Hand Flashcards
(28 cards)
Describe the surface anatomy of the hand
- tendons
- creases and associated joint
- ligaments
Extensor digitorum on fingers
EPL, EPB and APL tendon around anatomical snuffbox
Distal radioulnar crease => midcarpal joint
Proximal radioulnar crease => radiocarpal joint
Distal phalangeal crease => DIP joint
Middle phalangeal crease => PIP joint
Under proximal phalangeal crease => MCP joint
Phalangeal crease on thumb => IP joint
MCP, PIP, DIP have collateral ligaments
Name the 4 proximal carpal bones
Name the 4 distal carpal bones
Name the bones in the mid hand
Name the bones in the forehand
From thumb => little finger Scaphoid Lunate Triquetrum Pisiform (under triquetrum
Trapezium
Trapezoid
Capitate
Hamate (hook)
5 metacarpals
Thumbs
-proximal, distal phalanges
Fingers
-proximal, medial, distal phalanges
Name the wrist bones and their articulations
Radius
Proximal row of carpals
NOT THE ULNA
What movements is the thumb capable of
Abduction, adduction
Extension, flexion
Opposition, reposition
Name the 5 extrinsic hand flexors
Flexor carpi radialis (ant sup) Flexor carpi ulnaris (ant sup) Flexor digitorum superficialis (ant int) Flexor digitorum profundus (ant deep) Palmaris longus (ant sup)
All arise from med epicondyle
Describe the location of the median and ulnar nerve in the wrist
Radius <=> ulnar
FCR Median PL
Ulnar FCU (the most medial tendon)
Name the 2 extrinsic muscles involved in finger flexion
Flexor digitorum profundus
Flexor digitorum superficialis
What are the
- attachments
- innervations
- actions of the finger flexors
- flexor digitorum profundus
- flexor digitorum superficialis
Flexor digitorum profundus
- Ulna, IOM => DP fingers
- MCP, DIP, wrist flexors
- Medial half => ulnar
- Lateral half => median
Flexor digitorum superficialis
- Med epicondyle => MP of fingers
- MCP, PIP, wrist flex
- Median
Name the 5 posterior superficial extrinsic hand extensors
Name the 4 posterior deep extrinsic hand extensors
Extensor digitorum (4 fingers) Extensor digiti minimi (little finger) Extensor carpi ulnaris (MB5) Extensor carpi radialis longus (MB2) Extensor carpi radialis brevis (MB3)
Abductor pollicis longus
Extensor pollicis longus
Extensor pollicis brevis
Extensor indicis
Name the 5 hand compartments and the muscles associated with them
Central (lumbricals) Hypothecate Interosseous (between metacarpals) Adductor comp (adductor pollicis) Thenar (base of thumb)
Name the 3 thenar muscles
Opponens pollicis
Abductor pollicis brevis
Flexor pollicis brevis
What are the
- attachments
- innervations
- actions of the thenars
- opponens pollicis
- Abductor pollicis brevis
- flexor pollicis brevis
Opponens pollicis
- Trapezium => MI
- Opposition
- Median
Abductor pollicis brevis
- Scaphoid, trapezium => PPI
- Abduction
- Median
Flexor pollicis brevis
- Trapezium => PPI
- MCPI flexion
- Median
Name the 3 hypothenar muscles
Opponens digiti minimi
Abductor digiti minimi
Flexor digiti minimi brevis
What are the
- attachments
- actions
- innervations of the hypothenars
- opponens digiti minimi
- abductor digiti minimi
- flexor digiti minimi brevis
Opponens digiti minimi
- Hamate => MP5
- Opposition
- Ulnar
Abductor digiti minimi
- Pisiform => PP5
- Abducts
- Ulnar
Flexor digiti minimi brevis
- Hamate => PP5
- MCP flex
- Ulnar
Describe the
- attachments
- innervation
- actions of the
-lumbricals
- FDP tendon => PP of fingers
- MCP flex, IP extension
- F2, 3=> median
- F4, 5 => ulnar
Name the 2 interossei muscles
Dorsal interossei
Palmar interossei
Describe the
- attachment
- actions
- innervations of the interossei
- dorsal interossei
- palmar interossei
Dorsal interossei
- Lat and med MC => PP of fingers
- Abduct fingers at MCP
- Ulnar
Palmar interossei
- Lat and med MC => PP of fingers
- Adduct fingers at MCP
- Ulnar
How would you test the palmar interossei and dorsal interossei
Why would you do this
Palmar
- Place a piece of paper between the fingers
- Ask them to adduct as they try to pull the paper
Dorsal
-Ask them to abduct their fingers between theirs
Test the ulnar nerve
Describe the pathway of the
- median nerve
- ulnar nerve
- radial nerve
Median
-Carpal tunnel => thenar and finger II, III
Ulnar
-Guyon’s canal => hypothenar, finger IV, V, interosseous
Radius
-Radial side of wrist => dorsal sensory
Describe the arterial pathway from the forearm to the fingers
Radial, ulnar
Superficial and deep palmar arches
Digital arteries
Describe the superficial venous drainage
Describe the deep venous drainage from the hand
Superficial palmar arch => median and cephalic
Median => basilic => subclavian
Cephalic => Median cubital => basilic => subclavian
Cephalic => subclavian
Superficial and deep palmar arch => radial, ulnar => brachial
Describe the flexor tendons of the hand
What are they surrounded by
What does this allow for
FDP goes deeper in finger than FDS
Tendons surrounded by synovial sheath
Synovial sheath surrounded by angular fibrous digital sheath and crucial fibrous digital sheath
Synovial membrane and covering, covers tendon
Each one moves on synovial membrane
Tendons move independently within synovium
Describe the main types of injuries to the hand
Trauma
- avocado hand
- Friday night fracture (M5 fracture)
Wear and tear
Describe skiers thumb
What happens
What are the consequences of this
Ulnar collateral ligament of MCP I
-supports thumb in pinching and gripping
Damage => chronic instability
