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Limbs anatomy > The hand > Flashcards

The hand Flashcards

1
Q

What does the interosseous membrane do?

A

creates the separation between the anterior and posterior compartments of arm

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2
Q

What do the distal radius and ulna articulate with?

A

With the proximal row of carpal bones (apart from pisiform)

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3
Q

What are the proximal carpal bones?

A

Scaphoid, lunate, triquetrium, pisiform

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4
Q

What are the distal carpal bones?

A

Trapezium, trapezoid, capitate, hamate

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5
Q

What is the carpal arch?

A

carpal bones don’t lie in a flat plane

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6
Q

what forms the anterior wall of carpal tunnel?

A

flexor reticulum spans distance b/ medial, lateral sides of base to form ant wall

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7
Q

How many metacarpals? what do they articulate with?

A

5, articulate with distal row of carpal bones

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8
Q

How many phalanges are there in each finger?

A

3 (proximal, middle, distal)

2 in thumb (proximal, distal)

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9
Q

What is palmar fascia?

A

palmar aponeurosis which overlies the long flexor tendons of the hand

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10
Q

what is the palmar fascia continuous with proximally?

A

flexor retinaculum

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11
Q

what is the palmar fasica continous with distally?

A

fibrous digital sheaths

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12
Q

what is the palmar aponeurosis?

A

triangular condensation of deep fascia that covers palm, anchored to skin in distal regions

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13
Q

what lies deep to the palmar aponeurosis in palm?

A

vessels, nerves, long flexor tendons

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14
Q

What is the palmaris brevis?

A

small intrinsic muscle of hand

originates from palmar aponeurosis and flexor retinaculum

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15
Q

what does the palmaris brevis overlie?

A

hypothenar muscles,
ulnar artery,
superficial branch of ulnar nerve

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16
Q

What are fibrous digital sheaths?

A

contain the flexor tendons and their synovial sheaths

hold tendons to bone plane, prevent tendons from bowing when digits are flexed

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17
Q

What is the anatomical snuffbox?

A

triangular depression on posterolateral side of wrist and metacarpal 1
formed by extensor tendons passing into thumb

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18
Q

What passes through the snuffbox?

A

radial artery

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19
Q

what can you feel in the anatomical snuffbox?

A

scaphoid

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20
Q

describe the position of the medial septa

A

palmar aponeurosis to metacarpal of little finger

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21
Q

describe the position of the lateral septa

A

palmar aponeurosis to metacarpal of middle finger

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22
Q

what are the 5 compartments of the hand?

A 
thenar - near thumb
hypothenar - medial, near little finger
central - defined by 2 septa
adductor - dorsal to thenar space
interosseous - most dorsal, demarcated by interosseous fascia
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23
Q

What are the 2 spaces in the hand?

A

thenar - b/ thenar compartment and adductor

midpalmar - below central compartment

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24
Q

what muscles are in the anterior superficial compartment?

A 
Pronator teres
Flexor carpi radialis
Palmaris longus
Flexor digitorium superficialis
Flexor carpi ulnaris
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25
Q

what muscles are in the anterior deep compartment?

A

flexor digitorium profundus
pronator quadratus
felexor pollicis longus

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26
Q

What muscles are in the posterior compartment?

A 
supinator
Extensor carpi radialis longus
Extensor carpi radialis brevis
Extensor carpi ulnaris
Brachioradialis
Aconeus
Extensor digiti minimi
Abductor pollicis longus
Extensor pollicis brevis
Extensor indices
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27
Q

In general, what are the intrinsic muscles of the hand?

A

Occur entirely in hand

mainly execute precision movements w/ fingers and thumb

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28
Q

In general, what are the extrinsic muscles?

A 
originate in forearm, insert in hand
function in power grip
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29
Q

what muscles are included in the “intrinsic muscles of the hand”?

A
  • lumbricals
  • interossi: Palmar, dorsal
  • abductor digiti minimi
  • flexor digiti minimi
  • opponens digiti minimi
  • adductor pollicis
  • adductor pollicis brevis
  • flexor pollicis brevis
  • opponens pollicis
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30
Q

what do the lumbricals do?

A

flex the metacarpals,

extend the interphalangeal joints

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31
Q

what do the interossi muscles do?

A

Palmar interossi - adduct the digits (PAD)

Dorsal interossi - abduct the digits (DAB)

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32
Q

what does the abductor digiti minimi do?

A
  • in the hypothenar compartment

- abducts the little finger at the metacarpophalangeal joint

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33
Q

what does the flexor digiti minimi do?

A
  • in the hypothenar compartment

- flexes little finger at metacarpophalangeal joint

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34
Q

what does the opponens digiti minimi do?

A
  • in hypothenar compartment

- laterally rotates metacarpal V

35
Q

what does the adductor pollicis do?

A
  • adductor compartment

- only pollicis muscle supplied by ulnar nerve

36
Q

what does the abductor pollicis brevis do?

A
  • thenar compartment

- abducts thumb at metacarpophalangeal joint

37
Q

which muscles abduct the thumb?

A
  • abductor pollicis brevis (APB)

- abductor pollicis longus (APL)

38
Q

Which muscles adduct the thumb?

A
  • adductor policis

- first dorsal interosseus

39
Q

which muscle cause thumb opposition?

A

opponens pollicis

40
Q

which muscles cause thumb flexion?

A
  • flexor pollicis longus

- flexor pollicis brevis

41
Q

which muscles extend the thumb?

A
  • extensor pollicis longus
  • extensor pollicis brevis
  • abductor pollicis longus
42
Q

what are the tendons in the anterior compartment?

