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human anatomy > m6: forearm, wrist, hand > Flashcards

m6: forearm, wrist, hand Flashcards

1
Q

● Positions the hand.
● Provides a stable platform from which the hand functions.
● Finely tuned hand positioning.
● Global positioning of the hand.

A

Wrist

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2
Q

● Predominant part of the body serving many purpose.
● Contains the _ and _.
○ Both sturdy and mobile.
● Complex, multipurpose organ
● As a prehensile organ, it can grasp with forces exceeding _ lb (445 N or 45 kg) or manipulate a delicate thread
● Conform around objects
● Pushing and pulling

A

Hand
palm and fingers
100 lb

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3
Q

“Pollex”

A

1st digit or thumb

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4
Q

Often used to point, and pointing is a method of making things clearer and it is the purpose of an index.

A

2nd digit or Index/Pointing/Forefinger

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5
Q

Longest finger of the hand

A

3rd digit or Middle Finger

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6
Q

It was believed that this finger contained a “vein of love” that flowed directly to the heart

A

4th digit or Ring Finger

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7
Q

Smallest finger

A

5th digit or Pinky/Little finger

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8
Q

●
● Although the primary forearm bone for the elbow joint is the ulna, the primary forearm bone of the _ is the .
● There are two proximal carpal bones ( + _) that interact with the radius to form the wrist joint.

A

Wrist

wrist; radius

Scaphoid + Lunate

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9
Q

●
● Not in direct contact with the carpal bones.
● _ _ separates the ulna from the carpal bones.
● _ portion of the _ is an important part of the wrist.
● The distal ulna has three parts:
1.
2.
3.

A

Distal Ulna

Fibrocartilaginous disc

Distal portion of the ulna

  1. Ulnar styloid process
  2. Fovea
  3. Pole
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10
Q

the part of the distal ulna that has bony projection, easily palpated with the forearm pronated, on the ulnar side of the wrist

A

ulnar styloid process

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11
Q

the part of the distal ulna that has a depression at the base of this styloid process and provides attachment for the fibrocartilaginous disc.

A

fovea

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12
Q

the part of the distal ulna that’s a concave articular surface allowing ulnar articulation with the fibrocartilaginous disc

A

pole

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13
Q

●
● The dorsal surface has a palpable tubercle that is known as the
○
○
○

A

Distal Radius

○ tubercle of the radius
○ Lister’s tubercle
○ dorsal tubercle

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14
Q

●
● Lies about _/- of the wrist’s width from the radial styloid process.
● Has grooves on either side of it that serve as a pulley for the:
○ extensor _ _ tendon on the _ side
○ extensor _ and extensor _ tendons on the _ side.

A

Lister’s tubercle

1/3

○ extensor pollicis longus tendon on the ulnar side
○ extensor digitorum and extensor indicis tendons on the radial side.

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15
Q

●
● Distal projection on the radial surface of the radius.
● More _ than ulnar styloid process.
● Ulnar and radial styloid processes serve as attachment sites for the _ and _ _ _ ligaments, respectively.

A

Radial Styloid Process

distal

Ulnar and radial styloid processes serve as attachment sites for the ulnar and radial carpal collateral ligaments, respectively.

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16
Q

●
● Sigmoid notch
● On the _ (lateral) aspect of the distal radius is the articulating surface for the _ _ joint

A

Ulnar notch

On the ulnar (lateral) aspect of the distal radius is the articulating surface for the distal radioulnar joint

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17
Q

●
● The _ surface of the _ makes up the proximal joint surface of the wrist and articulates with the _ and _ carpal bones.

A

Distal Radius + Scaphoid + Lunate

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18
Q

● Carpal bones
● PROXIMAL ROW:
1.
2.
3.
4.
● DISTAL ROW:
1.
2.
3.
4.

