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GA Lecture NVB > Outline 9: Wrist and Hand > Flashcards

Outline 9: Wrist and Hand Flashcards

1
Q

The flexor retinaculum has attachments to:

A

(From) Pisiform, hook of hamate

(to) Trapezium, Scaphoid

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2
Q

The extensor retinaculum has attachments to:

A

Radius, ulna, pisiform, and triquetrum

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3
Q

Flexor retinaculum + carpal arch =

A

The carpal tunnel

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4
Q

What enters the hand through the carpal tunnel?

A
  1. Median nerve

Tendons of:

  1. FDS
  2. FDP
  3. Flexor pollicis longus
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5
Q

Bursa in the hand, filled with (X), enclose (Y).

A 
X = SA fluid
Y = Tendons
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6
Q

Tendons of (X) and (Y) pass (over/under) flexor retinaculum and continue up digit 5. They are enclosed by (Z) bursa.

A 
X = FDS
Y = FDP

Under

Z = ulnar

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7
Q

Tendon of (X) passes (over/under) flexor retinaculum and continues up digit 1. It’s enclosed by (Y) bursa.

A

X = FPL

Under

Y = radial

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8
Q

What can be palpated in the anatomical snuffbox?

A
  1. Scaphoid
  2. Trapezium
  3. Radial artery
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9
Q

Where is the flexor retinaculum, wrt the wrist?

A

Distal

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10
Q

Superficial layer of the palm contains:

A

Palmar aponeurosis

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11
Q

What’s between the superficial and middle layers of the palm?

A
  1. Median and superficial ulnar nerve branches

2. Superficial palmar arch

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12
Q

The middle layer of the palm contains:

A

Long flexor tendons and lumbricals

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13
Q

What’s between the middle and deep layers of the palm?

A
  1. Deep branch of ulnar nerve

2. Deep palmar arch

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14
Q

The deep branch of the ulnar nerve is the (muscular/cutaneous) branch.

A

Muscular

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15
Q

The median and superficial branches of the ulnar nerve are the (muscular/cutaneous) branches.

A

Primarily cutaneous

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16
Q

The superficial palmar arch supplies which part(s) of the hand?

A

Fingers

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17
Q

The deep palmar arch supplies which part(s) of the hand?

A

Wrist and Palm

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18
Q

The deep layer of the hand contains:

A

Interossei

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19
Q

What’s even more dorsal than the deep layer of the hand?

A

Extensor tendons

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20
Q

Palmaris brevis, an example of (superficial/deep) fascia in hand, attaches:

A

Superficial

Attaches skin to palmar aponeurosis

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21
Q

List the deep fascia present in the hand:

A
  1. Flexor retinaculum
  2. Palmar aponeurosis
  3. Thenar fascia
  4. Hypothenar fascia
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22
Q

What attaches to the palmar aponeurosis?

A
  1. Palmaris longus tendon
  2. Transverse fasciculi
  3. Deep transverse metacarpal ligament
  4. Superficial transverse metacarpal ligament
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23
Q

Fibro-osseous tunnels contain:

A

Phalanges and fibrous digital sheaths

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24
Q

Fibrous digital sheaths are composed of:

A
  1. Annular pulleys (vaginal ligaments)

2. Cruciate fibers

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25
Q

Annular pulleys are mainly attached to (cartilage/bone/tendons/other)

A

Bone

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26
Q

Synovial digital sheaths are essentially (X) surrounding (Y) of which digits?

A 
X = bursa
Y = flexor tendons

Digits 2-4

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27
Q

Bowstringing is prevented by which structure(s)?

A

Annular pulleys A4 and A2

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28
Q

Palmar plates are (X) that are (anterior/posterior) to which joints?

A

X = fibrocartilagenous covers

Anterior to IP and MCP joints

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29
Q

What do palmar plates connect to?

A

Connect to distal bone and hang over proximal bone

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30
Q

Vinculae are fibers of (X) that attach to (Y). What is their function?

A 
X = long flexor tendons (FDS and FDP)
Y = periosteum of bone

Provide blood supply to distal tendons

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31
Q

Structure(s) that protect/aid wrist in gliding mechanism during finger flexion.

A

Flexor retinaculum and radial/ulnar bursae

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32
Q

Structure(s) that protect/aid digits in gliding mechanism during finger flexion.

A

Annular pulleys and synovial tendon sheaths

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33
Q

List the general categories of intrinsic hand muscles:

A
  1. Interosseous
  2. Lumbricals
  3. Thenar
  4. Hypothenar
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34
Q

How many dorsal interossei? How many palmar?

A

4 dorsal and 3 palmar

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35
Q

Describe the architecture of the palmar interossei. And the dorsal?

