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MSK Exam II > Wrist and Hand > Flashcards

Wrist and Hand Flashcards

1
Q

How many carpal bones make up the wrist?

A

8

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2
Q

How many metacarpals are present in the hand?

A

5

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3
Q

How many bones are present in the phalanges (fingers)?

A

14

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4
Q

The lunate and scaphoid have a major articulation with which bone(s) of the forearm?

A

Just the radius, the ulna does not have a major articulation with the carpal bones

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5
Q

What condition is characterized by thickening of the fibrous tissue underneath the skin of the palm and has a painless presentation?

A

Dupuytren’s contracture

[see wrinkles at creases when fingers are flexed; progressive-can reach the point of restricting opening the hand]

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6
Q

What are the causes of Dupuytren’s contracture?

A

Unknown; but it has been associated with alcohol, diabetes, and aging

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7
Q

What movements are possible at the digits?

A

Flexion and extension of MP joint

Flexion and extension of IP joints

Abduction and adduction

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8
Q

What movements are possible at the thumb?

A

Extension/flexion

Adduction/abduction

Opposition

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9
Q

There are several synovial sheaths associated with the hand; they cover the tendons of which muscles?

A

Flexor digitorum superficialis m.

Flexor digitorum profundus m.

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10
Q

The 5th digital synovial sheath is continuous with the ______ ______

A

Ulnar bursa

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11
Q

What are the intrinsic muscle groups of the hand?

A 
4 thenar mm.
3 hypothenar mm.
Lumbricals
Palmar interosseous mm.
Dorsal interosseous mm.
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12
Q

What constitutes the midline of the hand?

A

The middle finger

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13
Q

What innervates most of the thenar muscle of the hand?

A

Recurrent branch of median n.

[deep head of flexor pollicis brevis is innervated by the deep ulnar n.; adductor pollicis oblique and transverse heads are innervated by deep ulnar n.]

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14
Q

What muscles make up the thenar group of the hand?

A

Abductor pollicis brevis m.
Opponens pollicis m.
Flexor pollicis brevis m.
Adductor pollicis m.

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15
Q

Origin of abductor pollicis brevis m.

A

Flexor retinaculum and tubercles of scaphoid and trapezium

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16
Q

Insertion of abductor pollicis brevis m.

A

Lateral side base of proximal phalanx of thumb

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17
Q

Action of abductor pollicis brevis m.

A

Abducts thumb; aids in opposition

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18
Q

Innervation of abductor pollicis brevis m.

A

Recurrent branch of median n.

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19
Q

Origin of opponens pollicis m.

A

Flexor retinaculum and tubercles of scaphoid and trapezium

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20
Q

Insertion of opponens pollicis m.

A

Lateral 1st metacarpal

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21
Q

Action of opponens pollicis m.

A

Oppose thumb; rotate medially

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22
Q

Innervation of opponens pollicis m.

A

Recurrent branch of median n.

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23
Q

Which thenar muscle of the hand has 2 heads on either side of the flexor pollicis longus as well as a sesamoid bone in its tendon?

A

Flexor pollicis brevis m.

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24
Q

Origin of the superficial head of the flexor pollicis brevis m.

A

Flexor retinaculum and tubercle of trapezium

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25
Q

Insertion of the superficial head of the flexor pollicis brevis m.

A

Lateral side of base of proximal phalanx of thumb

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26
Q

Action of the superficial head of the flexor pollicis brevis m.

A

Flexes thumb

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27
Q

Origin of the deep head of the flexor pollicis brevis m.

A

Trapezoid and capitate

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28
Q

Innervation of the superficial head of the flexor pollicis brevis m.

A

Recurrent branch of median n.

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29
Q

Insertion of the deep head of the flexor pollicis brevis m.

A

Lateral side of base of proximal phalanx of thumb

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30
Q

Action of the deep head of the flexor pollicis brevis m.

A

Flexes thumb

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31
Q

Innervation of the deep head of the flexor pollicis brevis m.

A

Deep branch of ulnar n.

