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MSK 1 > The hand > Flashcards

The hand Flashcards

1
Q

abduction and adduciton of the thumb is iin which plane

A

sagittal- bringing it forward and back

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2
Q

proximal row of carpals from lateral to medial

A

scaphoid, lunate, triquetrum, pisiform (sesamoid bone w/i tendon of flexor carpi)

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3
Q

distal row of carpals from lateral to medial

A

trapezium, trapezoid, capitate, hamate

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4
Q

mnemonic for carpals

A 
Some (scaphoid)
Lovers (lunate)
Try (triquetrum)
Positions (pisiform)
That (trapezium)
They (trapezoid)
Cant (capitate)
Handle (hamate)
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5
Q

most common carpal fracture

A

scaphoid

lunate most commonly dislocated

both usually from FOOSH

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6
Q

complications from scaphoid fractures

A

can disrupt blood supply causing delayed necrosis of bone

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7
Q

significance of 1st carpometacarpal joint

A

one of the most common sites of arthritis

b/w trapezium and base of first metacarpal

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8
Q

easy fracture in Boxer’s fracture

A

commonly in 5th metacarpal neck, most ROM and easily broken

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9
Q

which nerve tested by OK sign

A

anterior interosseus nerve- innervates FPL (thumb) and FDP (index finger)

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10
Q

palmar aponeurosis def and septa

A

continuation of antebrachial fascia

sends a medial septum to 5th metacarpal and lateral septum to 3rd metacarpal and divides hand into compartments

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11
Q

5 compartments of hand

A 
hypothenar
thenar
central
adductor
interosseus

limit spread of infection in hand

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12
Q

base of palmar aponeurosis becomes…

A

4 longitudinal fibrous digital sheaths w/i fingers

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13
Q

fibrous digital sheaths contain…

A

superficial and deep flexor tendons and their synovial sheaths

5 annular and 4 cruciform ligaments

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14
Q

trigger finger patho

A

trauma to tendons causes scar tissue, creates nodule on tendon

causes finger to lock into flexion position as nodule catches beneath annular ligament

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15
Q

tenosynovitis

A

inflammation of synovial tendon sheaths

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16
Q

fn of synovial tendon sheath

A

permit tendons to move freely w/ less friction

17
Q

hypothenar compartment muscles

A

3 intrinsic muscles:
abductor digiti minimi
flexor digiti minimi brevis
opponens digiti minimi

innervated by deep branch of ulnar nerve

located medially in hand

18
Q

thenar compartment

A

located laterally

3 intrinsic muscles (mainly for opposition of thumb)
abductor pollicis brevis
flexor pollicis brevis
opponens pollicis (main one responsible for thumb opposition)

all innervated by recurrent branch of median nerve except deep head of flexor pollicis brevis

19
Q

muscle of adductor compartment

A

adductor pollicis- fan shaped w/ two heads (transverse and oblique, contains small sesamoid bone in tendon)

innervated by deep branch of ulnar nerve

20
Q

location/muscles of central compartment

A

under aponeurosis, contains long flexor tendons and lumbrical muscles

21
Q

lumbrical muscles origin/insertion, innervation

A

4 intrinsic muscles arising from tendons of FDP

lateral 2 by median nerve, medial 2 by ulnar

insert into extensor expansion (hood ligament) of dorsum of digits 2-5

22
Q

lumbrical function

A

flex digits at MCP and extend interphlangeal joints at the same time- tightens hood ligament and extends fingers

23
Q

interosseus compartment location

A

b/w metacarpal bones

24
Q

interosseus muscles

A

interossei muscles- aid in grip strength

3 palmar from metacarpals 2,4,5 help adduct digits toward axial line

4 dorsal interossei from metacarpals, insert into extensor expansion of digits 2,3,4- abduct digits away from axial line

all innervated by deep branch of ulnar nerve

25
Q

3 extrinsimuscles providing tendons into hand

A

flexor pollicis longus -1
FDS- 4
FDP- 4

all passing thru carpal tunnel w/ median nerve

26
Q

carpal tunnel syndrome

A

any condition causing reduction in size of the carpal tunnel, traps median nerve

sx in hand distal to median nerve

27
Q

sx of carpal tunnel syndrome

A

nerve problems w/ lateral 3.5 digits along palmar surface

can lose opposiiton of thumb when thenar muscles affected

28
Q

blood supply to hand all from..

A

ulnar and radial arteries

29
Q

two terminal branches of ulnar artery

A

superficial palmar arch- gives common and proper palmar digital arteries

deep palmar branch

both contribute to medial aspect of hand

30
Q

location of distal radial artery

A

courses dorsally thru anatomical snuff box, enters palm passing deep to first dorsal interosseus muscle

31
Q

2 branches of radial artery

A

radial indicis and princeps pollicis arteries (index and thumb)

lateral aspect of hand

32
Q

anastamosis of radial and ulnar arteries

A

deep palmar arch, radial artery w/ deep palmar branch of ulnar

superficial palmar arch- ulnar artery and superficial branch of radial

33
Q

all intrinsic muslces innervated by which nerve roots

A

C8 and T1- via deep branch of ulnar and radial

34
Q

describe sesnsory innervation to hand

A

ulnar- dorsal and palmar of 5th digit, half of 4th

radial- dorsal of 1,2,3, half of 4th digit

median- palmar of 1,2,3 half of 4th digit and nail beds

35
Q

describe median nerves entry into hand, branches, and key innervations

A

enters thru carpal tunnel (except palmar branch)

gives off recurrent branch innervating thenar muscles

innervates 1st and 2nd lumbricals

common and proper digital branches for sensation, palmar carpal branch supplies central palm (prior to carpal tunnel, runs over the roof)

36
Q

ulnar nerve entry into hand, branches, key innervations

A

over flexor retinaculum w/ ulnar artery thru canal of guyon into hand

deep branch supplies almost all intrinsic muscles (except 1 and 2 lumbrical)

superficial branch gives common and proper digital branches for sensation to digit 5 and half of 4

MSK 1 (10 decks)

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