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ANAT 314 > Lecture 23: intrinsic hand > Flashcards

Lecture 23: intrinsic hand Flashcards

1
Q

Surface anatomy of hand

A

Hypothenar eminence = movement of pinky, pinky side
Thenar eminence = intrinsic thumb msucles

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2
Q

Describe palmar aponeurosis

A

Starts and ends in hand
Triangle of deep v thick fascia in superficial layer of palm
Deep to skin and anchored to it, but superficial to digital flexor tendons and palmar n/v structures
TRANSVERSE AND LONGITUDINAL FIBERS

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3
Q

What is point of Palmaris aponeurosis

A

Protect underlying neurovasculature Structrues and tendons

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4
Q

What muscle is near Palmaris aponeurosis

A

PALMARIS brevis = little muscle, variably present

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5
Q

Describe Palmaris brevis

A

Thin quadrangualr muscle
Stretches between palmar aponeurosis and skin of hypothenar eminence, draws hypothenar skin over to centre of palms (tenses palmar aponeurosis) = strengthends palmar grip

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6
Q

What does Palmaris longus do

A

When present = blends and ends into palmar aponeurosis

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7
Q

Describe palmar carpal ligament

A

Communicates with palmar aponeurossi
(Not flexor retinaculum, not roof of carpal tunnel)

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8
Q

What is carpal tunnel

A

3rd and most distal n/v funnel of upper limb

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9
Q

Describe flexor retinaculum

A

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

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10
Q

What does flexor retinaculum create

A

Forms carpal tunnel

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11
Q

What does flexor retinaculum do

A

Prevents bowing of tendons of digital flexors originating in forearm when these contract

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12
Q

Describe carpal tunnel

A

Carpal bones form carpal arch - flexor retinaculum closes it = forms carpal tunnel

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13
Q

Describe contents of carpal tunnel

A

Tendons of flexor digitorum superficialis - 4x
Flexor digitorum profundus tendons = 4x
Flexor pollicis longus = 1x
Median nerve
= 10 total things, 9 tendons, 1 nerve

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14
Q

What does median nerve do

A

Passes through all 3 funnels in arm

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15
Q

Where is carpal tunnel

A

On palm
Not wrist region

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16
Q

Describe carpal tunnel syndrome - clinical correlate

A

Chronic pressure on median nerve deep to flexor retinaculum = causes numbness, weakness, tingling in intrinsic hand msucles = compression of contents of carpal tunnel

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17
Q

Describe ulnar canal

A

Formed by palmar carpal ligament stretching from tendon of flexor carpi ulnaris to flexor retinaculum

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18
Q

What’s in ulnar canal

A

Ulnar nerve and artery

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19
Q

Describe clinical correlate ulnar canal

A

Can cause chronic compression of these structures = muscle weakness, deprivation of blood too

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20
Q

Name intrinsic muscles - thenar eminence

A

Flexor pollicis brevis
Abductor pollicis brevis
Opponens pollicis

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21
Q

Attachments flexor pollicis brevis

A

Flexor retinaculum and scaphoid/trapezium to lateral side of first proximal phalanx

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22
Q

Functions flexor pollicis brevis

A

Flex and abduct thumb mcp joint
Assist in opposition

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23
Q

abductor pollicis brevis attachments

A

Flexor retinaculum and scaphoid/trapezium to lateral side of first proximal phalanx