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32
Q

T/F: the adductor pollicis m. may have a sesamoid bone in its tendon

A

True

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33
Q

What are the 2 heads associated with adductor pollicis m.?

A

Oblique head

Transverse head

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34
Q

What innervates both heads of the adductor pollicis m.?

A

Deep ulnar n.

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35
Q

Origin of oblique head of adductor pollicis m.

A

Capitate and base of 2nd and 3rd metacarpal

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36
Q

Insertion of oblique head of adductor pollicis m.

A

On medial side proximal phalanx of thumb

37
Q

Action of oblique head adductor pollicis m.

A

Adducts thumb

38
Q

Origin of transverse head of adductor pollicis m.

A

Palmar ridge of 3rd metacarpal

39
Q

Insertion of transverse head of adductor pollicis m.

A

Joining tendon of oblique head

40
Q

Action of transverse head of adductor pollicis m.

A

Adducts thumb

41
Q

Origin of abductor digiti minimi m.

42
Q

Insertion of abductor digiti minimi m.

A

Medial base of proximal phalanx of 5th digit

43
Q

Action of abductor digiti minimi m.

A

Abducts 5th digit; assists flexion

44
Q

Origin of flexor digiti minimi brevis m.

A

Hook of hamate and flexor retinaculum

45
Q

Insertion of flexor digiti minimi brevis m.

A

Medial base of proximal phalanx of 5th digit

46
Q

Action of flexor digiti minimi brevis m.

A

Flexes proximal phalanx of 5th digit

47
Q

Origin of opponens digiti minimi m.

A

Hook of hamate and flexor retinaculum

48
Q

Insertion of opponens digiti minimi m.

A

Medial 5th metacarpal

49
Q

Action of opponens digiti minimi m.

A

Brings opposition to thumb

50
Q

What nerve innervates all of the hypothenar muscles?

51
Q

Lumbricals are considered deep intrinsic muscles of the hand; how many lumbrical muscles are there?

52
Q

T/F: The lumbrical muscles contribute to the extensor hood/extensor expansion, but the interosseous muscles do not

A

False; both the lumbricals and PADs and DABs contribute to the extensor hood/expansion

53
Q

Origin of lumbrical muscles

A

Off flexor digitorum profundus m.

54
Q

Insertion of lumbrical mm.

A

Side of extensor hood

55
Q

Action of lumbrical mm.

A

Flexion at MCP, extension at PIP and DIP joints

56
Q

What innervates each of the 4 lumbrical mm.?

A

1st and 2nd = median n.

3rd and 4th = deep branch of ulnar n.

57
Q

Which lumbricals often arise by 2 heads?

A

The 3rd and 4th

58
Q

Origin of palmar interosseous mm.

A

Palmar surfaces of metacarpals 2, 4, and 5

59
Q

How many palmar interosseous mm. are there?

60
Q

Insertion of palmar interosseous mm.

A

Bases of proximal phalanges

61
Q

Innervation of palmar interosseous mm.

A

Deep ulnar n.

62
Q

Action of palmar interosseous mm.

A

Adduction of digits to midline

63
Q

How many dorsal interosseous mm. are there?

64
Q

Origin of dorsal interosseous mm.

A

Adjacent sides of two metacarpals

65
Q

Insertion of dorsal interosseous mm.

A

Base of proximal phalanges

66
Q

Innervation of dorsal interosseous mm.

A

Deep ulnar n.

67
Q

Action of dorsal interosseous mm.

A

abduction of digits away from midline

68
Q

What artery contributes to the deep palmar arch?

A

Radial a.

[radial a. also gives off superficial palmar branch of radial a.]

69
Q

What artery contributes to the superficial palmar arch?

70
Q

What are the 2 major branches of the deep palmar arch?

A

Princeps pollicis a.

Radialis indicis a.

71
Q

What is the major branch of the superficial palmar arch and what arteries does this give off?

A

Common palmar digital a.

Gives of proper palmar digital aa.

72
Q

What 2 arteries make up the dorsal carpal arch responsible for supplying the dorsal aspect of the hand?

A

Radial a.

