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Anatomy > Palm Of The Hand > Flashcards

Palm Of The Hand Flashcards

1
Q

Carpus

A

.wrist

. 8 carpal bones arranged in 2 rows of 4

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2
Q

Prox. Row of carpus from lateral to medial

A

. Scaphoid w/ tubercle
. Lunate
. Triquetral
. Pisiform

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3
Q

Distal row of carpus from lateral to medial

A

. Trapezium w/ tubercle
. Trapezoid
. Capitate
. Hamate w/ hook

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4
Q

Metacarpals

A

. Numbered I-V lat. to med.
. Has base, shaft, and head (distal)
. Bases articulate w/ distal row of carpals and each other (except I which only articulates w/ trapezium)
. Heads articulate w/ base of prox. Phalanges

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5
Q

Digits

A

. I-V lat. to med.
. II-V has 3 phalanges (prox., intermediate, distal)
. I has 2 phalanges (prox., distal)
. Distal phalanges have expanded tuberosities that support digital pads

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6
Q

Carpometacarpal (CM) joints

A

. Btw distal carpal row and metacarpal bases

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7
Q

Metacarpophalangeal (MP) joints

A

Btw metacarpal head and prox. Phalangeal bases

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8
Q

Proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints

A

Btw heads and based of adjacent phalanges

. Thumb only has 1 interphalangeal joint (IP)

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9
Q

Carpal groove

A

Deep groove formed by palmar concavity of carpus

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10
Q

Flexor retinaculum (transverse carpal ligament) and attachments

A

Fibrous specialization of deep fascia that bridges carpal groove
. Med. attachment: pisiform and hook of hamate
. Lat. attachment: tubercles of scaphoid and trapezium

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11
Q

Carpal tunnel

A

. Osseofibrous tunnel formed by carpal bones and flexor retinaculum
. Connects ant. Compartment of forearm and palm

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12
Q

Contents of carpal tunnel proper

A

. Tendons of extrinsic flexors (flexor digitorum, flexor digitorum profundus. And flexor pollicis longus mm.)
. Synovial tendon sheaths
. Median n.

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13
Q

Where does flexor carpi radialis m. Enter hand?

A

Separate compartment in lat. wall of carpal tunnel

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14
Q

T/F palm of hand lacks sebacous glands

A

T

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15
Q

T/F skin of palm of hand does not adhere to underlying deep fascia

A

F, tightly adherent to deep fascia to facilitate gripping

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16
Q

Flexion creases

A

. Reflect patterns of habitual joint movement
. Distal wrist crease
. Prox. Transverse crease
. Distal transverse crease

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17
Q

Distal wrist crease

A

Marks prox. Border of flexor retinaculum

Start fo carpal tunnel

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18
Q

Prox. Transverse crease

A

Med. end marks location of superficial palmar arterial arch

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19
Q

Distal transverse crease

A

Marks prox. Extend of distal synovial sheathes of digits II-IV

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20
Q

Dermatoglyphs

A

Fine ridges on digital pads that inc. friction and facilitate grasping

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21
Q

Simian crease

A

. Single transverse palmar crease

. Indicative of trisomy 21 but can occur in small number of general population

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22
Q

Thenar eminence

A

Lat. fleshy mass formed by intrinsic muscles of digit I

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23
Q

Hypothenar eminence

A

Med. fleshy mass formed by intrinsic muscles of digit V

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24
Q

Deep palmar fascia

A

.Continuous w/ deep fascia of forearm (antebrachial fascia)
. Thin over thenar and hypothenar eminences
. Thick over central palm and digits

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25
Q

Palmaris aponeurosis

A

. Triangular thickened fascia of central palm
. Lies superficial go long flexor tendons, nerves, and vessels entering palm
. Apex continuous proximally w/ flexor retinaculum and tendon of palmaris longus m.

