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hand Flashcards

(144 cards)

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1
Q

lateral border of hand nerve innervation

A

superficial radial nerve

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2
Q

lateral 2/3 of palm of hand nerve innervation

A

palmar cutaneous (median) nerve (does not extend to the fingers)

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3
Q

medial 1/3 of palmar aspect of the hand nerve innervation

A

palmar cutaneous (ulnar) nerve (does not extend to the fingers)

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4
Q

sensory innervation for medial 1.5 fingers

A

digital (ulnar) nerve

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5
Q

sensory innervation for lateral 3.5 fingers

A

digital (median nerve)

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6
Q

C8 dermatome of hand

A

medial border of hand and pinky finger

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7
Q

C7 dermatome of hand

A

middle 3 fingers and some palm of hand

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8
Q

C6 dermatome of hand

A

thumb and some palm

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9
Q

best place to test C6 dermatome

A

tip of thumb

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10
Q

best place to test C7 dermatome

A

tip of index finger

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11
Q

best place to test C8 dermatome

A

tip of pinky finger

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12
Q

lateral 2/3 of dorsum of hand nerve innervation

A

superficial radial nerve, extends up to the PIP joint of lateral 3.5 fingers

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13
Q

medial 1/3 of dorsum of hand nerve innervation

A

dorsal cutaneous (ulnar) nerve, which extends to the PIP medial 1.5 fingeres

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14
Q

dorsal aspect of tips of medial 1.5 fingers nerve innervation

A

digital (ulnar) nerve

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15
Q

dorsal aspect of lateral 3.5 fingers nerve innervation

A

digital (median) nerve

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16
Q

most superficial structure of the hand after removing the skin

A

palmar aponeurosis

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17
Q

palmar aponeurosis

A

triangular membrane of dense regular CT which is comprised of longitudinal fibres that are connected together by transverse fibres

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18
Q

apex of palmar aponeurosis attachment

A

palmaris longus tendon

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19
Q

longitudinal fibres of palmar aponeurosis

A

extend into the fingers and blend with the fibrous digital sheath of corresponding fingers

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20
Q

what are longitudinal fibres of palmar aponeurosis anchored to each other by?

A

superficial transverse metacarpal ligaments at the level of MCP joints

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21
Q

superficial transverse metacarpal ligaments

A

are at the level of MCP joints and connect the longitudinal aspects of palmar aponeurosis together

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22
Q

fibrous digital sheaths

A

are attached to the phalanges and function to keep the long extensor tendons in place

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23
Q

what tendons pass deep to flexor retinaculum?

A

4 tendons of FDS, 4 tendons of FDP, and FPL tendon

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24
Q

when are tendons of the hand covered in synovial sheath

A

in the carpal tunnel and when covered by fibrous digital sheath, this functions to keep them moist and lubricated

