The Wrist and Hand Flashcards
Potential space btwn thenar and adductor compartments
Thenar space
Provides insertion for palmaris longus muscle; spreads over palmar surface and helps to adhere the skin tightly to the underlying structures
Palmar aponeurosis
Potential space with nerves and vessels running through it; contains lumbricals
Midpalmar space
____ compartment of hand and wrist contains ulnar nerve; intrinsic muscles of digit 5
Hypothenar:
____ compartment of hand and wrist contains median nerve; intrinsic muscles of digit 1 (thumb)
Thenar:
____ compartment of hand and wrist contains carpal tunnel (median n., tendons of f.d.s, f.d.p., flexor pollicis longus)
Central:
____ compartment of hand and wrist contains deep ulnar n.; adductor pollicis muscle
Adductor:
____ compartment of hand and wrist contains ulnar n., between metacarpals; palmar and dorsal interosseous muscles
Interosseous:
The _____ and the _______ are thickenings in the antebrachial fasciae.
extensor retinaculum; flexor retinaculum
The _____ forms the roof of the carpal tunnel.
flexor retinaculum (aka transverse carpal ligament)
____ function to keep tendons tightly adhered to palmar aspect of digits to keep structures from moving out of place; provide pulley joints
Fibrous flexor sheaths
What tendons go thru the carpal tunnel?
Flexor digitorum superficialis, flexor digitorum profundus, flexor digitorum longus, and median nerve
flexor digitorum superficialis flexor digitorum profundus enter a common flexor sheath called _____ beneath the flexor retinaculum.
ulnar bursa
T/F: each tendon of Flexor digitorum superficialis and flexor digitorum profundus has its own synovial sheath within a fibrous sheath
True
The synovial sheath of what digit is continuous with the ulnar bursa?
5th digit
Infection of flexor tendon sheaths
Infectious tenosynovitis
Infections of ___ digit can spread to ulnar bursa and carpal tunnel
5th digit
Infections of ___ digit can also spread to carpal tunnel and flexor pollicis longus tendon (radial bursa)
1st digit
Flexed position, Pain with any attempt at extending affected digit, Uniform swelling involving entire digit, and Percussion tenderness along course of tendon sheath are
Kanavel’s Four Cardinal Signs
What muscles form the thenar eminence?
abductor pollicis brevis, flexor pollicis brevis (superficial and deep head), and opponens pollicis
What muscle is also a thenar muscle but is not technically part of thenar eminence
adductor pollicis longus
Proximal Attachment:-flexor retinaculum & tubercles of scaphoid and trapezium
Distal Attachment:-lateral side of 1st metacarpal
Actions:-oppose thumb & medially rotate 1st metacarpal
Innervation:-recurrent branch of median nerve
Opponens pollicis
All thenar muscles are innervated by _____ nerve
recurrent branches of median n
Proximal Attachment:-flexor retinaculum & tubercles of scaphoid and trapezium
Distal Attachment:-lateral side of base of proximal phalanx of thumb
Abductor pollicis brevis
Proximal Attachment:-flexor retinaculum & tubercles of scaphoid and trapezium
Distal Attachment:-lateral side of base of proximal phalanx of thumb
Flexor pollicis brevis
Proximal Attachment:-bases of 2nd& 3rdmetacarpals,capitate, & adjacent carpals
Distal Attachment:-medial side of base of proximal phalanx of thumb
Adductor pollicis
What muscles form hypothenar eminence?
flexor digiti minimi, abductor digiti minimi•opponens digiti minimi
____ lies superficial to hypothenar eminence tightens skin over the hypothenar muscles
palmis brevis
Proximal Attachment:-pisiform
Distal Attachment:-medial side of base of proximal phalanx of 5th digit
Abductor digiti minimi
Proximal Attachment:-hook of hamate and flexor retinaculum
Distal Attachment:-medial side of base of proximal phalanx of 5th digit
Flexor digiti minimi (brevis)
Proximal Attachment:-hook of hamate and flexor retinaculum
Distal Attachment:-medial border of 5th metacarpal
Opponens digiti minimi
_____ are attached to the lateral 2 tendons of fundus digitorum profundus and are innervated by median nerve
1st and 2nd lumbricals
____ are attached to the medial 3 tendons of fundus digitorum profundus and are innervated by deep branch of ulnar nerve
3rd and 4th lumbricals
They flex the metacarpophalangeal joints and extend interphalangeal joints (via the extensor expansion & extensor hood) of digits 2-5.
