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Gross Anatomy > Quiz 3 > Flashcards

Quiz 3 Flashcards

1
Q

Sternoclavicular Joint

A
  • Fairly stable modified saddle joint
  • Fibrocartilagenous disc
  • Dislocations uncommon but can be dangerous with brachiocephalic veins right behind manubrium
  • Only boney attachment from apenedicular to axial skeleton
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2
Q

Sternoclavicular Ligaments

A

-Bind clavicle to the manubrium on both the anterior and posterior surfaces

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3
Q

Interclavicular Ligament

A

-Binds the medial surfaces of both the left and the clavicles to each other

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4
Q

Costoclavicular Ligament

A
  • Binds the clavicle to the first rib

- Branches of the brachial plexus can get trapped under there causing pain and muscle weakness

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5
Q

Sternoclavicular Joint (Innervation)

A
  • Subclavius Nerve

- Supraclavicular nerve (C3, C4)

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6
Q

Sternoclavicular Joint (Blood Supply)

A
  • Suprascapular

- Internal Thoracic

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7
Q

Acromioclavicular Joint

A
  • Planar type joint
  • Acromion to lateral end of the clavicle
  • Ligaments are the main stabilizing force
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8
Q

Acromioclavicular Ligament

A

-Binds clavicle to the acromion

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9
Q

Coracoclavicular Ligaments

A
  • Bind coracoid process with scapula

- Made of two parts

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10
Q

Conoid Ligaments

A

-Part of the coracoclavicular ligaments

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11
Q

Trapezoid Ligaments

A

-Part of the coracoclavicular ligaments

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12
Q

Acromioclavicular Joint (Innervation)

A
  • Suprascapular

- Lateral Pectoral

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13
Q

Acromioclavicular Joint (Blood Supply)

A
  • Suprascapular

- Thoracoacromial (Clavicular, acromion)

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14
Q

Glenohumeral Joint

A
  • Most mobile joint

- Ball and socket synovial joint

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15
Q

Coracoacromial Ligament

A
  • Coracoid process and to the acromion

- Prevents upward dislocation

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16
Q

Coracohumeral ligament

A
  • Strengthens superior portion of the capsule

- Resists excessive abduction

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17
Q

Transverse Humeral Ligament

A

-Tendon of the long head of biceps in the bicipital groove

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18
Q

Superior Glenohumeral Ligaments

A

-Over the humeral head to the depression above the lesser tuberosity

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19
Q

Middle Glenohumeral Ligament

A
  • In front of the lesser tuberosity

- Most common dislocation

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20
Q

Inferior Glenohumeral Ligament

A
  • Lower part of the anterior neck

- Key stabilizer of the anterior shoulder and weakness of the ligament often leads to anterior glenohumeral instability

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21
Q

Glenoid Labrum

A
  • Rim of fibrocartilage attaching to the outer rim of the glenoid fossa
  • Superior attachment of the labrum includes the supraglenoid tubercle and the origin of the biceps long head tendon
  • Deepens the articulation between the head of the humerous and the glenoid fossa
  • Tears often associated with genohumeral dislocations
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22
Q

Capsule of the shoulder joint

A

-Very thin and lax

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23
Q

Subscapular Bursa

A
  • Between the muscle and the neck of the scapula

- Communicates with the shoulder joint

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24
Q

Subacromial/ Subdeltoid

A
  • Inferior to the acromion and extending distally to area deep to the deltoid
  • Superficial to supraspinatous
  • Normally doesn’t communicate with the joint
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25
Q

Glenohumeral Joint (Innervation)

A
  • Suprascapular
  • Axillary
  • Lateral Pectoral
  • Posterior cord of the brachial plexus
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26
Q

Passive Stability Provided by:

A
  • Trapezius (Postoral muscle)
  • Deltoid (Prevents dislocation of the humerus)
  • Inferior Glenohumeral Ligament
  • Coracohumeral Ligament
  • Glenoid Labrum
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27
Q

Active Stability Provided by:

A

Rotator Cuff Muscles

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28
Q

Shoulder Impingement

A
  • Overuse injury

- Fatigue of Rotator cuff muscles

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29
Q

Shoulder Impingement (Causes)

