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Functional Architecture of the Body > Upper limb (hands) > Flashcards

Upper limb (hands) Flashcards

1
Q

What are the boundaries of the carpal tunnel?

A
  • Roof: Flexor retinaculum

- Walls: Carpal arch (carpal bones)

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2
Q

What are the attachments of the flexor retinaculum?

A
  • Scaphoid
  • Trapezium
  • Hook of hamate
  • Pisiform
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3
Q

What are the contents of the carpal tunnel (anterior to posterior)?

A
  • Tendon of flexor carpi radialis
  • Median nerve
  • Tendons of flexor digitorum superficialis
  • Tendon of flexor pollicis longus
  • Tendons of flexor digitorum profundus
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4
Q

What is the significance of the synovial sheaths of the carpal tunnel?

A
  • FDS and FDP tendons are all in the same synovial sheath.

- Tendons of FCR and FPL are in separate sheaths.

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5
Q

What is the main function of the carpal tunnel?

A

To fix tendons of flexor muscles in plane of carpal bondes to prevent bowing in flexion.

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6
Q

What are the relations of the carpal tunnel?

A
  • Ulnar artery and nerve pass though tunnel anterior to the flexor retinaculum whose floor is the flexor retinaculum and whose roof is the palmer carpal ligament.
  • This tunnel is called Guyon’s canal.
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7
Q

What type of joint is the wrist joint?

A

Synovial ellipsoid joint

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8
Q

What movements are associated with the wrist joint?

A
  • Flexion
  • Extension
  • Abduction
  • Adduction
  • Circumduction
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9
Q

What are the articulations of the wrist joint?

A
  • Radius with trapezium/lunate
  • Ulna with triquetrum
  • Distal radio-ulnar joint
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10
Q

What are the ligaments associated with the wrist joint?

A
  • Palmer radiocarpal ligament
  • Palmer ulnocarpal ligament
  • Medial collateral ligament
  • Lateral collateral ligament
  • Dorsal radiocarpal ligament
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11
Q

What are the functions of the hands?

A
  • Grip (prehension)
  • Communication
  • Mobility
  • Sensation
  • Defense
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12
Q

What are the types of grips?

A
  1. Divergent grip: Fingers abducted. Brought about by dorsal interossei. Used to hold flat objects.
  2. Convergent grip: Fingers adducted. Brought about by palmer interossei. Used to scoop.
  3. Hook grip: Interphalangeal joints flexed. Brought about by flexor digitorum superficialis/profundus. Used to carry bags by handle.
  4. Power grip: Tight flexion of the fingers and opposition of the thumb. Brought about by flexor digitorums, muscles of thenar eminence and extensors. Used to make fist .
  5. Pinch grip: Opposition of the thumb against the pads of the fingers. Brought about by flexors of the fingers and muscles of the thenar eminence. Most precise grip.
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13
Q

What is the function of wrist extension in power grip?

A
  • Reduces active insufficiency of the flexors of the fingers.
  • Active insufficiency is when the resting length of the muscle is shorter than natural length, so it produces reduced tension.
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14
Q

What are the boundaries of the anatomical snuffbox?

A
  • Anterior border: Tendons of adductor pollicis longus and extensor pollicis brevis.
  • Posterior border: Tendon of extensor pollicis longus.
  • Roof: Skin.
  • Floor: Scaphoid, trapezium, tendons of extensor carpi.
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15
Q

What is the significance of the snuffbox?

A

It is the location where scaphoid can be palpated in order to detect scaphoid fracture.

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16
Q

What are the contents of the snuffbox?

A
  • Radial artery
  • Superficial branch of radial nerve
  • Cephalic vein (on roof)
17
Q

What are the relations of the palmer aponeurosis?

A
  • All nerves and blood vessels are deep to the palmer aponeurosis.
  • It is thickest in centre and thinnest over the eminences.
  • It is attached to the skin by fibrous bands called minute fasciculi, dividing subcutaneous fat into loculi.
  • It is attached proximally to the palmaris longus tendon.
18
Q

What are the muscular attachments of the extensor hood on each finger?

A
  • Lumbricals
  • Interossei
  • Abductor digiti minimi
19
Q

What are the musclular attachments of the extensor hood on the thumb?

A
  • Adductor pollicis

- Abductor pollicis brevis

20
Q

What is the function of the extensor hood?

A

Allows fine movements such as extension of the interphalangeal joints and metacarpophalangeal joints (important in writing).

21
Q

What types of joints are carpometacarpal joints?

A
  • 1st joint is saddle joint, allows for wide range of movements of thumb.
22
Q

What types of joints are metacarpophalangeal joints?

A

Codylar joint

23
Q

What are the ligaments associated with the metacarpophalangeal joints?

A
  • Palmer ligament
  • Collateral ligaments
  • Deep transverse metacarpal ligaments
24
Q

What types of joints are interphalangeal joints?

A

Hinge joints

25
Q

What are the ligaments associated with the interphalangeal joints?

A
  • Palmer ligament

- Collateral ligaments

26
Q

What are the relationships of the ulnar artery?

A
  • The ulnar artery enters the hand superficial to the flexor retinaculum, through Guyon’s canal.
  • It is lateral to the ulnar nerve.
  • The artery then forms the superficial palmer arch just deep to the palmer aponeurosis.
27
Q

What are the branches of the ulnar artery?

A
  • Deep palmer artery: Anastomoses with radial artery to form deep palmer arch.
  • Palmer digital artery: Supplies little finger.
  • Common palmer digital arteries: Bifurcates into proper palmer digital arteries and supply the fingers.
28
Q

What are the relations of the radial artery?

A
  • The radial artery curves around the lateral aspects of the wrist joint and passes through the anatomical snuffbox.
  • It then enters the palmer aspects of the hand through the 1st webspace between the 2 heads of the 1st dorsal interosseus muscle and adductor pollicis respectively.
  • It forms the deep palmer arch.
29
Q

What are the branches of the radial artery?

A
  • Superficial palmer branch: Anastomoses with the ulnar artery to form the superficial palmer arch.
  • Palmer metacarpal arteries: Anastomoses with the common palmer digital arteries.
  • Princeps pollicis artery: Supplies the thumb
  • Radialis indicis artery: Supplies lateral side of index finger.
30
Q

What are the relations of the ulnar nerve?

A
  • The ulnar nerve enters the the hand superficial to the flexor retinaculum medial to the ulnar artery.
  • It immediately bifurcates into deep and superficial branches once it enters the hand.
31
Q

What are the branches of the ulnar nerve?

A
  • Deep branch: Supplies the muscles of the hypothenar eminence and interossei.
  • Superficial branch: Supplies palmaris brevis and the skin over palmer aspects of the hand.
32
Q

What are the relations of the median nerve?

A
  • The median nerve enters the hand through the carpal tunnel anterior to all tendons.
  • It immediately divides into its branches.
33
Q

What are the branches of the median nerve?

A
  • Recurrent branch: Supplies the muscles of the thenar eminence.
  • Palmer digital branches: Supplies the skin over the palmer aspects of the lateral 4.5 digits.
34
Q

What are the attachments of the extensor retinaculum?

A
  • Lateral margins of radius
  • Triquetrum
  • Pisiform

Functional Architecture of the Body (33 decks)

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