Wrist and Hand Flashcards
abduction/adduction of the fingers is what relative to what?
middle digit
what does power grip consist of? muscle responsible?
strong flexion of MP and IP joints; flexor digitorum profundus
abduction of the thumb is what direction?
perpendicular to palm
extension of thumb?
out (more laterally in anatomic position)
flexion of thumb?
bring just thumb across palm
opposition of thumb?
thumb and 5th metacarpal together
cutaneous nerve to posterior of hand near thumb?
radial n.
patient visits ER after stabbing themselves in lateral region of palm. You immediately test for function of what muscle group?
thenar eminence muscles
where does median nerve run in palmar aponeurosis? what pathology is associated?
deep to; carpal tunnel
patient visits ER after stabbing themselves in lateral region of palm. you test for function of their thenar eminence muscles and find that they have diminished ability to oppose their thumb. What nerve may have been damaged?
recurrent branch of median nerve
what does the recurrent branch of median nerve innervate and where does it run?
thenar eminence; runs superficially and easily injured
anterior hand is supplied by what 2 arteries and what are these branches off of?
superficial palmar arch- ulnar a.
deep palmar arch- radial a.
what does the superficial arch give rise to?
common digital arteries
what do common digital arteries become?
proper palmar digital arteries
what does the radial artery give rise to?
princeps pollicis artery
what artery does the princeps pollicis artery potentially give rise to?
radialis indicis artery (can come directly from radial artery)
the dorsal carpal arch gives rise to what?
dorsal metacarpal arteries
what does the dorsal carpal arch normally have a contribution from?
anterior interosseous artery
what 5 muscles are in thenar area?
abductor pollicis brevis, flexor pollicis brevis (superficial and deep heads), opponens pollicis, adductor pollicis (oblique and transverse heads)
what 3 muscles form hypothenar eminence?
flexor digiti minimi, abductor digiti minimi, opponens digiti minimi
what muscle lies superficial to hypothenar eminence?
palmaris brevis
3 muscles that make thenar eminence?
abductor pollicis brevis, opponens pollicis, flexor pollicis brevis (superficial and deep heads?)
how does dupuytren’s contracture present?
progressive shortening and thickening of palmar fascia. Pull 4th and 5th digit into partial flexion, tends to be hereditary
57yo male presents with 4th and 5th digit partially flex can’t unflex. grandpa has. what condition?
Dupuytren’s contracture
what 2 tendons enter common flexor sheath (ulnar bursa) beneath flexor retinaculum?
flexor digitorum superficialis, flexor digitorum profundus
what is unique about the synovial sheath for 5th digit?
continuous with ulnar bursa
the four tendons of fds and fdp enters its own synovial sheath that is surrounded by
fibrous digital sheath
what is unique about tendon of flexor pollicis longus?
synovial sheath separate from ulnar bursa
what is tenosynovitis?
infections of the digital synovial sheath that can cause inflammation of tendon and synovial sheath
what can happen with tenosynovitis of 5th digit?
can spread into carpal tunnel and forearm because it is continuous with ulnar bursa
pt presents with tenderness and swelling in ant wrist. Redness and swelling appear to radiate into hand in region of 5th digit. Low-grade temp. What’s wrong?
infection of synovial sheath
proximal attachment of oppenens pollicis?
lexor retinaculum & tubercles of scaphoid and trapezium
distal attachment of oppenens pollicis?
lateral side of 1st metacarpal
actions of opponent pollicis?
oppose thumb and medial rotate 1st metacarpal
blood supply to oppenens pollicis?
radial a.
innervation of oppenens pollicis?
recurrent branch of median n.
proximal attachment of abductor pollicis brevis
flexor retinaculum and tubercles of scaphoid and trapezium
what will happen if synovial sheath of 5th digit if infection is not treated
infection will spread thru carpal region
distal attachment of abductor pollicis brevis?
lateral side of proximal phalanx of thumb
action of abductor pollicis brevis?
abduct thumb, aid in opposition
blood supply to abductor pollicis brevis?
radial a.
innervation of abductor pollicis brevis?
recurrent branch of median nerve
flexor pollicis brevis proximal attachment
flexor retinaculum & tubercles of scaphoid and trapezium
distal attachment of flexor pollicis brevis
lateral side of base of proximal phalanx of thumb
action of flexor pollicis brevis?
flexes thumb
blood supply to flexorpollicis brevis?
radial a.
innervation of flexor pollicis brevis?
recurrent branch of median nerve
(C8, T1) (superficial head)
deep branch of ulnar nerve (C8, T1) (deep head)
muscle that contributes to extensor hood mechanism?
lumbricals
how many palmar interossei muscles are there?
3
action of palmar interossei?
adduction of 2nd, 4th, and 5th fingers (assist lumbricals)
PAD
innervation of palmar interossei?
deep branch of ulnar n
how many pennate are the palmar interossei?
unipennate
how many dorsal interossei are there?
4
innervation of dorsal interossei
deep branch of ulnar n.
function of dorsal interossei?
abduct 2-4th fingers toward axial line
DAB
blood supply to dorsal interossei?
mostly branches of radial a. contribution from ulnar a. tributaries
where do dorsal interossei attach?
adjacent sides of 2 metacarpals
blood supply to palmar interossei?
radial and ulnar a.
where do palmar interossei attach?
palmar surfaces of 2, 3 and 5th metacarpals
where do palmar interossei insert?
bases of proximal phalanges and extensor expansion of digits 2, 4, and 5