A
  • Any movement that reduce contact between head of humerous and glenoid fossa
  • Full abduction renders the shoulder joint unstable
  • Muscles fatigue causing the supraspinatous tendon to rub between the greater tubercle and the acromion
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30
Q

Shoulder Impingement (Tests)

A
  • Painful Arc Test
  • Full Can Test
  • Empty Can Test
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31
Q

Painful Arc Test

A
  • Tests shoulder impingement
  • Have patient fully abduct their arm
  • Extreme pain will be from 60-120 degrees of motion
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32
Q

Full Can Test

A
  • Have patient abduct their arm to the level of their shoulder
  • With arm in that position have them outwardly rotate their shoulder
  • Press down
  • Patient should be able to resist without pain
  • No pain because the supraspinatous tendon is away from acromion
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33
Q

Empty Can Test

A
  • Have patient abduct their arm to the level of their shoulder
  • With arm in that position have them inwardly rotate their shoulder
  • Press down
  • If patient has difficulty resisting your pressure or is in a lot of pain then the supraspinatous tendon is affected
  • Pain because tendon is directly on the acromion
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34
Q

Elbow Joint

A
  • Synovial Hinge Joint
  • Humeroradial Joint
  • Humeroulnar Joint
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35
Q

Humeroradial Joint

A

-Capitulum and head of radius

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36
Q

Humeroulnar Joint

A

-Trochlea and trochlear notch of ulnar

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37
Q

Capsule of elbow joint

A
  • Thin anteriorly and posteriorly
  • Attaches anteriorly to area proximal to coronoid and radial fossae and to annular ligament
  • Attaches posteriorly to the olecranon fossa and to trochlear notch
  • Synovial capsule continuous with that of radioulnar joint
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38
Q

Radial or Collateral Ligament

A
  • Fan shaped

- Lateral epicondyle of humerus and distally blends with the annular ligament of the radius

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39
Q

Ulnar or Medial Collateral Ligament

A
  • Triangular
  • Anterior from front of medial epicondyle of humerus to tubercle on medial margin of coronoid
  • Posterior from lower, back part of medial epicondyle to medial margin of the olecranon
  • Oblique connects the distal attachments of the two
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40
Q

Olecranon Bursa (two)

A
  • One subcutaneous

- One deep to the tendons of the triceps

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41
Q

Radioulnar Bursa

A

-Between extensor digitorum, supinator, and radiohumeral joint

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42
Q

Interosseal Bursa

A

-Behind supinator, lateral to biceps

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43
Q

Bicipitoradial Bursa

A

Between biceps and tuberosity of radius

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44
Q

Elbow Joint (Innervation)

A
  • Musculocutaneous (anterior lateral portion)
  • Radial
  • Some ulnar, median, and anterior interosseous
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45
Q

Elbow joint (Blood Supply)

A

-Anastomosis
~Connects brachial artery with radial and ulnar
~Circulation to forearm and wrist even with complete elbow flexion
-Deep brachial artery

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46
Q

Proximal Radioulnar Joint

A
  • Synovial Joint
  • Formed by the head of the radius with the radial notch of the ulnar
  • Synovial Cavity communicates with joint
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47
Q

Annular Ligament

A

-Circles the head of the radius forming 4/5 of the ring

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48
Q

Proximal Radioulnar Joint (Innervation)

A
  • Musculocutaneous
  • Median
  • Radial
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49
Q

Proximal Radioulnar Joint (Blood Supply)

A
  • Brachial Artery
  • Deep Brachial Artery
  • Radial Artery
  • Ulnar Artery
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50
Q

Anterior (Flexor) Compartment of the Arm (Muscles)

A
  • Biceps Brachii
  • Brachialis
  • Coracobrachialis
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51
Q

Anterior Compartment of the Arm (Nerve)

A
  • Musculocutaneous
  • C5-7
  • C6 is main contributor
  • C6 Dermatome
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52
Q

Anterior Compartment of the Arm (Blood Supply)

A
  • Branches of the brachial artery
  • Muscular branch
  • Collateral branch
  • Deep brachial branch
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53
Q

Posterior (Extensor) Compartment of the Arm (Muscles)

