Wrist and Hand Flashcards

1
Q

Name the 3 palmar arches

A
  1. Longitudinal arch
  2. Distal transverse arch
  3. Proximal transverse arch
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2
Q

What muscle is in the intermediate layer of extrinsic flexors?

A

Flexor digitorum superficialis

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3
Q

What is the deepest extrinsic muscle at the wrist?

A

Pronator quadratus

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4
Q

Flexor digitorum superficialis attaches to the ____ whereas Flexor digitorum profundus attaches ____

A

superficialis: Shafts of middle phalanges of medial four digits

profundus:Bases of DISTAL phalanges of digits

THE PROFUNDUS GOES FURTHER, It flexes DIP whereas superficialis does not

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5
Q

Flexor Digitorum Superficialis is innervated by the

A

Median nerve (C7, C8, T1)

Remember: it’s more superficial so it also gets C7 and not just C8 T1 like all the other intrinsic hand muscles)

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6
Q

what are the proximal attachments of the Flexor Digitorum Superficialis (Two heads)

A

Humero-ulnar head: Medial epicondyle
(common flexor origin and coronoid process)

Radial head: Superior half of anterior border

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7
Q

What is the distal attachment of the Flexor Digitorum Superficialis

A

Shafts of middle phalanges of medial four digits

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8
Q

What is the muscle action of the Flexor Digitorum superficialis

A

Flexes middle phalanges at PIJ

Flexes proximal phalanges at MCP(metacarpophalangeal) joint

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9
Q

What is the proximal attachment of the Flexor Digitorum Profundus

A

Proximal ulna and interosseous membrane

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10
Q

What is the distal attachment of the Flexor Digitorum Profundus?

A

Medial part: Bases of distal phalanges of digits 4-5
Lateral part: Bases of distal phalanges of digits 2-3

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11
Q

What is the innervation of the Flexor Digitorum Profundus

A

2-3 digits: Median (AIN) C8 and T1
4-5 digits: Ulnar C8 and T1

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12
Q

The flexor digitorum superificalis tendon and the flexor digitorum profundus tendon interact how?

A

FDS bifurcates and splits into two, so that the tendon from FDP can come between the split and attach to the distal phalange.

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13
Q

What zone is the most fragile?

A

Zone 2

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14
Q

Digital Pulley System consists of __ annular pulleys and __ Cruciate pulleys per finger

A

Annular pulleys:
▪ Five per finger
Cruciate pulleys:
▪ Four per finger

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15
Q

Trigger Finger is the inflammation of which pulley?

A

A1

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16
Q

What is the innervation of Flexor Pollicis Longus?

A

Median (AIN) C8 and T1

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17
Q

What is the DISTAL attachment of the Flexor Pollicus Longus?

A

Base of distal phalanx of thumb

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18
Q

What is the proximal attachment of the Flexor Pollicus Longus?

A

Anterior surface of radius and adjacent
interosseous membrane

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19
Q

What is the MA of the Flexor Pollicus Longus?

A

Flexes phalanges of 1st digit

(Flexes all joints of the thumb)

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20
Q

Name these 4 Arteries/structures

A
  1. Radial Artery
  2. Deep Palmar Arch
  3. Superficial Palmar Arch
  4. Digital branches
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21
Q

What joint is effected in Mallet Finger
Deformity

A

Distal Interphalangeal joint

Usually a Ruptured long extensor
tendon (avulsion fracture)

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22
Q

Boxer’s Fracture usually effects which Metacarpals?

A

4 and 5

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23
Q

What ligament is involved in Gamekeeper’s Thumb

A

Ulnar Collateral Ligament of the Thumb

24
Q

What is the Distal attachment of Flexor Pollicis Brevis

A

base of the proximal phalanx of the thumb

25
Q

What is the proximal attachment of the Flexor Pollicis brevis?

A

Flexor Retinaculum

Tubercles of scaphoid and Trapezium

26
Q

Innvervation of the Flexor Pollicis Brevis
( Superficial Head)

PLS REMEMBER THE NERVES TO THIS ONE

A

Superficial head: Median (recurrent branch) C8 and T1

Deep Head : Ulnar nerve
(Deep branch) C8 and T1

Dual Innervations
Lumbricals, DEEP FINGERS (flexor digitorum profundus), SHORT THUMB (Pollicis Brevis)

27
Q

What is the muscle action of Opponens Pollicis

A

Opposes thumb, Draws 1st metacarpal towards palm and rotates it medially

28
Q

What is the proximal attachment of the Opponens Pollicis

A

Flexor retinaculum and tubercles of scaphoid and trapezium

(SAME AS THE Abductor Pollicis Brevis AND Flexor Pollicis Brevis)

29
Q

What THREE MUSCLES attach to the tubercles of the Scaphoid, the Trapezium and the Flexor Retinaculum

A

Opponens Pollicis

Abductor Pollicis Brevis

Flexor Policis Brevis

REMEMBER: The FAO of the thumb all has the same proximal attachment!!