A

Proximal:
○ Scaphoid
○ Lunate
○ Triquetrum
○ Pisiform
Distal:
○ Trapezium
○ Trapezoid
○ Capitate
○ Hamate

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19
Q

● Navicular
● Most frequently FRACTURED carpal bone
● Floor of the anatomic snuffbox

A

Scaphoid

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20
Q

● Most frequently DISLOCATED carpal bone

A

Lunate

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21
Q

● “Triangular”

A

Triquetrum

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22
Q

● Pea-shaped

A

Pisiform

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23
Q

● “Greater multangular”

A

Trapezium

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24
Q

● “Lesser multangular”

A

Trapezoid

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25
Q

● Occupying a central position at the wrist (in line with the middle finger)
● Os magnum
● Best approached from the_, where a slight depression indicates its location
● The axis of motion for ulnar and radial deviation goes through this bone in a _ direction

A

Capitate

dorsum

dorsopalmar direction

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26
Q

● It has a hooked process on its palmar side, called the _ of the hamate

A

Hamate

hook

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27
Q

●
○ most commonly fractured carpal bone
○ MOI: _ _ _ _ _
○ articular risk of avascular necrosis after fracture | ‘_ _ supply’

A

Scaphoid Fracture

FOOSH

retrograde blood supply

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28
Q

● A triangular skin depression on the _ side of the wrist that is bounded medially by the tendon of the extensor pollicis longus and laterally by the tendons of the abductor pollicis longus and extensor pollicis brevis
● Its clinical importance lies in the fact that the _ bone is most easily palpated here and that the _ of the radial artery can be felt here

A

Anatomic Snuffbox

lateral side

scaphoid bone

pulsations of the radial artery

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29
Q

● These bones comprise the hand: _ and _
● The _ make up the digits.
● The metacarpals and digits are identified
numerically, laterally to medially (from the anatomical position), one through five.

A

Metacarpals and phalanges

phalanges

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30
Q

● Each of the five _ has a base that articulates:
○ proximally with one or more carpal bones
○ with its adjacent metacarpals

A

metacarpals

31
Q

● Tubercle at the _ base of _ Metacarpal = distal attachment _ _ _. (Dorsolateral aspect just distal to the hamate.

● Eminence at the base of _ metacarpal bone (dorsally) = distal attachment for _ _ _ _

A

● Tubercle at the medial base of 5th Metacarpal = distal attachment ECU. (Dorsolateral aspect just distal to the hamate.

● Eminence at the base of 2nd metacarpal bone (dorsally) = distal attachment for ECRL

32
Q

● Head of metacarpal bone (_)
● _ joint
● Palpated in _

A

biconvex

MCP joint

flexion

33
Q

●
○ fracture of the _ metacarpal neck
○ clenched fist striking a hard object

A

BOXER’S FRACTURE

5th

34
Q

●
○ fracture of the _ metacarpal base
○ forced hyperabduction of the thumb

A

BENNETT’S FRACTURE

1st

35
Q

● 2 phalanges of the thumb
○
○
● 3 phalanges of the 2nd to 5th digits
○
○
○

A

● 2 phalanges of the thumb
○ Proximal
○ Distal

● 3 phalanges of the 2nd to 5th digits
○ Proximal
○ Middle
○ Distal

36
Q

_ Joint
● Wide mobility of the hand
● Great structural stability in the wrist
● Allows the hand an extensive degree of function

● _ joint
● _ DOF
● _ bones
● _ joints
● Extensive ligament system

A

Wrist Joint

● Ellipsoidal joint
● 2 DOF
● 15 bones
● 17 joints
● Extensive ligament system

37
Q

_ Joint
● Biconcave: _ _ of radius
● Biconvex: Proximal articulating surface of the _ and _
● _ DOF
● Motions: _, _, _ deviation, _ deviation

A

Radiocarpal Joint
● Biconcave: Distal end of radius
● Biconvex: Proximal articulating surface of the scaphoid and lunate
● 2 DOF
● Motions: flexion, extension, radial deviation, ulnar deviation

38
Q

_ Joint
● Formed by the proximal and distal carpal rows.
● The scaphoid articulates with the _, _, and _.
● Lunate articulates with the _.
● Triquetrum articulates with the _.
● Wrist motions: _, _, and _ and _ deviation.

A

Midcarpal Joint
● Formed by the proximal and distal carpal rows.
● The scaphoid articulates with the trapezium, trapezoid, and capitate.
● Lunate articulates with the capitate.
● Triquetrum articulates with the hamate.
● Wrist motions: flexion, extension, and radial and ulnar deviation.