A
  • Triceps Brachii

- Anconeous

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54
Q

Posterior Compartment of the Arm (Nerve)

A
  • Radial Nerve
  • Contains C5-T1
  • C5-7 main contributors
  • C5 dermatome
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55
Q

Posterior compartment of the Arm (Blood Supply)

A

-Deep brachial artery

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56
Q

Cubital Fossa (Boundaries)

A
  • Superior: Imaginary line between epicondyles
  • Medial: Pronator Teres
  • Lateral: Brachioradialis
  • Roof: Skin, fascia, bicipital aponeurosis
  • Floor: medial= brachialis, lateral= supinator
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57
Q

Cubital Fossa (Contents)

A

-Radial Nerve
-Biceps tendon
-Brachial Artery
~Terminal Branches= Radial and ulnar
-Median Nerve

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58
Q

Venapuncture

A
  • Horizontal vein across the cubital fossa
  • Combo of the basilic and cephalic vein
  • Used for IVs
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59
Q

Flexor (Anterior) compartment of the forearm

Pronator Muscle

A
  • Pronator Teres

- Pronator quadratus

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60
Q

Wrist Flexor Muscles

A
  • Flexor Carpi Radialis
  • Palmiris Longus
  • Flexor Carpi Ulnaris
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61
Q

Digital Flexor Muscles

A
  • Flexor digitorum superficialis
  • Flexor digitorum profundus
  • Flexor pollicis longus
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62
Q

Median Nerve Innervation for Forearm

A
  • Pronator teres
  • Pronator quadratus
  • Flexor Carpi radialis
  • Palmaris longus
  • Flexor digitorum superificialis
  • Radial 1/2 of the flexor digitorum profundus
  • Flexor pollicis longus
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63
Q

Ulnar Nerve Innervation for Forearm

A
  • Flexor carpi ulnaris

- Ulnar portion of the flexor digitorum profundus

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64
Q

Lateral Cutaneous Forearm Innervation

A
  • Lateral antebrachial cuntaneous

- Terminal branch of the musculocutaneous

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65
Q

Medial Cutaneous Forearm Innervation

A

-Medial antebrachial nerve

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66
Q

What does the Radial Artery supply?

A
  • Muscular branches to the muscles in the flexor compartment

- Recurrent branches participate in the anastomosis of the elbow

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67
Q

What does the Ulnar Artery supply?

A
  • Muscular branches to the muscles in the flexor compartment

- Recurrent branches participate in the anastomosis of the elbow

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68
Q

Ulnar Artery Branches

A
  • Common Interosseous
  • Anterior= supplies deep lying muscles structures in the flexor compartment
  • Posterior= Main blood supply to the extensor compartment
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69
Q

Anatomical Snuff Box (Contents)

A
  • Abducotr pollicis longus
  • extensor pollicis brevis
  • extensor pollicis longus
  • Radial artery
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70
Q

Wrist Extensors

A
  • Extensor Carpi Radialis Longus
  • Extensor Carpi Radialis Brevis
  • Extensor Carpi Ulnaris
  • Extends to radial side because they are stronger extensors
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71
Q

Finger Extensors

A
  • Extensor Digitorum
  • Extensor Digiti Minimi
  • Extensor Indicis
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72
Q

Compartment 1 (Contents)

A
  • Abductor pollicis longus

- Extensor pollicis brevis

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73
Q

Compartment 2 (Contents)

A

-Extensor carpi radialis longus and brevis

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74
Q

Compartment 3 (Contents)

A

-Extensor Pollicis longus

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75
Q

Compartment 4 (Contents)

A
  • extensor digitorum

- extensor indicis

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76
Q

Compartment 5 (Contents)

A

-Extensor digit V

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77
Q

Compartment 6 (Contents)

A

-Extensor Carpi Ulnaris

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78
Q

Compartment 1 (Clinical Significance)

A

-Repetitive motion of thumb and wrist cause inflammation of the tendon sheath narrowing of the space within the first compartment

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79
Q

Compartment 1 (Tests)

A

-have patient fold thumb under fingers and ulnarly deviate and this will replicate the tension

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80
Q

Biceps Brachii (Attachments)

