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Anatomy UE > hand > Flashcards

hand Flashcards

(88 cards)

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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
Ligaments of the MCP 1-5
: 2 Collateral, 2 Accessory & Volar Plate
26
MCP collateral ligamaents
Strong, oriented obliquely Tension increases with flexion Resist Abd/Add
27
MCP Accessory ligaments
In flexion firmly holds volar plate against volar surface of MC head
28
Volar Plate MCP ligament - loction
Proximal: at the metacarpal head, loosely attached by membranous portion of volar plate Distal: at the base of proximal phalanx, firmly attached, fibrocartilage
29
volar plate function in extesnion​
increases contact surface with MC head / resists hyperextension
30
volar plate function in flexion
glides proximally / prevents flexor tendon pinching
31
transverse metacarpal ligament
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
32
what forms the tunnel that surrounds the flexor tendons
transverse metacarpal ligament and volar plate
33
MCP: 2nd - 5th Fingers and gripping
Mechanically stabilized for gripping at 70 to 90 degrees flexion
34
what muscle is connected o the volar plate of the thumb
Tunnel of FPL connecting the lateral ligaments and the volar plate with the sesamoids
35
what is a common ligament MCP issue in the thumb
UCL injury Gamekeeper’s or Skiers thumb
36
extension active range of motion and passive in the MCP jts (2-5)
Ext: 30 - 40 AROM; 90 PROM (large difference)
37
flexion in the MCP joints (2-5)
Flex: 90 deg. index; progressive increase to 110 at 5th digit
38
thumb MCP felxion
Flexion 50 degrees; Extension 0 degrees
39
closed packed position for MCP joint
full flexion
40
open packed for MCP
slight flexion
41
IP vex and cave
Distal: bi-convex head Proximal: bi-concave base
42
IP are what kind of joint
hinge or bicondylar
43
movement seen at IP
Transverse axis results in flex/ext
44
PIP - Volar Plate
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
PIP transverse ligament
this is none
46
PIP flexion
Flexion 110 degrees, more at 5th than 2nd. Thumb 90 degrees.
47
PIP extension
Extension limited, except thumb IP up to 50 degrees.
48
DIP flexion and extension
Flex. 90 degrees with ulnarward increase; hyperext up to 30 degrees
49
what side produces a tighter grip the ulnar or the radial side
ulnar side
50
Closed / Open Pack: all (PIP and DIP)
Closed: full ext Open: slight flexion
51
where do we see OA more DIP or PIP
PIP
52
when does OA increase
with age and in women
53
Joints of the Digits vasculature
Digital aa
54
joints of the digits Innervation
Digital nn
55
Flexors of the fingers
Flexor Digitorum Superficialis (FDS) and Profundus (FDP) Flexor Pollicis Longus (FPL)
56
Extensors of the fingers
Extensor Digitorum (ED) Extensor Digiti Minimi (EDM) Extensor Indicis (EI) Extensor Pollicis Brevis (EPB) Extensor Pollicis Longus (EPL) Abductor Pollicis Longus (APL)
57
FDS action
Flexes PIP Power grip muscle FDS can flex wrist and MCP when PIP is fully flexed
58
FDP actions
Only tendon to insert on distal phalanx Function DIP flexion FDP help with PIP ,MCP and wrist flexion Origin of lumbrical muscles
59
FPL action
Flex IP Ineffective as IP flexor during wrist flexion
60
APL action
Abd the CMC, radially deviates wrist
61
EPB action
Same as APL and extend MCP
62
EPL action
Extends IP Extends MCP, ext CMC joint Can’t extend IP with wrist, CMC, & MCP extended
63
ED
Pass beneath Ext Retinaculum / Sheaths/ No pulleys – Almost all extrasynovially ONLY muscle capable of extending MCP CANNOT extend PIP & DIP alone
64
EI & EDM action
Independent control 2nd & 5th
65
Extensor Mechanism
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
Mallet finger
Rupture at the terminal extensor tendon or bony avulsion at its attachment into distal phalanx
67
Swan-neck Deformity
hyperextended PIP, flexed DIP Superior subluxation of lateral bands
68
Boutonniere Deformity:
flexed PIP, hyperextended DIP Injury to the central slip with inferior subluxation of lateral bands
69
thenar compartment
the bulk of muscle tissue over the thumb side of the palm and contains 3 thenar muscles.
70
hypothenar compartment
the bulk of muscle tissue over the pinky side of the palm and contains 3 hypothenar muscles.
71
central compartment
lies in between, and mostly contains your extrinsic flexor tendons plus the intrinsic lumbrical muscles.
72
the adductor compartment
lies deep to the central and hypothenar compartments and just contains 1 muscle, the adductor pollicis.
73
Intrinsic Thenar (Thumb) Muscles
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
AbPB innervation
median n.
75
FPB - Two heads innervation
Lateral or superficial (median n.) inserts with AbPB assisting Abd. Medial or deep (ulnar n.) inserts with AdP assisting Add.
76
OP innervation
medial nerve
77
OP action
Only intrinsic thenar to insert on 1st metacarpal Effective in positioning metacarpal in abd, flex and rotation
78
Adductor Pollicis innervation
deep ulnar nerve
79
Adductor Pollicis action
has two heads (oblquie and trnasverse) Thumb adduction Stabilizes thumb against opposed finger
80
Hypothenar Muscles
Abductor Digiti Minimi Flexor Digiti Minimi Opponens Digiti Minimi
81
Hypothenar Muscles innervation
Deep branch ulnar n
82
Lumbricals attachments
Proximal: FDP tendons Distal: lateral bands of extensor mechanism
83
Lumbricals innervation
Two nerves (1,2-median; 3,4-ulnar)
84
lumbrical action
Extend IPs and flex MCP
85
Interossei innervation
deep branch of the ulnar nerve
86
mnomics Interossei
DAB – Dorsal ABduct PAD – Palmar ADduct Both help lumbricals
87
MCP Joint in Extension and interossi movement
Mechanical advantage for Abd/Add
88
MCP Joint in Flexion and interossei movment
movement in abd and ad is restricted

Anatomy UE (11 decks)

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