Wrist and Hand Flashcards by Blake Miller

radiocarpal joint

-carpal bones involved

scaphoid
lunate
triquetrum articulates via a fibrocartilaginous disc

How well did you know this?

Not at all

Perfectly

how does the ulna articulate at the wrist joint?

does not articulate with the carpal bones

has a fibrocartilaginous disk to the radius

How well did you know this?

Not at all

Perfectly

distal radioulnar joint

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

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

How well did you know this?

Not at all

Perfectly

radiocarpal ligament names

radial and ulnar collateral ligaments

How well did you know this?

Not at all

Perfectly

ligaments of the MCP, PIP and DIP joints

radial and ulnar collateral ligaments

How well did you know this?

Not at all

Perfectly

where is the longitudinal axis in the hand

through the 3rd finger

How well did you know this?

Not at all

Perfectly

thumb actions

radial abduction/adduction
palmar abduction/adduction
opposition
MP flexion/extension
IP flexion/extension

How well did you know this?

Not at all

Perfectly

finger MCP actions

flexion/extension
abduction/adduction
rotation

How well did you know this?

Not at all

Perfectly

finger PIP and DIP actions

flexion/extension

How well did you know this?

Not at all

Perfectly

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

technically circumduction, a movement that outlines a cone

MCP has only 2 degrees of freedom

How well did you know this?

Not at all

Perfectly

thumb radial abduction/adduction

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

flexion/extension of thumb
occurs at CMC joint
in frontal (coronal) plane

How well did you know this?

Not at all

Perfectly

palmar abduction/adduction

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

abduction/adduction
occurs at CMC
in sagittal plane

How well did you know this?

Not at all

Perfectly

fascia of wrist and hand

continuation of
fascial thickenings occur where and are named _____

continuation of antebrachial fascia (deep fascia of forearm)
thickenings
-near distal end of forearm
-flexor retinaculum (anterior)
-extensor retinaculum (posterior)

How well did you know this?

Not at all

Perfectly

flexor and extensor retinaculi of wrist

-function

fulcrums for the tendons of the forearm flexors and extensors

How well did you know this?

Not at all

Perfectly

flexor retinuaculum of wrist

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

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

How well did you know this?

Not at all

Perfectly

flexor retinaculum of wrist vs. transverse carpal ligament

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

How well did you know this?

Not at all

Perfectly

deep fascia of the palm

thin over…
thickened along…

thin
-thenar eminence
-hypothenar eminence
dthick
-middle of palm as palmar aponeurosis

How well did you know this?

Not at all

Perfectly

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

lateral and medial septa mark the boundaries

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

How well did you know this?

Not at all

Perfectly

central compartment of palm

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

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

How well did you know this?

Not at all

Perfectly

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

uncontrolled infection can spread into the forearm

How well did you know this?

Not at all

Perfectly

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

thenar eminence
hypothenar eminence
adductor pollicis muscle

How well did you know this?

Not at all

Perfectly

dorsal surface of the hand surface markings

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

How well did you know this?

Not at all

Perfectly

palmar surface of the hand surface markings

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)

nerves of the hand

nerves of the forearm
median
ulnar
radial

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

short muscles of the hand

what muscles of the hand does the radial nerve control

entirely sensory over the dorsolateral part of the hand and thumb

median nerve | -enters hand via ____ and with _____

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

median nerve recurrent branch - location - function

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)

median nerve motor function

motor innervation to lumbricals 1 and 2

median nerve sensory innervation

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

ulnar nerve - enters hand... - function

``` 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 ```

ulnar nerve sensory information | -done by...

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

ulnar nerve motor innervation | -done by...

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)

radial nerve - motor component to short muscles of the hand - how does it control hand movement

no motor component to the short muscles of the hand | controls hand movement due to innervation of muscles of the extensor compartment

radial nerve sensory innervation | -done by...

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

arteries/arterial structures of the hand

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

radial artery superficial palmar branch - where does it split off - anastomoses with...

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

radial artery after superficial palmar branch branches off - where does it go? - enters _____ as the _____

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

deep palmar arterial arch (end of radial artery) | -branches

princeps pollicis artery radialis indicis artery digital arteries

ulnar artery | -branches

deep palmar branch | superficial palmar branch

deep palmar branch of ulnar artery | -anastomoses with...

deep palmar artery of radius

superficial palmar artery of ulnar artery | -forms _____ with _____

forms superficial palmar arch with superficial palmar arch of radius

superficial palmar arterial arch - formed primarily by... - where is it formed - deep to the___

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

deep palmar arterial arch - formed primarily by... - location

formed primarily by the deep branch of the radial artery | located near the proximal ends of the metatarsals close to the carpal tunnel

carpal tunnel syndrome | -etiology

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

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

irritation infections abnormal growth of the flexor retinaculum genetics

sensory components of carpal tunnel syndrome

pain to anesthesia over the sensory map of the hand

motor components of carpal tunnel syndrome

weakenss of the thenar muscles | atrophy of the thenar muscles

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

flexor digitorum superficialis | flexor digitorum profundus

ulnar nerve damage | -sensory components

anesthesia or hypoesthesia over ulnar nerve sensory map of hand

ulnar nerve damage | -motor components

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

wrist drop | -evidence of...

radial nerve damage

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

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

wrist drop | -muscles affected

loss of - extensor digitorum (posterior interosseus; branch of radial enrve) - extensor carpi ulnaris - extensor carpi radialis longus - extensor carpi radialis brevis

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

finger extension thumb extension thumb abduction