Lecture 4.2 Flashcards

1
Q

What are the 2 posterior compartment muscles that do not pass the wrist joint?

A

Supinator and brachioradialis do not pass the wrist joint. *Brachioradialis flexes forearm at the elbow*

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2
Q

Where does the radial nerve split and where does each branch go?

A

Radial nerve splits at cubital fossa. Superficial radial nerve pierces the brachioradialis and the deep radial nerve pierces the supinator muscle.

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3
Q

Where does the superficial radial nerve reappear after piercing the brachioradialis?

A

Superficial radial nerve reappears in the anatomical snuffbox.

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4
Q

Which muscles start at ulnar and insert onto the thumb?

A

Adductor Pollicis Longus Extensor Pollicis Brevis Extensor Pollicis Longus

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5
Q

What are the medial and lateral borders of the anatomical snuffbox?

A

APL and EPB form the lateral border of anatomical snuffbox. EPL forms the medial border of the anatomical snuffbox.

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6
Q

What are the bones of the proximal row of carpal bones? Which bones articulate with the radius?

A

Scaphoid, Lunate, Triquitrium, Pisiform. Scaphoid and Lunate articulate with radius.

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7
Q

What sits between the triquitrium+pisiform and the ulna?

A

A triangular cartilaginous disk.

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8
Q

What are the bones of the distal row of carpal bones?

A

Trapezium, Trapezoid, Capitate, and Hamate.

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9
Q

Where does the blood supply of the scaphoid pass before supplying it?

A

Scaphoid contains a proximal and distal end. between these ends is a ridge through which the blood supply for the scaphoid passes through (the distal half)

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10
Q

What complications can happen from a FOOSH to the hand?

A

Scaphoid can get fractured

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11
Q

What is the design fault with blood supply of the scaphoid?

A

Proximal pole of the scaphoid can get necrotic as a result of fracture.

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12
Q

What causes handlebar neuropathy?

A

Hook of hamate and pisiform meet up with a ligament through which the ulnar nerve goes through. Entrapment of this nerve causes handlebar neuropathy. intrinsic muscles of the hand innervated by this nerve get compromised.

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13
Q

How many phallanges are there in each finger?

A

Thumb has only 2 phalanges while the rest have 3.

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14
Q

How are the hand’s compartments formed?

A

Palmar aponeurosis sends out extensions to the 5th metacarpal and the 3rd metacarpal. This creates fascial compartments (the thenar and hypothenar compartments and central compartment)

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15
Q

What are the 2 thenar compartments?

A

Superficial thenar compartment (Abd PB and FPB) Deep thenar compartment. (adductor pollicis here)

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16
Q

Where is the palmaris brevis muscle found?

A

Fibers from the palmar aponeurosis to the skin are called palmaris brevis.

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17
Q

What causes dupuytren’s contracture?

A

Palmar fascia can get thick and shrink and forms a contracture and this causes ring and little fingers to contract. This is known as dupuytren’s contracture. This is relieved surgically.

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18
Q

Where does the flexor retinaculum attach?

A

trapezium and scaphoid on lateral side and hamate and pisiform on the medial side

19
Q

What are the boundaries of the carpal tunnel?

A

Roof: Flexor retinaculum Floor: carpal bones Proximal end marked by wrist crease.

20
Q

What structures lie superficial to the flexor retinaculum?

A

PL tendon Ulnar artery, ulnar nerve superficial branch of radial artery. palmar cutaneous branch of median nerve.

21
Q

What passes through the flexor retinaculum?

A

FDS (x4 tendons) FDP (x4 tendons) FPL Median Nerve:(recurrant thenar branch and lateral+medial branches) FCR (within the roof of the carpal tunnel) Synovial sheaths

22
Q

Which FDS tendons pass more superficially and which pass more deeply?

A

Superficially: 3,4 Deep: 2,5

23
Q

Where do the FDP tendons pass through the carpal tunnel?

A

The FDP tendons pass more deeply to FDS tendons.

24
Q

Where in the carpal tunnel to FPL and FCR pass?

A

FPL passes through carpal tunnel deep to median nerve and FCR superficial to median nerve within flexor retinaculum.

25
Q

Where does the extensor retinaculum attach?

A

Extensor retinaculum attaches to radius laterally and triquetrium, pisiform and FCU medially.

26
Q

What are the contents of the extensor retinaculum?

A

6 tunnels 9 tendons Synovial sheaths.

27
Q

What are the boundaries of the anatomical snuffbox?

A

Anteriorly: tendons of APL and EPB. Posteriorly: tendon of EPL Roof: skin, subcutaneous tissue, cephalic vein, radial nerve. Floor: scaphoid and trapezium

28
Q

What can be found in the anatomical snuffbox?

A

Radial artery.

29
Q

What are the muscles of the first hand layer?

A

Thenar muscles: Abductor pollicis brevis Flexor pollicis brevis Hypothenar muscles: Abductor digiti minimi Flexor digiti minimi

30
Q

Where do the first layer of hand muscles originate from?

A

Flexor retinaculum

31
Q

Where do the first layer of hand muscles insert?

A

Base of proximal phallanx

32
Q

Where do the second layer of hand muscles originate from?

A

Flexor digitorum profundus tendons

33
Q

What are the second layer muscles called?

A

The lumbricals

34
Q

Where do the second layer muscles insert?

A

Extensor expansions of digits 1 - 4

35
Q

What is the function of the lumbricals?

A

Lumbricals flex the MCP joints while extending the IP joints.

36
Q

What are the muscles of the 3rd layer of the hand?

A

Thenar muscles: Opponens Pollicis Adductor Pollicis Hypothenar muscles: opponens digiti minimi

37
Q

What is the origin of adductor pollicis? Where does it insert?

A

One oblique head originates at the flexor retinaculum Transverse head starts at 3rd metacarpal It inserts at medial side of proximal phallanx.

38
Q

What branches does the median nerve form in the hand and what do they innervate?

A

Recurrent branch of the median nerve supplies muscles of the thenar compartment. Specifically; the abductor pollicis brevis, opponens pollicis, and flexor pollicis brevis. OAF. An earlier branch supplies the 1st and 2nd lumbricals . Lateral branch supplies the 5th lumbrical.

39
Q

What intrinsic muscles of the hand are innervated by the ulnar nerve?

A

All the non “1’+2’ LOAF” muscles are innervated by the ulnar nerve.

40
Q

Where do the 4th layer of hand muscles originate from?

A

The shafts of the Metacarpals

41
Q

What are the muscles of the 4th layer?

A

The interossei: 3 palmar (adduct; known as pAd) 4 dorsal (abduct; aka dAb)

42
Q

Where do muscles of the 4th layer insert?

A

Onto the lateral side of the digit onto the extensor expansion.

43
Q

What is the axis of the hand that interossei move fingers relative to?

A

The middle finger is the axis of the hand with no interossei attachments.

44
Q

Which muscle is partially supplied by the ulnar nerve?

A

Muscle supplied partially by ulnar nerve are the 2 medial heads of the flexor digitorum profundus.