39
Q

Hand
● Each digit has: C _ _ + M _ _
● Each of the 4 fingers has: P _ _ + D _ _

A

Hand
● Each digit has: CMC + MCP
● Each of the 4 fingers has: PIP + DIP

40
Q

CMC Joints
● _ and _ CMC joint = minimal movement
● _ CMC joint = least mobile (central pillar of the hand)
● _ CMC joint = _ to _ degrees dorsovolar movement

A

Carpometacarpal Joints
● 2nd and 3rd CMC joint = minimal movement
● 3rd CMC joint = least mobile (central pillar of the hand)
● 4th CMC joint = 10 to 15 degrees dorsovolar movement

41
Q

●
● Trapezium + Base of First Metacarpal
● _ joint
● Motions: _, _, _, _, _, _.

A

Carpometacarpal Joint of Thumb
● Trapezium + Base of First Metacarpal
● Saddle joint
● Motions: flexion,
extension, abduction, adduction, opposition, reposition.

42
Q

_ Joints
● _ type
● _ DOF
● Motion: _, _, _, and _.
○ Convex: Head of _
○ Concave: Base of _ _

A

Metacarpophalangeal Joints
● Condyloid type
● 2 DOF
● Flexion, extension, abduction, and adduction.
○ Convex: Head of metacarpals
○ Concave: Base of proximal phalanges

43
Q

_ Joints
● _ to _ digit = DIP and PIP
● _ = Interphalangeal joint
● _ DOF
● Motion: _ and _
● (+)_ _ _: prevents hyperextension

A

Interphalangeal Joints
● 2nd to 5th digit = DIP and PIP
● Thumb = Interphalangeal joint
● 1 DOF
● Motion: flexion and extension
● (+) volar plate mechanism: prevents hyperextension

44
Q

Proximal (radiocarpal)
Distal (carpometacarpal)

Radial collateral
Volar radiocarpal
Ulnocarpal ligamentous complex
Radiocarpal dorsal

A

Extrinsic ligaments

45
Q

Short/ Intermediate/ Long

Volar
Dorsal
Interosseous

Lunate-triquetral
Scaphoid-lunate
Scaphoid-trapezial

Volar intercarpal (deltoid, V, radiate or arcuate)
Dorsal intercarpal

A

Intrinsic ligaments

46
Q

Radio-scaphoid-capitate
Radiolunate
Radio-scaphoid-nate

Meniscus (radiotriquetral)
Triangular fibrocartilage

Ulno lunate ligament
Medial collateral ligament

A

Superficial
Deep

47
Q

● The hand is a compact, multipurpose organ with interdependency of structures in which injury to one may affect many others.
● The hand possesses both great mobility and great stability and can shift from one to the other in a fraction of a second.

A

Function

48
Q

● Almost all of the muscles are multiarticular and, therefore, can have an effect on each joint crossed.
● Some cross as many as seven joints, so to prevent an undesired motion by the muscle, other muscles must contract.

A

Function

49
Q

● The hand has many automatic, neurophysiologic synergies, which are so strongly linked that a person cannot willfully separate them.

A

Function

50
Q

● The hand is a wonderful sensory organ that provides us with tremendous feedback about our environment.
● For example, each finger tip has about _ sensory endings and the _ and _ are among the most sensitive parts of the body.

A

Function

100

fingertips and hands

51
Q

● (1) over which joints each muscle passes
● (2) the line of action of the muscle and its
tendon
● (3) the distance of the muscle to the axis of joint motion at various positions of the joint
● (4) the relative length of the muscle.

A

Considerations

52
Q

Wrist Extensor
● Proximal attachment: _ _
● ECRL: _ _ _

Primary wrist extensors (3 Es):
1.
2.
3.

A

Wrist Extensor
● Proximal attachment: Lateral epicondyle
● ECRL: lateral supracondylar ridge

Primary wrist extensors:
1. ECRL
2. ECRB
3. ECU

53
Q

●
● Proximal attachment: _ _ _
● Lies anterior to the elbow axis (not a good elbow flexor compared to wrist extensors)

A

Wrist Flexors

Medial humeral epicondyle

54
Q

Primary wrist flexors (FFPFFF)
1.
2.
3.
4.
5.
6.

