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Anatomy Exam 2: Lectures 8-15 > Lecture 13: Hand > Flashcards

Lecture 13: Hand Flashcards

1
Q

What does the radial nerve supply in the hand?

A

no muscles, only sensory

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2
Q

What does the palmar cutaneous branch of the median nerve supply?

A

central palm

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3
Q

Where does the palmar cutaneous branch of the median nerve arise from?

A

proximal to the flexor retinaculum

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4
Q

Where does the palmar cutaneous branch of the median nerve pass?

A

superficial to the flexor retinaculum

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5
Q

Where does the palmar cutaneous branch of the ulnar nerve arise from?

A

proximal to wrist

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6
Q

Where does the palmar cutaneous branch of the ulnar nerve pass?

A

superficial to flexor retinaculum and palmar aponeurosis

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7
Q

What does the palmar cutaneous branch of the ulnar nerve supply?

A

medial side of palm

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8
Q

What type of joint is the carpometacarpal joints

A

plane synovial

saddle joint between metacarpus and trapezium

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9
Q

What is the motion for the carpometacarpal joints for digits 2-3?

A

almost none

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10
Q

What is the motion for the carpometacarpal joints for digit 4?

A

limited

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11
Q

What is the motion for the carpometacarpal joints for digit 5?

A

more mobile: abduction/adduction
flexion/extension
circumduction/opposition

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12
Q

What is the vascularization of the carpometacarpal joints?

A

arterial anastomoses of dorsal and palmar carpal arches, deep palmar arch, and metacarpal arteries

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13
Q

What is the innervation of the carpometacarpal joints?

A

anterior interosseous branch of median nerve, posterior interosseous branch of radial nerve and dorsal/deep branches of ulnar nerve

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14
Q

What type of joint is the metacarpophalangeal joint?

A

condyloid synovial joints

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15
Q

What movement does the metacarpophalangeal joint do?

A

flexion/extension
abduction/adduction
some opposition at MCP 5

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16
Q

What capsular ligaments do the metacarpophalangeal joint have?

A

palmar ligaments

collaterals

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17
Q

What is the vascularization of the metacarpophalangeal joint?

A

deep digital arteries from superficial palmar arch

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18
Q

What is the innervation of metacarpophalangeal joint

A

digital nerves from ulnar and median nerves

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19
Q

Collateral ligaments are _____ during extension, ____ during flexion

A

slack; taut

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20
Q

What type of joint is the interphalangeal joint?

A

synovial hinge joint

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21
Q

What is the motion of interphalangeal joint?

A

flexion/extension

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22
Q

What are the ligaments of the interphalangeal joint?

A

strong collateral

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23
Q

What are the types of interphalangeal joints?

A

proximal interphalangeal joints (PIPs)

distal interphalangeal joints (DIPs)

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24
Q

What is the vascularization of the interphalangeal joint?

A

deep Digital arteries from superficial palmar arch

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25
Q

What is the innervation of the interphalangeal joint?

A

digital nerves from ulnar and median nerves

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26
Q

What is the palmar aponeurosis?

A

triangular layer of deep fascia located between two eminences

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27
Q

What does the palmar aponeurosis do?

A

provides protection for superficial vessels, nerves, and tendons

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28
Q

What is the palmar aponeurosis anchored to?

A

skin and flexor retinaculum

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29
Q

What does the flexor retinaculum attach to laterally?

A

tubercles of scaphoid and trapezium

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30
Q

What does the flexor retinaculum attach to medially?

A

hook of hamate and pisiform

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31
Q

palmaris brevis origin

A

flexor retinaculum and palmar aponeurosis

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32
Q

palmaris brevis insertion

A

skin on medial side of palm

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33
Q

palmaris brevis action

A

tenses skin on palm

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34
Q

What are the contents of the carpal tunnel?

A

long flexor tendons of:
flexor digitorum superficialis and profundus
flexor pollicis longus

median nerve

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35
Q

What do the ulnar nerve and artery pass through?

A

Guyon’s canal

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36
Q

Where is the thenar space?

A

located between palmar side of the adductor pollicis muscle and the long flexor tendons to the index finger and the thumb

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37
Q

Where is the midpalmar space?

A

located between metacarpals 4-5 and long flexor tendons to digits 4-5

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38
Q

Extensor indicis proximal attachment

A

posterior surface of distal 1/3 of ulna and interosseous membrane

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39
Q

Extensor indicis distal attachment

A

extensor expansion of second finger (index finger)

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40
Q

Extensor indicis actions

A

independent extension of 2nd finger but also helps with extension of the wrist

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41
Q

Extensor indicis blood supply

A

posterior interosseous artery and perforating branch of anterior interosseous artery

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42
Q

Extensor indicis innervation

A

posterior interosseous nerve (C7, 8)

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43
Q

What are the muscles of the thenar eminence?

