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49 Cards in this Set

  • Front
  • Back
carpals
PROXIMAL ROW
SCAPHOID
LUNATE
TRIQUETRUM
PISIFORM
distal row
TRAPEZIUM
TRAPEZOID
CAPITATE
HAMATE
metacarpals and phalanges
5 METACARPALS
DIGITS
FIRST DIGIT (THUMB)
TWO (2) PHALANGES
DIGITS 2-5
THREE PHALANGES
radiocarpal joint
COMPOUND JOINT --SINGLE CAPSULE
LIGAMENTS
DORSAL AND PALMAR RADIOCARPAL
RADIAL COLLATERAL
ULNAR COLLATERAL
radiocarpal joint is between what bones?

only which two carpals articulate directly with the radius?
Joint between radius and the proximal row of carpals.

Only scaphoid & lunate articulate directly with radius.
intercarpal and carpometacarpal joint
-COMPOUND JOINT
SINGLE CAPSULE
EXCEPT PISOTRIQUETRAL
PLANAR TYPE OF SYNOVIAL JOINTS
LIGAMENTS
INTERCARPAL
DORSAL
PALMAR
intercarpal and carpometacarpal joint
Pisiform has it’s own joint with triquetrum.

It’s the sum of all of the planar type joints (in the common capsule) that gives the total flexibility of motion.
metacarpophalangeal
-CONDYLOID
LIGAMENTS
COLLATERAL LIGAMENT
PALMAR LIGAMENT
DEEP TRANSVERSE METACARPAL LIGAMENT
metacarpophalangeal
Condyloid – like a ball and socket but oval rather than round – so movement in just two direction, not three. CANNOT ROTATE!! can circumflex...

Deep transverse metacarpal ligament -It’s relaxed until you reach a stop point and then kicks in.

Also has a superficial transverse metacarpal ligament.
interphalangeal
HINGE TYPE-flex and extend only
1 IN FIRST DIGIT
2 IN DIGITS 2-5
PROXIMAL
DISTAL
COLLATERAL LIGAMENTS
opposition
motion of mostly thumb with a little bit of flexion of pinky. Adduction + flexion at metacarpal-phalange joint with thumb.
where is the point of reference for the hand?
Abduction / adduction of fingers does NOT use body’s midline – it uses a line along the 3rd digit. Spreading fingers is abduction. Muscles are labeled for these motions.
skin and fascia
RELATIVELY THIN SKIN (on dorsum)
PALM THICKER
THIN LAYER OF SUPERFICIAL FASCIA
PALMAR APONEUROSIS
PALMARIS BREVIS
superficial palmar fascia
Lots of collagen in superficial palmar fascia Padding but stable enough to allow you to grip- don’t want loose skin. Soft but fixed.
palmar aponeurosis
is also heavy with collagen fibers – gives form to palm and acts as a retinaculum for tendons passing through the area.

pt of insertion for palmaris longus
palmaris brevis
it’s small an often missed. Deepens the hollow (cup) of hand. Not critical – sometimes not even present.


-origin from flexor retinaculum and palar aponeurosis
-inserts on skin

innervated by the ulnar nerve
like most hand muscles, except lumbricals and thenar eminence
where is there a superficial flexor tendon
SUPERFICIAL FLEXOR TENDON ON THE BASE OF MIDDLE PHALANX
deep flexor tendon where?
DEEP FLEXOR
TENDON ON DISTAL
PHALANX
flexor tendons
Running through the palm are the tendons for flexion. Two flexion muscles (flexor digitorum superficialis (also functions as a retinaculum for f.d.profundus (keeps it stable)& flexor digitorum profundus) each split into 4 tendons.Extensor digitorium – digits 2-5 – also splits its tendons.

Note split of each of the superficial tendons to anchor on sides of fingers. Note also that the deep passes through the superficial. Superficial is acting as a reticulum for deep ligament.
EXPANSION OR HOOD.
"WINGS"
TENDON DIVIDES INTO 3 BANDS
LUMBRICALS INSERT ON LATERAL BANDS
common extensor hood
extensors insert where? at what points? and originate where?
Note all of the tendons that insert on/in the “hood”. These are the “long” extensors – originate in the forearm & insert here.

Hood is actually a diamond shaped area. Muscles attach to the side points (wings) (proximal end) of the diamond.
thenar eminence
thumb to little finger – watch bulges in palm.
tendon from extensor digitorum joins with the tendons of what muscles? to form an expansion of the hood of each of the metacarpophalangeal joints
THE TENDON FROM EXTENSOR DIGITORUM JOINS WITH THE TENDONS OF THE INTEROSSEOUS MUSCLES TO FORM AN EXPANSION (slides) OR HOOD OVER EACH OF THE METACARPOPHALANGEAL JOINTS.
tendons of interosseus muscles form ? tendons angling from the primary tendon of which muscle?
THE TENDONS OF THE INTEROSSEOUS MUSCLES FORM "WING" TENDONS ANGLING FROM THE PRIMARY TENDON OF EXTENSOR DIGITORUM.

