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MSS - MSK Exam 2 > Hand > Flashcards

Hand Flashcards

1
Q

lots of pressure on digit 3 does what?

A

dislocates lunate

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2
Q

lots of pressure on digit 1 does what?

A

fracture of scaphoid

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3
Q

palmar surface

A

hairless, many sweat glads, transverse and longitudinal flexion creases

fingerprints - non-skid tread

looser skin

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4
Q

dorsal surface

A

loose skin with hair

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5
Q

superficial palmar fascia

A

thin layer
highly fibrous
bound tight to deep fascia

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6
Q

deep palmar fascia

A

continuous with deep fascia of antebrachium

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7
Q

webs in fingers?

A

important bc its the location of blood vessels and nerve

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8
Q

fascia distal to wrist?

A

becomes palmar carpal ligament (thicker)

-which is continuous to the transverse carpal ligament (flexor retinaculum)

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9
Q

what muscles attaches to palmar aponeurosis?

A

palmaris longus

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10
Q

superficial palmar aponeurosis

A

longitudinal orientation
-continuous proximally with the flexor retinaculum
and palmaris longus tendon

distally extends onto four lesser digits to attach to base of proximal phalanges and fuse with fibrous digital sheaths

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11
Q

dupuytrens contracture

A

thickening and contracture of longitudinal bands of palmar aponeurosis

fingers force to flexion

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12
Q

deep layer of palmar aponeurosis

A

transverse fibers continuous with thenar and hypothenar fascias, thicker distally

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13
Q

superficial transverse metacarpal ligament

A

unites longitudinal bands distal on their anterior surfaces assist in strengthening region of interdigital webs

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14
Q

fibrous digital sheaths

A

specializations of deep fascia anchored to margins of phalanges

form a fibro-osseous canal for passage of digital flexor tendons

prevent bowstringing of flexor tendons

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15
Q

synovial digital sheaths

A

located between fibrous sheath and accompanying tendon

-lubricate the fibrous digital sheath

fluid filled connective tissue bursa wrapped around tendons

each digit has own sheath

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16
Q

radial bursa

A

aka bursa of flexor pollicis longus tendon

extends from proximal to flexor retinaculum to distal attachment of flexor pollicis longus

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17
Q

ulnar bursa

A

aka common flexor bursa

surrounds tendons of long digital flexors
-flexor digitorum superficialis and profundus

extends from proximal to flexor retinaculum distally to tip of 5th digit

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18
Q

connective tissue septa?

A

from palmar neurosis to shafts of metacarpals delineating three compartments:
thenar, central, hypothenar

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19
Q

deeper transverse fascal plane?

A

fourth compartment:

-adductor inter-osseous compartment

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20
Q

plane of reference in hand?

A

digit 3

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21
Q

deep palmar space

A

between opposing fascias of central and adductor-interosseous compartment

extension of palmar aponeurosis to shaft of thid metacarpal divids this space into lateral palmar space and medial (mid-palmar space)

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22
Q

compartments of hand

A

thenar, hypothenar, central, adductor interosseous

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23
Q

in plane of palm?

