MMB [028] Movements & muscles of the Hand I Flashcards
Component’s of the palm’s fascia ?
- Palmar aponeurosis
- Flexor retinaculum
- Fibrous flexor sheath of the fingers
Define the Flexor Retinaculum
It is a thickened strong deep fascia in front of the carpus and converts its [anterior concavity] into the [carpal tunnel]
The carpal tunnel is formed of :
The Flexor Retinaculum , and the carpal arch
Main Function of the Flexor Retinaculum ?
prevents displacement of long flexor tendons during contraction
Structures passing superficial to the carpal tunnel ?
-Tendon of Palmaris Longus
-Ulnar nerve.
-Ulnar vessels.
-Palmar cutaneous br. of :
✓ ulnar nerve.
✓ median nerve.
Structures passing deep IN the carpal tunnel ?
❑ Median nerve
❑ Tendons of
➢ fl. digit. superficialis.
➢ fl. digit. profundus.
➢ flexor pollicis longus
➢ flexor carpi radialis
❑ Common synovial sheath of tendons
What is carpal tunnel syndrome?
Squeezing of the median nerve inside the carpal tunnel
Name this structure of the palmar fascia ,, and define it
Fibrous flexor sheaths ;
❑ These are dense plates of fibrous tissue which arch across the flexor tendons in the fingers
Define: The Synovial Sheaths of Flexor Tendons
And what’s it’s function ?
Synovial Sheaths of Flexor Tendons ;
- def : Tubular synovial sacs which surround the terminal parts of the tendons before its insertion
-to provide a sort of lubrication
The red arrow points to :
This structure is the….. for the 8 tendons of….. muscles
-1- Ulnar bursa ;
- common synovial sheath ,, flexor digitorum , superficialis & profundus
The black arrow points to :
Which surrounds the tendon of…… muscle
-2- Radial bursa ;
-Flexor pollicis longus
….. is the thick and strong fibrous sheet that covers the middle part of the palm
Palmar Aponeurosis
Shape and attachments of the Palmar Aponeurosis ?
- triangular in shape
- The apex: receives the insertion of Palmaris longus tendon& is divided at the roots of the medial 4 fingers into 4 slips.
Define Dupuytren contracture
a deformity in the hand in which the medial part of the palmar aponeurosis undergoes fibrosis producing progressive shortening and flexion of the little and ring fingers.
In Dupuytren contracture ; fibrosis of the ….. (Aspect of structure) produces progressive shortening and flexion of the little and ring fingers
medial part of the palmar aponeurosis
.
What is the Pulp space ?
It is the space which lies over the palmar surface of the terminal (distal) phalanx
Describe structure of the pulp space :
-It is divided into separate loculi that contain subcutaneous fat.
- It is the space which lies over the palmar surface of the terminal (distal) phalanx
Infection of the pulp space is very painful due to…..
accumulation of pus in narrow spaces under tension
Intrinsic muscles of the hand are….(no-) small muscles arranged in…. (No-)groups
20 ,, 3
The three groups of hand muscles ?
- I.Lateral group ; short muscles of thumb
- III.Central palm muscles ; [small muscles of fingers]
- II.Medial group ; short muscles of little finger
The I.Lateral group ; short muscles of thumb includes what muscles ?
- 3 Thenar muscles
- 1 Adductor pollicis deep to them
The three Thenar muscles of the lateral group ?
1.Abductor pollicis brevis.
2.Flexor pollicis brevis.
3.Opponens pollicis.
Nerve supply of the 3 Thenar muscles ?
(Abductor pollicis brevis, Flexor pollicis brevis and Opponens pollicis) ?
The Median Nerve
Nerve supply of the Adductor pollicis muscle ?
The Ulnar Nerve
The following diagram illustrates the different movements of the thumb ,,
-name them ;
-and mention the muscles responsible for each move
-Abductor pollicis brevis
- Adductor pollicis
- Extension ??
- Flexor pollicis brevis
- Opponens pollicis
The II.Medial group muscles ; [short muscles of little finger] includes :
- 3 Hypothenar muscles
- 1 Palmaris brevis
The 3 Hypothenar muscles ?
1.Abductor digiti minimi.
2.Flexor digiti minimi.
3.Opponens digiti minimi
The ….. muscle is superficial to the Hypothenar muscles
Palmaris brevis
Origin of the Palmaris brevis muscle ?
From palmar aponeurosis retinaculum
Insertion of the Palmaris brevis muscle ?
Skin of the medial border of the hand
Action of the Palmaris brevis muscle ?
Deepen the hollow of the palm to improve grip of the palm during holding a rounded object
Nerve supply of the 3 hypothenar muscles ?
ulnar nerve
Nerve supply of the Palmaris brevis muscle ?
ulnar nerve
Action of the Abductor digiti minimi ?
Abducts the little finger
Action of the Flexor digiti minimi ?
Flexes the little finger
Action of the Opponens digiti minimi ?
Pulls the 5 thmetacarpal bone forwards & rotates it laterally to deepen the hollow of the palm during gripping
Mention all the :
III.Central palm muscles [small muscles of fingers]
➢ 4 Lumbricals
➢ 4 Palmar interossei
➢ 4 Dorsal interossei
Name the muscles
Lumbrical muscles
Origins of the Lumbrical muscles ?
Tendons of Flexor Digitorum Profundus
…. are muscles of the hand that have No bony attachments
The Lumbrical muscles
The……. (tarteeb) lumbricals are unipennate
1 st & 2 nd lumbricals
The……. (tarteeb) lumbricals are supplied by median nerve
1 st & 2 nd lumbricals
The……. (tarteeb) lumbricals are bipennate
3 rd & 4 th lumbricals
Nerve supply of the 3rd& 4th lumbrical muscles ?
deep terminal branch of ulnar nerve
Name the muscles
Action of the Lumbrical muscles ?
Together with interossei → Put the fingers in writing position ;
- Flex the M-P joints
- extend the I-P joints ;;
through the extensor expansions of the medial 4 fingers
Name this group of muscles ,, and mention their fibrous arrangement shape
Name this group of muscles ,, and mention their fibrous arrangement shape
NERVE SUPPLY of all the interosseios muscles ?
Ulnar Nerve (deep terminal branch)
ACTION of the Palmar interosseis ?
ADDUCT the fingers towards the axis of the middle finger (Pad)
ACTION of the Dorsal interosseis ?
ABDUCT the fingers from the axis of the middle finger (Dab)
Which group of the palm muscles Put the fingers in the writing position ?
III.Central palm muscles ;
- Interossies muscles
-Lumbiricals
Name and define this structure
Extensor Retinaculum ;
A fibrous band that extends obliquely across the back of wrist
The Anatomical “snuff box” ?
It is a hollow on the lateral part of the wrist.
That can be identified when the thumb is abducted & extended
Medial Boundarie of the Anatomical “snuff box” ?
extensor pollicis longs
Lateral Boundarie of the Anatomical “snuff box” ?
-abductor pollicis longus
-extensor pollicis brevis
Floor of the Anatomical “snuff box” ?
-scaphoid
-trapezium