Session 10

Question 1

Which bone is not part of the wrist joint

Answer 1

Ulna

Question 2

Carpal bones form a

Answer 2

Convex surface which articulates with convex surface of radius and triangular fibrocartilage

Question 3

What type of joint is wrist

Answer 3

Ellipsoid synovial joint- movement in flexion, extension, adduction, abduction

2 axis

Question 4

What is the wrist joint stabilised by

Answer 4

Dorsal and palmar radiocarpal ligaments (ensure hand follows radius during pronation and supination)

Ulnar and radial collateral ligaments

Question 5

Muscles responsible for flexion of the wrist

Answer 5

Flexor carpi ulnaris
Flexor carpi radialis
Palmaris longus

Question 6

Muscles responsible for extension of the wrist

Answer 6

Extensor carpi radialis longus
Extensor carpi radialis brevis
Extensor carpi ulnaris

Question 7

Wrist adduction produced by

Answer 7

Extensor carpi ulnaris

Flexor carpi ulnaris

Question 8

Abduction at wrist is produced by

Answer 8

Extensor carpi radialis longus
Extensor carpi radialis brevis
Flexor carpi radialis

Question 9

Bones of hand

Answer 9

Scaphoid 
Lunate 
Triquetrum
Pisiform
Trapezium
Trapezoid 
Carpitate
Hamate

Question 10

Hamate has what on palmar surface

Answer 10

Projection called the hook which forms ulnar border of carpal tunnel and radial border of Guyon’s canal

Question 11

Blood supply of scaphoid?

Answer 11

Dorsal carpal branch of radial artery
Retrograde flow

Scaphoid fractures hence have high rate of non-union

Question 12

Each metacarpal consists of

Answer 12

Base shaft and head

Medial and lateral surfaces are concave and accommodate interossei muscles

Question 13

What is radial abduction

Answer 13

Continuation of extension beyond the anatomical position in the same plane of the palm

Question 14

What is palmar abduction

Answer 14

Raising thumb in sagittal plane, perpendicular to palm

Question 15

Difference between intrinsic and extrinsic muscles of the hand

Answer 15

Intrinsic- originate within the hand and insert with the hand
Extrinsic- originate within the forearm and insert within the hand

Question 16

4 compartments of intrinsic muscles

Answer 16

Thenar compartment- abductor pollicis brevis, flexor pollicis brevis, opponens pollicis

Adductor compartment- adductor pollicis

Hypothenar compartment- abductor digiti minimi, flexor digiti minimi, opponens digiti minimi

central compartment- lumbricals, interossei, palmaris brevis

Question 17

Thenar compartment-

Answer 17

abductor pollicis brevis, flexor pollicis brevis, opponens pollicis

Question 18

Adductor compartment-

Answer 18

adductor pollicis

Question 19

Hypothenar compartment-

Answer 19

abductor digiti minimi, flexor digiti minimi, opponens digiti minimi

Question 20

central compartment-

Answer 20

lumbricals, interossei, palmaris brevis

Question 21

Thenar eminence supplied by

Answer 21

Median nerve, except deep head of flexor pollicis brevis supplied by ulnar

Question 22

2 heads of adductor pollicis

Answer 22

Transverse head and oblique head

Question 23

Hypothenar compartment innervated by

Answer 23

Ulnar nerve

Question 24

Central compartment nerve supply

Answer 24

Radial 2 lumbricals- median nerve

Ulnar 2 lumbricals- ulnar nerve

Question 25

What do lumbricals do

Answer 25

Link flexor digitorum profundus tendon on palmar surface to extensor digitorum tendon on dorsum When they contract they flex the fingers at the MCPJ and extend at PIP

Question 26

Lumbricals to index and middle fingers are

Answer 26

Unipennate

Question 27

Lumbricals to ring and little fingers are

Answer 27

Bipennate

Question 28

2 groups of interossei

Answer 28

Dorsal and palmar

Question 29

Interossei actions

Answer 29

DAB (dorsal abduct) PAD (palmar adduct) Assist lumbricals in flexing MCPJs and extending IPJs Ulnar nerve

Question 30

Central slip in RA causes

Answer 30

Boutonnière deformity

Question 31

FDP originates from

Answer 31

Proximal 2 thirds of shaft of ulna Inserts into base of distal phalanx

Question 32

FDS originated from

Answer 32

Medial epicondyle of humerus and superior half of radius Insert into base of middle phalanx

Question 33

Deep border of carpal tunnel

Answer 33

Carpal bones form concavity

Question 34

Supericial border of carpal tunnel

Answer 34

Flexor retinaculum

Question 35

Attachments of flexor retinaculum

Answer 35

Lateral- scaphoid, trapezium Medial- hook of hamate, pisiform

Question 36

Structures passing through carpal tunnel

Answer 36

Flexor pollicis longus Flexor digitorum superficialis tendons x4 Flexor digitorum profundus tendons x4 Median nerve

Question 37

Tendons of FDS through carpal tunnel

Answer 37

Middle and ring finger pas superficial to index and little finger

Question 38

What supplies sensation to the radial 2/3rds of palm

Answer 38

Palmar cutaneous branch of median nerve given off proximal to carpal tunnel This is why sensation to the palm is unaffected

Question 39

What passes through Guyon’s canal

Answer 39

Ulnar nerve and artery

Question 40

Guyon’s canal location

Answer 40

Superficial to flexor retinaculum | Lateral to pisiform bone and hook of hamate

Question 41

Guyon’s canal roof

Answer 41

Palmar carpal ligament

Question 42

What is anatomical snuff box

Answer 42

Radial fossa- triangular depression on radial aspect of dorsum of hand at level of carpal bones

Question 43

Medial and lateral Borders of anatomical snuffbox

Answer 43

Lateral- tendons of abductor pollicis longus, extensor pollicis brevis Medial- tendon of extensor pollicis longus

Question 44

Proximal border, floor and roof of anatomical snuffbox

Answer 44

Proximal border- styloid process of radius Floor- scaphoid and trapezium Roof- skin

Question 45

Contents of anatomical snuffbox

Answer 45

Radial artery Superficial branch of radial nerve Cephalic vein

Question 46

Arterial supply of hand

Answer 46

Radial and ulnar artery via deep and superficial palmar arches

Question 47

Superficial palmar arch gives off

Answer 47

Common palmar digital arteries Ulnar contributes mainly to superficial palmar arch so fingers

Question 48

Radial artery contributes mainly to

Answer 48

Deep palmar arch, blood supply of thumb and radial side of index finger

Question 49

3 branches of brachial plexus that supply hand

Answer 49

Median radial and ulnar

Question 50

Median and ulnar nerve arise from

Answer 50

Anterior brachial plexus - supply anterior forearm

Question 51

Radial nerve arises from the

Answer 51

Posterior divisions of the brachial plexus and therefore supplies the posterior compartment of the forearm

Question 52

ulnar nerve supplies

Answer 52

All intrinsic muscles of hand except LOAF

Question 53

What are LOAF and what supplies them

Answer 53

Median nerve Lumbricals- lateral 2 Opponens pollicis Abductor pollicis brevis Flexor pollicis brevis (superficial head)

Question 54

Nerve supply to palm of hand is derived from the

Answer 54

Palmar cutaneous branch of median nerve And palmar cutaneous branch of ulnar nerve Palmar digital branches arise in palm

Question 55

How do you test for sensation in radial nerve

Answer 55

Dorsum of 1st web space

Question 56

How do you test for sensation in median nerve

Answer 56

Palmar surface of tip of index finger

Question 57

How do you test for sensation in ulnar nerve

Answer 57

Ulnar border of hand