Flashcards
Sc14L04 The hand

Cards in this deck (167)
- 1Power grip involves _______ of the digits and thumbs to grasp objects b/w the palm and digits.flexion

- 2Which type of grip emphasises the involvements of the digital pulp? Are the digits flexed or extended? The thumb is opposed and palmarly adducted or abducted?precision grip
flexed
adducted
- 3What digits position is an important requirement of hand function?thumb opposition
- 4Which thumb joint is different than the same joint at the other digits? What is the function of this difference?The carpometacarpal (CMC) joint of the thumb allows much wider movement

- 5What type of joint are the CMC joints?saddle

- 6Other than the thumb's CMC joint, which other digits allow some movement?4th and 5th
- 7What hand motion relies on the CMC joints' action?cupping our hands
- 8What kind of joints are the interphalangeal joints?bicondylar
NB: very stable and only allow movement in one plane
- 9The precision grip involves rotation at the _______________ joint of the thumb, and the _______________ joint of the thumb and fingers.carpometacarpal
metacarpophalangeal - 10Precision grip involves the intrinsic muscles of the hand working together with which other muscles?flexor digitorum superficialias
flexor digitorum profundus
flexor pollicis longus
- 11What is a key action for precision grip?opposition
- 12What is the strongest power grip?palmar

- 13What type of grip involves the thumb acting as a buttress to an object placed in the palmar gutter?palmar grip
- 14What type of grip involves an object being held b/w palm and flexed fingers.hook grip
- 15Which grip does not involve any thumb action?hook grip
- 16Which grip is only secure in one direction?hook grip
- 17What is digit 1?the thumb
- 18What is digit 5?the little finger
- 19What is another name for the thumb?pollex
- 20What is another name for finger 2?index finger, digiti indicus
- 21What is another name for digit 3?middle finger, digiti medius
- 22What is another name for digit 4?ring finger, digiti anularis
- 23What is another name for digit 5?little finger, digiti minimae
- 24The hand has (5) metacarpal bones. From proximal to distal what the features of the metacarpal bones?base, shaft and head

- 25What carpal bone does the thumb's metacarpal articulate with proximally?trapezium

- 26Which carpal bones do the digit 2-5 metacarpals articulate with proximally?trapezoid, capitate, hamate and trapezium

- 27What structures form the knuckles?the heads of the metacarpals
- 28What do the metacarpals articulate with distally?the proximal phalanges
- 29The shaft of the metacarpal bone is: concave/convex? _________ shape in transverse cross section has (3) surfaces called?concave
triangular
medial, lateral and posterior
- 30How many phalanges does the hand have?14
3 for each finger (12)
2 for each thumb (2)
- 31What phalanges do the fingers have?proximal, intermediate and distal

- 32What phalanges does the thumb have?proximal and intermediate
- 33What aspect of skin can be used to distinguish the distal interphalangeal (DIP) and proximal interphalangeal (PIP) joints?creases
- 34The palmar digital crease (PDC) is located over what?the middle of the proximal phalanx

- 35The proximal and distal palmar crease lie proximal to what?metacarpophalangeal (MCP) joint

- 36Each digit has a _____________ bone proximally?metacarpal
- 37The bases of the metacarpal bones make joints with the nearest carpal bone of the distal row. What are the joints called?carpometacarpal (CMC) joint
- 38The 2nd and 3rd CMC joint are said to be fixed as they make little movement. The 4th and 5th joints as well as the 2-3 are ________, _________ joints.ellipsoidal (or irregular plane), synovial

- 39What is the 1st CMC joint?synovial, saddle joint (highly mobile)

- 40In what planes do movements occur at the 1st CMC joint?it is biaxial, it permits flexion/extension and abduction/ adduction
these joints also allow the thumb to make the movement of opposition (a combination of flexion and abduction and some additional rotations at this and the intercarpal joints)
- 41What is reposition?the resetting of opposition to the anatomical position