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26
Q

Longitudinal digital bands

A

. Distal extensions of palmar aponeurosis

. Blend w/ fibrous digital sheaths of digits II-V

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27
Q

Medial and lateral intermuscular septa

A

. Extend from med. and lat. borders of palmar aponeurosis to attach to shafts of 3rd and 5th metacarpals
. Define central, thenar, and hypothenar compartments

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28
Q

Palmaris brevis m. OIAN

A

A: Wrinkles the skin of med. palm
. O: med. palmar aponeurosis and adjacent flexor retinaculum
I: skin of med. palm
. N: ulnar nerve (superficial branch)

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29
Q

Fibrous digital sheaths

A

. Specialization of deep fascia
. Attach along med. and lat. palmar margins of phalanges forming osseofibrous tunnels enclosing long flexor tendons and digital synovial sheaths
. Thickness and fiber orientation vary
. annular pulleys and cruciform pulleys
. Sheaths of II-V continuous proximally w/ longitudinal digital bands of palmar aponeurosis

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30
Q

Annular pulleys

A

. Thick, transversely oriented component of digital sheath

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31
Q

Cruciform pulleys

A

Thin, obliquely oriented component of digital sheath

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32
Q

Duputyren’s contracture

A

. Pathological fibrosis and shortening of palmar aponeurosis or longitudinal digital bands creases traction on the fibrous digital sheaths
. Flexors deformity of digits IV-V

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33
Q

Synovial tendon sheaths

A

. Thin-walled sacs lined by synovial membrane and containing thin layer of synovial fluid

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34
Q

Common flexor synovial sheath or ulnar bursa

A

. Common sheath enveloping tendons of flexor digitorum superficialis and flexor digitorum profundus mm.
. Begins prox. To flexor retinaculum
. Continuous distally w/ the digital synovial sheath of digit V

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35
Q

Synovial sheath of flexor pollicis longus/ radial bursa

A

. Lat. to the common synovial flexor sheath (communicates w/ it often)
. Begins prox. To flexor retinaculum
. Continuous distally w/ the digital synovial sheath of the thumb

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36
Q

Digital synovial sheaths

A

. Envelop flexor tendons w/ digital tendons
. Synovial sheaths of digits II-IV terminate prox. At the metacarpal midshaft
. Digits I and V continuous w/ radial and ulnar bursae

37
Q

Vincula

A

Specialized synovial folds (mesotenons) connecting extrinsic flexor tendons to underlying bone and ligament
. Transmits small vessels

38
Q

Bacterial tenosynovitis

A

. Caused by deep penetrating injuries
. Infections in digits I or V (radial/ulnar bursa) can spread rapidly to neighboring bursa and proximally to forearm
. Digits II-IV infections contained w/in digit

39
Q

Plane of flexion/extension in digits

A

Sagittal plane

40
Q

Abduction/adduction plane for digits

A

. Coronal plane

41
Q

Medal/lateral rotation in digits

A

. Transverse plane
. Limited in 5th CM joint
. Occurs when cupping palm or opposing thumb and little finger

42
Q

Digit I first CM joint properties

A

. 1st CM joint and palmar surface of thumb rotated medially

. Movements of thumb occur at right angles to those of the other digits

43
Q

Flexion/extension in thumb

A

. Coronal plane
. Occurs at IP, MP, and CM joints
. Flexion of 1st CM contributes significantly to thumb flexion

44
Q

Abduction in thumb

A

Move ant. Away from the plane of the palm

45
Q

Adduction in thumb

A

. Movement post. Toward plane of palm

46
Q

Opposition in thumb

A

. Compound movement involving flexion and abduction accompanied by med. rotation of 1st CM joint
. allows thumb tip to contact (oppose) tips of other digits

47
Q

Reposition in thumb

A

. Return of the thumb to the neutral position

48
Q

Extrinsic muscles of the palm

A

. Flexor digitorum superficial m.
. Flexor digitorum profundus m.
. Flexor pollicis longus m.

