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Regional Anatomy 1 > The hand > Flashcards

The hand Flashcards

1
Q

what kind of joint is the CMC joint at the base of the thumb

A

synovial saddle joint

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2
Q

the synovial saddle joint at the base of the thumb permits

A

opposition of the thumb

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3
Q

the MCP joints of all the digits are

A

synovial condyloid joints

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4
Q

what movements are allowed at the MCP joints

A

flexion
extension
abduction
adduction
small degree of circumduction

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5
Q

what type of joints are the IP joints

A

synovial hinge

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6
Q

what movements are allowed at IP joints

A

flexion and extension of the fingers

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7
Q

what type of joints are between carpal bones

A

synovial plane - small gliding movements allowed

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8
Q

what are the bones of the hand

A

carpals
metacarpals
phalanges - proximal, middle, distal

(thumb doesnt have a middle phalanx)

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9
Q

what is the first structure seen immediately beneath the skin of the palm

A

palmar aponeurosis

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10
Q

what does the palmar aponeurosis do

A

tough connective tissue layer that adheres to the skin of the palm - it helps to hold the skin of the palm in place during movement to prevent skin from slipping and loss of grip
also protects the delicate nerves and vessels of the palm

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11
Q

what tightens the palmar aponeurosis

A

palmaris longus from the forearm

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12
Q

where is palmaris brevis

A

thin intrinsic muscle that lies superficial to the muscles of the hypothenar eminence

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13
Q

what is the origin and insertion of palmaris brevis

A

palmar aponeurosis and flexor retinaculum to dermis

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14
Q

what is the function of palmaris brevis

A

grip

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15
Q

what is the innervation of palmaris brevis

A

ulnar nerve (superficial C8,T1)

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16
Q

what nerve innervates most of the muscles of the hand

A

ulnar nerve

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17
Q

what is the difference between intrinsic and extrinsic muscles of the hand

A

intrinsic are entirely within the hand
extrinsic muscles enter the hand from the forearm

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18
Q

what are the deepest muscles of the hand called

A

interossei because they lie between the metacarpal bones of the hand

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19
Q

the thumb (lateral) side of the hand is dominated by what nerve

A

median - some but not all muscles are supplied by it

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20
Q

the little finger (medial) side of the hand is dominated by

A

ulnar nerve

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21
Q

the deepest intrinsic muscles of the hand are supplied by

A

ulnar nerve

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22
Q

how many muscles make up the thenar eminence

A

3 - two superficial and one deep

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23
Q

the muscles of the thenar eminence all act on what

A

CMC joint of the thumb

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24
Q

what muscle lies on the lateral side of the eminence

A

abductor pollicis brevis

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25
Q

what does abductor pollicis brevis do

A

acts to pull the thumb away from the plane of the palm

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26
Q

what muscle is medial in the thenar eminence

A

flexor pollicis brevis

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27
Q

what does flexor pollicis brevis do

A

acts to bend the joint of the thumb in the same plane as the palm

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28
Q

the long abductor and flexor muscles originate where

A

forearm

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29
Q

flexion of the thumb is dominated by what nerve

A

median nerve

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30
Q

abduction of the thumb is what nerve

A

both radial and median

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31
Q

what is the deepest muscle in the thenar eminence

A

opponens pollicis

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32
Q

what does opponens pollicis do

A

acts to oppose the thumb by pulling the base of the thumb across the palm allowing the pulp of the thumb to touch the pulp of other digits

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33
Q

opposition of the thumb is controlled by what nerve

A

median nerve

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34
Q

the muscles of the thenar eminence are supplied by

A

median nerve - although sometimes the ulnar nerve may send innervation to flexor pollicis brevis

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35
Q

what branch of the median nerve supplies the thenar eminence

A

recurrent branch of the median nerve - the median nerve sends a branch that passes backwards towards the thenar eminence

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36
Q

what are the attachments of abductor pollicis brevis

A

scaphoid and trapezium to base of proximal phalanx of thumb

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37
Q

abductor pollicis brevis does what

A

CMC joint abduction

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38
Q

what nerve supplies abductor pollicis brevis

A

median nerve (recurrent C8, T1)

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39
Q

what are the attachments of the flexor pollicis brevs

A

flexor retinaculum, capitate, trapezium to base proximal phalanx of thumb

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40
Q

what is the function of flexor pollicis brevis

A

CMC joint flexion

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41
Q

what is the innervation of flexor pollicis brevis

A

median (recurrent) and some texts also say ulnar nerve (C8,T1)

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42
Q

what are the attachments of opponens pollicis

A

trapezium to first metacarpal

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43
Q

what is the function of opponens pollicis

A

CMC joint opposition

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44
Q

what is the innervation of opponens pollicis

A

median nevre (recurrent C8, T1)