A

adducted

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24
Q

out of plane of palm

A

abducted

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25
opposition what is moved?
metacarpals moving toward midline of hand -opponins muscles
26
hypothenar
digit 5
27
thenar
digit 1
28
muscles of thenar compartment
abductor pollicic brevis
29
attachments of abductor pollicis brevis
origin: flexor retinaculum, scaphoid, trapeqium insertion: ventral base of proximal phalanx of thumb laterally
30
action of abductor pollicis brevis
abducts thumb (with slight flexion of carpometacarpal joint) out of plane of thumb**
31
innervation of abductor pollicis brevis
median nerve (recurrent)
32
attachments of flexor pollicis brevis
origin: flexor retinaculum, trapezium insertion: lateral base of proximal phalanx of thumb
33
action of flexor pollicis brevis
flexion of thumb at carpometacarpal metacarpophalangeal joints
34
innervation of flexor pollicis brevis
superficial head - median nerve recurrent | deep head - deep branch ulnar nerve
35
order of muscles in thenar and hypothenar | -superficial to deep?
abductor, flexor, opponens
36
attachments of opponens pollicis
origin: flexor retinaculum, trapezium insertion: most of radial palmar border of first metacarpal
37
action of opponens pollicis
opposition of thumb
38
innervation of opponens pollicis
median nerve recurrent
39
what else is in thenar compartment?
tendon of flexor pollicis longus with radial bursa
40
muscles of the hypothenar compartment
abductor digiti minimi, flexor digiti minimi, opponens digiti minimi
41
attachments of abductor digiti minimi
origin: pisiform insertion: medial base of proximal phalanx of digiti minimi
42
action of abductor digiti minimi
abducts and flexes metacarpophalangeal joint of digiti minimi
43
innervation of abductor digiti minimi
ulnar nerve (deep branch)
44
attachments of flexor digiti minimi
origin: hamulus of hamate and flexor retinaculum insertion: medial base of proximal phalanx of digiti minimi (with abductor digiti minimi)
45
action of flexor digiti minimi
flexes digiti minimi at metacarpophalangeal joint
46
innervation of flexor digiti minimi
ulnar nerve (deep branch)
47
attachments of opponens digiti minimi
origin: hamulus of hamate insertion: medial border of fifth metacarpal
48
action of opponens digiti minimi
pulls fifth petacarpal towards thumb during opposition
49
innervation of opponens digiti minimi
ulnar nerve (deep branch)
50
contents of central compartment
**structures beneath the palmar aponeurosis superficial palmar arterial arch branches of ulnar/median nerve tendons and synovial linings of long flexors lumbricals
51
attachments of lumbricals?
origin: radial sides of flexor digitorum profundus tendons insertion: extensor expansion of extensor digitorum tendons
52
action of lumbricals?
flexes metacarpophalangeal joints and extends interphalangeal joints MP joint - on palmar side IP joint - on dorsal side
53
innervation of lumbricals?
median - 1 and 2 | ulnar - 3 and 4
54
lumbricals 1 and 2?
unipennate
55
lumbricals 3 and 4?
bipennate stronger
56
contents of adductor-interosseous compartment?
deep palmar arterial arch adductor pollicis palmar and dorsal interossei deep branch of ulnar arch metacarpals 2 3 4
57
attachments of adductor pollicis
origin: oblique head - capitate and bases of second and third metacarpals transverse head - palmar surface, shaft of third metacarpal insertion: ulnar surface, base of proximal phalanx of thumb
58
action of adductor pollicis
adducts thumb
59
innervation of adductor pollicis?
ulnar deep branch
60
attachments of palmar interossei
origin: interosseous surface of ulnar sides of 1st and 2nd metacarpal and radial side of metacarpal 4 and 5 insertion: sides of base of proximal phalanx and extensor expansion of digits 1, 2, 4, 5
61
actions of palmar interossesi
adducts 1, 2, 4, 5 | flex MP joint and extend IP joint of digit 1, 2, 4, 5
62
innervation of palmar interossei
ulnar nerve deep branch
63
deep head of flexor pollicis brevis?
considered an adductor of thumb by virtue of its deep position and by the fact that it is innervated by deep branch of ulnar nerve
64
attachments of dorsal interossei?
origin: adjacent sides of all metacarpals insertion: extensor expansions and sides of bases of phalanges 2, 3, 4
65
action of dorsal interossei?
abduct digit 2, 3, 4 | flex MP joint and extend IP joint digit 2, 3, 4
66
innervation of dorsal interossei?
ulnar nerve deep branch
67
two major arteries of arm
radial and ulnar enter palm and anastomose
68
anastomosis of radial and ulnar arteries?
superficial and deep palmar arch
69
superficial palmar arterial arch
anastomose of: superficial branch of radial artery ulnar artery (chief contributor) - under palmar aponeurosis - over flexor tendons - more distal and larger than deep arch at risk to get cut
70
deep palmar arterial arch
major contributor is radial artery (dorsal side of thumb) - sits on bones deep to flexor tendons on top of interossei muscles - continuous with deep branch of ulnar artery
71
how many arteries on glomus of fingers?
4 **why you bleed alot on your fingers
72
radial artery
courses through snuff box and goes to dorsum of carpal bones gives off dorsal carpal arch -then dives deep to first interossei muscle two heads
73
dorsal carpal arch
of radial artery -anastomoses with dorsal carpal branch of ulnar artery **won't see on body give rise to dorsal metacarpal arteries
74
dorsal metacarpal arteries
from dorsal carpal arch -two for every finger form proper dorsal digital arteries
75
deep palmar arterial arch
small, proximal, deep to tendons on the metacarpals and interossei muscles forms from radial artery continuation -branches princeps pollicis and radialis indicis anastomose with deep branch of ulnar artery
76
princeps pollicis
arises from radial artery
77
radialis indicis
variable - sometimes from radial artery (distal to princeps pollicis) or from princeps pollicis
78
branches from deep palmar arterial arch?
palmar metacarpal arteries (usually 3) anastomose with common palmar digital branches -from superficial palmar arterial arch
79
perforating branches
connect dorsal metacarpal arteries with palmar metacarpal arteries
80
ulnar artery
goes over flexor retinaculum lateral to pisiform forms the superficial palmar arterial arch
81
superficial palmar arterial arch
continuation of ulnar artery - gives rise to common palmar digital arteries - in webs branches to proper digital arteries
82
common palmar digital arteries
branch of superficial palmar arterial arch (3)
83
each finger receives how many arteries?
4
84
veins of fingers?
vena comitantes that accompany branches of radial and ulnar arteries in hand
85
cutaneous innervation of hand?
from C678
86
ulnar nerve
on top of bones next to ulnar artery passes under pisohamate ligament
87
median nerve
cutaneous - 1, 2, 3, lateral 4
88
ulnar nerve
cutaneous - medial 4, 5
89
median motor innervation?
**recurrent branch thenar and 1 2 lumbricals
90
ulnar nerve motor innervation
hypothenar muscles 3 4 lumbricals dorsal and palmar interossei ends at adductor pollicis and deep head of flexor pollicis brevis
91
branches of ulnar nerve
superficial - cutaneous (and palmaris brevis) | deep - follow deep palmar arterial arch
92
major innervation of forearm?
median
93
ulnar nerve
C8 T1
94
carpal tunnel what nerve?
median nerve
95
guyans tunnel
for ulnar nerve

MSS - MSK Exam 2 (13 decks)

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