Carpal Tunnel and Hand

Question 1

How many bones are in each hand (including the wrist)

Answer 1

27

Question 2

What are the components of each metacarpal

Answer 2

Proximal base, shaft, distal head

Question 3

What types of bones are the metacarpals?

Answer 3

Long bones

Question 4

How many phalanges does each digit have?

Answer 4

Digits 2-5 have proximal, middle, and distal phalanges

Question 5

How many phalanges does the first digit have?

Answer 5

2 phalanges- proximal and distal

Question 6

What are the parts of the phalanges?

Answer 6

• Proximal
• Shaft
• Distal heads

Question 7

Describe the carpometacarpal joints

Answer 7

Synovial–> Plane

Question 8

What is the one exception to the carpometacarpal joint?

Answer 8

The first digit is a saddle joint (trapezium and first metacarpal)

Question 9

Describe the intermetacarpal joint

Answer 9

Synovial–> Planar

Question 10

Describe metacarpophalangeal joint

Answer 10

Synovial –> Condyloid

Question 11

Describe the interphalangeal joint

Answer 11

Synovial –> Hinge

Question 12

What do the MCP and IP joints have to support the fibrous capsule?

Answer 12

Collateral ligaments

Question 13

This is the main osseofibrous tunnel of the hand

Answer 13

Carpal Tunnel

Question 14

What are the proximal row structures that create the carpal tunnel?

Answer 14

• Triquetrum
• Lunate
• Scaphoid
• Flexor retinaculum

Question 15

Where does the flexor retinaculum span from (proximal row)?

Answer 15

Pisiform to the tubercle of the scaphoid

Question 16

What are the distal row structures that make up the carpal tunnel

Answer 16

Hamate, capitate, trapezoid, trapezium, and flexor retinaculum

Question 17

What is another name for the flexor retinaculum?

Answer 17

Transverse carpal ligament

Question 18

Where does the flexor retinaculum span from (distal row)

Answer 18

The hoot of the hamate to the tubercle of the trapezium

Question 19

How many tendons of the flexor digitorum superficialis are there?

Answer 19

4 (more superficial)

Question 20

How many tendons of the flexor digitorum profundas are there?

Answer 20

4 (deeper)

Question 21

What is the most superficial structure of the carpal tunnel?

Answer 21

The median nerve

Question 22

What structure lies laterally to the median nerve?

Answer 22

Flexor pollicis longus

Question 23

What structure lies superficially to flexor digitorum profundus but inferiorly to median nerve

Answer 23

Flexor digitorum superficialis

Question 24

What structure superficial and medial to the flexor retinaculum?

Answer 24

Ulnar nerve and artery

Question 25

Where is the radial artery located?

Answer 25

The anatomical snuff box

Question 26

Where does the tendon of the flexor carpi radialis lie?

Answer 26

Between (NOT THROUGH) the tunnel and the trapezium on its way to attach to the base of the second metacarpal

Question 27

Describe carpal tunnel syndrome

Answer 27

-Inflammation and swelling of the carpal tunnel due to overuse and repetitive motion that compress the MEDIAN nerve

Question 28

What are some symptoms of carpal tunnel syndrome

Answer 28

- Always effect the median nerve - paresthesis - atrophy of thenar muscles

Question 29

What is a nick name for the groove formed by the ulnar canal?

Answer 29

Guyon canal

Question 30

The palmar fascia is a continuation of what?

Answer 30

The antebrachial fascia

Question 31

What does the palmar fascia thicken into?

Answer 31

Palmar aponeourosis

Question 32

Is the apex of the palmar aponeourosis proximal or distal?

Answer 32

Proximal

Question 33

What does the apex fuse with?

Answer 33

The tendon of the palmaris longus muscle

Question 34

What does the base of the palmar aponeosis do?

Answer 34

Sends 4 projections to the medial 4 digits | -Blend with fibrous tendon sheaths of the digits

Question 35

What is the purpose for the sheaths?

Answer 35

They incase the bones and tendons of each finger and form more osseofibrous tunnels

Question 36

These structures are continuous with the fascia

Answer 36

Fibrous septa

Question 37

What is the purpose of the fibrous septa?

Answer 37

Compartmentalize the palm

Question 38

What secure the skin of the palm to the palmar fascia and aponeuroisis?

Answer 38

Ligaments called retinacula cutis (they are very strong and prevent sliping of the skin of the palm

Question 39

What does the hypothenar compartment contain?