A
  • Short head proximal: tip of the coracoid process
  • Long head proximal: super glenoid tubercle
  • Distal: Radial tuberosity and aponeurosis
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81
Q

Biceps Brachii (Innervation)

A

Musculocutaneous Nerve

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82
Q

Biceps Brachii (Action)

A
  • most powerful supinator of the forearm
  • Flex forearm
  • flex arm
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83
Q

Brachialis (Attachments)

A
  • Proximal: distal half of the anterior surface of the humerus
  • Distal: Coronoid process and ulnar tuberosity
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84
Q

Brachialis (Innervation)

A

Musculocutaneous nerve

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85
Q

Brachialis (Action)

A

Flex forearm

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86
Q

Coracobrachailis (Attachments)

A
  • proximal: coracoid process of the scapula

- distal: middle 1/3 of the medial surface of the humerus

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87
Q

Coracobrachialis (Innervation)

A

Musculocutaneous

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88
Q

Coracobrachialis (Action)

A
  • flex arm

- addict arm

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89
Q

Triceps Brachii (Attachments)

A
  • lateral head proximal: posterior surface of the humerus superior to the radial groove
  • medial head proximal: posterior surface of the humerus inferior to the radial groove
  • long head proximal: infraglenoid tubercle of the scapula
  • distal: olecranon of ulnar
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90
Q

Triceps Brachii (Innervation)

A

Radial nerve

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91
Q

Triceps Brachii (action)

A
  • extends forearm

- long head extends arm

92
Q

Anconeus (Attachment)

A
  • proximal: lateral epicondyle of the humerus

- distal: later surface of the olecranon and posterior part of the ulnar

93
Q

Anconeus (Innervation)

A

Radial nerve

94
Q

Anconeus (action)

A
  • extends forearm

- abducts ulna during pronation

95
Q

Pronator teres (attachments)

A
  • proximal: Coronoid process of ulna and medial epicondyle of humerus
  • distal: Lateral surface of radius
96
Q

Pronator teres (Innervation)

A

Median nerve

97
Q

Pronator teres (action)

A
  • pronate forearm

- flex forearm

98
Q

Flexor carpi radialis (attachments)

A
  • proximal: medial epicondyle of the humerus

- distal: base of the second metacarpal

99
Q

Flexor Carpi Radialis (Innervation)

A

Median nerve

100
Q

Flexor Carpi Radialis (action)

A
  • Flex hand

- Abduct hand

101
Q

Palmaris Longus (attachments)

A
  • proximal: medial epicondyle of the humerus

- distal: flexor retinaculum and palmar aponeurosis

102
Q

Palmaris Longus (Innervation)

A

Median nerve

103
Q

Palmaris Longus (action)

A
  • flex hand

- tenses palmar aponeurosis

104
Q

Flexor Carpi ulnaris (attachments)

A
  • proximal: medial epicondyle of the humerus

- distal: pisiform, hook of hamate, 5th metacarpal

105
Q

Flexor Carpi ulnaris (Innervation)

A

Unlar nerve

106
Q

Flexor Carpi ulnaris (action)

A
  • flex hand

- adduct hand

107
Q

Flexor digitorum superficialis (attachments)

A
  • proximal: medial epicondyle of humerus, Coronoid process of ulna, superior sheaf of the radius
  • distal: middle phalanx of digits 2-4
108
Q

Flexor digitorum superficialis (Innervation)

A

Medial nerve

109
Q

Flexor digitorum superficialis (action)

A
  • flexes proximal interphalangeal joint

- assists in flexion of the metacarpophalangeal joint

110
Q

Flexor digitorum profundus (attachments)

A
  • proximal: shaft of ulna, interosseous membrane

- distal: distal phalanx of digits 2-4

111
Q

Flexor digitorum profundus (Innervation)

A 
Median nerve(digits 2-3) 
Radial nerve(digits 4-5)
112
Q

Flexor digitorum profundus (actions)

A
  • flex distal interphalangeal joint

- assists wrist flexion

113
Q

Flexor pollicis Longus (attachments)

A
  • proximal: anterior surface of radius, interosseous membrane
  • distal: distal phalanx of the thumb
114
Q

Flexor pollicis Longus (Innervation)

