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YR2: Limbs > The hand > Flashcards

The hand Flashcards

1
Q

How are the thumb and digits named?

A 
Thumb
Index Finger 
Middle Finger 
Ring Finger
Little Finger
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2
Q

Name the carpal bones.

A

Scaphoid, Lunate Triquetrum, Pisiform

Trapezium, Trapezoid, Capitate, Hamate

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3
Q

What other bones make up the hand?

A

Metacarpals

Proximal, Middle + Distal Phalanges

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4
Q

How many radio-ulnar joints are there?

A

2: proximal + distal

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5
Q

Describe the distal articulation of the radius and ulna with the carpal bones.

A

Radius: articulates with scaphoid + lunate
Ulna: articulates with an articular disc

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6
Q

What separates the anterior and posterior compartments of the forearm?

A

Interosseous membrane

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7
Q

What type of bone is the pisiform bone?

A

Sesamoid: it is encased within flexor carpi ulnaris tendon

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8
Q

What are the four parts of the metacarpals?

A

Head (distal), tubercle, shaft + base

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9
Q

Which two carpal bones have bone protrusions?

A

Hook of Hamate

Tubercle of Trapezium

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10
Q

What type of skin do you get on the palms of your hands?

A

Palmar-plantar skin

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11
Q

Which muscle forms the palmar aponeurosis? (If present)

A

The distal end of palmaris longus

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12
Q

What is the palmar aponeurosis distally and proximally continuous with?

A

Distal: fibrous digital sheaths
Proximal: flexor retinaculum

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13
Q

What is contained within the fibrous digital sheaths?

A

Flexor tendons + their synovial sheaths

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14
Q

Which muscle tendons are found within the fibrous digital sheaths? Describe their attachments.

A

Flexor digitorum superficialis
Flexor digitorum profundus
FDS lies superficial to FDP + splits in 2 about midway up the proximal phalanx
FDP then runs between the 2 divisions of FDS
The 2 branches of FDS attach to the middle phalanx + FDP attaches to the distal phalanx

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15
Q

Which small quadrate muscle is found proximal to the hypothenar compartment?

A

Palmaris brevis

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16
Q

What is another name for the flexor retinaculum?

A

Transverse carpal ligament

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17
Q

Name the 4 compartments of the hand.

A

Thenar
Hypothenar
Adductor
Central

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18
Q

What separates the compartments of the hand?

A

Fibrous septa
From palmar aponeurosis to little finger metacarpal medially
From palmar aponeurosis to middle finger metacarpal laterally

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19
Q

What are the two main spaces found within the hand?

A

Midpalmar

Thenar

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20
Q

What structures do the septa form within the hand?

A

Channels that contain structures e.g. long flexors passing from the wrist into the digits

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21
Q

What does ‘carpi’ mean?

A

Acting on the wrist

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22
Q

What does ‘digitorum’ mean?

A

Acting on >1 finger

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23
Q

State the muscles in the superficial anterior compartment of the forearm.

A 
Pronator teres (PT)
Flexor carpi radialis (FCR) 
Palmaris longus (PL)
Flexor digitorum superficialis (FDS)
Flexor carpi ulnaris (FCU)
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24
Q

What is the name given to the proximal attachment of all of the superficial muscles of the forearm?

A

Common flexor origin (at medial epicondyle of the humerus)