Anterior interosseous a. (Ulnar a. branch)

73
Q

What 2 nerves supply the majority of the cutaneous innervation to the dorsal aspect of the hand?

A

Ulnar n. to medial hand (5th digit and part of 4th)

Radial n. to remainder

[there is some innervation to finger tips on dorsal side from median n.]

74
Q

What 2 nerves supply the majority of the cutaneous innervation to the palmar aspect of the hand?

A

Median n. to lateral hand including digits 1, 2, 3, and part of 4

Ulnar n. to medial hand including digit 5 and part of 4

[radial n. has small area in sub-thenar region]

75
Q

What are the intrinsic muscles in the dorsal hand?

A

There are none!

Dorsal interosseous mm. are innervated by the palmar side ulnar branches

76
Q

T/F: the only innervation on dorsum of hand is sensory

77
Q

Origin/insertion/innervation/action:

Abductor pollicis brevis m.

A

Origin: flexor retinaculum and tubercles of scaphoid and trapezium

Insertion: lateral side base of proximal phalanx of thumb

Innervation: recurrent br. of median n.

Action: abduct thumb, aids in opposition

78
Q

Origin/insertion/innervation/action:

Opponens pollicis m.

A

Origin: flexor retinaculum and tubercles of scaphoid and trapezium

Insertion: lateral 1st metacarpal

Innervation: recurrent br. of median n.

Action: oppose thumb/rotate medially

79
Q

Origin/insertion/innervation/action:

Flexor pollicis brevis m. (Superficial head)

A

Origin: flexor retinaculum and tubercle of trapezium

Insertion: lateral side of base of proximal phalanx of thumb

Innervation: recurrent branch of median n.

Action: flexes thumb

80
Q

Origin/insertion/innervation/action:

Flexor pollicis brevis m. (Deep head)

A

Origin: trapezoid and capitate

Insertion: lateral side of base of proximal phalanx of thumb

Innervation: deep branch of ulnar n.

Action: flexes thumb

81
Q

Origin/insertion/innervation/action:

Adductor pollicis m. (Oblique head)

A

Origin: capitate and base of 2nd and 3rd metacarpal

Insertion: on medial side proximal phalanx of thumb

Innervation: deep ulnar n.

Action: adducts thumb

82
Q

Origin/insertion/innervation/action:

Adductor pollicis m. (Transverse head)

A

Origin: palmar ridge of 3rd metacarpal

Insertion: joining tendon of oblique head

Innervation: deep ulnar n.

Action: adducts thumb

83
Q

Origin/insertion/innervation/action:

Abductor digiti minimi m.

A

Origin: pisiform

Insertion: medial base of proximal phalanx of 5th digit

Innervation: ulnar n.

Action: abducts 5th digit, assists flexion

84
Q

Origin/insertion/innervation/action:

Flexor digiti minimi brevis m.

A

Origin: hook of hamate and flexor retinaculum

Insertion: medial base of proximal phalanx of 5th digit

Innervation: ulnar n.

Action: flexes proximal phalanx of 5th digit

85
Q

Origin/insertion/innervation/action:

Opponens digiti minimi m.

A

Origin: hook of hamate and flexor retinaculum

Insertion: medial 5th metacarpal

Innervation: ulnar n.

Action: brings opposition to thumb

86
Q

Origin/insertion/innervation/action:

Lumbrical mm.

A

Origin: flexor digitorum profundus m.

Insertion: side of extensor hood

Innervation: 1st and 2nd are median n.; 3rd and 4th are deep br. ulnar n.

Action: flex at MCP, extend PIP and DIP joints

87
Q

Origin/insertion/innervation/action:

Palmar interosseous mm. (3)

A

Origin: palmar surfaces of metacarpals 2, 4, and 5

Insertion: bases of proximal phalanges

Innervation: deep ulnar n.

Action: PAD (adduction)

88
Q

Origin/insertion/innervation/action:

Dorsal interosseous mm. (4)

A

Origin: adjacent sides of 2 metacarpals

Insertion: base of proximal phalanges

Innervation: deep ulnar n.

Action: DAB (abduction)

MSK Exam II (20 decks)

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