hand and wrist anatomy

Question 1

how many phalanges are in the hand?

Answer 1

14 phalanges

- 2 seamoid bones (tumb)

Question 2

how many metacarpals are their?

Answer 2

5

Question 3

how many carpal bones are in the hand/wrist?

Answer 3

8

Question 4

what is the distal radius?

Answer 4

• forms small ulnar notch to acceps the ulnar head

- radial styloid process

Question 5

what is the distal ulna?

Answer 5

• ulnar styloid process arises from madial surface

- ulnear head

Question 6

What are the carpal bones?

Answer 6

• “Stop letting those people touch the cadaver’s hand”

- ScaphoidLunate Triquetrum Pisiform, Trapezium Trapezoid Capitata Hamate

Question 7

3 main muscle groupd in the hand and wrist?

Answer 7

• flexor group on anterior side
• rotators on anterior side
• extensor on posterior side

Question 8

Wrist and hand muscle flexors? Originates?

Answer 8

• anterior/ palmer/ volar

- originate at medial epicondyle of elbow or proximal ulna and insert at hand

Question 9

flexors at the wrist and hand include? (5)

Answer 9

• flexor carpi radialis- flex
• flexor carpi ulnas- flex and adduct wrist
• palmaris longus- flexion
• flexor digitorum profundus- flex distal finger joints
• flexor digitorum superficialis- flex fingers

Question 10

extensor location and function?

Answer 10

• dorsal and posterior

- extend from lateral epicondyle of elbow and insert at the hand

Question 11

the extensor of the wrist and hand muscles include? (4)

Answer 11

• extensor carpi radialis longus- extend and abduct
• external carpi radialis brevis- extend and abduct
• external carpi ilnaris- extend and adduct
• external digitorum- extend fingers

Question 12

deep extensors function and originate?

Answer 12

• act on the thumb

- originate at ulna and radius and interosseous membrane

Question 13

deep extendors include? (3)

Answer 13

• abductor pollicis longus
• extensor pollicis brevis- extend prox phalanx thumb
• extensor pollicis longus- extend distal phalax

Question 14

dorsal aspect of wrist contents?

Answer 14

• extensor tendons

- ganglia- assess scapholunate ligament

Question 15

dorsal aspect of wrist 3 standard views?

Answer 15

• extensor compartments 3-6
• extensor compartments 1-2
• scapholunate ligament

Question 16

scapho lunate ligament distal to?

Answer 16

• listers tubercle

Question 17

lister’s tubercle on dorsal radius separates?

Answer 17

compartment 2 and 3

Question 18

whats the triangular fibrocartilage complex?

Answer 18

provides cushioning for movement of radiocarpal and ulnar joint spaces

Question 19

triangular fibrocartilage complex?

Answer 19

• provides cushioning for movement of radiocarpal and ulnar joint spaces

Question 20

longitudinal flexor and extensor tendons of the hand protocol?

Answer 20

• assessment of tendons- especially flexors
• assessment of metacarpal phalangeal and interphalangeal joints
• use real-time examination during flexion and extension of the fingers

Question 21

FDP tendon inserts into?

Answer 21

the base of the distal phalanx

Question 22

FSD tendon inters into?

Answer 22

middle phalanx

Question 23

what the snuff box?

Answer 23

• gap between extensors of tumb
• compartment 1 lies anteriorl y
• compartment 3 lies posteriorly
• radial atery lies in the floor
• radial styloid process is proximal
• base of 1st metacarpal is distal
• scaphoid and trapezium at floor

Question 24

where is snuff box best appreciated during extension and abduction?

Answer 24

the fossa is best appreciated during extension and abduction of the thumb

Question 25

rotators are responsible for?

Answer 25

- rotating the arm at the radioulnar joint

Question 26

pronator quadratus?

Answer 26

- distal ulna and distal radius - rotates arm medially - pronate hand

Question 27

tendon pulleys?

Answer 27

- fibrous sheaths that maintain the flexor tendons in place - prevent bowstringing during flexion of the finger - anular and cruciform parts

Question 28

tendon pulleys sono appearance?

Answer 28

- thin hyporeflective band at the anterior margin of the flexor tendons

Question 29

A2 pulley?

Answer 29

proximal phalanx pulley

Question 30

A4 pulley?

Answer 30

middle phalanx pulley

Question 31

function of pulleys?

Answer 31

tendons that run down our fingers are held in place by a series of ligaments called pulleys - arch over the tendons forming a "tunnel-like" sheath

Question 32

tendons =

Answer 32

stabilizers

Question 33

what holds the tendons in place on the bones?

Answer 33

- ligaments in a tunnel- like arrangement hold the tendons in place on the bones

Question 34

what is tenosynovium?

Answer 34

slippery coating, called tenosynovium, surrounds the tendons and keeps the tendons moving smoothly under the ligaments when the hand grasps objects.

Question 35

annular pulleys (A1-A5)?

Answer 35

prevent palmar tendon dislocation and allow optimal function

Question 36

what pulleys are generally not well demonstrated by ultrasound?

Answer 36

- cruciform pulleys

Question 37

where are collateral ligaments found?

Answer 37

- on each side of each joint on the fingers and thumb

Question 38

role of collateral ligaments?

Answer 38

- precent abnormal sideways bending

Question 39

flexor tendon?

Answer 39

- flexor aspect at metacarpo-phalangeal joint

Question 40

extensor tendon?

Answer 40

MCPJ with extension and flexion

Question 41

interphalangeal joint?

Answer 41

- long axis view of 2nd prox interphalangeal joint, flexor aspect - small quanitiy of fluid is normal

Question 42

median nerve?

Answer 42

can be seen in carpal tunnel and in cubital fossa of elbow

Question 43

ulnar nerve?

Answer 43

- can be seen medially in the wrist and posteriorly in the elbow

Question 44

radial nerve?

Answer 44

- can be seen (with difficulty) postero-laterally in wrist and antero-laterally in elbow

Question 45

contents of the guyon tunnel?

Answer 45

- ulnar nerve | - ulnar artery

Question 46

borders of guyon tunnel?

Answer 46

- TRV carpal lig./ flexor retinaculum: posterior - superficial palmar lig.: anterior - pisiform and hamate mediallu

Question 47

communicaition exists between the brances of the median nerve and ulnar nerve T or F

Answer 47

T

Question 48

radial nerve?

Answer 48

- radial aspect of the wrist | - crosses the 1st extendor compartment to reach the dorsal wrist

Question 49

radial nerve?

Answer 49

- radial aspect of the wrist | - crosses the 1st extendor compartment to reach the dorsal wrist