hand/wrist LOs Flashcards

(40 cards)

1
Q

abductor digiti minimi

A
  • BL: pisiform > ulnar side of base of proximal phalanx of 5th digit
  • action: abducts 5th digit
  • innervation: deep branch of ulnar nerve
  • SC: C8-T1
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2
Q

abductor pollicis brevis

A
  • BL: transverse carpal ligament > radial side of base of proximal phalanx of thumb
  • action: abducts thumb
  • innervation: recurrent branch of median nerve
  • SC: C6-T1
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3
Q

adducutor pollicis

A
  • BL: capitate, 2nd and 3rd metacarpals (oblique head), palmar aspect of 3rd metacarpal (transverse head) > base of proximal phalanx of thumb
  • action: adducts thumb
  • innervation: deep branch of ulnar nerve
  • SC: C8-T1
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4
Q

dorsal interossei

A
  • BL: adjacent sides of metacarpals > proximal phalangeal bases, dorsal digital expansions of digits 2-4
  • actions: abduct MCP, flex MCP, extends IP (digits 2-4)
  • innervation: deep branch of ulnar nerve
  • SC: C8-T1
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5
Q

flexor digiti minimi brevis

A
  • BL: hamate > ulnar side of base of proximal phalanx of 5th digit
  • action: flexes MCP of 5th digit
  • innervation: deep branch of ulnar nerve
  • SC: C8-T1
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6
Q

flexor pollicis brevis

A
  • BL: transverse carpal ligament, trapezium > radial side of base of proximal phalanx of thumb (deep bead blends with opponens pollicis)
  • action: flexes MCP of thumb
  • innervation: recurrent branch of median nerve (superficial head), deep branch of ulnar nerve (deep head)
  • SC: C6-T1 (superficial head), C8-T1 (deep head)
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7
Q

lumbricals

A
  • BL: tendons of flexor digitorum > radial side of dorsal digital expansions of digits 2-5
  • action: flexes MCP 2-5, extends IP 2-5
  • innervation: median nerve (1, 2), deep branch of ulnar nerve (3, 4)
  • SC: C7-T1 (1, 2), C8-T1 (3,4)
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8
Q

opponens digiti minimi

A
  • BL: hook of hamate > ulnar margin of shaft 5th metacarpal
  • action: opposition of 5th digit to thumb
  • innervation: deep branch of ulnar nerve
  • SC: C8-T1
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9
Q

opponens pollicis

A
  • BL: transverse carpal ligament, trapezium > palmar surface of first metacarpal
  • action: opposition of thumb to fifth digit
  • innervation: recurrent branch of median nerve
  • SC: C6-T1
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10
Q

palmar interossei

A
  • BL: palmar aspects of metacarpals 2, 4, 5 > dorsal digital expansions of digits 2, 4, 5
  • action: adducts MCP, flex MCP, extend IP (2, 4, 5)
  • innervation: deep branch of ulnar nerve
  • SC: C8-T1
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11
Q

distal radio-ulnar joint

A

pivot/trochoid

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12
Q

radiocarpal joint

A

ellipsoidal/condyloid

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13
Q

thumb carpometacarpal joint

A

sellar/saddle

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14
Q

digits 2-5 carpometacarpal joint

A

plane/gliding

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15
Q

metacarpophalangeal joint

A

ellipsoidal/condyloid

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16
Q

interphalangeal joint

A

ginglymus/hinge

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17
Q

transverse carpal ligament

A
  • attachments: pisiform, hook of hamate > scaphoid, trapezium
  • function: prevent bowstringing of tendons of flexor pollicis longus, flexor digitorum superficialis, flexor digitorum profundus mm.
18
Q

collateral ligaments of metacarpophalangeal joints

A
  • attachments: head of metacarpals > base of adjacent proximal phalanx
  • function: stabilizes metacarpophalangeal joints
19
Q

collateral circulation of hand

A
  • ulnar:
    • superficial palmar arch
      • common palmar digital aa. > proper palmar digital aa.
    • deep palmar branch
  • radial:
    • princeps pollicis
    • radialis indicis
    • deep palmar arch
      • palmar metacarpal (to common palmar digital aa.)
    • superficial palmar branch
20
Q

surface features of hand and wrist

21
Q

carpal bones

A
  • some lovers try positions that they can’t handle
  • scaphoid, lunate, triquetrum, pisiform, trapezium, trapezoid, capitate, hamate
  • proximal: scaphoid, lunate, triquetrum, pisiform
  • distal: trapezium, trapezoid, capitate, hamate
22
Q

actions/motions of the wrist

23
Q

transverse carpal ligament/flexor retinaculum

A
  • attachments: hook of hamate, pisiform > trapezium, scaphoid
  • function:
    • thenar and hypothenar mm. attachment
    • maintains carpal arch
    • prevents bowstringing of flexor tendons
    • protects median n.
24
Q

triangular fibrocartilage complex (TFCC)

