Palm of the hand Flashcards
Where is the thenar eminence
area at the base of the thumb
Where is the hypothenar eminence
area at the base of the little finger
How many digital branches are there in each finger
2 - one that runs down the lateral side and the other is more medial
What does the radial nerve innervate
small part seen at the base of the thumb, small parts on the palmer side and a large portion of the dorsum of the hand
What do both the ulnar and radial arteries divide into
a superficial and deep branch
What does the superficial branch of the radial and ulnar artery do
Unite to form the superficial palmer arch
What artery is the main contributor to the superficial palmer arch
ulnar artery
What do the deep branches of the ulnar and radial artery do
unite to form the deep palmer arch
Which artery is the main contributor to the deep palmer arch - ulnar or radial
radial
What is an anastomses
when arteries come together and have a joint blood supply and mix
What branches does the superficial palmer arch give
3-5 branches called common digital arteries
Where do the common digital arteries run
they run with the digital nerves in either side if the digits beside the flexor sheath (one for ulnar and one for medial). Rejoin at tip of finger to form terminal anastomose
Where do branches of the deep palmer arch run
mainly branches running to the thumb
What is the palmer aponeurosis
connective tissue structure that sits in the middle of the palm
What is the function of the palmer aponeurosis
an attachment for other structures, where the skin finds firm attachment to some deeper structures
What doe the thenar group of muscles form
the thenar eminence
What does the hypothenar group of muscles form
the hypothenar eminence
What are the groups of intrinsic muscles
interosseous muscles, lumbricals, short muscles of the thumb, short muscles of the little finger
How many interosseous muscles are ther
7
Where are the interosseous muscles
one for each side of the index, middle and ring finer and there is one for radial side of little finger
How many dorsal and palmer interosseous muscles are there
4 dorsal and 3 palmer
Where do the 2 interosseous muscles of the middle finger arise from
the shaft of their own metacarpal and its neighbours.
Where are the 2 interosseous muscles of the middle finger located
pass behind deep transverse metacarpal ligament, on each side of MP joint they narrow down into a double tendon that has a long and short part
Where does the short part of the interosseous muscle insert
onto the base of proximal phalanx
Where does the long part of the interosseous tendon insert
it joins the extensor mechanism to become the most outer-lying part
How does the long interosseous tendon join the extensor mechanism
merges with the lateral slip of the extensor tendon, forms the lateral band of the extensor mechanism
What do the 2 lateral bands of the extensor mechanism so
come together distally, to insert on distal phalanx
What is the line of action of the interosseous muscles
passes in front of the axis of rotation on the MP joint and behind the axis of the 2 IP joints
What happens when the 2 interosseous muscles of one finger contract together
flexes the MP joint and extends both IP joints
What happens when tone of the interosseous muscles contracts separately
produces an ulnar or radial deviation
What us the interosseous muscle on the radial side of the index finger called
the first dorsal interosseous muscle
Describe the first dorsal interosseous muscle
it is large and has 2 heads which arise from the first and second metacarpals
Which artery passes between the 2 heads of the first dorsal interosseous muscle
Radial artery
What is the function of the first dorsal interosseous muscle
powerful radial deviation of the index fingers
How many lumbrical muscles are there
4 - one for each finger
Where does each lumbrical arise from
the side of one or both of adjoining flexor digitorum profundus tendons
Where does each lumbrical pass
in front of the deep transverse metacarpal ligaments
Where does each lumbrical insert
on the radial side of the extensor mechanism, ditsal to the long part of the interosseous tendon
What is the action of the lumbrical
reinforces the action of the interossei by extending the IP joints and the radial deviation of the MP joint
How many short muscles of the thumb are there
4 - one lies by itself and 3 lie close together
Which of the short muscles of the thumb lies by itself
adductor policis
What are the 2 heads of adductor pollicis
a transverse and oblique head
Where does the transverse head of adductor pollicis arise from
3rd metacarpal
Where does the oblique head of adductor pollicis arise
from the ligaments in the base of the carpal tunnel
Where does adductor pollicis insert
on the ulnar sesamoid bone and on the base of the proximal phalanx of the thumb
What does adductir pollicis do
produces adduction at the carpometacarpal joint
What are the 3 muscles that make up the thenar eminence
On the outside there is flexor pollicis brevis and abductor pollicis brevis. Deep to them both is opponens pollicis
Where does abductor brevise arise from
the trapezium and flexor retinaculum
Where does flexor brevis arise from
the flexor retinaculum and from the trapezoid
Where does abductor brevis and flexor brevis insert
on the base of the proximal phalanx of the thumb on the radial side
Where does opponens pollicis arise from
the trapezium and the flexor retinaculum
Where does opponens pollicis insert
on the radial side of the first metacarpal
What is the function of the thenar muscles
They produce abduction and flexion at the carpometacarpal joint – brings thumb away from second metacarpal and across the palm, rotating it medially
What are the 3 muscles that make up the hypothenar eminence
Outside there is abductor digiti minimi and flexor digiti minimi. Deep to them lies opponens digit minimi.