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25
synovial sheath of flexor policis longus and long flexors of 5th finger
the sheath is continuous from the carpal tunnel to the distal part of these fingers
26
synovial sheath of fingers 2-4
the sheath is interrupted in the central part of the hand and is not continuous like the thumb and pinky finger
27
how many groups of hand muscles are there?
3
28
thenar muscles
is a group of hand muscles that is comprised of abductor pollicis brevis, flexor pollicis brevis, and opponens policis
29
abductor pollicis brevis origin
scaphoid, trapezium, and the adjacent flexor retinaculum
30
abductor pollicis brevis insertion
lateral proximal phalanx and DDE of the thumb
31
abductor pollicis brevis nerve innervation
recurrent branch of median nerve
32
abductor pollicis brevis function
abduct the thumb at the MCP joint
33
flexor pollicis brevis origin
trapezium and flexor retinaculum
34
flexor pollicis brevis insertion
proximal phalanx of the thumb after embracing the small sesamoid bone
35
heads of flexor pollicis brevis
there is a larger superficial head and a smaller deep head
36
flexor pollicis brevis nerve innervation
recurrent branch of median nerve, and sometimes the deep head is innervated by deep ulnar nerve
37
flexor pollicis brevis function
flexes the thumb at the MCP joint
38
deepest muscle in the thenar group
opponens pollicis
39
opponens pollicis origin
trapezium and flexor retinaculum
40
opponens pollicis insertion
lateral margin and palmar surface of the 1st MC bone
41
opponens pollicis nerve innervation
recurrent branch of median nerve
42
opponens pollicis function
medially rotate the thumb (opposing the thumb against the tips of other fingers)
43
hypothenar group of muscles
comprised of 4 muscles, including abductor digiti minimi, flexor digiti minimi brevis, opponens digiti minimi, and palmaris brevis
44
palmaris brevis origin
palmar aponeurosis, flexor retinaculum, and palmaris longus tendon
45
palmaris brevis insertion
deep surface of skin of medial margin of the hand
46
palmaris brevis nerve innervation
superficial branch of ulnar nerve
47
what is the only muscle innervated by superficial branch of the ulnar nerve?
palmaris brevis
48
palmaris brevis function
improve the grip of the hand
49
abductor digiti minimi origin
pisiform, pisohamate ligament, and tendon of flexor carpi ulnaris
50
abductor digiti minimi insertion
proximal phalanx of pinky finger
51
abductor digiti minimi nerve innervation
deep branch of ulnar nerve
52
abductor digiti minimi function
abduct pinky finger at the MCP joint
53
flexor digiti minimi brevis origin
hook of hamate and flexor retinaculum
54
flexor digiti minimi brevis insertion
proximal phalanx of 5th finger
55
flexor digiti minimi brevis nerve innervation
deep branch of ulnar nerve
56
flexor digiti minimi brevis function
to assist in flexion of 5th finger at MCP joint
57
opponens digiti minimi origin
hook of hamate and flexor retinaculum
58
opponens digiti minimi insertion
medial aspect of 5th MC bone
59
opponens digiti minimi nerve innervation
deep branch of ulnar nerve
60
opponens digiti minimi function
laterally rotates the 5th MC bone
61
3 groups of hand muscles
thenar, hypothenar, and central
62
central muscles of the hand
includes adductor policis, lumbricals, palmar interossei, and dorsal interossei
63
2 heads of adductor policis
oblique head and transverse head
64
oblique head of adductor policis origin
capitate and bases of carpals 2 and 3
65
transverse head of adductor policis origin
shaft of third MC bone
66
adductor policis insertion
base of proximal phalanx and DDE of thumb
67
adductor policis nerve innervation
deep branch of ulnar nerve
68
adductor policis function
prime mover of thumb adduction
69
lumbricals
are four small muscles of the hand belonging to the central group
70
lumbricals origin
tendons of FDP
71
lumbricals insertion
DDE of fingers 2-5
72
lumbricals nerve innervation
1 and 2 are direct median nerve and 3 and 4 are deep branch of ulnar nerve
73
lumbricals function
flex MCP while keeping the interphalangeal joints extended
74
DDE of the hand
is a triangular fibrous sheath covering the dorsal surface of the proximal phalanx of the fingers
75
apex of DDE
points towards the tip of the fingers and then divides into branches that attach to the middle and distal phalanges of fingers
76
what tendons insert to the DDE?
ED, dorsal interosseous muscles, and lumbricals (via FDP)
77
what anchors DDE of the hand?
deep transverse MC ligament
78
significance of DDE
allows for intrinsic muscles to do complex and delicate movements of the digits that could not be done with the long flexor and extensor tendons alone
79
how many palmar interossei are there?
3
80
palmar interossei origin
sides of MC bones
81
palmar interossei insertion
the DDE of index, ring, and pinky fingers
82
palmar interossei nerve innervation
deep branch of ulnar nerve
83
palmar interossei function
adduct the fingers to the axis of adduction
84
axis of adduction/abduction of hand
axis of middle finger
85
dorsal interossei origin
adjacent surfaces of MC bones
86
dorsal interossei insertion
DDE of index, middle, and ring fingers
87
dorsal interossei nerve innervation
deep branch of ulnar nerve
88
dorsal interossei function
abduct the corresponding fingers from the axis of abduction/adduction of hand
89
what arteries enter into the hand?
radial and ulnar, and then these form three major arterial arches
90
3 arterial arches of the hand
superficial palmar arch, deep palmar arch and ? (he never mentioned the third)
91
what forms the superficial palmar arch
the superficial branch of ulnar artery and the superficial branch of radial artery
92
where is the superficial palmar arch located?