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25
What muscles are in the deep anterior compartment of the forearm?
``` Flexor digitorum profundus (FDP) Flexor pollicis longus (FPL) Pronator quadratus (FQ) ```
26
Where do the muscles in the deep anterior compartment of the forearm attach?
Flexor digitorum profundus (FDP) Posterior + medial borders of ulna + interosseous membrane To the distal phalanges of the 4 fingers Flexor pollicis longus (FPL) Interosseous membrane + anterior surface of radius To palmar side of the distal phalanx of the thumb Pronator quadratus (PQ) Anterior surface of distal ulna To anterior surface of distal radius
27
Which muscles of the anterior compartment do not cross the wrist?
Pronator quadratus + pronator teres
28
State the 12 muscles of the posterior compartment of the forearm.
``` Extensor carpi radialis longus (ECRL) Extensor carpi radialis brevis (ECRB) Extensor carpi ulnaris (ECU) Extensor indicis (EI) Extensor digitorum (ED) Extensor digiti minimi (EDM) Abductor pollicis longus (APL) Extensor pollicis longus (EPL) Extensor pollicis brevis (EPB) Brachioradialis Supinator Extensor retinaculum (not a muscle) ```
29
What is the common proximal attachment of most of the posterior forearm muscles?
Common extensor origin (just distal to the lateral epicondyle)
30
Which muscles have a proximal attachment along the ulna rather than the common extensor tendon?
``` Abductor pollicis longus (APL) Extensor pollicis longus (EPL) Extensor pollicis brevis (EPB) Extensor indicis (EI) ```
31
Describe the attachment of brachioradialis.
Distal lateral side of the humerus | To the lateral part of the styloid process of the radius
32
Name the intrinsic muscles of the hand.
Thenar: Abductor pollicis brevis (APB), Flexor pollicis brevis (FPB), Opponens pollicis (OP) Hypothenar: Abductor digiti minimi (ADM), Flexor digiti minimi (FDM), Opponens digiti minimi (ODM) Adductor: Adductor pollicis (AP) Interossei + Lumbricals: Palmar interossei, Dorsal interossei, Lumbricals
33
What movements are the lumbricals responsible for?
Flexion of metacarpophalangeal joint (MCP) | Extension of the interphalangeal joints (IPJs)
34
What movements are the palmar and dorsal interossei responsible for?
PAD + DAB Palmar = ADduction of fingers Dorsal = ABduction of fingers
35
Which muscles are responsible for the following thumb movements:
``` Abduction: APL + APB Adduction: AP + 1st dorsal interosseus Extension: EPL, EPB, APL Flexion: FPL, FPB Opposition: Opponens pollicis ```
36
Why is adductor pollicis in a different compartment to the other pollicis muscles?
It is innervated by the ulnar nerve whereas the thenar muscles are all innervated by the median nerve
37
How many lumbricals, dorsal interossei and palmar interossei are there?
Lumbricals: 4 Dorsal interossei: 4 Palmar interossei: 3
38
Describe the attachments of the dorsal interossei and explain why they cause abduction of the fingers.
Attached proximally to adjacent metacarpals They attach distally to the base of the proximal phalanx + extensor expansion towards the axial line (towards middle finger) of the hand Dorsal interossei 2 + 3 are attached to opposite sides of the middle finger, fixing middle finger in the midline while dorsal interossei 1 + 4 cause abduction of the index + little fingers
39
Describe the attachments of the palmar interossei.
Attached to extensor expansion away from the axial line (no palmar interossei attached to the middle finger) Cause adduction of the fingers whilst the middle finger remains still
40
Describe the attachments of the lumbricals.
Attached proximally to tendons of flexor digitorum profundus Wrap around lateral side of the digits + insert into a hood of connective tissue: the extensor expansion, at the proximal interphalangeal joint
41
Describe the sheaths that that the tendons of flexor digitorum superficialis and flexor digitorum profundus travel in after passing under the flexor retinaculum.
Pass under flexor retinaculum in the carpal tunnel then enter a common synovial sheath Those going to the middle 3 fingers enter digital synovial sheath, within its own digital sheath
42
Describe how the little finger and thumb sheaths are different to the other three fingers.
Their digital synovial sheaths are continuous with the common synovial sheath
43
Describe the arrangement and attachment of flexor digitorum superficialis and flexor digitorum profundus as it runs along the fingers.
FDS splits around FDP around the middle of the proximal phalanx FDS then attaches to the middle phalanx FDP attaches to the distal phalanx
44
What are the two types of pulley that hold the tendons down to the bone?
Annular | Cruciform
45
Describe the posterior tendinous anatomy of the hand.
Extensor retinaculum Synovial tendon sheaths Inter-tendinous bands At the end of the long extensors there are extensor expansions
46
Which muscles attach to the extensor expansions?
Lumbricals + some interossei
47
What are the two fibrous capsules found at the wrist joint?
Radio-carpal joint | Distal radio-ulnar joint
48
Which two ligaments are found on the radial and ulnar sides of the wrist?
Radial Collateral Ligament | Ulnar Collateral Ligament
49
Which muscles are important for the following wrist movements:
Flexion: Flexor carpi radialis Flexor carpi ulnaris (+ long flexors of the thumb + fingers + palmaris longus + abductor pollicis longus) ``` Extension: Extensor carpi radialis longus Extensor carpi radialis brevis Extensor carpi ulnaris (+ long extensors of the thumb + fingers) ``` ``` Radial Deviation: Flexor carpi radialis Extensor carpi radialis longus Extensor carpi radialis brevis Abductor pollicis longus ``` Ulnar Deviation: Flexor carpi ulnaris Extensor carpi ulnaris