A

Palmar are unipennate. Dorsal are bipennate.

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36
Q

General interossei insertion:

A

Extensor expansions and bases of proximal phalanges

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37
Q

Actions of palmar interossei:

A
  1. Flex MCP
  2. Extend IP
  3. Adduction at MCP
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38
Q

Actions of dorsal interossei:

A
  1. Flex MCP
  2. Extend IP
  3. Abduction at MCP
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39
Q

Lumbricals attach to (ulnar/radial/both) sides of what?

A

Radial sides of extensor expansions

40
Q

Superficial thenar muscles:

A

Abductor pollicis brevis

Flexor pollicis brevis

41
Q

Which tendon(s) contain(s) a sesamoid bone? Why?

A

Flexor pollicis brevis and adductor pollicis

Protects the FPL tendon as it goes out to attach to distal phalanx of thumb

42
Q

Middle layer of thenar muscle:

A

Opponens pollicis

43
Q

Deep layer of thenar muscle:

A

Adductor pollicis

44
Q

The less-mobile of digits 2-5 are which two? They have 1 (X) and 2 (Y).

A

3 and 4

X = extensor muscle
Y = intertendonous connection
45
Q

The more-mobile of digits 2-5 are which two? They have 1 (X) and 2 (Y).

A

2 and 5

X = intertendonous connection
Y = extensor muscles
46
Q

Extensor expansion consists of:

A
  1. Central tendon of ED
  2. Lateral bands of ED
  3. Transverse retinacular ligaments
  4. Tendons of interossei and lumbricals
47
Q

When MCP joints are flexed, extensor expansion is (proximal/distal) because ED is (relaxed/contracted).

A

Distal; relaxed

48
Q

What pulls on the extensor hood during MCP Flexion?

A

Lumbricals and interossei

49
Q

When ED and intrinsics are activated, which joint(s), if any, are in extension?

A

All joints (MCP, IP) are extended

50
Q

When ED contracts, what happens to the extensor hood?

A

Extensor hood is pulled proximally, covers MCP joints

51
Q

The ulnar artery enters the hand and branches off into:

A
  1. Dorsal carpal branch
  2. Palmar carpal branch
  3. Superficial palmar arch
  4. Deep branch
52
Q

Which two branches off the ulnar artery supply the wrist?

A

The dorsal and palmar carpal branches

53
Q

The ulnar artery’s (X) branch gives off the dorsal carpal rete, which then gives off:

A

X = dorsal carpal

The dorsal carpal rete gives off:
Dorsal metacarpal and dorsal digital branches

54
Q

The (X), which stems from the (ulnar/radial) artery, gives off the (Y), which are the main blood supply for the fingers.

A

X = superficial palmar arch

Ulnar

Y = common and proper palmar digital branches

55
Q

The (X) branch of the ulnar artery completes the deep palmar arch.

56
Q

Which arteries feed into the common palmar digital arteries?

A

Palmar metacarpal arteries

57
Q

The palmar metacarpal arteries, which feed into (X), stem from (Y).

A

X = common palmar digital arteries

Y = deep palmar arch

58
Q

The (X) branches of (Y) arteries feed into the dorsal metacarpal arteries.

A 
X = perforating 
Y = palmar metacarpal
59
Q

Before turning toward the (palmar/dorsal) side of the hand at the (X) process, the radial artery gives off which branches?

A

Dorsal
X = Styloid

  1. Palmar carpal branch
  2. Superficial palmar branch
60
Q

The radial artery’s (X) branch supplies the wrist.

A

X = palmar carpal

61
Q

The radial artery’s (X) branch completes the superficial palmar arch.

A

X = superficial palmar branch

62
Q

In the snuff box, the radial artery branches into:

A
  1. Princips pollicis
  2. Radialis indicis
  3. Dorsal carpal branches
63
Q

Which branch(es) off the radial artery contribute to the dorsal carpal rete?

A

The dorsal carpal branches

64
Q

The radial artery eventually travels between (X) and completes the (Y).

A

X = two heads of first dorsal interosseous

Y = deep palmar arch

65
Q

List the veins in the hand.

A
  1. Dorsal digital veins
  2. Intercapitular (or dorsal metacarpal) veins
  3. Lateral veins
  4. Medial veins
66
Q

The (X) vein in the hand becomes the (Y) vein in the antebrachium and then becomes the axillary vein.

A 
X = lateral
Y = cephalic
67
Q

The (X) vein in the hand becomes the (Y) vein in the antebrachium and then becomes the brachial vein.

A 
X = medial
Y = basilic
68
Q

When you think of SENSATION, which nerve should you think of?

