The Caprus and Hand

Question 1

Name the carpal bones in the proximal row

Answer 1

Scaphoid
Lunate
Triquetral
Pisiform

Question 2

Name the carpal bones in the distal row

Answer 2

Hamate
Capitate
Trapezoid
Trapezium

Question 3

Which carpal bones articulate with the radius?

Answer 3

Schapoid
Lunate
Triquetrum

Question 4

Pain and tenderness in anatomical snuffbox after FOOSH indicates what pathology?

Answer 4

Scaphoid fracture

Question 5

Where would you find a boxer’s fracture?

Answer 5

neck of metacarpal

Question 6

What movements is the thumb capable of?

Answer 6

Flexion/extension
Abduction/adduction
Opposition

Question 7

What are Heberden’s nodes?

Answer 7

Bony swellings on DIP joints

Question 8

What are Bouchard’s nodes?

Answer 8

Bony swellings on PIP joints

Question 9

What is the palmar aponeurosis and what is its function?

Answer 9

• Triangular shaped thickening of the deep fascia of the hand.
• Protects the underlying muscle compartments and fans out distally into four digital rays which then become the fibrous digital sheaths
• The fibrous digital sheaths cover the synovial sheaths (which contain the flexor tendons) in the digits and keep them in place

Question 10

What is Dupytren’s contracture?

Answer 10

Partial flexion of one or more digits as a result of thickening of the palmar fascia to due fibrosis.
Patient cannot fully extend fingers and may find gripping objects difficult.

Question 11

What structures pass through the carpal tunnel?

Answer 11

4 tendons of FDS
4 tendons of FDP
1 tendon of FPL
Median nerve

Question 12

What is carpal tunnel syndrome? What is its clinical presentation?

Answer 12

Compression of the median nerve within the carpal tunnel.
Clinical features include numbness, tingling and pain in the distribution of the median nerve. The pain will usually radiate to the forearm.

Question 13

Name the thenar muscles

Answer 13

Oppopens policis
Abductor policis brevis
Flexor pollicis brevis

Question 14

What is the innervation of the thenar muscles?

Answer 14

Median nerve

Question 15

Name the hypothenar muscles

Answer 15

Oppopens digiti minimi
Abductor digiti minimi
Flexor digiti minimi brevis

Question 16

What is the innervation of the hypothenar muscles?

Answer 16

Ulnar nerve

Question 17

What are the attachments of the lumbrical muscles?

Answer 17

Originate from a tendon of the flexor digitorum profundus. They pass dorsally and laterally around each finger, and insert into the extensor hood (digits II-V)

Question 18

What actions do the lumbrical muscles allow?

Answer 18

Flex at MCP joints

Extend at IP

Question 19

What is the innervation of the lumbrical muscles?

Answer 19

Medial 2 (ring and little finger) = ulnar
Lateral 2 (index and middle finger) = median

Question 20

What are the actions of the dorsal and palmar interossei?

Answer 20

Dorsal: abduct = DAB
Palmar: adduct = PAD

Question 21

What is the innervation of the interossei?

Answer 21

Ulnar nerve

Question 22

Which arteries supply blood to the hand?

Answer 22

Radial and Ulnar

Question 23

What are the palmar arches and what is their function?

Answer 23

Anastomoses between radial and ulnar arteries.

Allow the hand to be perfused during tight grip.

Question 24

What comprises the superficial palmar arch?

Answer 24

Mainly ulnar artery, with branch from radial artery

Question 25

What comprises the deep palar arch?

Answer 25

Mainly radial artery, with contribution from ulnar artery

Question 26

What is the cutaneous innervation of the ulnar nerve?

Answer 26

PALM
ulnar 1 1/2 digits
DORSUM
ulnar 1 1/2 digits and adjacent part of dorsum

Question 27

What is the cutaneous innervation of the median nerve?

Answer 27

Skin of palmar aspect of thumb and 2 1/2 digits

Skin on dorsal aspect of distal phalanges

Question 28

What is the cutaneous innercation of the radial nerve?

Answer 28

Skin of dorsum of thumb and 2 1/2 digits as far as the DIP joint