lecture 15: intrinsic hand Flashcards by Tanya Thibault

know the surface anatomy of the hand

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the thumb is digit number BLANK

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the pinky is digit number BLANK

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the index is digit number BLANK

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what are the two mounds of muscle on the palm

thenar and hypothenar eminence

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what is most lateral, the thenar or hypothenar eminence

the thenar eminence

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what joint makes up the knuckle

MCP

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what structure lies most superficial on the palm of the hand

palmar aponeurosis

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what is the palmar apeunorosis

triangle of deep fascia, in superficial layer of the palm

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explain the attachment of the palmar apomeurosis

deep to the skin (dermis) and anchored to it, but superficial to flexor tendons, palmar neurovascular structures)

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true or false, the palmar aponeurosis is anchored to the dermis

true

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true or false: the palmar aponeurosis is deep to the skin (dermis) and anchored to it, but deep to flexor tendons, palmar neurovascular structures)

false, superficial to the flexor tendons

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true or false: palmaris longus tendon always present

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what is the palmaris brevis

is stretches between palmar aponeurosis to the skin of hypothenar eminence

draws skin over hypothenar emonience to the center of the palm

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palmar aponeurosis is the end of what tendon

palmaris longus

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what is the flexor retinaculum

ligamentous band stretching from pisiform and hook of the hamate (medial) to the trapezium and scaphoid (lateral)

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what forms the roof of the carpal tunnel

flexor retinaculum

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what is the function of the flexor retinaculum

creates carpal tunnel and prevents bowing of the flexors of the forearm

=makes a pulley for the flexor tendons

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what are the contents of the carpal tunnel

tendons of the FDS (4), FDP (4), FPL (1) and median n

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what nerve passes through the carpal tunnel

median n

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what muscle tendons pass through the carpal tunnel

FDS
FDP
FPL

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what is carpal tunnel syndrome

chronic pressure on the median nerve resulting in numbness and weakness in the hand

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true or false: carpal tunnel syndrome is chronic pressure on the ulnar n

false, median

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what are some actions that can cause carpal tunnel syndrome

typing, excessive extended wrist position

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how many tendons pass through the carpal tunnel

9 total

what nerve passes through the guyons tunnel

ulnar n

true of false: guyon canal can also lead to compression syndromes but in the ulnar n

true

what are the contents that pass through the guyon canal

ulnar a and n

what two things make up the roof of carpal tunnel

flexor retinaculum guyon canal

what are the 3 muscles that make up the thenar eminence that are innevated by the reccurent branch of the median n

flexor pollicis brevis abductor polllic brevis opponens pollicis

what is the origin of the thenar eminence

flexor retinaculum and scaphoid/trapezium

what is the insertion of the thenar eminence (3)

lateral side of PP1 (proximal phalanx 1) for the APB and FPB the MC1 for the OP

what is the function of the thenar eminence muscles (3)

FPB/APB= flex and abduct thumb and MCP and IP joints and assist in opposition OP= opposition

opposition motion is a combo of what moves

abduction and flexion

what are the muscles of the thenar eminence inneravted by

the reccurent branch of median n

true or false, the thenar eminence muscles all share a common origin

true

what si the muscle part of the thenar eminence that is an exception to the inneravtion pattern

adductor pollicus

true or false: adductor pollicus has 3 heads and name them

false only 2 transverse head, and oblique head

what is the origin/palmar attachement of the adductor pollicis

oblique head: capitate (and adj), base of the MCII and MCIII tranverse head: shaft of the MCIII

what is the insertion/thumb attachment of the adductor pollicus

medial side of the base of the first proximal phalanx (PP1)

what is the function of the adductor pollicis

adduction of the thumb

what is the innevation of the addcuctor pollicis

deep ulnar n

the deep ulnar n is a branch of what nerve

ulnar (near guyon cnaal)

how many muscles make up the hypothenar eminence

what are the 3 muscles that make up the hypothenar eminence

abductor digiti minini flexor digiti minimi brevis opponens digiti minimi

wht is the origin (proximal attachemnt) of the hypothenar eminence

posiform (Abnductor digiti minim) hook hamate and flexor retinaculum (opponents digiitmi minini and flexor digiti minimi brevis)

what is the insertion of the hypothenar eminence

medial side of the MC5 (opponents digiti minimi) PP5 (for AB/FL)

what are the functions of the hypothenar eminence

abducts (AB/FL), flexes PIP (AB/FL), and brings 5th digit into opposition to thumn (OP)

what is the innervation of the hypothenar eminence

deep ulnar n (also to adductor pollicus)

true or false: only hypothenar emonence muscles are innervated by the deep ulnar n

false, also the adductor pollicus

what are the origins of the lumbricales

tendons of the FDP (NOT FDL)

what is the insertion of the lumbricales

lateral aspect of the extensor hood

what are the functions of the lumbricals

simultaneus flexion of MCP and extension of the IP joints via extensor hood

what is the inneravtion of the l;umbricales

median n (1 and 2) and deep ulnar (3 and 3)

how many lumbricales do we have

lumbricale 1 and 2 go to whar digits

2 and 3

lumbricales 3 and 4 goto what digits

4 and 5

how many palmar interossei are there

what is the function fo the palmar interossei

adduction and flexion of the MCP, extension of the IP joints for digits II, IV and V

what is the innervation of the palmar interossei

deep ulnar n

what is the general o/i of the interossei muscles

O: shafts of MCs to the sides of PPs and extensor hoods

how many dorsal interossi are there

what is the function of the dorsal interossei

abduction and flexion of MCP, extension of Ip joints for digits II, III, IV

flexor tendons in palm and digits are surrounded by what

synovial sheaths encapsulated by fibrous sheets

explain hoe FDP and FDS run

the FDP runs deep the FDS which splits to allow the FDP to pass through

what is the function of the digital fibrous sheaths

keeps flexors tendons stuck to bone to prevent bowing

understand slide with synovial sheats in the hand

ulnar n is where in the hand

guyon canal

median n is deep to what

flexor retinaculum

reccurent branch of medial n supplies what

to thenar eminence except the adductor pollicus

deep ulnar n supples what

hyoothenar eminence, medial 2 lumbricals ( IV and V), adductor pollicus and interossei

lumbricals I and II are directly inneravted by

median n

adductor pollicus is inneravted by what

deep ulnar

nerves on the dorsum are sensory or motor only

sensory

understand sensory innevation of the hand

last slides intrisic hand

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