L9 Surgical and functional anatomy of the hand Flashcards
1
Q
Palmar fascia
A
- Tough layer anchoring skin to skeleton
- Extension of forearm fascia
- Tightened by palmaris longus (apes) - variable in humans
- Dupuytren’s disease
2
Q
Duypuytren’s disease
A
- Thickening of fascia
- Contracture
- Genetic
- Smoking
- Alchohol
- Diabetes/epilepsy
Genetic predisposition is the biggest risk factor
3
Q
Flexor tendons - 2 sets
A
- Superficial/deep
- Single/mass action and nerve supply
- Flexor sheath
- Lumbrical muscles (unique)
- Traumatic rupture
- Trigger fingers
4
Q
Trigger fingers
A
- Catching of tendons at A1 pulley
- Degenerate nodule
- Thickening of sheath
- Overuse
- Degeneration
- Change of direction of tendon
5
Q
Nerve problems
A
- Median and ulnar nerves
- Digital nerves to each finger/thumb
- Dermatomes
- Injury
- Compression neuropathies
6
Q
Median nerve test
A
- Tip of index finger
7
Q
Ulnar nerve test
A
- Tip of little finger
8
Q
Carpal tunnel syndrome
A
- Median nerve compression at wrist
- Osseous/ligamentous tunnel
- Tendons
- Nerves
- Nerve function. 3 of thenar muscles and sensory symptoms in the radial half of the hand
9
Q
Thenar muscles
A
- Abductor brevis
- Opponens
- Flexor brevis
- Adductor (ulnar)
- Fine control
- Species advantage
10
Q
Carpal tunnel signs
A
- Thenar wasting
- Loss of abduction
- Loss of opposition
11
Q
Cubital tunnel syndrome
A
- Ulnar nerve compression at elbow
- Fascial compression at 3 sites
- Nerve only
- Nerve function. forearm and hand muscles, sensory symptoms ulna half of hand
12
Q
Muscles affected by cubital tunnel syndrome
A
- Flexor digiti quinti
- Abductor
- Opponens
- Interossei
- FCU, FDP (m/r/l)
13
Q
Interosseous muscles
A
- Palmar/dorsal
- Insertion to proximal phalanx
- Adduction/abduction
- Insertion to extensor hood
- Interphalangeal extension
- Ulnar nerve
14
Q
Ulnar nerve signs
A
- Wasted hypothenar web spaces
- Paradoxical wasting thenar
- Forearm wasting
- Clawing of digits
15
Q
Extensor tendons
A
- Extend MCP joints of fingers
- Thumb tendons
- Wrist tendons
- Retinaculum
- 12 in all
- Some multistranded (APL/EDC/EDQ)
