Wrist and Hand: outline 17 Flashcards by luan nguyen

What muscles in hand is only in thumb side?

Lumbricals

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What travels through the carpel tunnel and carpal arch?

FDP/FDS/ FPL

Median N

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What are the fascia in hand?

Extensor retinaculum (dorsal)

Flexor Retinaculum (palmar)

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What are the synoveal sheaths in palmar? What are their functions?

Radial

Ulnar

To reduce friction between muscles and flexor retinaculum

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Where does radial bursae cover? Ulna bursae?

Digis 1-4 and FPL

FDP and FDS + little finger

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What are the contents in snuff box?

radial A

scaphoid

trapezium

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Layers of hand from dorsal to palm?

Extensor Tendons

Interossei

deep palmar arch + deep branch ulnar N

Flexor Tendons + Lumbricals

median & superior ulnar N branch & SF palmar arch

palmar aponeurosis

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What are the fascia in the palmaris aponeurosis

palmaris longus tendon

transverse fasculi

SF/ Deep transverse metacarpal ligaments

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What does trransverse fasculi do? deep transverse metacarpal ligaments?

connect between tendons

support the metacarpals

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What is unique about superficial palmar fascia?

It has palmaris brevis muscle

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Where is the fibro-osseous tunnels? What does it contain?

in the phalanges on palmar side

fibrous digital sheaths (annular puileys and cruciate fibers)

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What is the function of fibro-osseous tunnels?

preven tendons (FDP/FDS) from sagging when hand prone

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What is synovial digital sheath?

the sheath that covers the tendons, locating underneath fibrous digital sheaths

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What is vincula? What is its function?

It is the subset of FDP and FDS

Pick up blood from digits BS to nuture the FDS and FDP tendons

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What is similar between wrist and finger fascia?

In wrist, flexor retinaculum covers ulnar& radial bursae

In finger, annular pulleys cover synovil digital sheaths

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What are the intrinsics muscle? Which one is the deepest?

lumbricals/ interossei

hypothenar and thenar

interossei

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What does interosseous muscle divide? What unique action does each muscle do?

dorsal (abduction)

palmar (adduction)

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OIANB of lumbricals

FDP tendons

Extensor expansion of digits 2-5 on radial side of proximal phalanges

Flexion of digits 2-5 at MCP joint

Extension ______ at PIP/DIP joints

Ulnar N: digit 4-5

Median N: digit 2-3

Deep palmar arch

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What is the nerve supply for interossei muscles? BS?

Ulnar N

Deep palmar arch (ulnar A)

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What are the muscles in thenar?

Abductor Pollucis brevis

Flexor _______

Opponen Pollicis

Adductor Pollicis

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What thenar muscles has sesamoid bone? What is the nerve supply for thenar muscles?

flexor pollucis brevis and adductor pollicis

Median N (except adductor pollicis)

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What is the exception of nerve supply in thenar muscles?

Adductor pollicis has ulnar N

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What are the hypothenar muscles?

abductor digiti minimi

flexor __________

Opponen DM

Palmaris Brevis

What cause the adduction of digit 5?

palmaris interossei

Due to what then index and baby finger has more independent movement?

intertendinous that is only on one side and extra muscles EDM for baby finger and EI for index

What does extensor retinaculum consist of?

Central tendon of ED Lateral \_\_\_\_\_\_\_ Transverse retinacular lig Tendons of interosseous and lumbricals

What are the branches of ulnar A in hand?

dorsal and palmar carpal branch superficial/ deep palmar branch

What are branches from ulnar artery that supply the wrist?

dorsal carpal and palmar carpal branch

What does palmar carpal branch of ulna anastomoses with?

palmar carpal branch of radius

What is the branch of dorsal carpal branch of ulna?

dorsal carpal rete

What does superficial palmar arch of ulna give off? What does this artery continue to give off?

Common Palmar digital Proper Palmar Digital to supply fingers

Where is the deep palmar arch in between?

it is in between interossei and lumbricals& flexor tendons

What does radial A give off at the wrist before turning dorsally?

palmar carpal branch superficial palmar branch

What does superficial palmar arch supply?

thenar muscles

Where does radial A travel after branch off palmar carpal branch and superficial palmar branch?

it travels dorsally (post compartment) onto snuff box

What does radial artery at snuff box give off on dorsal side?

princips pollicis radialis indicis dorsal carpal branches

What does radialis indicis supply? princips pollicis supply?

it supply the radial side of digit 2 the thumb

What does dorsal carpal branches give off?

dorsal carpal rete

What doe dorsal carpal rete of radial A give off?

dorsal metacarpal dorsal digital A

What side of hand are princips/ radialis indicis, dorsal carpal rete travels?

Dorsal side of hand

What does radial A give off after emergin from btw 2 heads of dorsal interosseous?

deep palmar arch

What does deep palmar arch of radius give off?

palmar metacarpals which gives off palmar perforating branchs

What are the veins in hand?

dorsal digital vein intercapitular vein (between head of metacarpal) basilic (medial) cephilic (lateral)

Where exactly does the radial cutaneous N innervate? ulnar cutaneous N?

dorsal surface of hand digit 5 and half 4 whole hand palmar side of digits 1-31/2 and half dorsal side of digits 1-31/2

What does median N in hand give off?

palmar cutaneous N palmar cutaneous digital common and proper muscular branch of thenar

What part of median N that doesn't suffer the carpal tunnel syndrom? Why?

palmar cutaneous median N Because it branches off laterally at antebrachium and doesn't travel under carpal tunnel

What does ulnar N branch?

palmar cutaneous branch (half digit 4 and full 5) dorsal cutaneous branch

What does dorsal branch of ulnar N travel under?

Canal of Guyton & palmar carpal ligament

What does the dorsal branch of radial N give off?

dorsal digital N Superficial and deep palm branch

What does superficial palmar branch of radial nerve supply? What does deep palmar branch of radial N innervte?

moto to palmaris brevis common and proper palmar digital communicating branch interossei, lumbricals and hypothenar

Where does median N travel in hand?

under flexor retinaculum on palmar side

Lost what muscle cause to claw hand?

interossei (flexionf of MCP joints) Lumbricals (Extension of IP joints)

What muscles that compensate to the muscles lost in claw hand?

extension fo MCP joint (FDP) flexion IP joints (FDS + FDP)

What does radial N in hand give off?

dorsal superficial digital N (skin only)

What are the ligaments that help stabilize the wrist joints?

dorsal radiocarpal ligament palmar carpal ligaments

What is the exception of characteristic of carpometal joint?

in thumb it is saddle joint instead of plane joint

BS for wrist joints?

Palmar Carpal Branch (Ulna and radial) Dorsal Carpal Rete Deep palmar arch