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Anatomy > EXAM2_G13_Palmar > Flashcards

EXAM2_G13_Palmar Flashcards

1
Q

ALLENS TEST

A

test patentcy of blood flow of radial and ulnar arteries

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2
Q

What supplies palm via deep palmar arch?
What is deep palmar arch in contact with (location)?
What are the thumb and index finger branches of this artery called respectively?

A

Radial Artery
contacts bases of metacarpals
PRINCEPS POLLICIS ARTERY (Thumb)
RADIALIS INDICIS ARTERY (Index finger)

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3
Q

What artery supplies via superficial palmar arch?
what is it deep to? superficial to? Lateral to?
Where does it travel through ?

A

Ulnar artery
deep to palmar aponeurosis, superficial to flexor aponeurosis and flexor tendons, lateral to ulnar nerve
Travels through GUYONS CANAL and terminates as superficial palmar arch and deep palmar branch

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4
Q

Compression of ulnar nerve through guyons canal is called what?
What symptoms?

A

ULNAR CANAL SYNDROME

Hyper-esthesia (diminished sensation of medial palm & pinky)

Paresis (weakness) of intrinsic hand muscles that are innervated by deep branch of ulnar nerve

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5
Q

Where is Ulnar nerve found?
deep to ? ermerges where? branches?

Where does it pass through

A

deep to FCU, medial to Ulnar artery
Emerges at wrist and gives palmar cutaneous branch

pass between palmar carpal ligament and flexor retinaculum and enters hand through Guyons Canal

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6
Q

What is guyons canal?

A

Tunnel between hook of hamate and pisiform

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7
Q

What does ulnar nerve divide into?

What innervations of each?

A

Deep branch (motor for hypothenar muscles, AdP, deep head of FPB, medial two lumbricals, all interossei)

Superficial branch (Motor to PB; common and proper palmar digital nerves that parallels arteries)

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8
Q

What provides cutaneous sensation of medial forearm and medial proximal palm?

A

Palmar Ulnar branch

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9
Q

What provides cutaneous sensation of lateral pinky and some palm around base of pinky?

A

Superficial branch of ulnar nerve

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10
Q

What provides cutaneous sensation of middle palm and up middle inner wrist?

A

Palmar Branch (median nerve derived proximal to wrist)

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11
Q

Where does palmar branch of median nerve enter the hand?

When enters hand what does it branch into?
What function?

A

Enters deep to flexor retinaculum then branches to become

-. Recurrent branch (MOTOR to THENAR) except deep head FPB

  • Common palmar digital nerves
  • Proper palmar digital nerves
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12
Q

Where do you test median nerve? Ulnar nerve?

Where can median be compressed? what symptoms

A

Median at tip of digit 2, ulnar at tip of pinky

Median can be compressed under flexor retinaculum and produces pain and paresthesias in cutaneous, can progress to motor problems too

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13
Q

LUMBRICALS- ONIA

A

O- TENDONS of FDP
I- Lateral bands of extensor expansions of digits 2,3,4,5
A- FLEX MCP joints, EXTENDS PIP/DIP joints
N- 1 &2 median, 3,4,5, deep ulnar

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14
Q

PALMAR INTEROSSEI (3)

A

O-Metacarpals of 2,4,5
I-base of proximal phalanx and extensor expansion of digits 2,4,5
-adducts 2,4,5 to axial line
DEEP BRANCH OF ULNAR

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15
Q

DORSAL INTEROSSEI (4)

A

O- adjacent sides of Metacarpals
I- base of proximal phalanx and extensor expansion of digits 2,3,4
A- abduction of digits 2,3,4 away from axial line- assists lumbricals (flex mcp, extend dip, pip)
N- Deep ulnar

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16
Q

Hypothenar muscles (3) OINA

A

AbDM- pisiform to prox phalanx of pinky
FDM- HookHam to proximal phalanx
ODM- HookHam to metacarpal (5th)

17
Q

FPB

what bones does this one have?

