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Gross Anatomy > Upper Extremity: Hand (Part 2) > Flashcards

Upper Extremity: Hand (Part 2) Flashcards

1
Q

Hypothenar Muscles

A
  • Abductor digiti minimi
  • Flexor digiti minimi brevis
  • Opponens digiti
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2
Q

Hypothenar Muscles Proximal Attachment

A
  • Carpals

- Flexor retinaculum

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3
Q

Hypothenar Muscles Distal Attachment

A
  • Distal attachment
    5th metacarpal (ODM)
    Base of 5th proximal phalanx (FDMB, ADM)
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4
Q

Hypothenar Innervation

A
  • Deep branch of ulnar
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5
Q

Hypothenar Function

A
  • Name tells you function

- ADM can also help flex proximal phalanx of 5th digit

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6
Q

Lumbricals (“Worm-Like”) Proximal Attachment

A
  • Tendons of FDP
  • 1st and 2nd attach to one tendon
  • 3rd and 4th attach to 2 adjacent tendons
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7
Q

Lumbricals (“Worm-Like”) Distal Attachment

A
  • Extensor expansion of digits 2-5 (lateral side)

- Ex: 1st lumbrical > 2nd digit extensor expansion

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8
Q

1st and 2nd Lumbricals (“Worm-Like”) Innervation

A
  • Median nerve
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9
Q

3rd and 4th Lumbricals (“Worm-Like”) Innervation

A
  • Deep branch of ulnar nerve
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10
Q

Lumbricals (“Worm-Like”) Function

A
  • Flex MCP joint and extend IP joints
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11
Q

Palmar Interossei Proximal Attachment

A
  • Metacarpals 2 (1st), 4 (2nd), 5 (3rd)
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12
Q

Palmar Interossei Distal Attachment

A
  • Base of proximal phalanges
  • Extensor expansion of digits
  • Medial 2nd (1st), Lateral 4th (2nd), Lateral 5th (3rd)
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13
Q

Palmar Interossei

A
  • 3 in number (numbered from lateral to medial)
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14
Q

Palmar Interossei Function

A
  • Adduct digits 2,4,5

- Flex MCP and extend IP’s of respective digits

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15
Q

Dorsal Interossei

A
  • 4 in number
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16
Q

Dorsal Interossei Proximal Attachment

A
  • Adjacent metacarpals

- Ex: 1st dorsal interossei attaches to 1st and 2nd metacarpal

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17
Q

Dorsal Interossei Distal Attachment

A
  • Base of proximal phalanges and extensor expansion of digits 2-4
  • Lateral 2nd (1st), lateral 3rd (2nd), medial 3rd (3rd), medial 4th (4th)
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18
Q

Dorsal Interossei Innervation

A
  • Deep branch of ulnar nerve
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19
Q

Dorsal Interossei Function

A
  • Abduct digits 2,4,5

- Flex MCP and extend IP’s of respective digits

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20
Q

Palmar Interossei Innervation

A
  • Deep branch of ulnar nerve
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21
Q

Radial and Ulnar Arteries of Hand

A
  • Form the dorsal carpal arch, superficial and deep palmar arches
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22
Q

Dorsal Carpal Arch

A
  • Formed by branches of radial and ulnar arteries
  • Gives off 2nd – 4th dorsal metacarpal arteries
  • 1st dorsal metacarpal is a branch off of radial
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23
Q

Superficial Palmar Arch

A
  • Formed by ulnar artery + superficial branch of radial
  • Superficial to long flexor tendons
  • Located about mid-palm
  • Gives off 3 common palmar digital branches
24
Q

3 Palmar Digital Branches

A
  • Travels on the lumbricals 2 - 4

- Proper palmar digital branch off from common palmar digital

25
Q

Radial passes through snuffbox and through 1st dorsal interossei. Gives off:

A
  • Princeps pollicis artery: palmar side of 1st digit

- Radialis indicis: lateral side of 2nd digit

26
Q

Deep Palmar Arch

A
  • Formed by radial + deep branch of ulnar
  • Deep to long flexor tendons and adductor pollicis
  • Located at the base of metacarpals
27
Q

Deep Palmar Arch Gives Off

A
  • Palmar metacarpal arteries

- Perforating branches

28
Q

Palmar Metacarpal Arteries of Deep Palmar Arch

A
  • Anastomose with common palmar digital
29
Q

Perforating Branches of Deep Palmar Arch

A
  • Anastomose with dorsal metacarpal arteries
30
Q

Nerves of the Hand (Palmar Aspect)

A
  • Median nerve

- Ulnar nerve

31
Q

Median Nerve of Hand (Palmar Aspect)

A
  • Palmar cutaneous branch
  • Recurrent branch
  • Common palmar digital nerves
32
Q