A

Median nerve

69
Q

Median nerve enters hand by passing under:

A

Flexor retinaculum

70
Q

Upon entering the hand, the median nerve branches into:

A
  1. Palmar cutaneous branch
  2. Muscular (recurrent) branch
  3. Common and proper palmar digital nerves
  4. Communicating branch
71
Q

The (X) branch off the median nerve goes to flexor retinaculum.

A

X = palmar cutaneous

72
Q

Which branches of the (X) nerve are affected by Carpal Tunnel Syndrome?

A

X = median

  1. Muscular branch
  2. Common and proper palmar digital nerves
  3. Communicating branch
73
Q

The muscular branch of the median nerve innervates:

A

2.5 thenar muscles

We know these from lab: 1/2 LOAF

74
Q

Nerves to lumbricals 1 and 2 branch off of (X), which branches off of (Y) nerve.

A

X = common palmar digital nerves

Y = median

75
Q

Compression of median nerve results in (X). What are mild symptoms? And severe?

A

X = carpal tunnel syndrome

Mild: tingling, buzzing sensation and muscle weakness

Severe: loss of sensation and muscle paralysis

76
Q

A cut or severed median nerve in the wrist area results in:

A

Severe cutaneous loss

77
Q

A cut or severed median nerve in the thenar eminence results in:

A

Loss of 2.5 thenar muscles (not big handicap)

78
Q

Before entering the palm, the ulnar nerve gives off which branch(es)?

A

Palmar cutaneous branch and dorsal branch

79
Q

The (X) branch of the (Y) nerve innervates the cutaneous portion of medial palm.

A

X = palmar cutaneous

Y = ulnar

80
Q

The (X) branch of the ulnar nerve innervates cutaneous ulnar half of digit (Y) and

A 
X = dorsal 
Y = 4

Dorsal body

81
Q

Canal of Guyon is a space made by which four structures?

A

Scaphoid, pisiform, flexor retinaculum and palmar carpal ligament

82
Q

Which structures would you find in the Canal of Guyon?

A

Ulnar artery
Ulnar nerve
FCU tendon

(“ANT”)

83
Q

The (X) branch of the (Y) nerve is cutaneous except for the motor branch that innervates (Z), a muscle that connects skin to palmar aponeurosis.

A

X = superficial

Y = ulnar

Z = palmaris brevis

84
Q

The ulnar nerve’s (X) branch divides and branches into:

A

X = superficial

  1. Motor to palmaris brevis
  2. Common and proper palmar digital nerves
  3. Communicating branch
85
Q

The ulnar nerve’s (X) branch supplies multiple muscles. List them.

A

X = deep

Hypothenar muscles, interossei, lumbricals 3 and 4, adductor pollicis, deep head FPB

86
Q

In claw hand, the thumb is (abducted/adducted) because which muscle is lost?

A

Abducted

Adductor pollicis

87
Q

In claw hand, the MCP joints are (flexed/extended) because (X) muscle(s) is/are lost and (Y) muscle(s) dominate(s).

A

Extended

X = Lumbricals 4 and 5; interossei

Y = ED

88
Q

In claw hand, the IP joints are (flexed/extended) because (X) muscle(s) is/are lost and (Y) muscle(s) dominate(s).

A

Flexed

X = interossei; lumbricals 4 and 5

Y = FDS and FDP

89
Q

In claw hand: Between digits 2-5, which digit(s) is/are not as affected as the others? Explain.

A

Digits 2 and 3 not as affected

Median nerve innervation for the two radial lumbricals

90
Q

In claw hand, is there any cutaneous loss? If so, where?

A

Yes

Ulnar side of palm and dorsum
Digit 5 and ulnar half of digit 4

91
Q

List the wrist and hand joints (total of 6):

A
  1. Radiocarpal (wrist)
  2. Intercarpal
  3. Carpometacarpal
  4. Intermetacarpal
  5. Metacarpo-phalangeal
  6. Interphalangeal
92
Q

The radiocarpal joint is which type of joint?

93
Q

The most important ligament in the palm is:

A

Palmar radiocarpal ligament

94
Q

In MCP joints, what ligament(s) attach(es) to the palmar ligaments?

A
  1. Collateral
  2. Fibrous digital sheaths
  3. Deep transverse metacarpal
95
Q

Which ligament in MCP joint is tightest during flexion?

A

Collateral ligament

96
Q

What does the deep transverse metacarpal ligament attach to? In which digits?

A

Both sides of adjacent finger metacarpals; between all digits EXCEPT between 1 and 2

97
Q

Blood and nerve supply for MCP and IP joints:

A

Digital arteries and digital nerves

GA Lecture NVB (12 decks)

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