A
  • articular disc: primary structure
    • triangular shape
    • shock absorption
    • like meniscus in knee (no good blood supply)
    • fibrocartilaginous: degenerates with overuse and aging
  • dorsal/volar radioulnar ligament
  • ulnar collateral ligament
  • ECU sheath
  • ulnotriquetral ligament
  • ulnolunate ligament
25
compartments formed by extensor retinaculum and tendons found within each
1. abductor pollicis longus, extensor pollicis brevis (APL, EPB) 2. extensor carpi radialis longus/brevis (ECRL, ECRB) 3. extensor pollicis longus (EPL) 4. extensor digitorum, extensor indicis (ED, EI) 5. extensor digiti minimi (EDM) 6. extensor carpi ulnaris (ECU)
26
bones and joints of hand
27
actions/motions of fingers and thumb
28
structure of palmar fascia and palmar digital sheaths
* palmar fascia: continuous with antebrachial fascia * includes thenar fascia, hypothenar fascia, palmar aponeurosis * palmar digital sheaths: pulleys * annular: straight (A1-A5) * cruciate: crossed (C1-C3) * functions: maintain relationship of flexor tendons to bone * prevents bowstringing of tendons (A2-A4 are most critical)
29
juncturae tendinae
* structure: intertendinous connections of extensor digitorum (ED) * number/location vary between/among individuals * function: distributes forces
30
intrinsic vs. extrinsic muscles
* intrinsic: originate and insert on hand * thenar, hypothenar, adductor pollicis, lumbricals, interossei * extrinsic: originate in forearm and insert on hand * flexor digitorum profundus, flexor digitorum superficialis, flexor pollicis longus, abductor pollicis longus, extensor pollicis longus, extensor digitorum, extensor indicis, extensor digiti minimi
31
location and function of ligaments of fingers
* radial/ulnar collateral: gives radial/ulnar stability * dorsal surface \> volar surface * taut in flexion (lengthens), lax in extension (shortens) * at MP, PIP, DIP * volar plate: prevents finger hyperextension * palmar ligament/plate
32
muscles that attach to extensor mechanism/hood/expansion and how they move finger
* extensor hood: tendon covering dorsal digits, cable system to extend MPs and IPs * allows lumbricals and dorsal/palmar interossei to assist in MP flexion * components: extensor digitorum, juncturae tendinae, central slip, sagittal bands, lateral bands, transverse retinacular ligament, oblique retinacular ligament, terminal tendon
33
radial nerve supply
* triceps brachii (long, lat, med), brachioradialis, ECRL, ECRB, anconeus, supinator, EDM,ECU, APL, EPL, EPB * posterior portion of arm and forearm, radial dorsum of hand * no motor in hand, only extensors/supinators
34
median nerve supply
* pronator teres, FCR, PL, FDS, FDP, FPL, pronator quadratus, APB, FPB, OP, lumbrical 1, lumbrical 2 * cutaneous: radial side of palm (digits 1-4), ends of digits 1-2 * flexors/pronators, radial hand
35
ulnar nerve supply
* FCU, FDP, AP, FPB (deep head), PB, abductor/flexor/opponens digiti minimi, lumbricals 3/4, interossei * cutaneous: dorsal and volar digits 3-4, palmar aspect * mostly hand
36
anatomical snuff box
* dorsal border: extensor pollicis longus (EPL) * volar border: abductor pollicis longus, extensor pollicis brevis (APL, EPB)
37
underlying anatomy of carpal tunnel syndrome
* median nerve compression at wrist under flexor retinaculum
38
oblique head of adductor pollicis
39
transverse head of adductor pollicis
40
abductor digiti minimi