Hand and Wrist Flashcards

(44 cards)

1
Q

What are the bones of the hand?

A

Carpal bones (x8)
Metacarpals (x5)
Phalanges (2-3 in each digit)

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2
Q

What are the carpal bones called (lat to med)?

A

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

(Some Lover Try Positions That They Cant Handle)

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3
Q

What bones articulate at the wrist?

A

Radius with scaphoid&lunate (radiocarpal joint)

-no participation by ulnar

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4
Q

What strengthens the radiocarpal joint (ant and post)?

A

Radiocarpal ligaments

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5
Q

What is the function of the distal radio-ulnar joint?

A

Assists proximal radio-ulnar joint in pronation and supination of the hand

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6
Q

What are the movements of the wrist?

A
  • Adduction/abduction
  • Flexion/extension
  • Circumduction
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7
Q

Where are the radial and ulnar styloid processes?

A

On the dorsal surface of hand (lat/med)

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8
Q

What are the 6 extrinsic ant flexor muscles of the hand?

NB. all act on wrist joint

A
  • FCR
  • FCU
  • Palmaris longus
    (^^all common tendon)
  • Flexor digitorum superficialis (2 heads)
  • Flexor pollicis longus
  • Flexor digitorum profundus
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9
Q

Which nerves supply the extrinsic ant flexor muscles of the hand?

A

Median and ulnar nerves

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10
Q

What are the 8 extrinsic posterior extensor muscles of the hand?

A
  • Extensor carpi radialis longus
  • Extensor carpi radialis brevis
  • Extensor digitorum
  • Extensor carpi ulnaris
  • Extensor digiti minimi
  • Abductor pollicis longus
  • Extensor pollicis brevis
  • Extensor pollicis longus
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11
Q

Which nerve supplies the extrinsic posterior extensor muscles of the hand?

A

Radial nerve

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12
Q

What passes through the carpal tunnel? (4)

A
  • Flexor digitorum superificialis tendons (4)
  • Flexor digitorum profundus tendons (4)
  • Flexor pollicis longus tendon
  • Median nerve
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13
Q

What are the intrinsic muscles of the hand?

A
  • thenar muscles
  • hypothenar muscles
  • adductor pollicis
  • lumbricals
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14
Q

What nerve supplies the intrinsic muscles of the hand?

A

Ulnar nerve

EXCEPT thenar muscles and 1st & 2nd lumbricals - MEDIAN nerve

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15
Q

What are the thenar muscles? (3)

A
  • flexor pollicis brevis
  • opponens pollicis
  • abductor pollicis
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16
Q

What are the hypothenar muscles? (3)

A
  • opponens digiti minimi
  • flexor digiti minimi
  • abductor digiti minimi
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17
Q

What is the important of opponens pollicis?

A

Allows opposition of thumb - grip

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18
Q

Why are the lumbricals called “bye bye” muscles?

A

Attach to flexor and extensor tendons giving them dual function;

  • flexion at MCP joint
  • extension at IP joint
19
Q

How are thumb movements different from fingers?

A

Rotated 90*

  • flexion = putting thumb towards palm
  • abduction = moving thumb towards wrist
20
Q

What are the 3 main branches of the median nerve?

A
  • palmar cutaneous branch
  • recurrent branch
  • digital branch (after carpal tunnel)
21
Q

What does the palmar cutaneous branch of the median nerve innervate?

A

Sensory supply to lateral side of palm

22
Q

What does the recurrent branch of the median nerve innervate?

A

Motor to the thenar muscles

23
Q

What does the digital branch innervate?

A

Motor - 1st & 2nd lumbricals
Sensory - palmar lat 3 1/2
- dorsal dist lat 3 1/2

24
Q

What does the median nerve innervate altogether?

A

Sensory - lat 3 1/2 palmar
-dorsal dist lat 3 1/2
Motor - thenar muscles and lat 2 lumbricals

25
What are the medial and lateral attachments of the flexor retinaculum?
Medial - Pisiform and hook of hamate | Lateral - Scaphoid tuberosity and trapezium
26
What is compressed in carpal tunnel syndrome?
Median nerve
27
What are the symptoms of carpal tunnel syndrome? (3)
- Pins and needles in the cutaneous distribution of digital branches - Thenar atrophy & weakness - Inability to oppose thumb
28
How else is the median nerve damaged?
Lunate dislocation (FOOSH) - anterior
29
What are the 4 main branches of the ulnar nerve?
- Palmar branch - Dorsal branch - Suerficial branch - Deep branch
30
Where does the ulnar nerve pass in relation to the flexor retinaculum?
Superficial to flexor retinaculum | medial to median nerve
31
What does the palmar branch of the ulnar nerve innervate?
Sensory - medial palm
32
What does the dorsal branch of the ulnar nerve innervate?
Sensory - med dorsum and med 1 1/2 digits
33
What does the superficial branch of the ulnar nerve innervate?
Sensory - palmar med 1 1/2 digits | Motor - palmaris brevis
34
What does the deep branch of the ulnar nerve innervate?
Hypothenar muscles, adductor pollicis, interossei and 4th and 5th lumbricals
35
What is the innervation of the ulnar nerve?
Sensory - med 1 1/2 digits | Motor - hypothenar muscles, med 2 lumbricals, 7 interossei, adductor pollicis
36
What is Guyon's canal?
Tunnel superficial to medial flexor retinaculum.
37
What passes through Guyon's canal?
Ulnar nerve and artery
38
What is 'handlebar neuropathy' caused by?
Compression of the ulnar nerve at the wrist
39
What are the 3 clinical features of handlebar neuropathy?
- sensory loss to palmer lateral 1 1/2 digits - Motor weakness in the intrinsic muscles (except thenar eminence & lat 2 lumbricals) - Hyperextension of MCP joints of IV & V (paralysis of lumbricals)
40
What does the adductor compartment consist of?
Adductor pollicis | -ulnar nerve (C8, T1)
41
What does the central compartment consist of?
Flexor tendons and lumbricals
42
Where are the dorsal interossei?
Fill 4 spaces between the 5 digits | -mid finger has 2 tendons, II&IV have 1
43
Where are the palmar interossei?
1st: med of metacarpal II 2nd & 3rd: lat of IV/V metacarpal (NB. none on mid finger)
44
What is the function of the dorsal and palmar interossei?
DORSAL: -abduction -contraction pulls II &IV away PALMAR: -adduction -contraction draws II/IV/V towards III