Lecture 14- Wrist and Hand Flashcards Preview

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Flashcards in Lecture 14- Wrist and Hand Deck (45):
0

3 groups of bones:
• Carpals, n=....
• Metacarpals, n=...
• Phalanges, n=...
• Cartilaginous at birth.
• Ossified by .....-years-of-age

8
5
14
12

1

Scaphoid (“boat”) – ..... ..... .........
• Lunate (“moon”)
• Triquetrum (“3 cornered”)
• Pisiform (“pea”)

most commonly fractured

2

Trapezium (“Table”)
• Trapezoid (resembles trapezium)
• Capitate (“Head”)
• Hamate (“.... .....”)

Little hook

3

Condyloid radiocarpal joint
• Condyloid joint = oval articular surface of one
bone fits into complementary ......... in
another.

concavity

4

Wrist (Radiocarpal) joint
• Synovial (condyloid) joint between the distal end
of the radius and the articular disc overlying the
distal end of the ulna, and the .......,........ And ........

scaphoid, lunate
triquetrum.

5

Wrist (Radiocarpal) joint
Anterior & posterior ligaments strengthen the
....... ......

joint capsule

6

Wrist (Radiocarpal) joint
Movements?

Movements: flexion, extension, abduction,
adduction and circumduction.

7

Which has a greater range of motion?
Abduction ( radial deviation) or adduction (ulnar deviation)
WHY?

Abduction, ulnar styloid gets in the way

8

Palmar .......... and palmar ........ ligaments reinforce the wrist joint capsule.

radiocarpal
ulnocarpal

9

Dorsal ......... and radial and ulnar ......... ligaments
reinforce the wrist joint.

radiocarpal
collateral

10

What is the function of the deep transverse metacarpal ligament?

Bounds heads of metacarpals

11

Phalangeal ligaments
What is their function?

Strapping tendons to bone

12

What is the function of the extensor retinaculum?

Strapping down tendons

13

What is the function of the synovial sheaths?

Helps ligaments move independently

14

Flexor Retinaculum
Thickening of deep fascia that holds ...... ...... ...... in
position at the wrist.

long flexor tendons

15

Flexor Retinaculum
Proximal border = ....... ........ ...... crease on anterior wrist.

distal transverse skin

16

Flexor Retinaculum
Distal border = attached to ......... .........

palmar aponeurosis

17

Flexor Retinaculum
Medial attachment = ....... bone and ....... Of .......


pisiform
hook of hamate

18

Flexor retinaculum
Lateral attachment = tubercle of ........ and .......... bones.

scaphoid
trapezium

19

Carpal Tunnel
Created by position of ........ bones and ........ .........

carpal
flexor retinaculum

20

Carpal Tunnel
• 4 tendons of flexor .......... .........
• 4 tendons of flexor .......... .........
• Tendon of flexor ......... ..........
•......... nerve

digitorum profundus
digitorum superficialis
pollicis longus
Median

21

Carpal Tunnel Syndrome
• Entrapment syndrome.
• Pressure on ....... nerve.

Median

22

Carpal tunnel syndrome
Aetiology: overuse, swelling of tendons and tendon ........ (e.g.
rheumatoid arthritis) and cysts arising from ........ joints.

sheaths
carpal

23

Carpal tunnel syndrome
Symptoms: pain and ...... And ...... in distribution of median nerve.
• Treatment: surgery, ........... injections.

pins and needles
corticosteroid

24

Palmar aponeurosis
Gives firm attachment to overlying ...... to improve ...... and protect underlying ........

skin
grip
tendons

25

Intrinsic hand muscles
• Entirely within hand (on ....... side)
• Execute ......... ..........

palmar
precision movements

26

Intrinsic hand muscles
• Palmaris brevis
• Interossei (dorsal or palmar) (n=7 or 8)
• Lumbrical muscles (n=4)
• Adductor pollicis
• Thenar: ball of .......
• Hypothenar: ball of ......

Thumb
Pinky

27

Phalangeal muscles
• Palmar .........
• Dorsal ........
• Lumbricals

interossei
Interossei

28

Interossei muscles
All innervated by deep branch of ...... nerve
(.....,....)

ulnar C8, T1

29

Palmar muscles:....... fingers toward middle finger PAD

adduct

30

Dorsal: ...... fingers from middle DAB

Abduct

31

Adductor pollicis
Adducts .......;
Pollicis = Latin for ......

thumb
Thumb

32

Thenar muscles
• ........ pollicis brevis
• .......... pollicis brevis
• .......... pollicis

Abductor
Flexor
Opponens

33

Thenar muscles Chiefly responsible for

opposition of the thumb

34

Abductor pollicis brevis (abducts thumb, moves anterior in AP
plane)
• Adductor pollicis (adducts thumb)
• Extensor pollicis longus
• Flexor pollicis brevis (flexes thumb at CM and MCP joints)
• Flexor pollicis longus
• Opponens pollicis (moves thumb to touch tip of little finger)

.

35

Hypothenar muscles
What three muscles?

• Abductor digiti minimi
• Flexor digiti minimi brevis
• Opponens digiti minimi

36

Arteries of the palm
Ulnar artery => ....... ....... arch
Radial artery => ....... ...... arch
Anastomoses between the two

superficial palmar
deep palmar

37

Superficial palmar arch
Ulnar artery anterior to flexor retinaculum ->Superficial palmar
arch (deep to palmar aponeurosis)
Anastomoses with radial artery -> 4 digital arteries

.

38

Deep palmar arch
Direct continuation of the ....... artery.
Joins with deep branch of ...... artery.
Sends branches ........ to anastomosis around wrist joint and inferiorly to join digital branches of ....... ....... ......

radial
ulnar
superiorly
superficial palmar arch.

39

Arteries of the palm
Thumb and lateral side of index finger mainly supplied by ...... artery
Medial side of index finger, middle, ring and little finger mainly
supplied by ...... artery

radial
ulnar

40

Venous network
Dorsal venous network drain back into ...... and ...... veins

basilic
cephalic

41

Dermatomes
C6 = ......
C7 = ....... ... ....... ......
C8 = ..... ..... ...... ......

Thumb
index & middle finger
ring & little finger

42

Median nerve palsy
Median nerve lesion result in ?
Ring and little fingers still flexed because ?

inability to flex thumb, index and middle finger at MCP joint.
ulnar nerve is intact.

43

Ulnar nerve palsy “Claw hand”
....... ...... lesion results in inability to ....... ....... ....... of ring and little finger.
Patients can’t make a ........ .......

Also can’t extend
interphalangeal joints to
straighten fingers.

Ulnar nerve
flex the DIP joint
complete fist.

44

Radial nerve palsy “Wrist drop”
Radial nerve lesion results in ........ ......... ..... in forearm. Because ........ ........ ....... no longer opposed, ....... ........

denervation of extensor muscles
forearm flexor muscles
Wrist drops