A

abductor pollicis brevis
flexor pollicis brevis
opponent pollicis

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44
Q

What is the innervation of the thenar eminence?

A

recurrent branch of median nerve (C8, T1)

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45
Q

Adductor pollicis innervation

A

deep branch of ulnar nerve (C8, T1)

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46
Q

Opponens pollicis proximal attachment

A

flexor retinaculum and tubercles of scaphoid and trapezium

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47
Q

Opponens pollicis distal attachment

A

lateral side of 1st metacarpal

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48
Q

Opponens pollicis actions

A

oppose thumb and medially rotate 1st metacarpal

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49
Q

Opponens pollicis blood supply

A

radial artery

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50
Q

Opponens pollicis innervation

A

recurrent branch of median nerve (c8, T1)

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51
Q

Abductor pollicis brevis proximal attachment

A

flexor retinaculum and tubercles of scaphoid and trapezium

52
Q

Abductor pollicis brevis distal attachment

A

lateral side of base of proximal phalanx of thumb

53
Q

Abductor pollicis brevis actions

A

abduct thumb, aid in opposition

54
Q

Abductor pollicis brevis innervation

A

recurrent branch of median nerve (C8, T1)

55
Q

Flexor pollicis brevis origin

A

flexor retinaculum and tubercles of scaphoid and trapezium

56
Q

Flexor pollicis brevis insertion

A

lateral side of base of proximal phalanx of thumb

57
Q

Flexor pollicis brevis actions

A

flexes thumb

58
Q

Flexor pollicis brevis blood supply

A

radial artery

59
Q

Flexor pollicis brevis innervation

A

superficial head: recurrent branch of median nerve (c8, T1) and deep head: deep branch of ulnar nerve (C8, T1)

60
Q

Adductor pollicis origin

A

bases of second and third metacarpals (oblique head)

capitate, and adjacent carpals (transverse head)

61
Q

Adductor pollicis insertion

A

medial side of base of proximal phalanx of thumb

62
Q

Adductor pollicis action

A

adducts thumb toward lateral border of palm

63
Q

Adductor pollicis blood supply

A

radial artery

64
Q

Adductor pollicis innervation

A

deep branch of ulnar nerve (C8, T1)

65
Q

Muscles of hypothenar eminence

A

abductor digiti minimi
flexor digiti minimi brevis
opponens digiti minimi

66
Q

innervation of hypothenar eminence

A

ulnar nerve

67
Q

Abductor digiti minimi origin

68
Q

Abductor digiti minimi insertion

A

medial side of base of proximal phalanx of fifth digit

69
Q

Abductor digiti minimi actions

A

abducts fifth digit, aids in flexion of with proximal phalanx

70
Q

Abductor digiti minimi blood supply

A

ulnar artery

71
Q

Abductor digiti minimi innervation

A

deep branch of ulnar nerve (c8, T1)

72
Q

Flexor digiti minimi brevis origin

A

hook of hamate and flexor retinaculum

73
Q

Flexor digiti minimi brevis insertion

A

medial side of base of proximal phalanx of fifth digit

74
Q

Flexor digiti minimi brevis actions

A

flexes proximal phalanx of fifth digit

75
Q

Flexor digiti minimi brevis blood supply

A

ulnar artery

76
Q

Flexor digiti minimi brevis innervation

A

deep branch of ulnar nerve, C8 and T1

77
Q

Opponens digiti minimi origin

A

hook of hamate and flexor retinaculum

78
Q

Opponens digiti minimi insertion

A

medial border of 5th metacarpus

79
Q

Opponens digiti minimi actions

A

brings fifth metacarpal anterior and rotates it to bring it into opposition with thumb

80
Q

Opponens digiti minimi blood supply

A

ulnar artery

81
Q

Opponens digiti minimi innervation

A

ulnar nerve deep branch, C8, T1

82
Q

What does the flexor digitorum superficialis do?

A

flexes PIP and MCP and wrist

83
Q

Each tendon of the flexor digitorum superficialis does what?

A

passes through fibrous flexor sheath
bifurcates opposite proximal phalanx
inserts on middle phalanx

84
Q

What does the flexor digitorum profundus do?

A

flexes DIP and PIP and MCP

85
Q

Each tendon of the flexor digitorum profundus inserts on what?

A

distal phalanx

86
Q

What are vinculae?

