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Flashcards

Wrist&Hand:09

Fiona Doolan English 68 cards

Cards in this deck (68)

  1. 1which carpals are on top of one another?on palmar side, pisiform is on top of Triquetrum
    they are right below Hook of Hamate
  2. 2transverse carpal archyour hand's natural arc- the metacarpal arch is made by the knuckles, the carpal by the carpal bones
  3. 3what are the attachments of flexor retinaculum on hand?Hamate-------------Trapezium
    pisiform-------------scaphoid
  4. 4flexor retinaculum is _____ to wrist jointdistal
  5. 5what enters hand via carpal tunneltendons of FDP, FDS, FPL, median N.
    NOT PL tendon
  6. 6major arterial blood supplypalmar side of hand
    so where does the blood drain? High pressure region to low
  7. 7radial bursaprotect FPL
    Palmar side, obviously
  8. 8ulnar bursaFDS & FDP tendons, continues up baby finger
  9. 9dorsal bursae6 bursae/ tendon sheaths, 9 tendons
  10. 10can palpate in snuffboxradial A
    scaphoid
    Trapezium
    EPB volar border
    EPL more lateral border
  11. 11snuffbox bordersmore volar/ radial: extensor pollicis brevis
    right at/ under it abductor pollicis longus
    more medial border: Extensor pollicis longus.
  12. 12dorsal hand extensor tendons interossei & carpals/metacarpalsinterossei take deep branch ulnar N
  13. 13hand has fascial layer on palmar side.1. superficial- PALMARIS BREVIS
    2. deep- flexor retinaculum, palmar aponeurosis, thenar fascia, hypothenar fascia
  14. 14palmar aponeurosispalmaris longus tendon
    transverse fasciculi
    deep transverse metacarpal ligament
    superficial transverse metacarpal ligament
  15. 15hand- flexor tendons layer fibro-osseus tunnels1- osseus- phalanges
    2. fibro- annular pulleys and cruciate fibers
  16. 16synovial digital sheaths are on which digits?2,3,4
    b/c radial bursa on thumb, ulnar bursa pinkie)
  17. 17palmar platesknow
  18. 18vinculatendon fibres of FDS and FDP that connect to the bone. path for blood vessels supply distal ends of tendon.
  19. 19only see one tendon hand digits?must be distal phalanges
  20. 20gliding mechanism for finger flexion depends onflexor retinaculum
    ulnar and radial bursae
    annular pulleys
    synovial tendon sheaths
  21. 21is it a right or a left hand?look for hook of hamate
    look at palmar interosseus and dorsal?
    no. they change depending on the digit.
    you MUST use lumbricals to work out if right or left hand because they're always on the RADIAL side of the finger.
  22. 22interosseous3 adductors
    4 abductors
    why? dont need to bring middle finger to midline
  23. 23lumbricals- 4, radial side, palmarfat little guys!
    innervated 1/2 ulnar 1/2 median
    part of 1/2 LOAF
  24. 241/2 LOAFthe MEDIAN N innervated parts of hand
    lumbricals 1&2
    opponens pollicis
    abductor pollicis brevis
    flexor pollicis brevis (SUPERFICIAL 1/2)
  25. 25DAB PADdorsal abduct
    palmar adduct
    interossei
  26. 26need 2 dorsal io for middle fingerDAB abduct- 2 directions for middle finger
  27. 27no IO on thenarAPB and ADD pollicis take care of the adduction and abduction
  28. 28can you abduct pinkie? Yes.Radial nerve, hypothenar muscles, abductor digiti minimi.
    ulnar damage: pinkie pulled into ABD by undamages radial N innervated hypothenar extrinsics like EDmin
  29. 29lumbrical and long flexor tendons formmiddle layer of palm
  30. 30FDP tendon goes to Ext expansion of EDED the main ext can see cords on back of hand
  31. 31lumbricalsflex MCP
    extend IP but not DIP by themselves
    not atached to bone.
  32. 32sesamoid bonesFPB and Adduct Poll where tendon of FPL runs through thumb
  33. 33Abd Poll Brev, flexor pollicis Brev- superficial Adduct pollicis- deepopponens pollicis kind of in middle
  34. 34what's in hypothenar eminence?abductor digiti minimi (about same as abduct poll brev in thumb)
    flexor digiti minimi
    opponens digiti minimi
    palmaris brevis=== nto attached to bone. skin---- flexor retinaculum
  35. 35abductor digiti minimiulnar proximal phalanx
  36. 36muscles on dorsal side of hand that act on fingersEPB
    EPL