A

● FCR
● FCU
● Palmaris longus
● FDS
● FDP
● FPL

55
Q

Radial and _ Motions
● _ longus and E _ _ B = centrally located.
● Muscles located on the radial side: _
deviation
● Muscles located on the ulnar side: _
deviation

A

Radial and Ulnar Motions

● Palmaris longus and ECRB = centrally located.
● Muscles located on the radial side: radial
deviation
● Muscles located on the ulnar side: ulnar
deviation

56
Q

Muscles Acting on the Digits

● _ muscles with proximal attachments in the forearm or humerus and distal attachments in the hand
● _ muscles with both proximal and distal attachments existing within the hand.

A

Extrinsic

Intrinsic

57
Q

_ Muscles
● Long finger extensors
● Long finger flexors
● Thumb muscles (FEAb):

A

Extrinsic Muscles

○ Flexors
○ Extensors
○ Abductors

58
Q

_ Muscles
● Mid-Palm Muscles
● Thenar muscles
● Hypothenar muscles

A

Intrinsic

59
Q

Extensor Mechanism
● Other names

A

Extensor Mechanism
● Other names
○ extensor hood mechanism
○ extensor expansion
○ apparatus,
○ aponeurosis
○ retinaculum
○ dorsal hood, or hood

60
Q

● The purpose of the assembly is to extend the digits in different positions of finger flexion.
● To provide shortcuts for the extensor tendons across the joints and to permit the digits full flexion.

A

Extensor Mechanism

61
Q

Extensor Mechanism
● The extensor tendons must cover a longer distance from maximum extension to full flexion.
● This distance is about _ mm and can be measured in the normal subject by placing a string over the dorsum of a finger and marking the change in length from full extension to end flexion.

A

25 mm

62
Q

6 Extensor Tunnels
● Tunnel 1: _ + _
● Tunnel 2: _ + _
● Tunnel 3: _
● Tunnel 4: _ + _
● Tunnel 5: _
● Tunnel 6: _

A

● Tunnel 1: APL + EPB
● Tunnel 2: ECRL + ECRB
● Tunnel 3: EPL
● Tunnel 4: ED + EI
● Tunnel 5: EDM
● Tunnel 6: ECU

63
Q

● a fibrous band connecting the proximal phalanx and distal sheath that covers the proximal and distal interphalangeal joints and middle phalanx

A

Extensor hood

64
Q

● the flexor digitorum superficialis and profundus tendons are enclosed in synovial-lined tunnels, which are maintained against the palmar surfaces of the phalanges by pulleys.

○ _ pulleys
○ _ pulleys

A

Flexor pulleys

Annular pulleys
Cruciate pulleys

65
Q

● Consists of a burning pain or “pins and needles” along the distribution of the median nerve to the lateral three and a half fingers and weakness of the _ muscles.
● It is produced by compression of the median nerve within the tunnel

A

Carpal Tunnel Syndrome

thenar muscles

66
Q

● There is a palpable and even audible snapping when a patient is asked to flex and extend the fingers.
● It is caused by the presence of a localized swelling of one of the _ _ tendons that catches on a narrowing of the fibrous flexor sheath anterior to the metacarpophalangeal joint. It may take place either in flexion or in extension.

A

Trigger Finger

long flexor

67
Q

1st and 2nd digit = ?

A

Fine movement

68
Q

3rd, 4th, and 5 digits = ?

A

Gross and strength

69
Q

ligaments that connect carpal bones to the radius, ulna, or metacarpal

A

extrinsic ligaments

70
Q

ligaments that attach between the carpal bones only

A

intrinsic ligaments

71
Q

provide support, stability, and transmission of forces through the hand

A

extrinsic and intrinsic ligaments

72
Q

Ex or In?

Dorsal musles:
5 Extensors
1 Abductor

A

Extrinsic

ED
EI
EDM
EPL
EPB
APL

73
Q

Ex or In?

Ventral muscles:
3 Flexor

A

Extrinsic

FDS
FDP
FPL

74
Q

Ex or In?

3 Mid-palm muscles:
4 Thenar muscles:
3 Hypothenar muscles :

A

Intrinsic

4 L, 3 PI, 4 DI

OP, APB, AP, FPB

ODM, ADM, FDM

human anatomy (12 decks)

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