Upper Limb: Hand and Wrist Flashcards
Describe what is present in the superficial palm
- Flexor retinaculum
- Palmer aponeurosis
- Fibrous digital sheaths
- Thenar eminence
- Hypothenar eminence
What is Dupuytren’s contracture
Palmar aponeurosis becomes thickend, fibrosed and contracted. It flex’s the 5th and 4th digit and you cannot pull them back - associated with alcoholics
Where are the midpalmar and thenar spaces found?
Midpalmar - between central and interosseous compartment
Thenar space - between thenar and adductor compartments
What are the different synovial sheaths in the hand?
- Common flexor synovial sheath for flexor digitorum superficialis and flexor digitorum profundus tendons
- Separate synovial sheath for the tendon of flexor policis longus
- Synovial sheaths for each digit with the digiti minimi sheath being continuous with the palm
Where are fibrous sheaths found and what is their function?
Found superficial to synovial sheaths in the digits (means they are covering them). They act as pullys making movement more efficient
What are the types of fibrous sheaths and where are they found?
Annular - over bone
Cruciform - over joints
How do the tendons of the flexor digitorum superficialis and flexor digitorum profundus appear in the digits
FDS splits to allow FDP through distally
Describe the sensory supply of the hand
Radial nerve - Covers lateral boarder of the hand and including anatomical snuffbox
Median Nerve - Lateral 3 digits on the anterior side and nail beds of the lateral three digits on the posterior side.
Ulnar nerve - Supplies the 5th and 1’2 of the 4th digits on both sides
Of the thenar muscle, what two are supplied by the recurrent branch of the median nerve (C8,T1)
Abductor pollicis brevis and Opponens Pollicis
Name the two other muscles of the thenar muscles, their two heads and nerve supply.
Flexor pollicis brevis - Superficial head supplied by recurrent median N and Deep head supplied by deep ulnar nerve (C8, T1)
Adductor pollicis - Transverse and Oblique both supplied by deep branch of ulnar (it is a deeper thenar muscle)
Name the three hypothenar muscles and their nerve supply
- Abductor digiti minimi
- Opponens digiti minimi (deep to the flexor digiti minimi)
- Flexor digiti minimi brevis
All supplied by the deep branch of Ulnar nerve (C8,T1)
On the back of the hand what holds the synovial sheaths of tendons in place at the wrist?
Extensor retinaculum
What occurs to the tendons of the extensor digitorum?
They flatten as they reach the metacarpals and become extensor expansions. Lumbricals then insert into the extensor expansion/hood
What is the origin of the lumbrical muscles?
The radial side of the flexor digitorum tendon
Where do the lumbrical muscles insert?
Into the extensor expansion