A

Anterior interosseous nerve

115
Q

Flexor policis Longus (action)

A

Flex phalanges of thumb

116
Q

Pronator quadratus (attachments)

A
  • proximal: distal 1/4 of the anterior ulna

- distal: distal 1/4 of anterior radius

117
Q

Pronator quadratus (Innervation)

A

Anterior interosseous nerve

118
Q

Pronator quadratus (action)

A

Pronates forearm

119
Q

Brachioradialis (attachments)

A
  • proximal: proximal 2/3 of the lateral supracondylar ridge of humerus
  • distal: distal radius near styloid process
120
Q

Brachioradialis (Innervation)

A

Radial nerve

121
Q

Brachioradialis (action)

A

Flex forearm in neutral position

122
Q

Extensor Carpi Radialis Longus (attachments)

A
  • proximal: distal 1/3 of lateral supracondylar ridge of the humerus
  • distal: base of the 2nd metacarpal
123
Q

Extensor Carpi Radialis Longus (Innervation)

A

Radial nerve

124
Q

Extensor Carpi Radialis Longus (action)

A
  • extends hand

- Abducts hand

125
Q

Extensor Carpi Radialis Brevis (attachments)

A
  • proximal: lateral epicondyle of the humerus

- distal: base of 3rd metacarpal

126
Q

Extensor Carpi Radialis Brevis (Innervation)

A

Deep branch of the radial nerve

127
Q

Extensor Carpi Radialis Brevis (action)

A
  • extends hand

- abducts hand

128
Q

Extensor digitorum (attachments)

A
  • proximal: lateral epicondyle of humerus

- distal: extensor expansion of digits 2-5

129
Q

Extensor digitorum (Innervation)

A

Posterior interosseous

130
Q

Extensor digitorum (action)

A

Extends digits 2-5

131
Q

Extensor digiti minimi (attachments)

A
  • proximal: lateral epicondyle of humerus

- distal: extensor expansion of 5 digit

132
Q

Extensor digiti minimi (Innervation)

A

Posterior interosseous

133
Q

Extensor digiti minimi (action)

A

Extends 5th digit

134
Q

Extensor Carpi Ulnaris (attachments)

A
  • proximal: lateral epicondyle of the humerus and posterior ulna
  • distal: base of 5th metacarpal
135
Q

Extensor Carpi ulnaris (Innervation)

A

Posterior interosseous

136
Q

Extensor Carpi ulnaris (action)

A
  • Extends hand

- Adducts hand

137
Q

Supinator (attachments)

A
  • proximal: lateral epicondyle of humerus and supinator crest of ulna
  • distal: proximal 1/3 of radius
138
Q

Supinator (Innervation)

A

Deep branch of radial nerve

139
Q

Supinator (action)

A

Supinates forearm

140
Q

Abductor pollicis Longus (attachments)

A
  • proximal: posterior aspect of proximal radius, ulna and interosseous membrane
  • distal: base of 1st metacarpal
141
Q

Abductor pollicis Longus (Innervation)

A

Posterior interosseous

142
Q

Abductor pollicis Longus (action)

A
  • abducts thumb

- extends thumb

143
Q

Extensor pollicis Longus (attachments)

A
  • proximal: posterior aspect of middle 1/3 of ulna and interosseous membrane
  • distal: base of distal phalanx of thumb
144
Q

Extensor pollicis Brevis (Innervation)

A

Posterior interosseous

145
Q

Extensor pollicis Longus (Innervation)

A

Posterior interosseous

146
Q

Extensor pollicis Longus (action)

A

Extends thumb

147
Q

Extensor pollicis Brevis (attachments)

A
  • proximal: posterior aspect of distal 1/3 of radius and interosseous membrane
  • distal: base of distal phalanx of the thumb
148
Q

Extensor pollicis Brevis (action)

A

Extends thumb

149
Q

Extensor indicis (attachments)

A
  • proximal: posterior aspect of distal 1/3 of ulna and interosseous membrane
  • distal: extensor expansion of 2nd digit
150
Q

Extensor indicis (Innervation)

A

Posterior interosseous

151
Q

Extensor indicis (actions)

A

Extends 2nd digit

152
Q

Proximal carpal row from lateral to medial:

