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85 Cards in this Set
- Front
- Back
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Proximal Row of Carpal Bones, lateral to medial
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S = scaphoid
L = lunate Tq = triquetrum P = pisiform |
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Distal Row of Carpal Bones, lateral to medial
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Tm = trapezium
Td = trapezoid C = capitate H = hamate (hook) |
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Name the Fascia of the Anterior Wrist
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Palmar Carpal Ligament, Flexor Retinaculum, Palmar Aponeurosis
Thickened deep fascia holds tendons of long flexors at the wrist. |
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Describe the Carpal Tunnel
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Carpal tunnel is a fibro-osseous passageway under the flexor retinaculum and over a deep arch formed by the carpal bones.
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Describe the Flexor retinaculum in the Carpal Tunnel
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the Flexor retinaculum is attached laterally to the scaphoid and trapezium, and medially to the pisiform and hamate.
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Name the Contents of the Carpal Tunnel
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Flexor retinaculum
Median Nerve Flexor digitorum superficialis tendons Flexor digitorum profundus tendons Flexor pollicis longus tendon |
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Describe Carpal Tunnel Syndrome
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Median Nerve is compressed in the wrist, resulting in numbness or pain
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Describe the Extensor Retinaculum in the Wrist
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From radius to pisiform and hamate.
Forms 6 tunnels for long extensor tendons. |
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Name the Contents of the Posterior Wrist Fasciae, lateral to medial
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1. Abductor pollicis longus, Extensor pollicis brevis
2. Extensor carpi radialis longus, Extensor carpi radialis brevis 3. Extensor pollicis longus 4. Extensor digitorum, Extensor indicis 5. Extensor digiti minimi 6. Extensor carpi ulnaris |
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Extension of the Wrist is produced by:
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long extensor muscles
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Flexion of the wrist is produced by:
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long flexor muscles
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Abduction of the Wrist is Produced by:
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FCR, ECRL, and ECRB
(radial deviation) |
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Adduction of the Wrist is Produced by:
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FCU and ECU
(ulnar deviation) |
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Name the Boundaries of the Anatomical Snuff Box
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Base: Distal radius
Apex: 1st metacarpal Medial: Extensor pollicis longus tendon Lateral: Extensor pollicis brevis and abductor pollicis longus tendons |
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Name the Contents of the Anatomical Snuff Box
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Scaphoid
Trapezium Radial artery |
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Describe the Shape of the Scaphoid
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has a proximal pole (near radius), a narrow middle (waist, neck), and a distal pole (near thumb).
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Describe Scaphoid Fracture Complications
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most common carpal bone fracture
Blood supply is from distal brs. of the radial a., and flows from distal segment to proximal segment. Proximal and middle parts do not have a good blood supply. Fractures at the waist can disrupt the blood flow to the proximal segment, resulting in avascular necrosis (AVN). |
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Describe a Scaphoid Fracture
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Cause: Fall on outstretched hand.
Symptoms: Tenderness in the anatomical snuffbox. |
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Describe the Bones of the Hand
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3 phalanges for each finger (digits 2-5): proximal, middle, distal
2 phalanges for the thumb (digit 1): proximal, distal 5 metacarpals |
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Describe the Line of Force in the Hand
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Capitate >>lunate & scaphoid>>radius
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Name the Cutaneous Nerves of the Hand, Palmar Side
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Median Nerve: Palmar cutaneous br., Common and proper digital brs.
Radial Nerve: Superficial Radial Nerve Ulnar Nerve: Palmar cutaneous br., Superficial ulnar n., Common and proper digital brs. |
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Name the Cutaneous Nerves of the Hand, Dorsal Side
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Median Nerve: Proper digital brs.
Radial Nerve: Superficial radial n., Dorsal digital brs. Ulnar Nerve: Dorsal br., Dorsal digital brs. |
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Name the Superficial Veins of the Hand, Dorsal Side
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Dorsal venous arch
Cephalic v. Basilic v. |
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List the Palmar Fascia
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Deep fascia, thin medially and laterally, thick centrally
Palmar aponeurosis, Thenar fascia, Hyptothenar Fascia |
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Describe the Palmar Aponeurosis
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Thick, triangular-shaped; 4 bands attached to proximal phalanges of digits 2-5.
