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KNES 360 Exam 3 > Wrist and Hand Anatomy > Flashcards

Wrist and Hand Anatomy Flashcards

1
Q

Wrist and Hand Anatomy: Bones

A 
Radius: larger of two bones
Ulna
8 Carpal Bones
5 Metacarpals: number 1-5 (thumb is 1)
14 Phalanges: 3 per finger, 2 for thumb
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2
Q

Carpal Bones Names

A 
Scaphoid
Lunate
Triquetrum
Pisiform
Trapzium
Trapezoid
Capitate
Hamate
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3
Q

Carpal Bones

A 
Concave on palmar side
Bony arch is spanned by transverse carpal and vulgar ligaments
Creates carpal tunnel
Median nerve and all flexor tendons except flexor carpi ulnas and palmaris longs pass through carpal tunnel
-flexor digitorum profundus(4)
-flexor digitorum superficialis (4)
-flexor pollicis longus
-median nerve
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4
Q

Landmarks Humerus

A

Supracondylar ridge
Medial epicondyle
Lateral epicondyle

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5
Q

Landmarks Radius

A

Radial styloid process
Radial head
Radial tuberosity

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6
Q

Landmarks Ulna

A

Ulnar styloid process
Olecranon process
Coronoid process

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7
Q

Landmarks Hand

A

Transverse carpal ligament: carpal tunnel
Hook of hamate
Tunnel of guyon: ulnar nerve

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8
Q

Carpal tunnel borders

A

radial- scaphoid and trapezium

ulnar: pisiform and hook of hamate
top: flexor retinaculum

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9
Q

Carpal tunnel contents:

A

flexor digitorum profundus (4 tendons)
flexor digitorum superficialis (four tendons)
flexor pollicis longus
median nerve

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10
Q

Snuffbox

A

Extensor pollicis longus (medial side)
Extensor pollicis brevis (lateral side)
Extensor pollicis longus (lateral side)

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11
Q

Brachioradialis

A

O: supracondylar ridge of humerus
I: styloid process of radius
A: elbow flexion; pronation from supinated position to neutral; supination from pointed position to neutral
IN: Radial nerve

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12
Q

Superficial flexor/pronators

A

Pronator teres
flexor carpi radialis
palmaris longus
flexor carpi ulnaris

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13
Q

Pronator Teres

A

O: Humeral head: Medial epicondylar ridge and common flexor tendon
Ulnar head: coronoid process of ulna
I: Middle of lateral surface of radius
A: forearm pronation; assists in elbow flexion
IN: median nerve

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14
Q

Flexor Carpi Radialis

A

O: Medial epicondyle of humerus
I: Base of 2nd/3rd metacarpal bones
A: Wrist flexion, radial deviation, assists in elbow flexion
IN: Median nerve

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15
Q

Palmaris Longus

A

O: Medial epicondyle of humerus
I: transverse carpal ligament and palmar aponeurosis
A: Wrist flexion and assists in elbow flexion
IN: median nerve

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16
Q

Flexor Carpi Ulnaris

A

O: Humeral head- medial condyle of humerus
Ulnar head- olecranon
I: pisiform, hamate, and 5th metacarpal
A: wrist flexion, ulnar deviation, assist in elbow flexion
IN: Ulnar Nerve

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17
Q

Deep flexor/pronator muscles

A

flexor digitorum superficialis
flexor digitorum profundus
flexor pollicis longus
pronator quadratus

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18
Q

Flexor Digitorum Superficialis

A

O: Humeral head: medial epicondyle of humerus
Ulnar head: coronoid process
Radial head: Oblique line of radius
I: Palmar surface of middle phalanx of medial 4 digits
A: Flex middle phalanges (PIP) of medial 4 digits, aids in wrist and forearm flexion
IN: Median nerve

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19
Q

Flexor Digitorum Profundus

A

O: Medial and anterior surface of ulna and interosseous membrane
I: base of distal phalanges of medial 4 digits
A: MCP, PIP, DIP flexion; wrist flexion
IN: Median nerve (2-3 digit), Ulnar nerve (4-5th digit)

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20
Q

Flexor Pollicis Longus

A

O: Anterior surface of radius and interosseous membrane; coronoid process of ulna
I: base of distal phalanx of the thumb
A: thumb CMC, MCP, IP joint flexion; wrist flexion
IN: median nerve

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21
Q

Pronator Quadratus

A

O: distal 1/4 of the anterior surface of ulna
I: distal 1/4 of the anterior surface of radius
A: Forearm pronation
IN: median nerve

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22
Q

Superficial extensor/supinators

A

Extensor carpi radialis longus
Extensor carpi radialis brevis
Extensor digitorum
Extensor carpi ulnaris

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23
Q

Extensor Carpi Radialis Longus

A

O: Lateral supracondylar ridge; lateral epicondyle
I: dorsal surface of base and 2nd metacarpal
A: wrist extension, radial deviation, assists with elbow extension
IN: Radial nerve

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24
Q

Extensor Carpi Radialis Brevis

A

O: lateral epicondyle of humerus
I: dorsal surface of base of 3rd metacarpal
A: wrist extension, radial deviation, assist with elbow extension
IN: Radial nerve

