Hand and Wrist 1

Question 1

Palmar aspect of hand

Hypothenar Eminence

Answer 1

3 Muscles

Flexor digiti minimi

Abductor digiti minimi

Opponens digiti minimi

Palmaris brevis

Question 2

Opponens pollicis

Answer 2

Origin: flexor retinaculum
scaphoid and trapezium

Insertion: 1st metacarpal

Axns: oppose thumb
medially rotate 1st metacarpal

Blood: radial artery

Nerve: recurrent branch of median nerve

Question 3

Abductor pollicis brevis

Answer 3

Origin: flexor retinaculum
scaphoid and trapezium

Insertion: base of proximal phalanx of thumb

Axns: abduct thumb
opposition

Blood: radial artery

Nerve: recurrent branch of median nerve

Question 4

Flexor pollicis brevis

Answer 4

Origin: flexor retinac.
scaphoid and trapezium

Insertion: base of prox. phalanx of thumb

Axn: flex thumb

Blood: radial artery

Nerve: recurrent branch of median nerve (superficial head)
Deep branch of ulnar nerve (deep head)

Question 5

Adductor pollicis (not in thenar eminence)

Answer 5

Origin: 2nd and 3rd metacarpal base
capitate and adjacent carpals

Insertion: base of prox. phalanx of thumb

Axns: adducts thumb toward lateral border of palm

Blood: radial artery

Nerve: deep branch of ulnar nerve

Question 6

Abductor digiti minimi

Answer 6

Origin: pisiform

Insertion: base of prox. phalanx of 5th digit

Axns: abducts 5th digit
flexion of 5th prox. phalanx

Blood: ulnar artery

Nerve: ulnar artery

Question 7

Flexor digiti minimi brevis

Answer 7

Origin: hook of hamate
flexor retinac

Insertion: prox. phalanx of 5th digit

Axns: flexes prox. phalanx of digit 5

Blood: ulnar artery

Nerve: deep branch of the ulnar nerve

Question 8

Opponens digiti minimi

Answer 8

Origin: hook of hamate
flexor retinac.

Insertion: 5th metacarpal

Axns: opposition of 5th digit to thumb
(anterior pull, rotates)

Blood: ulnar artery

Nerve: deep branch of ulnar artery

Question 9

Intrinsic (short) muscles

Answer 9

Lumbricals

Palmar interossei

Dorsal interossei

Question 10

1st and 2nd Lumbricals

Answer 10

attached to lateral 2 tendons of FDP

Median nerve

Blood: radialis indicis artery

Superficial palmar arch (ulnar ar)

Question 11

3rd and 4th lumbricals

Answer 11

attach to medial 3 tendons of FDP

Deep branch of ulnar nerve

Blood: superficial palmar arch (ulnar artery)
dorsal carpal arch ( ulnar and radial artery)

Insert on lateral sides of the extensor expansions of digits 2-5

Flex MCP joint

Extend IP joint

Extensor hood

Question 12

Palmar Interossei

Answer 12

3 muscles

Origin: palmar surface of 2, 4, 5 metacarpals

Insertion: base of prox. phalanges/extensor hoods of digits 2, 4, 5

PAD: adduct 2, 4, 5 fingers toward axial line: assist lumbricals

Blood supply from radial and ulnar artery

Innervated by deep branch of ulnar nerve

Question 13

Dorsal Interossei

Answer 13

4

Origin: adjacent sides of 2 metacarpals

Insertion: bases of prox. phalanges and exensor hood of 2-4 digits

DAB: abduct 2-4th fingers toward axial line: assist lumbricals

Blood: radial a mainly: some ulnar

Nerve: deep branch of ulnar nerve

Question 14

Dupuytren’s Contracture

Answer 14

Progressive shortening and thickening of palmar fascia

pulls 4th and 5th digit into partial flexion

hereditary

Question 15

Fascial compartments of Hand and Wrist

Answer 15

Hypothenar

Thenar

Central

Adductor

Interosseous

Question 16

Long Flexor Tendons & Synovial Sheaths:

Long tendons of:

Flexor Digitorum superficialis

Flexor Digitorum Profundus

Answer 16

enter common flexor sheath (ulnar bursa) beneath flexor retinaculum

4 tendons of each enter individual synovial sheath

synovial sheath for digit 5 continuous w/ ulnar bursa

long tendon of flexor pollicis longus has a synovial sheath separate from ulnar bursa

Question 17

Tensosynovitis

Answer 17

Infections in digital synovial sheath

Inflammation of tendon and sheath

5th digit infection can spread to carpal tunnel and forearm (sheath continuous w/ ulnar bursa)

Question 18

Abduction & Adduction of fingers and thumb

Answer 18

toward the middle digit

Question 19

Palmar aspect of Hand:

Thenar Eminence

Answer 19

Abductor pollicis brevis

Flexor pollicis brevis : deep and superficial head

Opponens pollicis

Adductor pollicis: transverse and oblique head

Question 20

Power grip

Answer 20

Flexor digitorum profundus

Question 21

Movements of the thumb

Answer 21

Abduction

Adduction

Extension

Flexion

Opposition

Reposition

Question 22

Innervation of the Hand (motor)

Superficial branch of Ulnar Nerve

Answer 22

Hypothenar muscles (5th digit)

3rd and 4th lumbricals

Palmar interosseous muscles (1-4)

Dorsal interosseous muscles (1-3)

Some pollicis brevis

Question 23

Innervation (motor)

Deep branch of the Ulnar Nerve

Answer 23

Adductor pollicis (transverse and oblique head)

Deep portion of flexor pollicis brevis

Question 24

Innervation:

Recurrent Branch of Median Nerve

Answer 24

Thenar muscles (1st digit)

(except deep portion of flexor pollicis brevis)

1st and 2nd lumbrical muscles

Question 25

Innervation of the Hand (sensory distribution)

Answer 25

INSERT PIC on website

Question 26

Median Nerve

Answer 26

Deep to palmar aponeurosis Recurrent branch: very superficial = easily injured innervates thenar eminence AND Palmar aspect of 1-3 digits and palm

Question 27

Carpal Tunnel Syndrom

Answer 27

Transverse carpal ligament medial to thenar eminence pinches down on median nerve released by cutting transverse carpal ligament

Question 28

Blood supply to forearm and hand (review) Anterior Forearm:

Answer 28

Ulnar artery Anterior interosseous artery

Question 29

Blood Supply: Posterior Forearm

Answer 29

Radial artery recurrent interosseous artery posterior interosseous artery ulnar artery

Question 30

Superficial Palmar Arch

Answer 30

Ulnar artery gives rise to common digital arteries which become proper palmar digital arteries

Question 31

Deep Palmar Arch

Answer 31

Radial artery gives rise to pinceps pollicis artery which gives rise to radialis indics artery

Question 32

Dorsal Carpal Arch

Answer 32

Dorsal aspect of hand Gives rise to dorsal metacarpal arteries normally has contribution from anterior interosseous artery

Question 33

Thenar Eminence (thumb)

Answer 33

3 muscles abductor pollicis brevis flexor pollicis brevis (superficial and deep head) Opponens pollicis also adductor pollicis oblique and transverse head

Question 34

Hypothenar Eminence (under pinky)

Answer 34

3 muscles flexor digiti minimi abductor digiti minimi opponens digiti minimi palmaris brevis is superficial