Flashcards in Wrist and Hand pgs 86-97 Deck (29)
What 3 parts does the skeleton of the hand consist of?
Carpals, Metacarpals, and Phalanges
How are the digits of the hand numbered?
1-thumb 2-index 3-middle 4-ring 5-little finger
What is the Thenar eminence?
Lateral larger and more prominent at base of the thumb. Steve def- chunk of meat at the base of the thumb
What is the Hypothenar eminence?
medial, smaller proximal to 5th digit. Steve def- muscle group on the medial side of the palm
Which types of movement are allowed in the Radiocarpal joint?
Lots! flexsion/extension, radial and ulnar deviation, and circumduction
Where and what is the function of the Ulnar collateral ligament?
Attached to ulnar styloid process and triquetrum-it strengthens the capsule medially
Where and what is the function of the Radial collateral ligment?
Attached to radial styloid process and scaphoid- strengthens capsule laterally
Where and what is the function of the Palmar radiocarpal l.?
Passes from radius to two rows of carpals- strengthens capsule from palmer side- strong so hand follows radius during supination of forearm
Where is the Palmer ulnocarpal l.?
passes from Ulna to first two rows of carpals
Where and what is the function of the Dorsal radiocarpal l.?
It passes from the radius to two rows of carpals on dorsum of hand- strengthens capsule on dorsl side- strong so hand follows radius on pronation of the forearm
The Carpometacarpal joint is composed of which 3 ligaments?
Dorsal CMC l., Palmar CMC l., Superficial and deep transverse CMC l.
The Metacarpophalangeal joints are composed of which 3 ligaments?
Medial collateral l., Lateral collateral l.-cord like with thin parts that fan out and attach to the palmar ll.(plates), Deep Transverse metacarpal l.- unites palmar ll. of 2nd-5th MP joints
there are distal and proximal ones (PIP) and (DIP) also each joint has a medial and lateral collateral ligament.
What is the Palmar Aponeurosis?
It is deep fascia that is continous with the antebrachial fascia and fascia of the dorsum of the hand. It is thin over the thenar and hypothenar eminences.
What is the deep fascia of the palm continous with? Has 10 parts
Palmar Aponeurosis, flexor retinaculum, palmaris longus tendon, fibrous digital sheaths, medial fibrous septum, lateral fibrous septum, and the thenar compartment, Hypothenar compartment, central compartment, and adductor compartment...Yikes
What are the 4 compartments of the palm?
Thenar, hypothenar, central, and adductor
Where, what does the thenar space contain and what is the is it bound by?
Helpful to see a diagram for this. It is lateral to the lateral fibrous septum and contains the thenar mm. and is bounded by the thenar fascia
Where, what does the hypothenar space contain, and what is it bound by?
It is medial to medial fobrous septum, contains hypothenar mm. and bounded anteriorly by hypothenar fascia
Where, what is in the central compartment of the palm, and what is it bound by?
Between hypothenar and thenar comprtments, contains flexor tt. and sheaths, lumbricals, superficial palmar arterial arch and digital vessels and nn., bounded anteriorly by palmar aponeurosis
Where is the adductor compartment what is it bound by?
Between thenar and interosseous compartments, contains adductor pollicus m.
What are the two potential spaces that can exist in the palm?
Thenar space- underlies thenar compartment, lateral to lateral fibrous septum, distally relates to the synovial tendon sheath of the index finger, and proximally related to common flexor sheath distal to carpal tunnel
Midpalmar space- Underlies central compartment, lateral to medial fibrous septum, distally to synovial tendon sheath of digits 3-5, and proximally related to common flexor sheath as it emerges from the carpal tunnel
What is a Dupuytren Contracture?
It is a disease of the palmar fascia on both hands in men over the age of 50. The cause is unknown and results in a progressive shortening, thickening, and fibrosis of palmar fascia. Not painful at first but over time palmar ridges start to form under the 4th and 5th digits. Those digits result in constant partial flexion. Requires surgery and has a high reoccurance rate
What ligament forms the carpal tunnel?
The flexor retinaculum (transverse carpal l.)
Which tendons go through the carpal tunnel?
Tendons of the FDS(flexor digitorm supercials, FDP(flexor digitorm profundus), and FPL(flexor pollicus longus). Also the median nerve between the FDS and FDP tt.
Which structures pass over the carpal tunnel?
Palmaris cutaneous branch of the median nerve, radial a., Ulnar n. and a., FCU t., Palmaris Longus t., FCR t.
Guyon Canal(tunnel) AKA- Ulnar canal. what froms it and what is in it????
Formed by depression between pisiform and hook of hamate, covered by pisohamate l., and forms an osseofibrous tunnel. It contains the Ulnar n. and a.
What is up with Ulnar Canal Syndrome?
It is caused by compression of the Ulnar n. in the Guyon Canal. Results in: Hypoesthesia(diminished sensation) in the medial 1 1/2 digits, weakness of intrinsic hand muscles, "Clawing" may occur in 4th and 5th digits.
Unlike proximal ulnar n. injuries: ability to flew is unaffected and no radial deviation in the hand
What do the thenar muscles do?
They are responsible for the opposition of the thumb