Hand Flashcards by Steven Grapperhaus

Q

Thenar muscles (4)

A

Abductor Pol Brev
Opponens Pol
Flexor pol brev
Adductor pol

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Q

Hypothenar muscles (4)

A

Palmaris Brevis
Abductor digiti minimi
Flexor digiti minimi brevis
Opponens digiti minimi

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Q

Intrinsic hand muscles (3)

A

Lumbricals
Dorsal interosseous
Volatile interosseous

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Q

1st dorsal compartment (2)

A

Abductor pollicis longus
Extensor pollicis brevis

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Q

2nd dorsal compartment (2)

A

Extensor carpi radialis longus (ECRL)
Extensor carpi radialis brevis (ECRB)

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Q

3rd dorsal compartment (1)

A

Extensor pollicis longus (EPL)

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Q

4th dorsal compartment (2)

A

Extensor digitorum communis (EDC)
Extensor indicis propius (EIP)

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Q

5th dorsal compartment (1)

A

Extensor digiti minimi (EDM)

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Q

6th dorsal compartment (1)

A

Extensor carpi ulnaris (ECU)

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Q

1DC: Anatomic considerations (2)

A

EPB tendon is ulnar to abductor PL (APL)
APL may have multiple tendon slips, which should be addressed for release of…

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Q

1DC pathology

A

Duquervain tenosynovitis

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Q

2DC pathology

A

Extensor tendinitis (intersection syndrome)

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Q

3DC pathology (2)

A

EPL rupture at Lister’s after wrist fx
Drummer’s tendinitis of the wrist

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Q

4DC pathology

A

Extensor tenosynovitis

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Q

5DC pathology

A

Vaughn-Jackson syndrome (RA; rupture of EDM)

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Q

6DC pathology

A

Snapping at ulnar styloid

Q

Abd pol brev

Origin
Insertion
Action
Innervation

A

Origin: Scahpoid, trapezoid

Insertion: base of proximal phalanx, radial side

Action: abducts thumb

Innervation: median nerve

Q

Opponens pollicis

Origin
Insertion
Action
Innervation

A

Origin: trapezium

Insertion: thumb metacarpal

Action: abduction, flexion, medial rotation

Innervation: median nerve

Q

Flexor pollicis brevis

Origin
Insertion
Action
Innervation

A

Origin: Trapezium, capitate

Insertion: base of thumb P1, radial side

Action: thumb MCP flexion

Innervation: median, ulnar

Q

Adductor pollicis

Origin
Insertion
Action
Innervation

A

Origin: Capitate, second/third metacarpals

Insertion: base of thumb P1, ulnar side

Action: adduct thumb

Innervation: ulnar nerve

Q

Palmaris brevis

Origin
Insertion
Action
Innervation

A

Origin: TCL, palmar aponeurosis

Insertion: ulnar palm

Action: retract skin

Innervation: ulnar nerve

Q

Abductor digiti minimi

Origin
Insertion
Action
Innervation

A

Origin: Pisiform

Insertion: base of SF P1, ulnar side

Action: abduct SF

Innervation: ulnar nerve

Q

Flexor digiti minimi brevis

Origin
Insertion
Action
Innervation

A

Origin: Hamate, TCL

Insertion: Base of SF P1, ulnar side

Action: Flex SF MCP

Innervation: Ulnar nerve

Q

“Hand” muscles are grouped into (3)

A

Thenar
Hypothenar
Intrinsic

Opponens digiti minimi Origin Insertion Action Innervation

Origin: Hamate, TCL Insertion: SF MC Action: Abduct, flex, rotate laterally Innervation: Ulnar nerve

Lumbricals Origin Insertion Action Innervation

Origin: Flexor digitorum profundus Insertion: Lateral bands (radial) Action: PIP extension Innervation: median and ulnar nerves

Dorsal and volar interossei Origin Insertion Action Innervation

Origin: Adjacent metacarpals Insertion: base of P1/extensor apparatus Action: Volar: adduction and MCP flexion, Dorsal: abduction and MCP flexion Innervation: Ulnar nerve

Four components of hand extensor mechanism

Saggital bands Transverse bands Lateral bands Oblique retinacular ligament (Landsmeer)

Saggital bands Attachments Significance

Attachments: Covers MCP joint Significance: Allows MCP extension

Transverse ligament of extensor apparatus Attachments Significance

Attachments: Volar plate fibers Significance: Allows MCP flexion (interossei)

Lateral bands Attachments Significance

Attachments: Covers PIP Significance: allows PIP extension (Lumbricals)

Oblique retinacular ligament (Landsmeer) Attachments Significance

Attachments: A4 pulley, terminal tendon Significance: Allows DIP extension (passive)

Carpal tunnel borders (4) Roof Floor Radial Ulnar

Roof: TCL Floor: Carpal bones Radial: Scaphoid tubercle/trapezium Ulnar: Hook of hamate

5 Superficial flexors, innervation?

PT PL FCR FCU FDS All median nerve except FCU (ulnar)

3 Deep flexors, innervation?

FDP FPL PQ AIN

7 Superficial extensors

Anconeus BR ECU ECR L ECR B ED EDM

5 Deep extensors, innervation?

Supinator Abductor pollicis longus Extensor pollicis longus Extensor pollicis brevis Extensor indicis proprius ALL PIN