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Anatomy Block 1 > Wrist and Palm of Hand > Flashcards

Wrist and Palm of Hand Flashcards

1
Q

Define carpal tunnel.

A

the canal in the wrist bounded by osteofibrous material through which the flexor tendons and median nerve pass

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2
Q

What runs through the carpal tunnel?

A

12 components:

1) NINE flexor tendons pass through the carpal tunnel, the flexor digitorum profundus (4), superficialis (4), and the flexor pollicis longus (1)
2) median nerve (1)
3) Synovial sheaths (2)

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3
Q

What is the the fleshy prominence on the inner side of the palm next to the little finger?

A

Hypothenar eminence

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4
Q

What is the fleshy prominence at the base of the thumb?

A

Thenar eminence

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5
Q

What is also known as the transverse carpal ligament?

A

Flexor retinaculum

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6
Q

What is the flexor retinaculum?

A

fibrous bands that arch of the carpals creating the deep groove into the carpal tunnel

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7
Q

Where does the flexor retinaculum attach?

A

medial: pisiform and hook of hamate bone
lateral: scaphoid and trapezium

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8
Q

Where does the flexor retinaculum lie?

A

deep to the palmar aponeurosis; between the bases of the thenar and hypothenar eminencies

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9
Q

what is the palmar aponeurosis?

A

thick, central portion of the deep palmar fascia

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10
Q

What is the palmar aponeurosis usually a continuation of?

A

palmaris longus tendon

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11
Q

What is your first digit called?

A

Thumb

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12
Q

What is your first finger called?

A

Index

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13
Q

What is your 5th digit and 4th finger called?

A

Little finger

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14
Q

What is the palmar hand fascia continuous with?

A

Antebrachial fascia

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15
Q

What is the mid carpal joint?

A

joint between proximal rose and distal row of carpus

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16
Q

What movements does the midcarpal joint allow?

A

limited flexion and extension

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17
Q

What type of joint is the carpometacarpal (CM) joints?

A

synovial (although not a lot of movement, except at thumb)

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18
Q

1st metacarpal bone forms a carpometacarpal joint (CM) with which carpal bone?

A

Trapezium

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19
Q

2nd metacarpal bone forms a carpometacarpal (CM) joint with which carpal bone?

A

Trapezoid (planar)

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20
Q

3rd metacarpal bone forms a carpometacarpal (CM) joint with which carpal bone?

A

capitate (planar)

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21
Q

What is the 4th and 5th metacarpal bone forms a carpometacarpal (CM) joint with which carpal bone?

A

Hamate (planar)

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22
Q

What are the three parts of the metacarpal bone?

A 
Base (CM joint, finger)
Shaft
Head ( MP joints ie: knuckles)
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23
Q

How many total phalanges are there?

A

14 phalanges (2 in thumb and 3 in each finger)

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24
Q

Which part of the phalange is the smallest?

A

the distal segments are smaller; the proximal sections are the largest

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25
Q

What joints are located in the phalanxes?

A

PIP (proximal interphalangeal) joint and DIP (distal interphalangeal) joint

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26
Q

What forms the roof of the carpal tunnel?

A

flexor retinaculum

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27
Q

What forms the floor of the carpal tunnel?

A

carpal arch

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28
Q

Which tendons are stacked?

A

FDS (Flexor digitorum superficialis)

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29
Q

Which tendons are not stacked?

A

FDP (Flexor digitorum profundus)

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30
Q

Since the FDP (Flexor digitorum profundus) tendons are stacked, which ones are superficial and which ones are deep?

A

tendons to the middle and right finger= SUPERFICIAL

tendons to the index and little fingers = DEEP

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31
Q

Function of synovial tendon sheath

A

secrete synovial fluid

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32
Q

what is a synovial tendon sheath?

A
  • common tendon sheath for flexor digitorum superficialis and profundus
  • separate flexor pollicis longs sheath
  • extension for small finger tendon
  • new tendon sheath for digits 2-4
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33
Q

what are fibrous digital sheaths?

A

fibrous sheaths attach to bone

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34
Q

what are the two different types of fibrous sheaths?

A

annular and cruciform

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35
Q

What doe the fibrous digital sheath surround?

A

FDS and FDP tendons & synovial sheaths

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36
Q

tendons of the FDS split and insert on?

A

middle phalanges

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37
Q

tendons of the FDP spit and insert on?

A

distal phalanges

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38
Q

Three groups of muscles in the hand?

A

1) Thenar muscles (4)
2) Hypothenar muscles (3)
3) Short muscles (11)

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39
Q

What three muscles form the thenar eminence?

A

1) Abductor Pollicis Brevis (APB)
2) Flexor Pollicus Brevis (FPB)
3) Opponens Pollicis

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40
Q

What are the movements of the thumb?

