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Examination of the Hand Flashcards

(65 cards)

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1
Q

What is the palmar surface of the hand aka?

A

Volar

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2
Q

What is the back surface of the hand also known as?

A

Dorsal surface

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3
Q

Where are the flexor tendon located?

A

Volar surface of hand

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4
Q

Where are the extensor tendons located?

A

Dorsal surface of hand

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5
Q

What is the thenar eminence?

A

Soft tissue bulk on the volar surface proximal to the thumb

It contains the intrinsic muscles of the thumb

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6
Q

What is the hypothenar eminence?

A

Soft tissue bulk on volar surface of hand proximal to pinky

Contains intrinsic muscles of the pinky

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7
Q

What are the bones of the hands?

A

Carpals (8 bones of wrist)
Metacarpals (1 to 5)
Phalanges (3 per finger, 2 for thumb)

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8
Q

What joints exist between the carpal and metacarpal bones?

A

Carpo-metacarpal joints

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9
Q

What joints exist between the metacarpal and phalangeal bones?

A

Metacarpo-phalangeal joints

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10
Q

What joints exist between the phalangeal bones?

A

Interphalangeal point (proximal and distal)

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11
Q

What forms the carpal tunnel?

A

Carpal arch of the carpal bones

Flexor retinaculum forms roof

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12
Q

What passes through the carpal tunnel?

A

Median nerve

9 flexor tendons of the digits

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13
Q

What muscles make up the thenar eminence? State their function

A

Opponens pollicis - opposition of thumb
Abductor pollicis brevis - abduction of thumb
Flexor pollicis brevis - flexion of thumb

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14
Q

What muscles make up the hypothenar eminence? State their function

A

Opponens digiti minimi - opposition of little finger
Abductor digiti minimi - abduction of little finger
Flexor digiti minimi - flexion of little finger

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15
Q

What muscles exist between metacarpal bones?

A

Interosseous muscles (dorsal and volar)

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16
Q

How many dorsal interossei are there? What is their role?

A

4

Abduction of fingers

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17
Q

How many volar dorsal interossei are there? What are their role?

A

3

Adduction of fingers

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18
Q

Where are the lumbrical muscles found?

A

FDP tendons

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19
Q

What is the role of the lumbrical muscles?

A

Flexion of MCP

Extension of PIP and DIP

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20
Q

What is the action of palmaris brevis?

A

Helps improve grip

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21
Q

What is the action of adductor pollicis?

A

Adduction of thumb

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22
Q

What are the extrinsic muscles of the hand?

A 
Flexor digitorum superficialis
Flexor digitorum profundus
Flexor pollicis longus
Flexor carpi radialis
Flexor carpi ulnaris
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23
Q

Where does the tendon of the FDS insert and what is its role?

A

Inserts on middle phalange so allows flexion of PIP

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24
Q

Where does the tendon of the FDP insert and what is its role?

