Hand

Question 1

What can you find under skin on dorsal side of hand?

Answer 1

Superficial radial nerve, dorsal branch ulnar nerve, dorsal interossei

Question 2

Wrist Bones

Answer 2

So Long to Pinky,
Here comes the thumb

Palmar View

Proximal: Scaphoid, Lunate, Triquetrum, Pisiform
Distal: Hamate, Capitate, Trapezium, Trapezoid

Question 3

Most common hand fracture?

Answer 3

Scaphoid: falls on base of palm forcing capitate into scaphoid.

Question 4

Only two wrist bones to articulate with radius?

Answer 4

Scaphoid and lunate

Question 5

Metacarpals

Answer 5

5 bones numbered from lateral - medial

Common characteristics: base articulates with the carpal bones; linear shaft; rounded head

Question 6

Phalanges

Answer 6

14 bones
2 in thumb (proximal and distal)
3 in digits 2 to 5 (proximal, middle, and distal)
Each bone has a base (proximal), shaft and head (distal)

Question 7

What cutaneous regions does the median nerve inervate in hand?

Answer 7

Palmar: Thumb, first 2.5 fingers
Dorsal: tips of same fingers

Question 8

What cutaneous regions does the ulnar nerve inervate in hand?

Answer 8

Palmar: last 1.5 fingers
Dorsal: Same area plus first half of middle finger

Question 9

What cutaneous regions does the radian nerve inervate in hand?

Answer 9

Dorsal: Thumb to middle finger but only halfway up fingers

Question 10

Dermatomes in hand

Answer 10

C6 - Thumb
C7 - 2 -3
C8 - 4-5

Question 11

Palmar Aponeurosis

Answer 11

Thick layer of fascia in palm of hand attached to palmaris longus

Question 12

Dupuytren’s Contracture

Answer 12

Progressive fibrosus producing abnormal bands of fibrous tissue from aponeurosis to bases of phalanges, pulling digits into marked flexion. Cannot open hand completely.

Question 13

Synovial Sheaths

Answer 13

Go around tendons to help slide through hand. Flexor digitorum sheath: escases profundus and superficialis

Question 14

Borders of Carpal Tunnel

Answer 14

Posterior: carpal bones.
Anterior: flexor retinaculum.

Question 15

Contents of Carpal tunnel

Answer 15

Flexor digitorum superficialis (4 tendons)
Flexor digitorum profundus (4 tendons)
Flexor pollicis longus
Median Nerve

Question 16

Causes of carpal tunnel syndrome

Answer 16

Fluid retention
Infection
Excessive exercise

Question 17

Effects of Carpal Tunnel syndrome

Answer 17

Thenar wasting, sensory loss

Question 18

What are the Thenar muscles?

Answer 18

“OAF”
Oponens policis
Abductor policis brevis
Flexor Policis Brevis
Innervated by recurrent median nerve in thumb side
Innervated by recurrent Ulna nerve in pinky side

Question 19

Lumbricals

Answer 19

Flex the hand while extending proximal and distal interphalangeal joints

Question 20

What inervates lumbricals?

Answer 20

1-2 median, 3-4 ulnar

Question 21

Where do lumbricals originate?

Answer 21

Profundus tendon

Question 22

Extensor Expansion

Answer 22

Common “hood” which aids in extension of fingers

Receives extensor digitorum, interossei, and lumbrical tendons.

Question 23

Dorsal Interossei

Answer 23

Go between bones on dorsal and Palmar Group
Dorsal: DABS - Dorsal ABdcut (4 of them, 4 letters) move fingers away from midline
Palmar: PAD (3) ADDuct (3 letters) move fingers back to midline

Question 24

Ulnar or radial artery deep in hand?

Answer 24

USRD

Radial deep

Question 25

What fingers does only radial a. supply

Answer 25

Thumb and lateral side of index

Question 26

Which artery is in canal of Guyon?

Answer 26

Ulnar

Question 27

What does median nerve inervate in hand?

Answer 27

``` 1/2 LOAF 1-2Lumbercals Oponens policis Abductor policis brevis Flexor Policis Brevis ALL OTHER MUSCLES IN HAND DONE BY ULNAR NERVE ```

Question 28

Most dommonely dislocated bond in wrist?

Answer 28

Lunate

Question 29

Why is adduction spared in carpal tunnel?

Answer 29

Adductor policis is inervated by the ulnar nerve

Question 30

OAF Iintrinsic or extrinsic?

Answer 30

Intrinsic

Question 31

What side of digits to lumbricals insert on?

Answer 31

Lateral

Question 32

Ulnar artery branches in hand

Answer 32

Superficial Palmar Arch - Anastamose swith superficial branch of radial artery. Deep branch - Passes between abductor digiti minimi and flexor digiti minimi Anastomoses with deep palmar arch

Question 33

Radial artery branches in hand

Answer 33

Superficial Palmar – branches off radial before wraps around the lateral carpals, passes through thenar muscles to anastamose with superficial palmar arch. Deep Palmar Arch - Continues through palm as the deep palmar arch, anastamosing with deep branch of ulnar a.

Question 34

Venous return from fingers

Answer 34

Follows superficial palmar arch to ulnar vein.

Question 35

2. Deep venous arcades

Answer 35

Follow deep palmer arch to radial vein.

Question 36

Does Entire median nerve go through carpal tunnel?

Answer 36

Palmar cutaneous branch does not! Provides feeling to skin

Question 37

Lumbricals below or on top of interosseous?

Answer 37

On top - palmar side