- 42What is the joint b/w the metacarpal bones with the proximal phalanx?metacarpophalangeal joints
- 43What type of joints are the metacarpophalangeal joints?synovial condyloid (ellipsodial)
but the first ones behave more like a hinge joint
- 44What prevents the metacarpal bones from moving too far apart from each other?deep transverse metacarpal ligaments

- 45What ligaments prevent excessive abduction and adduction (or flexion/ extension of the thumb)?radial (lateral) and ulnar (medial) collateral ligaments

- 46What structure limits hyperextension of the hand?a plate of fibrous tissue on the palmar side of the joint (volar plate), with a complex of ligaments

- 47What type of joints are the proximal interphalangeal joints (PIP) and the distal interphalangeal (DIP) joints?synovial hinge joints
- 48What interphalangeal jont does the thumb have?interphalangeal
- 49At what joints can the hand move?mid-carpal, carpometacarpal, metacarpophalangeal and interphalangeal (PIP and DIP)
- 50Which (2) joints are pretty much rigid/ fixed due to ligaments?carpometacarpal joints due the palmar and dorsal carpometacarpal ligaments
intermetacarpal joints due to dorsal, palmar and interosseous ligaments - 51What kind of joints are the metacarpophalangeal joints?condyloid w/ a lax capsule
- 52What structures strengthen the metacarpophalangeal joints' capsule?palmar ligaments and fibrous cartilage
- 53What planes of movement are the MCP joints capable of?flexion/ extension, abduction/ adduction
- 54What is the plane of adduction/ abduction of the MCP joints based around?the 3rd digit (middle finger)
- 55Certain ligaments tighten when movement at the MCP joints become too excessive. What are these ligaments called??collateral
- 56What movement makes it impossible for abduction at the MCP joints?flexion
- 57The MCP joints can be passively rotated up to __ degrees50
- 58The interphalangeal joints are what kind of joint? What is their plane of movement?hinge
flexion/ extension - 59What joints prevent excessive movement at the IP joints?collateral and palmar ligaments
- 60What angle does the thumb jut out at?45 degrees
- 61What joint allows the thumb to lie flat ?the carpometacarpal joint
- 62What joint is the thumb's CMC joint? What are the axes of movement?saddle joint
opposition, reposition and circumduction - 63Flexion and extension of the thumb take place _____ to the plane of the armparallel
- 64_________________ is the motion wherein the tip of the thumb comes into contact with the tip of any other digit on the same handOpposition
- 65If the thumb contacts any other portion of the digits other than the tip it is called?Apposition
- 66_________ is the movement that describes a cone with the apex at the first CMJ and the circular opening at the tip of the thumbCircumduction

- 67The ligaments surrounding the first CMJ are very important to maintaining thumb function. There are (5) and they allow considerable movement, protecting them from injury more so the MP joint. However, what is the CMJ commonly affected by?osteoarthritis

- 68What ligament of the thumb's MP is frequently stretch or torn? It is referred to as "gamekeeper's thumb" or "rabbits revenge" "skier's thumb" "ULC tear"ulnar ligament

- 69What (2) fascia is the palm fascia continuous with?antebrachial (forearm) and dorsum fascia

- 70The palmar fascia is thin over the thenar and hypothenar eminences but thick centrally where it forms what?fibrous palmar aponeurosis (part of the deep fascia of the hand)

- 71What structures are covered by the fibrous palmar aponeurosis?soft tissue and long flexor tendons

- 72The proximal end of the palmar aponeurosis os continuous with what (2) structures?flexor retinaculum and palmaris longus tendon

- 73Distally, what does the palmar aponeurosis form?four longitudinal digital bands that radiate from the apex

- 74What do the longitudinal bands attach to? Then do what they become?the bases of the proximal phalanges and become continuous with the fibrous digital sheaths

- 75What keeps the longitudinal bands together?the transverse fibres of the palmar aponeurosis
- 76What joins the digits across the web-space, distal to the palmar aponeurosis?the superficial transverse metacarpal ligaments

