Hand (Exam 1) Flashcards by Elizabeth Dower

What type of joints are the carpometacarpals

synovial, plane gliding

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What type of joints are the intermetacarpals

synovial plane gliding

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What type of joints are the metacarop-phalangeal

synovial, condyloid (proximal and distal)

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What type of joints are the interphalangeal

synovial, hinge

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What join the fingers will allow abduction and adduction

metacarpo-phalangeal: synovial condyloid joint

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What join in the fingers will allow flexion and extension

proximal and distal interphalangeal

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What type of joint is the 1st carpometacarpal joint

synvoial saddle

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What types of movement are permitted at the 1st carpometacarpal joint

adduction
abduction
extension
flexion
opposition
reposition

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Where does the C7 dermatome go

middle finger

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What arterial arches are seen at the radial and ulnar arterial arches

superficial palmar arch at ulnar and deep palmar arch at radial

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What are the PAD muscles

the interosseous palmar muscles that adduct

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What are the DAB muscles

the interosseous palmar muscles that abduct

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What muscles in the hand are innervated by median nerve

(2 Loaf)

2 lumbricals, opponens, abductor, and a flexor

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What are the myotomes of the hand

c8-t1

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What are the dermatomes of the hand

C6 thumb
C7 Middle finger
C8 pinky

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What causes Dupytren’s contracture

fibrotic thickening and shortening of palmar aponeuroses

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What occurs during Dupytren’s contracture

pulls digits 5 and 6 into the palm of the hand and you cannot move these digits

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Is Dupytren’s contracture a neurologic condition

no, it is dysfunction of CT

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Wheres is the midpalmar space found within the hand

found between the deep muscles and central compartment of the hand

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What is the clinical correlation regarding the midpalmar space

travels from the hand to the carpal tunnel to the forearm: infection can spread from hand and damage median nerve and travel to forearm

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What compartment of the hand are the tendons held within

central compartment

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What is the thenar space

thumb space

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What is the hypothenar space

pinky

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What are the borders of the carpal tunnel

floor: carpal bones
Roof: flexor retinaculum (scaffoid, trapezium)

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What will run through the flexor retinaculum

tendon of flexor carpi radialis

What structures run through the carpal tunnel

flexor digitorum profundus tendons (4) flexor digitorum superficialis tnedons (4) flexor pollicis longus tendon (1) median nerve

Will the palmar cutaneous nerve be affected in carpal tunnel syndrome

no as it branches off above the tunnel

Where is Guyon's canal located

between hamate and pisiform carpal bones

What causes handle bar neuropathy

numbness from compression the ulnar nerve in guyon's tunnel

What are the main points of compression of the ulnar nerve

palmar carpal ligament transverse carpal ligament deep motor ulnar branch superficial sensory ulnar branch

What synovial digit sheaths are continous with the palm

digits 1-5 are connected to the sheath of the palm digits 2-4 are continuous with the palm

Name the thenar muscles

abductor pollicis brevis flexor pollicis brevis opponens pollicis

What are the thenar muscles innervated by

recurrent branch of the median nerve

What is another name for the recurrent branch of the median nerve

million dollar nerve

What happens if you cut the recurrent branch of the median nerve

you cannot use the thumb

Name the hypothenar muscles

Abductor digiti minimi Flexor digiti minimi opponens digiti minimi

What are the interosseous muscles

4 dorsals and 3 palmar muscles

What do the 4 dorsal interosseous muscles do

abduct

What do the 3 palmar interosseous muscles do

adduct

What are the interosseous muscles innervated by

ulnar nerve

Which finger lacks a palmar interossei

middle finger

What are the lumbricale muscles

run along the radial side of each digit and attach to the extensor hood

What is the innervation of lumbricale muscles

digits 2-3 are median nerve digits 4-5 are ulnar nerve

What is adductor pollicis innervated by

deep branch of ulnar nerve (C8-T1)

What are the actions of the lumbricals

flexes the MP joint and extends the IP joint

What is the function of the dorsal interosseous muscle

abduction of the thumb

What muscles connect to the extensor hood

interosseous muscles and lumbricals

What is ulnar claw

muscles of digits 4 and 5 have lost innervation from the ulnar nerve

What is Klumpke's palsy

clawing of digits 2-5 due to damage to C8-T1, all lumbricals and interosseous muscles are paralyzed

What is the arterial supply to the hand

superficial palmar arch

What is the superficial palmar arch

direct continuation of ulnar artery on top of digitorum tendons

Where is the radial pulse taken

lateral aspect of hand near the base of the thumb

What arterial arches of the hand are associated with the ulnar and radial arteries

superficial palmar arch and deep palmar arch

Which artery is more involved in the superficial palmar arch

ulnar

Which artery is more involved in the deep palmar arch

radial

Which arch is more distal

superficial palmar arch

Which arterial arch is more proximal

deep palmar arch

Are the arches always a full arch

no, sometimes arches can be incomplete

How is the deep palmar arch related to the interosseous muscles

runs with deep branch of ulnar nerve that supplies all the deep muscles

What are the branches off of the superficial arch

common palmar digital arteries that give rise to proper digital arteries

What are the branches off of the deep palmar arch

1. palmar metacarpal arteries x3 2. perforating brs (join dorsal metacarpal aa.) 3. Recurrent brs (join palmar carpal arch)

Describe the arterial supply to the digits

arteries and nerves on palmar side go to the tip and go back over the top

Do dorsal nerves and arteries supply the tip of phalanges

no, they are too short

What are the borders of the anatomical snuff box

extensor pollicis longus extensor pollicis brevis abductor pollicis longus

What is the palmar branch of the median nerve

supplies the skin over the thenar compartment and center of the palm

What is the clinical significance of the palmar branch of the median nerve

Does not go through the carpal tunnel and will not be affected by carpal tunnel syndrome thus, no loss of sensation with carpal tunnel, if nerve injury is higher sensation can be lost

What is the course of the palmar branch of the ulnar nerve and clinical relevance

travels over guyons tunnel, thus will not be affected when there is compression will still have sensation over the last 2 digits

What nerve is referred to as the million dollar nerve

recurrent branch of median nerve

Where does the recurrent branch of the median nerve travel

over the top of the carpal tunnel, more superficial

Where would sensory loss occur in a radial nerve injury

dorsum of the hand | palmar surface okay

Where would sensory loss occur if there were damage to C6

both dorsum and palmar surface as it innervates both