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53 Cards in this Set
- Front
- Back
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Where are the two ossiiication centers of the second through fifth metacarpals located?
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Body (ossifies at 8
Neck (ossihes at 3 years) |
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How is the first metacarpal ossihcation center unique?
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Ossiiication center at the base (like phalanx)
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What two intrinsic muscles are responsible for flexion at the metacarpophalangeal (MCP) joints?
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lnterossei (IO)
Lumbricals |
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What two muscles are responsible for flexion of the proximal interphalangeal (PIP) joints?
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Flexor digitorum superficialis (FDS)
Flexor digitorum profundus (EDP) |
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What muscle is responsible for flexion of the distal interphalangeal (DIP) joints?
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EDP
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What intrinsic muscles are innewatecl by the ulnar nerve?
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Third and fourth lumbricals
All volar interosseous muscles All dorsal interosseous muscles Adductor pollicis Deep head flexor pollicis brevis All four hypothenar muscles |
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What structures are responsible for extension at the MCP joints?
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The extensor digitorum communis (EDC)
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What structures are responsible for extension at the PIP joints?
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Intrinsic muscles (through the lateral bands)
Central slip of the EDC |
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What structures are responsible for extension at the DIP joints?
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Terminal tendon of the EDC
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What structures span between extensor tendons?
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Juncturae tendinum
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What is the origin of the opponens digit quinti? What is the insertion? What is the function?
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Origin: hook of hamate
Insertion; ulnar fifth metacarpal Function: adduct and flex the fifth metacarpal |
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How many dorsal interossei are there?
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Four
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On which digits are they located?
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Radial aspect of index finger
Radial and ulnar aspects of long linger Ulnar aspect of ring finger |
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What dorsal interosseous muscle does not have two muscle bellies?
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Third dorsal IO
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Do dorsal interossei abduct or adduct?
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Abduct
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How many palmar interossei are there?
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Three
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On which digits are they located?
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Situated toward the midline on:
Index finger—ulnar aspect Ring finger—radial aspect Small finger—radial aspect |
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How many lumbricals are there?
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Four
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Origin?
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FDP tendon
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Insertion?
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Radial lateral band
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Innervation?
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Ulnar nerve (two): bipennate
lumbricals Median nerve (two): unipennate lumbricals |
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What is the relationship of the lumbricals to the transverse intermetacarpal (IM) ligaments?
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Lumbricals pass volar to transverse IM ligament
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In what hand deformity do lumbricals play a key role?
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Lumbrical plus hand
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What is the classic symptomatic description of this syndrome?
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Paradoxical extension of the PIP with actual digital flexion
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Why does paradoxical extension occur?
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A transected FDP tendon retracts with active flexion
Lumbrical is drawn proximally by retracting FDP Lumbrical pulls on the lateral band PIP extension results |
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What is the preferred treatment of chronic lumbrical plus hand?
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Lumbrical release from FDP origin
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What two structures form the lateral bands?
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(Dorsal/volar) interosseous muscles
Lumbricals (attached to the radial lateral bands) |
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Is Cleland’s ligament dorsal or volar relative to Grayson’s?
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Cleland: dorsal
Grayson: volar |
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What is the relationship of the digital nerves to the digital arteries in the digit?
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Nerve volar to artery in digit
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What is the relationship of the digital nerves to the digital arteries in the palm?
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Nerve dorsal to artery in palm
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What artery provides the principal supply to the deep palmar arch?
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Radial
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ls the deep arch relatively proximal or distal to the superncial palmar arch?
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Proximal
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The deep arch is codominant with the superficial arch in what percentage of patients?
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21.5%
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Between which two bones does the radial artery course to pass from the dorsal to the volar hand?
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Between the base of the first and second metacarpals
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The deep arch is complete in what percentage of patients?
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98.5%
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The superhcial arch is complete in what percentage of patients?
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78.5%
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What carpal bone is the first to ossify?
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Capitate
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What are the next to ossify (in order)?
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Hamate
Triquetrum Lunate Scaphoid |
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What is the last carpal bone to ossify?
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Pisiform
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At what age?
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Around 9 years
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At which articulation does the majority of wrist flexion occur?
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Radiocarpal joint (two thirds)
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Where does the remainder of wrist flexion occur?
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lntercarpal joint (one third)
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Are the radiocarpal ligaments stronger volarly or dorsally?
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Volarly
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Are the scapholunate ligaments stronger volarly or dorsally?
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Dorsally
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Are the lunotriquetral ligaments stronger volarly or dorsally?
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Volarly
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What is the importance of the radioscapholunate (RSL) ligament (ligament of Testut)?
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Serves as a vascular conduit supplying the SL ligament
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What are the contents of each of the six compartments of the wrist?
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First: APL, EPB (abductor pollicis longus, extensor pollicis brevis)
Second: ECRL, ECRB (extensor carpi radialis longus and brevis) Third: EPL (extensor pollicis longus) Fourth: EDC, EIP (extensor digitorum communis, extensor indicis proprius) Fifth: EDM (extensor digiti minimi) Sixth: ECU (extensor carpi ulnaris) |
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What structure in the first compartment may have multiple slips (important if release needed)?
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APL
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In which compartment is the PIN (posterior interosseous nerve) located?
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Floor of the fourth compartment
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What is the relationship between the EIP and EDC of the index linger?
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EIP is ulnar to EDC of the index linger
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What is the relationship between the EDM and EDC of the small finger?
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EDM is ulnar to EDC of the small linger
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What is the relationship between EPL and EPB?
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EPL ulnar to EPB
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What is the relationship between ECRB and ECRL?
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ECRB is ulnar to ECRL
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