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Year 2 - T3 Theme 2 > L8 Anatomy of the hand > Flashcards

L8 Anatomy of the hand Flashcards

1
Q

Hand - bone groups

A
  • Carpals
  • Metacarpals
  • Phalanges
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2
Q

Carpal bones

A
  • Scaphoid
  • Lunate
  • Triquetral/triquetrium
  • Pisiform
  • Trapezium
  • Trapezoid
  • Capitate
  • Hamate
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3
Q

Joints of the hand

A
  • Wrist (radiocarpal)
  • Midcarpal/intercarpal
  • Carpometacarpal (saddle joint)
  • Metacarpophalangreal
  • Interphalangeal
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4
Q

Wrist(radiocarpal) joint

A
  • Between radius/disc and first carpal row

- Reinforced by ligaments

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5
Q

Ligaments that reinforce the wrist(radiocarpal) joint

A
  • Ulnar and radial collateral ligaments (limits abduction/adduction)
  • Ligaments on the palmar/dorsal surfaces (limits extension/flexion)
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6
Q

Purpose of radial styloid process

A
  • Limits range of abduction
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7
Q

What does the wrist joint allow for

A
  • Flexion/extension
  • Abduction/adduction
  • Circumduction
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8
Q

Carpometacarpal joints

A
  • Plane joints (limited movement)

- Except for the saddle joint(between trapezium and d1) - enables opposition

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9
Q

Movements of the thumb

A
  • Extension
  • Flexion
  • Abduction
  • Adduction
  • Opposition
  • Reposition
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10
Q

Metacarpophalangeal joints

A

Condylar joints - flexion/extension, abduction/adduction

  • Deep transverse metacarpal ligaments –> unifies metacarpals, not between digit 1 and 2
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11
Q

Interphalangeal joints

A
  • Hinge joints
  • Flexion/extension
  • Proximal and distal interphalangeal joints
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12
Q

Palmar aponeurosis

A
  • Thickened deep fascia
  • Triangular
  • Continuous with palmaris longus
  • Consists of longitudinal and transverse fibres
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13
Q

Clinical relevance of palmar aponeurosis

A
  • Dupuytren’s contracture
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14
Q

Long flexor tendons to digits

A
  • From muscles in anterior forearm

- Pass through carpal tunnel

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15
Q

Flexor retinaculum

A
  • Transverse carpal ligament

- Prevents bowing of tendons

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16
Q

Long flexor tendons associated with each digit

A
  • Flexor digitorum superficialis (d2-5)
  • Flexor digitorum profundus (d2-5)
  • Flexor pollicis longus (d1)
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17
Q

Flexor tendon insertions

A
  • Alternating fibrous annular (A1-A5 pulley’s) and cruciate ligaments
18
Q

Where does flexor digitorum profundus insert

A
  • To base of distal phalanx
19
Q

Where does flexor digitorum superficialis insert

A
  • To base of middle phalanx

- Note the vinculae (attach tendons to phalanges)

20
Q

Long extensor tendons to digits

A

From muscles in posterior forearm

Extensor digitorum, indicis and digit minimi –> d2-5

Extensor pollicis longus, extensor pollicis brevis and abductor pollicis longus –> d1

21
Q

Extensor tendons that go through the anatomical snuff box

A

Abductor pollicis longus - to base of 1st metacarpal

Extensor pollicis brevis - to base of proximal phalanx

Extensor pollicis longus - to base of distal phalanx

22
Q

Which artery goes through the anatomical snuff box

A
  • Radial artery
23
Q

Extensor digitorum insertion

A
  • Medial band (into middle phalanx)

- Lateral band(into distal phalanx)

24
Q

Muscles that insert into the extensor hoods

A
  • Lumbricals and interossei insert into the extensor hoods
25
Q

Lumbricals

A

Link flexor to extensor tendons

  • Extend interphalangeal joints and flex MCP joints
  • Precision grip (hold pen/pinch)
26
Q

Palmar interossei

A

Interossei sit between the metacarpals

27
Q

Where do the palmar interossei muscles run from

A

3 palmar interossei

- Run from the metacarpals to the extensor hoods (d2, d4, d5)

28
Q

Role of palmar interossei muscles

A
  • Palmar adduct (PAD) MCP joints - relative to middle finger (D3)
  • No palmar interossei for D1(performed by adductor pollicis muscle) or D3
29
Q

Where do the dorsal interossei run from

A

4 dorsal interossei

- Run from metacarpals to extensor hoods d2, d3(x2), d4

30
Q

Action of dorsal interossei

A
  • Dorsal abduct (DAB) MCP joints - relative to middle finger (D3)
  • No dorsal interossei for D1 or D5 (performed by thenar and hypothenar muscles)
31
Q

Role of thenar and hypothenar muscles

A

Thenar muscles - fine movements of the thumb (d1)

Hypothenar muscles - fine movements of the little finger (d5)

32
Q

Origin of thenar and hypothenar muscles

A

Thenar muscles - fine movements of the thumb (d1)

Hypothenar muscles - fine movements of the little finger (d5)

33
Q

Thenar muscles

A
  1. Opponens pollicis (deepest) - inserts into first metcarpal
  2. Abductor pollicis brevis
  3. Flexor pollicis brevis - inserts into proximal phalanx
34
Q

Hypothenar muscles

A
  1. Opponens digiti minimi (deepest) - inserts into fifth metacarpal
  2. Abductor digiti minimi
  3. Flexor digiti minimi - inserts into proximal phalanx
35
Q

Adduction of the thumb

A
  • Adductor pollicis
  • Oblique head from the base of 2nd and 3rd metacarpal + carpal bones into proximal phalanx
  • Transverse head -from the 3rd metacarpal into the proximal phalanx
  • Deep to thenar muscles
36
Q

Blood supply to the hand

A

Radial artery - towards dorsal surface
Ulnar artery
- Form complex anastomosis in hand so that blood can reach all parts in hand positions

37
Q

Deep palmar arch

A
  • Below long flexor tendons
  • Radial artery enters between first dorsal interosseous muscle and floor of anatomical snuff box
  • D1 and 1/2 D2 = mainly radial artery
38
Q

Superficial palmar arch

A
  • Above long flexor tendons
  • Ulnar artery
  • Lead to 3 common palmar digital arteries and proper palmar digital arteries
  • 1/2 d2 to d5 = mainly ulnar artery
39
Q

Which nerve passes through carpal tunnel

A

Median

40
Q

Branches of median nerve in hand

A
  • Recurrent branch –> thenar muscles

- Digital nerves –> lateral 2 lumbricals + sensory d1 to 1/2 d4

41
Q

Ulnar nerve branches in hand

A

Deep branch - hypothenar muscles, interossei, medial 2 lumbricals, adductor pollicis

Superficial branch - sensory 1/2 d4 and d5

42
Q

ulnar nerve clinical relevance - hand

A

clawed hand

Year 2 - T3 Theme 2 (17 decks)

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