The Wrist and Hand Flashcards

1
Q

Fascial Compartments of the Hand & Wrist (5)

A
Hypothenar
Thenar
Cantreal 
Adductor
Interosseous
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2
Q

Hypothenar: (2)

A

ulnar nerve;

intrinsic muscles of digit 5

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3
Q

Thenar: (2)

A

median nerve;

intrinsic muscles of digit 1 (thumb)

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4
Q

Central:

A

carpal tunnel (median n., tendons of f.d.s, f.d.p., flexor pollicis longus)

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5
Q

Adductor: (2)

A

deep ulnar n.;

adductor pollicis muscle

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6
Q

Interosseous: (2)

A

ulnar n., between metacarpals;

palmar and dorsal interosseous muscles

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7
Q

The (2) are thickenings in the antebrachial fasciae

A

extensor retinaculum and the flexor retinaculum

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8
Q

The flexor retinaculum (aka transverse carpal ligament) forms the

A

roof of the carpal tunnel

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9
Q

Long Flexor Tendons & Synovial Sheaths:

The long tendons of: (2)

A
  1. flexor digitorum superficialis

2. flexor digitorum profundus

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10
Q

Long Flexor Tendons & Synovial Sheaths:

enter a common flexor sheath (ulnar bursa) beneath the

A

flexor retinaculum

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11
Q

Long Flexor Tendons & Synovial Sheaths:

each of their 4 tendons then entered its own separate

A

synovial sheath

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12
Q

the synovial sheath is within a

A

fibrous digital sheath

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13
Q

Long Flexor Tendons & Synovial Sheaths:

the synovial sheath for digit 5 is continuous with the

A

ulnar bursa

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14
Q

Long Flexor Tendons & Synovial Sheaths:

the long tendon of flexor pillicis longs has a synovial sheet that is separate from the

A

ulnar bursa

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15
Q

Clinical Correlation: Infectious Tenosynovitis:

infection of

A

flexor tendon sheaths

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16
Q

Clinical Correlation: Infectious Tenosynovitis:

infections of the 5th digit can spread to (2)

A

ulnar bursa

carpal tunnel

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17
Q

Clinical Correlation: Infectious Tenosynovitis:

infections of the 1st digit can also spread to (2)

A

carpal tunnel

flexor pollicis longus tendon (radial bursa)

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18
Q

Clinical Correlation: Infectious Tenosynovitis:

“Kanavel’s Four Cardinal Signs” (“Kanavel’s Sign”) (4)

A
  1. Flexed position
  2. Pain with any attempt at extending affected digit
  3. Uniform swelling involving entire digit
  4. Percussion tenderness along course of tendon
    sheath
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19
Q

Thenar Eminence=

A

(Thenar = Thumb)

rounded mound under thumb

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20
Q

Thenar Eminence:

formed by 3 muscles

A
  1. abductor pollicis brevis
  2. flexor pollicis brevis
    • superficial head
    • deep head
  3. opponens pollicis
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21
Q

— is also a thenar muscle but is not technically part of thenar eminence

A

adductor pollicis

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22
Q

Opponens pollicis:

PA (2)

A
  • -flexor retinaculum

- tubercles of scaphoid and trapezium

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23
Q

Opponens pollicis:

DA

A

-lateral side of 1st metacarpal

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24
Q

Opponens pollicis:

Actions (2)

