Movement and Muscles of the Hand Flashcards
Does the thumb have a middle phalanx?
No, it only has a proximal and distal phalanx
Why is pisiform not strictly a carpal bone?
It is a sesamoid bone (similar to patella)
What is the function of the deep transverse metacarpal ligaments?
It connects the metacarpal joints of digits 2-5 which restricts their movement. Thumb is not included therefore is much more mobile.
Where are the palmar ligaments located on the hand?
Between the carpal bones
Which superficial flexor muscle does the palmar aponeurosis connect to?
Palmaris longus
What is the function of the palmar aponeurosis?
Protects deep structures of the hand (nerves, arteries)
What is the function of the extensor retinaculum?
Ligament prevents the extensors on the fingers from bowing out so they remain close to the joint.
Which is larger, flexor or extensor retinaculum?
Flexor retinaculum is larger because we flex the hand more than we extend it
Which is larger, flexor or extensor retinaculum?
Flexor retinaculum is larger because we flex the hand more than we extend it
Tendons of which muscles form the extensor hood of the fingers?
Tendons of the posterior extrinsic muscles (APL, EPL, EPB, ECRL, ECRB, ECU, EDM, EI, ED)
Where do the extensor hoods attach on the digits?
The distal and middle phalanges
Where do extensor hoods attach on the thumb?
The proximal and distal phalanges
Is the lumbrical muscle or dorsal interosseus muscle deep to the flexor digitorum profundus tendon on the anterior surface of the hand?
The dorsal interosseus muscle is deep to the flexor digitorum profundus, lumbrical muscles are superficial to the flexor digitorum profundus
Name the 2 ligaments involved in the extensor hoods of the fingers
Palmar ligaments
Deep transverse metacarpal ligament
Is the extensor digitorum tendon on the posterior surface of the hand deep or superficial to the deep transverse metacarpal ligament?
The extensor digitorum tendon lies deep to the deep transverse metacarpal ligament
Is the fibrous digital sheath and synovial sheath on the anterior or posterior surface of the hand?
On the anterior surface of the hand
Is the fibrous digital sheath and synovial sheath on anterior surface of hand deep or superficial to the flexor retinaculum and palmar aponeurosis?
It is deep to the flexor retinaculum and palmar aponeurosis
Is the fibrous digital sheath and synovial on the anterior surface of the hand deep or superficial to the intrinsic muscles of the hand?
It is superficial to the intrinsic muscles of the hand
Is the carpal tunnel deep or superficial to the intrinsic muscles of the finger?
The carpal tunnel is superficial to the intrinsic muscles of the fingers
What can cause a scaphoid fracture?
Falling on an outstretched hand
If a scaphoid fracture is missed what can occur in later life?
Wrist arthritis
What can be damaged from a lunate fracture?
Median nerve
Which metacarpal is damaged in Boxer’s fracture?
5th metacarpal
What can cause Boxer’s fracture?
Striking an object with a clenched fist
Which metacarpal is damaged in Bennett’s fracture?
1st metacarpal
What causes Bennett’s fracture?
Hyperabduction of the thumb
What is the name of the presentation of median nerve palsy?
Benediction hand
What is the presentation of ulnar nerve palsy?
Claw hand, hyperextension of metacarpophalangeal joint and flexion of interphalangeal joint
Why is ulnar nerve palsy not as bad if the injury occurs further up the forearm?
The muscle innervated by the ulnar nerve is more affected, so tendon flexors closer to the fingers and not as clawed
Why is ulnar nerve palsy not as bad if the injury occurs further up the forearm?
The muscle innervated by the ulnar nerve is more affected, so tendon flexors closer to the fingers and not as clawed
What is the presentation of radial nerve injury?
Wrist drop, loss of sensation in back of hand
Which tendons enable flexion of the distal phalanges, flexor digitorum superficialis or profundus?
Flexor digitorum profundus
Which tendons enable flexion of the distal phalanges, flexor digitorum superficialis or profundus?
Flexor digitorum profundus
Which carpal bone is at the medial side of the carpal tunnel?