Answer 39

Muscles that act on the 5th finger | -These muscles give rise to the hypothenar eminence on the medial palmar surface

Question 40

What does the thenar compartment contain?

Answer 40

Muscles that act on the thumb | to place it in opposition

Question 41

What does the central compartment contain?

Answer 41

Long flexor tendons of the digits - lumbrical muscles - arterial arches of the palm

Question 42

What does the adductor compartment contain

Answer 42

-Adductor pollicis muscle

Question 43

What does the interosseous compartment contain

Answer 43

The interossei muscle

Question 44

What is the midpalmar space continuous with?

Answer 44

Carpal tunnel and the anterior compartment of the forearm

Question 45

Does the third digit always adduct or abduct?

Answer 45

Abduct (it cant move to the midline cause it is the midline)

Question 46

What plane are flexion and extension of the thumb in?

Answer 46

Coronal

Question 47

What plane are abduction and adduction of the thumb in?

Answer 47

Saggital

Question 48

This is continuous with the antebrachial fascia | -thickened to protect the deeper musculotendinous structures

Answer 48

Palmar Aponeuroisis

Question 49

This is subcutaneous - covers the guyon canal - protects the deep branches of the ulnar nerve and artery

Answer 49

Palmaris brevis

Question 50

These muscles act on the 1st digit

Answer 50

Thenar muscles

Question 51

What are the thenar muscles?

Answer 51

- Abductor pollicis Brevis - Flexor pollicis Brevis - Opponens pollicis

Question 52

What are the hypothenar eminence muscles?

Answer 52

- Abductor digiti minimi - Flexor digiti minimi Brevis - Opponens digiti minimi

Question 53

This is a thickening part of the palmar fascia between the tubercles of the scaphoid/trapezium and pisiform/hamate

Answer 53

Flexor Retinaculum

Question 54

What do flexor tendons go through?

Answer 54

The carpal tunnel

Question 55

Where do flexor tendons insert?

Answer 55

Into distal (profundas) and middle phalanges (superficialis)

Question 56

These are on digits 2-5 on the lateral side

Answer 56

Lumbricals

Question 57

Are lumbricals 1 & 2 unipennate/bipennate?

Answer 57

Unipennate

Question 58

Are lumbricals 3 and 4 unipennate/bipennate?

Answer 58

Bipennate

Question 59

What are the 2 heads of the adductor pollicis?

Answer 59

Transverse and oblique

Question 60

What structure splits the 2 heads of the adductor pollicis?

Answer 60

The radial artery

Question 61

This is an abductor of digits 2, 3, and 4

Answer 61

Dorsal Interossei

Question 62

Do digits 1 and 5 have their own abductors?

Answer 62

Yes um

Question 63

What is special about abduction of the 3rd digit?

Answer 63

Being the midline, digit 3 abducts both laterally and medially so it requires 2 dorsal interossei muscles

Question 64

What muscle adducts digits 2, 4, and 5?

Answer 64

Palmar Interossei (the thumb has its own adductor muscle

Question 65

Due to the fibrous sheath, what happens when the extensor digitorum contracts?

Answer 65

The IP and MP joints all extend

Question 66

Can the lumbricals flex the MP joints while extending the IP joints?

Answer 66

Yes- because... - the lumbrical crosses the MP joint anteriorly - distally, tension is placed on the sheath when the lumbrical pulls

Question 67

Is the extensor mechanism opposite of the flexor arrangement?

Answer 67

Yes

Question 68

Where does the split of the tendon run in an extensor mechanism?

Answer 68

To the distal phalanx

Question 69

Where does the center continuation of the tendon run to?

Answer 69

The middle phalanx

Question 70

What are the 2 ligaments of the fingers?

Answer 70

- Annular | - Cruciform

Question 71

Describe the annular ligaments?

Answer 71

- Pulleys | - Extend over the flexor digitorum superficialis tendon

Question 72

Describe cruciform ligaments

Answer 72

- They look like "x" | - Extend over the flexor digitorum superficialis tendon

Question 73

Describe trigger finger

Answer 73

- Due to forcefully flexing fingers - Thickens fiber sheaths - Causes the flexed finger not to be able to extend actively since the tendon sheaths of the FDS and FSP cant return to the osseofibrous tunnel

Question 74

Describe tenosynovitis

Answer 74

-inflammation of the sheaths of the flexor tendons -causes pain and disrups movement -