Outline 9: Wrist and Hand Flashcards
The flexor retinaculum has attachments to:
(From) Pisiform, hook of hamate
(to) Trapezium, Scaphoid
The extensor retinaculum has attachments to:
Radius, ulna, pisiform, and triquetrum
Flexor retinaculum + carpal arch =
The carpal tunnel
What enters the hand through the carpal tunnel?
- Median nerve
Tendons of:
- FDS
- FDP
- Flexor pollicis longus
Bursa in the hand, filled with (X), enclose (Y).
X = SA fluid Y = Tendons
Tendons of (X) and (Y) pass (over/under) flexor retinaculum and continue up digit 5. They are enclosed by (Z) bursa.
X = FDS Y = FDP
Under
Z = ulnar
Tendon of (X) passes (over/under) flexor retinaculum and continues up digit 1. It’s enclosed by (Y) bursa.
X = FPL
Under
Y = radial
What can be palpated in the anatomical snuffbox?
- Scaphoid
- Trapezium
- Radial artery
Where is the flexor retinaculum, wrt the wrist?
Distal
Superficial layer of the palm contains:
Palmar aponeurosis
What’s between the superficial and middle layers of the palm?
- Median and superficial ulnar nerve branches
2. Superficial palmar arch
The middle layer of the palm contains:
Long flexor tendons and lumbricals
What’s between the middle and deep layers of the palm?
- Deep branch of ulnar nerve
2. Deep palmar arch
The deep branch of the ulnar nerve is the (muscular/cutaneous) branch.
Muscular
The median and superficial branches of the ulnar nerve are the (muscular/cutaneous) branches.
Primarily cutaneous
The superficial palmar arch supplies which part(s) of the hand?
Fingers
The deep palmar arch supplies which part(s) of the hand?
Wrist and Palm
The deep layer of the hand contains:
Interossei
What’s even more dorsal than the deep layer of the hand?
Extensor tendons
Palmaris brevis, an example of (superficial/deep) fascia in hand, attaches:
Superficial
Attaches skin to palmar aponeurosis
List the deep fascia present in the hand:
- Flexor retinaculum
- Palmar aponeurosis
- Thenar fascia
- Hypothenar fascia
What attaches to the palmar aponeurosis?
- Palmaris longus tendon
- Transverse fasciculi
- Deep transverse metacarpal ligament
- Superficial transverse metacarpal ligament
Fibro-osseous tunnels contain:
Phalanges and fibrous digital sheaths
Fibrous digital sheaths are composed of:
- Annular pulleys (vaginal ligaments)
2. Cruciate fibers
Annular pulleys are mainly attached to (cartilage/bone/tendons/other)
Bone
Synovial digital sheaths are essentially (X) surrounding (Y) of which digits?
X = bursa Y = flexor tendons
Digits 2-4
Bowstringing is prevented by which structure(s)?
Annular pulleys A4 and A2
Palmar plates are (X) that are (anterior/posterior) to which joints?
X = fibrocartilagenous covers
Anterior to IP and MCP joints
What do palmar plates connect to?
Connect to distal bone and hang over proximal bone
Vinculae are fibers of (X) that attach to (Y). What is their function?
X = long flexor tendons (FDS and FDP) Y = periosteum of bone
Provide blood supply to distal tendons
Structure(s) that protect/aid wrist in gliding mechanism during finger flexion.
Flexor retinaculum and radial/ulnar bursae
Structure(s) that protect/aid digits in gliding mechanism during finger flexion.
Annular pulleys and synovial tendon sheaths
List the general categories of intrinsic hand muscles:
- Interosseous
- Lumbricals
- Thenar
- Hypothenar
How many dorsal interossei? How many palmar?
4 dorsal and 3 palmar
Describe the architecture of the palmar interossei. And the dorsal?
Palmar are unipennate. Dorsal are bipennate.
General interossei insertion:
Extensor expansions and bases of proximal phalanges
Actions of palmar interossei:
- Flex MCP
- Extend IP
- Adduction at MCP
Actions of dorsal interossei:
- Flex MCP
- Extend IP
- Abduction at MCP