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MSK > Hand+ Wrist Anatomy > Flashcards

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
Q

State the Origins (2 heads) and Insertion of Adductor pollicis

A

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)

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26
Q

State the Innervation and Action of Adductor pollicis

A

Innervation: Ulnar nerve

Action: Thumb adduction (Both palmar and radial)

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27
Q

Which structure are the Hypothenar muscles responsible for?

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

A

Hypothenar Eminence (Muscular prominence on ulnar aspect of palm)

Opponens digit minimi

Is deeper to other 2 (ADM, FDMB)

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28
Q

State the Origins and Insertion of Opponens digiti minimi

A

Origins: Hamate hook, Flexor retinaculum

Insertion: Ulnar aspect of metacarpal 5

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29
Q

State the Innervation and Action of Opponens digiti minimi

A

Innervation: Ulnar nerve

Action: Little finger opposition against thumb (rotates metacarpal 5 towards palm)

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30
Q

State the Origins and Insertion of Abductor digiti minimi

A

Origins: Pisiform, tendon o FCU

Insertion: Base of proximal phalanx of little finger

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31
Q

State the Innervation and Action of Abductor digiti minimi

A

Innervation: Ulnar nerve

Action: Little finger abduction

32
Q

State the Origins and Insertion of Flexor digiti minimi brevis

A

Origins: Hamate hook, Flexor retinaculum

Insertion: Base of proximal phalanx of little finger

33
Q

State the Innervation and Action of Flexor digiti minimi brevis

A

Innervation: Ulnar nerve

Action: Flexion of MCPJ of little finger

34
Q

State the Origins and Insertion of Palmaris Brevis

A small, thin, superficial muscle overlying the hypothenar eminence

A

Origins: Palmar aponeurosis, Flexor retinaculum

Insertion: Dermis of skin on medial margin of hand

35
Q

State the Innervation and Action of Palmaris Brevis

A

Innervation: Ulnar nerve

Action: Wrinkles the skin of the hyothenar eminence (Deepens the curvature of palm, improving grip)

36
Q

Describe the combined actions of the 4 Lumbricals

A

Flexion at MCPJ

Extension at IPJ

37
Q

State the Origin, Insertion, Innervation of Lumbrical I

Is it Unipennate or Bipennate?

A

Origin: FDP to index finger
Insertion: ED to index finger
Innervation: Median nerve

Unipennate

38
Q

State the Origin, Insertion, Innervation of Lumbrical II

Is it Unipennate or Bipennate?

A

Origin: FDP to middle finger
Insertion: ED to middle finger
Innervation: Median nerve

Unipennate

39
Q

State the Origin, Insertion, Innervation of Lumbrical III

Is it Unipennate or Bipennate?

A

Origin: FDP to middle and ring finger
Insertion: ED to ring finger
Innervation: Ulnar nerve

Bipennate

40
Q

State the Origin, Insertion, Innervation of Lumbrical IV

Is it Unipennate or Bipennate?

A

Origin: FDP to ring and little finger
Insertion: ED to little finger
Innervation: Ulnar nerve

Bipennate

41
Q

Where are the Interossei located? What are the 2 groups?

A

Between metacarpals, Dorsal and Palmar

42
Q

What do the Palmar and Dorsal Interossei muscles do?

A

PAD DAB

  • Palmar ADduct the fingers
  • Dorsal ABduct the fingers
43
Q

State the Origin and Insertions of Dorsal Interossei I

A

Origin: Shaft of metacarpals 1,2

Insertions: Radial aspect of base of proximal phalanx of index finger and extensor expansion

44
Q

State the Innervation and Actions of Dorsal Interossei I

A

Innervation: Ulnar nerve

Actions: Index finger abduction + Assist lumbricals

45
Q

State the Origin and Insertions of Dorsal Interossei II

A

Origin: Shaft of metacarpals 2,3

Insertions: Radial aspect of base of proximal phalanx of middle finger and extensor expansion

46
Q

State the Innervation and Actions of Dorsal Interossei II

A

Innervation: Ulnar nerve

Actions: Middle finger radial abduction + Assist lumbricals

47
Q

State the Origin and Insertions of Dorsal Interossei III

A

Origin: Shaft of metacarpals 3,4

Insertions: Ulnar aspect of base of proximal phalanx of middle finger and extensor expansion

48
Q

State the Innervation and Actions of Dorsal Interossei III

A

Innervation: Ulnar nerve

Actions: Middle finger ulnar abduction + Assist lumbricals

49
Q

State the Origin and Insertions of Dorsal Interossei IV

A

Origin: Shaft of metacarpals 4,5

Insertions: Ulnar aspect of base of proximal phalanx of ring finger and extensor expansion

50
Q

State the Innervation and Actions of Dorsal Interossei IV

A

Innervation: Ulnar nerve

Actions: Ring finger abduction + Assist lumbricals

51
Q

Other than abduct the fingers, what do the Dorsal Interossei do?