- 77What are the ligamentous tubes the enclose synovial sheaths, the superficial deep flexor tendons and the tendon of flexor pollicis longus in their passage to their respective digit?fibrous digital sheaths

- 78b/w the flexor tendons and fascia covering the deep palmar muscles are two potentials spaces. What are they called?thenar and midpalmar space

- 79What separates the thenar and midpalmar spaces?a fascial layer that connects the palmar aponeurosis to the 3rd metacarpal bone
- 80What can happen to these spaces if they become infected or if there is a lesion to the web space?they can swell causing pain on the affected side of the 3rd metacarpal

- 81Inside the digital fibrous sheaths lie the long tendons of the fingers. These tendons are surrounded by synovial sheaths. The synovial sheaths contain fluid. The tendons appear to be invaginate into a synovial sheath from one side, and suspended in it a by a fold of synovial membrane. What is this membrane called?mesotendon

- 82Other than suspending the tendons. What else does the mesotendon do?transports blood vessels and nerves to the tendon
- 83What is the other term for mesotendon?vinculae
- 84Where do the digital fibrous sheaths end?just proximal to the MCP joint and just distal to the PIP joint
- 85Where do the digital fibrous sheaths extend to proximally?1 and 5 to the flexor retinaculum, 2-4 proximal to the fibrous sheath
- 86What is the sheath surrounding digiti minimi tendon referred to as?ulnar bursa

- 87What is the sheath surrounding pollicis longus tendon referred to as?radial bursa
- 88What does the ulnar bursa expand to surround?the tendons of the flexors of the fingers by a single common flexor sheath, into which they are invaginated from by the lateral side
- 89The synovial sheaths surrounding the tendons of the flexors of the fingers are prone to infection. What is this called?tenosynovitis

- 90What could happen the synovial sheaths of the pollex or digiti mini are inflamed (or infected) and track upwards?it may reach the carpal tunnel and cause carpal tunnel syndrome
- 91How many pennate, interossei muscles are there?7
- 92How can the interossei muscles be divided?three palmar single-headed and four dorsal double-headed
- 93What supplies the interossei muscle?deep branch of the ulnar nerve
- 94What do the palmar interossei arise from?2nd, 4th and 5th metacarpal bones

- 95What do the palmar interossei insert to?the corresponding tendons of the dorsal aponeurosis
- 96Which joints do the palmar interossei flex at?MCP joints
- 97Which joints do the palmar interossei extend at?IP joints
- 98What is the prime movement of the palmar interossei muscles?adduction of digits 3-5 toward the middle finger
- 99Where do the dorsal interossei arises from?two heads arise from the adjacent sids of the five metacarpal bones

- 100Where does the 1st interosseous extend to?proximal phalanx of the 2nd finger on the radial side
- 101Where does the 2nd interosseous extend to?the proximal phalanx of the middle finger on the radial side
- 102Where does the 3rd interosseous extend to?the proximal phalanx of the middle finger on the ulnar side
- 103Where does the 4th interosseous extend to?the proximal phalanx of the 4th finger on the ulnar side
- 104Which joints do the dorsal interossei flex at?MCP joints
- 105Which joints do the dorsal interossei extend at?IP joints
- 106What is the main function of the dorsal interossei?abduction of digits toward the middle finger
- 107What muscle arises from the radial side of flexor digitorum longus tendon and inserts into the dorsal expansion?lumbrical muscles

- 108What joints do the lumbricals extend and flex?flex: MCP joints
extend: IP joints - 109What innervates the lumbricals?1st and 2nd: median n. (C8 - T1)
3rd and 4th: ulnar nerve (deep terminal branch C8-T1)
NB: there is variation, sometimes the 1st and 2nd are also innervated by the ulnar - 110What muscle movements are lumbricals responsible for?extension of the finger PIP and DIP joints
flexion of the finger MCP joints - 111What structures are formed on the distal ends of the metacarpals and on the digits as the extensor tendons become flattened?extensor (dorsal expansions)
that wrap around the dorsum and sides of the metacarpal head and proximal phalanx
- 112How do the dorsal expansions found on our dorsal digits attach themselves?they anchor like visor-like hoods onto each side of a phalanx via the palmar ligament

