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TBL 12 Flashcards

Functional anatomy of wrist and hand

1
Q

unique feature of hand

A

pincer-like action of thumb (grasp objects)

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2
Q

anterior (ventral) side of hand

A

palmar (volar) surface

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3
Q

posterior aspect of hand

A

dorsal (back) surface

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4
Q

digit 1

A

thumb (pollux)

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5
Q

thin, hairy, freely mobile skin of hand

A

dorsum

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6
Q

thick and hairless skin of hand

A

palm

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7
Q

sites of skin movement identified via

A

flexure creases

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8
Q

present in large numbers on hand

A

sweat glands

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9
Q

palm of the hand has a ___ that separates two eminences: ___

A

central concavity;

thenar eminence; hypothenar eminence

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10
Q

lateral, larger eminence in the base of the thumb

A

thenar eminence

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11
Q

medial, smaller eminence, proximal to base of 5th finger

A

hypothenar eminence

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12
Q

the fascia of the palm is continuous with the

A

antebrachial (forearm) fascia and dorsum fascia

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13
Q

palmar fascia is thick centrally where it forms the

A

palmar aponeurosis

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14
Q

the proximal end (apex) of the palmar aponeurosis is continuous with the

A

flexor retinaculum and palmaris longus tendon

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15
Q

articulation is between the radius and the articular disc and the scaphoid, lunate, and triquetral bones

A

radiocarpal (wrist) joint

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16
Q

the radiocarpal joint articulates between the ___ and the ___ and the ___

A

radius;
articular disc;
scaphoid, lunate, triquetrum

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17
Q

does the ulna directly participate in the joint surfaces

A

no

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18
Q

forms a concave surface, which is adapted to the distal convex surface

A

proximal articular surface of the wrist joint (radiocarpal)

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19
Q

the proximal articular surface of the radioulnar joint forms a ___ which is adapted to the ___

A

concave surface; distal convex surface

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20
Q

encloses the joint and is attached above to the distal ends of the radius and ulna and below to the proximal row of carpal bone

A

radiocarpal joint capsule

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21
Q

the wrist joint capsule is attached above to the ___ and below to the ___

A

distal radius and ulna;

proximal row of carpal bones

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22
Q

lines the capsule and is attached to the margins of the articular surfaces

A

synovial membrane of the radiocarpal joint

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23
Q

synovial membrane of the wrist joint is attached to the __

A

margins of the articular surfaces

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24
Q

the joint cavity does NOT communicate with the

A

distal radioulnar joint or the joint cavities of the intercarpal joints

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25
Q

nerve supply of the wrist joint

A

anterior interosseous nerve (from median) and the deep branch of the radial nerve

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26
Q

ligaments of the wrist joint

A

anterior (palmar radiocarpal) and posterior (dorsal radiocarpal), ulnar collateral (medial), radial collateral (lateral)

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27
Q

strengthens the radiocarpal joint capsule

A

anterior (palmar) and posterior (dorsal) radiocarpal ligaments

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28
Q

attached to the styloid process of the ulna and to the triquetral bone

A

ulnar collateral (medial) ligament

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29
Q

attached to the styloid process of the radius and to the scaphoid bone

A

radial collateral (lateral) ligament

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30
Q

the carpal bones form an arch that is convex on the ___ and concave on the ___

A

dorsal; palmar

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31
Q

palmar groove is called the

A

sulcus carpi

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32
Q

sulcus carpi is covered by the

A

flexor retinaculum

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33
Q

attached radially to trapezium and on the ulnar side to the pisiform and hook of hamate

A

flexor retinaculum

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34
Q

the flexor retinaculum is attached radially to the ___ and ulnarly to the ___

A

trapezium; pisiform and hook of hamate (hamulus)

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35
Q

the 9 tendons that pass through the carpal tunnel

A

flexor digitorum profundus (4) and superficialis (4) and flexor pollicis longus (1)

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36
Q

courses between the tendons of the flexor digitorum profundus and superficialis

A

median nerve

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37
Q

the recurrent branch of the median nerve innervates

A

the thenar muscles

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38
Q

the thenar muscles are innervated by

A

the recurrent branch of the median nerve

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39
Q

the median nerve bifurcates after the nerve

A

exits the carpal tunnel

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40
Q

in 5-10% people, the median nerve bifurcates

A

more proximally in the carpal tunnel, wrist, or forearm

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41
Q

ulnar canal / tunnel

A

Guyon’s canal

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42
Q

space between the pisiform and hamate bone through which the ulnar artery and the ulnar nerve travel into the hand