Are they Bipennate or Unipennate?

A

They all assist the lumbricals

All are Bipennate

52
Q

How many Palmar Interossei are there?

Are they Uni or Bipennate

A

3 (Thumb adduction is done by Adductor pollicis, middle finger moved by Dorsal Interossei 2,3)

Unipennate

53
Q

State the Origin and Insertions of the Palmar Interosseus muscle to the Index finger

A

Origin: Shaft of metacarpal 2

Insertions: Ulnar side of base of proximal phalanx and extensor expansion to index finger

54
Q

State the Innervation and Action of the Palmar Interosseus muscle to the Index finger

A

Innervation: Ulnar nerve

Action: Index finger adduction

55
Q

State the Origin and Insertions of the Palmar Interosseus muscle to the Ring finger

A

Origin: Shaft of metacarpal 4

Insertions: Radial side of base of proximal phalanx and extensor expansion to ring finger

56
Q

State the Innervation and Action of the Palmar Interosseus muscle to the Ring finger

A

Innervation: Ulnar nerve

Action: Ring finger adduction

57
Q

State the Origin and Insertions of the Palmar Interosseus muscle to the Little finger

A

Origin: Shaft of metacarpal 5

Insertions: Radial side of base of proximal phalanx and extensor expansion to little finger

58
Q

State the Innervation and Action of the Palmar Interosseus muscle to the Little finger

A

Innervation: Ulnar nerve

Action: Little finger adduction

59
Q

List the muscles in the hand innervated by the Median Nerve

A

LOAF

Lumbricals (I and II, to index and middle fingers)
Opponens pollicis
Abductor pollicis brevis
Flexor pollicis brevis (superficial head)

60
Q

What is the Carpal Tunnel?

What structures pass through to enter the palm?

A

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
Q

What are the Deep and Superficial borders of the carpal tunnel?

A

Deep: Carpal bones, which form a concavity

Superficial: Flexor retinaculum/ Transverse carpal ligament)

62
Q

What are the Lateral and medial attachments of the flexor retinaculum

A

Lateral: Scaphoid, Trapezium
Medial: Hamate hook, Pisiform

63
Q

What is the surface marking of the proximal border of the flexor retinaculum

A

The distal wrist crease

64
Q

What is Guyon’s/ ulnar canal?

What forms the roof the the canal?

A

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
Q

Why is the ulnar nerve not involved in carpal tunnel syndrome?

A

Passes through Guyon’s canal, which is superficial to the Flexor Retinaculum

(which is superficial to the carpal tunnel)

66
Q

What is the anatomical snuffbox/ radial fossa?

A

A triangular depression on the radial aspect of the dorsum of the hand, at the level of the carpal bones

67
Q

What are the 5 borders of the anatomical snuffbox

A
  • Radial/ lateral border
  • Ulnar/ medial border
  • Proximal border
  • Floor
  • Roof
68
Q

What structures make up the Radial, Ulnar and Proximal borders of the Anatomical Snuffbox

A

Radial/ Lateral: Tendons of APL (most lateral) and EPB

Ulnar/ Medial: Tendon of EPL

Proximal: Styloid process of radius

69
Q

What structures make up the Floor and Roof of the Anatomical Snuffbox

A

Floor: Scaphoid and Trapezium

Roof: Skin

70
Q

What are the contents of the Anatomical Snuffbox

A

Radial artery
Superficial branch of radial nerve
Cephalic vein

71
Q

Describe the path of the Ulnar artery as it enters the hand to when it reaches the fingers (4 steps)

A
  • 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
Q

What does the ulnar artery contribute to mainly in most people?

A

Mainly to Superficial Palmar Arch, and therefore to the fingers’ blood supply

73
Q

Describe the path of the Radial Artery as it enters the hand to the point where the Deep palmar Arch is formed

A
  • 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
Q

What does the Radial artery contribute to mainly in most people?

A

Mainly to deep palmar arch, therefore to blood supply of thumb and radial side of index finger

75
Q

With reference to the brachial plexus, why do the Median and Ulnar nerves supply the anterior compartment of the forearm and hand muscles

A

They come off the anterior divisions

76
Q

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

A
  • 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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