the hand

Question 1

lateral epicondylitis?

Answer 1

Lateral epicondylitis, or tennis elbow, is swelling or tearing of the tendons that bend your wrist backward away from your palm. It’s caused by repetitive motion of the forearm muscles, which attach to the outside of your elbow. The muscles and tendons become sore from excessive strain

Question 2

complications associated with venipuncture?

Answer 2

infiltration - blood in interstitial space beneath skin

nerve damage

bruising (hematoma)

Question 3

give an overview of the structures of the hand, and the muscles controlling the fingers

Answer 3

hand = wrist, metacarpus, digits
have the anterior (palm) and the dorsal surface

coarse movements of fingers = extrinsic muscles originating in the forearm and inserting in the palm of the hand. the tendons of these muscles are held in place by the flexor retinaculum anteriorly and the extensor retinaculum posteriorly

fine movement = intrinsic muscles originating (and inserting?) in the palm

Question 4

name the 8 carpals

Answer 4

looking at the palm of the hand, going from thumb to pinky, starting with the proximal row, then the distal row:

Some – Scaphoid
Lovers – Lunate
Try – Triquetrum
Positions – Pisiform
That – Trapezium
They – Trapezoid
Can’t – Capitate
Handle – Hamate

Question 5

what bones form the wrist joint, what kind of joint is it and what movements does it allow?

Answer 5

● The wrist joint is a condyloid synovial joint between the scaphoid, lunate and triquetrum and the distal ends of the radius and ulna

● The wrist joint allows for abduction, addiction, flexion and extension of the hand

Question 6

what are the metacarpals?

Answer 6

in the palm, there are 5 (I-V) with 1 being related to the thumb (then the index, middle, ring and little fingers for metacarpals 2-5)

Question 7

what are the phalanges?

Answer 7

you’ve got three rows -

proximal, middle and distal

you’ve got one of each for the 5 digits, EXCEPT the thumb doesn’t have a middle phalange so only four of those

Question 8

what are carpal joints?

Answer 8

synovial joints between the carpal bones. The joints are reinforced by many ligaments

● Movements at these joints are limited, but they contribute to abduction, adduction, flexion and extension of the hand

Question 9

CMC (carpometacarpal) joints? 1st one vs 2-5?

Answer 9

between the distal carpal bones and the metacarpal.

● The 1st CMC joint is between metacarpal 1 and the pollex (thumb) and it is a saddle joint
● The 1st CMC joint is highly mobile. Movements at this joint are flexion, extension, adduction, abduction, rotation and circumduction.
● The CMC joints between metacarpals 2–5 are less mobile, allowing for only limited gliding movements

Question 10

metacarpophalangeal joints?

Answer 10

Also known as the knuckles, They are formed by the articulation of the metacarpals and proximal phalanges

multiaxial condyloid joints

allow for flexion, extension, abduction, adduction motions, circumduction and limited rotation

Question 11

interphalangeal joints?

Answer 11

synovial hinge joints

allow for flexion and extension

They are formed by articulations between the phalanges

Question 12

what is the thenar eminence and what muscles are responsible for it?

innervation?

Answer 12

a group of three muscles causing the prominent swelling on the lateral/thumb side of the palm

the muscles are =

abductor pollicis brevis
flexor pollicis brevis
opponens pollicis

innervation = median nerve

Question 13

abductor pollicis brevis?

Answer 13

intrinsic hand muscle, anterior (palm)

O: scaphoid, trapezium and flexor retinaculum
I: proximal phalanx and extensor hood of the thumb Median nerve

part of the thenar eminence (lateral)

abducts the thumb

Question 14

flexor pollicis brevis?

Answer 14

intrinsic palm muscle of the thenar eminence

O: trapezium and flexor retinaculum
I: proximal phalanx of thumb
F: flexion of the thumb

Question 15

opponens pollicis?

Answer 15

palm muscle of the thenar eminence

O: trapezium and flexor retinaculum
I: metacarpal 1
F: OPPOSITION - makes humans different from apes I think, its touching fingers to your thumb

from edge of hand going in = opponens, abductor, flexor

Question 16

what is the hypothenar eminence made up of? innervation?

Answer 16

bump of muscles under the little finger/medial side of the palm

made up of:
abductor digiti minimi
flexor digiti minimi
opponens digiti minimi

innervated by ulnar nerve

Question 17

abductor digiti minimi?

Answer 17

hypothenar muscle -

O: pisiform, tendon of flexor carpi ulnaris
I: proximal phalanx of little finger
F: abducts pinky

Question 18

flexor digiti minimi?

