions of Dorsal Interossei III
Origin: Shaft of metacarpals 3,4 Insertions: Ulnar aspect of base of proximal phalanx of middle finger and extensor expansion
48
State the Innervation and Actions of Dorsal Interossei III
Innervation: Ulnar nerve Actions: Middle finger ulnar abduction + Assist lumbricals
49
State the Origin and Insertions of Dorsal Interossei IV
Origin: Shaft of metacarpals 4,5 Insertions: Ulnar aspect of base of proximal phalanx of ring finger and extensor expansion
50
State the Innervation and Actions of Dorsal Interossei IV
Innervation: Ulnar nerve Actions: Ring finger abduction + Assist lumbricals
51
Other than abduct the fingers, what do the Dorsal Interossei do? Are they Bipennate or Unipennate?
They all assist the lumbricals All are Bipennate
52
How many Palmar Interossei are there? Are they Uni or Bipennate
3 (Thumb adduction is done by Adductor pollicis, middle finger moved by Dorsal Interossei 2,3) Unipennate
53
State the Origin and Insertions of the Palmar Interosseus muscle to the Index finger
Origin: Shaft of metacarpal 2 Insertions: Ulnar side of base of proximal phalanx and extensor expansion to index finger
54
State the Innervation and Action of the Palmar Interosseus muscle to the Index finger
Innervation: Ulnar nerve Action: Index finger adduction
55
State the Origin and Insertions of the Palmar Interosseus muscle to the Ring finger
Origin: Shaft of metacarpal 4 Insertions: Radial side of base of proximal phalanx and extensor expansion to ring finger
56
State the Innervation and Action of the Palmar Interosseus muscle to the Ring finger
Innervation: Ulnar nerve Action: Ring finger adduction
57
State the Origin and Insertions of the Palmar Interosseus muscle to the Little finger
Origin: Shaft of metacarpal 5 Insertions: Radial side of base of proximal phalanx and extensor expansion to little finger
58
State the Innervation and Action of the Palmar Interosseus muscle to the Little finger
Innervation: Ulnar nerve Action: Little finger adduction
59
List the muscles in the hand innervated by the Median Nerve
LOAF Lumbricals (I and II, to index and middle fingers) Opponens pollicis Abductor pollicis brevis Flexor pollicis brevis (superficial head)
60
What is the Carpal Tunnel? What structures pass through to enter the palm?
A narrow passage on anterior (Volar/ Palmar) surface of wrist - FPL tendon - FDS tendons (4) - FDP tendons (4) - Median nerve (Tendons to middle and ring finger pass superficial to those to index and little finger)
61
What are the Deep and Superficial borders of the carpal tunnel?
Deep: Carpal bones, which form a concavity Superficial: Flexor retinaculum/ Transverse carpal ligament)
62
What are the Lateral and medial attachments of the flexor retinaculum
Lateral: Scaphoid, Trapezium Medial: Hamate hook, Pisiform
63
What is the surface marking of the proximal border of the flexor retinaculum
The distal wrist crease
64
What is Guyon’s/ ulnar canal? What forms the roof the the canal?
A longitudinal canal in the wrist that allows passage of ulnar nerve and artery into the hand Roof: Palmar carpal ligament (Not the same as the transverse carpal ligament/ flexor retinaculum)
65
Why is the ulnar nerve not involved in carpal tunnel syndrome?
Passes through Guyon’s canal, which is superficial to the Flexor Retinaculum (which is superficial to the carpal tunnel)
66
What is the anatomical snuffbox/ radial fossa?
A triangular depression on the radial aspect of the dorsum of the hand, at the level of the carpal bones
67
What are the 5 borders of the anatomical snuffbox
- Radial/ lateral border - Ulnar/ medial border - Proximal border - Floor - Roof
68
What structures make up the Radial, Ulnar and Proximal borders of the Anatomical Snuffbox
Radial/ Lateral: Tendons of APL (most lateral) and EPB Ulnar/ Medial: Tendon of EPL Proximal: Styloid process of radius
69
What structures make up the Floor and Roof of the Anatomical Snuffbox
Floor: Scaphoid and Trapezium Roof: Skin
70
What are the contents of the Anatomical Snuffbox
Radial artery Superficial branch of radial nerve Cephalic vein
71
Describe the path of the Ulnar artery as it enters the hand to when it reaches the fingers (4 steps)
- Passes through Guyon’s Canal, lying lateral to Ulnar nerve and Pisiform bone - In hand, divides into Deep + Superficial branches - Branches anastomose with corresponding branches of radial artery to form Superficial + Deep Palmar arches - Superficial palmar arch gives off Common Palmar Digital Arteries (Supply fingers)
72
What does the ulnar artery contribute to mainly in most people?
Mainly to Superficial Palmar Arch, and therefore to the fingers’ blood supply
73
Describe the path of the Radial Artery as it enters the hand to the point where the Deep palmar Arch is formed
- Enters hand between tendons of FCR and Brachioradialis - Gives off a superficial branch that anastomoses with superficial ulnar artery branch-> Superficial Palmar Arch - Then passes dorsally to cross floor of the anatomical snuffbox on dorsum of hand, then re-enters palm between 2 heads of adductor pollicis - Radial artery anatostomoses with deep branch of ulnar artery-> Deep Palmar Arch
74
What does the Radial artery contribute to mainly in most people?
Mainly to deep palmar arch, therefore to blood supply of thumb and radial side of index finger
75
With reference to the brachial plexus, why do the Median and Ulnar nerves supply the anterior compartment of the forearm and hand muscles
They come off the anterior divisions
76
Why are the nailbed and dorsal skin overlying the distal phalanges of each finger, innervated by the nerve that innervates the palmar aspect? Explain in 2 steps
- As embryo, fingernails initially develop on the palmar aspect of hand - Are then dragged over to dorsal aspect, taking their nerve supply with them

MSK (21 decks)

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