- 113What do the dorsal expansions divide into?2 lateral bands which pass to the base of the distal phalanx
- 114What structures may joint the lateral bands of dorsal expansion on the way to the distal phalanx?an interosseous and lumbrical tendon

- 115On which digit, may the interossei and lumbrical gain insertion on the middle phalanx?middle
- 116In what condition has the distal phalanx been forcibly flexed when the extensor is taut, resulting in avulsion (tearing away) of the insertion of one of the extensor tendons into the distal phalanges?Mallet finger
- 117In what condition does a direct end-on trauma to the finger, at the back of the proximal IP joint OR from laceration to the dorsum of the finger result in avulsion (tearing away) of the central slip of the extensor tendon into the base of the middle phalanx?Boutonniere deformity

- 118What four small muscles are found near the thumb on its thenar side?abductor pollicis brevis, flexor pollics brevis, opponens pollicis and adductor pollicis
the first (3) make up the thenar eminence

- 119Where do the thenar muscles originate from?flexor retinaculum and carpal bones
- 120Where do the thenar muscles insert?onto the base of the thumb or onto the sides of the first metacarpal bone
- 121What nerves supply the thenar muscles?median nerve
except adductor pollicis which is supplied by the deep branch of the ulnar nerve - 122What are the three hypothenar muscles, found around the little finger?abductor digiti minimi, flexor digiti minimi, oppens digiti minimi
they form the hypothenar eminence
- 123Where do the hypothenar muscles arise from?flexor retinaculum and carpal bones
- 124Where do the hypothenar muscles insert?the ulnar base of the 5th metacarpal
- 125How are the hypothenar muscles innervated?ulnar nerve
- 126Where does abductor pollicis brevis insert? What is its action?abduction of the thumb
proximal phalanx of the thumb
- 127Where does flexor pollicis brevis arise from? Where does it insert?arises superificially from flexor retinaculum
arises deeply from the tubercle of the trapezium
inserts into the radial sesamoid bone of the MCP joint of the thumb
- 128What is the action of the flexor pollicis brevis?flexion, adduction and abduction of the thumb
(aka opposition) - 129Where does opponens pollicis insert? What is its action?radial margin of 1st metacarpal
opposition of the thumb, adduction
- 130Where does adductor pollicis arise? Where does it insert?arises transversely from the entire length of the 3rd metacarpal
obliquely from adjacent carpal bones
inserts into the ulnar sesamoid bone of the MCP joint of the thumb
- 131What is the action of the adductor pollicis?adduction, some flexion and opposition
- 132What is the function of abductor digit minimi?abduction

- 133What is the function of flexor digiti minimi brevis?flexion at the MCP joint

- 134What is the function of opponens digiti minimi?it brings the 5th digit in position for opposition

- 135What muscle, though not strictly hypothenar, arises from the palmar aponeurosis, inserting over the hypothenar eminence, provides protection to the ulnar nerve and artery in the region?palmaris brevis

- 136Which artery enters the hand through the anatomical snuffbox, to the dorsum of the hand and forms the deep palmar arch?radial artery

- 137Which artery enters the palm laterally to the pisiform bone, turning laterally to form the superficial palmar arch located b/w the palmar aponeurosis and finger flexion tendons?ulnar artery

- 138Which crease lies level with the superficial palmar arch?proximal transverse palmar crease

- 139Which end of the superficial palmar arch joins the superficial palmar branch of the radial artery, forming continuous arterial anastomosis?lateral end

- 140The superficial palmar arch gives rise to an artery to the medial side of digiti minimi and (3) what?common digital arteries