A

TWO HEADS!
O- Flexor retinaculum & Trapezium
I- proximal phalanx base of thumb

superficial head- Recurrent b. median
Deep head- deep b. ulnar

Flex thumb

Has sesamoid bones and forms FPL tendon channel

18
Q

OP

A

O-flexor retin, trapezium
I- 1st metacarpal
CMC joint opposition in thumb
Recurrent b. median

19
Q

Central Compartment contents:

A
  1. tendons of long flexors related to FDS and FDP
  2. Lumbricals
  3. Superficial palmar arch and branches
  4. Median nerve and branches
  5. Midpalmar space
20
Q

Hypothenar Compartment

A

3 muscles (AbDM,FDMb,ODM),
digit 5 digitiminimi,
deep branch of ulnar nerve

21
Q

Interosseous compartment

A

Dorsal interosseous muscles (abduction of digits 234 away)
Palmar IM’s (adduction 2,4,5 toward axial line)
Innervated by Deep branch of ulnar nerve

22
Q

Adductor compartment:

A

AP- deep branch of ulnar

23
Q

What compartments affected by deep ulnar lesion?

A

Adductor compartment, Interosseous compartment, Hypothenar compartment

ALSO deep head of FPB

24
Q

What compartment affected by median nerve lesion

A

Central comparment, Thenar compartment (if recurrent branch affected)

25
Q

Thenar compartment

A

AbPB, FPB, OP- Recurrent branch of median (except deep head FPB is deep ulnar)

26
Q

What is potential space called that is continuous w/ forearm via carpal tunnel and can spread infection from forearm to hand?

A

Midpalmar Space

27
Q

What creates the tunnel over the concavity of the carpal bones? What are the structures in that tunnel?

A

Flexor retinaculum

  1. tendons of long flexor muscles (4 muscle tendons related to FDS, 4 related to FDP)
  2. Tendon of FPL
  3. MEDIAN NERVE
28
Q

What 4 structures are superficial to the flexor retinaculum?

A

Tendon of FCR,PL, Ulnar Nerve, Ulnar Artery

29
Q

TENOSYNOVITIS

A

inflammation of tendon and digital synovial sheaths

-can spread infection from digits 1 or 5 into the forearm via the Ulnar or Radial Bursa

30
Q

What is Trigger finger called?

A

Digital tenovaginitis stenosans-
Fibrous digital sheath inflammation by repeated trauma
Narrows tendon tunnels

31
Q

What covers the synovial tendon sheaths of digits?

A

Fibrous digital sheaths

creates osteofibrous tunnels that prevent bowstringing across joints

32
Q

Ulnar bursa vs Radial Bursa

A

Ulnar- tendons of FDS & FDP within a common flexor sheath- continuous with digit 5

Radial bursa- FPL tendon in its own synovial sheath called radial bursa

33
Q

What is Palmar aponeurosis disease?

what digits most affected?

A

DUPUYTREN CONTRACTURE
-progressive fibrosis and degeneration of palmar fascia and aponeurosis
Digits 4,5 most affected
Males>females

34
Q

What are the two ligaments across the wrist superficial to deep?

A

Palmar carpal ligament

Flexor retinaculum

35
Q

What is continuous with palmaris longus tendon and flexor retinaculum?

A

Palmar aponeurosis

holds skeleton in palm together

36
Q

What are the ligaments across metacarpals called?

A

transverse metacarpal ligaments

37
Q

What digit movements in Coronal plane?

A

Adduction/abduction of digits 2-5

Flexion/extension of thumb across palm

38
Q

What digit movements in Sagittal plane?

A

Flexion/Extension of digits 2-5

AB/Adduction of thumb

39
Q

Where are sesamoid bones found?

A

Pisiform in FCU, embedded in FPB tendon

Anatomy (24 decks)

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