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Gross Anatomy > Upper Extremity: Hand (Part 1) > Flashcards

Upper Extremity: Hand (Part 1) Flashcards

1
Q

A digit (ray) contains

A
  • Metacarpal
  • Proximal phalanx
  • Intermediate (Middle) phalanx
  • Distal phalanx
  • Thumb (pollex) does not have a middle phalanx
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2
Q

Joints of the Hand

A
  • Carpometacarpal joints
  • Metacarpophalangeal (MCP) joints (“knuckles”)
  • Interphalangeal (IP) joints
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3
Q

Carpometacarpal Joints

A
  • Between proximal end of metacarpal and distal row of carpals
  • 1st carpometacarpal joint is a saddle joint
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4
Q

Metacarpophalangeal (MCP) Joints (“Knuckles”)

A
  • Between distal end of metacarpal and proximal phalanges
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5
Q

Interphalangeal (IP) Joints

A
  • Proximal (PIP)
  • Distal (DIP)
  • Thumb only has an interphalangeal joint
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6
Q

Middle Finger

A
  • Used as a reference point with finger abduction/adduction
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7
Q

Types of Grips

A
  • Power

- Precision

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8
Q

Power Grip

A
  • Different types

- Significant force produced

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9
Q

Power Grip Relies on

A
  • Finger flexion
  • Wrist extension
  • Thumb adduction, flexion, opposition
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10
Q

Precision Grips

A
  • Different types

- Less force

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11
Q

Fascia of the Palm

A
  • Continuous with antebrachial fascia (forearm deep fascia)
  • Fascia is thin over thenar and hypothenar regions
  • Palmar aponeurosis
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12
Q

Palmar Aponeurosis

A
  • Thick, covers central compartment and flexor tendons

- Made up of longitudinal and transverse bands

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13
Q

Palmar Aponeurosis Attaches to

A
  • Flexor retinaculum and palmaris longus

- Fibrous sheaths

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14
Q

Compartments of the Palm

A
  • Compartments created by bone, deep fascia, and septa extensions
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15
Q

Compartments of the Palm Containing Muscle

A
  • Thenar
  • Hypothenar
  • Central
  • Adductor
  • Interosseous
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16
Q

Spaces of the Compartments of the Arm

A
  • Thenar

- Midpalmar

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17
Q

Midpalmar Compartment of the Arm

A
  • Communicates through carpal tunnel into the forearm
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18
Q

Fibrous Digital Sheath (Tendon Sheath of the Hand)

A
  • Osseofibrous tunnel
  • Surrounds digital synovial sheaths
  • Vincula
19
Q

Fibrous Digital Sheath Structure

A
  • Surrounds digital synovial sheaths
  • Formed by annular and cruciform ligaments
  • Prevents bowstringing
20
Q

Vincula of Fibrous Digital Sheath

A
  • Attaches tendons to bones and neighboring tendons

- Allow for the passage of blood vessels

21
Q

Tendon Sheaths of the Hand

A
  • Fibrous digital sheath
  • Ulnar bursa
  • Radial bursa
22
Q

Ulnar Bursa

A
  • Communicate with the synovial sheath of the 5th digit
23
Q

Radial Bursa

A
  • Communicates with 1st digital synovial sheath
24
Q

Spread of Infection (Hand to Forearm)

A
  • Midpalmar space > forearm
  • 1st digit > wrist/distal forearm
  • 5th digit > wrist/distal forearm
25
Q

Clinical Importance of Tendon Sheaths/Infection

A
  • Infection in the synovial sheaths of the hand/digits can spread into the forearm (Space of Parona)
26
Q

Dupuytren’s Contracture

A
  • Thickening and shortening of palmar aponeurosis
  • Most common in ring and little finger
  • Nodule thickenings progresses to contracture of longitudinal bands
27
Q

Dupuytren’s Contracture Cause

A
  • Unknown
  • Hereditary predisposition
  • Possible risk factors: smoking, diabetes, manual labor
  • Microvascular ischemia
28
Q

Dupuytren’s Contracture Treatment

A
  • Fasciotomy
  • Fasciectomy
  • Collagenase injections (break down collagen)
29
Q

Trigger Finger

A
  • Thickening of a flexor tendon in the distal palm
  • Restriction of tendon gliding under the fibrous sheath
  • Palpable nodule that gets “stuck”
  • Locking of finger into flexion (most common)
  • “Snaps” into place
30
Q

Trigger Finger Cause

A
  • Unknown
  • Other disease conditions (diabetes, inflammatory arthritis)
  • Repetitive, forceful digital flexion
31
Q

Intrinsic Muscles of the Hand

A
  • Thenar muscles
  • Adductor pollicis
  • Hypothenar muscles
  • Lumbricals
  • Interossei
32
Q

Thenar Muscles

A
  • Abductor pollicis brevis
  • Flexor pollicis brevis
  • Opponens pollicis
33
Q

Hypothenar Muscles

A
  • Abductor digiti minimi
  • Flexor digiti minimi
  • Opponens digiti minimi
34
Q

Interossei Muscles

A
  • Dorsal

- Palmar

35
Q

Thenar Muscles Proximal Attachments

A
  • Flexor retinaculum

- Carpal bones (trapezium, scaphoid)

36
Q

Thenar Muscles Distal Attachments

A
  • 1st metacarpal (OP)
  • Base of thumb proximal phalanx
  • Sesamoid bone ( for APB, FPB)
37
Q

Thenar Muscles Innervation

A
  • Recurrent branch of median nerve

- Deep portion of FPB can be innervated by deep branch of ulnar nerve

38
Q

Thenar Muscles Function

A
  • Name tells you function
  • APB: abduction of the thumb
  • FPB flexes CMC and MCP
  • Opposition involves flexion, abduction and medial rotation at thumb CMC
39
Q

Adductor Pollicis

A
  • 2 heads
  • Oblique
  • Transverse
40
Q

Oblique Adductor Pollicis Proximal Attachment

A
  • Capitate

- Base of 2nd and 3rd mets

41
Q

Transverse Adductor Pollicis Proximal Attachment

A
  • Palmar surface of 3rd met
42
Q

Adductor Pollicis (Both Obliqe and Transverse) Distal Attachments

A
  • Medial aspect of proximal phalanx, sesamoid bone
43
Q

Adductor Pollicis (Both) Innervation

A
  • Deep branch of ulnar nerve
44
Q

Adductor Pollicis (Both) Function

A
  • Moves thumb toward hand

Gross Anatomy (50 decks)

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