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Describe the Hypothenar Fascia
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Over hypothenar eminence; contains palmaris brevis m.
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Describe the Thenar Fascia
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over the thenar eminence.
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What is the Base of the Palmar Aponeurosis?
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Base: Superficial transverse metacarpal lig. between bands.
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What is the Apex of the Palmar Aponeurosis?
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Apex: Attached to flexor retinaculum and palmaris longus tendon.
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Describe Dupuytren’s Contracture
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Progressive shortening of the palmar aponeurosis. (Grade 1,2, or 3)
Can severely compromise the grasping ability of the hand. Chiefly affects 4th and 5th digits. Cause poorly understood. |
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Name the 4 Compartments of the Hand
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Hypothenar
Thenar Central Adductor |
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Name the 2 Spaces of the Hand
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Thenar
Midpalmar |
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Name the Extrinsic Hand Muscles
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Long flexors
Long extensors |
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Name the Intrinsic Hand Muscles
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Thenar muscles
Hypothenar muscles Adductor muscle Mid-palmar muscles |
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Long Flexors are located in the:
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Central Compartment
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Describe Digital synovial sheaths
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surround long flexor tendons across phalanges of digits 2-4.
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Describe the Fibrous Digital Sheath
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forms osseofibrous tunnel around tendons.
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Describe the Common flexor sheath
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(ulnar bursa) synovial sheath surrounds tendons of FDS and FDP under flexor retinaculum; extends onto 5th digit.
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Describe the Flexor pollicis longus sheath
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(radial bursa) synovial sheath surrounds tendon of FPL under flexor retinaculum.
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Describe the Ligaments of Fibrous Digital Sheaths
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Annular (5) and Cruciform (3) ligaments anchor long flexor tendons to the phalanges to prevent bowstringing of the tendons during flexion of the finger joints.
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Name the tendons in a Fibrous Digital Sheath
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FDS – flexor digitorum superficialis tendon
FDP – flexor digitorum profundus tendon |
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Describe the Extensor Expansion
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Triangular expansion (hood) of the long extensor tendon wraps around the head of a metacarpal and base of a proximal phalanx.
Lumbricals, palmar and dorsal interossei mm. insert into the extensor expansion. Forms a central band attached to the middle phalanx and two lateral bands attached to the distal phalanx. |
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Innervation of the Thenar Compartment?
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Recurrent branch of the median nerve
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Abductor Pollicis Brevis Muscle Action
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Abducts thumb.
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Abductor Pollicis Brevis Muscle Attachement
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Base of proximal phalanx
Flexor retinaculum, scaphoid, trapezium |
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Flexor Pollicis Brevis Muscle Action
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Flexes thumb at CM and MP (metacarpophalangeal) joints
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Flexor Pollicis Brevis Muscle Attachments
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Base of proximal phalanx
Flexor retinaculum, scaphoid, capitate, trapezium |
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Opponens Pollicis Muscle Action
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Medially rotates 1st metacarpal at CM joint to oppose thumb.
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Opponens Pollicis Muscle Attachment
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Radial border of 1st metacarpal
Flexor retinaculum, scaphoid, capitate, trapezium |
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Name the Intrinsic Hand Muscles of the Thenar Compartment
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Abductor pollicis brevis m.
Flexor pollicis brevis m. Opponens pollicis m. |
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Name the Intrinsic Hand Muscles of the Hypothenar Compartment
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Opponens digiti minimi m.
Abductor digiti minimi m. Flexor digiti minimi m. |
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Innervation of the Intrinsic Hand Muscles of the Hypothenar Compartment?
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Deep ulnar nerve
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Opponens Digiti Minimi Muscle Action
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Laterally rotates 5th metacarpal at CM joint
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Opponens Digiti Minimi Muscle Attachment
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Flexor retinaculum, hook of hamate
Ulnar border of 5th metacarpal to the Base of proximal phalanx, extensor expansion |
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Abductor Digiti Minimi Muscle Action
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Abducts 5th digit.