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45
Q

what is the other intrinsic muscle of the thumb

A

adductor pollicis

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46
Q

is adductor pollicis part of the thenar eminence

A

no

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47
Q

what are the attachments of adductor pollicis

A

transverse head from 3rd metacarpal; oblique head from capitate and 2nd/3rd metacarpals to base of proximal phalanx of thumb

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48
Q

what are the functions of adductor pollicis

A

adduction of CMC joint of thumb
flexion of MCP joint of thumb

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49
Q

what is the innervation of adductor pollicis

A

ulnar nerve (deep C8, T1)

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50
Q

adductor pollicis is one of the deep/superficial intrinsic muscles

A

one of the deeper layer

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51
Q

the muscles of the hypothenar eminence do what

A

move the MCP joint of the little finger

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52
Q

the muscles of the hypothenar eminence are all supplied by the

A

ulnar nerve

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53
Q

what is the medial muscle in the hypothenar eminence

A

abductor digiti minimi

54
Q

what is the lateral muscle in the hypothenar eminence

A

flexor digiti minimi

55
Q

what are the attachments of abductor digiti minimi

A

pisiform bone to base of 5th proximal phalanx and dorsal digital expansion

56
Q

what is the function of abductor digiti minimi

A

abduction and flexion of MCP joint of little finger

57
Q

what is the innervation of abductor digiti minimi

A

ulnar nerve (deep C8, T1)

58
Q

what are the attachments of flexor digiti minimi

A

hamate, flexor retinaculum to base of 5th proximal phalanx

59
Q

what is the function of flexor digiti minimi

A

flex MCP joint of little finger

60
Q

what is the innervation of flexor digiti minimi

A

ulnar nerve (deep C8, T1)

61
Q

what are the attachments of opponens digiti minimi

A

hamate and flexor retinaculum to 5th metacarpal

62
Q

what is the function of opponens digiti minimi

A

weak opposition of little finger

63
Q

what is the innervation of opponens digiti minimi

A

ulnar nerve (deep C8, T1)

64
Q

why can opponens digiti minimi not allow pulp-to-pulp opposition in the same way that opponens pollicis can for the thumb

A

the CMC joint at the base of the little finger is synovial plane not synovial saddle so it cant pull the base of the finger towards the palm in the same way

65
Q

what are the attachments of the lumbricals

A

4 small muscles that go from tendons of flexor digitorum profundus to the dorsal expansion of index, middle, ring and little fingers

66
Q

what is the function of the lumbricals

A

MCP joint flexion and IP joint extension for digits 2-4

67
Q

what nerve supplies the lateral 2 lumbricals (1 and 2)

A

median nerve (digital C8, T1)

68
Q

what nerve supplies the medial 2 lumbricals (3 and 4)

A

ulnar nerve (deep C8, T1)

69
Q

the ulnar nerve supplies all the intrinsic muscles of the hand except for what

A

LOAF
- lateral 2 lumbricals
- opponens pollicis
- abductor pollicis brevis
- flexor pollicis brevis

all supplied by median nerve

70
Q

where are the palmar interossei

A

between metacarpal bones

71
Q

where do the palmar interossei insert

A

proximal phalanx and dorsal expansion of the fingers

72
Q

are there interossei for the thumb

A

no it already has its own abductor and adductor muscles

73
Q

the interossei are innervated by what

A

deep branch of the ulnar nerve (C8, T1)

74
Q

what is the function of the palmar interossei

A

move the fingers towards the midline

75
Q

how many palmar interossei are there

A

3 - middle finger is already in midline

76
Q

what are the attachments of the 1st palmar interossei

A

from 2nd metacarpal to base of 2nd proximal phalanx and dorsal expansion

77
Q

what are the attachments of the 2nd palmar interossei

A

from 4th metacarpal to base of 4th proximal phalanx and dorsal expansion

78
Q

what are the attachments of the 3rd palmar interossei

A

from 5th metacarpal to base of 5th proximal phalanx and dorsal expansion

79
Q

what is the function of the palmar interossei

A

adduction towards middle finger
also flex MCP and extend IP

80
Q

what is the function of the dorsal interossei

A

move the fingers away from the midline to spread the fingers
MCP flexion and IP extension

81
Q

how many dorsal interossei are there

A

4

82
Q

the first dorsal interossei moves the

A

index finger

83
Q

the second and third dorsal interossei move the

A

middle finger

84
Q

the fourth dorsal interossei moves the

A

ring finger

85
Q

why does the little finger not have a dorsal interossei

A

already has abductor digiti minimi in the hypothenar eminence

86
Q

what are the attachments of the 1st dorsal interossei

A

sides of 1st and 2nd metacarapals to 2nd proximal phalanx and dorsal digital expansion

87
Q

what are the attachments of the 2nd dorsal interossei

A

sides of 2nd and 3rd metacarpals to 3rd proximal phalanx and dorsal digital expansion