A

small vascular bundles connecting palmar surface of phalanges with long flexor tendons

87
Q

Dorsal interossei (DAB) are what?

A

four bipinnate muscles

88
Q

Where does DAB arise from?

A

via two heads from adjacent sides of two metacarpals

89
Q

What is the insertion of DAB?

A

onton extensor expansions and radial sides of proximal phalanges 2 and 3
ulnar sides of proximal phalanges 3 and 4

90
Q

Action of DAB?

A

abduct MP joints of digits 2-4

91
Q

What innervates all interossei?

A

ulnar nerve

92
Q

What are palmar interssei (PAD)?

A

four unipennate muscles

93
Q

What do PAD supply?

A

each digit except for third

94
Q

Where does PAD insert?

A

onto ulnar sides of proximal phalanges 1 and 2

onto radial rides of proximal phalanges 4 and 5

95
Q

PAD action

A

adduct MP joints of digits 1,2,4,5

96
Q

What are the lumbricals?

A

four small, narrow, elongated muscles

97
Q

Where do the lumbricalls arise from?

A

radial side of flexor digitorum profundus tendon

98
Q

Lumbricalls innervation

A

two on radial side: median nerve

two on ulnar side: ulnar nerve

99
Q

Lumbricalls action

A

flex MCP and extend IP joints

100
Q

Where are the 1st and 2nd lumbricals attached?

A

lateral 2 tendons of FDP

101
Q

What innervates the 1st and 2nd lumbricals?

A

median nerve (C8, T1)

102
Q

Blood supply of the 1st and 2nd lumbricals?

A

radials indicis artery (radial artery) and superficial palmar arch (ulnar artery)

103
Q

third and fourth lumbrical attachments

A

medial 3 tendons of FDP

104
Q

third and fourth lumbrical innervation

A

deep branch of ulnar nerve (C8, T1)

105
Q

third and fourth lumbrical blood supply

A

superficial palmar arch (ulnar artery) and dorsal carpal arch (ulnar and radial arteries)

106
Q

Where do lumbricals insert?

A

lateral sides of the extensor expansions of digits 2-5

107
Q

What is the arterial supply to the dorsum of the hand?

A

dorsal arterial arch from radial and ulnar arteries
dorsal metacarpal arteries
dorsal digital arteries

108
Q

What is the venous drainage for the dorsum of the hand?

A

dorsal venous arch
medially drains into basilic
laterally drains into cephalic

109
Q

What is the lymphatic drainage of the dorsum of the hand?

A

medial via lymph vessels accompanying basilic vein to supratrochearl nodes to lateral axillary nodes

110
Q

The superficial palmar arch is a continuation of the _____ and the deep palmar arch is a continuation of the ______

A

ulnar artery; radial artery

111
Q

Ulnar nerve enters hand _____ to flexor retinaculum

A

superficial

112
Q

The superficial branch of the ulnar nerve supplies a muscular branch to

A

palmaris brevis

113
Q

Deep branch of ulnar nerve supplies what?

A

hypothenar muscles, all interossei, two ulnar side lumbricals, and adductor pollicis

114
Q

Median nerve enters palm ____ to flexor retinaculum

115
Q

Lateral branch of median nerve goes to what?

A

thenar muscles and first lumbrical

116
Q

Medial branch of median nerve goes to what?

A

second lumbrical

117
Q

What is mallet finger?

A

avulsion by long extensor tendon resulting in hyper flexion of DIP

118
Q

What is Dupuytren’s contracture?

A

progressive fibrosis of palmar aponeurosis

results in marked flexion of fingers at MP joints

119
Q

What is Colle’s fracture?

A

fracture in the distal end of the radius

more common in persons over the age of 50

120
Q

What is fracture of the scaphoid?

A

most commonly fractured carpal bone

typically occurs at waist

121
Q

What happens in median nerve injury?

A

loss of thumb opposition
atrophy of thenar muscles
ape hand

122
Q

What happens in ulnar nerve injury?

A

paralysis and atrophy of interossei muscles
loss of thumb adduction
claw hand

123
Q

What are the components to the extensor mechanism?

A

hood
lateral bands:bases to distal phalanges
central band: to base of middle phlanx

124
Q

What is the function of the extensor mechanism?

A

flexion at MCP joints

extension at PIP, DIP joints

125
Q

Extension of the PIP is always accompanied by the simultaneous ______ of the DIP

126
Q

When PIP is flexed, the DIP may be _____ or ______

A

extended or flexed

127
Q

Extensor tendons form a moveable hood over the ____ and ____ joints of the fingers called the extensor expanision

Anatomy Exam 2: Lectures 8-15 (7 decks)

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