A
  • scaphoid
  • lunate
  • triquetrum
  • pisiform
153
Q

Distal row of carpals from lateral to medial

A
  • trapezium
  • trapezoid
  • capitate
  • hamate
154
Q

Radiocarpal component

A

-condyloid articulation between the distal end of the radius with the scaphoid and lunate bones

155
Q

Intercarpal component

A
  • articulation between adjacent carpal bones

- little movement because of the string interosseous ligaments

156
Q

Midcarpal component

A
  • articulation between proximal and distal rows of carpals

- no interosseous ligament= movement at that joint

157
Q

Carpometacarpal joints

A
  • articulation of the base of the metacarpal and the distal row of carpals
  • 2-5th digit allow for little movement
158
Q

1st Carpometacarpal joint

A
  • between trapezium and first metacarpal
  • true saddle joint
  • enables opposable thumbs
159
Q

Triangular fibrocartilage complex

A
  • triangular fibrocartilage disc separates the triquetrum bone so that the ulna strictly speaking is not part of the wrist
  • Helps distribute force from the hand to the radius and ulna
  • Increases the range of motion for ulnar and radial deviation
  • Greatly increase the capacity of the wrist to absorb the forces from falling and other things
160
Q

Ulnar collateral ligament

A
  • Binds styloid process of the ulna to the proximal row of carpals
  • Very strong
  • Limits wrist abduction
161
Q

Radial collateral ligament

A
  • attaches the styloid process of the radius to the carpal bones
  • limits the amount of wrist adduction
162
Q

Palmar radiocarpal ligament

A
  • binds carpals to the palmar surface of the wrist

- limits amount of wrist extension

163
Q

Dorsal radiocarpal ligament

A
  • binds carpals to the dorsal surface of the wrist

- limits wrist flexion

164
Q

Flexor Retinaculum

A
  • continuation of deep fascia of forearm that attaches to trapezium, scaphoid, hamate, and pisiform
  • converts the space between the ligament and bones into the carpal tunnel
165
Q

Sensory Innervation for the wrist

A
  • Median (Anterior interosseous)
  • Radial (Posterior interosseous)
  • Ulnar (carpal branch)
166
Q

Blood supply to the wrist

A
  • Radial artery
  • Ulnar artery
  • Through dorsal and palmar carpal branches
167
Q

Wrist fractures

A
  • Often result from FOOSH
  • Most common to the scaphoid
  • Noticeable pain in the snuff box
  • Bleeding from deep radial artery
168
Q

Colles fracture

A
  • Pain and swelling just above the wrist
  • Inability to hold or lift any objects with significant weight
  • Dinner fork appearance because wrist maybe pushed back over broken bone
169
Q

Radial Nerve Lesion symptoms from cubital fossa and above

A
  • Wrist drop
  • Loss of sensation in the dorsum of the hand
  • Especially noticeable in prone position
  • Confirm nerve damage by placing wrist in supine extension and the patient won’t be able to resist your flexing of their wrist
170
Q

Tenosynovitis

A

-inflammation/ irritaion within the synovial sheath around the tendons of the forearm muscles and they cross the wrist

171
Q

Tedinosis

A
  • disruption of the tendon

- caused by damage of to the tendon synovial sheath

172
Q

Metacarapal Joints (MP)

A

-Condylois joints between the head of the metacarpal with the base of proximal phalanx

173
Q

Proximal Interphalangeal Joint (PIP)

A

-Articulation between the head of the proximal phalanx with the base of the middle phalanx

174
Q

Distal Interphalangeal Joint (DIP)

A

-Articulation between the head of the middle phalanx and base of the distal phalanx

175
Q

Interphalangeal Joinr (IP)

A
  • In thumb

- hinge joint

176
Q

Thick palmar carpal ligament

A

-Made of fibrocartilage reinforces the metacarpophalangeal and interphalangeal joints

177
Q

Ulnar and radial collateral ligaments of MP joint

A
  • Support the mc joint
  • taut during flexion and loose during extension
  • Difficult to abduct fingers during flexion
178
Q