A

Guyon’s canal

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43
Q

Guyon’s canal is the space between the

A

pisiform and hamate bone

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44
Q

ulnar neuropathy is caused by

A

entrapment of ulnar nerve at the ulnar canal (Guyon’s canal)

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45
Q

guyon canal syndrome

A

rare peripheral ulnar neuropathy

injury to the distal portion of the ulnar nerve

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46
Q

movements of radiocarpal joint include

A

flexion, extension, abduction, adduction, circumduction

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47
Q

why is rotation of the radiocarpal joint not possible

A

articular surfaces are ellipsoid shaped

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48
Q

what allows rotation ??

A

radioulnar joints

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49
Q

movements that compensate for the lack of rotation in the wrist joint

A

pronation and supination of the forearm

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50
Q

flexion of the wrist joint is performed by

A

flexors of the forehand

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51
Q

the flexors of the forehand attach to the

A

metacarpal bones

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52
Q

extension of the wrist joint is performed by

A

the extensors of the forehand

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53
Q

abduction of the wrist joint is performed by

A

the flexor carpi radialis and the extensor carpi radialis longus and brevis

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54
Q

adduction of the wrist joint is performed by

A

the flexor and extensor carpi ulnaris

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55
Q

deep fascia of the wrist and palm is thickened to form

A

the flexor retinaculum and the palmar aponeurosis

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56
Q

triangular space occupying the central area of the palm

A

palmar aponeurosis

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57
Q

apex of the palmar aponeurosis is attached to

A

the distal border of flexor retinaculum

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58
Q

the apex of the palmar aponeurosis receives insertion of

A

the palmaris longus tendon

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59
Q

the base of the palmar aponeurosis divides at ___ into ___

A

the bases of the fingers; 4 slips

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60
Q

the medial and lateral borders of the palmar aponeurosis are continuous with the ___ covering the ___

A

thinner deep fascia; hypothenar and thenar muscles

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61
Q

from the medial and lateral borders of the palmar aponeurosis, ___ pass deeply into the ___ and take part in the formation of the ___

A

fibrous septa; palm; palmar fascial spaces

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62
Q

function of the palmar aponeurosis

A

gives firm attachment to the overlying skin, improves the grip and to protect the underlying tendons

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63
Q

potential spaces filled with loose connective tissue

A

fascial spaces of palm

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64
Q

boundaries of the fascial spaces of the palm are important clinically because

A

limit the spread of infection in the palm

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65
Q

passes from the ulnar border of the palmar aponeurosis and attaches to anterior border of the 5th metacarpal bone

A

medial fibrous septum

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66
Q

passes from the lateral border of the palmar aponeurosis to the anterior border of the 3rd metacarpal bone

A

lateral fibrous septum

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67
Q

passes between the long flexor tendons of the index and middle fingers

A

lateral fibrous septum

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68
Q

what limits the spread of infection in the palm

A

boundaries of the fascial spaces of palm

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69
Q

the medial fibrous septum passes from the ___ and attaches to the ___

A

ulnar border of the palmar aponeurosis;

anterior border of the 5th metacarpal bone

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70
Q

the lateral fibrous septum passes from the ___ to the ___ and between the __

A

lateral border of the palmar aponeurosis;
anterior border of the 3rd metacarpal;
long flexor tendons of the index and middle fingers

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71
Q

between the 1st and 3rd metacarpal

A

oblique septum

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72
Q

the oblique septum lies between the ___

A

1st and 3rd metacarpal

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73
Q

the palm of the hand is divided into:

A

medial, midpalmar space, thenar space (misnomer), lateral

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74
Q

part of the palm that contains the hypothenar muscles

A

medial compartment

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75
Q

part of the palm that lies between the oblique and lateral septa

A

thenar space (misnomer)

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76
Q

part of the palm that lies between the medial and oblique fibrous septum

A

midpalmar space

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77
Q

part of the palm that contains the muscles of the thenar

A

lateral compartment

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78
Q

fascial spaces of the palm: proximally, the ___ are closed off from the forearm by the ___