50
What is the name given to the joint between the proximal + distal row of carpal bones?
Midcarpal joint
51
Which carpal bone does the thumb metacarpal articulate with?
Trapezium
52
What movements are the metacarpophalangeal joints capable of?
Flexion + Extension | Abduction + Adduction
53
What ligament prevents hyperextension of the interphalangeal joints?
Palmar plates (AKA volar plates)
54
Which ligaments prevent abduction and adduction of the interphalangeal joints?
Collateral ligaments
55
What are the two main arteries of the hand and what do they divide into?
Ulnar Artery (beside FCU in wrist): Interosseous arteries of the forearm Superficial palmar arch: palmar digital arteries Deep palmar branch Radial Artery (under brachioradialis + beside FCR in wrist) Found in anatomical snuff box Deep palmar arch Palmar metacarpal arteries
56
What are the anterior and posterior interosseous arteries a branch of?
Ulnar Artery
57
What is the arch on the dorsal side of the hand called?
Dorsal carpal arch
58
Where do you find anastomoses in the hand?
Between the dorsal + palmar digital arteries | The arches + plexuses are also places of anastomoses between the radial + ulnar arteries
59
What are the two main superficial veins of the arm?
Cephalic (lateral border of arm) | Basilic (medial border of arm)
60
What happens to the basilic and cephalic veins as they pass into the upper arm?
Basilic vein joins venae comitantes to form axillary vein | Cephalic vein joins the axillary vein in the axilla
61
At what point does the axillary vein become the subclavian vein?
At the level of the first rib
62
What pattern do the deep veins from the hand follow?
They pass in the opposite direction to the arteries
63
What vein links the cephalic and basilic vein in the cubital fossa?
Median cubital vein
64
Which spinal nerves contribute to the Ulnar, Median and Radial nerve?
Ulnar Nerve : C8-T1 Median Nerve: C6-T1 Radial Nerve: C5-T1
65
What is the main motor nerve of the hand?
Ulnar nerve
66
What is the radial nerve responsible for in the hand?
Sensory innervation of the lateral half of the dorsum of the hand
67
What type of nerve are the digital nerves?
Purely sensory because motor innervation to muscles controlling fingers happens more proximally
68
What are the contents of the carpal tunnel?
4 tendons of flexor digitorum superficialis 4 tendons of flexor digitorum profundus Flexor pollicis longus tendon Median nerve
69
Where does the median nerve lie relative to the forearm muscles at the wrist?
In between FDP + FDS | Deep to PL
70
What intrinsic hand muscles does the median nerve provide motor supply to?
``` LOAF Lumbricals (1 + 2) Opponens pollicis Abductor pollicis brevis Flexor pollicis brevis ```
71
What does the median nerve provide sensory supply to?
``` Palmar surface of thumb Index finger Middle finger Half of the ring finger Some of the dorsal surface of those digits ```
72
Describe the position of the ulnar nerve at the wrist.
It lies by flexor carpi ulnaris | It runs over the flexor retinaculum, lateral to the pisiform
73
What are the two branches of the ulnar nerve in the hand and what are their roles?
``` Superficial branch sensory to: palmar surfaces of Little finger + medial half of right finger Deep branch motor to: Hypothenar muscles Adductor pollicis Lumbricals 3 + 4 All the interossei (all muscles except LOAF) ```
74
The radial nerve divides into two branches just above the elbow. What are the two branches of the radial nerve?
Superficial radial nerve (sensory) | Posterior interosseous nerve (motor, deep)
75
Which part of the hand does the radial nerve supply sensory innervation to?
Dorsum of the hand (mainly thumb, index finger + middle finger) NO motor supply to hand
76
What sensory branches does the median nerve give off before passing under the flexor retinaculum?
Palmar cutaneous branch | Dorsal digital branches
77
What branches do the superficial radial nerve and dorsal branch of the ulnar nerve split into?
Dorsal digital nerves/branches
78
What are the bony attachments of the carpal tunnel that forms a gutter?
Scaphoid Trapezium Pisiform Hamate
79
What is the roof of the carpal tunnel?
Flexor retinaculum
80
Through which canal do the ulnar nerve and artery pass through?
Guyon’s Canal
81
What are the three different types of grip and which muscles are involved in each type?
Power Grip: Long flexors of the fingers + thumb Intrinsic muscles of the palm Extensors of the wrist joint Precision Grip: The wrist + fingers are held rigidly by the long flexors + extensors The intrinsic muscles of the hand carry out the fine movements needed Hook Grip: Consumes little energy Mainly involves long flexors of the digits (e.g. carrying briefcase)
82
What is the function of the flexor retinaculum and extensor retinaculum?
To hold tendons to bones | Prevent bow-stringing
83
What do you call the joints between the adjacent proximal carpal bones or distal carpal bones? What occurs here?
Intercarpal joints | Gliding occurs here
84
What movements are the carpometacarpal and intermetacarpal joints capable of?
Flexion + extension Radial + ulnar deviation Circumduction
85
What movements are the interphalangeal joints capable of?
Flexion + Extension

YR2: Limbs (8 decks)

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