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Anatomy UE > hand > Flashcards

hand Flashcards

1
Q

prehension

A

the act of grasping or seizing

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2
Q

Essential function of the hand

A

prehension

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3
Q

Key to prehension

A

thumb orientation and rich supply of sensory receptors

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4
Q

how mann bones are there distal to the carpals

A

19 bones distal to the carpals
5 rays comprised of: Metacarpals (5); Proximal phalanges (5); Middle phalanges (4); Distal phalanges (5)

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5
Q

MCP joints

A

between the metacarpal and the phalages

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6
Q

where are sesamoid ​found

A

under the thumb

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7
Q

Longitudinal arch of the hand

A

Carpometacarpo-phalangeal arches

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8
Q

Transverse arch of the hand

A

Proximal transverse
Distal transverse

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9
Q

proximal transverse

A

carpal arch

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10
Q

Distal transverse

A

level of metacarpal heads

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11
Q

Oblique arch

A

Thumb during opposition with other fingers

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12
Q

Flexion Creases

A

Wrinkles - Present to stress and stretch the hand without tensioning the skin

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13
Q

is the fascia of the palm thicker on the thumb or pinky side

A

thumb

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14
Q

Dupuytren’s contracture

A

Increase in fibrous tissue of palmar aponeurosis

Pt get flexion contraction of the finger – normally 4th and 5th digits

Treat with splinting and stretching – sometime need a surgical release – slice open the fascia

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15
Q

MCP joints

A

condyloid (2DF)

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16
Q

MCP joints movement

A

flexion and extension
abd and add

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17
Q

IP joints

A

bicondylar

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18
Q

IP joints movement

A

Most: Flex and ext (active)
Do have some passive rotation

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19
Q

IP joints vex and cave

A

biconvex head of phalanx and biconcave base of middle/distal phalanx

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20
Q

MCP 2nd - 5th Fingers vex and cave

A

Proximal: convex (oval MC head)
Distal: concave base (oval phalanx)

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21
Q

MCP 2nd - 5th Fingers actions

A

Flex/Ext - Sagittal plane about transverse axis

Abd/Add - Frontal plane about A-P axis

Circumduction

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22
Q

MCP Thumb

A

flexion/extension and limited abd/add

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23
Q

where do we find the sesamoid bones of the hand

A

distal aspect of the 1st metacarpal, there are 2 sesamoid bones

Sesamoids are incorporated into the fibrocartilage of the volar plate

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24
Q

MCP – 1st to 5th digits capsule

A

Dorsally fibrous; continuous volarly with volar plate
Lax in extension

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25
Q

Ligaments of the MCP 1-5

A

: 2 Collateral, 2 Accessory & Volar Plate

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26
Q

MCP collateral ligamaents

A

Strong, oriented obliquely
Tension increases with flexion
Resist Abd/Add

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27
Q

MCP Accessory ligaments

A

In flexion firmly holds volar plate against volar surface of MC head

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28
Q

Volar Plate MCP ligament - loction

A

Proximal: at the metacarpal head, loosely attached by membranous portion of volar plate
Distal: at the base of proximal phalanx, firmly attached, fibrocartilage

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29
Q

volar plate function in extesnion​

A

increases contact surface with MC head / resists hyperextension

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30
Q

volar plate function in flexion

A

glides proximally / prevents flexor tendon pinching

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31
Q

transverse metacarpal ligament

A

Connects metacarpal heads and adjacent volar plates

volar plates blend with transverse metacarpal ligament

Hold heads of MC together
Facilitate adaptability to size and shape of objects

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32
Q

what forms the tunnel that surrounds the flexor tendons

A

transverse metacarpal ligament and volar plate

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33
Q

MCP: 2nd - 5th Fingers and gripping

A

Mechanically stabilized for gripping at 70 to 90 degrees flexion

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34
Q

what muscle is connected o the volar plate of the thumb

A

Tunnel of FPL

connecting the lateral ligaments and the volar plate with the sesamoids

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35
Q

what is a common ligament MCP issue in the thumb

A

UCL injury
Gamekeeper’s or Skiers thumb

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36
Q

extension active range of motion and passive in the MCP jts (2-5)

A

Ext: 30 - 40 AROM; 90 PROM (large difference)

37
Q

flexion in the MCP joints (2-5)

A

Flex: 90 deg. index; progressive increase to 110 at 5th digit

38
Q

thumb MCP felxion

A

Flexion 50 degrees; Extension 0 degrees

39
Q

closed packed position for MCP joint

A

full flexion

40
Q

open packed for MCP

A

slight flexion

41
Q

IP vex and cave

A

Distal: bi-convex head

Proximal: bi-concave base

42
Q

IP are what kind of joint

A

hinge or bicondylar

43
Q

movement seen at IP

A

Transverse axis results in flex/ext

44
Q

PIP - Volar Plate

A

has thick distal insertion and two check ligaments proximally

Prevents hyperextension

Ruptures occur in the thicker distal insertion

Reinforced by pulleys of flexor sheath

45
Q

PIP transverse ligament

A

this is none

46
Q

PIP flexion

A

Flexion 110 degrees, more at 5th than 2nd. Thumb 90 degrees.

