Upper Extremity: Hand (Part 1) Flashcards
(44 cards)
1
Q
A digit (ray) contains
A
- Metacarpal
- Proximal phalanx
- Intermediate (Middle) phalanx
- Distal phalanx
- Thumb (pollex) does not have a middle phalanx
2
Q
Joints of the Hand
A
- Carpometacarpal joints
- Metacarpophalangeal (MCP) joints (“knuckles”)
- Interphalangeal (IP) joints
3
Q
Carpometacarpal Joints
A
- Between proximal end of metacarpal and distal row of carpals
- 1st carpometacarpal joint is a saddle joint
4
Q
Metacarpophalangeal (MCP) Joints (“Knuckles”)
A
- Between distal end of metacarpal and proximal phalanges
5
Q
Interphalangeal (IP) Joints
A
- Proximal (PIP)
- Distal (DIP)
- Thumb only has an interphalangeal joint
6
Q
Middle Finger
A
- Used as a reference point with finger abduction/adduction
7
Q
Types of Grips
A
- Power
- Precision
8
Q
Power Grip
A
- Different types
- Significant force produced
9
Q
Power Grip Relies on
A
- Finger flexion
- Wrist extension
- Thumb adduction, flexion, opposition
10
Q
Precision Grips
A
- Different types
- Less force
11
Q
Fascia of the Palm
A
- Continuous with antebrachial fascia (forearm deep fascia)
- Fascia is thin over thenar and hypothenar regions
- Palmar aponeurosis
12
Q
Palmar Aponeurosis
A
- Thick, covers central compartment and flexor tendons
- Made up of longitudinal and transverse bands
13
Q
Palmar Aponeurosis Attaches to
A
- Flexor retinaculum and palmaris longus
- Fibrous sheaths
14
Q
Compartments of the Palm
A
- Compartments created by bone, deep fascia, and septa extensions
15
Q
Compartments of the Palm Containing Muscle
A
- Thenar
- Hypothenar
- Central
- Adductor
- Interosseous
16
Q
Spaces of the Compartments of the Arm
A
- Thenar
- Midpalmar
17
Q
Midpalmar Compartment of the Arm
A
- Communicates through carpal tunnel into the forearm
18
Q
Fibrous Digital Sheath (Tendon Sheath of the Hand)
A
- Osseofibrous tunnel
- Surrounds digital synovial sheaths
- Vincula
19
Q
Fibrous Digital Sheath Structure
A
- Surrounds digital synovial sheaths
- Formed by annular and cruciform ligaments
- Prevents bowstringing
20
Q
Vincula of Fibrous Digital Sheath
A
- Attaches tendons to bones and neighboring tendons
- Allow for the passage of blood vessels
21
Q
Tendon Sheaths of the Hand
A
- Fibrous digital sheath
- Ulnar bursa
- Radial bursa
22
Q
Ulnar Bursa
A
- Communicate with the synovial sheath of the 5th digit
23
Q
Radial Bursa
A
- Communicates with 1st digital synovial sheath
24
Q
Spread of Infection (Hand to Forearm)
A
- Midpalmar space > forearm
- 1st digit > wrist/distal forearm
- 5th digit > wrist/distal forearm
25
Clinical Importance of Tendon Sheaths/Infection
- Infection in the synovial sheaths of the hand/digits can spread into the forearm (Space of Parona)
26
Dupuytren's Contracture
- Thickening and shortening of palmar aponeurosis
- Most common in ring and little finger
- Nodule thickenings progresses to contracture of longitudinal bands
27
Dupuytren's Contracture Cause
- Unknown
- Hereditary predisposition
- Possible risk factors: smoking, diabetes, manual labor
- Microvascular ischemia
28
Dupuytren's Contracture Treatment
- Fasciotomy
- Fasciectomy
- Collagenase injections (break down collagen)
29
Trigger Finger
- Thickening of a flexor tendon in the distal palm
- Restriction of tendon gliding under the fibrous sheath
- Palpable nodule that gets “stuck”
- Locking of finger into flexion (most common)
- “Snaps” into place
30
Trigger Finger Cause
- Unknown
- Other disease conditions (diabetes, inflammatory arthritis)
- Repetitive, forceful digital flexion
31
Intrinsic Muscles of the Hand
- Thenar muscles
- Adductor pollicis
- Hypothenar muscles
- Lumbricals
- Interossei
32
Thenar Muscles
- Abductor pollicis brevis
- Flexor pollicis brevis
- Opponens pollicis
33
Hypothenar Muscles
- Abductor digiti minimi
- Flexor digiti minimi
- Opponens digiti minimi
34
Interossei Muscles
- Dorsal
| - Palmar
35
Thenar Muscles Proximal Attachments
- Flexor retinaculum
| - Carpal bones (trapezium, scaphoid)
36
Thenar Muscles Distal Attachments
- 1st metacarpal (OP)
- Base of thumb proximal phalanx
- Sesamoid bone ( for APB, FPB)
37
Thenar Muscles Innervation
- Recurrent branch of median nerve
| - Deep portion of FPB can be innervated by deep branch of ulnar nerve
38
Thenar Muscles Function
- Name tells you function
- APB: abduction of the thumb
- FPB flexes CMC and MCP
- Opposition involves flexion, abduction and medial rotation at thumb CMC
39
Adductor Pollicis
- 2 heads
- Oblique
- Transverse
40
Oblique Adductor Pollicis Proximal Attachment
- Capitate
| - Base of 2nd and 3rd mets
41
Transverse Adductor Pollicis Proximal Attachment
- Palmar surface of 3rd met
42
Adductor Pollicis (Both Obliqe and Transverse) Distal Attachments
- Medial aspect of proximal phalanx, sesamoid bone
43
Adductor Pollicis (Both) Innervation
- Deep branch of ulnar nerve
44
Adductor Pollicis (Both) Function
- Moves thumb toward hand