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Abductor Digiti Minimi Muscle Attachment
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Base of proximal phalanx, extensor expansion
Pisiform |
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Flexor Digiti Minimi Muscle Action
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Flexes 5th digit at MP joint
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Flexor Digiti Minimi Muscle Attachment
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Base of proximal phalanx
Flexor retinaculum, hook of hamate |
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Adductor Pollicis Muscle Action
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Adducts thumb.
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Adductor Pollicis Muscle Innervation
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Deep Ulnar Nerve
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Adductor Pollicis Muscle Attachment
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Transverse Head: 3rd metacarpal to Base of proximal phalanx
Oblique Head: Base of proximal phalanx to 2nd & 3rd metacarpals, capitate |
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What are the Mid-Palmar Intrinsic Hand Muscles ?
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Lumbricals (4), Palmar Interossei (3), and Dorsal Interossei (4)
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Innervation of the Lumbricals
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Median Nerve to lumbricals #1 and #2.
Deep ulnar Nerve to lumbricals #3 and #4. |
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Actions of the Lumbricals
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Flex at MP joint and extend at IP joints of digits 2-5.
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Attachments of the Lumbricals
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Attached to extensor expansion
Attached to flexor digitorum profundus tendons |
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Innervation of the Palmar Interossei
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Deep Ulnar Nerve
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Actions of the Palmar Interossei
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(PAD) Adduct fingers 2, 4, and 5 at MP joints and extend at IP joints; minimal flexion at MP joints.
Middle finger does not adduct ( no muscle that adducts) |
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Attachments of the Palmar Interossei
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Base of proximal phalanx, extensor expansion
Radial side of 4th & 5th metacarpals Ulnar side of 2nd metacarpal |
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Innervation of the Dorsal Interossei
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Deep Ulnar Nerve
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Actions of the Dorsal Interossei
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(DAB) Abduct digits 2, 3, and 4 at MP joints and extend at IP joints; minimal flexion at MP joints
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Attachments of the Dorsal Interossei
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Ulnar side of proximal phalanx, extensor expansion (#3, and #4)
Radial side of proximal phalanx, extensor expansion (#1 and #2) Adjacent metacarpals |
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Median Nerve Cutaneous Innervation in the Hand
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lateral palm, thumb, 2 1/2 fingers, distal dorsal thumb and 2 1/2 fingers
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Ulnar Nerve Cutaneous Innervation in the Hand
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medial palm and dorsum of hand and 1 1/2 fingers
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Radial Nerve Cutaneous Innervation in the Hand
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(superficial radial nerve): lateral 2/3 of dorsum of hand
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Median Nerve Muscular Innervation in the Hand
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Recurrent Branch to Thenar muscles
Digital branches to 1st and 2nd lumbrical muscles. |
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Ulnar Nerve Muscular Innervation in the Hand
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Superficial branch to palmaris brevis muscle
Deep branch to all other hand muscles (hypothenar mm., lumbricals #3 and #4, adductor pollicis, deep head of flexor pollicis brevis, and all interossei mm.) |
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Describe Flexion and Extension of the Fingers
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At both MP and IP joints; Produced by both extrinsic and intrinsic hand muscles.
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Describe Abduction and Adduction of the Fingers
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At MP joints only; Produced only by intrinsic hand muscles.
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The Ulnar Artery in the Hand forms the:
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Superficial palmar arch
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The Radial Artery in the Hand forms the:
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Deep Palmar Arch
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Describe the Superficial Palmar Arch
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3 common palmar digital aa.
(Proper palmar digital arteries; to adjacent sides of digits 2-4) Deep palmar branch (anastomoses with deep palmar arch) |
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Describe the Deep Palmar Arch
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Princeps pollicis artery: to thumb
Radialis indicis artery: to 2nd digit Palmar metacarpal arteries: to common palmar digital arteries Superficial Palmar branch: anastomoses with superficial palmar arch |
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Ulnar Artery Route to the Wrist:
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anterior to flexor retinaculum
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Radial Artery Route to the Wrist:
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: in anterior wrist >> anatomical snuff box >> between 2 heads of 1st dorsal interosseous m. >> into palm
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Describe Palpation of the Radial Artery in the Wrist
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The radial artery lies superficial on the radial side of the anterior wrist. It can be palpated between the tendon of the flexor carpi radialis and the tendon of the brachioradialis.
Radial pulse is felt on the wrist, just below the thumb |
