Wrist and Hand

Question 1

what are the three groups of bone in the wrist and hand

Answer 1

8 carpal bones of the wrist
5 metacarpals
phalanges (thumb 2, fingers 3)

Question 2

which bones make up the proximal wrist

Answer 2

lateral to medial 
scaphoid (articulates with radius) 
lunate (articulates with radius) 
triquetrum 
pisiform

Question 3

which bones make up the distal row of the wrist

Answer 3

lateral to medial 
trapezium 
trapezoid 
capital 
hamate

Question 4

what are metacarpals made up of

Answer 4

base, shaft and head

Question 5

what do the phalanges consist of

Answer 5

thumb - proximal and distal

finger - proximal middle and distal

Question 6

what are carpometacarpal joints

Answer 6

between metacarpals and distal row of the carpal bones

Question 7

what makes up the first caropmetacarpal joint

Answer 7

metacarpal 1 and trapezium

Question 8

what bones of the wrist compose 2-5 carpometacarpal joints

Answer 8

2nd - trapezoid
3rd - capitate
4th/5th - capitate

Question 9

what are metacarpophalangeal joints

Answer 9

condylar joints

related metacarpals and the proximal phalanges

Question 10

what movements can the metacarophalanageal joints do and what are they protected by

Answer 10

flexion extension abduction adduction circumduction and rotation
palmar ligament and collateral ligaments

Question 11

what are the four walls of the carpal tunnel

Answer 11

roof = flexor digitorum
medial wall = pisiform and hook of hamate
lateral = scaphoid and trapezium

Question 12

what structures travel through the carpal tunnel

Answer 12

flexor digitorum superficlis and profundus (deep)
flexor pollicis longus
median nerve

Question 13

what is the thenar eminence

Answer 13

three muscles in area at base of thumb
opponens pollicis, flexor pollicis brevis, abductor pollicis brevis
these muscles are innervated by the recurrent branch of the median nerve

Question 14

describe the structure and role of the opponens pollicis

Answer 14

largest of thenar muscles 
deep 
O = tubercle of trapezium and flexor reticulum 
I = lateral margin of metacarpal 1
rotates and flexes meta 1 on trapezium

Question 15

describe the structure and function of the abductor pollicis brevis

Answer 15

overlies opponens and proximal to flexor pollicis brevis
O = tubercles scaphoid and trapezium
I = lateral base of proximal phalanx + extensor hood
abducts thumb

Question 16

describe the stricture and function of the flexor polliicis brevis

Answer 16

distal to abductor pollicis
O = tubercle of trapezium
I = lateral side, base proximal phalanx
flexes metacarpophalangeal joint of thumb

Question 17

what is the hypothenar eminence

Answer 17

opponens digiti minimi, abductor digiti minimi flexor digiti minimi
swelling on medial side of palm
innervated by the deep branch of the ulnar nerve

Question 18

describe the structure and role of the of opponens digiti minimi

Answer 18

deepest of three
O = hook of hamate
I = medial margin and palmar surface of metacarpal 5

Question 19

describe the structure and role of the of abductor digiti minimi

Answer 19

overlies opponens
O = pisiform, pisohamate ligament
I = medial side base of proximal phalanx of little finger into extensor hood
principle abductor

Question 20

describe the structure and role of the of flexor digiti minimi brevis

Answer 20

lateral to abductor minimi
O = hook of hamate
I = same as abductor
flexes at metacarpophalengeal point

Question 21

apart from the thenar and hypotheanr emnincens what are the other muscles of the hand

Answer 21

interossei
adductor pollicis
lumbrical muscles

Question 22

what are the two types of lumbricals

Answer 22

medial, bipennate
O = tendon of FDP, little and ring, middle and ring
I = laterally into extensor hood
innervated by deep branch of ulnar

lateral, unipennate
O = tendon of FDP middle and index
I = laterally into extensor hood
digital branches of median

they flex metacarpophalangeal but extend interphalangeal

Question 23

what are the two types of interossei muscles

Answer 23

dorsal and palmar

Question 24

describe the structure an d function of the dorsal interosseous muscles

Answer 24

4 bipinnate between shafts of metacarpal bones on the dorsal aspect of hand
insert into proximal phalanx
1st - largest, lateral side of index
2nd / 3rd - lateral and medial side of middle finger
4th - medial side of 5th finger

flexion and extension, major abductors of index, middle and ring at metacarpophalangeal

Question 25

describe the structure and function of the palmar interosseous muscles

Answer 25

anterior to dorsal interosseoi unipennate 1 isn't always present but 2,3,4 are medial on index finger but lateral on ring and little adduct thumb, index, ring and little, flexion and extension due to passing through extensor hood

Question 26

what is the difference between palmar and dorsal interosseous muscles

Answer 26

PAD - palmar adduct | DAB - dorsal abduct

Question 27

what is the role of the adductor pollicis

Answer 27

triangular muscle transverse (MC 3) and oblique head (base MC 2 and 3) inserts into base of proximal phalanx of thumb and into extensor hood adductor and opposes digits for gripping

Question 28

what forms the extensor hood

Answer 28

tendons of the extensor digitorum and extensor pollicis longus

Question 29

which tendons join into the extensor hood

Answer 29

extensor digiti minimi | extensor indicis, extensor pollicis brevis

Question 30

what is the benefit of the extensor hood

Answer 30

allows intrinsic muscles of the hand to produce complex delicate movements of the digits

Question 31

what are the all muscles that attach to the extensor hood which anchor the hood

Answer 31

index, middle, ring, little, lumbrical, inyterossei, abductor digiti minimi adductor pollicis and abductor pollicis brevis

Question 32

what is responsible for the fine movement of the upstroke in writing

Answer 32

flex at MCP but extending the IPJ | intrinsic muscles working through extensor hood

Question 33

what two main arteries supply the hand

Answer 33

radial - mainly to supply the tumblebug and the lateral side of the index finger ulnar - medial side of index finger and reset of digits

Question 34

what happens to the ulnar artery when it reaches the hand

Answer 34

splits into superficial player arch and deep from superior - common palmar digital arteries superior anastomoses with radial artery

Question 35

describe the route of the radial artery in the hand

Answer 35

enters dorsally anastomoses with the deep palmar arch which gives rise to 5 arteries supplying the digits

Question 36

where does the ulnar artery and radial artery end in the hand

Answer 36

ulnar terminates at the superficial arch | radial terminates at the deep arch

Question 37

where do the cephalic and basilic veins originate

Answer 37

C - lateral side of dorsal - passes over snuffbox | B - medial side passes into dorsomedial aspect of forearm

Question 38

describe the cutaneous innervation of the median nerve to the hand

Answer 38

C6 palmer aspect of thumb, index, middle and half of ring dorsal aspect - distal phalanges of lateral 3.5 digits

Question 39

describe the cutaneous innervation of the /radial nerve of the hand

Answer 39

C7 | mainly dorsal apart from anterior lateral aspect of thumb, dorsal of first 3.5 digs excluding the tips

Question 40

describe the cutaneous innervation of the ulnar nerve of the hand

Answer 40

C8 palmar - lateral 1.5 digits dorsal lateral 1.5 digits