Hands Flashcards

1
Q

Proximal row of carpal bones

A
Lateral to medial when viewed anteriorly
Scaphoid 
Lunate
Triquetrum
Pisiform (sesamoid bone in FCU - articulates with anterior surface of triquetrum)

Scaphoid and lunate articulate with radius to form wrist joint

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2
Q

Distal row of carpal bones

A
Lateral to medial when viewed anteriorly
Trapezium - articulates with metacarpal of thumb
trapezoid
capitate - largest of carpal bones
hamate
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3
Q

Carpal tunnel borders

A

lateral - scaphoid and trapezium
medial - pisiform and hook of hamate
Anterior - flexor retinaculum

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4
Q

Wrist joint

A

Synovial joint between distal end of radius and ulna and scaphoid lunate and triquetrum

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5
Q

Contents of carpal tunnel

A
4 tendons of FDP
4 tendons of FDS
Tendon of FPL 
Median nerve (anterior to tendons)

FCR passes through flexor retinaculum
ulnar artery, ulnar nerve and palmaris longus passes anterior to flexor retinaculum

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6
Q

Extensors at wrist

A

Posterior surface has 6 compartments defined by an extensor retinaculum
ECU and EDM have their own synovial sheaths
ED and EI share a synovial sheath on posterior surface of wrist

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7
Q

palmar aponeurosis

A

apex continuous with palmaris longus

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8
Q

Palmaris brevis

A

Overlies the hypothenar muscle, ulnar artery and superficial branch of the ulnar nerve at medial side of palm.
Innervated by superficial branch of ulnar nerve

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9
Q

Anatomical snuffbox

A

Medial border - EPL
lateral border - APL and EPB
Floor - scaphoid and trapezium + distal ends of ECRL and ECRB

Radial artery passes through deep to extensor tendons of thumb

Terminal parts of superficial branch of radial nerve + origin of cephalic vein passes subcutaneously over snuffbox

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10
Q

Intrinsic muscles of hands

A
Palmaris brevis
Interossei
Adductor pollicis - radial artery comes out anteromedially between the two heads to form deep palmar arch
Hypothenar
Thenar 
Lumbricals

All innervated by deep branch of ulnar nerve

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11
Q

Interossei

A

Between and attached to metacarpals
Insert into proximal phalanx of each digit and into extensor hood.

Radial artery pass between two heads of first dorsal interossei

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12
Q

Thenar muscles

A

Opponens pollicis
Abductor pollicis brevis
Flexor pollicis brevis

All originate from tubercle of trapezium
All innervated by recurrent branch of median nerve
Opponens pollicis deep to the other 2
APB is proximal to FPB, both insert onto extensor hood of thumb

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13
Q

Hypothenar muscles

A

Flexor digiti minimi brevis
Opponens digiti minimi
Abductor digiti minimi

Opponens lies deep to the other 2. Base is penetrated by deep branch of ulnar nerve and ulnar artery
ADM is medial to FDMB

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14
Q

Lumbricals

A

Medial 2 are bipennate
lateral 2 are unipennate
Pass dorsally around lateral side of each finger and insert into extensor hood.
Tendons are anterior to deep transverse metacarpal ligaments

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15
Q

Arteries to hands

A

Radial artery - thumb and lateral side of index finger

Ulnar artery - remaining digits and medial side of index

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16
Q

Ulnar artery

A

Lies between palmaris brevis and flexor retinaculum and is lateral to ulnar nerve and pisiform bone.
Forms superficial palmar arch (superficial to long flexor tendons of digits and just deep to palmar aponeurosis)

Branches into deep palmar arch and anatastomose with deep palmar arch derived from radial artery

17
Q

Radial artery

A

Passes between 2 heads of 1st dorsal interosseous and then 2 heads of adductor pollicis to form deep palmar arch

18
Q

Ulnar nerve

A

Divides into deep branch (mainly motor) and superficial branch (mainly sensory) distal to pisiform
Lateral to pisiform and medial to ulnar artery when it enters hand

Deep branch of ulnar nerve lies in Guyon’s canal between hook of hamate and flexor tendons.

Superficial branch of ulnar nerve supplies palmaris brevis and cutaneous to medial half of hand

19
Q

How to distinguish damage to ulnar nerve at wrist or site proximal to wrist

A

Evaluate function of dorsal branch of ulnar nerve, which supplies dorsal surface of medial side of hand. As this branches from distal regions in forearm.

20
Q

Median nerve

A

After carpal tunnel branches into recurrent branch and palmar digital branches (superficial to flexor retinaculum)

Recurrent - three thenar muscles. Passes between PFB and APB.
Palmar digital - Cutaneous and lateral two lumbricals

21
Q

Radial nerve in hand

A

Only part of radial nerve that enters hand is superficial branch. Passes over anatomical snuffbox.
Cutaneous supply