A

thenar and midpalmar spaces;

carpal tunnel

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79
Q

fascial spaces of the palm: distally, the thenar and midpalmar spaces are ___

A

continuous with the appropriate lumbrical canals

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80
Q

continuous with the appropriate lumbrical canals

A

distal thenar and midpalmar spaces

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81
Q

part of the palm that contains the first lumbrical muscle

A

thenar space

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82
Q

the thenar space lies deep to the ___ and superficial to the ___

A

long flexor tendons to the index finger;

adductor pollicis muscle

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83
Q

part of the palm that lies deep to the long flexor tendons to the index finger and superficial to the adductor pollicis muscle

A

thenar space

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84
Q

part of the palm that contains the second, third, and fourth lumbrical muscles

A

midpalmar space

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85
Q

the midpalmar space lies posterior to the ___ and superficial to the ___

A

long flexor tendons to the middle, ring, and little fingers;

interosseous muscles and the third, fourth, and fifth metacarpal bones

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86
Q

part of the palm that lies posterior to the long flexor tendons to the middle, ring, and little fingers and superficial to the interosseous muscles and the third, fourth, and fifth metacarpal bones

A

midpalmar space

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87
Q

a potential space surrounding the tendon of each lumbrical muscle

A

lumbrical canal

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88
Q

the lumbrical canal is normally filled with

A

connective tissue

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89
Q

is proximally continuous with one of the palmar spaces

A

lumbrical canal

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90
Q

the lumbrical canal is proximally continuous with ___

A

one of the palmar spaces

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91
Q

the muscles of the thumb include:

A

abductor pollicis brevis,
flexor pollicis brevis,
opponens pollicis,
adductor pollicis

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92
Q

which of the thumb muscles are innervated by the median nerve

A

abductor pollicis brevis,
flexor pollicis brevis,
opponens pollicis,

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93
Q

which of the thumb muscles are innervated by the ulnar nerve

A

adductor pollicis

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94
Q

muscle located superficially and laterally in the thenar eminence

A

abductor pollicis brevis

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95
Q

the abductor pollicis brevis is located ___

A

superficially and laterally in the thenar eminence

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96
Q

the origin of the abductor pollicis brevis

A

scaphoid, trapezium, flexor retinaculum

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97
Q

the insertion of the abductor pollicis brevis

A

lateral aspect of the base of the proximal phalanx of the thumb

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98
Q

muscle that originates in the scaphoid, trapezium, and flexor retinaculum and inserts in the lateral aspect of the base of the proximal phalanx of the thumb

A

abductor pollicis brevis

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99
Q

innervation of the abductor pollicis brevis

A

recurrent branch of the median nerve

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100
Q

action of the abductor pollicis brevis

A

abduction of the thumb at the carpometacarpal and metacarpophalangeal joints

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101
Q

muscle located medially and below the abductor pollicis brevis

A

flexor pollicis brevis

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102
Q

the flexor pollicis brevis is located ___

A

medially and below the abductor pollicis brevis

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103
Q

the origin of the flexor pollicis brevis

A

flexor retinaculum and trapezium

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104
Q

insertion of the flexor pollicis brevis

A

lateral aspect of the base of the proximal phalanx of the thumb (with the abductor PB)

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105
Q

muscle that originates in the flexor retinaculum and trapezium and inserts in the lateral aspect of the base of the proximal phalanx of the thumb

A

flexor pollicis brevis

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106
Q

innervation of the flexor pollicis brevis

A

recurrent branch of the median nerve

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107
Q

action of the flexor pollicis brevis

A

flexion of the thumb at the carpometacarpal and metacarpophalangeal joints

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108
Q

muscle located deep to the abductor pollicis brevis

A

opponens pollicis

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109
Q

the opponens pollicis is located ___

A

deep to the abductor PB

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110
Q

origin of the opponens pollicis

A

flexor retinaculum and trapezium

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111
Q

insertion of the opponens pollicis

A

lateral border of the shaft of the 1st metacarpal

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112
Q

muscle that originates in the flexor retinaculum and trapezium and inserts in the lateral border of the shaft of the 1st metacarpal

A

opponens pollicis

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113
Q

innervation of the opponens pollicis

A

recurrent branch of the median nerve

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114
Q

action of the opponens pollicis

A

opposition of the thumb

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115
Q

origin of the adductor pollicis

A

oblique head from the bases of metacarpals 2 and 3 and adjacent carpal bones

transverse head from the shaft of the 3rd metacarpal

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116
Q

muscle that originates in the oblique head from the bases of metacarpals 2 and 3 and adjacent carpal bones and inserts in the medial aspect of the base of the proximal phalanx of the thumb

