Musculoskeletal System > The Hand > Flashcards

The Hand Flashcards

(48 cards)

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1
Q

Name the intrinsic muscles of the hand

A
  • Interossei (7; 3 palmar 4 dorsal)
  • Lumbricals (4)
  • Thenar eminence (3)
  • Hypothenar eminence (3)
  • Adductor pollicis (1)
  • Palmaris brevis (1)
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2
Q

What is the function of the interossei?

A
  • Flex the straight finger (metacarpophalageal joint)
  • Adduction
  • Abduction
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3
Q

Which interossei adduct and which abduct?

A
  • PAD and DAB
  • Palmar adduct
  • Dorsal abduct
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4
Q

What nerve supplies the interossei?

A

-Ulnar

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5
Q

How do you test the palmar interossei?

A
  • Palm down on a flat surface

- Insert ruler between fingers and try to pull free

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6
Q

How do you test the dorsal interossei?

A

-Squeeze the fingers together and get patient to try to resist

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7
Q

What are the functions of the lumbricals?

A
  • Extension of the interphalangeal joints

- Flexion of the metacarpophalangeal joint

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8
Q

Where do the lumbricals arise from?

A

-The 4 tendons of FDP

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9
Q

What nerve serves the lateral to lumbricals?

A

-median

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10
Q

What nerve serves the medial two lumbricals?

A

-Ulnar

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11
Q

What is the consequence of denervation of the lumbricals?

A
  • Ulnar claw (medial two)

- Hand of benediction (lateral two)

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12
Q

What three muscles make the thenar eminence?

A
  • Opponens pollicis
  • Abductor pollicis brevis
  • Flexor pollicis brevis
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13
Q

What nerve supplies the thenar eminence?

A

-Median

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14
Q

What muscles make the hypothenar eminence?

A
  • Abductor digiti minimi
  • Flexor digiti minimi
  • Opponens digiti minimi
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15
Q

Where does abductor digiti minimi arise from?

A

-The tendon of FCU

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16
Q

What nerve supplies the hypothenar eminence?

A

-Ulnar nerve

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17
Q

What nerve damage is associated with atrophy of the thenar eminence

A

-Median nerve compression ie carpal tunnel

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18
Q

Where is palmaris brevis?

A

-Overlays the hypothenar eminence

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19
Q

What nerve supplies palmaris brevis?

A

-Ulnar nerve

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20
Q

What is the function of palmaris brevis?

Study These Flashcards
A
  • Tightens palmar aponeurosis

- Improves grip by pulling skin of ulnar side of hand to centre

21
Q

What is the function of adductor pollicis?

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A

-Adduct the thumb

22
Q

What are the two heads of adductor pollicis?

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A
  • Transverse

- Oblique

23
Q

What nerve supplies adductor pollicis?

24
Q

What passes between the two heads of adductor pollicis?

Study These Flashcards
A

-Radial artery

25
List the layers of the hand from superficial to deep
- Skin - Subcutenous tissue - Fascia - Palmar aponeurosis - Muscle compartments - Carpal bones
26
What is the carpal tunnel?
- A compartment which passes through the wrist - Formed by two layers -> carpal arch from capral bones - Flexor retinaculum forms the roof
27
What travels through the carpal tunnel?
- 4 tendons of FDS - 4 tendons of FDP - Tendon of Floxor pollicis longus - Median nerve
28
What is carpal tunnel syndrome?
-Compression of the median nerve within the carpal tunnel
29
What are the symptoms of carpal tunnel syndrome?
- Aching of the wrist and/or forearm | - Parasthesia of the 1st and second digits
30
Where does the blood supply to the hand originate from?
-The radial and ulnar arteries
31
Describe the path of the radial artery after it has passed the wrist
- Crosses the wrist and travels dorsally across the anatomical snuff box - Gives off a branch proximal to the thumb; superficial palmar branch of radial artery
32
Describe the path of the ulnar artery after it has passed the wrist
-Passes over flexor retinaculum and divides into deep and superficial branches
33
What forms the superficial palmer arch?
-The superficial branches of the ulnar and radial arteries
34
What forms the deep palmar arch?
-Deep branch of ulnar artery anastamoses with radial artery as it passes through the two heads of adductor pollicis
35
What branches arise from the deep palmar arch?
-Palmar metacarpal arteries
36
What branches arise from the superficial palmer arch?
-Common palmer digital arteries
37
What forms the digital arteries?
-Anastomoses of common palmar digital arteries and palmar metacarpal arteries
38
Describe venous supply to the hand
-A dorsal network of veins drains into the superficial cephalic and basilic veins
39
What does the median nerve supply in the hand? (motor and sensory)
- Innervates Thenar eminance and lateral two lumbricals - Sensory innervation of lateral 3 and a half digits, the associated palm (except for small area over thenar eminence) and the back of the 3 and half finger tips
40
What does the radial nerve supply in the hand?
- No motor function - Supplies sensory innervation to dorsal lateral 3 and half fingers (except the fingertips) and the associated dorsum - Also supplies an area over the thenar eminence
41
What does the ulnar nerve supply in the hand? (motor and sensory)
- Medial 1 and a half fingers and associated palmar and dorsal area - Medial two lumbricals - Interossei - Hypothenar eminence - Adductor pollicis - Palmaris brevis
42
What does the ulnar nerve travel down the forearm with?
-Ulnar artery
43
How does the ulnar nerve enter the hand?
-Passes over flexor retinaculum through guyons canal
44
What is the presentation of ulnar claw?
-Hyperextension of the MCP joints and unopposed flexion of the IP joints of the 4th and 5th digits
45
What causes ulnar claw?
- Long standing ulnar nerve damage at the wrist causing ulnar claw by paralysis of the medial 2 lumbricals (flex MCP + extend IP) - Hyperextension at MCP occurs because of unopposed extension from extensor digitorum - Flexion at IP due to unnopposed flexion from FDP
46
What is ulnar paradox?
-Ulnar claw but to a lesser extent as damaged occurs at the elbow -> FDP damaged so less unopposed flexion
47
What is the presentation of hand of benediction?
-On attempting to form a fist, there is inability to flex the 2nd and 3rd didgit
48
What causes hand of benediction to occur?
- Long-term median nerve damage at the elbow causes paralysis of the long flexors in anterior forearm (except FCU and med half FDP) and the lateral two lumbricals - This results in loss of flexion at the MCP and IP and the inability to make a complete fist producing a claw like shape (4th and 5th digit still work)
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