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118 Cards in this Set

  • Front
  • Back
What is the Hypothenar eminence?
on the thumb side
Why is the skin on the palm of the hand different than backside?
Cause it is attached to the palmar aponeurosis
How many metatarsals are there?
5
How many phalanges are there in the fingers?
2 in the thumb and 3 in the fingers
How many carpal bones are in the wrist?
8 which are in 2 rows
What are the thenar muslces?
Short muscles of the hand
bring thumb toward thumb is what?
adduction
Humans are the only primatess that can do what?
opposition
what is the short adductor of the thumb?
adductor pollicis brevis
what hand muscle does not everyone have?
Palmaris brevis
What are the hypothenar muscles?
abductor digiti minimi, flexor digiti
What are the PAD muscles?
Adductors of the fingers
there are 3 muscles
What are the DAB muscles?
abductors of the fingers and there are 4 of them
how many lumbrical muscles are there?
4
Where do the lumbricals originate?
on the tendons of the flexor digitiorium profundus
What is included in the dorsal surface of the hand?
Extensor tendons
Knuckles (heads of metacarpals)
Anatomical snuff box
What is contained in the anatomical snuff box?
radial artery and the styloid process of the radius
What is the anatomical snuff box bounded by?
tendons of the abductor pollicis longus, extensor pollicis brevis (laterally), and the extensor pollicis longus (medially)
What is located on the palmer or ventral side of the hand?
Palmar and digital creases
Thenar eminence of the thumb
Hypothenar eminence of 5th digit
Abundance of sweat glands and absence of hair
Well-patterened ridges on the ventral surface of the distal phalanges (finger prints) to prevent slippage of grasped objects
How many metacarpals are there?
5
How many phalanges are there?
14
Digits 2-5 all have what?
three phalanges (proximal, middle and distal)
The first digit has what?
has two phalanges (proximal and distal)
How many articulatons are there?
4
Carpometacarpal joints and intermetacarpal joints
metacarpalphalangeal (MP)joints
Proximal interphalangeal (PIP) joints
Distal interphalangeal (DIP) joints
What are the 3 short muscles of the thenar eminence that are muscles of the thumb?
abductor pollicis brevis
flexor pollicis brevis
opponens pollicis
What is the other thumb muscle that is NOT a thenar muscle?
adductor pollicis
All thenar muscles arise from what?
the flexor retinaculum and the trapezium
All thenar muscles insert on what?
shaft of the 1st metacarpal
Where does the adductor pollicis insert?
at the base of the proximal phalanx but arises by two heads.
What are the two heads of the adductor pollicis?
Transverse head of from the shaft of the 3rd metacarpal and oblique head from the bases of the 1st, 2nd and 3rd metacarpals
Where is the adductor pollicis found between?
Between the thumb and the index finger in the webbing
What innervates the three thenar muscles? (abductor pollicis brevis, extensor pollicis brevis and the opponens pollicis)
Reccurrent branch of the median nerve
What is the only thenar muscle that is not innervated by the recurrent branch of the median nerve
the deep head of the flexor pollicis brevis which when present is innervated by the ulnar nerve
What other muscle of the thumb is supplied by the roots of the ulnar nerve?
The adductor pollicis
What do the hypothenar muscles consist of?
Palmaris Brevis
Abductor digiti minimi
Flexor digiti minimi brevis
opponens digiti minimi
Where does the palmaris brevis muscle originate from?
flexor retinaculum and palmar aponeurosis
Where does the abductor digiti minimi originate from?
pisiform bone
Where does the flexor digiti minimi brevis and opponens digiti minimi originate?
flexor retinaculum and the hook of the hamate
Where do the hypothenar muscles insert at except for the opponens digiti minimi?
they insert at the base of the proximal phalanx of the 5th digit

The opponens digiti minimi inserts on the shaft of the 5 metacarpal
The hypothenar muscles are supplied by what nerve?
By the deep branch of the ulnar nerve except the palmaris brevis which is innervated by the ulnar nerve or its superficial branch
What are the interossei muscles divided into?
dorsal and palmar
3 on the PAD (palmar)
4 on the DOOR (Dorsal)
Where are the interossei muscles located?
in the space between the metacarpal bones
What interossei muscle inserts on the 3rd digit?
none!
how many dorsal interossei insert on the 3rd digit?
2
The dorsal interossei muscles do what?
abduct the 2nd, 3rd and 4th digits
The palmar interossei muscles do what?
adduct the 2nd, 4th and 5th digits
The interossei muscles may do what?
