Lecture 6: The hand Flashcards

1
Q

What do grips of the hand provide us with?

A

Manipulation of objects, dexterity

Precise application of force from the upper limb

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2
Q

What are the 5 joints of the hand?

A

Distal interphalangeal (DIP)

Proximal interphalangeal (PIP)

Interphalangeal joint of the thumb

Metacarpophalangeal (MCP)

Carpometacarpal (CMC)

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3
Q

What are the bones of the hand?

A
  1. Distal phalanges
  2. Intermediate phalanges
  3. Proximal phalanges
  4. Metacarpals
  5. Carpals
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4
Q

Which groups of muscles are the movements of the fingers and thumbs brought about by?

A
  • Extrinsic
  • Intrinsic
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5
Q

What are the extrinsic muscles?

A

muscles in the anterior and posterior forearm whose tendons travel down into the hand. The tendons of these muscles are vulnerable to injury at the wrist or in the hand.

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6
Q

What are the intrinsic muscles?

A

muscles located in the hand; their origins and insertions are within the hand. These are, by definition, short, or small muscles. Many of them have the term ‘brevis’ in their name.

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7
Q

Where do the intrinsic muscles lie?

A

Almost all of them lie in the palm of the hand (the dorsum of the hand has just one set)

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8
Q

What are the groups of muscles and one singular muscle in the intrinsic muscles?

A
  1. thenar eminence
  2. hypothenar eminence
  3. The lumbrical muscles
  4. The interosseous muscles
    Single muscle: Adductor pollicis
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9
Q

What is the thenar eminence?

A

3 muscles, lie in the palm below the thumb, move the thumb

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10
Q

What are the 3 muscles in the thenar eminence?

A

Opponens pollicis (deeper)
Flexor pollicis brevis
Abductor pollicis brevis

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11
Q

Where does the thenar eminence originate?

A

Origins = carpal bones (centred on the trapezium and scaphoid)

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12
Q

Where does the thenar eminence insert?

A

OP = 1st metacarpal
APB and FPB = base of the proximal phalanx of the thumb

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13
Q

what innervates the thenar eminence?

A

recurrent branch of
the median n.

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14
Q

What is the hypothenar eminence?

A

3 muscles, lie in the palm below the little finger, move the little finger. They mirror the thenar eminence muscles

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15
Q

What are the 3 muscles in the hypothenar eminence?

A

Opponens pollicis (deeper)
Flexor pollicis brevis
Abductor pollicis brevis

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16
Q

Where does the hypothenar eminence originate?

A

carpal bones
(centred on the hamate and pisiform)

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17
Q

Where does the hypothenar eminence insert?

A

ODM on the 5th metacarpal
ADM and FDM = base of the proximal phalanx of the 5th digit

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18
Q

What innervates the hypothrnar eminence?

A

deep branch of the ulnar n.

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19
Q

What are the lumbrical muscles?

A

4 of these; each one is attached to an FDP tendon

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20
Q

where do the lumbrical muscles originate?

A

tendons of FDP

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21
Q

Where do the lumbrical muscles insert?

A

base of proximal phalanges & extensor expansion

22
Q

What is the action of lumbrical muscles?

A

MCPJ flexion, PIPJ and DIPJ extension

23
Q

What innervates the lumbrical muscles?

A

medial 2 = ulnar n.; lateral 2 = median n. (i.e. innervated by the same nerve as their ‘parent’ FDP muscle / tendon)

24
Q

What is the adductor pollicis?

A

is a single muscle that lies in the palm and adducts the thumb

25
Q

Where does the adductor pollicis originate?

A

3rd metacarpal and capitate

26
Q

where does the adductor pollicis insert?

A

base of proximal phalanx of thumb
Adducts the thumb

27
Q

what innervates the adductor pollicis?

A

deep branch of the ulnar n.

28
Q

Is there an adductor minimi?

A

No
There isn’t an adductor digiti minimi, equivalent to adductor pollicis; because one of the interosseous muscles adducts the little finger

29
Q

Where does the palmar interossei orginiate?

A

metacarpals.

30
Q

Where does the palmar interossei insert?

A

base of proximal phalanges & extensor expansion

31
Q

What does PAD stand for?

A

Palmar adduct fingers

32
Q

What do the PADs contribute to?

A

Palmar adduct fingers (= PAD) and contribute to flexion at the MCPJs and extension at the PIPJs and DIPJs via their insertion onto the extensor expansion

33
Q

What innervates the palmar interossei?

A

deep branch of the ulnar n.

34
Q

Where does the dorsal interossei originate?

A

metacarpals.

35
Q

Where does the dorsal interossei insert?

A

base of proximal phalanges & extensor expansion

36
Q

What does DAB stand for?

A

Dorsal abduct fingers

37
Q

What does the dorsal interossei contribute to?

A

and contribute to flexion at the MCPJs and extension at the PIPJs and DIPJs via their insertion onto the extensor expansion

38
Q

What innervates the dorsal interossei?

A

deep branch of the ulnar n.

39
Q

What do the radial and ulnar arteries anastomose in the palm to form?

A

palmar arches.

40
Q

What arises from the palmar arches?

A

Metacarpal and digital arteries arise from these

41
Q

Does the median or the ulnar nerve travel through the carpal tunnel?

A

Median

42
Q

What do the superficial veins on the dorsum of the hand form?

A

The cephalic and basilic veins

43
Q

Where does the cephalic vein formed in the ASB course to?

A

up the lateral forearm towards the cubital fossa

44
Q

Where does the basilic vein formed on the medial aspect of the forearm travel to?

A

Cubital fossa

45
Q

What forms the axillary veins in the axilla?

A

The basilic vein joining with the deep veins

46
Q

Where does the cephalic vein drain into?

A

axillary vein

47
Q

Why is the dorsal venous network clinically important?

A

A site for IV cannulation

48
Q

What is atrophy of the thumb?

A

Atrophy (wasting) and
weakness of the thumb

49
Q

What does atrophy of the thumb cause?

A

Sensory disturbance (e.g. pain, diminished sensation, pins and needles) in the distribution of the median n.

50
Q

What does the ulnar nerve injury at the wrist cause?

A

Sensory disturbance (e.g. pain, diminished sensation, pins and needles) in the distribution of the ulnar n.

51
Q

What is the typical appearance of injury to the ulnar nerve (Claw hand)?

A

Describes the typical appearance of the hand after injury to the ulnar n.

Hyperextension of MCP joints of 4th and 5th
Flexion at PIP and DIP joints of 4th and 5th
Guttering between the metacarpals