Where does abductor digiti minimi arise and insert
arises from the pisiform bone and inserts partly into the base of the proximal phalanx and partly into the extensor mechanism
Where does flexor flexor digiti minimi arise and insert
arises from the hamate bone and the flexor retinaculum and inserts near the abductor on the proximal phalanx
Where does opponens digiti minimi arise and insert
arises from the hook of the hamate and inserts along the ulnar side of the fifth metacarpal
What passes under flexor opponens as they enter the hand
ulnar nerve and artery
What is the function of flexor digit minimi
helps flex the MP joint
What is the function of opponens digit minimi
produces flexion of the firth metacarpal - the carpometacarpal joint
What is the radial arteries relationship with the muscles as it runs down the forearm
artery runs down the forearm, deep to brachioradialis, it lies on pronator teres, flexor digitorum superficialis, and flexor pollicis longus
Where does the radial artery lie in the distal forearm
it emerges from beneath brachioradialis and lies superficially, between the border of the radius, and the tendon of flexor carpi radialis
What does the radial artery do at the wrist
At the wrist it gives off the superficial branch then spirals around the lateral aspect of the wrist, running beneath the tendons of abductor pollicis longus, extensor pollicis brevis and extensor pollicis longus
Which artery passes between the 2 heads of the first dorsal interosseous muscle
radial
Where does the radial artery give off branches to
to the thumb and sometimes index finger
What does the radial artery pass between to enter the palm
the 2 heads of adductor pollicis
After the radial artery emerges from the 2 heads of adductor pollicis where does it go
it crosses in front of the interossei, anastomosing with branches of the ulnar artery to form deep palmer branch
What does the ulnar artery first pass beneath
pronator teres
After the ulnar artery has passed under pronator etres what does it do
gives off the common interosseous branch
Where does the ulnar artery pass after it has given off its branch
between the 2 heads of flexor digitorum superficialis
As the ulnar artery runs down the forearm what does it run between
Flexor digitorum superficialis and profundus
In the distal forearm where does the ulnar artery emrge
along with ulnar nerve, between flexor digitorum superficialis and flexor carpi ulnaris
Where does the ulnar artery pass at the wrist
it passes through the carpal tunnel in the side of the flexor retinaculum to reach the hand
What does the ulnar artery do once it emerges from the carpal tunnel
divides into large and superficial branch
Where does the deep ulnar branch go
between the hypothenar muscles
Where does the superficial branch of the ulnar artery go
runs behind the palmer aponeurosis and runs across the palm in front of the flexor tendons
Which artery is the median nerve next to
brachial artery
Where does the median nerve pass through
, it dives between the 2 heads of pronator teres. Then passes between the 2 heads of flexor digitorum superficialis. Then passes down the forearm between flexor digitorum superficialis and profundus. It emerges at the wrist to the radial side of the superficialis tendons
What is the median nerve crossed by
tendons of palmaris longus and flexor carpi radilais
After the median nerve has passed through the carpal tunnel where does it lie
reaches the hand and lies just beneath the palmer aponeurosis
What does the median nerve give off in the pal
a motor branch to thenar muscles and common digital nerves
What do the common digital nerves break up into
palmer digital nerves - 2 each for thumb, index and middle fingers and one for radial side of ring finger
Where does median nerve provide sensory distribution
to medial half of palm, the flexor aspect of the thumb, index and middle fingers and radial side of ring finger
Which extrinsic hand muscles does median nerve supply
it suppled the flexor digitorum superficialis, pollicis longus and radial half of flexor digitorum profundus
Which intrinsic hand muscles does the median nerve supply
3 thenar muscles and the radial 2 lumbricals
How does the ulnar nerve enter
by passing round the medial epicondyle and between the 2 heads of flexor carpi ulnaris
As the ulnar nerve runs down the forearm what is it between
flexor carpi ulnaris and flexor digitorum superficialis, with profundus deep to it
What branch does the ulnar nerve give off as it goes down the foream
a dorsal sensory branch which goes to the back of the hand
What die sthe ulnar nerve run by at the wrist
the radial side of the flexor carpi ulnaris
What does the ulnar nerve pass through at the wrist
the side tunnel in the edge of the flexor retinaculum
What does the superficial branch of the ulnar nerve do
divides into palmer digital nerves for the little finger and ulnar side of ring finger
Where does the deep branch of the ulnar nerve pass
between hypothenar muscles
Where does the deep branch of the ulnar nerve run across
runs across palm in front of interossei and passes in between the 2 heads of adductor pollicis
Where does the ulnar nerve provide sensory branch
to ulnar half of the front and back of the hand and to the little finger and ulnar half of ring finger
What extrinsic muscles does ulnar nerve innervate
innervates ulnar half of flexor digitorum profundus
What intrinsic muscles foes the ulnar nerve innervate
innervates the hypothenar muscles, all the interossei, adductor pollicis and ulnar 2 lumbricals
As flexor digitorum profundus emerges from the carpal tunnel what does it give rise to
the lumbricals
What does superciicalis and profundus enter before the MP point
the flexor tendon sheath
What happens to superficial tendon over the proximal phalanx
splits into 2 halves which pass around the profundus tendon
When do the 2 halves of superficialis tendon reunite
middle phalanx which they insert onto
Where does the profundus tendon emerge
emerges between the 2 halves of suoerficialis and continues distally to insert on the base of the distal phalanx
What passes through the carpal tunnel
flexor pollicis longus, median nerve, flexor digitorum profundus and superficialis
