Wrist and Hand: outline 17 Flashcards
What muscles in hand is only in thumb side?
Lumbricals
What travels through the carpel tunnel and carpal arch?
FDP/FDS/ FPL
Median N
What are the fascia in hand?
Extensor retinaculum (dorsal)
Flexor Retinaculum (palmar)
What are the synoveal sheaths in palmar? What are their functions?
Radial
Ulnar
To reduce friction between muscles and flexor retinaculum
Where does radial bursae cover? Ulna bursae?
Digis 1-4 and FPL
FDP and FDS + little finger
What are the contents in snuff box?
radial A
scaphoid
trapezium
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
What are the fascia in the palmaris aponeurosis
palmaris longus tendon
transverse fasculi
SF/ Deep transverse metacarpal ligaments
What does trransverse fasculi do? deep transverse metacarpal ligaments?
connect between tendons
support the metacarpals
What is unique about superficial palmar fascia?
It has palmaris brevis muscle
Where is the fibro-osseous tunnels? What does it contain?
in the phalanges on palmar side
fibrous digital sheaths (annular puileys and cruciate fibers)
What is the function of fibro-osseous tunnels?
preven tendons (FDP/FDS) from sagging when hand prone
What is synovial digital sheath?
the sheath that covers the tendons, locating underneath fibrous digital sheaths
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
What is similar between wrist and finger fascia?
In wrist, flexor retinaculum covers ulnar& radial bursae
In finger, annular pulleys cover synovil digital sheaths
What are the intrinsics muscle? Which one is the deepest?
lumbricals/ interossei
hypothenar and thenar
interossei
What does interosseous muscle divide? What unique action does each muscle do?
dorsal (abduction)
palmar (adduction)
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
What is the nerve supply for interossei muscles? BS?
Ulnar N
Deep palmar arch (ulnar A)
What are the muscles in thenar?
Abductor Pollucis brevis
Flexor _______
Opponen Pollicis
Adductor Pollicis
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)
What is the exception of nerve supply in thenar muscles?
Adductor pollicis has ulnar N
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