Anatomy: Palm

Front 1

What two carpal bones articulate with the radius?

Back 1

Scaphoid and Lunate

Front 2

What carpal bone is most frequently fractured and why?

Back 2

Scaphoid because it takes the brunt of the force during a fall because it articulates with the radius

Front 3

Name the joints of the phalanges working out distaly.

Back 3

MP, PIP, DIP

Front 4

What forms the keystone of the carpal arch, the bondry boundary of the carpal tunnel?

Back 4

Capitate

Front 5

Injury to the scaphoid would present as what?

Back 5

Pain in the "snuff-box"

Front 6

What muscle inserts into the palmar aponeurosis?

Back 6

Palmaris longus

Front 7

What is the thick layer of palmar fascia that protects the nerves and arteries running into the hand?

Back 7

Palmar aponerurosis

Front 8

Where are most hand infections found?

Back 8

In the hollow of the palm between or distal to the hypothenar and thenar eminences

Front 9

What is a shortening, thickening, and fibrosis of the palmar fascia and aponeurosis?

Back 9

Dupuytren's contracture

Front 10

What hand muscles are innervated by the median nerve?

Back 10

5 muslces:
The 3 muscles of the Thenar Eminence
2 lateral Lumbricals

Front 11

What is the moderate thickening of the antebrachial fascia that surrounds the muscles of the forearm?

Back 11

Palmar carpal ligament

Front 12

What is the dense, tough band of connective tissue continuous with the antebrachial fascia beneath the palmar carpal ligament?

Back 12

Flexor Retinaculum (Transverse carpal ligament)

Front 13

What forms the roof of the carpal tunnel?

Back 13

Flexor retinaculum

Front 14

The tendons of what muscles pass through the carpal tunnel?

Back 14

Palmaris Longus, Flexor digitorum superficialis, Flexor digitorum profundus

Front 15

What nerve passes through the carpal tunnel?

Back 15

Median

Front 16

What does the radial bursa encase?

Back 16

Tendon of the flexor pollicis longus

Front 17

What does the ulna bursa encase?

Back 17

Tends of the flexor digitorum superficialis and the flexor digitorum profundus

Front 18

What specific nerve branch innervates the thenar muscles?

Back 18

recurrent branch of the median nerve

Front 19

What is the function of the thenar muscle?

Back 19

opposes thumb toward center of palm and adducts thumb

Front 20

What is the function of the hypothenar muscle?

Back 20

opposes little finger to thumb

Front 21

What does the superficial branch of the ulnar artery supply?

Back 21

cutaneous sensory fibers to one and one-half digits

Front 22

What does the deep branch of the ulnar artery supply?

Back 22

Motor fibers to the hypothenar muscles, lumbricals for the fourth and fifth digits, all of the interossei muscles, and the adductor pollicis muscle

Front 23

Through what does the ulnar nerve pass into the hand?

Back 23

Guyon's canal

Front 24

What would Guyon's canal syndrome present like?

Back 24

hypoesthesia of the medial one and one-half fingers and weakness of intrinsic hand muscles

Front 25

Where is the superficial arterial palmar arch is found?

Back 25

Immediately beneath the palmar aponeurosis

Front 26

What is the superficial palmar arch artery a branch of?

Back 26

Ulnar artery

Front 27

What artery and nerve pass lateral to the pisiform?

Back 27

Ulnar

Front 28

What does the superficial palmar arch artery give rise to?

Back 28

Common palmar digital --> Proper palmar digital

Front 29

The tendons of the flexor digitorum superficialis and profundus are held in place over the digits by what? What is inside of this structure?

Back 29

Fibrous digital sheaths
inside of which are the synovial digital sheaths

Front 30

What two arteries form the superficial palmar arterial arch?

Back 30

Superficial branches of the radial and ulnar arteries (mostly ulnar)

Front 31

Where does the tendon of the flexor pollicus longus insert?

Back 31

distal phalanx of the thumb

Front 32

Where do the tendons of the flexor digitorum superficialis split and where do they insert?

Back 32

over the body of the proximal phalanx and inserts into the base of the middle phalanx

Front 33

Where do the tendons of the flexor digitorum profundus pass through and where do they insert?

Back 33

the split in the tendons of the flexor digitorum superficialis and continue distally to insert into the base of the distal phalanx

Front 34

What is thought to carry a blood supply from the bone to the tendons in the fingers?

Back 34

Vincula

Front 35

What side do the tendons of the lumbricals pass?

Back 35

radial

Front 36

Where do the tendons of the lumbricals insert?

Back 36

extensor hood

Front 37

What nerve are lumbricals 1 and 2 innervated by?

Back 37

Median

Front 38

What nerve are lumbricals 3 and 4 innervated by?

Back 38

Ulnar

Front 39

What is the function of the lumbricals?

Back 39

Flex digits at MP joint and extend at PIP and DIP

Front 40

What innervates the interossei muscles?

Back 40

Ulnar nerve

Front 41

What is the function of the PADs?

Back 41

Adduct the 2, 4 and 5th fingers

Front 42

Which artery primarily gives rise to the deep palmar arch?

Back 42

Continuation of the deep branch of the Radial artery

Front 43

What binds down the extensor tendons that pass over the dorsal surface?

Back 43

extensor retinaculum

Front 44

What nerve is involved in carpal tunnel syndrome?

Back 44

Median

Front 45

What nerve may be harmed during a hamate fracture?

Back 45

Ulnar (close to hook)

Front 46

What would a hamate fracture present as?

Back 46

decreased grip strength

Front 47

What causes a boxer's fracture?

Back 47

fracture of the 5th metacarpal

Front 48

Parasthesia

Back 48

Tingling

Front 49

Hypoesthesia

Back 49

diminished sensation

Front 50

Anesthesia

Back 50

Absence of sensation

Front 51

What are the clinical manifestations of carpal tunnel?

Back 51

Paresthiesia, Hypoesthesia, or anesthesia in the lateral three and a half digits.

Front 52

Why does sensation in the central palm remain during CTS?

Back 52

the palmar cutaneous branch of teh median nerve arises proximal to and does not pass through the carpal tunnel

Front 53

Where does injury to the median nerve usually occur?

Back 53

wrist and forearm

Front 54

What muscle function in the hand is lost due to CTS?

Back 54

Opposition of the thumb

Front 55

What muscles are affected in CTS?

Back 55

APB and opponeens pollicis

Front 56

What muscles would be paralyzed in the hand due to median nerve damage?

Back 56

Thenar muscles and the first two lumbricals

Front 57

What is a ganglion?

Back 57

non-cystic swelling appears on dorsum of the wrist

Front 58

Why do hand infections manifest on the dorsal surface?

Back 58

Because the palmar fascia is thick and strong and the fascia of the dorsal surface is thinner

Front 59

What limits the spread of infection in the hand?

Back 59

fascial spaces