Lecture 13: Hand Flashcards

(71 cards)

1
Q

Palmar cutaneous branch of median supplies, arises, passes

A

Supplies central palm
Arises proximal to the flexor retinaculum
Passes superficial to flexor retinaculum

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2
Q

Palmar cutaneous branch of ulnar nerve supplies, arises, passes

A

Supplies medial side of palm
Arises proximal to wrist
Passes superficial to flexor retinaculum and palmar aponeurosis

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3
Q

Venous drainage of dorsum of hand

A

Dorsal venous arch medially drains into basilic, laterally drains into cephalic

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4
Q

Extensor indicis blood supply/innervation

A

BS- Posterior interosseous and perforating branch of anterior interosseous
I-Posterior interosseous

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5
Q

Superficial branch of ulnar nerve branches to

A

Muscular branch to palmaris brevis
Cutaneous branch to palmar aspect of ulnar side of little finger and adjacent sides of little and ring fingers, including tips and dorsum

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6
Q

Flexor pollicis brevis attachments

A

P- Flexor retinaculum and tubercles of scaphoid and trapezium
D- Lateral side of base of proximal phalanx of thumb

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7
Q

Medial branch of median nerve

A

To second lumbrical

cutaneous to adjacent sides of digits 2-4, including nailbed and fingertips

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8
Q

Opponens digiti blood supply/innervation

A

BS- Ulnar artery

I- Deep branch of ulnar nerve

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9
Q

Metacarpophalangeal joints vascularization

A

Deep digital arteries from superficial palmar arches

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10
Q

Abductor pollicis brevis attachments

A

P- Flexor retinaculum and tubercles of scaphoid and trapezium
D- Lateral side of base of proximal phalanx of thumb

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11
Q

Contents of carpal tunnel

A

Long flexor tendons of-
Flexor digitorum superficialis and profundus
Flexor pollicis longus
Median nerve

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12
Q

Lumbricals Distal attachments and function

A

They insert on lateral sides of the extensor expansions of digits 2-5
They flex the metacarpophalangeal joints and extend interphalangeal joints of digits 2-5

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13
Q

Palmar aponeurosis

A

Triangular layer of deep fascia between two eminences

Anchored to skin and flexor retinaculum

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14
Q

Ulnar nerve enters hand

A

Superficial to the flexor retinaculum

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15
Q

PAD (Palmar interossei) description

A

Four (three) unipennate muscles
-First is sometimes considered to be part of flexor pollicis brevis
Supply each digit except third- reference is middle finger

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16
Q

Extensor expansion function

A

Flexion at MCP joint

Extension at PIP, DIP joints

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17
Q

DAB (Dorsal interossei) description, attachments, action, innervation

A

Four bipennate muscles
Arise via two heads from adjacent sides of two metacarpals
Insert onto extensor expansions and radial sides of proximal phalanges 2/3, ulnar sides of proximal phalanges 3/4
Digit 3 has 2 dorsal interossei
Abduct MP joints of digits 2-4, reference line is middle finger
Ulnar nerve

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18
Q

Carpometacarpal joint vascularization

A

Dorsal/palmar carpal arch anastomoses, deep palmar arch

Metacarpal arteries

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19
Q

Metacarpophalangeal joint innervation

A

Digital nerves from ulnar/median nerves

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20
Q

PAD insertion
Action
Innervation

A

Onto ulnar sides of proximal phalanges 1 and 2
Onto radial sides of proximal phalanges 4 and 5
Adduct MP joints of digits 1,2,4,5
Ulnar nerve

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21
Q

Palmaris brevis origin, insertion, action

A

Origin: flexor retinaculum and palmar aponeurosis
Insertion: skin on medial side of palm
Action: tenses skin on palm

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22
Q

Colles fracture

A

Fracture in distal end of radius

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23
Q

Flexor digiti minimi actions

A

Flexes proximal phalanx of 5th digit

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24
Q

Function notes extensor expansion

A

Extension at the PIP is always accompanied by simultaneous extension at the DIO
When the PIP is flexed, the DIP may be extended or flexed

