The Hand

Question 1

List the carpal bones

Answer 1

Some Lovers Try Positions That They Can’t Handle

Explanation: to remember the carpal bones

Proximal row: Scaphoid, Lunate, Triquetral, Pisiform,
Distal row: Trapezium, Trapezoid, Capitate, Hamate

Question 2

Tubercle of scaphoi, pt position, how to find?

Answer 2

model in sitting, hand supported
Palpate just distal to the wrist crease in line with base of the thumb, prominent on extension, disappears on flexion.
Provides attachment for; Flexor retinaculum, AbPB (few fibres)

Question 3

Pisifor, pt position, how to find? Attachment for?

Answer 3

model in sitting, hand supported
Forearm supinated, just distal to wrist crease, medial side of hand, use action of Abductor minimi digiti to check.
Provides attachment for; Flexor retinaculum, FCU, AbDM, Extensor retinaculum

Question 4

Hook of Hammate, pt position, how to find?

Answer 4

model in sitting, hand supported 1 - 1.5cm distal and just lateral to pisiform
Provides attachment for; Flexor retinaculum, FDM, ODM

Question 5

Ridge on Trapeziu, pt position, how to find?

Answer 5

model in sitting, hand supported
1cm distal to tubercle of scaphoid palpate deeply. Hand must be relaxed (from space between index and middle finger → down hand to upper border of thenar emminence) Provides attachment for; Flexor retinaculum

Question 6

Surface mark the Joint line: 1st carpometacarpal, what type of joint is this, what movements?

Answer 6

Synovial saddle, flexion , ext, abd, add, opposition

Joint line between base of 1st metacarpal and distal border of Trapezium easiest to palpate lateral aspect of the joint

Question 7

Surface mark the Joint line: 2nd - 5th CMC joint, what type of joint is this, what movements?

Answer 7

Synovial plane, just glides baby

Lie between the base of the metacarpals and distal surfaces of carpal bones. Slide proximally along metacarpals towards the carpus

Question 8

Surface mark the Joint line: Metacarpophalangeal, what type of joint is this, what movements, what surfaces, strengthened by?

Answer 8

Synovial ellipsoid (condyloid). flex / ext/ abd / add
Head of metacarpals and proximal base of phalanges. Strengthened by  collateral ligs and Palmer ligs 

Flex MCP joint, large bony prominence is head of metacarpal. Slide fingers distally joint line

Question 9

Extensor retinaculum of the hand function (2)?

Answer 9

Prevent bow stringing of tendons

Forms the roof of the carpal tunnel (flexor tendon and median nerve runs through here)

Question 10

Demonstrate movements occurring at the 1st CMC joint ?

Answer 10

Synovial saddle, flexion , ext, abd, add, opposition

Question 11

Demonstrate movements occurring at the MCP and IP joints

Answer 11

MCP: Synovial ellipsoid (condyloid). flex / ext/ abd / add

Interphalangeal joints: flexion and extension

Question 12

Extrinsic vs intrinsic muscles of the hand?

Answer 12

Extrensic more situated on the elbow / forearm and tendon runs into the hand

Intrinsic, they are more situated actually like on the hand lol

Question 13

What are the extrinsic muscles of the hand?

Answer 13

E.g FDS, FDP, FPL, ED, EI, EDMi

• Flexor digitorum superficialis
• Flexoor digitorum profundus
• Flexor pollicis longus
• Extensor digitorum
• Extensor indicies
• Extensor digit mini

Question 14

What are the intrinsic muscles of the hand?

Answer 14

Intrinsic muscles*
		Thenar (3)
		Hypothenar (3)
		Lumbricals (4)
		Palmar Interossei 3   
                Dorsal Interossei  4)

Question 15

Category B attachements:

• Flexor Digitorum Superficialis
• Profundus
• Extensor Digitorum

Answer 15

• Flexor Digitorum Superficialis - med conny - middle phalnges
• Profundus - medy con - distal aspect of phalenges
• Extensor Digitorum - latty con - extensor expansion of middle and distal phalanges

Question 16

Extension at 1st CMC joint -
Flexion at 1st CMC joint - 
Abduction at 1st CMC joint - 
Adduction at 1st CMC joint - 
Opposition at 1st CMC joint-

Answer 16

Extension at 1st CMC joint - Extensor pollicis longus, extensor pollicis brevis

Flexion at 1st CMC joint - Flexor pollicis longus, Flexor pollicis brevis

Abduction at 1st CMC joint - Abductor pollicis longus, abductor pollicis brevis

• Adduction at 1st CMC joint - adductor pollicis
• Opposition at 1st CMC joint- opponens pollicis
• no longus / brevis

Question 17

Identify muscles responsible for :-

Flexion at MCP joints
Extension at MCP joints
Abduction at MCP joints
Adduction at MCP joints

Answer 17

Flexion at MCP joints - Lumbricles, flex dig produndus, flex dig superficialis

Extension at MCP joints - Extensor digitorum

Abduction at MCP joints - Dorsal interossei (DAB)

Adduction at MCP joints - Palmar interossei (PAD)

Question 18

Identify muscles responsible for :

Flexion at PIP jt.
Extension at PIP jt.

Flexion at DIP jt.
Extension at DIP jt

Answer 18

Fexion at PIP jt. - FD superficialis, FD profundus
Extension at PIP jt. - Ext digitorum, lumbricles

Flexion at DIP jt. - Flextor digitorum profundus
Extension at DIP jt - Extensor digitorum, lumbricles

Question 19

Lumbricles

Answer 19

Interphalangeal joints (DIP / PIP) extension

Metacarpophalangeal joints 2-5: Finger flexion