ASSIST!!!! in flexion of the metacarpal joints or with extension of the PIP (proximal interpharangeal joint) and DIP (distal interphalangeal joint)
These muscles cross over the MP joints
How many Lumbrical muscles are there?
4
Where do the lumbricals arise from?
the flexor digitorum profundus tendons
What nerve are the medial (3rd and 4th) lumbricals innervated by?
Ulnar nerve
What nerve innervates the lateral lumbricals (1st and 2nd)?
by the Median nerves
What is the primary function of the lumbricals?
to extend the interphalangeal joints, while their secondary function is to flex the MP joints
Why are the abundent dense connective tissues of the hand an overwhelming influence on hand function?
Dense connective tissues require long periods of time to heal. For this reason, injury to these tissues impair manual dexterity in work and leisure activities.
Skin on the palmar surface of the hand is attached to what?
palmar aponeurosis
Where does the palmaris longus tendon go to?
Palmar Aponeurosis
What muscles are innervated by the recurrent branches of the median nerve?
Abductor pollicis brevis
Flexor pollicis brevis
Opponens pollicis
Which lumbricals are innervated by seperate branches of the median nerve?
1st and the 2nd
How many muscles in the hand are innervated by the Median nerve and its branches?
5
What muscles of the hand are innervated by the Ulnar nerve?
All the other muscles of the hand
what muscle is the abductor of the little finger?
Abductor digiti minimi
What is the Palmar Aponeurosis?
a thickening of the deep fascia in the central area of the palm. This structure is strong and overlies the long flexor tendons and the other soft tissues. Proximally, it is continuous with the flexor retinaculum, while distally it divides into 4 longitudinal bands that attach to the bases of the proximal phalanges and fuse with the fibrous digital sheaths of each of the 4 fingers. The tendon of the Palmaris longus inserts into this aponeurosis
What is still being investigated by the scientific community?
the anatomy of the palmar fascial spaces
describe the fascial components of the palm
fromt he lateral border of the palmar aponeurosis a lateral fibrous septum extends deeply to the 1st metacarpal. A lateral or thenar compartment is therefore formed lateral to this septum. Similarily, from the medial border of the aponeurosis, a fibrous medial septum extends dorsally (the rest on page 50)
What is the Flexor retinaculum?
a heavy thickening of the anteriro antebrachial fascia at the level of the wrist.
What is the flexor retinaculum?
it is a heavy thickening of the anterior antebrachial fascia at the level of the wrist.
What course deep to the flexor retinaculum?
The median nerve and all the flexor tendons, EXCEPT the palmaris longus tendon
Together with the carpal bones, what do they and the flexor retinaculum form?
A carpal tunnel
What is the extensor retinaculum?
A thickening of the posterior antebrachial fascia. As it passes from the lateral border of the radius to the medial border of the ulna and the triquetrum and the pisiform, it sends septa into the underlying bone, thus separating the space deep to it into six typical compartments
What nerve and how many tendons pass under the flexor retinaculum?
9 tendons and the median nerve
What extensor tendons pass under the extensor retinaculum?
All of them
What is the clinical components of the hand?
they are independently seperated so that infection cannot spread!
What tendons pass deep to the flexor retinaculum?
Tendons of the flexor digitorum superficialis and flexor digitorum profundus
What sheeth does the does the flexor digitorum superficialis and the flexor digitorum profundus pass through?
the osteofibrous flexor digital sheaths
The long and short tendons to each tendon lie within the same fibrous sheath what are they enclosed in?
Each seperate one has its own synovial membrane so that they can slide freely over each other.
Close to the base of the proximal phalanx the tendon of the flexor digitorum superficialis does what?
It splits and twists to surround the tendon of the flexor digitorum profundus, which passes through the opening between the two halves. Soon after, the two halves reach their insertions at the margins of the middle phalanx. The tendons of the deep flexor, after passing through the openings in the tendons of the superficial flexor, pass distally to their insertions at the base of the distal vinculum
Small blood vessels from the periosteum of the phalanges pass through what?
The long and short vincula to supply each of the long flexor tendons.
What are the lumbricals attached to and not attached to?
tendons of the flexor digitorum profundus and not that of the superficialis
What does each extensor tendon sheath consist of?
outer fibrous layer and an inner synovial membrane
Unlike the flexors what does the extensor have that is different?