A

adductor pollicis

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117
Q

muscle that originates in the transverse head from the shaft of the 3rd metacarpal and inserts in the medial aspect of the base of the proximal phalanx of the thumb

A

adductor pollicis

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118
Q

insertion of the adductor pollicis

A

medial aspect of the base of the proximal phalanx of the thumb

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119
Q

innervation of the adductor pollicis

A

deep branch of the ulnar nerve

120
Q

action of the adductor pollicis

A

adduction of the thumb at the carpometacarpal and metacarpophalangeal joints

121
Q

movements of the thumb

A

abduction, adduction, extension, flexion, opposition, reposition

122
Q

hypothenar muscles include:

A

abductor digiti minimi,
flexor digiti minimi brevis,
opponens digiti minimi

123
Q

innervation of the hypothenar (pinky) muscles

A

deep branch of the ulnar nerve

124
Q

muscle located superficially and medially in the hypothenar eminence

A

abductor digiti minimi

125
Q

the abductor digiti minimi is located

A

superficially and medially in the hypothenar eminence

126
Q

origin of the abductor digiti minimi

A

pisiform bone

127
Q

insertion of the abductor digiti minimi

A

medial side of the base of the proximal phalanx of the little finger

128
Q

muscle that originates in the pisiform bone and inserts in the medial side of the base of the proximal phalanx of the little finger

A

abductor digiti minimi

129
Q

action of the abductor digiti minimi

A

abduction of the little finger at the metacarpophalangeal joint

130
Q

muscle located under the abductor digiti minimi in the hypothenar eminence

A

flexor digiti minimi

131
Q

the flexor digiti minimi is located

A

under the abductor digiti minimi in the hypothenar eminence

132
Q

origin of the flexor digiti minimi

A

pisiform bone

133
Q

insertion of the flexor digiti minimi

A

medial side of the metacarpophalangeal joint

134
Q

muscle that originates in the pisiform bone and inserts in the medial side of the metacarpophalangeal joint

A

flexor digiti minimi

135
Q

action of the flexor digiti minimi

136
Q

location of the opponens digiti minimi

A

deep to the abductor and flexor digiti minimi

137
Q

muscle that is located deep to the abductor and flexor digiti minimi

A

opponens digiti minimi

138
Q

origin of the opponens digiti minimi

A

flexor retinaculum and hook of hamate

139
Q

insertion of the opponens digiti minimi

A

medial border of the shaft of the 5th metacarpal

140
Q

muscle that originates in the flexor retinaculum and hook of hamate and inserts in the medial border of the shaft of the 5th metacarpal

A

opponens digiti minimi

141
Q

action of the opponens digiti minimi

A

flexion and lateral rotation of the 5th metacarpal at the carpometacarpal joint

helps to bring the pinky into opposition with the thumb

142
Q

intrinsic muscles of the hand include:

A 
lumbricals (4)
palmar interssei (3)
dorsal interossei (4)
143
Q

lumbrical muscles act on the

A

2nd to 5th fingers

144
Q

muscles that act on the 2nd to 5th fingers

A

lumbrical (4)

145
Q

origin of the lumbrical muscles

A

tendons of the flexor digitorum profundus

146
Q

insertion of the lumbrical muscles

A

lateral side of the extensor expansion of the corresponding finger

147
Q

muscle that originates from the tendons of the flexor digitorum profundus and inserts on the lateral side of the extensor expansion of the corresponding finger

A

lumbrical muscles

148
Q

innervation of lumbricals 1 and 2

A

median nerve

149
Q

innervation of lumbricals 3 and 4

A

deep branch of the ulnar nerve

150
Q

action of the lumbrical muscles

A

flexion of the metacarpophalangeal joints

extension of the interphalangeal joints

151
Q

essentially, the only extensors of the fingers

A

lumbrical muscles

152
Q

when lumbrical muscles contract, they pull the ___ towards the ___ and simultaneously pull the ___ to extend the ___

A

proximal phalanx;
palm;
extensor tendon;
middle and distal phalanges

153
Q

the palmar interossei muscles act on the

A

index, ring, and little fingers

154
Q

action of the palmar interossei muscles

A

adduction of the fingers at metacarpophalangeal joints
(PAD)

flexion at metacarpophalangeal joints

extension at interphalangeal joints

155
Q

origin of the palmar interossei muscles

A

metacarpals of the corresponding finger (2, 4, 5)

