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Human Structure - Block 1 > HS1-11 Wrist Hand > Flashcards

HS1-11 Wrist Hand Flashcards

1
Q

The radiocarpal joint allows what movements?

A

flexion; extension; abduction; adduction

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2
Q

What kind of joint is the radiocarpal joint?

A

condyloid (ellipsoid-type) joint

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3
Q

**Label the following diagram of the anterior forearm/wrist.

A

anterior forearm/wrist

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4
Q

**Label the following diagram of the posterior forearm/wrist.

A

posterior forearm/wrist

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5
Q

**Label the following diagram of superficial wrist structures.

A

superficial wrist structures

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6
Q

Which structures pass through the carpal tunnel/flexor retinaculum?

A

flexor pollicis longus, flexor digitorum superficialis, flexor digitorum profundus

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7
Q

Contrast the flexor retinaculum and the extensor retinaculum.

A

extensor retinaculum is thinner, broader, and longer than flexor retinaculum

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8
Q

Which structure is most medial in all of the wrist?

A

flexor carpi ulnaris

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9
Q

Which structures form the outline of the anatomical snuffbox?

A

abductor pollicis longus; extensor pollicis longus; extensor pollicis brevis

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10
Q

Which vascular structure passes through the anatomical snuff box?

A

radial artery

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11
Q

What general groups of muscles are found in the three layers of the hand?

A

deepest layer - interosseous muscles; middle layer - long flexor tendons and lumbrical muscles; superficial layer - palmar aponeurosis

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12
Q

The flexor retinaculum is attached to what bones of the hand?

A

scaphoid and trapezium

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13
Q

Differentiate between the median and ulnar nerve in the context of the flexor retinaculum.

A

median nerve passes THROUGH flexor retinaculum, but ulnar nerve passes superficial to flexor retinaculum

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14
Q

What systems support the palmar concavity of the hand?

A

two transverse and one longitudinal arch systems (3 total)

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15
Q

The proximal transverse arch of the hand is formed by

A

distal row of carpal bones

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16
Q

Describe the properties of the proximal transverse arch.

A

static and rigid; forms carpal tunnel along with flexor retinaculum

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17
Q

What is the keystone structure of the proximal transverse arch of the hand?

A

capitate bone

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18
Q

The distal transverse arch of the hand is formed by

A

MP joints

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19
Q

Describe the properties of the distal transverse arch.

A

concavity of the distal transverse arch, unlike proximal transverse arch, can change

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20
Q

What is the keystone structure of the distal transverse arch of the hand?

A

second and third carpometacarpal joints

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21
Q

The longitudinal transverse arch is formed by

A

metacarpals and phalanges of 2nd and 3rd digits

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22
Q

What is the keystone structure of the longitudinal transverse arch?

A

metacarpophalangeal joints of the 2nd and 3rd digits

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23
Q

The first metacarpal joint of the hand can undergo what kinds of motion?

A

abduction, adduction, flexion, extension

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24
Q

What kind of joint is the carpometacarpal joint of the thumb?

A

saddle-shaped joint

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25
Q

What kind of joints are the metacarpophalangeal joints?

A

condylar biaxial joints (knuckle joints)

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26
Q

What kind of joints are the proximal interphalangeal joints?

A

uniaxial hinge joints

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27
Q

What kind of joints are the distal interphalangeal joints?

A

uniaxial hinge joints

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28
Q

What are the 4 thenar muscles?

A

abductor pollicis brevis; opponens pollicis; flexor pollicis brevis; adductor pollicis

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29
Q

**Label the following diagram of deep-layer hand muscles.

A
30
Q

What are the 4 hypothenar muscles?

A

palmaris brevis; abductor digiti minimi; flexor digiti minimi brevis; opponens digiti minimi

31
Q

Where, in terms of depth, are the lumbrical muscles of the hand found?

A

found in an intermediate layer between the palmar aponeurosis and deepest layer containing interosseous muscles

32
Q

Where are the interossei of the hand found?

A

deepest layer and fill spaces between metacarpals

33
Q

The intrinsic muscles of the hand are primarily innervated by what nerve?

A

by the ulnar nerve, with the exception of the LOAF muscles

34
Q

What nerve innervates the LOAF muscles?

A

(recurrent + digital) branches of the median nerve

35
Q

What are the LOAF muscles?

A

lateral two lumbricals; opponens pollicis; abductor pollicis brevis; flexor pollicis brevis

36
Q

What specific nerve innervates the three thenar muscles that comprise part of the LOAF muscles?

A

recurrent branch of the median nerve

37
Q

What specific nerve innervates the two lateral lumbrical muscles that comprise part of the LOAF muscles?

A

digital branch of the median nerve

38
Q

Which muscles are responsible for flexion of the fingers?

