HANDS Flashcards
which muscles are in the thenar?
abductor pollicus brevis,
adductor pollicus,
opponens pollicus
what muscles in the hypothenar?
abductor digiti minimi
flexor digiti minimi
palmaris brevis
where do the lumbricals come from?
tendon of flexor digitorum profundus
dorsal interossie does what?
abduction of digits 1-4
which digit is the most mobile component of the hand
D5
both lumbricals and dorsal/palmar interossie insert into the extensor mechanism?
yes
what is the primary extensor of distal and proximal ip joints?
extensor digitorum communis EDC
EDC IS A PROXIMAL EXTENSOR
REMEMER THAT
define the extensor mechanism:
central slip inserts into base of mid. phalanx
interossie & lumbricals go into dorsal apparatus
lumbricals is primary extensor of DIP jt
EDC is primary extensor of PIP jt
which nerve passes through carpel tunnel
median
does the ulnar nerve wrap around the hook of the hamate?
yess
T OR F: median nerve has largest % of pain fibers
true
is the ulnar nerve responsible for fine motor control?
yes
list the steps of digital flexing? (fisting)
EDC extends wrist and MCP
FDC flexes DIP
EDC relaxes, FDS flexes PIP & interossie flex MCP
power grip with full fisting= both from interossie and FDP
what do the interossie do?
extend PIPs
flex MCPs
adduct and abduct digits
what do the lumbricals do
extend DIPs
what does the FDP do
flex DIPs as a group
what does the FDS do
flexes PIP individually
with mallet finger, what fails?
extensor mechanism attaching to DIP , its a distal extensor tendon injury
t or f: if you lose extension of 1 joint youll get flexion?
true
define swan neck deformity
injury to palmar PIP joint (hyperextension)
what is the flexor injury template
3 weeks immobilized, then passive action then active flexion
1) inflammatory stage (0-4days)
2) fibroblastic stage (3-21days) wound care and elevation
3) remodelling phase (3-5 weeks) splints, ROM, NO PÂSSIVE EXTENSION
what Is the one wound scar concept
tissue healing = cross linkages of collagen that hold structures together
low loads and prolonged stretch is best for tendon injuries
true
scars that are warm, moist and have less O2 heal faster true or false
true
define claw hand:
4&5th digits, intrinsic muscles (lumbricals and interossie)
PIP & DIP flexion with MCP extension
ulnar nerve injury
cant abduct & adduct fingers
define ape hand
atrophy to thenar eminence
adduction of thumb towards D2 without ability to oppose
median n injury
extensors take over for flexors
define wrist drop:
radial nerve injury
EDC and extensors are rendered useless
- no muscle pump in hand
elevate to prevent swelling, blood pooling
define dupuytrens disease
contractures in the fascia of hand
develops @ distal palmar crease in line with d4
what is a contracture
tissue stuck in a short position
what is a fasciectomy
having something removed
what are the main movers of joints in the hand
FDP FDS lumbricals interossie EDC
PIP flexion comes from what muscle
FDS !!!
what flexes DIPS as a group
FDP!!
what extends the DIPS
LUMBRICALS
what do lumbricals do
extend pips(lateral bands) flex mcps (saggital bands) adduct and abduct all digits
why are the extensors a more common injury?
they are always exposed , thinner skin
what side of the hand are the annular ligaments on
palmar (volar)
the ulnar nerve innervates what? (responsible for fine motor)
FDP
lumbricals
interossie
which nerve does wrist drop affect
radial
muscles involved in carpal tunnel (median nerve)
FDS , FDP, flexor pollicus longus
the FDS inserts on both sides of the phalanx
yessss
is the FDP deep to the FDS
yes
where does the FDP insert
distal phalanx
what joints does the EDC act on
PIP
MCP
radiocarpal joint
lumbricals come from the FDP
yes
what hand condition would affect the ulnar nerve
claw hand
what hand condioiton would affect the radial nerve
wrist drop
what hand condition would affect the median nerve
ape hand (extensors take over for flexors)
when a flexor is contracting an extensor is being stretched
yes
what is the most mobile component of the hand
D5
which muscles in the posterior compartment of the hand:
starting radial side: ABL,EPB,ECRL,ECRB,EPL,EIP,EDC,EDM,ECU