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24
Q

abductor pollicis brevis Functions

A

Flex and abduct thumb mcp joint, assist in opposition

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25
opponens pollicis attachments
Flexor retinaculum and scaphoid/trapezium to lateral side of first metacarpal
26
opponens pollicis Functions
Opposition = bring thumb to hypothenar side palm
27
Innervation of flexor pollicis brevis, abductor pollicis brevis, opponens pollicis
Reccurrent branch fo median nerve = goes back and innervates these 3 muscles
28
Name intrinsic muscles - deep thenar eminence
Adductor pollicis- 2 heads
29
Adductor pollicis Attachments oblique head
Capitate, base of mc ii and iii to medial side of base of first proximal phalanx - heads converge
30
Adductor pollicis FUCNTION
Adduction of thumb cmc joint = trapezium and 1st metacarpal Also bit of flexion of thumb mcp joint
31
Adductor pollicis INnervation
Deep ulnar nerve - arcs to innervate adductor policis
32
Name muscles of hypothenar eminence
Abductor digiti minimi Flexor digiti minimi brevis Opponens digiti minimi
33
Abductor digiti minimi Attachments
Pisiform to medial side proximal phalanx v
34
Abductor digiti minimi FUCNTION
Abducts, flexes mcp 5th digit
35
Flexor digiti minimi brevis Attachments
Hamate hook and flexor retinaculum to medial side proximal phalanx v
36
Flexor digiti minimi brevis Functions
Abducts, flexes mcp 5th digit
37
Attachments Opponens digiti minimi
Hamate hook and flexor retinaculum To medial side of metacarpal v
38
Functions Opponens digiti minimi
Brings 5th digit into opposition to thumb
39
Innervation of Abductor digiti minimi Flexor digiti minimi brevis Opponens digiti minimi
Deep ulnar nerve
40
Describe ulnar nerve/artery - branches and pathway
Passes under ulnar canal then splits = to deep ulnar nerve and artery, and superificial ulnar nerve (sensory) and artery Both send deep branches to metacarpals to innervate hypothenar msucles
41
Name muscles of central compartment of hand
Lumbricals
42
Lumbricals attachments
Tendons of flexor digitorum profundus to lateral aspect fo extensor hood NOT TO THUMB
43
Lumbricals Functions
Flexion of mcp and extension of ip joints via extensor hood = Passes anterior to palmar mcp but post/dorsal to ip joints
44
Lumbricals Innervation
Lumbricals1 and 2 = median nerve (to digits 2 and 3) Lumbricals 3 and 4 = deep ulnar nerve (to digits 4 and 5)
45
Name muscles of interosseous - deep - compartment
Palmar interossei Dorsal interossei
46
Attachments of interossei
Shafts of metacarpals —> sides of proximal phalanges + extensor hoods (distal) = all contribute to extensor hood
47
Palmar interossei FUCNTION
3 msucles = Adduction and flexion of mcp, extension of ip joints for digits ii, iv, v (Towards 3rd digit)
48
Dorsal interossei FUCNTION
4x Abduction and flexion of mcp, extension of ip joints for digits ii, iii, if (Deepest in hand, but can see on dorsal aspect)
49
Way to remember functions interossei
PAD = palmar adducts Vs DAP = dorsal abducts
50
Describe abduction and adduction at mcp joints ii-v - interossei
Defined in relation to 3rd digit Third digit has 2 abductors in relation to this axis = dorsal interossei ii and iii = so 3rd digit abducts in both direction (No adductors= palmar interossei) Abducts - medial, and then abducts back to lateral aspect - midline
51
What are tendons of digital flexors and extensors surrounded by
Synovial sheaths And encapsulate by fibrous sheaths
52
How do synovial sheaths help
Reduces friction bc filled with synovial fluid
53
How do fibrous sheaths help
Keep tendons from bowing - including extensor hood = at each joints they pass
54
Describe extensor retinaculum
Dorsum of hand Functionally analogous to felxor retinaculum
55
Describe ulnar nerve - motor
In ulnar canal - deep to palmar carpal ligament Splits
56
Describe median nerve - motor
Deep to felxor retinaculum - through carpal tunnel
57
Describe deep ulnar nerve - motor
Hypothenar eminence, medial 2 Lumbricals (iii and iv), adductor pollicis (arcs over), interossei
58
Describe reccurent branch medial nerve - motor
To thenar eminence expect adductor pollicis
59
What innervates lumbricals I and ii
Median nerve
60
What innervates adductor pollicis
Deep ulanr nerve
61
Describe palmar sensory - ulnar nerve
Sends off dorsal branch early - that goes on top of flexor retinacula Then splits = superficial branch of ulnar nerve (mostly sensory to palmar medial 1.5 digits, motor to palmaris brevis) —> digital branches, sensory
62
Describe palmar sensory - Median nerve
Before passes under flexor retinaculum = gives off palmar branches (sensory) —> recurrent branch median nerve = motor Then digital branches - sensory = to rest of Palm and hand, also wrap arounf nail beds - to dorsal side
63
Describe dorsal sensory - radial nerve
Superficial branch radial nerve (recall snuff box) —> dorsal digital branches of radial nerve
64
Describe dorsal sensory -Ulnar nerve
Dorsal branch of ulnar nerve - part of dorsum, medial side —> dorsal digital branches of ulnar nerve
65
Describe dorsal sensory -Median nerve
Wrapped arounf nail beds = tips of fingers supplied by digital branches of median nerve
66
Describe vascular supply to hand - Gen
3 arterial arches = 2 palmar 1 dorsal = branch out to provide blood to metacarpals and digits, forms extensive anastomoses
67
Which artery supplies more fo hand
Ulnar artery on palmar side
68
Describe ulnar artery in hand
Splits after ish flexor retinaculum = deep ulnar artery
69
Describe radial artery in hand
Split before flexor retinaculum —> superficial branch of radial artery
70
Describe superficial palmar arch
Ulnar artery and palmar branch radial artery —> sends off common palmar digital arteries —> proper palmar digital arteries
71
Describe deep palmar arch
Radial artery and deep ulnar artery
72
Describe dorsal carpal arch
From radial artery —> dorsal metacarpal arteries —> dorsal digital arteries Under tendons extensor digitorum
73
What does the regions of sensory innervation allow for clinicians
Allow clinicians to pin point injuries
74
Adductor pollicis Attachments transverse head
Shaft of mc iii to medial side of base of first proximal phalanx - heads converge
75
What is extensor hood
Broadening of tendon of extensor digitorum
76
Innervation interossei
Deep ulnar nerve
77
What happens if injure deep ulnar nerve
Loose adduction of all digits

ANAT 314 (27 decks)

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