88
Q

what are the attachments of the 3rd dorsal interossei

A

sides of 3rd and 4th metacarpals to the 3rd proximal phalanx and dorsal digital expansion

89
Q

what are the attachments of the 4th dorsal interossei

A

sides of 4th and 5th metcarpals to 4th proximal phalanx and dorsal digital expansion

90
Q

the 1st dorsal interossei moves the

A

index finger

91
Q

the 2nd dorsal interossei moves the

A

middle finger

92
Q

the 3rd dorsal interossei moves the

A

middle finger

93
Q

the 4th dorsal interossei moves the

A

ring finger

94
Q

what is the innervation of the dorsal interossei

A

ulnar nerve (deep C8, T1)

95
Q

DAB

A

Dorsal interossei ABduct

96
Q

PAD

A

Palmar ADduct

97
Q

what muscles are found between the webspace between the thumb and the index finger

A

first dorsal interosseous muscle and adductor pollicis

98
Q

from the palmar surface what muscle do you see in the thumb and index finger webspace

A

adductor pollicis

99
Q

from the dorsal surface what muscle do you see in the thumb and index finger webspace

A

first dorsal interosseous muscle

100
Q

what is the blood supply to the hand

A

radial and ulnar arteries anastomose to supply the hand

101
Q

where does the ulnar artery cross the wrist

A

above the carpal tunnel

102
Q

the ulnar artery forms most of the

A

superficial arch of the palm

103
Q

where does the radial artery pass into the hand

A

in the floor of the anatomical snuffbox

104
Q

the radial artery forms most of the

A

deep palmar arch

105
Q

where do the radial and ulnar arteries anatomose

A

via the palmar arches

106
Q

what is the blood supply of the fingers

A

digital branches supply the fingers and lie on lateral sides of each digit to prevent damage to vessels during flexion and extension

107
Q

does everyone have a superficial arch

A

it can vary and some people dont have a communication between the radial and ulnar arteries

108
Q

does everyone have a deep palmar arch

A

it is very small and little variation is seen in this structure

109
Q

describe the course of the radial artery

A

through the anatomical snuffbox over the scaphoid and trapezium into hand, passes between the heads of adductor pollicis to anastomose with the ulnar artery

110
Q

in addition to the deep arch the radial artery also forms

A

the princeps pollicis artery - the largest artery to the thumb

111
Q

in addition to the deep arch and princeps pollicis the radial artery also usually forms what

A

a vessel to the index finger

112
Q

what surrounds tendons of flexor muscles as they pass through the palm

A

small synovial sheaths - synovial membrane plus fluid

113
Q

the synovial sheaths extend where

A

around tendons at wrist, palm and into digits

114
Q

what are the small anatomical spaces created by the synovium

A

the palmar and thenar spaces

115
Q

what is the clinical significance of the palmar and thenar spaces

A

spread of infection across the palm

116
Q

what nerve dominates the thumb (lateral) side of the hand

A

median nerve

117
Q

what nerve dominates the little finger (medial) side of the hand

A

ulnar nerve

118
Q

what does the median nerve supply in the hand

A

muscles of the thenar eminence and the lumbricals to the index and middle fingers

119
Q

what does the ulnar nerve supply in the hand

A

muscles of the hypothenar eminence and the lumbricals to the ring and little fingers as well as to adductor pollicis and all of the dorsal and palmar interossei

120
Q

what nerves carry sensory innervation to the hand

A

radial
ulnar
median

121
Q

what does the median nerve give sensory innervation to

A

skin of the lateral side of the palm, the palmar surface of the thumb and the lateral two and half digits (index middle and half of ring) and the dorsum of these fingers and thumb to approximately between the DIP and PIP joints

122
Q

what does the ulnar nerve give sensory innervation to

A

skin of both the palmar and dorsal surfaces of the medial side of the palm and the medial one and half fingers (little and half of ring)

123
Q

what does the radial nerve supply sensory innervation to

A

skin on the thenar eminence and the lateral side of the dorsum of the hand

124
Q

what does the musculocutaneous nerve terminate as

A

lateral cutaneous nerve of the forearm

125
Q

the medial cutaneous nerves of the arm and forearm are direct branches of what

A

medial cord of the brachial plexus

126
Q

what is the sensory innervation of the axillary nerve

A

badge patch area - the superior lateral part of the arm

127
Q

what is a dermatome

A

the expression of a single spinal root on the skin

128
Q

dermatome of badge patch area

A

C5 carried by axillary nerve

129
Q

dermatome of the pad of the thumb (part on the palmar surface used for pulp-to-pulp opposition)

A

C6

130
Q

dermatome of pad of the middle finger

A

C7 (7 up)

131
Q

dermatome of pad of the little finger

A

C8 (maaaate)

132
Q

dermatome of medial side of elbow

A

T1

Regional Anatomy 1 (30 decks)

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