They do not share a common extensor sheath
What are the extensors compartmentalized by?
the extensor retinaculum
What is there on the dorsum of the hand?
there is an intertendinous connection between the four tendons of the extensor digitorum
The tendons of the extensor digitorum insert where?
at the bases of the proximal, middle and distal phalanges in a unique manner.
At the base of the proximal phalanges what does the tendon do?
the tendons expand to form aponeuroses to which the tendons of the lumbricals and the interossei insert
What is the vincula tendinum?
Two strands of connective tissue which attaches the tendon to the osteofibrous sheath on the anterior surface of the phalanx
What passes through the long and short vincula to supply each of the long flexor tendons?
Small blood vessels
What are the lumbricals attached to?
the tendons of the flexor digitorum profundus
The tendon sheaths that surround the flexor and extensor tendons of the hand consist of what?
of an outer fibrous layer and an inner synovial membrane
On the dorsum of the hand there is an intertendinous connection between what?
The four tendons of the extensor digitorum
The intertendinous connection between the 4 tendons of the extensor digitorum expand to form what?
Aponeurosis to which the tendons of the lumbricals and the interossei insert
The expanded tendon of insertion thus formed is known as what?
extensor hood or the dorsal digital expansion
What is the distal prolongation of the extensor hood known as?
The extensor aponeurosis
Towards the base of each middle phalanx each extensor aponeurosis splits to form what?
To form a wide central band (the main tendon) and two lateral bands.
Where does the central band insert at?
the base of each middle phalanx while the lateral bands unite on the dorsum of each middle phalanx to insert jointly at the base of each distal phalanx
What digit is not consistant with in people as to cutaneous innervation?
the 4th digit
Why does the palmer branch of the median nerve not get carpal tunnel?
because it passes over it
Cutaneous innervation of the hand is provided by what?
radial, ulnar, and the median nerves
The anterior interosseous nerve supplies what in the hand?
all the extrinsic flexors except the flexor carpi ulnaris and the ulnar half of the flexor digitorum profundus which are innervated by the ulnar nerve
What does the radial nerve and the posterior interosseous nerves innervate?
all the extensor muscles
What does AFOL stand for?
Abductor pollicis brevis
Flexor pollicis brevis
Opponens pollicis
Lumbricals 1 and 2
What innervates the AFOL?
the recurrent branch of the median nerve
All the intrinsic muscles of the hand are innervated by the ulnar nerve except what?
AFOL
Arterial blood supply to the hand is provided mainly by what?
the superficial palmar arch
The superficial palmer arch is what?
a continuation of the ulnar artery and the deep palmar arch
What is the deep palmar arch a continuation of?
the radial artery
The superficial palmar arch gives off what?
common digital arteries which then divide to form the proper palmar digital arteries.
The deep palmar arch gives off what?
palmar metacarpal arteries which communicate with the common digital arteries
At the creases of the palm the skin is firmly bound to what?
subcutaneous tissue beneath
An incision across a crease results in what?
much scar tissue and remarkable reduction in range of motion
What is Dupuytren's contracture?
Its when the palmar aponeurosis becomes abnormally thickened by fibrous bands that extend from it to the base of the phalanges. As the bands pull the fingers into flexion, the aponeurosis becomes contracted so that the flexed MP joints cannot be straightened
What cause Dupuytren's contracture?
the condition is not very well known but there appears to be a hereditary predisposition
Injury to the median nerve in the forearm or at the wrist produces paralysis of what?
the thenar muscles
How do you know if the thenar muscles have become paralyzed?
Loss of opposition of the thumb
What muscles of the hand can mimic opposition if the thenar muscles have become paralyzed?
abductor pollicis longus together with the adductor pollicis and the deep intrinsic flexor
What is the apehand deformity?
when the median nerve is severed and the thenar muscles are no longer innervated and they atrophy and become flattened
If injury to the ulnar nerve occurs what happens?
may include loss of sensation in the 5th finger and the ulnar half of the 4th finger; impaired abduction and the adduction of the 5th finger and paralysis of the adductor pollicis, the 3rd and 4th lumbricals and the interossei
What is claw hand?
subsequent atrophy of the muscles of the hand that the ulnar nerve supplies produces a characteristic furrow between the metacarpals
The radial nerve does not supply what?
DO NOT supply any of the intrinsic hand muscles
What is wrist drop?
injury to the radial nerve produces the inability of the arm and forearm to extend the wrist