UL: Hand

Question 1

Carpal bones

Answer 1

Question 2

Structures through the carpal tunnel

Answer 2

Median nerve

Flexor digitorum profundus

Flexor digitorum superficialis

Flexor pollicis longus

(flexor carpi radialis)

Question 3

Structures going over the carpal tunnel

Answer 3

Ulnar nerve

Ulnar artery

Palmaris longus tendon

Question 4

Palmar aponeurosis

Answer 4

Continuous of palmaris longus tendon if present otherwise anchored to the retinaculum

Question 5

Anatomical snuffbox borders

Answer 5

Extensor pollicis longus

Extensor pollicis brevis

Question 6

Anatomical snuffbox content

Answer 6

Scaphoid

Radial artery

Cephalic vein

Question 7

Origin and insertion of palmaris brevis

Answer 7

palmar apneurosis to skin on medial side

Question 8

Innervation of palmaris brevis

Answer 8

Superficial branch of ulnar nerve

Question 9

Action of palmaris brevis

Answer 9

Improves grop

Question 10

Origin and insertion of dorsal interossei

Answer 10

Adjacent metacarpals to proximal phalanges

Question 11

Origin and insertion of palmar interossei

Answer 11

Side of metacarpals to extensor hoods and proximal phalanx of thumb

Question 12

Innervation of dorsal and palmar interossei

Answer 12

Deep branch of ulnar

Question 13

Action of interossei muscles

Answer 13

PAD DAB

Palmar adducts

Dorsal abducts

Question 14

Origin and insertion of adductor pollicis

Answer 14

Transvers head: metcarpal 3

Oblique head: capitate and base of 2 and 3

To extensor hood of thumb

Question 15

Innervation of adductor pollicis

Answer 15

Deep ulnar nerve

Question 16

Origin and insertion of lumbricals

Answer 16

Tendon of flexor digitorum produndus

To extensor hoods

Question 17

Innervation of lumbricals

Answer 17

Medial 2: deep ulnar

Lateral 2: digiatal branch of median

Question 18

Action of lumbricals

Answer 18

MCP flexion

IP extension

Question 19

Muscles of the thenar eminence

Answer 19

Opponens pollicis

Abductor pollicis brevis

Flexor pollicis brevis

Question 20

Origin and insertion of opponens pollicis

Answer 20

Tubercle of trapezium to lateral and palmar metacarpal

Question 21

Origin and insertion of Abductor pollicis brevis

Answer 21

Tubercle of scaphoid and trapezium to proximal phalanx

Question 22

Origin and insertion of flexor pollicis brevis

Answer 22

Tubercle of trapezium to proximal phalanx

Question 23

Innervation of thenar muscles

Answer 23

Recurrent branch of median nerve

Question 24

Action of opponens pollicis

Answer 24

Medial rotation of thumb

Question 25

Hypothenar muscles

Answer 25

Opponens digiti minimi Abductor digiti minimi Flexor digiti minimi brevis

Question 26

Origin and insertion of opponens digit minimi

Answer 26

Hook of hamate to medial metacarpal 5

Question 27

Origin and insertion of abductor digiti minimi

Answer 27

Pisiform to proximal phalanx

Question 28

Origin and insertion of flexor digiti minimi brevis

Answer 28

Hook of hamate to proximal phalanx

Question 29

Action of opponens digiti minimi

Answer 29

Lateral rotation of metacarpal 5

Question 30

Innervation of hypothenar muscles

Answer 30

Deep branch of ulnar nerve

Question 31

Guyon's canal

Answer 31

Ulnar nerve crossing over carpal tunnel

Question 32

Median nerve branch at risk of damage over thenar eminence

Answer 32

recurrent branch

Question 33

Extensor retinaculum tunnels

Answer 33

6

Question 34

Structures superficial to extensor retinaculum

Answer 34

Cephalic and Basilic vein Dorsal cutaneous branch of ulnar and superficial branch of radial nerve

Question 35

Structures deep to extensor retinaculum

Answer 35

Question 36

How are flexor tendons staying in place and not bow-stringing

Answer 36

Pulley system (thickening of fascia) that allows them to move but not come out A1 - MCP A2 - proximal phalanx C1 (cruciate) A3- PIP C2 A4- middle phalanx C3 A5 - DIP

Question 37

Flexor sheath coverage

Answer 37

Synovial sheath covers flexor tendons of digits (doesn't cover extensors) At the ulnar and radial side forms bursae

Question 38

Problems with flexor sheath infection

Answer 38

1. Fixed tough fibros tissue. Cannot expand leading to do necrosis of tendon/later presents as atrophic tendon rupture 2. Scarring between the tendon and the flexor sheath leads to reduced functionality

Question 39

Branches of radial artery in hand

Answer 39

Princeps pollicis Radialis indicis Radial side of the deep palmar arch

Question 40

Attachment of flexor retaniculum

Answer 40

Lateral edge of the trapezium Tubercle of scaphoid Hook of hamate pisiform

Question 41

What structures cut through for carpal tunnel release op

Answer 41

Skin, Subcut fascia, Palmar fascia, (palmaris brevis), flexor retaniculum

Question 42

What structures at risk during carpal tunnel release

Answer 42

Nerves: * Palmar cutaneous branch (median) * Recurrent branch (median) * Ulnar n (if incision too ulnar) * Median (if too deep) + Superficial palmar arch Flexor tendons