49
Q

Intrinsic muscles of the palm groups

A

.thenar muscles
. Hypothenar muscles
. central compartment muscles

50
Q

Thenar muscle characteristics

A

. Make up thenar eminence
. Share common origin from flexor retinaculum and its bony reattachments
. All innvervated by recurrent branch of median n.

51
Q

Thenar muscle names

A

. Abductor pollicis brevis
. Flexor pollicis brevis
. Opponens pollicis m.

52
Q

Abductor pollicis brevis IA

A

I: base of prox. Phalanx of the thumb
A: abducts thumb

53
Q

Flexor pollicis brevis m. IA

A

I: base of prox. Phalanx of the thumb
A: flexes CM and MP joints of thumb

54
Q

Opponens pollicis m. IA

A

I: lat. shaft of metacarpal
A: opposes thumb

55
Q

Hypothenar muscle characteristics

A

. Intrinsic muscles of digit V
. Common origin from flexor retinaculum and its attachments
. Innervated by deep branch of ulnar n.

56
Q

Hypothenar muscles names

A

. Abductor digiti minimi
. Flexor digiti minimi
. Opponens digiti minimi

57
Q

Abductor digiti minimi IA

A

I: medial base of prox. Phalanx of digit V
A: abducts digit V

58
Q

Flexor digiti minimi IA

A

I: base of prox. Phalanx of digit V
A: flexes MP joint of digit V

59
Q

Opponens digiti minimi IA

A

I: shaft of metacarpal V
A: opposes digit V

60
Q

Adductor pollicis m. OIAN

A

O: transverse head from shaft of metacarpal III, oblique head from capitate and bases of metacarpals II-III
I: med. base of prox. Phalanx of the thumb
A: adducts and flexes thumb
N: deep branch of ulnar n.

61
Q

Palmar interosseous muscles number of them and OIAN

A 
.3 muscles
O: shafts of metacarpals II, IV, and V
I: extensor expansions of digits II, IV, V
A: adducts and flexes thumb
N: deep branch of ulnar n.
62
Q

Dorsal interosseous muscles number and OIAN

A

. 4 muscles
O: bipennate muscles originating from adjacent metacarpal shafts
I: prox. Phalangeal bases and extensor expansions of digits II-I
A: abduction, flexion of MP joints, extension of PIP and DIP joints
N: deep branch ulnar nerve

63
Q

Lumbricals m. Number and OIAN

A

. 4 muscles
. O: tendons of flexor digitorum profundus m.
I: lat. side of extensor expansion of digits II-V
A: flexion of MP joints, extension of PIP and DIP joints, abduction of digits II-III, adduction of digits IV-V
N: lumbricals 1-2 by median n., 3-4 by deep branch of ulnar n.

64
Q

Claw-hand deformity

A

. Lumbrical paralysis causes inadequately opposed extrinsic flexors draw the affected digit into a flexed position

65
Q

T/F interossei and lumbricals all act to flex the MP joints and extend the IP joints

66
Q

What muscles perform the flexing motion of MP joints while extending IP joints most effectively?

A

Lumbricals

67
Q

Median n.

A

. Motor supply to 5 intrinsic muscles of the hand

. Innervation to lat. palm and lat. 3.5 digits

68
Q

Median nerve pathway

A

. Enters palm throug carpal tunnel deep to flexor retinaculum
. Goes ant. To long flexor tendons

69
Q

Median n. Branches and their pathways

A

. Palmar cutaneous branch: prox. To carpal tunnel, passes superficial to flexor retinaculum to supply lat. palm
. Recurrent median n.: deep to flexor retinaculum , courses proximolaterally to supply 3 thenar muscles

70
Q

What occurs when you get a superficial laceration over the thenar eminence that severs recurrent median n.?

A

Loss of opposition, weakened thumb flexion and abduction

Atrophy of thenar muscles

71
Q

Common palmar digital nn.

