The HAND Flashcards
What does the 1st carpometacarpal joint involve?
Trapezium and first metacarpal
What movements does the thumb make?
- Extension
- flexion
- opposition
- abduction
- adduction
what are the 3 hypothenar muscles?
- abductor digiti minimi (outside)
- flexor digiti minimi brevis (inside)
- opponens digiti minimi (deep)
what nerve supplies the 3 hypothenar muscles?
Ulnar nerve
What are the 3 thenar muscles?
Abductor pollicis brevis
Flexor pollicis brevis
Opponens pollicis
what nerve supplies the 3 thenar muscles?
Recurrent branch of median nerve
what muscle is responsible for adduction of the thumb?
Adductor pollicis
what is the nerve supply of adductor pollicis
Deep branch of ulnar nerve
Where do the lumbricals originate from and insert?
1st :
Origin = Radial side of 2nd digit tendon of flexor digitorum profundus
Inserts = index finger
2nd:
Origin = Radial side of 3rd digit tendon of flexor digitorum profundus.
Inserts = middle finger
3rd:
Origin head 1 = Ulnar side of 3rd finger tendon
Origin head 2 = Radial side of 4th finger tendon.
Insertion = Ring finger
4th :
Origin head 1 = Ulnar side of 4th finger tendon
Origin head 2 = Radial side of 5th finger tendon
Insertion = little finger
What are the actions of the lumbricals?
Flex metacarpophalangeal joint
Extend interphalangeal joint
what is the innervation of the lumbricals?
1st and 2nd lumbricals = MEDIAN NERVE
3rd and 4th lumbricals = deep branch of ULNAR nerve
what do the the dorsal interossei muscles do?
ABDUCT
What do the palmar interossei muscles do?
ADDUCT
what are the positions of the palmar interrosei?
1st :
Medial side of 2nd metacarpal
*middle finger has no palmar interossei
2nd:
lateral side of 4th metacarpal
3rd:
lateral side of 5th metacarpal
Which muscle abducts digit 5?
Abductor digiti minimi
what is the nerve supply of abductor digiti minimi
Deep branch of ulnar nerve
Where do the blood supply to the digits originate?
superficial palmar arch
What parts of the hand are supplied by the ulnar nerve?
PALM of hand:
- sensory to digits half of 4 and 5 (palm side)
- hypothenar muscles (abductor digiti minimi, flexor digiti minimi, opponens digiti minimi)
- 3rd and 4th lumbricals
- all 7 interossei
- adductor pollicis
DORSUM of hand:
- sensory to half of digits 4 and 5 (dorsal side)
What parts of the hand are supplied by the radial nerve?
sensory to dorsal side of thumb and digits 2, 3 and half of 4. (only up to the distal interphalangeal joint)
What parts of the hand are supplied by the median nerve?
Sensory to skin of palmar/ dorsal aspect of thumb, digits 2, 3, and half of 4
thenar muscles
lumbricals 1 and 2
What are the nerves acting on the flexors of the wrist?
Median and Ulnar nerves
What are the nerves acting on the extensors of the wrist ?
Radial
What structures pass through the carpal tunnel?
1) Median nerve
2) Tendons of flexor digitorum profundus / superficialis
3) flexor polliicis longus tendon
Whats the nerve supply of the intrinsic muscles of the hand?
All supplied by the ulnar nerve.
EXCEPT
Median nerve supplies
1st and 2nd Lumbricals
and thenar muscles
What are the symptoms of carpal tunnel syndrome?
1) Pins and needles in areas supplied by median nerve
2) weakness of thumb and atrophy of thenar muscles
3) inability to oppose thumb
What muscles are supplied by the ulnar nerve?
- hypothenar muscles
- adductor pollicid
- Interossei
- Lumbricals 4 + 5
What does compression of the ulnar nerve at the wrist cause?
- Handlebar neuropathy.
- clawing of 4th and 5th fingers
- Interosseous atrophy
What fracture does tenderness in the anatomical snuffbox indicate?
Scaphoid fracture
Why is the scaphoid bone the most likely to fracture from a fall on an outstretched hand?
It has a narrow waist
Colles Fracture
fracture of distal end of radius