Game Keeper’s Thumb

A
  • Common injury of hyperabduction of mp joint of the themb
  • Tears ulnar collateral ligament and can result in fractures to the head of the 1st metacarpal and proximal phalanx of the thumb
179
Q

Annular and cruciform bands

A

-bind to palmar plates to form longitudinal grooves in which the digital tendon sheath are supported as they cross the joint

180
Q

Palmar plates of MP joints (Digits 2-5)

A
  • United to form the transverse metacarpal ligament

- Keeps the heads of the metacarpal from being mobile

181
Q

MP IP PIP and DIP Joints (Blood Supply)

A

-Superficial palmar arch

182
Q

MP IP PIP and DIP Joints (Innervation)

A

-Median and ulnar nerves

183
Q

Power grip

A

-Tightly grasping between fingers and palm

184
Q

Power Grip (Actions)

A
  • Extension of wrist providing tension thus allowing maximal contraction of finger flexors
  • Finger IP joints are flexed by flexor digitorum superficialis and profundus
  • MC joints are flexed by interossei
  • Thumb is strongly adducted by adductor pollicis
185
Q

Precision Grip

A
  • Used when threading a needle
  • Lumbricals are active on the first finger if flexed while ip joint is extended
  • Thenar muscles are used whenever the thumb is opposed
186
Q

Carpal Tunnel

A

-Compression of the median nerve due to inflammation of tendons

187
Q

Carpal Tunnel (Sensory Symptoms)

A
  • Range from pain and redness to parathesia and ultimately anesthesia along the cutaneous innervation of the median nerve
  • Pain is usually felt over the palmar surface of the first 3.5 digits
188
Q

Carpal Tunnel (Motor Symptoms)

A
  • Starts as weak opposition of the thumb
  • Lost ability of opposition of thumb
  • Wasting of thenar eminence
  • Eventually causing ape-hand because adductor pollicis, and extensor pollicis brevis
189
Q

Pronator Teres Syndrome (Causes)

A

-The median nerve is compressed as it goes through the pronator teres

190
Q

Pronator Teres Syndrome (Symptoms)

A
  • Wrist flexion and radial deviation are weakened due to loss of flexor carpi radialis
  • Papal hand: First two fingers are extended because extensors act unopposed and thumb is in ape position
  • Inability to make a closed fist
  • Precision grip is difficult
191
Q

Guyon’s Tunnel Syndrome (Causes)

A
  • Compression of the ulnar nerve as it passes into the hand
  • Tunnel between pisiform and hook of hamate
  • Symptoms depend on where and how the ulnar nerve divides
192
Q

Guyon’s Tunnel Syndrome (Symptoms)

A

-Wrist function is unaffected
-If sensory branch: parasthesia of ulnar side of of the hand of both dorsal and palmar surfaces
-If motor branch:
~Thumb will hyperabduct
~No abduction or adduction MC joints of the fingers
~Hard to make tight fist

193
Q

Cubital Tunnel Syndrome

A
  • Proximal Ulnar nerve lesion
  • All the symptoms of distal ulnar lesion
  • Movements of flexion and ulnar deviation very weak
194
Q

Tinel Sign

A
  • Tapping on the entrapped nerve

- Tapping will reproduce sensory syptoms

195
Q

Phalen’s Test

A
  • Have patient hold hands in inverse prayer position for at least 30 seconds
  • Positive sign is tingling on palmar surface of thumb and 1 and 2 fingers
196
Q

Froment’s Sign

A
  • Indicates ulnar nerve damage

- Cannot tightly hold a piece of paper between thumb and first finger

197
Q

Mallet finger

A
  • Damage to the insertion of the lateral slips of the extensor mechanism at the base of the distal phalanx
  • DIP cannot extend so it ends up flexed
198
Q

Boutonniere Deformity

A
  • PIP is in flexed position
  • Damage to the central band of the extensor mechanism onto the base of the middle phalanx allowing flexor digitorum superficialis to act unopposed
  • Laterl bands exert a constant pull on the DIP forcing this joint into the extended position
199
Q

Swan Neck Deformity

A
  • Results from rheumatoid arthritis
  • DIP and MP joints are flexed while PIP joint is hyperextended
  • Inflammation of the long flexor tendon sheath causes the MP joint to be in flexion
  • Inflammation leads to disruption of the palmar plate of PIP joint causing hyperextension
  • All this causes the flexor digitorum profundus to put the DIP joint into flexion
200
Q