A

flexion, extension, opposition, reposition, abduction and adduction

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41
Q

Abductor Pollicis Brevis: Insertion

A

proximal thumb phalange (lateral side)

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42
Q

Abductor Pollicis Brevis: Origin

A

Flexor retinaculum, scaphoid and trapezium

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43
Q

Abductor Pollicis Brevis: Innervation

A

Recurrent branch of the median nerve

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44
Q

Abductor Pollicis Brevis: Actions

A

ABduct thumb

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45
Q

What lies medial and lapped by the APB?

A

Flexor Pollicus Brevis

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46
Q

How many heads does the flexor pollicus brevis have?

A

two: superficial and deep

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47
Q

Flexor Pollicus Brevis (Superifical Head): Origin

A

Flexor retinaculum and Trapezium

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48
Q

Flexor Pollicus Brevis (Deep head): Origin

A

trapezoid and capitate

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49
Q

Flexor Pollicus Brevis: Insertion

A

Proximal thumb phalange (palmer surface) via tendon containing radial seasmoid bone

50
Q

What tendon passes between the superficial and deep head of the flexor pollicus brevis?

A

flexor pollicus longus

51
Q

Flexor Pollicus Brevis: Innervation

A

Superficial head: Recurrent branch of the median nerve

Deep: Deep branch of ulnar nerve

52
Q

Flexor Pollicus Brevis: Actions

A

flexion of thumb at MP joint

53
Q

Opponens Pollicis: Origin

A

Flexor retinaculum, Scaphoid and Trapezium

54
Q

Opponens Pollicis: Insertion

A

1st metacarpal (lateral border)

55
Q

Opponens Pollicis: Innervation

A

Recurrent median nerve

56
Q

Opponens Pollicis: Actions

A

opposes thumb

57
Q

What lies deep to the thenar eminence muscles?

A

Adductor Pollicis

58
Q

What is the adductor pollicis muscle?

A

fan shaped muscle with two heads (oblique and transverse) that contribute to the web between thumb and index finger

59
Q

adductor pollicis (Oblique head): origin

A

2nd and 3rd metacarpals & Capitate

60
Q

adductor pollicis (transverse head): origin

A

3rd metacarpal

61
Q

adductor pollicis: Insertion

A

proximal phalax of the thumb

62
Q

the adductor pollicis tendon contains?

A

ulnar seasmoid bone

63
Q

adductor pollicis: Innervation

A

deep ulnar

64
Q

adductor pollicis: actions

A

adducts thumb

65
Q

what shape is the opponens pollicis?

A

quadrangular shape

66
Q

What lies deep to the abductor pollicus brevius?

A

opponens pollicis

67
Q

What three muscles comprise the hypothenar eminence?

A

1) aBductor Digiti Minimi
2) flexor digiti minimi brevis
3) opponens digiti minimi

68
Q

what are the functions of the hypothenar muscles?

A

1) move small finger (5th digit)

2) small finger movements- flexion, extension, opposition, reposition, aBduction and aDduction (not by hypothenars)

69
Q

Which muscle is most superifical of the hypothenar muscles?

A

aBductor digiti minimi

70
Q

abductor digiti minimi: origin

A

pisiform

71
Q

abductor digiti minimi: insertion

A

proximal phalanx, 5th digit, lateral edge

72
Q

abductor digiti minimi: innervation

A

Deep ulnar nerve

73
Q

abductor digiti minimi: actions

A

aBducts 5th digit

74
Q

What lies lateral to the abductor digiti minimi?

A

flexor digiti minimi (brevis)

75
Q

flexor digiti minimi (brevis): origin

A

hook of hamate and flexor retinaculum

76
Q

flexor digiti minimi (brevis): insertion

A

proximal phalanx 5th digit

77
Q

flexor digiti minimi (brevis): innervation

A

deep ulnar nerve

78
Q

flexor digiti minimi (brevis): action

A

flexes MP joint

79
Q

Opponens Digiti Minimi: Origin

A

hook of hamate and flexor retinaculum

80
Q

Opponens Digiti Minimi: Insertion

A

medial border of 5th metacarpal

81
Q

Opponens Digiti Minimi: innervation

A

deep ulnar n

82
Q

Opponens Digiti Minimi: actions

A

opposition

83
Q

Most of the muscles of the thenar emminence have their counterpart in the hypothenar emminence, except?

A

Adductor pollicus brevis

84
Q

What are the short muscles of the palmar hand?

A

1) Lumbrical mm (4)
2) Palmar Interossei mm (3)
3) Dorsal interossi mm (4)

85
Q

which muscles are termed the “wormy” muscles?

