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(J) Anatomy Test 2 > Lecture 13 - Hand > Flashcards

Lecture 13 - Hand Flashcards

1
Q

What nerves innervate the dorsal hand and what portions of the hand do they innervate?

A

Radial:

  • dorsolateral hand
  • dorsal thumb
  • dorsal proximal second and third digits

Median:

  • distal dorsal second and third digits (exclusive)
  • distal dorsal fourth digit

Ulnar:

  • dorsomedial hand
  • dorsal proximal third digit
  • dorsal fourth digit
  • dorsal fifth finger (exclusive)
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2
Q

What nerves innervate the palmar hand and what portions of the hand do they innervate?

A

Median:
-central palm

Ulnar:
-medial palm

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3
Q

What are the joints in the hand?

A

Carpometacarpal joints

Metacarpophalangeal joints
-MCP

Interphalangeal joints

  • proximal interphalangeal (PIP)
  • distal interphalangeal (DIP)
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4
Q

What type of joint are the carpometacarpal joints and what movements do they allow?

(slide 7)

A

Type:
-plane, synovial joint

Movement:

  • digits 2-3; almost none
  • digit 4; limited
  • digit 5; ab/adduction, flexion/extension, circumduction
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5
Q

What type of joint are the metacarpophalangeal joints and what movements do they allow?
What ligaments are present

(slide 8)

A

Type:
-condyloid, synovial

Movement:

  • flexion/extension
  • abduction/adduction

Ligaments:

  • palmar ligaments
  • collateral ligaments
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6
Q

Why can you not spread your fingers while they are flexed?

A

-collateral ligaments are taut during flexion preventing it

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7
Q

What type of joint are the interphalangeal joints and what movements do they allow?
What ligaments are present?

(slide 9)

A

Type:
-hinge, synovial

Movement:
-flexion/extension

Ligaments:
-collateral ligaments

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8
Q

What are the superficial palmar structures?

slides 11

A

Palmar aponeurosis

Flexor retinaculum

Palmaris brevis

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9
Q

Describe the palmar aponeurosis.

A
  • triangular layer of deep fascia
  • protects for superficial vessels, nerves, and tendons
  • anchored to skin by flexor retinaculum
  • spilt into 4 sheaths which blend into flexor sheaths of digits 2-4
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10
Q

Describe the flexor retinaculum.

A
  • laterally attaches to tubercles of scaphoid and trapezium

- medially attaches to hook of hamate and pisiform

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11
Q

Describe the carpal tunnel.

A
  • groove between pisiform and hook of hamate
  • roof is flexor retinaculum

Contains:

  • tendon of flexor digitorum superficialis
  • tendon of flexor digitorum profundus
  • tendon of flexor pollicis longus
  • median nerve
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12
Q

What passes through Guyon’s canal?

A
  • ulnar nerve

- ulnar artery

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13
Q

What are the intrinsic muscles of the thumb?

A
  • abductor pollicis brevis
  • flexor pollicis brevis
  • opponens pollicis
  • adductor pollicis
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14
Q

Of the intrinsic muscles of the thumb, which muscles are part of the thenar eminence?
Other than this, what differentiates these muscles?

A

Thenar eminence:

  • innervated by MEDIAN nerve
  • abductor pollicis brevis
  • flexor pollicis brevis
  • opponens pollicis

Not:

  • innervated by ULNAR nerve
  • adductor pollicis
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15
Q

What are the intrinsic muscles of the fifth digit?

What is the common innervation?

What structure do these muscles form?

A

Muscles:

  • abductor digiti minimi
  • flexor digiti minimi brevis
  • opponens digiti minimi

Innervation:
-ulnar nerve

Hypothenar eminance

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16
Q

What are the thenar and midpalmar spaces?

A

Thenar:
-area between the adductor pollicis muscle and the long flexor tendons of the index finger/thumb

Midpalmar:
-area between metacarpals 4-5 and long flexor tendons to digits 4-5

17
Q

What path does he radial artery take through the wrist and hand?

A
  • lies lateral to the tendon of the flexor carpi radialis (radial pulse)
  • passes across scaphoid in anatomical snuff box
  • wraps around dorsum of the first metacarpus
  • pierces first dorsal interosseous muscle into the palm of the hand
  • forms deep palmar arch
18
Q

What vessels supply the dorsum of the hand?

Slide 35

A

Arteries:

  • dorsal arterial arch (radial and ulnar arteries)
  • dorsal metacarpals
  • dorsal digitals

Venous:
-dorsal venous arch (medially to basilic vein and laterally to cephalic vein)

Lymphatic:
-medial through lymph nodes accompanying basilic vein (to subtrochlear and lateral axillary nodes)

19
Q

What is the arterial supply to the palmar hand?

A
  • superficial palmar arch (continuation of ulnar artery)

- deep palmar arch (continuation of radial artery)

20
Q

What path does the ulnar nerve take in the hand?

A
  • enters superficial to flexor retinaculum
  • branches into superficial branch and deep branch

Superficial branch:

  • innervates palmaris brevis
  • cutaneous innervation

Deep branch:
-innervates other muscles innervated by ulnar nerve

21
Q

What path does the ulnar nerve take in the hand?

A
  • enters deep to flexor retinaculum

- divides into lateral and medial branches

22
Q

What is mallet finger?

Slide 40

A
  • avulsion of long extensor tendon

- results in hyper flexion of DIP

23
Q

What is Dupuytren’s contracture?

Slide 40

A
  • progressive fibrosis of palmar aponeurosis

- marked flexion of fingers at MP joints

24
Q

What is Colle’s fracture?

A

-fracture of distal end of the radius

25
Q

What results from median nerve injury?

A
  • loss of thumb opposition
  • atrophy of thenar muscles
  • ape hand
26
Q

What results from ulnar nerve injury?

A
  • paralysis of interossei (guttering)
  • loss of thumb adduction
  • claw hand
27
Q

What are the components of the extensor mechanism and what is its function?

A

Components:

  • hood
  • lateral bands (bases of distal phalanges)
  • central bands (bases of middle phalanx)

Function:

  • flexion at MCP joint
  • extension at PIP and DIP joints

(J) Anatomy Test 2 (13 decks)

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