A
  • oppose thumb

- medially rotate 1st metacarpal

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25
Opponens pollicis: | Inn
recurrent branch of median nerve | C8, T1
26
Abductor pollicis brevis: | PA (2)
-flexor retinaculum & tubercles of scaphoid and trapezium
27
Abductor pollicis brevis: | DA
-lateral side of base of proximal phalanx of thumb
28
Abductor pollicis brevis: | Actions (2)
- abduct thumb, | - aid in opposition
29
Abductor pollicis brevis: | Inn
-recurrent branch of median nerve | C8, T1
30
Flexor pollicis brevis: | PA
-flexor retinaculum & tubercles of scaphoid and trapezium
31
Flexor pollicis brevis: | DA
-lateral side of base of proximal phalanx of thumb
32
Flexor pollicis brevis: | Action
-flexes thumb
33
Flexor pollicis brevis: Inn (2) superficial head, deep head
-recurrent branch of median nerve (C8, T1) (superficial head) -deep branch of ulnar nerve (C8, T1) (deep head)
34
Adductor pollicis: | PA
-bases of 2nd & 3rd metacarpals, capitate, & adjacent carpals
35
Adductor pollicis: | DA
-medial side of base of proximal phalanx of thumb
36
Adductor pollicis: | Action
-adducts thumb toward lateral border of palm
37
Adductor pollicis: | Inn
deep branch of ulnar nerve | C8, T1
38
``` Hypothenar Eminence (5th digit): formed by 3 muscles" ```
* flexor digiti minimi * abductor digiti minimi * opponens digiti minimi
39
``` Hypothenar Eminence (5th digit): what lies superficial? ```
palmaris brevis
40
Abductor digiti minimi: | PA
pisiform
41
Abductor digiti minimi: | DA
-medial side of base of proximal phalanx of 5th digit
42
Abductor digiti minimi: | Actions (2)
- abducts 5th digit, | - aids in flexion of 5th proximal phalanx
43
Abductor digiti minimi: | Inn
- deep branch of ulnar nerve | C8, T1
44
Flexor digiti minimi (brevis): | PA
-hook of hamate and flexor retinaculum
45
Flexor digiti minimi (brevis): | DA
-medial side of base of proximal phalanx of 5th digit
46
Flexor digiti minimi (brevis): | Actions
-flexes proximal phalanx of digit 5
47
Flexor digiti minimi (brevis): | Inn
deep branch of ulnar nerve | C8, T1
48
Opponens digiti minimi: | PA
-hook of hamate and flexor retinaculum
49
Opponens digiti minimi: | DA
-medial border of 5th metacarpal
50
Opponens digiti minimi: | Actions
-brings 5th metacarpal anterior & rotates it to bring it into opposition with thumb
51
Opponens digiti minimi: | Inn
deep branch of ulnar nerve | C8, T1
52
Intrinsic (Short) Muscles=
Lumbricals
53
1st & 2nd lumbricals (2)
* attached to lateral 2 tendons of FDP | * median nerve (C8, T1)
54
3rd & 4th lumbricals (2)
* attached to medial 3 tendons of FDP | * deep branch of ulnar nerve (C8, T1)
55
Lumbrcals insert on the lateral sides of the
extensor expansions of digits 2-5
56
Lumbricals function to (2)
- flex the metacarpophalangeal joints | - extend interphalangeal joints (via the extensor expansion & extensor hood) of digits 2-5
57
The extensor tendons form a moveable hood over the MP joints of the fingers called the
extensor expansion
58
The arrangement of both extensor muscles and intrinsic hand muscles that attach to this dorsal digital expansion enable
the uncoupling of flexion & extension
59
This mechanism enables the long extensor tendons to (2)
strongly extend the MP joint and allows extension of IP joints when MP joints are flexed by lumbricals, which also attach to the “hood” part of the extensor expansion
60
This is also aided by contraction of --- --- muscles
dorsal interosseous
61
Palmar Interossei: | there are - of them
3
62
Palmar Interossei: | attach to
palmar surfaces of 2nd, 4th, & 5th metacarpals
63
Palmar Interossei: | insert at
bases of proximal phalanges and the extensor expansions of digits 2nd, 4th, & 5th digits
64
Palmar Interossei: | PAD
adduct 2nd, 4th, & 5th fingers toward axial line; also assist lumbricals
65
Palmar Interossei: | innervation
deep branch of ulnar nerve (C8, T1)
66
Dorsal Interossei: | there are - of them
4
67
Dorsal Interossei: | attach to
adjacent sides of 2 metacarpals
68
Dorsal Interossei: | insert at
bases of proximal phalanges and the extensor expansions of digits 2-4
69
Dorsal Interossei: | DAB
abduct 2nd-4th fingers toward axial line; also assist lumbricals
70
Dorsal Interossei: | innervation
deep branch of ulnar nerve (C8, T1)
71
Radial and Ulnar arteries: Forearm | Anterior Forearm: (3)
- ulnar artery (proper) - radial artery (proper) - anterior interosseous a.
72
Radial and Ulnar arteries: Forearm | Posterior Forearm: (4)
- radial artery (proper) - recurrent interosseous a. - posterior interosseous a. - Dorsal carpal branch (ulnar a.)
73
``` Radial & Ulnar arteries: Hand Radial a (2) Ulnar a (1) ```
deep palmar arch | superficial palmar branch of radial artery
74
deep palmar arch (2)
princeps pollicis artery | radialis indicies artery
75
ulnar artery (1)
superficial palmar arch
76
superficial palmar arch (1)
common palmar digital arteries
77
common palmar digital arteries (1)
proper digital arteries
78
Anatomical snuff box is bordered by (2)
extensor pollicis brevis and | extensor pollicis longus
79
The superficial branch of the radial nerve passes across the snuff box ---
superficially
80
the snuff box contains the (3)
radial artery, the trapezium, scaphoid bones
81
The median nerve passes through the carpal tunnel with
all of the tendons of f.d.s. and f.d.p.
82
Recurrent branch of median nerve (motor) is very superficial (easily injured) as it enters the
thenar eminence
83
Ulnar nerve passes --- to flexor retinaculum and enters ulnar canal (Guyon’s Canal) --- to ulnar artery
superficial | medial
84
Radial nerve supplies --- muscles in hand
NO
85
Superficial radial nerve provides sensation to --- of hand
dorsum