Hook of hamate and pisiform
Which carpal bone is at the lateral side of the carpal tunnel?
Scaphoid and trapezium
Which branch of the median nerve is given off before the carpal tunnel and travels superficially to the flexor retinaculum?
Palmar cutaneous branch
What 2 branches does the median nerve divide into after the carpal tunnel?
Recurrent branch and palmar digital nerves
What 2 branches does the median nerve divide into after the carpal tunnel?
Recurrent branch and palmar digital nerves
Which flexor tendons are kept within their own synovial sheath?
Flexor digitorum superficialis (4) Flexor digitorum prfoundus (4)
Which flexor tendon is within the carpal tendon but in its own synovial sheath?
Flexor pollicis longus
Which flexor tendon is within the flexor retinaculum but not carpal tunnel and has its own synovial sheath?
Flexor carpi radials
Which flexor tendon is within the flexor retinaculum but not carpal tunnel and has its own synovial sheath?
Flexor carpi radials
What tendon allows flexion on the thumb?
Flexor pollicis longus
How many lumbrical muscles of the hands are there?
4
Are the first and second lumbricals unipennate or bipennate?
Unipennate
Are the third and fourth lumbricals unipennate or bipennate?
Bipennate
What is the origin of the lumbrical muscles of the anterior surface of hand?
Tendons of the flexor digitorum profundus
What is the insertion of the lumbrical muscles of the anterior surface of the hand?
Extensor hoods of the fingers
What is the action of the lumbrical muscles of the anterior surface of the hand?
Flexion of the metacarpophalangeal joint and extension of interphalangeal joints
What innervates the 2nd and 3rd lateral digits?
Digital branches of the median nerve
What innervates the 4th and 5th medial digits?
Deep branch of the ulnar nerve
How many muscles make up the thenar muscles?
3
Name the 3 thenar muscles
Opponens pollicis
Flexor pollicis brevis
Abductor pollicis brevis
What is the origin of opponens pollicis?
Tubercle of trapezium
What is the insertion of opponens pollicis?
Radial / Lateral side of first metacarpal
What innervates opponens pollicis?
Recurrent branch of median nerve
What is the origin of abductor pollicis brevis?
Tubercle of scaphoid
What is the insertion of abductor pollicis brevis?
Radial / Lateral side of proximal phalanx of thumb
What is the action of opponens pollicis?
Opposition of the thumb
What is the action of abductor pollicis brevis?
Abduction of the thumb
What innervates abductor pollicis brevis?
Recurrent branch of median nerve
What is the origin of flexor pollicis brevis?
Flexor retinaculum, and trapezium
What is the insertion of flexor pollicis brevis?
Base of proximal phalanx of thumb
What innervates flexor pollicis brevis?
Recurrent branch of median nerve
What is the action of flexor pollicis brevis?
Flexion of the thumb
What is the origin of the adductor pollicis?
3rd metacarpal (one head)
Capitate and base of metacarpal 2+3 (second head)
What is the insertion of adductor pollicis?
Base of the proximal phalanx of thumb
What innervates the adductor pollicis?
Deep branch of ulnar nerve
What is the action of adductor pollicis?
Adduction of the thumb
Is the thenar eminence lateral or medial?
Lateral
Is the hypothenar eminence lateral or medial?
Medial
How many hypothenar muscles are there?
3
Name the 3 hypothenar muscles
Opponens digiti minimi
Flexor digiti minimi brevis
Abductor digiti minimi
What is the origin of opponens digiti minimi?
Hooke of hamate and flexor retincaculum
What is the insertion of opponens digiti minimi?
Ulnar / Medial side of 5th metacarpal
What is the innervation of opponens digiti minimi?
Deep branch of ulnar nerve
What is the action of opponens digiti minimi?
Opposition of little finger
What is the origin of abductor digiti minimi?
Pisiform
What is the insertion of abductor digiti minimi?
Base of 5th proximal phalanx
What innervates abductor digiti minimi?
Deep branch of ulnar nerve
What is the action of abductor digiti minimi?
