Hand Flashcards by Toni Carter

At the MCP what kind of movements can occur in digits 2-5?

What about for the thumb?

Where does the other action occur for the thumb?

•For digits 2-5: flexion/extension and abduction/adduction

Thumb:•For the thumb (digit 1): only flexion and extension occur at the MCP joint-opposition and ab- and adduction occur at the carpo-metacarpal joint

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Label

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Red?

Green?

Yellow?

Red- cephallic

green- basillic

yellow- dorsal venous network

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What is yellow?

extensor retinaculum

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Extensor retinaculum is a thickening of the_____ ____that holds in place the ____ passing from the forearm into the hand. The ER attaches to the ____ ___ and ____ to create 6 compartments (_____) for the tendons passing over the _____ of the wrist

antebrachial fascia

tendons

distal radius and ulna

tunnels

dorsum

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_____ ___ ___ cover the tendons that go to the ___ to reduce friction

synovial tendon sheaths

digits

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Extendor retinaculum creates _____ ____ on the back of the ____ through which certain specific tendons run together or alone through. The individual compartments may become inflamed and cause disease states.

dorsal compartment

wrist

tendons

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label 1-8

Compartment 1: Abductor pollicis longus and extensor pollicis brevis
Compartment 2: Extensor carpi radialis longus and brevis
Compartment 3: Extensor pollicis longus
Compartment 4: Extensor digitorum and extensor indicis
Compartment 5: Extensor digiti minimi
Compartment 6: Extensor carpi ulnaris

7 Radius

8 Ulna

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The extensor tendons from the forearm fan out from wrist to the digits and ____ to form ____ ____ ____(extensor expansions, extensor hoods). The extensor expansions Form a hood that wraps around the sides of the ___ ___. This allows more muscles to help control the digits.

flatten

dorsal digital expansions

MCP joint

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The extensor hood Inserts onto the___ &____ ____ via median and 2 lateral ___. The hood is reinforced by _____ and _____ ___ of the ____, which connect to the lateral bands and assist in _____ of ____ joints

iddle and distal phalanges

bands

lumbrical

interosseous muscles

palm

extension

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The ____ muscles will help regulate and pull the dorsal digital expansion tight so that when it is pulled the interphalangial joint will be _____

lumbrical

extended

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Traumatic finger injuries can cause rupture of the ______ _____ tendon at the distal ____, which prohibits extension of the ____ joint. If this happens, unopposed action of ____ _____ ___ produces “____ ____” in which the distal phalanx remains ________. (like a constant dino finger)

extensor digitorum tendon

distal phalanx

DIP

flexor digitorum profundus

mallet finger

flexed

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Deep fascia over the central palm forms a tough, thickened _____ _____. Right under this, there is the ____ ___ ___ that gives rise to blood vessels that will supply the digits.

Flanking the palmar aponeurosis at the base of the thumb you have the _____ ____ and on the side of the 5th digit, you will have the _____ ____. These are separated by a _____ ____.

palmar aponeurosis

superficial palmer arch

thenar eminence

hypothenar eminence

central concavity

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____ ______ is a disease of the palmar fascia resulting in progressive shortening and thickening of the ____ ____. Nodular like structures can be formed at the base of each digit due to this disease.

Dupuytren contracture

palmer aponeurosis.

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red

yellow

green

blue

R- extensor expansions

Y- interosseous muscles

G- Extensor tendon

B- lumbrical muscle

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label 1-10

palmar aponeurosis
midpalmer space
medial fibrous septum to 5th metacarpal
hypothenar fascia
5th metacarpal
thenar space
thenar fascia
1st metacarpal
1st dorsal interosseous
adductor pollicis

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Extrinsic vs intrinsic muscles of the hand?

intrinsic muscles start and end in the hand

extrinsic muscles may originate somewhere else

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The palmar aponeurosis and deep palmar fascia divide the palm into 5 muscular compartments, what are they?

thenar
hypothenar
central
adductor
interosseous

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The main supply to innervation of intrinsic muscles of the hand is the ____ ___, however, the ____ muscles are an exception as they are innervated byThe ___ _____ branch of the ____ ___.

ulnar nerve

thenar muscle

reccurent motor branch of the median nerve

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The Thenar compartment contains the ____ ____ that ___, ___, and ___ the thumb. These muscles are Innervated by the ____ ____ ____ of the ___ ___. What are the muscles?

