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Human Anatomy 2 > The hand > Flashcards

The hand Flashcards

1
Q

Dorsal Interossei

A

Origin:
1: 1st metacarpal (medially) and 2nd metacarpal laterally
2: 2nd metacarpal (medially) and 3rd metacarpal laterally
3: 3rd metacarpal medially and 4th metacarpal laterally
4: 4th metacarpal medially and 5th metacarpal lateral

Insertion:
1. proximal phalanges of 2-4 (2nd=lateral, 3=medial and lateral, 4-medial)

Action:
1. MCP abduction of fingers 2,3,4 (dab)

Innervation:
1. ulnar nerve C8,T1

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2
Q

Palmar Interossei

A

Origin:
1. Medial 1st metacarpal
2. Medial 2nd metacarpal
3. Lateral 4th metacarpal
4. lateral 5th metacarpal

Insertion:
1. Medial 1st proximal phalanx
2. medial 2nd proximal phalanx
3. Lateral 4th proximal phalanx
4. Lateral 5th proximal phalanx

action:
1. adduct fingers 1,2,4,5

Innervation:
1. ulnar nerve C8,T1

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3
Q

Opponens Pollicis

A

origin:
1. tubercle of trapezium and flexor retinaculum

Insertion:
1. 1st metacarpal

Action:
1. medially rotates thumb

Innervation:
1. recurrent branch median nerve C8,T1

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4
Q

Abductor Pollicis Brevis

A

origin:
1. tubercle of scaphoid and trapezium, flexor retinaculum

Insertion:
1. proximal phalanx, extensor hood of thumb

Action:
1. abduct the thumb MCP joint

Innervation:
1. recurrent branch median nerve C8,T1

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5
Q

Flexor Pollicis Brevis

A

origin:
1. tubercule of trapezium, flexor retinaculum

Insertion:
proximal phalanx of thumb

Action:
1. flexes thumb MCP joint

Innervation:
1. recurrent branch median nerve C8,T1

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6
Q

abductor Digiti Minimi

A

Origin:
1. pisiform, pisohamate ligament, tendon of FCU

Insertion:
1. proximal phalanx of little finger

Action:
1. abducts 5th finger MCP joint

innervation:
1. deep branch ulnar nerve C8,T1

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7
Q

Flexor Digiti Minimi Brevis

A

Origin:
1. hook of hamate, flexor retinaculum

Insertion:
1. proximal phalanx of little finger

Action:
1. flexes 5th finger MCP joint

innervation:
1. deep branch ulnar nerve C8,T1

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8
Q

Opponens Digiti Minimi

A

Origin:
1. hook of hamate, flexor retinaculum

Insertion:
1. 5th metacarpal

Action:
1. laterally rotates 5th metacarpal

innervation:
1. deep branch ulnar nerve C8,T1

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9
Q

Lumbricals of the hand

A

origin:
1. tendons of flexor digitorum profundus

Insertion:
1. extensor hood

Action:
1. flex MCP joints
2. extend IP joint lumbrical position

Innervation:
1. 1st and 2nd (laterally) = median nerve
2. 3rd and 4th (medially) =deep branch ulnar

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10
Q

Adductor Pollicis

A

origin:
1. transverse head: 3rd metacarpal
2. oblique head: capitate and bases of 2nd and 3d metacarpals

Insertion:
1. base of proximal phalanx of thumb

action:
1. adducts the thumb

Innervation:
1. ulnar never (deep branch) C8,T1

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11
Q

Blood supply into the hand

A
  • radial artery
  • ulnar artery
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12
Q

Radial artery

A
  • enters deep into palm to form deep palmar arch
  • supplies thumb and lateral index finger
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13
Q

Ulnar Artery

A
  • forms superficial palmar arch
  • supplies medial index finger and fingers 3-5
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14
Q

Nerves of the hand

A
  • Median nerve
  • radial nerve
  • ulnar nerve
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15
Q

What does the median nerve supply

A
  • motor- thenar muscles and lateral 2 lumbricals
  • sensory: thumb, index, middle and 1/2 ringfinger
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16
Q

Median nerve entrapment

location, cases, clinical findings

A
  • Location: in the carpal tunnel under transverse carpal ligament

Causes:

  • sprains
  • wrist fx
  • arthritis
  • ganglion cysts

Clinical findings:

  • numbness or pain in wrist/hands/fingers
  • tingling, difficulty with fine motor movements
17
Q

Radial Nerve (superficial branch)

supplies

A
  • sensory only
  • dorsal lateral palm, dorsal aspect of finges 1-3 and the lateral 1/2 of the ring finger
18
Q

Radial nerve entrapment at the hand

location, causes, clinical findings

A

Location:

  • wartenberg’s syndrome
  • between brachioradialis and ECRL

Clinical findings:

  • pain over distal radial forearm and paresthesia over dorsal radial hand

Causes:

  • trauma
  • stretch injury
19
Q

Ulnar Nerve Supplies

A

Sensory:

  • medial dorsal and palmar aspect of the hand, 5th digit and medial half of 4th digit

Motor:

  • all intrinscis EXCEPT 2 lateral lumbricals and thenar muscles
20
Q

Ulnar nerve Entrapment

location, causes, clinical findings

A

Location

  • tunnel of Guyon

Causes

  • ganglion cysts
  • trauma
  • repetitive wrist movements
  • arthritis
  • wrist fx

Clinical findings

  • wrist pain
  • numbeness/tingling in pinky and ring fingers
  • weakness in pal of hand and thumb
  • difficulty with grip
21
Q

Review Laceration zones

A

review picture

22
Q

MRI medical imaging in the hand

A
  • MRI is the most important imaging that takes place when lacerations of the hand occur, due to the ability to view the integrity of the tendons within the hand.
23
Q

X-ray at the hand

A
  • Depending on how a laceration occurs,
  • possible through a crushing accident,
  • an Xray may be required to assess bone integrity and see if there are any loose bodies within the hand.
24
Q

Ultrasound at the hand

A
  • bedside US in ED
  • takes less time to preform than traditional wound exploration techniques or MRI
25
Q

Wrist radial deviation

A

Ulnar subluxation of carpals

26
Q

Ulnar drift

A
  • Radial collateral ligament breakdown of the MCP joints
  • Swelling causes flexor tendons to migrate ulnarly causing deviation at MCP
27
Q

Swan neck

A
  • Hyperextension or PIP and flexion at DIP
  • Lateral bands at PIP drift dorsally and bowstring causes hyperextension at PIP
  • Taut FDP causes flexion at DIP
  • May have rupture of PIP volar plate
28
Q

Boutonniere

A

Flex of PIP, hyperextension of DIP
Rupture of the central slip
Lateral bands volarly to PIP

29
Q

Mallet finger

A

Flexed DIP
Rupture of lateral bands at or near DIP insertion
No active DIP extension

30
Q

Palmar dislocation at MCP

A

Due to collateral ligament tear and force of FDP and FDS

31
Q

Steps for Differential Diagnosis at the hand

A

medical hx:

  • co-morbities

Physical exam:

  • deformities, swelling, strength etc

labs:

  • blood tests

imaging:

  • Can see similar inflammation and pattern of joint involvement in lupus and psoriatic arthritis
    MSUS
  • Spot RA early in those who are seronegative (lack antibodies to confirm disease)
  • Convenient (during physical exam)
  • Less than MRI but more than X-ray
32
Q
A

Human Anatomy 2 (14 decks)

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