Palmar Cutaneous Branch

A
  • Arises before carpal tunnel and innervates palm
33
Q

Recurrent Branch

A
  • Supplies thenar muscles
34
Q

Common Palmar Digital Nerves

A
  • Proper palmar digital nerves
35
Q

Ulnar Nerve (In the Ulnar Canal)

A
  • Palmar cutaneous branch
  • Superficial branch
  • Deep branch
36
Q

Ulnar nerve (in the ulnar canal)
Palmar cutaneous branch
Superficial branch
Palmaris brevis muscle
Common palmar digital and proper palmar digital
Sensory to 5th digits and medial ½ of 4th
Deep branch
supplies all muscles of the hand innervated by ulnar nerve, except palmaris brevis
Joints
Accompanies deep branch of ulnar artery and deep palmar arch

A

Ulnar nerve (in the ulnar canal)
Palmar cutaneous branch
Superficial branch
Palmaris brevis muscle
Common palmar digital and proper palmar digital
Sensory to 5th digits and medial ½ of 4th
Deep branch
supplies all muscles of the hand innervated by ulnar nerve, except palmaris brevis
Joints
Accompanies deep branch of ulnar artery and deep palmar arch

37
Q

Superficial Branch of Ulnar Nerv

A
  • Palmaris brevis muscle
  • Common palmar digital and proper palmar digital
  • Sensory to 5th digits and medial ½ of 4th
38
Q

Deep Branch of Ulnar Nerve

A
  • Supplies all muscles of the hand innervated by ulnar nerve, except palmaris brevis
  • Joints
  • Accompanies deep branch of ulnar artery and deep palmar arch
39
Q

Common Palmar Digital and Proper Palmar Digital (Ulnar Nerve)

A
  • Sensory to 5th digits and medial ½ of 4th
40
Q

Nerves of the Hand (Dorsal Aspect)

A
  • Ulnar nerve

- Radial nerve

41
Q

Ulnar Nerve

A
  • Dorsal branch of ulnar (sensory)
  • Dorsal digital nerves
  • Supplies dorsum and medial 1 ½ digits
42
Q

Radial Nerve

A
  • Superficial branch of radial (sensory)
  • Dorsal digital branches
  • Supplies dorsum and lateral 3 ½ digits
  • Lateral portion of thenar eminence
43
Q

Palmar Digital Nerves from Median and Ulnar Nerves

A
  • Supplies distal aspect of fingers
44
Q

Floor (Posterior) of Carpal Tunnel

A
  • Carpal bones
45
Q

Roof (Anterior) of Carpal Tunner

A
  • Flexor retinaculum (transverse carpal ligament)
46
Q

Transverse Carpal Ligament Lateral Attachment

A
  • Scaphoid

- Trapezium

47
Q

Transverse Carpal Ligament Medial Attachment

A
  • Pisiform

- Hook of hamate

48
Q

Content of Carpal Tunnel

A
  • 4 tendons of FDS
  • 4 tendons of FDP
  • Tendon of FPL
  • Median nerve
49
Q

Carpal Tunnel Syndrome

A
  • Signs and symptoms due to median nerve compression in the carpal tunnel
  • Caused by different factors
50
Q

Carpal Tunnel Syndrome Symptoms

A
  • Pain, anesthesia, paresthesia (numbness, prickling sensation) to lateral 3 ½ digits
  • Hand clumsiness/weakness
  • Weakness and wasting of (LOAF muscles)
  • Ape-hand deformity
51
Q

Pain, anesthesia, paresthesia (numbness, prickling sensation) to lateral 3 ½ digits in Carpal Tunnel Syndrome

A
  • Pain can extend into distal forearm

- Central palm and lateral thenar sensation are normal

52
Q

Weakness and Wasting of (LOAF Muscles) in Carpal Tunnel Syndrome

A
  • 1st and 2nd Lumbricals
  • Opponens pollicis
  • APB
  • FPB
53
Q

Ape-Hand Deformity

A
  • Atrophy of thenar

- Inability to move thumb away from hand

54
Q

Ganglion Cyst

A
  • Common benign soft tissue tumor found in the hand/wrist
  • Most common over dorsal wrist
  • Volar ganglion cyst can cause compression of median or ulnar nerves (or branches)
  • Pathogenesis is unknown, originates from joints of the wrist or flexor sheaths
55
Q

Origination of Pathogenesis from Joints of the Wrist or Flexor Sheaths (Ganglion Cyst)

A
  • Connective tissue degeneration and cystic space formation
  • Herniation of synovium
  • Leakage of synovial fluid into surrounding space
56
Q

Pathogenesis of Ganglion Cysts

A
  • Unknown

- Originates from joints of the wrist or flexor sheaths

57
Q

Ganglion Cyst Treatment

A
  • Observation
  • Aspiration
  • Surgical resection

Gross Anatomy (50 decks)

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