156
Q

insertion of the palmar interossei muscles

A

proximal phalanx and extensor expansion of the corresponding fingers (lateral and medial side, respectively)

157
Q

muscles that act on metacarpal 2, 4, 5

A

palmar interossei muscles

158
Q

muscles that originate from metacarpal 2, 4, 5 and insert on the proximal phalanx and extensor expansion of the corresponding fingers

A

palmar interossei muscles

159
Q

innervation of the palmar interossei muscles

A

deep branch of the ulnar nerve

160
Q

action of the dorsal interossei muscles

A

abduction at metacarpophalangeal joints (DAB)

flexion at metacarpophalangeal joints

extension at interphalangeal joints

161
Q

muscles that act on the index, middle, and ring fingers

A

dorsal interossei muscles

162
Q

dorsal interossei muscles act on the

A

index, middle (2 muscles), and ring fingers

163
Q

origin of the dorsal interossei muscles

A

2 heads from adjacent sides of 2 metacarpal bones

164
Q

insertion of dorsal interossei muscles

A

side of base of proximal phalanx (2 lateral, 2 medial) and extensor expansion of corresponding finger

165
Q

muscle that originates from the adjacent sides of 2 metacarpal bones and inserts in the side of base of proximal phalanx and extensor expansion of corresponding finger

A

dorsal interossei muscles

166
Q

innervation of the dorsal interossei muscles

A

deep branch of the ulnar nerve

167
Q

key differences between lumbrical and dorsal interossei muscles

A

lumbrical - superficial, originate from tendon

dorsal interossei - deeper, originate from metatarsal bone

168
Q

each tendon of the flexor digitorum superficialis divides into:

A

two halves at the level of proximal phalanx

169
Q

each tendon of the ___ divides into two halves at the level of proximal phalanx

A

flexor digitorum superficialis

170
Q

the flexor digitorum superficialis tendon attaches to the ___

A

borders of the middle phalanx

171
Q

the tendon of the flexor digitorum profundus passes through the ___ and continues to insert into the ___

A

division of the superficialis tendon;

anterior surface of the base of the distal phalanx

172
Q

the long flexor tendon of the flexor digitorum superficialis inserts into the ___ while the long flexor tendon of the flexor digitorum profundus inserts into the ___

A

middle phalanx;

distal phalanx

173
Q

innervated by the median nerve

A

lumbricals 1 and 2

174
Q

innervated by the deep branch of the ulnar nerve

A

lumbricals 3 and 4, dorsal interossei (1-4), palmar interossei (1-3)

175
Q

flexes metacarpophalangeal joints

A

lumbricals 1-4, dorsal / palmar interossei

176
Q

extends interphalangeal joints of digits 2-5

A

lumbricals 1-4, dorsal / palmar interossei

177
Q

abducts digits 2-4 from axial line

A

dorsal interossei (1-4)

178
Q

adducts digits 2, 4, 5 toward axial line

A

palmar interossei (1-3)

179
Q

extensor expansions of digits 2-4

A

palmar interossei (1-3)

180
Q

extends from the metacarpal heads to the base of the distal phalanges

A

fibrous flexor sheaths

181
Q

fibrous flexor sheaths extend from the ___ to the ___

A

metacarpal heads;

base of the distal phalanges

182
Q

attach to the sides of the phalanges and arch over the long flexor tendons

A

fibrous flexor sheaths

183
Q

fibrous flexor sheaths attach to ___ and arch over the ___

A

the sides of the phalanges;

long flexor tendons

184
Q

osteofibrous tunnels for the long flexor tendons and their synovial sheaths are formed by the

A

fibrous sheaths, anterior surfaces of the phalanges and interphalangeal joints

185
Q

formed by the fibrous sheaths, anterior surfaces of the phalanges and the interphalangeal joints

A

osteofibrous tunnels for the flexor tendons and their synovial sheaths

186
Q

osteofibrous tunnel for the thumb contains the

A

tendon of the flexor pollicis longus

187
Q

contains the tendon of the flexor pollicis longus

A

osteofibrous tunnel for the thumb

188
Q

osteofibrous tunnels for the medial 4 fingers contain the

A

tendons of flexor digitorum superficialis and profundus

189
Q

contains the tendons of flexor digitorum superficialis and profundus

A

osteofibrous tunnels for the medial 4 fingers

190
Q

fuses with the periosteum of the terminal phalanx just distal to the insertion of the long flexor tendons