Lumbricals
The extensor tendons form a moveable hood over the MP joints of the fingers called the ______
extensor expansion
The arrangement of both ___ muscles and ______ muscles that attach to this dorsal digital expansion enable the uncoupling of flexion & extension.
extensor and intrinsic hand muscles
Extensor hood mechanism enables the long extensor tendons to strongly extend the MP joint and allows extension of IP joints when MP joints are flexed by ____, which also attach to the “hood” part of the extensor expansion
lumbricals
The lumbricals are aided by ____ in allow extension of interphalangeal joints when metaphalangeal joints are flexed
dorsal interosseous muscles
____ and ___ flex metacarpophalangeal joint and extend interphalangeal joint
Lumbricals and dorsal interosseous
attach to palmar surfaces of 2nd, 4th, & 5th metacarpals
insert at bases of proximal phalanges and the extensor expansions of digits 2nd, 4th, & 5th digits
Palmar interossei
How many palmar interossei are there?
3
How many dorsal interossei are there?
4
attach to adjacent sides of 2 metacarpals
•insert at bases of proximal phalanges and the extensor expansions of digits 2-4
Dorsal interossei
Which artery forms superficial palmar arch?
Ulnar artery
Which artery forms deep palmar arch?
Radial artery
___ artery comes off of deep palmar arch and supplies the thumb
Princeps pollicis artery
____ artery comes off deep palmar arch and supplies lateral 2nd digit
Radialis indicis artery
_____ is bordered by extensor pollicis brevis and extensor pollicis longus
Anatomical snuff box
The Anatomical snuff box contains ___ artery and what 2 bones of wrist?
radial artery; trapezium and scaphoid
The superficial branch of the ____ nerve passes across the Anatomical snuff box superficially
radial nerve
The _____ nerve passes through the carpal tunnel with all of the tendons of f.d.s. and f.d.p.
median nerve
Recurrent branch of ____ nerve (motor) is very superficial (easily injured) as it enters the thenar eminence
median nerve
_____ nerve passes superficial to flexor retinaculum and enters ulnar canal (Guyon’s Canal) medial to ulnar artery
Ulnar nerve
Actions:-abduct thumb, aid in opposition
Abductor pollicis brevis
Innervation of Abductor pollicis brevis from
recurrent branch of median nerve(C8, T1)
Actions:-flexes thumb
Flexor pollicis brevis
Innervation of Flexor pollicis brevis is from ____ and ____ nerve
recurrent branch of median nerve(C8, T1) (superficial head)deep branch of ulnar nerve (C8, T1)(deep head)
Actions:-adducts thumb toward lateral border of palm
Adductor pollicis
Innervation of Adductor pollicis is from the deep branch of ____ nerve
ulnar nerve(C8, T1)
Actions:-abducts 5th digit, aids in flexion of 5th proximal phalanx
Innervation:-deep branch of ulnar nerve(C8, T1)
Abductor digiti minimi
Innervation of Abductor digiti minimi is from deep branch of _____ nerve
ulnar nerve(C8, T1)
Actions:-flexes proximal phalanx of digit 5
Flexor digiti minimi (brevis)
Innervation of Flexor digiti minimi (brevis) deep branch of _____ nerve
ulnar nerve(C8, T1)
Actions:-brings 5th metacarpal anterior & rotates it to bring it into opposition with thumb
Opponens digiti minimi
Innervation of Opponens digiti minimi is from deep branch of _____ nerve
ulnar nerve(C8, T1)
Actions: adduct 2nd, 4th, & 5th fingers toward axial line; also assist lumbricals
Palmar interossei
Palmar interossei are Innervated by deep branch of ____ nerve
ulnar nerve (C8, T1)
Actions: abduct 2nd-4th fingers toward axial line; also assist lumbricals
Dorsal interossei
•Dorsal interossei are Innervated by deep branch of _____ nerve
ulnar nerve (C8, T1)