A

flexor digitorum profundus (primarily DIP but also PIP and MP); flexor digitorum sperficialis (primarily PIP but also MP); lumbricals (flex MP); palmar/dorsal interossei (flex MP)

39
Q

What is the extensor expansion (a.k.a. extensor hood)?

A

aponeurosis on dorsal side of digits formed by tendons of extensor digitorum, interossei, and lumbricals

40
Q

Which two muscles groups are responsible for extension of the fingers?

A

long extensor group; short muscle group

41
Q

The long extensor group is responsible for extension at what hand joints?

A

produce extension at MP, PIP and DIP joints

42
Q

Which muscles make up the long extensor group of the hand?

A

extensor digitorum; extensor indicis; extensor digitorum minimi

43
Q

Which muscle extends the 5th digit?

A

extensor digitorum minimi

44
Q

The short muscle group is responsible for extension at what hand joints?

A

PIP and DIP joints

45
Q

Which muscles make up the short muscle group of the hand?

A

lumbricals; palmar/dorsal interossei

46
Q

Abduction and adduction of the digits take place at what joint?

A

MP joints

47
Q

Which muscles are associated with abduction of the digits?

A

dorsal interossei; abductor digiti minimi (DAB)

48
Q

Which muscles are associated with adduction of the digits?

A

palmar interossei; adductor pollicis (PAD)

49
Q

Which muscles are responsible for flexion of the 5th digit?

A

flexor digiti minimi brevis; abductor digiti minimi (acting at MP joint)

50
Q

Which muscles are responsible for opposition of the 5th digit?

A

opponens digiti minimi

51
Q

Distinguish between the superficial and deep palmar arches in terms of contributions from the radial and ulnar arteries.

A

superficial arch is mainly formed by ulnar artery; deep arch is mainly formed by radial artery

52
Q

How does the median nerve enter the hand?

A

through the carpal tunnel

53
Q

Describe how the median nerve branches after crossing the carpal tunnel.

A

branches into recurrent branch (supplying thenar eminence) and common palmar digital nerves (digits 1-4)

54
Q

How does the ulnar nerve enter the hand?

A

lateral side of pisiform bone, along with ulnar artery

55
Q

Describe how the ulnar nerve branches in the hand.

A

branches while in ulnar canal, forming superficial branch (cutaneous to medial 1.5 fingers) and deep branch (motor function to hypothenar, interossei, medial 2 lumbricals, and adductor pollicis)

56
Q

Describe the cutaneous innervation of the hand supplied by the median nerve.

A

palm + first 3.5 fingers, along with fingertips of these fingers on dorsal side

57
Q

Describe the cutaneous innervation of the hand supplied by the ulnar nerve.

A

palm + [digit 4 + half of digit 5 (palmar + dorsal side)]

58
Q

Describe the cutaneous innervation of the hand supplied by the radial nerve.

A

dorsum of hand for the first 3.5 fingers except for their fingertips

59
Q

**Label the following diagram showing cutaneous innervation of the hand.

A
60
Q

What are the clinical presentations (relating to the hand) of a radial nerve injury resulting from a midshaft/spiral fracture?

A

wrist drop (inability to extend the wrist) because of paralysis of the extensor muscles of the forearm

61
Q

What is the characteristic feature of an ulnar nerve lesion?

A

“claw hand” posture, because of hyperextension of the MP joints resulting from loss of the interossei to oppose the extension

62
Q

What are the four most common sites of ulnar nerve lesions?

A

posterior to medial epicondyle of humerus; within cubital tunnel; anterior crossing of ulnar nerve @ wrist; in ulnar canal

63
Q

How does one test for palmar interossei (ulnar nerve) function?

A

subject asked to hold sheet/bill between fingers and prevent examiner from extracting sheet/bill

64
Q

How does one test for dorsal interossei (ulnar nerve) function?

A

examiner places subject’s abducted fingers between their own thumb and index finger, and subject is asked to adduct fingers against thumb/index finger resistance

65
Q

What are the two main categories of median nerve lesions?

A

proximal and distal lesions

66
Q

How do proximal median nerve lesions occur?

A

fracture of dislocation of elbow; entrapment of median nerve between the two heads of the pronator teres

67
Q

How do distal median nerve lesions occur?

A

lacerations of distal forearm/anterior wrist because of median nerve’s superficial location

68
Q

Chronic compression of the median nerve at the wrist can result in

A

carpal tunnel syndrome

69
Q

What are the clinical manifestations of a proximal median nerve lesion?

A

hand of benediction, resulting from loss of thumb opposition

70
Q

What are the clinical manifestations of a distal median nerve lesion?

A

thenar atrophy; sensory disturbances to palm/thumb/fingers

71
Q

What are the contents of the anatomical snuffbox?

A

radial artery; trapezium; scaphoid

72
Q

What is the most common snuffbox injury?

A

scaphoid fracture, which can damage the radial artery and lead to avascular necrosis of the bone

Human Structure - Block 1 (14 decks)

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