The hand and joints of the upper limb

Question 1

How are carpal bones connected to each other?

Answer 1

Intercarpal ligaments

Question 2

What are the components of each metacarpal bones?

Answer 2

Base, shaft and head

Question 3

How much movement at the carpometacarpal joint?

Answer 3

Minimal movement, except at thumb where more movement is permitted

Question 4

What type of joint is the first (thumb) carpometacarpal joint?

Answer 4

Saddle-shaped

Question 5

What joins the shafts of the metacarpal bones?

Answer 5

Transverse metacarpal ligaments and the palmar and dorsal interossei

Question 6

What is the shape of the metacarpophalangeal joints?

Answer 6

Condyloid (shaped like knob and cup)

Question 7

What type of movement is enabled by condyloid joints?

Answer 7

Biaxial (movement in 2 planes)

Question 8

What are the components of the phalangeal bones?

How many phalanges are there in each digit?

Answer 8

Base, shaft and head

3 in fingers (proximal, middle, distal)
2 in thumb (proximal and distal)

Question 9

What is the classification of the interphalangeal joints?

Answer 9

Hinge joints

Question 10

What movement is permitted by the interphalangeal joints?

Answer 10

Flexion and extension

Question 11

What stabilises the interphalangeal joints?

Answer 11

Radial and ulnar collateral ligaments

Question 12

What is the classification of the elbow joint?

Answer 12

Synovial hinge joint

Question 13

What happens to the radial head during pronation/supination at the elbow joint?

Answer 13

Articulates with the ulna

Question 14

What happens to the radial head during flexion/extension at the elbow joint?

Answer 14

Slides onto the capitulum of the humerus

Question 15

Where does the capsule of the elbow joint attach?

Answer 15

The margins of the articular surfaces

The epicondyles are extracapsular

Question 16

Where is the capsule of the elbow joint lax?

Why is this?

Answer 16

Anteriorly and posteriorly

To permit full flexion and extension

Question 17

How is stability of the elbow joint maintained?

Answer 17

The congruous articular surfaces of the trochlea and trochlea fossa

Medial and lateral collateral ligaments

Anular ligament around the radial neck

Question 18

What joints are involved in pronation/supination?

Answer 18

Superior and inferior radio-ulnar joints

The superior RU joint communicates with the elbow joint

Question 19

What is the classification of the wrist joint?

Answer 19

Synovial ellipsoid joint

Question 20

What bones are connected by the wrist joint?

Answer 20

Concave distal surface of the radius articulates with the convex proximal surfaces of the scaphoid and lunate

Question 21

How is the head of the ulna separated from the triquetrial bone?

How is the wrist joint separated from the distal radio-ulnar joint?

Answer 21

a triangular fibrocartilaginous disc which attaches to the edge of the ulnar notch of the radius and the base of the styloid process of the ulna

Question 22

What is the function of palmaris brevis?

Answer 22

Improves grip by stabilising the skin on the ulnar side of the palm

Question 23

Where is palmaris brevis?

Answer 23

Attached to the dermis and lies across the base of the hypothenar eminence

Question 24

What is the palmar aponeurosis?

Answer 24

Deep fascia of the palm to which the skin is firmly attached

(skin around palmaris brevis is an exception)

Question 25

Why do large subcutaneous veins drain from the palm?

Answer 25

So that the pressure of gripping does not impede venous return

Question 26

Describe the structure of the palmar aponeurosis

Answer 26

Consists of a central part that is thick and unyielding. Thinner over the thenar and hypothenar eminences for increased mobility

Question 27

What is proximal to the palmar aponeurosis?

Answer 27

Tendon of palmaris longus

Question 28

What is distal to the palmar aponeurosis?

Answer 28

Divides into 4 sheaths which are continuous with the fibrous flexor sheaths for the fingers

Question 29

What are the muscles of the thenar eminence?

Answer 29

Abductor pollicis brevis (lateral), flexor pollicis brevis(medial), opponens pollicis (deep)

Question 30

What are the muscles of the hypothenar eminence?

Answer 30

Abductor digiti minimi (medial), flexor digiti minimi (lateral) and opponens digiti minimi

Question 31

Which nerve supplies the thenar eminence?

Answer 31

Recurrent branch of the medial nerve

Question 32

Which nerve supplies the hypothenar eminence?

Answer 32

The ulnar nerve

Question 33

What are the deep muscles of the hand?

Answer 33

Adductor pollicis, interossei and lumbricals

Question 34

Which nerve supplies the deep muscles of the hand?

Answer 34

Ulnar nerve, except of lateral 2 lumbricals (median)

Question 35

How many palmar interossei are there?

Answer 35

3

Question 36

How many dorsal interossei are there?

Answer 36

4

Question 37

Where do the interossei originate?

Answer 37

The shafts of the metacarpals

Question 38

Where do the interossei insert?

Answer 38

Proximal phalanges

Question 39

What is the function of the palmar interossei?

Answer 39

Adduction (PAD)

Question 40

What is the function of the dorsal interossei?

Answer 40

Abduction (DAB)

Question 41

How many metacarpals does each palmar interossei arise from?

Answer 41

1

Question 42

How many metacarpals does each dorsal interossei arise from?

Answer 42

2

Question 43

How many lumbricals are there?

Answer 43

4

Question 44

Where do the lumbricals originate?

Answer 44

The tendons of the FDP

Question 45

Where do the tendons of the FDP insert?

Answer 45

Passes around the radial aspect of each finger to insert onto the dorsal expansion

Question 46

What is the function of the lumbricals?

Answer 46

Acts with the interossei to flex the metacarpophalangeal joints and extend the interphalangeal joints

Question 47

Which nerve supplies the lumbricals?

Answer 47

Medial 2 = ulnar Radial 2 = median

Question 48

What is the blood supply of the hand?

Answer 48

Superficial and deep palmar arches

Question 49

What is the superficial palmar arch a continuation of and where does it enter the palm?

Answer 49

Continuation of ulnar artery Enters palm with ulnar nerve, superficial to the flexor retinaculum

Question 50

What is the deep palmar arch a continuation of and where does it enter the palm?

Answer 50

Continuation of the radial artery Passes between the first dorsal interosseous and adductor pollicis to enter the palm from its dorsal aspect