Thenar muscles

flex

adduct

oppose

recurrent motor branch of median nerve

Abductor pollicis brevis

Flexor pollicis brevis

•Opponens pollicis

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Tell me the following about Abductor pollicis brevis:

Compartment:

Action:

Proximal attachment:

Distal attachment:

Innervation:

C-thenar

A-abducts

PA- Flexor retinaculum, scaphoid, trapezium

DA- Base of proximal phalanx of thumb

Inner.: •recurrent motor branch of median nerve

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Tell me the following about Flexor pollicis brevis:

Compartment:

Action:

Proximal attachment:

Distal attachment:

Innervation:

Tell me the following about flexorr pollicis brevis:

Compartment: Thenar

Action: flexes thumb

Proximal attachment: •Flexor retinaculum, scaphoid, trapezium

Distal attachment: Base of proximal phalanx of thumb

Innervation:• recurrent motor branch of median nerve

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Tell me the following about Opponens pollicis:

Compartment:

Action:

Proximal attachment:

Distal attachment:

Innervation:

Tell me the following about Opponens pollicis:

Compartment: thenar

Action: opposes thumb

Proximal attachment: •Flexor retinaculum, scaphoid, trapezium

Distal attachment: 1st metacarpal

Innervation:•recurrent motor branch of median nerve

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What is it

abductor pollicis brevis

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Name it

Flexor pollicis brevis

name

•Opponens pollicis

The Central compartment contains the ____ \_\_\_\_ ___ that ____ the digits and _____ that ___ &\_\_\_ the ___ of the digits. It also contains the Tendons of ___ \_\_\_ ___ and ___ as well as _____ (1-4).

forearm flexor tendons flex lumbricals flex and extend the joints flexor digitorum superficialis and profundus lumbricals

Lumbricals (1-4) are found in the central compartment. Describe the following: Action: Proximal attachment: Distal attachment: Innervation:

* Action: Flex metacarpophalangeal joints, extend interphalangeal joints of digits 2-5 * •Proximal attachment: Tendons of flexor digitorum profundus * •Distal attachment: Extensor expansions of digits 2-5 * Innervation: 1&2 are innervated by the medial nerve and 3&4 are innervated by the ulnar nerve

• Hypothenar compartment contains hypothenar muscles that \_\_\_\_, \_\_\_\_, and ____ the 5th digit. These muscles are innervated by the ____ \_\_ of ___ \_\_\_\_

flex, abduct and oppose 5th digit• Innervated by deep branch of ulnar nerve

What is in blue

lumbricals

What are the muscles in the hypothenar compartment? What are they innervated by?

•Flexor digiti minimi brevis abductor digiti minimi •Opponens digiti minimi deep branch of the ulnar nerve

Tell me the following about abductor digiti minimi Action: prox. attachment: distal attachment:

Abductor digiti minimi * Action: Abducts digit 5 * Proximal attachment: Pisiform * Distal attachment: Proximal phalanx of digit 5

Tell me the following about flexor digiti minimi brevis Action: prox. attachment: distal attachment:

* Flexor digiti minimi brevis * Action: Flexes proximal phalanx of digit 5 * Proximal attachment: Hook of hamate and flexor retinaculum * Distal attachment: Proximal phalanx of digit 5

Tell me the following about opponens digiti minimi Action: prox. attachment: distal attachment:

* Opponens digiti minimi * Action: Opposes 5th digit to thumb * Proximal attachment: Hook of hamate and flexor retinaculum * Distal attachment: 5th metacarpal

Adductor compartment contains the ____ \_\_\_ ___ that _____ the thumb. It has a ___ head and a ____ head.

adductor pollicis muscle adducts oblique transverse

What is the action of adductor pollicis? Proximal attachment of each head? distal attachment? What innervates?

* Adductor pollicis * Action: Adducts thumb * Proximal attachment: –Oblique head: Base of 2nd and 3rd metacarpals and capitate –Transverse head: Base of 3rd metacarpal •Distal attachment: Proximal phalanx of digit 1 Innervation: ulnar nerve

The interosseous compartment contains interossei muscles that ____ and _____ \_\_\_ \_\_\_. What are these muscles called?

abduct and adduct digits 2-5 palmer interossei dorsal interossei

The Dorsal interossei (1-4) will work the ____ digits \_\_\_-\_\_\_. What are the proximal and distal attachments?

Abduct digits 2-4 (“DAB”: Dorsal ABduct) * Proximal attachment: Adjacent sides of 2 metacarpals * Distal attachment: Base of proximal phalanges and extensor expansions of digits 2-4

The Palmar interossei (1-3) will work to _____ digits \_\_, \_\_, and \_\_. What are the proximal and distal attachments?

Adduct 2,4,5 * Proximal attachment: 2nd, 4th, 5th metacarpals * Distal attachment: Base of proximal phalanges and extensor expansions of digits 2, 4, 5

The _____ and _____ spaces are potential spaces deep in the palm between the long flexor tendons and the fascia over the deep palmar muscles. The midpalmar space is continuous with the anterior forearm via the ____ \_\_\_\_

Thenar and midpalmar spaces carpal tunnel

The carpal tunnel is located on ____ wrist. The\_\_\_\_ \_\_\_\_form the floor and sides of the tunnel; ____ \_\_\_\_ forms the roof.

anterior Carpal bones flexor retinaculum

The carpal tunnel allows for the passage of the tendons of ____ \_\_\_\_ \_\_\_, ____ \_\_\_ _____ and \_\_\_\_, and the ___ \_\_\_\_

•Tendons of flexor pollicis longus, flexor digitorum superficialis and profundus, along with the median nerve, pass through the tunnel