A
  • fibrous digital sheaths: annular, cruciform parts

- osseo-fibrous tunnels: long flexor tendons (FDP, FDS) run in these in their synovial sheaths

43
Q

what is the connection of the FDS and FDP with the phalanx?

A

FDS splits around FDP to the middle phalanx

FDP goes to the distal phalanx

44
Q

what are the tendons in the posterior compartment?

A
  • extensor retinaculum (6 main extensor tendons)
  • synovial tendon sheaths
  • intertendinous bands
  • extensor expansions
  • extensor digitorium, extensor indices, extensor digiti minimi
45
Q

what are the extensor expansions?

A
  • lumbricals and interossi attach to these
  • are hoods over phalangi-metacarpal joints
  • long extensor tendons go through them
46
Q

what is the wrist joint?

A

synovial joint b/ distal end of radius and articular disc overlying distal end of ulna and the scaphoid, lunate, triqetrum

47
Q

what is the capsule of the wrist joint reinforced by?

A
  • palmar radiocarpal
  • palmar ulnocarpal
  • dorsal radiocarpal ligaments
48
Q

what do the radial and ulnar collateral ligaments of the wrist do?

A

reinforce medial and distal rows

49
Q

describe how the carpal-metacarpal joints work?

A

carpal bones make a recess for metacarpals to project into

w/ the distal carpals articulating with the thumb metacarpal

50
Q

what are the movements of the carpal-metacarpal joints?

A 
flexion,
extension, 
adduction, 
abduction,
circumduction
51
Q

what is the saddle joint?

A

b/ metacarpal 1 and trapezium

gives wide range of mobility to thumb that you don’t get with other digits

52
Q

describe the metacarpo-phalangeal joint

A

joint b/ distal head of metacarpals and proximal phalanges

condylar joint

53
Q

what movements occur at the metacarpo-phalangeal joint?

A

flexion,
extension,
abduction,
adduction

54
Q

what is the metacarpo-phalangeal joint stabilised by?

A
  • ulnar collateral ligaments of the thumb

- palmar ligaments

55
Q

what muscles cause wrist flexion?

A
  • flexor carpi radialis
  • flexor carpi ulnaris
  • long flexors of thumb and fingers
  • palmaris longus
  • abductor pollicis longus
56
Q

what muscles cause wrist extension?

A
  • extensor carpi radialis brevis
  • extensor carpi radialis longus
  • extensor carpi ulnaris
  • long extensors of thumb and fingers
57
Q

what muscles cause wrist adduction?

A
  • extensor carpi ulnaris

- flexor carpi ulnaris

58
Q

what muscles cause wrist abduction?

A
  • abductor pollicis longus
  • flexor carpi radialis
  • extensor carpi radialis longus
  • extensor carpi radialis brevis
59
Q

where is the ulnar artery?

A

beside FCU at wrist

60
Q

name some of the branches of the ulnar artery

A
  • interosseous arteries in forearm
  • superficial palmar arch –> palmar digital arteries
  • deep palmar branch
61
Q

where is the radial artery?

A

under brachioradials
besides FCR at wrist
passes through snuffbox

62
Q

what are the branches of the radial artery?

A

deep palmar arch

give rise to palmar metacarpal arteries

63
Q

what is the median nerve?

A

main nerve of the anterior forearm

some supply to hands intrinsic muscles

64
Q

where is the median nerve?

A

deep to PL

goes through carpal tunnel

65
Q

what is the median nerve motor to?

A 
thenar muscles (APB, FPB, OP)
and lateral 2 lumbricals
66
Q

what is the median nerve sensory to?

A

palmar surface of thumb, index, middle and half of ring finger

67
Q

what is the ulnar nerve?

A

main nerve of hand

some of anterior compartment

68
Q

where is the ulnar nerve?

A

at wrist lies by FCU

runs over flexor retinaculum lateral to pisiform

69
Q

what does the superficial sensory branch of the ulnar nerve supply?

A

palmar surfaces of little finger, half of ring finger, ulnar part of palm and dorsum

70
Q

what does the deep motor branch of the ulnar nerve supply?

A

hypothenar muscles
adductor pollicis
lumbricals (3 and 4)
all the interossi

71
Q

what is the radial nerve?

A

posterior compartment of forearm

some sensory to hand

72
Q

where does the radial nerve divide? into what?

A

divides just above the elbow into:

  • deep posterior interosseous nerve (motor)
  • superficial radial nerve (sensory)
73
Q

what is the sensory supply of the radial nerve?

A

dorsum of hand

74
Q

what is the motor supply of the radial nerve?

A

no motor to the hand

75
Q

what are digital nerves?

A

purely sensory

often damaged

76
Q

describe the carpal tunnel structure

A

scaphoid, pisiform, hamate and trapezoid form a gutter

roof = flexor retinaculum

77
Q

what does the carpal tunnel contain?

A
  • median nerve
  • 4 flexor tendons of flexor digitorum superficialis
  • 4 flexor tendons of
  • digitorum profundus
  • flexor pollicis longus tendon
78
Q

what facilitates the free movement of tendons in the carpal tunnel?

A

synovial sheaths

79
Q

what is carpal tunnel syndrome?

A

entrapment syndrome

caused by pressure on median nerve within carpal tunnel

80
Q

what are the causes of carpel tunnel syndrome?

A

overuse,
swelling of tendons/tendon sheaths,
cysts arising from carpal joints

81
Q

describe the power grip

A
  • long flexors of fingers and thumb,
  • intrinsic palm muscles
  • extensors of the wrist joint to maintain tension
82
Q

describe the precision grip

A

wrist and fingers are held rigidly by long flexors/extensors

intrinsic hand muscles carry out fine movements

83
Q

describe the hook grip

A

consumes little energy

mainly long flexors of digits

Limbs anatomy (7 decks)

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