    ED: intertendinous connections
  37. 37dorsal side of hand has EDmin tendon, EI, ED, ECRL &B, EPL, EPB, ECU.some of which are unmatched on the palmar side!
    dorsal = snuffbox.
    radial- EPB, medial- EPL
  38. 38why can't you move your ring fingerinterosseous ligaments
  39. 39dorsal digital expansion=extensor expansion= extensor hood= extensor aponeuro
  40. 40extensor expansion consists ofED tendon, its lateral bands. the transverse retinacular ligaments, the tendons of interossei and lumbricals
  41. 41ED is sole extensor of MCP jointsorigin- lateral epicondyle (common extensor tendon)
    Insertion- extensor expansion of middle and distal phalanges of the 2nd, 3rd, 4th, and 5th fingers[1]
    Artery- posterior interosseous artery
    Nerve- radial nerve
    Actions- extension of hand, wrist and fingers
  42. 42activating only intrinsicsMCP flexion, IP extension
    lumbricals and interossei pull on relaxed hood
  43. 43ED + intrinsicshood covers MCP jt so all joints including IP DIP extend
  44. 44just FDPall joints flex (an extrinsic flexor)
  45. 45FDSall joints flex except DIP (an extrinsic finger flexor)
  46. 46intrinsics onlyholding a pen action
  47. 47dorsal carpal branch ulnarwraps palmar on ulnar side round to dorsal to supply dorsal carpal rete
  48. 48superficial palmar archformed by ulnar N
  49. 49superficial palmar arch- common palmar digital bifurcating into proper palmar digitalson palmar side you can see deep palmar arch feeding radialis indicis, the only unmatched artery running up side of fingers (like the proper palmar digitals but supplied radial)
  50. 50on dorsal side of hand radial artery gives offprincips pollicis, radialis indicis, dorsal carpal branches feeding rete, dorsal digital branches, perforating branches FROM palmar side
  51. 51direction of flow handpalmar to dorsal!!!
    dorsal where veins are
  52. 52radial A goes dorsal around snuffbox contributing to dorsal rete, etc. then itgoes back to palmar side- deep palmar arch
  53. 53deep palmar arch isblood supply wrist and metacarpals.
  54. 54superficial palmar arch isbetween long tendon and palmar aponeurosis layer
  55. 55deep palmar arch isbetween the IO and the lumbricals (deepest palm layer)
  56. 56lateral- cephalic vein, from axillary Veinmedial- basilic vein, from brachial vein
  57. 57cephalic and basilic vein are bridged bymedian cubital vein
  58. 58metacarpal veins on dorsal side hand akaintercapitular veins
  59. 59posterior ulnar, anterior ulnar region of hand cutaneousulnar nerve
  60. 60posterior (dorsal) radial side hand cutaneous, anterior radial side cutaneousradial nerve, median nerve
  61. 61what muscles of the hand does median nerve innervate1/2 loaf
    muscular branch
    also has cutaneous branch
    very superficial can be damaged
  62. 62the palmar digital nerves are given off by median nthey are common then proper. before become proper they give off the nerves to lumbricals 1 &2. after that, median innervation is ONLY SENSORY
  63. 63mild CT vs severemedian n damage
    mild :
    tingling hand but not base of thumb (radial- EPL deep IO N)
    severe:
    numbness
    lose OP, ABD PB, Flex Poll B, not total functional loss because have extrinsics but
    SHRIVELED thenar eminence
    lose LUMBRICALS- some IP joint trouble. but still have IO
  64. 64ulnar N in handbetween middle and deep layers
  65. 65ulnar N goes into hand through Canal of Guytonflexor retinaculum, palmar carpal ligament, scaphoid pisiform
  66. 66superficial branch Ulnar N handmostly cutaneous but innervates palmaris brevis
    common & proper palmar diigtal Ns
  67. 67Deep branch ulnar N in handhypothenar, interossei, lumbricals, add poll deep FPB
  68. 68ulnar claw handthumb ABD- lost add poll
    MCP hyper-extended
    IP-s flexed esp 4 & 5
    because interossei and 4&5 lumbricals, too.
    MCP extension dominates (ED)
    IP flexed (FDS FDP)

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Flashcards on Wrist&Hand:09, created by Fiona Doolan on 03/03/2016.
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Fiona Doolan
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