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MSS > The Hand > Flashcards

The Hand Flashcards

Week 9

1
Q

Name the carpal bones
(So Long to Pinky Here Comes The Thumb

A

Scaphaoid
Lunate
Triqyetrum
pisiform

Hamate Capitate
Trapaezoid
Trapezium

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2
Q

In the anterior view, where does the pisiform bone lie?

A

Anterior to the triquetum

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3
Q

Is the anterior hand palmar or dorsal?

A

palmar

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4
Q

Name the 5 joints of the hand and their functional type

A

interphalangeal joint (Hinge)

Metapophalangeal joint (Condyloid)

Carpometacarpal joint (plane)

Intercarapl joints (plane)

1st CMS
(saddle)

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5
Q

Which joints of the hand can do circumduction?

A

1st Carpometacarpal joint and metacarpophalangeal joint

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6
Q

What join forms the knuckles?

A

Metacarpophalangeal Joint

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7
Q

What differentiates intrinsic vs extrinsic muscles of the hand?

A

Intrinsic
Entirely within the hand

Extrinsic
Originate from forearm.

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8
Q

Name the 5 intrinsic muscles (inc groups) of the hand

A

Thenar, Hypothenar, lumbricals, interosseu and Adbsuctor pollic

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9
Q

What muscle does the abductor pollicis brevis contract simultaneously with

A

abductor pollicis longus

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10
Q

Where does the thenar group muscles originate?

A

tubercule of trapezium and flexor retinaculum

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11
Q

What movement does the thenar group muscles allow for and what are they all innervated by?

A

movement
-exert all actions at metacarpophalangeal joint

innervation
recurrent branch of median nerve

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12
Q

What muscles make up the thenar group?

A

Adb Pollicis Brevis
Flexor Pollicis Brevis
Opponens Pollicis

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13
Q

what muscles make up the hypothenar group?

A

Abd digiti minimi
flexor digiti minimi brevis
opponnens digiti minimi

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13
Q

What are all the Hypothenar group muscles innervated by?

A

deep branch of ulnar nerve

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14
Q

Which two Hypothenar group muscles have the same Origin. (what is this origin)

A

FDM and ODM = Hook of hamate and flexor retinaculum

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15
Q

O/I of lumbricals

A

Tendons of FDP –> extensor hood of index, middle, ring and little fingers

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16
Q

Movement of Lumbricals (and how)

A

Flexion at MCP joint and Extension at IP joint

=lumbricals insert on the palmar side of extensor hood, only continues to dorsal surface if finger therefore acts posteriorly to IP joint

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17
Q

Innervation of the lumbricals

A

1st and 2nd = median nerve

3rd and 4th = deep branches of ulnar nerve

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18
Q

Name the two interossei muscles

A

Palmar interossei

Dorsal inerossei

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19
Q

O/I and movement of palmar interossei

A

Side of metacarpals –> extensor hood of index, ring and little fingers

Adduction of index, middle and ring at MCP joint

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20
Q

O/I and movement of dorsal interossei

A

Adj side of metacarpals –> extensor hood and base of proximal phalanges of index, ring and middle fingers

Adduction of index, ring and little fingers at MCP joints

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21
Q

What are the interossei muscles innervated by?

A

Deep branch of ulnar

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22
Q

O/I of Abductor Pollicis Longus

A

Metacarpal II, capitate and bases of metacarpal II-III –> extensor hood and base of proximal phalanx of thumb

23
Q

Movement and innervation of Adbuctor pollicis

A

Thumb abduction

Deep branch of ulnar

24
Q

What is the extensor Hood?

A

tendons of long extensors (Ext D and Ext PL) flattened and expanded over the metacarpophalangeal joints

25
Q

What is the clinical significance of tendon sheaths?

A

affects the spread of infections

26
Q

How is the power grip created?

A

Extended wrist

IP and MCP joints flexed using extrinsic flexors

27
Q

What movements create the Precision grip?

A

Extended wrist, flexion of digits, opposition of CMC joint and use of short intrinsic muscles.

28
Q

What finger muscles are involved in flexion?

A

Intrinsic Muscle
Lumbricals
Interossei
FDMB

Extrinsic
FDS
FDP

29
Q

What finger movements are involved in extension?

A

Intrinsic
Lumbricals
Interossei

Extrinsic
ED
EI
EDM

30
Q

What finger movements are involved in Abduction?

