structure and function of the hand

Question 1

what is the flexor retinaculum?

Answer 1

thickening of the deep fascia, it stretches across palmar surfaces of carpal bones

Question 2

how is the flexor retinaculum attached?

Answer 2

medially to pisiform &hook of hamate.

Laterally to scaphoid & trapezium.

Question 3

what is the palmar aponeurosis

Answer 3

triangular in shape and occupies central part of the palm

Question 4

how does the palmar aponeurosis attach

Answer 4

tip attaches to distal border of flexor retinaculum
– It receives insertion of tendon of the palmaris longus
– Its base is divides into 4 slips which fuse with fibrous flexor sheath and deep transverse ligaments

Question 5

what is the function of the palmar aponeurosis

Answer 5

Improves grip strength.
It protects the underlying
structures in the palm.

Question 6

what is the name of the deformity resulting in fibrosis of the palmar aponeurosis

Answer 6

Dupuytren’s contracture

Question 7

what is the effects of the dupuytrens contracture

Answer 7

Thick, scar-like tissue forms under the skin of the palm and may extend
into the fingers, pulling them toward the palm and restricting motion.

Question 8

what are some treatments of dupuytrens contracture

Answer 8

1. Stretch.
2. Steroids & enzymes injection.
3. Radiations.
4. Needle aponeurotomy.

Question 9

what does the carpal tunnel transmit

Answer 9

1. Median nerve.
2. Flexor digitorum superficialis & profundus tendons with the
   synovial sheath (ulnar bursa).
3. Flexor pollicis longus tendon with its synovial sheath (radial
   bursa)
4. Flexor carpi radialis tendon with its synovial sheath.

Question 10

the muscles of the thumb are made up of thenar muscle group and adductor pollicis. what is this group made up of

Answer 10

1. Abductor pollicis brevis
2. Flexorpollicisbrevis
3. Opponens pollicis

Question 11

thenar muscle have a common origin what is it?

Answer 11

Common Origin:

Flexorretinaculum & trapezium.

Question 12

what is the origin and insertion points of adductor pollicis

Answer 12

Origin: Palmar surface of 2nd & 3rd metacarpals.
Insertion:Medial side of base of proximal phalanx of thumb.

Question 13

what are the origin and insertion points of palmar brevis

Answer 13

Origin:Palmar aponeurosis
Insertion:Skin on the medial margin of the hand.

Question 14

what is the origin points of

1. Abductor digiti minimi
2. Flexordigitiminimi
3. Opponensdigitiminimi

Answer 14

they share a common origin:Flexor retinaculum & hamate

Question 15

what are the insertion points of

1. Abductor digiti minimi
2. Flexordigitiminimi
3. Opponensdigitiminimi

Answer 15

1. Abductor digiti minimi:Base of proximal phalange of little finger medially.
2. Flexor digiti minimi: Base of proximal phalange of little finger
3. Opponens digiti minimi:Medial margin of metacarpal

Question 16

what is the origin of the lumbrical muscles(4 small, cylindrical muscles for the medial 4 fingers)

Answer 16

1st & 2nd from lateral sides of tendons of flex. dig. Prof.
3rd & 4th from adjacent sides of tendons of flex. dig. Prof.

Question 17

what is the insertion of the lumbrical muscles

Answer 17

common insertion point:extensor expansions

Question 18

what is the action of the lumbrical muscles

Answer 18

They flex the metacarpo- phalangeal joints and extend the inter- phalangeal joints (the writing position).

Question 19

where is the origin of palmar interossei muscles

Answer 19

1st & 2nd from the medial side of first & second metacarpals
respectively.
4th & 5th from the lateral side of the fourth & fifth
metacarpals respectively.

Question 20

where is the insertion of palmar interossei muscles

Answer 20

extensor expansions

Question 21

what are the actions of palmar interossei muscles

Answer 21

1. Like the lumbricals.
2. Adduct the thumb, index & the little ,ring
   fingers towards the central axis which pass through the middle finger around which the other fingers move.

Question 22

what is the origin of the dorsal interossei muscles

Answer 22

1. Like the lumbricals.

2. Abduct the index, middle & the little, ring fingers from the central axis which pass through the middle finger.

Question 23

what nerve supplies to the palmar and dorsal aspects of medial 1/3 of hand & medial 1 ½ digits.

Answer 23

the ulnar nerve

Question 24

what part of the hand does the median nerve suply

Answer 24

Sensory to skin of the lateral 2/3 of the palmar aspect of hand & lateral 3 ½ digits (including dorsal aspect of their distal phalanges).
Motor to thenar muscles &lateral 2 lumbrical muscles.

Question 25

what part of the hand does the radial nerve supply

Answer 25

It supplies the skin of lateral 2/3 of the dorsal surface of the hand & the skin of the dorsal surface of the lateral 3½ fingers except the distal phalanges which are supplied by median nerve.

Question 26

which 2 arteries form the deep palmar arch in the hand

Answer 26

It is formed by the radial artery and the deep palmar branch of the ulnar artery.

Question 27

where is the deep palmar arch located

Answer 27

It is located between the long flexor tendons and the metacarpal bones.

Question 28

which 2 arteries form the superficial palmar arch

Answer 28

It is formed by the ulnar artery and the superficial branch of radial artery. .

Question 29

where is the superficial palmar arch located

Answer 29

It is located between the palmar aponeurosis and long flexor tendons.

Question 30

how is the dorsal venous network of the hand drained

Answer 30

Dorsal venous network drains proximally into cephalic vein laterally and basilic vein medially.

Question 31

what causes carpal tunnel syndrome

Answer 31

increase size of some of the structures passing through the tunnel e.g. excessive exercise of the fingers , trauma >> swelling/infection >> compression of the median nerve.

Question 32

what would be the your diagnosis if a patient came in with Weakness in thenar muscles (recurrent branch). Numbness and tingling in the lateral 3 ½ fingers. The palmar aspect of the lateral 2/3 of hand is spared because palmer cutaneous nerve is spared because it passes superficial to the retinaculum.

Answer 32

these symptoms of carpal tunnel syndrome

Question 33

how do we treat carpal tunnel syndrome

Answer 33

Immobilization and ice | Surgery to increase space in the tunnel.