Abduction of little finger
What is the origin of flexor digiti minimi brevis?
Hook of hamate of flexor retinaculum
What is the insertion of flexor digiti minimi brevis?
Base of 5th proximal phalanx
What innervates flexor digiti minimi brevis?
Deep branch of ulnar nerve
What is the action of flexor digiti minimi brevis?
Flexion of little finger
What is the action of flexor digiti minimi brevis?
Flexion of little finger
What artery passes between the heads of adductor pollicis?
Radial artery
Name the 2 groups of interossei on the palm
Dorsal
Palmar
How many dorsal interossei are there?
4
What is the origin of the dorsal interossei?
Shafts of the metacarpals
What is the insertion of the dorsal interossei?
Extensor hoods and base of the first phalanxes
What innervates the dorsal interossei of the palm?
Deep branch of ulnar nerve
What is the action of the dorsal interossei of the palm?
Abduction of the digits
How many palmar interossei are there?
3
What is the origin of the palmar interossei?
Shaft of metacarpals
What is the insertion of the palmar interossei?
Extensor hoods and proximal phalanxes
What innervates the palmar interossei?
Deep branch of ulnar nerve
What is the action of the palmar interossei?
Adduction of the fingers
Name an intrinsic muscle of the hand that does not attach to a bone
Palmaris brevis
What is the origin of palmaris brevis?
Palmar aponeurosis and flexor retinaculum
What is the insertion of palmaris brevis?
Dermis of medial margin of hand
What innervates palmaris brevis?
Superficial branch of ulnar nerve
What is the action of palmaris brevis?
Deepens curvature of hand to improve grip
What structures pass over the anatomical snuffbox?
Radial artery
Cephalic vein
Superficial branches of radial nerve
What structures pass over the anatomical snuffbox?
Radial artery
Cephalic vein
Superficial branches of radial nerve
What forms the floor of the anatomical snuffbox?
Scaphoid and trapezium
Tendons of extensor carpi radialis longus and brevis
What does the recurrent branch of median nerve innervate?
Thenar muscles (motor)
What does the palmar digital nerve branch of median nerve innervate?
Tips of lateral 3.5 digits and palmar surface (sensory)
Lateral 2 lumbricals (motor)
What does the ulnar nerve branch into in the hand?
Deep branch and superficial branch
What does the deep branch of ulnar nerve innervate?
All hand muscles apart from 3 thenar muscles and 2 lateral lumbricals (motor)
What does the superficial branch of ulnar nerve innervate?
Medial 1.5 digits, mostly sensory
What branch of the radial nerve is present within the hand?
The superficial branch of radial nerve
What does the superficial branch of radial nerve innervate in the hand?
Dorsal aspect of lateral 3.5 digits and dorsal aspect of palm, small part of the anterior lateral part of palm, only sensory
Is the superficial palmar arch of ulnar artery deep or superficial to the adductor pollicis?
It is superficial to adductor pollicis
How many arteries comes off the superficial palmar arch of the posterior side of hand?
4
What is the main artery of the hand leading to the superficial palmar arch?
Ulnar artery
Name the 4 arteries that come off the superficial palmar arch
1 unnamed artery
3 palmar digital arteries
(covers medial 4 digits)
What artery does the superficial palmar arch join to laterally?
Radial artery
What is the main artery of the hand leading to the deep palmar branch?
Radial artery
How many arteries come off the deep palmar arch?
5
Name the 5 arteries that come off the deep palmar arch?
Princeps pollicis artery
Radialis indicis artery
(Lateral 2 digits)
3 palmar metacarpal arteries
What artery does the deep palmar arch attach to medially?
Deep ulnar artery
Are proper palmar digital arteries on the proximal or distal part of the digit?
On the distal part of the digit
Are common palmar digital arteries of the proximal or distal part of the digit?
One the proximal part of the digit
Name the structure by which the basilic and cephalic vein join on the dorsal surface of the hand
Dorsal venous arch
Which vein travels medially along the arm?
Basilic vein
Which vein travels laterally along the arm?
Cephalic vein