- 141The common digital arteries are joined by what arteries from the deep palmar arch?palmar metacarpal arteries
- 142What do the palmar metacarpal arteries give rise to? They run along side digits 2-5the proper digital arteries
- 143There are ________ _________ that pass b/w the metacarpals, either proximal or distal to the deep transverse metacarpal ligament, the go on to joint the dorsal metacarpal artery of the same interdigital cleft.perforating branches
- 144Dorsal metacarpal arteries arise from where?dorsal carpal arch

- 145As the radial artery leaves the dorsum, it passes b/w the heads of what muscle?1st dorsal interosseous muscle

- 146How does the radial artery typically divide?deep palmar arch and princeps pollicis artery

- 147Where does the palmar radialis indicis artery normally arise from?princeps pollicis artery

- 148The superficial and deep palmar venous arches run along which structures?The superficial and deep palmar arterial arches, respectively
- 149The dorsal digital veins unite to form what?a dorsal venous network
- 150Where are the superficial veins of the hand of located?on the dorsum of the hand, covered by the delicate skin of the dorsal hand

- 151What do the superficial hands of the vein form and what is this called?a venous plexus called the dorsal venous network
these can usually be seen through the skin of dorsum of the hand
- 152Where does the dorsal venous network drain?proximally to the lateral cephalic vein or medial basicilic vein,
thereby back to systemic circulation
- 153What nerve provides motor and sensitive innervation to most of the lateral side of the hand?median n.

- 154The median n. enters the hand via the _________ ________ b/w the flexor tendons of the digitscarpal tunnel
- 155The median n. supplies the (3) thenar muscles (abductor pollicis brevis, flexor pollicis brevis, opponens pollicis) via the _________ branchrecurrent

- 156The median n. supplies the (2) lumbricals via its _______ branchdeep palmar

- 157Sensory fibres supply the palmar surfaces and sides of the thumb, index finger and middle radial half of the ring finger (including the nail beds) via the median n.'s ______ branchsuperficial palmar

- 158There is a ___________ branch of the mn which is given off at the forearm, and travels proximal to the carpal tunnel. It supplies the ________ part of the palm. As it branches earlier, it is not affected by carpal tunnel syndrome.proximal cutaneous
lateral
- 159The ulnar nerve reaches the palmar aspect of the wrist _________ to the ulnar artery. Passing ____ the retinaculum, and reaches the hypothenar eminence.medial, over
- 160Over the hypothenar eminence, the ulnar nerve divides into (2) branches. What are they?deep and superficial

- 161The _______ branch of the ulnar n. provides the cutaneous innervations to the palmar aspect of the little finger and ulnar half of the ring finger. It also supplies the nail-beds of those fingers.superficial
- 162The ______ branch of the ulnar n. innervates the hypothenar muscles as well as what other muscles?the ulnar (2) lumbrical muscles, adductor pollicis and the dorsal and palmar interosseous muscles
- 163What branch does the ulnar nerve give off to the proximal wrist, supplying sensation to the medial side of the hand, 5th digit, medial half of the 4th digit?dorsal cutaneous

- 164What branch of the ulnar n. supplies a small area of skin over the lower forearm and hypothenar eminence?a small palmar cutaneous branch arising proximal to the wrist
- 165Affected patients often experience numbness and tingling along the little finger and the ulnar half of the ring finger. This discomfort is often accompanied by weakness of grip and, rarely, intrinsic wasting. One of the most severe consequences is loss of intrinsic muscle function in the hand. What nerve is trapped?ulnar nerve
(either at medial epicondyle of the humerus or at the level of the pisiform bone) - 166Which nerve provides sensory feedback form the dorsum of the hand, thumb and index middle end of the radial side of the ring finger?radial n.
- 167Which branch of the radial n. is a direct continuation of it, and is purely sensory?superficial
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- Medicine Y2 (Scenario 14 | Wrist and hand) Flashcards on Sc14L04 The hand, created by Emma Allde on 01/10/2016.
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