Wrist & Hand - General Information Flashcards
Creases on your palm are actually
attachments of skin to superficial palmar aponeuroses
Superficial palmar aponeurosis spilts into what two layers
superficial and deep
Functions of palmar aponeurosis (3)
minimize slippage during grasping activities (stabilize palmar skin)
protect underlying mm, n, vessels
help create carpal tunnel (deep layer of PA)
Extensor and flexor retinaculum mechanical function
maintain more constant moment arm at PIP and DIP that each tendon crosses
Flexor retinaculum of fingers is composed of (2)
cruciform ligaments
annular ligaments (A1-A5)
5 mm groups of hand?
Thenar eminence
Hypothenar eminence
Lumbricals
PADs
DABs
What composes the thenar eminence?
*** (All For One And) One For All
(4 layers, sup to deep:)
abductor pollicis brevis
flexor pollicis brevis
opponens pollicis
adductor pollicis
What composes the hypothenar eminence?
(3 mm)
abductor digiti minimi
flexor digiti minimi
opponens digiti minimi
Which lumbricals are unipennate or bipennate?
*** “LU MB ricals”
lateral 2 - unipennate
medial 2 - bipennate
DABs are unipennate or bipennate?
bipennate
What is the dorsal digital expansion?
triangular aponeurosis through which the extensor digitorum, interossei, and lumbricals exert their coordinated actions at the MCP and IP joints
Tendon of DDE trifurcates over the
proximal phalanx
The central tendon of the DDE inserts on
dorsal base of the middle phalanx
Two lateral bands of the DDE travel
on either side of the PIP and inserts on the dorsal base of the distal phalanx
The trifurcation of the DDE is held in place by the
transverse fibers of the expansion
The tendon of an _______ commingles with the lateral band of ED at the _______ and becomes an integral part to it
interosseous muscle
middle phalanx
On the radial side the tendon of the ________ joins the ED at the ______, just distal to the interosseous tendon
lumbrical
PIP
Name the carpals (8)
scaphoid
lunate
triquetrium
pisiform
trapezium
trapezoid
capitate
hamate
Pisiform lies ______ to the triquetrum
anterior
The pisiform and hook of hamate form the
***passage of ulnar n is here
tunnel of Guyon
What travels in the tunnel of Guyon?
ulnar n
FOOSH injuries typically result in what carpal being fractured?
usually through the narrow waist of the scaphoid
blood flow disrupted distal to proximal
poor prognosis - malunion (fractured bone heals in an abnormal position) or nonunion (A nonunion occurs when a fractured bone fails to heal after an extended recovery period)
pain on palpation of anatomical snuff box
often requires extensive mobilization and surgery
scaphoid fracture
The scaphoid bone is aka…
navicular
What allows for the extensive ROM at the 1st CMC joint?
base of 1st MC is saddle-shaped to articulate with trapezium, allows greater motion
What movements are at the first MCP joint? (4)
flex/extend
abduction/adduction
IR/ER
opposition/reposition
At your MCP joints, what is concave and what is convex?
heads of MC are convex
bases of proximal phalanges are concave
What movements are at the MCP (knuckle) joints? (2)
flex/extend
abduction/adduction
AT IP joints, what is concave and what is convex?
(similar to MCP joints)
concave proximal base
convex distal head
Where are the sesamoid bones around the thumb?
embedded in tendons of FPB and AddP
What runs in between the sesamoid bones of the thumb?
FPL
What are the joints of the wrist? (2)
DRUJ
radiocarpal joint
Distal ulna is separated from proximal row of carpals by the…
triangular fibrocartilage complex (TFCC)
Disruption of TFCC may lead to…
carpal instability
early osteoarthritis
Borders of carpal tunnel
Roof - flexor retinaculum
Radial border - scaphoid tubercle, trapezium tubercle
Ulnar border - pisiform, hook of hamate
Contents of carpal tunnel (10)
***F I spilled my meds. Dear, don’t panic.
FDS (4)
FDP (4)
FPL (1)
median n (1)
T or F; Flexor Carpi Radialis tendon is within carpal tunnel
FALSE
FCR tendon lies just lateral to carpal tunnel as it passes through its groove on the trapezium
Proximal row of carpal bones (4)
- scaphoid
- lunate
- triquetrum
- pisiform
Distal row of carpal bones
- trapezium
- trapezoid
- capitate
- hamate