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S1 Anatomy > Wrist and Hand > Flashcards

Wrist and Hand Flashcards

1
Q

radiocarpal joint

-carpal bones involved

A

scaphoid
lunate
triquetrum articulates via a fibrocartilaginous disc

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2
Q

how does the ulna articulate at the wrist joint?

A

does not articulate with the carpal bones

has a fibrocartilaginous disk to the radius

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3
Q

distal radioulnar joint

  • how are the radius and ulna attached
  • how do they articulate at this joint?
A

attached the entire extent of the forearm by an interosseus membrane
distal radioulnar joint has an articular joint with the ulnar notch of the radius “rolling” on the ulna

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4
Q

radiocarpal ligament names

A

radial and ulnar collateral ligaments

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5
Q

ligaments of the MCP, PIP and DIP joints

A

radial and ulnar collateral ligaments

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6
Q

where is the longitudinal axis in the hand

A

through the 3rd finger

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7
Q

thumb actions

A 
radial abduction/adduction
palmar abduction/adduction
opposition
MP flexion/extension
IP flexion/extension
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8
Q

finger MCP actions

A

flexion/extension
abduction/adduction
rotation

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9
Q

finger PIP and DIP actions

A

flexion/extension

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10
Q

finger rotation is technically_____, since the MCP has ____ degrees of freedom

A

technically circumduction, a movement that outlines a cone

MCP has only 2 degrees of freedom

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11
Q

thumb radial abduction/adduction

  • what is another name?
  • where does this motion occur
  • what plane is it in?
A 
flexion/extension of thumb
occurs at CMC joint
in frontal (coronal) plane
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12
Q

palmar abduction/adduction

  • what is another name
  • where does this motion occur
  • what plane is it in
A

abduction/adduction
occurs at CMC
in sagittal plane

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13
Q

fascia of wrist and hand

  • continuation of
  • fascial thickenings occur where and are named _____
A 
continuation of antebrachial fascia (deep fascia of forearm)
thickenings
-near distal end of forearm
-flexor retinaculum (anterior)
-extensor retinaculum (posterior)
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14
Q

flexor and extensor retinaculi of wrist

-function

A

fulcrums for the tendons of the forearm flexors and extensors

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15
Q

flexor retinuaculum of wrist

  • function (apart from acting as a pulley)
  • some texts say ____ performs this function
A

closes off the carpal groove (sulcus) for the formation of the carpal tunnel
some texts say a transverse carpal ligament performs this function

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16
Q

flexor retinaculum of wrist vs. transverse carpal ligament

A

flexor retinaculum
-made of superficial collagen fibers running transversely as part of antebrachial fascia
transverse carpal ligament
-attached to
–carpal bones
–tubercles of the scaphoid and trapezium (radially)
–pisiform and hook of the hamate (ulnar side)
we will consider them to be the same in this class

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17
Q

deep fascia of the palm

  • thin over…
  • thickened along…
A 
thin
-thenar eminence
-hypothenar eminence
dthick
-middle of palm as palmar aponeurosis
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18
Q

what marks the lateral and medial boundaries of the central compartment of the palm
-central compartment is separated from…

A

lateral and medial septa mark the boundaries

separates from the thenar (lateral) and hypothenar (medial) eminences

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19
Q

central compartment of palm

  • palmar extension of…
  • carries…
  • this fascial space is continuous with…
A

palmar extension of carpal tunnel
carries
-tendons of the superficial and deep digital flexor muscles
continuous with the fascial plane separating the superficial and deep muscles of the anterior compartment of the forearm

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20
Q

if the central compartment of the palm is penetrated (such as by puncture wounds from a drill bit), what can happen?

A

uncontrolled infection can spread into the forearm

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21
Q

what other areas on the palm can be potential spaces for harboring infections

A

thenar eminence
hypothenar eminence
adductor pollicis muscle

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22
Q

dorsal surface of the hand surface markings

A

tendons of extensor digitorum (best seen with digits extended and abducted)
veins
-part of the dorsal venous plexus of the hand
-a number can be seen to enter the cephalic vein on the lateral side of the wrist

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23
Q

palmar surface of the hand surface markings

A

transverse and longitudinal fissures
-within thick skin of palm
digital flexion creases
-mark the levels of the MCP joint (proximal digital crease), PIP (middle digital crease), and DIP (distal digital crease)

24
Q

nerves of the hand

A

nerves of the forearm
median
ulnar
radial

25
Q

which muscles in the hand do the median and ulnar nerves control

A

short muscles of the hand

26
Q

what muscles of the hand does the radial nerve control

A

entirely sensory over the dorsolateral part of the hand and thumb

27
Q

median nerve

-enters hand via ____ and with _____

A 
enters hand via carpal tunnel with...
tendons of
-flexor digitorum superficialis
-flexor digitorum profundus
-flexor pollicis longus
28
Q

median nerve recurrent branch

  • location
  • function
A

location
-seen on the surface of the thenar eminence
-moved deep and proximally to be seen branching just distal to the flexor retinaculum
function
-motor nerve to thenar eminence muscles (except adductor pollicis)