A

. Small branches give motor innervation to lumbricals 1-2

72
Q

Proper palmar digital nn.

A

. Terminal branches of common palmar digital nn.

. Give cutaneous innervation to palmer surfaces and nail beds of the lat. 3.5 digits

73
Q

Carpal tunnel syndrome

A

. Caused by edema or repetitive flexion/extension of wrist and fingers
. Compression. Of median n. W/in carpal tunnel
. Numbness and tingling in lat. 3.5 digits, weakness of thumb movements and clawing of digits 2-3

74
Q

Ulnar n.

A

. Motor innervation to all other intrinsic hand muscles and cutaneous innervation to palmar and dorsal aspects of med. hand and 1.5 digits

75
Q

Ulnar n. Pathway

A

. Ulnar n. Crosses the wrist in a groove btw pisiform and hook of hamate and superficial to flexor retinaculum
. Ligament bridging the groove creates an osseofibrous tunnel (ulnar Guyon’s canal) for ulnar nerve and vessels

76
Q

Ulnar n. Branches and pathways

A

. Palmar cutaneous branch: arises in forearm and supplies skin of med. palm
. Dorsal cutaneous branch: arises in forearm, supplies skin of med. side of the dorsal aspect of the hand, gives dorsal digital branches to med. 1.5 digits
. Superficial branch: supplies palmaris brevis, common
. Deep branch: passes through hypothenar muscles mass to reach the deep palmar space, gives muscular branches to hypothenar muscles, lumbricals 3-4, interossei, and adductor pollicis m.

77
Q

Common and proper palmar digital nn.

A

. Off of superficial branch of ulnar n.

. To palmar surfaces and nail beds of the med. 1.5 digits

78
Q

To achieve full anesthesia of a finger local anesthetic must be injected on ____

A

Both sides (med. and lat.) of digital base

79
Q

Cyclist’s palsy

A

. Numbness or tingling of med. 1.5 digits and weakness of intrinsic hand muscles
. Caused by ulnar nerve compression

80
Q

What happens when ulnar n. Is severed?

A

. Clawing of digits 4-5, inability to ab/adduct digits and wasting of intrinsic palm muscles

81
Q

Ulnar artery

A

. Accompanies ulnar nerve through ulnar canal then curves lat. to form superficial palmar arterial arch

82
Q

Ulnar a. Deep branch

A

Accompanies the deep branch of ulnar n. And unites w/ radial artery to complete the deep palmar arterial arch

83
Q

Radial a. Superficial branch

A

Penetrates thenar muscle mass and anastomoses w/ altar. A. To complete superficial palmar arterial arch

84
Q

Radial artery pathway

A

. Winds dorsally across floor of anatomical snuffbox
. Passes btw heads of 1st dorsal interosseous m. To reach central compartment
. Gives large branches (princeps pollicis and radialis indicis aa.) to the 1st 2 digits
. Curves medially deep to adductor pollicis m. (Oblique head) to form deep palmar arterial arch

85
Q

Superficial palmar arterial arch

A

. Formed primarily by ulnar a. And completed by superficial palmar branch of radial a.
. Lies deep to palmar aponeurosis but superficial to extrinsic flexor tendons
. Groves rise to common palmar digital arteries

86
Q

Palmar digital aa. Pass distally and divide into ___

A

Proper palmar digital aa.

87
Q

Deep palmar arterial arch

A

. Formed primarily by radial a. And completed by deep palmar branch of ulnar a.
. Prox. To superficial arch and distal to metacarpal bases
. Ant. To metacarpal shafts and interosseous mm. But post. (Deep) to adductor pollicis m.
. Gives rise to palmar metacarpal aa.

88
Q

Palmar metacarpal aa.

A

. Pass distally in intermetacarpal spaces

. Terminate by anastomosing w/ common palmar digital aa.

89
Q

How to control bleeding in surgical field of palm

A

. Temporarily ligate brachial a.

Anatomy (49 decks)

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