47
Q

PIP extension

A

Extension limited, except thumb IP up to 50 degrees.

48
Q

DIP flexion and extension

A

Flex. 90 degrees with ulnarward increase; hyperext up to 30 degrees

49
Q

what side produces a tighter grip the ulnar or the radial side

A

ulnar side

50
Q

Closed / Open Pack: all (PIP and DIP)

A

Closed: full ext
Open: slight flexion

51
Q

where do we see OA more DIP or PIP

A

PIP

52
Q

when does OA increase

A

with age and in women

53
Q

Joints of the Digits vasculature

A

Digital aa

54
Q

joints of the digits Innervation

A

Digital nn

55
Q

Flexors of the fingers

A

Flexor Digitorum Superficialis (FDS) and Profundus (FDP)
Flexor Pollicis Longus (FPL)

56
Q

Extensors of the fingers

A

Extensor Digitorum (ED)
Extensor Digiti Minimi (EDM)
Extensor Indicis (EI)
Extensor Pollicis Brevis (EPB)
Extensor Pollicis Longus (EPL)
Abductor Pollicis Longus (APL)

57
Q

FDS action

A

Flexes PIP
Power grip muscle
FDS can flex wrist and MCP when PIP is fully flexed

58
Q

FDP actions

A

Only tendon to insert on distal phalanx

Function
DIP flexion
FDP help with PIP ,MCP and wrist flexion
Origin of lumbrical muscles

59
Q

FPL action

A

Flex IP
Ineffective as IP flexor during wrist flexion

60
Q

APL action

A

Abd the CMC, radially deviates wrist

61
Q

EPB action

A

Same as APL and extend MCP

62
Q

EPL action

A

Extends IP
Extends MCP, ext CMC joint
Can’t extend IP with wrist, CMC, & MCP extended

63
Q

ED

A

Pass beneath Ext Retinaculum / Sheaths/ No pulleys – Almost all extrasynovially

ONLY muscle capable of extending MCP
CANNOT extend PIP & DIP alone

64
Q

EI & EDM action

A

Independent control 2nd & 5th

65
Q

Extensor Mechanism

A

Complex broad, flat aponeurotic band

Composed of extrinsic extensor tendon that continues as the central band

cover the entire dorsal surface of the finger

66
Q

Mallet finger

A

Rupture at the terminal extensor tendon or bony avulsion at its attachment into distal phalanx

67
Q

Swan-neck Deformity

A

hyperextended PIP, flexed DIP
Superior subluxation of lateral bands

68
Q

Boutonniere Deformity:

A

flexed PIP, hyperextended DIP
Injury to the central slip with inferior subluxation of lateral bands

69
Q

thenar compartment

A

the bulk of muscle tissue over the thumb side of the palm and contains 3 thenar muscles.

70
Q

hypothenar compartment

A

the bulk of muscle tissue over the pinky side of the palm and contains 3 hypothenar muscles.

71
Q

central compartment

A

lies in between, and mostly contains your extrinsic flexor tendons plus the intrinsic lumbrical muscles.

72
Q

the adductor compartment

A

lies deep to the central and hypothenar compartments and just contains 1 muscle, the adductor pollicis.

73
Q

Intrinsic Thenar (Thumb) Muscles

A

Abductor Pollicis Brevis (AbPB)
Flexor Pollicis Brevis (FPB)
Opponens Pollicis (OP)

Adductor Pollicis (AdP)
only 3 of them are considered thenar muscles because they share the same fascial compartment

74
Q

AbPB innervation

A

median n.

75
Q

FPB - Two heads innervation

A

Lateral or superficial (median n.) inserts with AbPB assisting Abd.

Medial or deep (ulnar n.) inserts with AdP assisting Add.

76
Q

OP innervation

A

medial nerve

77
Q

OP action

A

Only intrinsic thenar to insert on 1st metacarpal

Effective in positioning metacarpal in abd, flex and rotation

78
Q

Adductor Pollicis innervation

A

deep ulnar nerve

79
Q

Adductor Pollicis action

A

has two heads (oblquie and trnasverse)

Thumb adduction
Stabilizes thumb against opposed finger

80
Q

Hypothenar Muscles

A

Abductor Digiti Minimi
Flexor Digiti Minimi
Opponens Digiti Minimi

81
Q

Hypothenar Muscles innervation

A

Deep branch ulnar n

82
Q

Lumbricals attachments

A

Proximal: FDP tendons
Distal: lateral bands of extensor mechanism

83
Q

Lumbricals innervation

A

Two nerves (1,2-median; 3,4-ulnar)

84
Q

lumbrical action

A

Extend IPs and flex MCP

85
Q

Interossei innervation

A

deep branch of the ulnar nerve

86
Q

mnomics Interossei

A

DAB – Dorsal ABduct

PAD – Palmar ADduct

Both help lumbricals

87
Q

MCP Joint in Extension and interossi movement

A

Mechanical advantage for Abd/Add

88
Q

MCP Joint in Flexion and interossei movment

A

movement in abd and ad is restricted

Anatomy UE (11 decks)

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