30
Q

What is the distal attachment of the Opponens Pollicis

A

1st metacarpal

31
Q

What tendons are in the first compartment of the extensor retinaculum?

A

APL (Abductor Pollicis Longus)

EPB (Extensor Pollicis Brevis)

(remember apple peanutbutter)

32
Q

What tendons are in synovial shealth 2?

A

Extensor Carpi Radialis Brevis and Longus

TENNIS ELBOW (remember these are the 2 tennis elbow muscles, and they’re both in comparment 2)

33
Q

What tendons are in synovial sheath 3 of the extensor retinaculum.

A

Extensor Pollicis Longus

(Remember listers tubercle, the tubercle used as a pulley for EPL)

34
Q

What synovial sheaths of the Extensor Retinaculum make up the anatomical snuff box?

A

1 and 3

35
Q

What is found in the 4th synoveal shealth?

A

EI and ED

Extensor Digitorum

and Extensor Indicis

36
Q

What is in the synoveal sheath 5?

A

Extensor Digiti Minimi

(think 5 for 5th digit)

37
Q

What is in the 6th sheath of the extensor retinaculum

A

Extensor carpi ulnaris

(think the muscle farthest from the thumb, because the thumb muscles occupies the first sheath)

38
Q

The opponens digiti minimi originates from the _________ AND _______ inserts at the medial border of the __________

A

The opponens digiti minimi goes from the Flexor Retinaculum AND hook of the hamate to the medial border of the 5th metacarpal

39
Q

The abductor digiti minimi goes from the ____________ to the _______________

A

The abductor digiti minimi goes from the Pisiform to the base of the 5th proximal phalanx

(minimi starts at the pisiform (mini bone)
(remember the Pisiform is the smallest Carpal bone, and it get’s abducted)

40
Q

What is the muscle action of the Extensor Indicis?

A

Extend the 2nd digit (MCP joint)

May assist to extend the wrist

41
Q

What is the proximal attachment of the Extensor Indicis?

A

Posterior ulna and interosseous membrane

42
Q

What is the distal attachment of the extensor indicis?

A

Extensor expansion of 2nd digit

43
Q

What thenar muscle is innervated by the Ulnar nerve?

A

Adductor Pollicis

44
Q

What is the innervation of the Extensor Indicis?

A

Radial (PIN) C7 and C8

45
Q

What is the proximal attachment of the Abductor Pollicis Longus

A

Posterior surface of the ulna, radius, and interosseous membrane

46
Q

What is the distal attachment of the Abductor Pollicis Longus?

A

Base of the 1st metacarpal

47
Q

What is the innervation of the abductor pollicis longus?

A

Radial Pin nerve, C7 C8

48
Q

What is the proximal attachment of the extensor pollicis longus?

A

Posterior surface of the ulna and interosseus membrane

rememeber: the longus comes from the ulna and the brevis comes from the radius

49
Q

what is the proximal attachment of the extensor pollicis brevis?

A

posterior surface of the radius and interosseous membrane

rememeber: the longus comes from the ulna and the brevis comes from the radius

50
Q

What is the distal attachment of the extensor pollicis brevis

A

Base of the proximal phalanx of thumb

Remember: the longus goes to the distal phalanx and the brevis goes to the proximal phalanx

51
Q

What is the distal attachment of the extensor pollicis longus?

A

base of the distal phalanx of the thumb

Remember: the longus goes to the distal phalanx and the brevis goes to the proximal phalanx

52
Q

What is the muscle action of the extensor pollicis longus AND brevis?

A

Extend the thumb (IP joint), EPL only

Extend the thumb (MCP and CMC joints)

(Remember: Extensor Pollicis Brevis cannot extend the IP joint because it attaches to the base of the proximal metacarpal, not distal)

53
Q

What is the innervation of the extensor pollicis longus AND brevis

A

Radial PIN c7 c8

54
Q

What is the proximal attachment of the adductor pollicis?

A

Oblique head: Base of the 2nd and 3rd metacarpals, capitate, and adjacent carpals

Transverse: shaft of the 3rd metacarpal

55
Q

What is the distal attachment of the Adductor Pollicis

A

base of the proximal phalanx of the thumb

56
Q

What is the innervation of the adductor pollicis

A

Ulnar Nerve c8 t1