A

deep fascia of the pulp of each finger

191
Q

the deep fascia of the pulp of each finger fuses with the ___ and closes off the ___

A

periosteum of the terminal phalanx just distal to the insertion of the long flexor tendons;
pulp space

192
Q

supplies the terminal phalanx

A

terminal branch of the digital artery

193
Q

runs through the pulp space

A

terminal branch of the digital artery

194
Q

the terminal branch of the digital artery supplies the ___ and runs through the ___

A

terminal phalanx;

pulp space

195
Q

the pulp space is filled with

196
Q

synovial joints that comprise the hand and fingers include:

A 
midcarpal,
carpometacarpal,
intermetacarpal,
metacarpophalangeal,
interphalangeal
197
Q

articulation of the midcarpal joint

A

between the individual bones of the proximal and the distal row of carpal bones

198
Q

ligaments of the midcarpal joint that unite the bone

A

strong anterior, posterior, and interossei ligaments

199
Q

synovial membrane of the midcarpal joint is attached to

A

the margins of the articular surfaces

200
Q

nerve supply of the midcarpal joint include:

A

anterior interosseous nerve, deep branch of the radial nerve, and deep branch of the ulnar nerve

201
Q

movements of the midcarpal joint

A

small amount of gliding movement

202
Q

articulates between the individual bones of the proximal and the distal row of carpal bones

A

midcarpal joint

203
Q

synovial plane joints that possess anterior, posterior, and interosseous ligaments

A

carpometacarpal and intermetacarpal joints

204
Q

have a common joint cavity separated by the cavity of the intercarpal joint

A

carpometacarpal and intermetacarpal joints

205
Q

carpometacarpal and intermetacarpal joints have a ___ separated by the ___

A

common joint cavity;

cavity of the intercarpal joint

206
Q

movements of the carpometacarpal and intermetacarpal joints include:

A

flexion, extension, small amount of gliding in the intermetacarpal joints

207
Q

articulation of the carpometacarpal joint of the thumb

A

between the trapezium and the saddle-shaped base of the first metacarpal bone

208
Q

articulated between the trapezium and the saddle-shaped base of the first metacarpal bone

A

carpometacarpal joint of the thumb

209
Q

the carpometacarpal joint of the thumb is a ___ joint

A

synovial saddle-shaped joint

210
Q

the capsule of the midcarpal joint

A

lines the joint

211
Q

the capsule of the carpometacarpal joint of the thumb

A

surrounds the joint

212
Q

movements of the thumb include:

A

flexion, extension, abduction, adduction, opposition

213
Q

flexes the thumb

A

flexor pollicis brevis, opponens pollicis

214
Q

extends the thumb

A

extensor pollicis longus and brevis

215
Q

abducts the thumb

A

abductor pollicis longus and brevis

216
Q

adducts the thumb

A

adductor pollicis

217
Q

opposition (medial rotation) of the thumb is performed by

A

opponens pollicis

218
Q

articulation of the metacarpophalangeal joints is

A

between the heads of the metacarpal bones and the bases of the proximal phalanges

219
Q

metacarphophalangeal joint is a type of

A

synovial condyloid joint

220
Q

ligaments of the metacarpophalangeal joint include:

A

palmar metacarpal ligaments

221
Q

palmar metacarpal ligament is associated with the ___ joint

A

metacarpophalangeal

222
Q

strong and contain from fibrocartilage

A

palmar metacarpal ligament

223
Q

palmar ligaments of the 2,3,4,5 joints are united by the

A

deep transverse metacarpal ligaments

224
Q

ligaments that hold the heads of the metacarpal bones

A

deep transverse metacarpal ligaments

225
Q

the deep transverse metacarpal ligaments unite the ___ and hold the ___

A

palmar ligaments of the 2,3,4,5 joints;

heads of the metacarpal bones together

226
Q

present on each side of the metacarpophalangeal joints

A

collateral ligaments

227
Q

each collateral ligament passes from the ___ to the ___

A

head of the metacarpal bone;

base of the phalanx

228
Q

taut when the metacarpophalangeal joint is in flexion

A

collateral ligaments

229
Q

lax when the metacarpophalangeal joint is in extension

A

collateral ligaments

230
Q

collateral ligaments are ___ when the mcp joint is in flexion and ___ when the mcp joint is in extension

231
Q

movements of the mcp joints include:

A

flexion,
extension,
abduction,
adduction

232
Q

flexion of the mcp joint is performed by:

A

lumbricals and interossei,

assisted by flexor digitorum superficialis and profundus

233
Q

extension of the mcp joint is performed by:

A

extensor digitorum,
extensor indicis,
extensor digiti mini

234
Q

abduction of the mcp joint is performed by:

A

dorsal interossei (DAB)

235
Q

adduction of the mcp joint is performed by:

A

palmar interossei (PAD

236
Q

flexion of the mcp joint of the thumb is performed by ___, while extension of the mcp joint of the thumb is performed by ___

A

flexor pollicis longus and brevis;

extensor pollicis longus and brevis

237
Q

anastomotic arterial arches form from branches of the radial and ulnar arteries and include:

A

superficial palmar arterial arch (palmar);
deep palmar arterial arch (palmar);
dorsal carpal arch (dorsal)

238
Q

dorsal, deep, and superficial arches send proper ___ to supply the fingers

A

digit arteries

239
Q

each digit gets 4 arteries:

A

2 dorsal digital from dorsal carpal arch;

2 proper palmar digital from the superficial arterial arch;

240
Q

the radial artery gives rise to the ___ arteries which supply blood to the ___

A

princeps pollicis and radialis indicis;

thumb and ring finger

241
Q

normal range of motion for flexion

A

70-90 degrees

242
Q

normal range of motion for extension

A

70 degrees

243
Q

normal range of motion for ulnar deviation

A

30-50 degrees

244
Q

normal range of motion for radial deviation

A

20 degrees

245
Q

normal range of motion for forearm supination

A

80 degrees

246
Q

normal range of motion for forearm pronation

A

80 degrees

247
Q

bony landmarks on the volar surface include:

A

pisiform, hook of hamate, palmaris longus, scaphoid tubercle

248
Q

ulnar side of palm just proximal to palmar crease

249
Q

hypothenar wrist, 1 cm distal to flexor crease

A

hook of hamate

250
Q

absent in 15% population; corses above hamate

A

palmaris longus

251
Q

palpable at extensor carpi radialis at palmar crease

A

scaphoid tubercle

252
Q

bony landmarks of dorsal surface include:

A

anatomic snuffbox, radial tubercle, scapholunate joint / interval

253
Q

located at anatomic snuffbox

A

scaphoid pole

254
Q

lister’s tubercle

A

radial tubercle

255
Q

distal radius prominence on wrist dorsum

A

radial tubercle

256
Q

lines up with 3rd metacarpal

A

radial tubercle

257
Q

palpate radius dorsum when patient flexes wrist

A

radial tubercle

258
Q

most common carpal dislocation

A

scapholunate joint / interval

259
Q

most commonly fractured carpal bone

260
Q

swelling of flexor tendon and sheath with difficult passage of swollen tendon through the sheath

A

Trigger Finger

261
Q

snapping the affected finger at the MCP joint, tenderness to palpation, swollen

A

Trigger Finger

262
Q

Tigger Finger gets ___ after rest, ___ with active finger use, and the ___ may lock

A

worse;
improves;
entire finger

263
Q

Trigger Finger occurs with the swelling of ___ with difficult ___

A

flexor tendon and sheath;

passage of swollen tendon through sheath

264
Q

treatment of Trigger Finger could include

A

NSAIDs, immobilization, avoid offending activity, moist heat as needed, steroid injection, surgical correction if refractory to above management

265
Q

median nerve entrapment between transverse carpal ligament and underlying carpal bones

A

Carpal Tunnel Syndrome

266
Q

Carpal Tunnel Syndrome is caused by ___ between ___

A

median nerve entrapment;

transverse carpal ligament and underlying carpal bones

267
Q

median nerve is entrapped from the

A

inflamed and enlarged flexor tendons

268
Q

conditions associated with carpal tunnel syndrome

A

hypothyroidism,
diabetes mellitus,
pregnancy

269
Q

proximal radiation into forearm (may radiate into shoulder and neck)

A

carpal tunnel

270
Q

may be confused with chest pain

A

carpal tunnel

271
Q

carpal tunnel: increase in wrist swelling with ___

A

inactivity

272
Q

testing carpal tunnel:

direct pressure over ___ for 30 seconds

A

transverse carpal ligament

273
Q

Tinel’s sign

A

tap over the palmaris longus tendon

274
Q

Phalen’s maneuver

A

elicits pain by compressing the median nerve

275
Q

a localized thickening and contracture of the palmar aponeurosis, which limits hand function and may eventually disable the hand