Answer 18

hypothenar muscle -

O: hook of hamate ad flexor retinaculum
I: proximal phalanx of little finger

Question 19

opponens digiti minimi?

Answer 19

hypothenar muscle -

O: hook of hamate and flexor retinaculum
I: metacarpal 5
F: flexion and lateral rotation of the little finger

Question 20

name the four intrinsic muscles of the palm not are not in either eminence

Answer 20

palmaris brevis

adductor pollicis

palmar interossei (four usually, can have three)

lumbricals

Question 21

palmaris brevis?

Answer 21

intrinsic muscle of the palm, not in either eminence

O: palmar aponeurosis
I: dermis of the skin
F: tenses the skin of the palm on the ulnar side during a grip action. It also deepens the hollow of the palm (grip)

Question 22

adductor pollicis?

Answer 22

intrinsic muscle of the palm not belonging to wither eminence

O: transverse head- metacarpal 3.
oblique head-metacarpal 2-3
I: base of proximal phalanx and extensor hood of the thumb
F: adducts thumb, bringing it toward the palm for grasping/pinching

Question 23

palmar interossei?

Answer 23

don’t belong to either eminence

O: metacarpals

I: extensor hoods of fingers 2-5 and proximal phalanx of the thumb

F: adduction of fingers towards midline, important in grip strength

Question 24

lumbricals?

Answer 24

O: tendons of flexor digitorum profundus

I: extensor hood of phalanges 2-5

F:Flex metacarpophalangeal joints and extend interphalangeal joints, aiding in precision hand movements

Question 25

what muscles are in the dorsum of the hand?

Answer 25

dorsal interossei (four between metacarpals)

O: sides of metacarpals
I: extensor hood, base of proximal phalanges of fingers 2-5
F: Abduct and assist in spreading fingers apart

Question 26

what does flexion of the thumb look like?

Answer 26

bringing the thumb towards the palm

Question 27

making a claw is…

Answer 27

flexion at the interphalangeal joints

Question 28

what supplies blood to the hand?

Answer 28

the radial and ulnar arteries form two anastomotic arches in the palm, superficial and deep

the media 3.5 fingers mostly get blood from the ulnar artery, the lateral 1.5 the radial artery

Question 29

what do the deep and superficial palmar arches look like/how do they form?

Answer 29

The superficial palmar arch
● The ulnar artery enters the hand on the medial side of the wrist and forms the superficial palmar arch

The deep palmar arch
● The radial artery enters the hand on the lateral side of the wrist and forms the deep palmar arch

Question 30

what is the venous drainage of the hand?

Answer 30

dorsal venous network on the dorsal aspect of the hand drains into the cephalic and basilic veins

Question 31

sensory innervation of the hand - what three nerves innervate what part of the hand?

Answer 31

● The radial nerve innervates the skin on the lateral side of the dorsum of the hand and lateral 3.5 digits
● The median nerve innervates the skin on the palm of the hand and lateral 3.5 digits

● The ulnar nerve innervates the skin on the palmar surface and dorsum of the medial two and half digits

Question 32

what are the four extrinsic muscles of the palm?

Answer 32

Flexor digitorum superficialis
Flexor digitorum profundus
Flexor pollicis longus
Palmaris longus

Question 33

what are the six extrinsic muscles of the dorsal hand?

Answer 33

Extensor digiti minimi
Extensor indices
Abductor pollicis longus
Extensor pollicis brevis
Extensor pollicis longus
Extensor digitorum

Question 34

what happens when the median nerve gets compressed in the carpal tunnel? causes?

Answer 34

carpal tunnel syndrome (carpal tunnel = flexor and extensor retinaculum?)

caused by accumulation of fluid/inflammation of tendons in the area, causing pain in all areas the median nerve supplies

Can lead to wasting of thenar muscles, resulting in ‘ape hand’ losing the ability of opposition
Paralysis of median nerve = partial claw hand fo the lateral 3.5

Question 35

what is the anatomical snuff box?

Answer 35

The triangular dent when you extend your thumb

known as the radial fossa

Question 36

most common carpal fracture…?

Answer 36

scaphoid - can lead to avascular necrosis

Question 37

lumbricals vs palmar interossei?

Answer 37

palmar interossei are a bit higher as in more on the fingers I think idk

Question 38

what do dorsal interossei kind of look like?

Answer 38

Vs or arrow heads (the fibres seem to run in a distinct direction)

Question 39

how not to get confused with the arches and the nerves?

Answer 39

if looking at the deep arch for example, remember that the radial artery enters on the radial or lateral side, so the structure on the medial/pinky finger side may be the ulnar nerve