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25
Midpalmar space
Located between metacarpals 4&5 and the long flexor tendons to digits 4&5
26
Guyons canal formed by, what passes through
Formed by a groove between the pisiform and the hook of hamate Ulnar nerve and artery pass through
27
Third and fourth lumbricals origin, innervation, blood supply
Attached to medial 3 tendons of FDP Deep branch of ulnar nerve Superficial palmar arch(ulnar a), dorsal carpal arch (ulnar and radial artery)
28
Innervation of thenar eminence muscles
Recurrent branch of median nerve
29
Dupuytrens contracture
Progressive fibrosis of palmar aponeurosis | Results in marked flexion of fingers at MP joints
30
Lumbricals innervation, action
Two on radial side- median nerve Two on ulnar side- ulnar nerve Flex MCP joints and extend IP joints
31
Adductor pollicis blood supply/innervation
BS- Radial artery | I- Deep branch of the ulnar nerve
32
Abductor pollicis brevis actions
Abducts thumb, aids in opposition
33
Abductor digiti minimi attachments
P- Pisiform | D-Medial side of base of proximal phalanx of 5th digit
34
Flexor digiti minimi brevis attachments
P- Hook of hamate and flexor retinaculum | D- Medial side of base of proximal phalanx of 5th digit
35
Adductor pollicis actions
Adducts thumb toward lateral border of palm
36
Carpometacarpal joints motion
Almost none 2-3 Limited for 4 More mobile for 5- flexion/extension, abd/add, circumduction, opposition
37
Flexor retinaculum
Laterally attaches to tubercles of scaphoid and trapezium | Medially attaches to hook of hamate and pisiform
38
Arterial supply to dorsum of hand
Via dorsal arterial arch from radial & ulnar arteries
39
Mallet finger
Avulsion by long extensor tendon, results in hyperflexion of DIP
40
Ulnar nerve injury
Paralysis and atrophy of interosseous muscles Loss of thumb adduction Clawhand
41
Lymphatic drainage of dorsum of hand
Medial via lymph vessel accompanying basilic vein to supratrochlear nodes to lateral axillary nodes
42
Lateral branch of median nerve
To thenar muscles and first lumbrical | Cutaneous to anterior surface of thumb and radial side of index finger
43
Opponens digiti minimi actions
Brings 5th metacarpal anterior and rotates it to bring it to opposition with the thumb
44
Carpometacarpal joint innervation
Anterior interosseous-median Posterior interosseous-radial Dorsal/deep branches ulnar nerve
45
Flexor digitorum superficialis action, tendons characteristics and insertion
Flexes PIP and MCP and wrist Each tendon passes through fibrous flexor sheath Each tendon bifurcates opposite proximal phalanx Each tendon inserts on middle phalanx
46
Opponens digiti minimi attachments
P- Hook of hamate and flexor retinaculum | D- Medial border of 5th metacarpus
47
Opponens pollicis actions
Oppose thumb and medially rotate first metacarpal
48
Opponens pollicis proximal/distal attachments
P-Flexor retinaculum and tubercles of scaphoid and trapezius | D-Lateral side of 1st metacarpal
49
Abductor digiti minimi actions
Abducts 5th digit, aids in flexion of 5th proximal phalanx
50
Vinculae
Small vascular bundles connecting palmar surface of phalanges with long flexor tendons
51
Median nerve injury
Loss of thumb opposition Atrophy of thenar muscles Ape hand
52
Flexor pollicis brevis actions
Flexes thumb
53
Opponens pollicis blood supply/innervation
BS- Radial artery | I- Recurrent branch of median nerve
54
Clinical notes extensor expansion
If lateral bands detach lateral bands will flex the PIP and hyperextend the DIP Look at this more
55
Flexor digiti minimi blood supply/innervation
BS- Ulnar artery | I- Deep branch of ulnar nerve
56
Median nerve enters hand
Deep to flexor retinaculum, divides into lateral and medial branches
57
Flexor digitorum profundus action, insertion
Flexes DIP and PIP and MCP More active than superficialis Each tendon inserts on distal phalanx
58
Route of radial artery
Passes proximally deep to brachioradialis Distally lies against radius lateral to tendon of flexor carpi radialis Passes across scaphoid in anatomical snuff box Wraps around dorsum of metacarpus one-gives off arteries to thumb/index finger Pierces first dorsal interosseous muscle and reappears in palm Forms deep palmar arch
59
Extensor expansion lateral/central band attachment
Lateral- Bases of distal phalanges | Central- Base of middle phalanx
60
First and second lumbricals origin, innervation, blood supply
``` Attached to lateral 2 tendons of FDP Median nerve Radialis indicis (radial), superficial palmar arch (ulnar) ```
61
Extensor indicis proximal/distal attachment
P-Posterior surface of distal 1/3 of ulna and interosseous membrane D- Extensor expansion of index finger
62
Abductor pollicis brevis blood supply/innervation
BS- Radial artery | I- Recurrent branch of median nerve
63
Deep branch of ulnar nerve
Supplies hypothenar muscles, all interossei, two ulnar side lumbricals and adductor pollicis
64
Lumbricals description, origin
Four small, narrow, elongated muscles | Each arises from the radial side of a flexor digitorum profundus tendon
65
Hypothenar eminence muscles and their innervation
Abductor digiti minimi Flexor digiti minimi brevis Opponens digit minimi Ulnar nerve innervates
66
Abductor digiti minimi blood supply/innervation
BS- Ulnar artery | I-Deep branch of ulnar nerve
67
Muscles of thenar eminence
Abductor pollicis brevis Flexor pollicis brevis Opponens pollicis
68
Adductor pollicis attachments
P- Bases of 2nd/3rd metacarpals, capitite, and adjacent carpals D- Medial side of base of proximal phalanx of thumb
69
Thenar space
Located between palmar side of adductor pollicis and the long flexor tendons to the index finger and thumb
70
Extensor indicis actions
Independent extension of index finger, helps with extension of wrist
71
Flexor pollicis brevis blood supply/innervation
BS- Radial artery | I- Recurrent branch of median nerve, deep branch of ulnar nerve