A

Lumbricals

86
Q

There are 4 lumbricals, which are unipennate and which are bipennate?

A

1st and 2nd= unipennate

3rd and 4th= bipennate

87
Q

Lumbricals: Origin

A

lateral side of 1st and 2nd FDP tendons; Adjacent sides of (2nd&3rd) and (3rd&4th) tendons

88
Q

Lumbricals: Insertion

A

lateral (radial) side of extensor expansion of digits 2-5

89
Q

Lumbricals: Innervation

A

1st and 2nd –> by median n

3rd and 4th –> by deep ulnar n

90
Q

Lumbricals: Actions

A

Flex MP

Extend IP

91
Q

T/F: Palmar Interossei are all unipennate.

A

True

92
Q

Palmar Interossei: Origin

A

medial side of 2nd metacarpal

lateral side of 4th and 5th metacarpal

93
Q

Palmar Interossei: Insertion

A

proximal phalanges of 2nd, 4th and 5th digits AND

extensor expansions of 2nd, 4th and 5th digits

94
Q

True or False: Dorsal Interossei are all unipennate.

A

False, Dorsal Interossei are all bipennate

95
Q

Dorsal interossei: Origin

A

adjacent surfaces of 1st through 5th metacarpals

96
Q

Dorsal interossei: Insertion

A

via two tendons:

1) Proximal phalanges of 2,3 and 4 digits
3) extensor expansions of 2,3,4 digits

97
Q

Dorsal interossei: Innervation

A

Deep ulnar nerve

98
Q

What do the extensor expansions allow for in the doral interossei?

A

Flex MP joint

Extend IP joint

99
Q

Palmer interossei: actions

A

PAD= Palmer-ADuction
adducts 2,4 and 5th digit
can’t really adduct the middle finger because its already in the middle

100
Q

Dorsal interossei: actions

A

DAB- Dorsal- ABduct

aBducts 2,3,4 digits

101
Q

What vessel lies anterior to the flexor retinaculum?

A

Ulnar artery

102
Q

What are the two branches of the ulnar artery?

A

Superficial and Deep

103
Q

What makes up the superficial palmer arch

A

superficial palmar branch of radial and ulnar artery

104
Q

Which artery is dominant in the superficial palmar arterial arch?

A

ulnar a.

105
Q

What are the branches of the superficial palmar arterial arch?

A

1 proper palmar digital artery –> 5th digit

3 common palmar digital arteries which give rise to 6 proper palmar digital artery to 2/3, 3/4, 4/5 digits

106
Q

Where does the radial artery pass before branching?

A

between two heads of the 1st dorsal interosseus then branches to and one form the deep palmar arterial arch

107
Q

What is the dominant vessel in the deep palmar arterial arch?

A

radial artery

108
Q

what is the median nerve pathway?

A

gives rise to a small superficial branch –> enters carpal tunnel –> enters midland –> branches –> into motor and cutaneous branches

109
Q

what does the recurrent branch of the median nerve innervate?

A

1) aBductor pollicis brevis
2) Superifical head of flexor pollicis brevis
3) Opponens pollicis

110
Q

the median nerve cutaneous branch and innervate the digits, each has a proper palmas digital nerve. However, there is no common palmar digital nerve to which digit?

A

1st digit (thumb)

111
Q

What are the median nerve motor branches?

A

1) recurrent branch

2) nerves to 1st and 2nd lumbricals

112
Q

What does the median nerve branches innervate?

A 
MeatLOAF
Median n
Lumbricals (1&2)
Opponens (pollicis)
Abductor (pollicis)
Flexor (superficial)
113
Q

What is the ulnar nerve pathway?

A

enters superfically to the flexor retinaculum –> divides into deep and superficial branches

114
Q

What kinds of fibers does the superficial branch of the ulnar n carry?

A

sensory

115
Q

What kinds of fibers does the deep branch of the ulnar n contain?

A

motor

116
Q

The ulnar nerve cutaneous branches innervates which digits?

A

4th and 5th digit
palmer skin of medial 1.5 digits and palm
dorsum skin of medial 1.5 digits and midhand

117
Q

which is the nerve “of fine hand movements”

A

Ulnar n

118
Q

Where does the ulnar nerve enter the palm?

A

through the Guyon’s canal

119
Q

What does the deep branch of the ulnar nerve innervate?

A 
motor!
3 hypothenar muscles
3&4 lunbricals
dorsal interossei
palmer interossei
adductor pollicis
deep head of flexor pollicis brevis
120
Q

what is the manual part of the upper limb?

A

the hand

121
Q

how many bones and muscles are in the hand?

A

27 bones (8 carpals, 5 metacarpal and 14 phalanges) and 19 muscles

Anatomy Block 1 (6 decks)

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