A

Dupuytren Contracture

276
Q

commonly starts near the root of the ring finger and draws that finger into the palm, flexing it at the metacarpophalangeal joint

A

Dupuytren Contracture

277
Q

nodules and pitting may appear in the hand, rope-like cord forms in the palm, fingers bend toward the palm

A

Dupuytren Contracture

278
Q

In long-standing cases of Dupuytren Contracture, the pull on the ___ of these fingers results in ___ of the ___ joints

A

fibrous sheaths;
flexion;
proximal interphalangeal

279
Q

The distal interphalangeal joints are not involved and are actually extended by the pressure of the fingers against the palm

A

Dupuytren Contracture

280
Q

Dupuytren Contracture is a localized thickening and contracture of the ___ which limits hand function and commonly starts near the ___ and draws that finger into the ___, ___ it at the ___ joint; the ___ joints are not involved and are ___ by the pressure of the fingers against the ___

A 
palmar aponeurosis;
root of the ring finger;
palm;
flexing;
metacarpophalangeal;
distal interphalangeal;
extended;
palm
281
Q

usual form of treatment for a Dupuytren Contracture of the palmar fascia include

A

surgical division of the fibrous bands, physiotherapy to the hand

282
Q

alternative form of treatment for a Dupuytren Contracture of the palmar fascia include

A

injection of enzyme collagenase into the contracted bands of fibrous tissue

283
Q

injury to the median nerve near the elbow

A

Hand of Benediction and Ape Hand (Pronator Syndrome)

284
Q

unable to flex the index and middle fingers when the patient tries to make a fist

A

Hand of Benediction and Ape Hand (Pronator Syndrome)

285
Q

caused by loss of lateral lumbrical action, leading to unopposed action on the finger extensors (radial nerve)

A

Hand of Benediction and Ape Hand (Pronator Syndrome)

286
Q

wasting of thenar muscles due to loss of abductor pollicis and unopposed extensors

287
Q

Hand of Benediction and Ape Hand (Pronator Syndrome) is caused by injury to the ___ near the ___ leading to the loss of ___, leading to ___ on the ___; patient is unable to ___ when the patient tries to ___

A 
median nerve; elbow;
lateral lumbrical action;
unopposed action; finger extensors (radial nerve);
flex the index and middle fingers;
make a fist
288
Q

the lesion location of ulnar claw is a ___ or ___ leading to clawing of the ___ due to weakness of the ___

A

medial epicondyle fracture;
Guyon canal compression;
3rd and 4th fingers;
ulnar-supplied lumbrical muscles

289
Q

medial epicondyle fracture or Guyon canal compression can lead to

A

Ulnar claw (clawing of 3rd and 4th fingers)

290
Q

Erb-Duchenne Palsy (Waiter’s Tip) is caused by damage to the ___ leading to deficits in ___, weakness of the ___, and the upper limb is ___

A

cervical nerve roots of the upper trunk (C5-C6);

abduction (Axillary),
lateral rotation (Suprascapular, Axillary),
flexion (Musculocutaneous), and supination (Radial);

extensors of the hand (radial);

medially rotated, extended, pronated, and hangs by the patient’s side in adduction

291
Q

caused by birth injury or fall on the shoulder in adults

A

Erb-Duchenne Palsy (Waiter’s Tip)

292
Q

Lower trunk injury (Klumpke paralysis) is caused by injury to the ___, affecting the ___, and leading to ___

A

C8-T1 / ulnar nerve / 3rd and 4th lumbrical;

intrinsic muscles of the arm and unopposed extensors;

hyperextension of the metacarpophalangeal joints, flexion of interphalangeal joints

293
Q

caused by birth trauma or extreme abduction of the arm, waste of the interossei

A

Lower trunk injury (Klumpke paralysis)

294
Q

most often injured in the axilla

A

radial nerve

295
Q

weakness of hand extensors and sensory loss of the dorsal surface of the hand, forearm, and arm

A

Radial nerve injury (Saturday Night Palsy)

296
Q

Radial nerve injury (Saturday Night Palsy) is caused by injury to the ___, leading to weakness of ___, and sensory loss of the ___

A

radial nerve;
hand extensors;
dorsal surface of the hand, forearm, and arm

MSK - OMS I (11 decks)

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