Stenosing Tenosynovitis (Trigger Finger)

A
  • The affected digit is in the flexed because of swelling of the common flexor digitorum sheath
  • Painful
  • Passively extended with a sudden popping into place
201
Q

Extensor Hood

A
  • Covers the MP joints of each finger
  • Formed by the extensor digitorum, interossei, and lumbricals
  • Extensor indices for 2nd digit
  • Extensor digiti minimi for 5th digit
202
Q

Bands of Dorsal Digital Expansion

A
  • Central band: base of the middle phalanx

- 2 lateral bands extend to the distal phalanx of each finger

203
Q

Dorsal Digital Expansion (Function)

A
  • Enables extrinsic extensor tendons to strongly extend the MP joint
  • Allow DIP and PIP to be extended while MP is flexed
204
Q

Abductor Pollicis Brevis (Attachments)

A
  • Proximal: flexor retinaculum, scaphoid and trapezium

- Distal: Base of proximal phalanx of thumb

205
Q

Abductor Pollicis Brevis (Innervation)

A

Recurrent branch of the median nerve

206
Q

Abductor Pollicis Brevis (Action)

A
  • Abducts thumb

- Assists with opposition

207
Q

Flexor Pollicis Brevis (Attachments)

A
  • Proximal: flexor retinaculum, scaphoid and trapezium and palmar surface of the 1st metacarpal
  • Distal: Base of the proximal phalanx of the thumb, medial to Abductor pollicis brevis
208
Q

Flexor Pollicis Brevis (Innervation)

A

Recurrent Branch of the median nerve

209
Q

Flexor Pollicis Brevis (Action)

A
  • Flexes MCP, CMC joints

- Aids in opposition

210
Q

Opponens Pollicis (Attachments)

A
  • Proximal: Flexor retinaculum and trapezium

- Distal: Lateral aspect of palmar 1st metacarpal

211
Q

Opponens Pollicis (Innervation)

A

-Recurrent branch of the median nerve

212
Q

Opponens Pollicis (Action)

A
  • Opposition

- Draws thumb to palm and medially rotates

213
Q

Abductor Digiti Minimi (Attachments)

A
  • Proximal: Pisiform, flexor carpi ulnaris tendon, pisohamate ligament
  • Distal: Medial side base of proximal phalanx of the little finger, and the extensor hood
214
Q

Abductor Digiti Minimi (Innervation)

A

Deep Ulnar

215
Q

Abductor Digiti Minimi (Action)

A
  • Abduct pinky

- Aids in flexion of MP joint

216
Q

Flexor digiti Minimi (Attachments)

A
  • Proximal: Hook of the hamate and flexor retinaculum

- Distal: Medial base of proximal phalanx; fuses with abduct pollicis minimi

217
Q

Flexor Digiti Minimi (Innervation)

A

-Deep Ulnar

218
Q

Flexor Digiti Minimi (Action)

A

-Flex MP joint of pinky

219
Q

Opponens Digiti Minimi (Attachments)

A
  • Proximal: Hook of the hamate and flexor retinaculum

- Distal: Medial portion of palmar 5th metacarpal

220
Q

Opponens Digiti Minimi (Innervation)

A

Deep ulnar

221
Q

Opponens Digiti Minimi (Action)

A

-Draws the 5th metacarpal forward and rotates it laterally

222
Q

Adductor Pollicis (Attachments)

A

-Proximal: Oblique head: base of 2 and 3 meta carpals and capitate
Transverse head: Anterior 3rd metacarpal
-Distal: Medial side of base of proximal phalanx

223
Q

Adductor Pollicis (Innervation)

A

Deep Ulnar

224
Q

Adductor Pollicis (Action)

A
  • Adduct thumb

- Assist in power grip

225
Q

Lumbricals (Attachments)

A
  • Proximal: Tendons of digitorum profundus

- Distal: Radial side of extensor hood

226
Q

Lumbricals (Innervation)

A
  • Later 2= median

- Medial 2= deep ulnar

Gross Anatomy (3 decks)

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