week 5 movement Flashcards
what can the hand be divided into?
the wrist ( 8 carpal bones)
digits (phalanges)
5 metacarpals
what are the 3 divisions of the phalanges?
distal, middle and proximal
what phalanges does the thumb have?
distal and proximal no middle
which digits have all 3 of the phalanges?
2 to 5
what is the name of the joint between the distal and middle phalanges?
the distal interphalageal joint
what is the name of the joint between the proximal and middle phalanges?
the proximal interphalangeal joint
what is the name of the the joint between the phalanges and the metacarpals?
the metacarpo-phalangeal joint
name the 8 carpal bones?
Scaphoid, Lunate, Triquetrum, Pisiform, trapezium, trapezoid capitate, hamate
how do you ring the carpal bones?
from proximal to distal. Lateral to medial.
what is the name of the wrist joint?
radiocarpal joint
what two bones are involved in the radiocarpal joint?
the radius and carpal joint
which two carpal bones articulate with the radius?
the scaphoid and lunate
what joint is not involved in the radiocarpal joint?
the distal radioulnar joint
what is the function of the distal radioulnar joint?
its supports the posterior radioulnar joitn in supination
what does the radiocarparl ligament do?
it is supportive ligament which allow the hand to move with the radius
what are the movements of the wrist joint?
extension and flexion
abduction and adduction
all those movements together circumduction
which muscles of the forearm don’t act on the wrist?
pronator teres –> anterior flexor compartment
Brachioradialis and Anconeus of the posterior extensor compartmetn
what nerve controls the anterior flexor muscles of the wrist joint?
median and ulna nerve?
what nerve controls the posterior extensor muscles of the wrist joint?
radial nerve
which structures runs through carpal tunnel?
flexor digitorium superficials tendon
flexor digitorium profundus tendon
flexor pollicis longus tendon
median nerve
what is the boundaries of the carpal tunnel?
flexor retinaculum and carpal bones
which intrinsic muscle of the hand is not suppleid by the ulnar nerve and what nerve are they supplied by?
the 1st and 2nd lumbrical muscles (lateral) unipennate are not. The thenar muscles are not either. They are supplied by the medial nerve
what are the movements of the thumb?
abduction, adduction, flexion, extension, oppositiona dn reposition
what does the Palmar cutaneous branch of median nerve supply?
the lateral side of the palm
what branch of the median nerve supplies the thenar muscle?
the recurrent branch
what does the digital branch of teh median nerve supply?
Innervates the palmar surface and fingertips of the lateral three and half digits and 1st and 2nd lumbrical muscles
what do the lumbrical muscle do?
Flexion at metacarpophalangeal joint and extension at interphalangeal joint
what is the knuckle actually called?
the metacarpophalangeal joint
what is the medial attachment of the flexor retinaculum?
pisiform and hook around of the hamate
what is the lateral attachment of the flexor retinuculum?
scaphoid tubersosity and trapezium
what is the symptome of carpal tunnel syndrome?
Pins and needles in the cutaneous distribution of digital branches of median nerve
Weakness of thumb and muscle atrophy in thenar region –> Inability to oppose thumb
what occurs in surgery to relieve carpal tunnel syndrome?
cut the flexor retinaculum –> this will relieve pressure on the median nerve and tendons. When the flexor retinaculum heals and joins it will have lengthened giving it more space which will reduce pressure
which carapal bone is most commonly dislocated and how is it done?
lunate bone and falling on a outstretched hand
how is the medial nerve damaged by dislocated of the lunate bone?
anterior dislocation of the lunate bone can stretch and damage the median nerve –> cause similar symptoms to carpal syndrome
what does the palm branch of the ulnar nerve supply?
the medial side of the palm
what does the deep branch of the ulnar nerve supply?
Hypothenar muscles, adductor pollicis, interossei and 4th + 5th lumbricals.
what is within the guyons canal?
the ulnar nerve and artery
what is the outcome of the compression of the ulnar nerve at the wrist?
Handlebar neuropathy –> ulna claw
Sensory loss palmer surface of lateral 1 ½ digits
Hyperextension of metacarpophalangeal joints of digits 4 and 5 and flexion at the IP
Motor weakness in the intrinsic muscle of the hand
what type of wrist fracture is common for young adults
scaphoid wrist fracture –> tenderness at the anatomical snuff box
what is the boundaries of the anatomical snuff box?
Medial boundary –>extensor pollicis longus tendon –> extrinsic and long
Lateral border –> extensor pollicis brevis tendon –> the shorter version and along with the abductor pollicis longus.
how does scaphoid fracture occur?
fall on outstretched hand in the abduction position
how is blood supplied to the scaphoid bone?
it is supplied distally to the scaphoid bone
what is colles fracture and in whom does it most occur in?
fracture of the distal end of the radius, most common in older people especially women with osteporosis
why is there a good prognosis for colles fracture?
Because there is rich blood supply to the distan end of the radius
what are epiphysis ?
growth plates in children in the wrist
what can to much damage to epiphysis cause?
premature fusion of joints –> one limb shorter than the other
how is the lunate bone dislocated and what is its consequence?
if you land on a outstreatch hand –> dislocation
can compress the median nerve
what is the consquence of damage to the median nerve at the wrist?
loss of motor innervation/weakness in the lateral 2 digits
cannot abudct or opsonise your thumb
sensory loss in the lateral 3 1/2 digits