FROM THIS EXPANSION (HOOD) THE TENDON CONTINUES DISTALLY TO THE DISTAL END OF THE PROXIMAL PHALANX WHERE IT SPLITS INTO TWO LATERAL BANDS AND ONE CENTRAL BAND. THE CENTRAL BAND WILL RECEIVE "WING" TENDONS FROM THE LUMBRICALS.
the central of the tendon will attach to the base of which phalanx
THE CENTRAL BAND OF THE TENDON WILL ATTACH TO THE BASE OF THE MIDDLE PHALANX, WHILE THE LATERAL BANDS WILL CONTINUE DISTALLY.
the lateral bands of the extensor hood will unite to form what tendon? that will attach tot he base of the distal phalanx
THE LATERAL BANDS WILL UNITE TO FORM THE TERMINAL TENDON THAT WILL ATTACH TO THE BASE OF THE DISTAL PHALANX.
thenar eminence is made up of what 3 muscles and innervated by ?
ABDUCTOR POLLICIS BREVIS
FLEXOR POLLICIS BREVIS
OPPONENS POLLICIS
-median nerve
abductor pollicis brevis
ORIGIN: FLEXOR RETINACULUM AND THE TUBERCLES OF THE SCAPHOID AND TRAPEZIUM
INSERTION: LATERAL SIDE, BASE OF PROXIMAL PHALANX OF THE FIRST DIGIT (THUMB)
ACTION: ABDUCTS THUMB AND HELPS IN OPPOSITION
flexor pollicis brevis
ORIGIN: FLEXOR RETINACULUM AND TUBERCLE OF THE TRAPEZIUM
INSERTION: LATERAL SIDE OF 1ST METACARPAL BONE
ACTION: FLEXES THUMB
opponens pollicis
ORIGIN: FLEXOR RETINACULUM AND TUBERCLE OF THE TRAPEZIUM
INSERTION: LATERAL SIDE OF 1ST METACARPAL BONE
ACTION: OPPOSES THUMB AND ROTATES IT MEDIALLY
hypothenar eminence
-PALMARIS BREVIS
-ABDUCTOR DIGITI MINIMI
-FLEXOR DIGITI MINIMI (BREVIS)
O-PPONENS DIGITI MINIMI
palmaris brevis
VERY SMALL MUSCLE THAT OFTEN IS MISSING.
ORIGIN: FLEXOR RETINACULUM AND PALMAR APONEUROSIS
INSERTION: SKIN ON THE MEDIAL SIDE OF THE PALM
ACTION: WRINKLES SKIN ON MEDIAL SIDE OF PALM AND DEEPENS THE HOLLOW OF THE PALM, AIDS IN GRIP
INNERVATION: ULNAR NERVE
abductor digiti minimi
ORIGIN: PISIFORM BONE
INSERTION: MEDIAL SIDE OF BASE OF THE PROXIMAL PHALANX OF THE FIFTH DIGIT.
ACTION: ABDUCTS DIGIT 5 (LITTLE FINGER)
flexor digiti minimi brevis
ORIGIN: HOOK OF HAMATE AND THE FLEXOR RETINACULUM
INSERTION: MEDIAL SIDE OF BASE OF THE PROXIMAL PHALANX OF THE FIFTH DIGIT
ACTION: FLEXES PROXIMAL PHALANX OF DIGIT 5
OPPONENS DIGITI MINIMI
ORIGIN: HOOK OF HAMATE AND THE FLEXOR RETINACULUM
INSERTION: MEDIAL BORDER OF THE FIFTH METACARPAL
ACTION: DRAWS FIFTH METACARPAL ANTERIORLY AND ROTATES IT LATERALLY TO BRING THE FIFTH DIGIT IN OPPOSITION WITH THE THUMB
the palm-abductor pollicis
ORIGIN:
OBLIQUE HEAD: CAPITATE AND BASES OF 2nd AND 3rd METACARPALS
TRANSVERSE HEAD: JUST BODY OF 3rd METACARPAL
INSERTION: MEDIAL SIDE OF BASE OF PROXIMAL PHALANX OF THE FIRST DIGIT (THUMB)
ACTION: ADDUCTS THUMB (FIRST DIGIT)
INNERVATION: ULNAR N.
Note: NOT muscle of thenar eminence!
the palm-lumbricals
ORIGIN:
LUMBRICALS 1 & 2 (digits 2&3): LATERAL TWO TENDONS OF FLEXOR DIGITORUM PROFUNDUS
LUMBRICALS 3 & 4 (digits 4&5): MEDIAL THREE TENDONS OF FLEXOR DIGITORUM PROFUNDUS
INSERTION: LATERAL SIDES (WINGS) OF EXTENSOR TENDON DISTAL TO THE METACARPOPHALANGEAL JOINT
ACTION: FLEX THE METACARPOPHALANGEAL JOINT AND EXTEND THE INTERPHALANGEAL JOINTS (Wave bye-bye)
INNERVATION: Lateral 2 by median; medial 2 by ulnar. (The ½ exception)
palmer interosseus (the palm deeper)
Can see two heads of adductor pollicis.