25
Extensor Digitorum
O: Lateral epicondyle of humerus I: bases of middle and distal phalanges of medial 4 digits A; MCP extension of medial 4 digits, assists with wrist and elbow extension IN: Radial nerve
26
Extensor Carpi Ulnaris
O: Lateral epicondyle of humerus I: Medial side of base of 5th metacarpal A: Wrist extension, ulnar deviation, assist with elbow extension IN: Radial nerve
27
Deep extensor/supinators
``` Supinator Abductor Pollicis Longus Extensor Pollicis Longus Extensor Pollicis Brevis Extensor Indicis ```
28
Supinator
O: Lateral epicondyle of the humerus; lateral proximal ulna I: lateral surface of radius A: forearm supination IN: radial nerve
29
Abductor Pollicis Longus
A: thumb and wrist abduction IN: radial nerve
30
Extensor Pollicis Brevis
A: Extension of proximal phalanx thumb IN: Radial nerve
31
Extensor Pollicis Longus
A: Extension of distal phalanx of thumb IN: Radial nerve
32
Radial Nerve
``` Brachioradialis Ext. Carpi Radialis Longus Ext. Carpi Radialis Brevis Ext. Digitorum Ext. Digiti Minimi Ext. Carpi Ulnaris Supinator Ext. Indicis ```
33
Median Nerve
``` Pronator Teres Flexor Carpi Radialis Palmaris Longus Flexor Digitorum Superficialis Flexor Pollicis Longus Pronator Quadratus ```
34
Ulnar Nerve
Flexor Carpi Ulnaris Flexor Digitorum Profundus Flexor Pollicis Longus
35
Thenar eminence Muscles
Abductor pollicis brevis Flexor pollicis brevis Opponens pollici Adductor pollicis
36
Abductor Pollicis Brevis
A: Thumb abduction (at CMC) IN: Median nerve
37
Opponens Pollicis
A: Thumb opposition (at CMC) IN: Median nerve
38
Flexor Pollicis Brevis
A: Flexes proximal phalanx of thumb IN: Median nerve
39
Adductor Pollicis
A: thumb adduction (at CMC) IN: ulnar nerve
40
Hypothenar Eminence Muscles
Abductor Digiti Minimi Flexor Digiti Minimi Brevis Opponens Digiti Minimi
41
Abductor Digiti Minimi
A: Abduction of the 5th digit from the 4th digit IN: Ulnar nerve
42
Opponens Digiti Minimi
A: opposition of the 5th digit IN: Ulnar nerve
43
Flexor Digiti Minimi
A: flexion of proximal phalanx of the 5th digit IN: Ulnar nerve
44
Palmar muscles
Lumbricals Palmar interossei Dorsal itrossei
45
Palmar Muscle: Lumbricals Action
MCP flexion of medial 4 digits and PIP/DIP extension of medial 4 digits
46
Palmar Muscle: Palmar Interossei Action
MCP adduction of 2nd, 4th and 5th digits
47
Palmar Muscle: Dorsal Introssei
MCP flexion MCP abduction PIP/DIP extension of 2, 3, 4th digits
48
Median Nerve
Abductor Pollicis Brevis Opponens Pollicis Flexor Pollicis Brevis Lumbricales (2 lateral)
49
Ulnar Nerve
``` Abductor Digiti Minimi Opponens Digiti Minimi Flexor Digiti Minimi Adductor Pollicis Lumbricales (2 medial) Dorsal Interossei Palmar Interossei ```
50
Radial Nerve
Abductor Pollicis Longus Extensor Pollicis Brevis Extensor Pollicis Longus
51
Scaphoid Fracture
Most common carpal fracture | Pain in anatomical snuff box
52
Forearm Fractures
Epidemiology: highest ratio of open to closed than any other fracture except the tibia More common in males than females (contact sports, altercations, falls
53
Carpal Tunnel Syndrome
Most common compression neuropathy of the wrist -Compression of the median nerve as it passes through the carpal tunnel Any sports related activity that involves repetitive wrist motion may be the cause Fine, coordinated movements may become difficult due to a loss in proprioception Signs and symptoms of this compression injury are relieved by the division of the flexor retinaculum, "tunnel release"
54
Carpal Tunnel Syndrome Symptoms
Movements of fingers unaffected, thumb movements not seriously impaired Flexion accomplished by flexor pollicis longus (ant. interosseous nerve) and by deep head of the flexor pollicis braves (ulnar nerve) Opponens pollici action lost, OPP is attained by flexors, ABD provided by abductor pollicis longus (radial nerve)
55
Radial Nerve Injury
Compression: Transient paralysis Humeral fracture: surgical neck or shaft, skin sensitively testing may not represent injury, elbow extension may still be obtained, test with arm ABD, wrist extensors may be paralyzed "wrist drop"
56
Radial Nerve Injury Lesions
Different paralysis patterns "wrist drop" paralysis of extensor arm muscles, if lesion exists in nerve after it pierces the lateral inter muscular septum Complete deep branch lesions may cause inability to extend MCP joints, radial extensors can still extend wrist Surgical repair is difficult
57
Ulnar Nerve Injury- Damage at Wrist
Flexor digitorum profundus unaffected Hypothenar, interossei, ulnar two lumbricals, ADD pollicis become paralyzed MCP joint become hyperEXT, due to overall of ext. digitorum FLEX of IP joints, due to overall of flexor digitorum profundus Muscle imbalance at the thumb results in ABD The transverse MC arch becomes flat, "ulnar claw hand" Sensation lost in area distal to lesion, skin dry, and vasodilated
58
Ulnar Nerve Injury- Damage at Elbow
Less severe than wrist (unlike median nerve) Vulnerable behind medial epicondyle May become loose and dislocate from groove Results in possible neuritis, paralysis Supply to hand may be affected before flexor carpi ulnas and flexor digitorum muscles When nerve supply to flexor digitorum is lost, muscle imbalance in the ulnar two fingers improves and the degree of "clawing" is reduced
59
Volkmann's Contracture
Degeneration, contracture, fibrosis, and atrophy of muscles Results from injury to blood and nerve supply -Brachial artery and median nerve Usually seen in the hand

KNES 360 Exam 3 (2 decks)

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