Hands

Question 1

Carpal bones:
Some 
Lovers
Try
Positions 
That
They
Can't 
Handle

Answer 1

Scaphoid

Lunate

Traquetral/ Triquetrium

Pisiform

Trapezium

Trapezoid

Capitate

Hammate

Question 2

Ligaments of the radoiocarpal joint

Answer 2

Ulnar carpal collateral
- Limits abduction
(Radial styloid process also limits abduction)

Radial carpal collateral
- Limits adduction

Palmar surface ligaments
- Limits extension

Question 3

Radiocarpal joint

Answer 3

Joint formed from the articulation of:
- Radius
- Disc
And 1st carpal row of bones.

Movements

• Flex/Extension
• Add/Abduct
• Circumduction

Question 4

Carpometacarpal joints

Answer 4

Between distal carpal row and metacarpal bones.
- Plane joint mainly

Trapezium and D1 joint–> Saddle joint.
- Enables opposition/ reposition.

Question 5

Metcarpophalangeal joints

Answer 5

Condylar joints (between metacarpal bones and proximal phalanges)

Movements: flex/extension, adduction/abduction.

Deep transverse metacarpal ligaments unifies metacarpals (XC between digit 1+2)

Question 6

Interphalangeal joints

Answer 6

Hinge joints–> proximal (PIPs) and distal (DIPs)

Question 7

Dupuytren’s contracture

Answer 7

Thickened fascia (palmar aponeurosis)–> permanently bent, flexed fingers.

Risk factors: family history, alcoholism, smoking, thyroid problems…

Question 8

Palmar aponeurosis

Answer 8

Continuation of the palmaris longus into the hand

- Transverse and longitudinal fibres

Question 9

Long flexor tendons

Answer 9

Includes tendons of:

• Flexor digitorium superficialis (d2-5, middle phalanx)
• Flexor digitorium profundus (d2-5 distal phalanx)
• Flexor policus longus (d1)

Pass through carpal tunnel
- Under flexor retinaculum

Surrounded by synovial sheaths and fibrous digital sheaths (alternating in annular and cruciate ligaments)

Question 10

Long extensor tendons

Answer 10

To d2-5

• Extensor digitorium
• Extensor indicis
• Extensor digit minimi

To d1

• Extensor pollicus longus
• Extensor pollicus brevis
• Abductor pollicus longus

Tendons pass under extensor retinaculum
- Forms Extensor hood at Proximal phalanges-Traingular aponeurosis of tendons

Question 11

Palmar interosseous muscles

Answer 11

3 Muscles between metacarpals.

Origin- metacarpal
Insertion- d2, d4-5.

Action- Palmar adduction (relative to d3) of MCP joints

Question 12

Lumbrical muscles

Answer 12

Links flexors to extensor tendons.

Origin- Flexor digitorium profundus tendon

Insertion- Extensor hood d2-5

Action

• Extend interphalangeal joint
• Flexes metacarpophalangeal joints

Question 13

Dorsal interosseous muscles

Answer 13

Origin: Metacarpal

Insertion: Extensor hoods d2, d3 (x2), d4.
- No d1 and d5 due to thenar and hypothenar muscles

Action
- Abduction

Question 14

Thenar muscles

Answer 14

Carries out fine movements of the thumb
- From flexor reticulum and adjacent carpal bones

• Opponens pollcius (deepest)- to 1st metacarpal
• Abductor pollicus brevis- to proximal phalanx
• Flexor pollicus brevis- to Proximal phalanx

Question 15

Hypothenar muscles

Answer 15

Carries out fine movements of d5
- From flexor reticulum and adjacent carpal bones

• Opponens digit minimi (deepest)- into 5th metacarpal
• Abductor digit minimi- into proximal phalanx
• Flexor digiti minimi- into Proximal phalanx

Question 16

Adductor pollicus

Answer 16

Adducts the thumb, deep to thenar muscles
- Inserts into proximal phalanx

Oblique head
- From base of 2nd and 3rd metacarpal+ carpal bones

Transverse head
- From 3rd metacarpal

Question 17

Ulnar nerve branches

Answer 17

Deep branch

• Hypothenar muscles
• Interossei muscles
• Medial 2 lumbrials
• Adductor pollicis

Superficial branch
- Sensation to 1/2 d4-d5

Question 18

Ulnar claw

Answer 18

Hyperextension of the metacarpophalangeal joints and flexion of DIPs and PIPs of digits 4-5
- Due to paralysis of lumbricals.

Question 19

Supercial palmar arch

Answer 19

From ulnar artery
- Above long flexor tendons

Supplies ½ d2-5

Branches:

• Common palmar digital arteries
• Proper palmar digital arteries

Question 20

Median nerve

Answer 20

Recurrent branch to thenar muscles

Digital nerves:

• Lateral 2 lumbricals
• Sensation to d1- 1/2 d4

Question 21

Deep palmar arch

Answer 21

From radial artery
- Below long tendon flexors, pierces the 1st dorsal interosseous muscle.

Branches supply d1- ½ d2

• Princeps pollicus
• Radialis indicis

Question 22

Anatomical snuff box borders

Answer 22

Laterally:

• Abductor pollicus longus (to base of d1 metacarpal)
• Extensor pollicus brevis (to base of proximal phalanx)

Medially:
- Extensor pollicus longus (to base of distal phalanx)

Floor- Scaphoid bone, trapezium bone

Content- radial artery