A

Inserts on distal phalanges so allows flexion of DIP

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25
Where does the tendon of the flexor pollicis longus insert and what is its role?
On distal phalanx of thumb, so allows flexion of thumb
26
What is the role of flexor capri radialis?
Abduction of hand
27
What is the role of flexor capri ulnaris?
Adduction of the hand
28
What muscles are found in the 1st extensor compartment and what are their roles?
Abductor pollicis longus (abduction of thumb) | Extensor pollicis brevis (extension of proximal phalanx of thumb)
29
What muscles are found in the 2nd extensor compartment and what are their roles?
Extensor carpi radialis longus and brevis (extension + abduction of wrist)
30
What muscle is found in the 3rd extensor compartment and what is its r role?
Extensor pollicis longus (extends distal phalanx of thumb)
31
What muscles are found in the 4th extensor compartment and what are their roles?
``` Extensor digitorum (extends digits expect thumb and extends wrist) Extensor indicis proprius (extends index finger) ```
32
What muscles are found in the 5th extensor compartment and what are their roles?
Extensor digiti minimi (extension of little finger)
33
What muscle is found in the 6th extensor compartment and what is its role?
Extensor carpi ulnaris (extension + adduction of wrist)
34
What are the extensor hoods?
Formed by the tendons of the ED and EPL | An important site of attachment for many intrinsic muscles
35
What tendon forms the palmar apnoeurosis?
Palmaris longus tendon
36
What is the anatomical snuffbox?
Triangular depression on posterolateral side of wrist
37
What forms the borders of the anatomical snuffbox?
Lat - abductor pollicis longus + extensor pollicis brevis Med - extensor pollicis longus Floor - scaphoid + trapezium
38
What are the contents of the anatomical snuffbox?
Extensor carpi radialis longus and brevis Radial artery Radial nerve Cephalic vein
39
What is the blood supply to the hand?
Ulnar + radial arteries which form the superficial and deep palmar arches
40
Where does the ulnar artery supply?
Side of index finger, middle, ring and little finger
41
What are the branches of the ulnar artery?
Deep palmar branch (anastomoses with deep palmar arch formed by radial artery) Palmar digital artery (supplies ulnar side of little finger) 3 common palmar digital arteries (branch into proper palmar digital arteries to supply radial side of little finger, ring and middle finger and ulnar side of index finger)
42
Where does the radial artery supply?
Radial side of index finger, thumb
43
What four branches does the radial artery become?
Princeps pollicis artery and radialis indicis artery | Dorsal carpal + dorsal metacarpal branches supply dorsal aspect of hand
44
What artery supplies the dorsal interossei?
Radial
45
What is the venous drainage of the hand?
Interconnected networks of deep and superficial veins
46
From what side of the hand does the cephalic vein arise?
Radial
47
From what side of the hand does the basilic vein arise?
Ulnar
48
What is the distribution of the radial nerve?
Dorsal surface from thumb to middle finger
49
What is the distribution of the median nerve?
Thumb, index, middle and half of ring finger
50
What is the distribution of the ulnar nerve?
Little finger and half of ring finger | Motor supply to all intrinsic muscles expect thenar muscles and lateral 2 lumbricals
51
Why is it essential to treat swelling of the hand?
If left untreated it will encourage a fibroblastic change causing moving parts of the hand to adhere --> loss of function
52
How can we minimise swelling of the hand?
Keeping it elevated
53
What are the purposes of splinting?
Protect injured structures Prevent joint contracture Prevent development of strong substitution patterns Maximise functional use of hand
54
Should you tell the patient to avoid moving the hand when its in a splint?
No encourage controlled active mobilisation (i.e. movement within the splint as this helps with rehab)
55
What are the different ways of immobilising the hand?
Hand cast Buddy splint - for finger injuries (tape fingers together) FDP and FDS splint - when flexors of fingers injured FPL splint FCR and FCU splint ED splint etc.
56
How should you manage a burnt hand?
Put in clear bag, elevate to reduce swelling, move fingers + wrist to prevent adhesions/contractions Pain relief Excision of dead tissue, appropriate surgery
57
How should you manage a hand infection?
``` Elevation Rest Antibiotics (swab wound first) Incision + drainage if pus present Tetanus prophylaxis for open wounds ```
58
What is paronychia?
Infection of skin fold that sits over the finger nail
59
What tends to cause paronychia?
Nail biting or aggressive manicure
60
How does paronychia present?
Painful, swollen, red nail fold
61
Who does chronic paronychia tend to occur in?
Those who constantly have wet hands, e.g. bartenders, usually a fungal infection
62
What is felon?
Infection of distal pad of finger usually caused by puncture of finger tip by thorn or splinter
63
What is tenosynovitis?
Infection of flexor tendon sheath
64
What are the 4 signs of tenosynovitis?
Partially flexed posture of finger Pain with passive finger extension over the palmar side of finger Pain to touch over palmar side of finger Circumferential swelling around entire finger
65
What is the commonest organism from a human bite to cause infection in the hand?
Eikenella corrodens

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