PALMAR INTEROSSEI (3 of them – PAD)
ORIGIN: PALMAR SURFACES OF 2ND, 4TH, & 5TH METACARPALS
INSERTION: EXTENSOR EXPANSIONS (Wings) AND BASES OF THE PROXIMAL PHALANGES OF DIGITS 2, 4, & 5
ACTION: ADDUCTS DIGITS 2-5. EXTENDS THE INTERPHALANGEAL JOINTS AND FLEXES THE METACARPOPHALANGEAL JOINT

Note: No need for 3rd digit to have an adductor since it doesn’t move.
dorsal interossei of palm
(4 of them – DAB)
ORIGIN: ADJACENT SIDES OF TWO METACARPAL BONES
INSERTION: EXTENSOR EXPANSIONS AND BASES OF THE PROXIMAL PHALANGES OF 2ND - 4TH DIGITS
ACTION: ABDUCTS DIGITS 2-4. EXTENDS THE INTERPHALANGEAL JOINTS AND FLEXES THE METACARPOPHALANGEAL JOINT
lumbricals and interossei actions
EXTEND INTERPHALANGEAL JOINT(S)
FLEX METACARPO-PHALANGEAL JOINT
DORSAL-ABDUCT (DAB)
PALMAR-ADDUCT (PAD)
lumbricals and interossei of palm contd
Fine motor control – fine muscles – suspect ulnar N in fine motor issues. Use long muscles in arm for strength.

MOVEMENT OF THE EXTENSOR EXPANSION (HOOD) OVER THE METACARPOPHALANGEAL JOINT (KNUCKLE)

POSITION OF THE LONG FLEXORS - VARIATION IN LUMBRICAL ORIGIN
dorsal carpal arch
DORSAL CARPAL ARCH
DORSAL CARPAL BRANCH OF ULNAR ARTERY
DORSAL CARPAL BRANCH OF RADIAL ARTERY

More of a mesh than an arch. (A third arch linking radial & ulnar.)
superficial palmar arch
(from ulnar with a small branch from radial)
PRIMARILY A CONTINUATION OF THE ULNAR ARTERY
SUPERFICIAL PALMAR BRANCH OF RADIAL ARTERY ANASTOMOSES WITH THE SUPERFICIAL PALMAR ARCH
deep palmar arch
(from radial with a small branch from ulnar)
PRIMARILY A CONTINUATION OF THE RADIAL ARTERY
ANASTOMOSIS WITH THE DEEP PALMAR BRANCH OF THE ULNAR ARTERY
deep and superficial metacarpal arteries join together to form ?
Deep & superficial metacarpal arteries join together to form common metacarpal arteries.

DIGITAL ARTERIES (bifulcation of common metacarpal arteries)
COMMON PALMAR DIGITAL ARTERIES
PROPER PALMAR DIGITAL ARTERIES
ulnar nerve know exceptions
MOTOR TO MUSCLES OF THE HAND EXCEPT FOR 1-1/2 MUSCLES
EXCEPTIONS
THENAR EMINENCE (3 muscles)
LAT. 2 LUMBRICALS
recurrent branch of the median nerve
motor branch TO MUSCLES OF THE THENAR EMINENCE
median nerve
MOTOR TO THE LATERAL TWO LUMBRICALS
SENSORY TO THE PALMAR SURFACE FROM THE MIDDLE OF THE FOURTH DIGIT TO THE FIRST DIGIT, ALSO TO THE DORSAL SURFACE OF DIGITS 2, 3 AND LATERAL 1/2 OF 4
sensory innervation by ulnar nerve
1) MOTOR TO THE INTRINSIC MUSCLES OF THE HAND EXCEPT FOR THE MUSCLES OF THE THENAR EMINENCE AND THE LATERAL TWO LUMBRICALS
2) SENSORY TO PALMAR, MEDIAL, AND DORSAL SURFACE OF THE HAND FROM THE MIDDLE OF THE FOURTH DIGIT TO THE FIFTH DIGIT
radial nerve sensory info
SENSORY TO THE DORSUM OF THE HAND NOT SUPPLIES BY EITHER THE ULNAR OR MEDIAN NERVES
ALL OF THE DORSUM OF DIGIT 1
ON THE DORSUM OF THE HAND, FROM THE WRIST TO THE PROXIMAL INTERPHALANGEAL JOINT OF DIGITS 2, 3, AND MEDIAL HALF OF 4, AND ALL OF THE DORSUM OF DIGIT 1 (THE THUMB).