MSK Session 6

Question 0

What gives the power grip?

Answer 0

Muscles in the forearm

Question 1

What allows for the precision grip?

Answer 1

Muscles of the hand

Question 2

How is blood supplied to the hand?

Answer 2

Ulnar artery branches into deep and superficial palmar arches
Radial anastomoses

Question 3

What is the venous drainage of the hand?

Answer 3

Veins follow arteries in the dorsal venous network

Question 4

What are the five intrinsic muscle groups of the hand?

Answer 4

Thenar
Lumbricals
Pollicis
Interossei
Digiti minimi

Question 5

What causes Hand of Benediction?

Answer 5

Damage of the median nerve at the wrist of elbow

Question 6

What causes wrist drop?

Answer 6

Damage of radial nerve at axilla/radial groove/deep superficial branch

Question 7

Which muscles of the hand are innervated by the median nerve?

Answer 7

Lateral 2 lumbricals
Opponens pollicis
Abductor policis
Flexor pollicis brevis

Question 8

What is the main action of opponens pollicis?

Answer 8

Oppose thumb by drawing 1st metacarpal medially to centre of Palm and rotating it medially

Question 9

What is the main action of abductor pollicis brevis?

Answer 9

Abducts thumb

Assists opposition

Question 10

What is the main action of flexor pollicis brevis?

Answer 10

Flex thumb

Question 11

What is the main action of adductor pollicis brevis?

Answer 11

Addicts thumb toward lateral border of palm

Question 12

What innervates adductor pollicis?

Answer 12

Ulnar nerve

Question 13

What is the main action of abductor digiti minimi?

Answer 13

Abduct 5th digit

Assist flexion of proximal phalanx of 5th digit

Question 14

What is the main action of flexor digiti minimi brevis?

Answer 14

Flex proximal phalanx of 5th digit

Question 15

What is the main action of opponens digiti?

Answer 15

Draw 5th metacarpal anterior

Rotate 5th metacarpal bringing it into opposition w/thumb

Question 16

What innervates the hypothenar muscles - ADM, FDMB and OD?

Answer 16

Ulnar nerve

Question 17

What is the main action of the 1st-4th lumbricals?

Answer 17

Flex metacarpophalangeal joints

Extend interphalangeal joints of 2nd-5th digits

Question 18

What is the main action of the dorsal interossei 1st-4th?

Answer 18

Abduct 2nd-4th digits from axial line

Act w/lumbricals in flexing metacarpophalangeal joints and extending interphalangeal joints

Question 19

What is the main action of the palmar interossei 1st-3rd?

Answer 19

Adduct 2nd, 4th and 5th digits towards axial line
Assist lumbricals in flexing metacarpophalangeal joints and extending interphalangeal joints
Extensor expansions of 2nd-4th digits

Question 20

What innervates the 3rd and 4th lumbricals and both dorsal and palmar sets of interossei?

Answer 20

Ulnar nerve

Question 21

What is ulnar claw?

Answer 21

Damage of the ulnar nerve at the elbow or wrist

Question 22

How do you test for Hand of Benediction?

Answer 22

Ask to make a fist - first three digits paralysed so only 4th and 5th bend

Question 23

How do you test the function of the dorsal interossei?

Answer 23

Ask patient to spread fingers and resist closure

Question 24

How do you test the function of the palmar interossei?

Answer 24

Ruler b/w fingers and pull

Question 25

Where is cutaneous sensation loss tested for in radial nerve damage?

Answer 25

Anatomical snuffbox

Question 26

What are the contents of the carpal tunnel?

Answer 26

4 tendons of flexor digitorum superficialis 4 tendons of flexor digitorum profundus Median nerve

Question 27

How is the location of the carpal tunnel found by surface anatomy?

Answer 27

Most distal crease of wrist when slightly flexed

Question 28

What forms the roof of the carpal tunnel?

Answer 28

Flexor retinaculum

Question 29

What is carpal tunnel syndrome?

Answer 29

Pain and paresthesia due median nerve compression

Question 30

What can carpal tunnel syndrome lead to?

Answer 30

Thenar muscle atrophy

Question 31

Describe the pain experienced in carpal tunnel syndrome.

Answer 31

Radiates to forearm | Worse at night and in morning

Question 32

What is found in Guyon's canal?

Answer 32

Palmaris longus tendon Ulnar artery Ulnar nerve

Question 33

What is Tinel's sign?

Answer 33

Tap median nerve to elicit carpal tunnel symptoms

Question 34

What is Phalen's manoeuvre?

Answer 34

Hold wrist in flexion (palms/dorsal aspects pressed together) for 60s to elicit carpal tunnel syndrome symptoms

Question 35

What are the treatments for carpal tunnel syndrome?

Answer 35

Splint to hold in dorsi-flexion overnight Corticosteroid injections into tunnel Surgical decompression

Question 36

What forms the carpal tunnel?

Answer 36

Deep carpal arch | Superficial flexor retinaculum

Question 37

What forms the carpal arch?

Answer 37

Laterally by scaphoid and trapezium | Medially by hook of hamate and pisisform

Question 38

Describe the path of the superficial flexor retinaculum.

Answer 38

Originates in lateral side and inserts on medial side of carpal arch

Question 39

What happens to the median nerve once it passes through the carpal tunnel?

Answer 39

Divides into recurrent branch and palmar digital nerve branch

Question 40

What does the palmar digital nerve give sensory innervation to?

Answer 40

Palmar skin | Dorsal nail beds of lateral 3.5 digits

Question 41

What surrounds the 8 tendons of the flexor digitorum profundus and superficialis?

Answer 41

Synovial sheath

Question 42

What is the flexor carpi radialis tendon associate with?

Answer 42

Flexor retinaculum