29
Q

median nerve motor function

A

motor innervation to lumbricals 1 and 2

30
Q

median nerve sensory innervation

A

radial 1/2 of palm
dorsal surface of thumb
lateral 2 1/2 digits (1/2 digit is variable and evident with dissection of the digital branches in the palmar side of the hand)
sensory component extends onto the distal end of the dorsal side of digits 2 through half of four

31
Q

ulnar nerve

  • enters hand…
  • function
A 
enters hand lateral to pisiform along with ulnar artery
-superficial to wrist at this point
function
-nerve of fine movement of the hand
-sensory and motor component
32
Q

ulnar nerve sensory information

-done by…

A

superficial branch to palmar surface of ulnar digit and a half
dorsal cutaneous branch that innervates the dorsal surface of ulnar digit and a half
-palmar branch that innervates ulnar half of palm

33
Q

ulnar nerve motor innervation

-done by…

A

deep branch (also sensory to joint) that innervates
-hypothenar muscles
-lumbricals 3 and 4
-adductor pollicis
-dorsal and palmar interosseus
all these small muscles give us fine motor control of digits (not the muscles of the forearm)

34
Q

radial nerve

  • motor component to short muscles of the hand
  • how does it control hand movement
A

no motor component to the short muscles of the hand

controls hand movement due to innervation of muscles of the extensor compartment

35
Q

radial nerve sensory innervation

-done by…

A

superficial branch of the radial nerve

-covers the radial 1/2 of the dorsum of the hand and thumb extending only up the proximal 1/2 of digits 2-4

36
Q

arteries/arterial structures of the hand

A

radial artery
ulnar artery
superficial palmar arterial arch
deep palmar arterial arch

37
Q

radial artery superficial palmar branch

  • where does it split off
  • anastomoses with…
A

branch from radial artery before it enters the extensor compartment through the anatomical snuff box
anastomoses with
-superficial palmar arterial arch of ulnar artery

38
Q

radial artery after superficial palmar branch branches off

  • where does it go?
  • enters _____ as the _____
A

goes through the snuff box and curves around the dorsal side of the thumb
enters the palm deep as the deep palmar arterial arch
anastomoses with the ulnar artery

39
Q

deep palmar arterial arch (end of radial artery)

-branches

A

princeps pollicis artery
radialis indicis artery
digital arteries

40
Q

ulnar artery

-branches

A

deep palmar branch

superficial palmar branch

41
Q

deep palmar branch of ulnar artery

-anastomoses with…

A

deep palmar artery of radius

42
Q

superficial palmar artery of ulnar artery

-forms _____ with _____

A

forms superficial palmar arch with superficial palmar arch of radius

43
Q

superficial palmar arterial arch

  • formed primarily by…
  • where is it formed
  • deep to the___
A

formed primarily by the superficial branch of the ulnar artery
crosses the palm about midway across the metatarsals
deep to palmar aponeurosis

44
Q

deep palmar arterial arch

  • formed primarily by…
  • location
A

formed primarily by the deep branch of the radial artery

located near the proximal ends of the metatarsals close to the carpal tunnel

45
Q

carpal tunnel syndrome

-etiology

A

swelling decreases the space in the carpal tunnel and increases the pressure on the median nerve and tendons fo the forearm flexors

46
Q

what can limit space in the carpal tunnel lead to carpal tunnel syndrome

A

irritation
infections
abnormal growth of the flexor retinaculum
genetics

47
Q

sensory components of carpal tunnel syndrome

A

pain to anesthesia over the sensory map of the hand

48
Q

motor components of carpal tunnel syndrome

A

weakenss of the thenar muscles

atrophy of the thenar muscles

49
Q

with carpal tunnel syndrome, weakness and pain may occur due to pressure on the synovial sheaths of the…

A

flexor digitorum superficialis

flexor digitorum profundus

50
Q

ulnar nerve damage

-sensory components

A

anesthesia or hypoesthesia over ulnar nerve sensory map of hand

51
Q

ulnar nerve damage

-motor components

A

loss of fine motor control due to loss of
-lumbricals 3 and 4
-all interossei
thumb only has weak adduction due to loss of adductor pollicis

52
Q

wrist drop

-evidence of…

A

radial nerve damage

53
Q

where can the radial nerve be damaged to lead to wrist drop?

A

as high as the arm as the radial nerve travels around the posterior side of the humerus
traveling over the lateral epicondyle

54
Q

wrist drop

-muscles affected

A

loss of

  • extensor digitorum (posterior interosseus; branch of radial enrve)
  • extensor carpi ulnaris
  • extensor carpi radialis longus
  • extensor carpi radialis brevis
55
Q

what other actions will be affected if wrist drop is present due to radial nerve damage

A

finger extension
thumb extension
thumb abduction

S1 Anatomy (31 decks)

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