Hand, Carpus Flashcards by Kelliane Tambe

movements of the wrist

abduction
adduction
extension
flexion
radial deviation
ulnar deviation

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joints of the wrist

Radiocarpal joint
Midcarpal
Plane joints between individual small
bones
Carpo-metacarpal joints 2-5
Carpo-metacarpal joint of the thumb
(first carpo-metacarpal joint)

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contents of radiocarpal joint and the type of joint (including its no. axes)

Synovial joint between
radius & proximal carpal row
Articular disc
Ellipsoid (condyloid)
2 axes + circumduction

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capsule of the radiocarpal joint attaches to..

at distal radius & ulna and around proximal carpal

bones

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ligaments that strengthen the capsule

Palmar and dorsal ligaments

- Radial & ulnar collateral lig.

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what type of joint is the first carp-metacarpal joint and in what direction does it move

saddle joint

2 axes

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most common carpal bone fracture

scaphoid fracture

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what percentage of scaphoid fractures cause absence of nutrients via supply?
what does this lead to?

13%

avascular necrosis

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lunate dislocation

separation of the lunate from both

the capitate and the radius.

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cause of lunate dislocation

from excessive pressure on to a
hyperextended wrist.
• e.g. a fall on an outstretched hand or
occur in a motor vehicle crash.

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dislocation of lunate carpal bones will effect which nerve

median nerve

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location of bennets fracture

First CMC (carpometacarpal) joint
Affects base of 1st metacarpal

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causes of bennets fracture

Caused by excessive abduction of 1st metacarpal

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bennets fracture

small fragment of 1st metacarpal, attached to anterior oblique ligament, continues to articulate with trapezium

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metacarpal phalangeal joint
location
type of joint
movement

metacarpal joint
ellipsoid joint - 2 axes
extension/flexion
abduction/adduction

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type of joint of a interphalangeal joint

hinge joint

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hand layers

skin and subcutis
deep fascia/palmar aponeurosis
superficial muscle layer
palmar spaces
deep muscle layer - adductor pollicis muscle, interossei

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shape of palmar aponeurosis

triangular shape
Apex of triangle is proximal
• Anchored to flexor retinaculum
• Palmaris longus 
divides into slips

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tendons and sheaths in palmar aponeurosis

• Fibrous flexor tendon sheaths
• Deep transverse metacarpal ligaments -
Across MC heads & MCP joints

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thenar eminence

Short muscles of the thumb

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attachment of thenar eminence

Attached to radial side of flexor

retinaculum & adjacent carpal bones

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innervation of thenar eminence

median nerve

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hypothenar eminence

Short muscles of the little finger

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attachment of hypothenar eminence

Attached to ulnar side of flexor

retinaculum & adjacent carpal bones

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innervation of hypothenar muscle

Ulnar nerve

name the 3 thenar muscles

Opponens Pollicis (1st MC) Abductor Pollicis Brevis (PP) Flexor Pollicis Brevis (PP)

muscles of the hypothenar muscles

Opponens Digiti Minimi (5th MC) Abductor Digiti Minimi (PP) Flexor Digiti Minimi (PP)

content of carpal tunnel

``` tendons of; flexor digitorum profundus flexor digitorum superficialis flexor pollicis longus median nerve ```

compression of tunnel contents leads to

Median Nerve palsy distal to the wrist Thenar muscle wasting Absence of opposition of the thumb

causes of carpal tunnel syndrome

``` Fluid retention cardiac, renal, pregnancy Tendonitis of the long flexors Bone overgrowth Arthritis ```

treatment for carpal tunnel syndrome

divide flexor retinaculum

guyon space

ulnar artery and nerve palmar carpal ligament flexor retinaculum

long flexor tendons

Flexor digitorum superficialis (PIP joints) Flexor digitorum profundus (DIP joints) Flexor pollicis longus (IP joint)

fibrous tendon sheaths function

Prevent Bowstringing of tendons | • Annular and Cruciate Pulleys

synovial flexor tendon sheaths function

reduce friction

lumbricals arise from

Flexor Digitorum Profundus

where do the lumbricals pass

Pass on radial side of MCP joint to insert | into extensor hood

function of lumbricals

Flex MCP & extend IP joints

innervation of lateral lumbricals

``` Median nerve (digital branch) Unipennate ```

innervation of medial lumbricals

``` Ulnar nerve (deep branch) Bipennate ```

palmar spaces

medial fibrous septum midpalmar space lateral fibrous septum thenar space

origin of adductor pollicis

Transverse head – shaft of 3rd MC | Oblique head – 2nd / 3rd MCs and capitate

insertion of adductor pollicis

Ulnar aspect PP of the thumb

action of adductor pollicis

adduction

innervation of adductor pollicis

ulnar nerve

muscle type of palmar interossei | insertion and origin

unipennate | on palmar surface 1-5 MC

action of palmar interossei

adduction | long axis of middle finger

dorsal interossei origin

Bipennate (attach to 2 metacarpals)

insertion of dorsal interossei

Into extensor expansions | 2nd, 3rd & 4th digits (3rd has 2)

innervation of dorsal interossei

Ulnar nerve

action of dorsal interossei

abduction | Dorsal interossei abduct (DAB)

interconnected networks of the arterial supply of the hand

Superficial palmar arch Deep palmar arch Dorsal network

radial artery locations

Lateral to Flexor Carpi Radialis Runs posteriorly Anatomical snuff box

where does the radial artery run anteriorly to

through webspace Through 1st dorsal interosseus Through Adductor Pollicis

ulnar artery direction

Runs superficial to flexor retinaculum Guyon’s canal Deep branch to deep arch

causes of klumpkes paralysis

Lower brachial plexus injury | Paralysis of C8 / T1

signs of klumpkes paralysis

``` Small muscles of hand - claw Unopposed action of long flexors & extensors Flexes PIP & DIP joints - extends MCP joints ```

distal injury of ulnar nerve leads to

paralysis of: • Interossei • 2 medial lumbricals • Hypothenar muscles

distal injury of deformity of ulnar nerve leads to

deformity • “Claw hand” • Maximal in medial (ulnar) 2 digits • Extension of MCPs & flexion of IPs

proximal injury of ulnar nerves causes

“Ulnar Paradox” | • Due to partial paralysis of FDP

injury of median nerve leads to paralysis of

* 2 radial / lateral Lumbricals * Thenar muscles (OAF) * Test opposition

injury of median nerve leads to deformity of

Ape hand / pointing finger

distal injury of median injury

carpal tunnel syndrome

proximal injury of median

FDP/FDS - increased digital extension

Hand, Carpus Flashcards

(64 cards)