A

Dorsal Interossei
ADM

31
Q

What finger muscles are involved in adduction?

A

palmar interossei

32
Q

What finger movements are involved in opposition of the little finger?

A

Opponens Digiti Minimi

33
Q

What muscles allow for flexion and extension respectively of teh thumb?

A

Flexion
FPB
FBL

Extension
EPB
EPL

34
Q

What muscles allow for Abduction and Adduction of the thumb respectively

A

Abduction
Abd PB
Abd PL

Adduction
Add P

35
Q

Where does the Ulnar Nerve innervate (sensory) (hand)

A

Palmar
-medial 1 ½
-medial palm

Dorsal
-medial dorsum
-medial 1 5/6

36
Q

Where does the Median nerve innervate (sensory) (hand)

A

Palmar
-lateral palm
Later 3 ½ dig

Dorsal
-tips of lateral 3 ½ digits

37
Q

What does the radial nerve innervate for the hand (sensory)

A

Palmar
-lateral thenar eminence

Dorsal
-lateral dorsum
-lateral 3 ½ digits without tips

38
Q

Path of ulnar artery

A

Ulnar artery –> superficial palmar arch –> common palmar digital arteries –> proper palmar digital arteries

39
Q

path of radial artery

A

Radial artery –> deep palmar arch –> palmar metacarpal arteries

40
Q

What is the Phalanx?

A

Singular word for phalanges

41
Q

What plane does flexion and extension of the MCP joints of digits 2-5 occur in?

A

saggital

42
Q

What plane does flexion of the thumb occur in and why?

A

coronal
1st CMC joint is rotated 90 degrees

43
Q

What is the Flexor Retinaculum and its role?

A

= thick connective tissue ligament that runs between the scaphoid and pisiform

= anterior boundary of carpal tunnel

= holds tendons that run through the carpal tunnel in place and prevents them form bowing out.

44
Q

Where does the:
a- radial artery
b- ulnar artery
enter the hand?

A

a- via anatomical snuffbox and through 2 heads of 1st dorsal interosseous and adductor pollicis

b- anterior to flexor retinaculum and through Gaylon’s canal

45
Q

Describe the Ulnar Claw

A

Caused by: Ulnar Nerve damage

This nerve supplies: Hypothenar, adductor pollicis, medial lumbricals and palmar interossei

impact= loss/impaired sensation to the medial side of hand and wrist (little finger and 1/2ring finger)

46
Q

Compare the damage caused if the ulnar nerve was damaged above the elbow joint versus below.

A

Below =
FDP is not affected by a wrist ulnar lesion = Distal IP are flexed

Above=
LESS clawing of 4th and 5th IP as the distal IP joints not flexed (FDP is affected)

radial deviation (due to loss of carpi ulnaris)

functional hand loss = similar

47
Q

Functional issues of ulnar claw

A

Difficulty making a fist due to hyperextension of the metacarpophalangeal joints.

Impaired movement of the little finger and weakness in the hypothenar muscles.

Weakness in finger abduction and adduction affecting both dorsal and palmar interossei.

48
Q

What are the borders of the anatomical snuffbox?

A

brevis sandwich
Extensor pollicis longus –> brevis –> abductor longus tendon

49
Q

What artery runs through the anatomical snuffbox?

A

Radial artery

50
Q

What are the bones on the floor of the snuffbox?

A

scaphoid and trapezium

51
Q

What nerve is affected in carpal tunnel and how is its damage caused?

A

Median nerve compression

Overuse, swelling of tendons and tend sheaths

(if swollen, nowhere for pressure to be released so it pushes on structures within the tunnel)

52
Q

Boundaries of the Carpal Tunnel

A

Roof = flexor retinaculum
Floor = carpal bones

Medial = lat surface of hamate
lateral= medial surface of trapezium

53
Q

What are the contents of the Carpal Tunnel?

A

9 tendons:
-4 tendons of FDP
- 4 tendons of FDS
- flexor pollicis longus tendon

54
Q

Functional issues associated with Carpal tunnel

A

Loss of cutaneous innervation for the palm of the hand which weakens the grip of the hand.

Loss of sensory feedback for hand = loss of feedback on how tight to hold objects.

thenar group weakness

55
Q

If there was damage to the radial artery at the wrist, would there be a wrist drop?

A

No

MSS (18 decks)

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