lecture 15: intrinsic hand Flashcards

1
Q

know the surface anatomy of the hand

A

.

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2
Q

the thumb is digit number BLANK

A

1

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3
Q

the pinky is digit number BLANK

A

5

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4
Q

the index is digit number BLANK

A

2

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5
Q

what are the two mounds of muscle on the palm

A

thenar and hypothenar eminence

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6
Q

what is most lateral, the thenar or hypothenar eminence

A

the thenar eminence

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7
Q

what joint makes up the knuckle

A

MCP

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8
Q

what structure lies most superficial on the palm of the hand

A

palmar aponeurosis

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9
Q

what is the palmar apeunorosis

A

triangle of deep fascia, in superficial layer of the palm

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10
Q

explain the attachment of the palmar apomeurosis

A

deep to the skin (dermis) and anchored to it, but superficial to flexor tendons, palmar neurovascular structures)

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11
Q

true or false, the palmar aponeurosis is anchored to the dermis

A

true

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12
Q

true or false: the palmar aponeurosis is deep to the skin (dermis) and anchored to it, but deep to flexor tendons, palmar neurovascular structures)

A

false, superficial to the flexor tendons

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13
Q

true or false: palmaris longus tendon always present

A

no

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14
Q

what is the palmaris brevis

A

is stretches between palmar aponeurosis to the skin of hypothenar eminence

draws skin over hypothenar emonience to the center of the palm

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15
Q

palmar aponeurosis is the end of what tendon

A

palmaris longus

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16
Q

what is the flexor retinaculum

A

ligamentous band stretching from pisiform and hook of the hamate (medial) to the trapezium and scaphoid (lateral)

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17
Q

what forms the roof of the carpal tunnel

A

flexor retinaculum

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18
Q

what is the function of the flexor retinaculum

A

creates carpal tunnel and prevents bowing of the flexors of the forearm

=makes a pulley for the flexor tendons

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19
Q

what are the contents of the carpal tunnel

A

tendons of the FDS (4), FDP (4), FPL (1) and median n

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20
Q

what nerve passes through the carpal tunnel

A

median n

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21
Q

what muscle tendons pass through the carpal tunnel

A

FDS
FDP
FPL

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22
Q

what is carpal tunnel syndrome

A

chronic pressure on the median nerve resulting in numbness and weakness in the hand

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23
Q

true or false: carpal tunnel syndrome is chronic pressure on the ulnar n

A

false, median

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24
Q

what are some actions that can cause carpal tunnel syndrome

A

typing, excessive extended wrist position

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25
Q

how many tendons pass through the carpal tunnel

A

9 total

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26
Q

what nerve passes through the guyons tunnel

A

ulnar n

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27
Q

true of false: guyon canal can also lead to compression syndromes but in the ulnar n

A

true

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28
Q

what are the contents that pass through the guyon canal

A

ulnar a and n

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29
Q

what two things make up the roof of carpal tunnel

A

flexor retinaculum
guyon canal

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30
Q

what are the 3 muscles that make up the thenar eminence that are innevated by the reccurent branch of the median n

A

flexor pollicis brevis
abductor polllic brevis
opponens pollicis

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31
Q

what is the origin of the thenar eminence

A

flexor retinaculum and scaphoid/trapezium

32
Q

what is the insertion of the thenar eminence (3)

A

lateral side of PP1 (proximal phalanx 1) for the APB and FPB
the MC1 for the OP

33
Q

what is the function of the thenar eminence muscles (3)

A

FPB/APB= flex and abduct thumb and MCP and IP joints and assist in opposition

OP= opposition

34
Q

opposition motion is a combo of what moves

A

abduction and flexion

35
Q

what are the muscles of the thenar eminence inneravted by

A

the reccurent branch of median n

36
Q

true or false, the thenar eminence muscles all share a common origin

A

true

37
Q

what si the muscle part of the thenar eminence that is an exception to the inneravtion pattern