A ____ \_\_\_\_ ____ \_\_\_\_ ____ encloses the flexor tendons as they pass through the carpal tunnel

common flexor synovial tendon sheath

The carpal tunnel is defined by ____ \_\_\_ and \_\_\_- boundaries and can be compromised by _____ of its contents, infiltration of fluid from \_\_\_\_\_, or _____ of a dislocated ___ \_\_\_\_. The ____ \_\_\_\_ is the most sensitive to increased pressure and signs of ____ \_\_\_\_ \_\_\_\_; this reflects the nerve’s distribution and leads to ____ or\_\_\_\_ on the palmar surface of the lateral 3 ½ digits.)

inflexible fascia bony swelling infection protrusion carpal bone median nerve carpal tunnel syndrome (tingling or weakness

The ____ \_\_\_ (\_\_\_ \_\_\_) is a narrow passageway on the medial side of the anterior wrist. The _____ \_\_\_\_forms the floor; ____ \_\_\_\_ ___ forms the roof. ___ and ____ form medial and lateral borders. The ____ \_\_\_\_ and ____ \_\_\_\_ through the tunnel into the palm of the hand

Ulnar tunnel (Guyon’s canal) flexor retinaculum palmar carpal ligament pisiform hamate Ulnar artery and nerve pass

Compression of the ulnar nerve at the wrist affects innervation of most intrinsic hand muscles; notably, the ____ \_\_\_\_ ____ of digits \_\_&\_\_ are _______ and the ___ \_\_\_\_ are flexed (bc the ____ of these digits are innevated by the ulnar nerve). This is called ___ \_\_\_.

Metacarpo-phalangeal joints of digits 4 and 5 hyperextended interphalangeal joints lumbricals claw hand

If a pt is asked to make a fist, but digits 2&3 are extended at the ___ and ___ joints, this means there is ____ \_\_\_\_ damage at the ____ so _____ \_\_\_\_\_ \_\_\_\_(lateral half) and the ____ \_ ____ aren't working. this is called the ___ of \_\_\_\_.

IP & MCP median nerve elbow flexor digitorum profundus lateral 2 lumbricals hand of benediction

The ____ & _____ arteries provide blood supply to the hand. The ulnar artery enters the hand via ____ \_\_\_ ( ___ \_\_\_ ), lying ____ to the ulnar nerve. It gives rise to a deep palmar branch and continues as the superficial palmar arch; the arch gives rise to __ \_\_\_\_ _____ \_\_\_\_ ____ that will come down and split at each digit as ___ \_\_\_ ___ \_\_\_ and supply the digits

ulnar and radial Guyon’s canal (ulnar canal) lateral deep palmar branch palmar arch 3 common palmar digital arteries proper palmar digital arteries

The Radial artery travels through the floor of the ___ \_\_\_ and enters the palm. The radial artery anatomoses with the ___ \_\_\_ of the ___ \_\_\_ to form the\_\_\_ ___ \_\_\_ which lies across the \_\_\_\_\_.The deep arch gives rise to 3 ____ \_\_\_ \_\_\_, _____ \_\_\_\_ \_\_\_, and ____ \_\_ \_\_\_.

anatomical snuffbox deep branch of the ulnar artery deep palmar arch metacarpals 3 palmar metacarpal arteries, princeps pollicis artery and radial indicis artery

The median nerve enters the hand via the ___ \_\_\_. Distal to the carpal tunnel, it supplies the muscles of the ___ \_\_\_ and the \_\_&\_\_ \_\_\_\_. It provides sensory innervation to the skin on the ___ \_\_\_ and ___ \_\_\_ of the ____ \_\_ \_\_\_, along with the ___ \_\_\_half of these digits.

carpal tunnel thenar compartment and the 1st 2 lumbricals lateral palm and palmar surfacelateral 3.5 digits dorsal distal

The ulnar nerve enters the hand via ____ \_\_\_\_ (\_\_\_\_ \_\_\_). It is proximal to the wrist, it gives rise to a ____ \_\_\_\_ ___ that supplies the skin on the medial palm. The\_\_\_\_ ___ \_\_\_\_ supplies the ___ \_\_\_of the dorsal skin of the hand and medial\_\_\_ \_\_\_.

Guyon’s canal (ulnar canal) wrist palmar cutaneous branch The dorsal cutaneous branch medial half 1 ½ digits.

The ulnar nerve terminates by splitting into a ____ and __ \_\_\_\_; the superficial branch supplies\_\_\_\_\_\_-branches to the _____ surface of ___ \_\_\_ __ while the deep branch supplies the ____ \_\_\_\_, \_\_\_&\_\_\_ \_\_\_\_\_, ____ \_\_\_, and ____ \_\_\_\_.

superficial and deep branch cutaneous anterior surface medial 1 ½ digits, hypothenar muscles, 3rd and 4th lumbricals, adductor pollicis and interossei muscles.

The radial nerve supplies NO ____ \_\_\_. Its superficial branch supplies ____ over the lateral aspect of the hand and dorsum of proximal parts of lateral\_\_\_ \_\_\_\_

hand muscles. skin 3 ½ digits

What is purple