Palmar Hand Flashcards
how many carpals in the wrist?
8
how many metacarpals in the wrist?
5
how many phalanges in the digits?
14
which carpal bones have a tubercle for the transverse carpal ligament (flexor retinaculum)?
- scaphoid
- pisiform
- hook of hamate
- trapezium
“Some Professors Hardly Teach”
which carpal is the largest bone?
capitate
what 2 fascia does the palmar fascia form?
- Palmar Aponeurosis
- Digital Sheaths
what does the palmar aponeurosis form distal to the apex?
4 Longitudinal Digital Bands/Rays»_space; Fibrous Digital Sheaths
What do fibrous digital sheaths enclose?
- synovial sheaths
- tendons of FDP
- tendons of FDS
what happens with Dupuytren Contracture of Palmar Fascia?
progressive shortening, thickening, and fibrosis of palmar fasica and aponeurosis
which fingers does Dupuytren Contracture affect most?
ring & little finder
how does Dupuytren Contracture present?
- nodular thickenings of palmar aponeourosis
- painless
- flexion
3 thenar muscles
- ABductor pollicis brevis
- flexor pollicis brevis
- opponens pollicis
3 hypothenar muscles
- ABductor digiti minimi
- flexor digiti minimi brevis
- opponens digiti minimi
nerve innervation of 3 thenar muscles
recurrent branch of median nerve
abductor pollicis brevis action
assists with opposition
flexor pollicis brevis action
- flexes thumb at MCP
- assists with opposition
opponens pollicis action
flexes and medially rotates 1st metacarpal at CMC joint during opposition
what is located in the adductor compartment?
- transverse head of adductor pollicis
- oblique head of adductor pollicis
what separates the 2 heads of adductor pollicis?
radial artery»_space; deep palmar arch
adductor pollicis (both) action
-adducts thumb (thumb to palm)»_space; grip
Abductor digiti minimi action
- abducts 5th finger
- helps flex 5th proximal phalanx
flexor digiti minimi brevis action
flexes proximal phalanx 5 at MCP
opponens digiti minimi
- draws 5th metacarpal anteriorly and rotates it laterally
- opposition with the thumb
which muscles act exclusively at the CMC joint?
- opponens digiti minimi
- opponens pollicis
which muscle is a small, thin muscle in the subcutaneous tissue of the hypothenar eminence?
palmaris brevis
palmaris brevis action
- grip
- covers and protects ulnar nerve/artery
Lumbrical innervation
1-2 = median 3-4 = ulnar
dorsal interossei action
ABduct (DAB)
palmar interossei action
Adduct (PAD)
which tendons do the lumbricals arise from?
flexor digitorum superficialis tendons
lubricals action
- flex at MCP
- extend at IP
what do the interossei and lubricals attach to for MCP flexion and IP extension?
extensor expansion (dorsal hood)
what is a triangular tendinous aponerosis with:
- tendon of extensor digitorum (centrally)
- interosseus tendons (sides)
- lumbrical tendon (laterally)
extensor expansion
what do the tendons of the FDS and FDP enter deep to the flexor retinaculum
flexor sheath
what allows tendons to slide freely over each other during movement of fingers
- common flexor sheath
- digital sheath
what part of the phalanx do the anterior half of the FDS tendons attach to?
anterior base of middle phalanx
what prevents bowstringing go tendons?
fibrous digital sheaths and their synovial sheaths
bone tunnel for tendons and fibrous sheaths
osseofibrous tunnel
what is the pulley that reinforces the fibrous digital sheaths?
anular and cruciform parts of digital sheath
2 terminal branches of ulnar artery
- deep palmar branch
- superficial palmar arch
which artery crosses the floor of the anatomical snuff box
radial artery
which tendons indicate the anterior boundary of the anatomical snuff box
- tendon of abductor pollicis longus
- tendon of extensor pollicis brevis
what artery is the deep palmar arch mainly formed by?
radial artery
arteries from the deep palmar arch
- palmar metacarpal arteries
- princeps pollicis artery
- radialis indicis artery
which nerve supplies NO hand muscles?
radial nerve
which branch of the radial nerve is entirely sensory?
superficial branch of radial nerve
what is in the carpal tunnel
- tendons of FDP
- tendons of FDS
- tendon of flexor pollicis longus
- tendon of flexor carpi radialis
- median nerve
2 terminal branches of median nerve
- palmar cutaneous branch of median nerve (sensory)
- recurrent branch of median nerve (motor)
which nerve may be easily severed by minor laceration of thenar eminence?
recurrent branch of median nerve