A

adductor pollicus

38
Q

true or false: adductor pollicus has 3 heads and name them

A

false only 2
transverse head, and oblique head

39
Q

what is the origin/palmar attachement of the adductor pollicis

A

oblique head: capitate (and adj), base of the MCII and MCIII

tranverse head: shaft of the MCIII

40
Q

what is the insertion/thumb attachment of the adductor pollicus

A

medial side of the base of the first proximal phalanx (PP1)

41
Q

what is the function of the adductor pollicis

A

adduction of the thumb

42
Q

what is the innevation of the addcuctor pollicis

A

deep ulnar n

43
Q

the deep ulnar n is a branch of what nerve

A

ulnar (near guyon cnaal)

44
Q

how many muscles make up the hypothenar eminence

A

3

45
Q

what are the 3 muscles that make up the hypothenar eminence

A

abductor digiti minini
flexor digiti minimi brevis
opponens digiti minimi

46
Q

wht is the origin (proximal attachemnt) of the hypothenar eminence

A

posiform (Abnductor digiti minim)

hook hamate and flexor retinaculum (opponents digiitmi minini and flexor digiti minimi brevis)

47
Q

what is the insertion of the hypothenar eminence

A

medial side of the MC5 (opponents digiti minimi)

PP5 (for AB/FL)

48
Q

what are the functions of the hypothenar eminence

A

abducts (AB/FL), flexes PIP (AB/FL), and brings 5th digit into opposition to thumn (OP)

49
Q

what is the innervation of the hypothenar eminence

A

deep ulnar n (also to adductor pollicus)

50
Q

true or false: only hypothenar emonence muscles are innervated by the deep ulnar n

A

false, also the adductor pollicus

51
Q

what are the origins of the lumbricales

A

tendons of the FDP (NOT FDL)

52
Q

what is the insertion of the lumbricales

A

lateral aspect of the extensor hood

53
Q

what are the functions of the lumbricals

A

simultaneus flexion of MCP and extension of the IP joints via extensor hood

54
Q

what is the inneravtion of the l;umbricales

A

median n (1 and 2) and deep ulnar (3 and 3)

55
Q

how many lumbricales do we have

A

4

56
Q

lumbricale 1 and 2 go to whar digits

A

2 and 3

57
Q

lumbricales 3 and 4 goto what digits

A

4 and 5

58
Q

how many palmar interossei are there

A

3

59
Q

what is the function fo the palmar interossei

A

adduction and flexion of the MCP, extension of the IP joints for digits II, IV and V

60
Q

what is the innervation of the palmar interossei

A

deep ulnar n

61
Q

what is the general o/i of the interossei muscles

A

O: shafts of MCs to the sides of PPs and extensor hoods

62
Q

how many dorsal interossi are there

A

4

63
Q

what is the function of the dorsal interossei

A

abduction and flexion of MCP, extension of Ip joints for digits II, III, IV

64
Q

flexor tendons in palm and digits are surrounded by what

A

synovial sheaths encapsulated by fibrous sheets

65
Q

explain hoe FDP and FDS run

A

the FDP runs deep the FDS which splits to allow the FDP to pass through

66
Q

what is the function of the digital fibrous sheaths

A

keeps flexors tendons stuck to bone to prevent bowing

67
Q

understand slide with synovial sheats in the hand

A

.

68
Q

ulnar n is where in the hand

A

guyon canal

69
Q

median n is deep to what

A

flexor retinaculum

70
Q

reccurent branch of medial n supplies what

A

to thenar eminence except the adductor pollicus

71
Q

deep ulnar n supples what

A

hyoothenar eminence, medial 2 lumbricals ( IV and V), adductor pollicus and interossei

72
Q

lumbricals I and II are directly inneravted by

A

median n

73
Q

adductor pollicus is inneravted by what

A

deep ulnar

74
Q

nerves on the dorsum are sensory or motor only

A

sensory

75
Q

understand sensory innevation of the hand

A

.

76
Q

last slides intrisic hand

A

ADD