immediately deep to palmar aponeurosis
93
deep palmar arch
is formed by the radial artery and the deep branch of the ulnar artery
94
radial artery path
wraps around the lateral aspect of the wrist, then through the anatomical snuff box, passes between the two heads of 1st dorsal interosseous muscle and 2 heads of adductor policis, then shows up on the palmar aspect of the hand
95
what does ulnar nerve divide into?
superficial branch and deep branch
96
superficial branch of ulnar nerve
is primarily a sensory branch but it does innervate the palmaris brevis muscle
97
what does superficial branch of ulnar nerve give rise to?
common palmar digital nerve and proper palmar digital nerve; these supply the skin of the medial 1.5 fingers (not the hand)
98
deep branch of ulnar nerve
is a pure motor nerve and supplies most of the intrinsic hand muscles
99
what does median nerve give rise to just before the carpal tunnel?
the palmar cutaneous branch
100
the palmar cutaneous branch of median nerve
supplies the skin of the lateral 2/3 of palmar aspect of hand; does not pass through capral tunnel
101
what does median nerve give rise to after passing through the carpal tunnel?
motor branch called recurrent branch, some direct motor fibres for lumbricals, and the common palmar digital nerve
102
recurrent branch of median nerve
supplies the thenar muscles of the hand
103
common palmar digital nerve of median nerve
divide into proper palmar digital nerves which supply the skin of the lateral 3.5 fingers (not the palm)
104
first CMC joint type
saddle joint
105
first CMC joint articulating surfaces
proximal end of 1st MC bone and trapezium
106
most laterally positioned bone in the distal carpal row
trapezium
107
what type are the other 4 CMC joints?
planar joints
108
MCP joint articulating surfaces
distal ends of MC bones and the proximal ends of phalanges
109
MCP joint type
condylar
110
PIP and DIP joint types
hinge joints
111
what supports the MCP joints?
deep transverse MC ligament, bridging between the distal ends of MC bones
112
anterior surface of capsule of MCP and interphalangeal joints
is significantly thicker compared to the rest of the capsule, forming palmar plate/palmar ligament
113
palmar plates
are formed by the thick anterior surface of MCP and interphalanegeal joint capsules
114
collateral ligaments
support the MCP and interphalangeal joints
115
MCP collateral ligaments during flexion
are tight
116
MCP collateral ligaments during extension
are loose
117
interphalangeal joint collateral ligaments during flexion and extension
are tight in both flexion and extension
118
myotome for shoulder abduction
C5
119
myotome for elbow flexion
C5/6
120
myotome for elbow extension
C6-8
121
myotome for finger abduction/adduction
T1
122
myotome for finger flexion
C8
123
when does superficial radial arise from radial nerve?
in the cubital fossa
124
Dupuytren's contracture
is when parts or bundles of palmar aponeurosis start to shrink for unknown reasons, affecting digits 4 and 5 of the hand; begins with phase 1 which is formation of nodules and phase 2 is nodules turning into cords or bands
125
treatment for Dupuytren's contracture
don't stretch, but instead some enzymes can be used to dissolve collagen fibres or surgery
126
relationship of synovial sheaths to carpal tunnel
because the thumb or pinky have continuous sheaths with the flexor retinaculum, a penetrating injury to these digits can cause infection to spread to the carpal tunnel, resulting in this syndrome
127
prime mover of thumb abduction
abductor pollicis longus
128
prime mover of thumb flexion
flexor pollicis longus
129
prime mover of pinky flexion
FDP
130
what do muscles attaching to the DDE assist in?
extension of the PIP and DIP joints
131
interossei muscles relationship to thumb
no relationship because it has their own muscles that abduct the thumb, therefore interossei muscles do not attach here
132
absence of superficial radial artery in superficial arch
in about 30% of people, superficial radial artery does contribute to the superficial radial arch
133
landmark for ulnar nerve
follows the ulnar artery and the FCU, then enters into the tunnel of guyon
134
tunnel of guyon
is a passageway for the ulnar artery and nerve on the medial anterior side of the hand, and is a potential site for impingement of the nerve
135
what does the ulnar nerve divide into after passing through the tunnel of guyon?
superficial and deep branches
136
claw hand
is a passive deformity of digits 4 and 5 due to ulnar nerve/ lumbrical damage, causing hyperextension of MCP joints 4 and 5, and PIP/DIP to go into flexion
137
when is the nerve pinched in claw hand?
in the tunnel of guyon, causing paralysis to lumbricals
138
sign of benediction
is an active deformity of 2 and 3 that cannot flex when asked to make a fist, so presents similar to claw hand due to damage of the FDP
139
when is the median nerve pinched for sign of benediction?
before the carpal tunnel, causing paralysis of FDP tendon
140
what nerve is damaged in claw hand?
ulnar
141
what nerve is damaged in sign of benediction?
median
142
ape hand deformity
is an injury to median nerve (not specific of the level of injury) that results in paralysis of opponens policis, resulting in a change in the resting position of the thumb, causing it to be positioned beside the other digits, as well as atrophy of thenar muscles
143
what movements are impacted with ape hand deformity?
opponens policis is paralyzed, and flexion and abduction are weak (this is because this movement has other innervation from ulnar and radial)
144
what forms the palmar plate/ligament
the deep transverse MC ligament that passes anterior to the capsule
392
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