Hand

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Author:
Omidancer1
ID:
146390
Filename:
Hand
Updated:
2012-04-09 00:40:55
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Hand
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Hand
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  1. Abductor Pollicis Brevis
    • Proximal Attachment: Trapezium and flexor retinaculum
    • Distal Attachment: Proximal phalanx of thumb
    • Innervation: Median n. (C8–T1)
    • Main Actions: ABducts thumb; helps oppose thumb
  2. Flexor Pollicis Brevis
    • Proximal Attachment: Trapezium and flexor retinaculum
    • Distal Attachment: Proximal phalanx of thumbe
    • Innervation: Superficial: median n. (C8–T1); Deep: ulnar n. (C8–T1)
    • Main Actions: Superficial: flexes thumb; Deep: ADducts thumb toward lateral border of palm
  3. Opponens Pollicis
    • Proximal Attachment: Trapezium and flexor retinaculum
    • Distal Attachment: 1st metacarpal
    • Innervation: Median n. (C8–T1)
    • Main Actions: Opposes thumb
  4. Adductor Pollicis
    • Proximal Attachment: 3rd metacarpal and capitate
    • Distal Attachment: Proximal phalanx of thumb
    • Innervation: Ulnar n. (C8–T1)
    • Main Actions: ADducts thumb toward lateral border of palm
  5. Abductor Digiti Minimi
    • Proximal Attachment: Pisiform
    • Distal Attachment: Proximal phalanx of 5th digit
    • Innervation: Ulnar n. (C8–T1)
    • Main Actions: ABducts 5th digit; assists in flexion of proximal phalanx of 5th digit
  6. Flexor Digiti Minimi Brevis
    • Proximal Attachment: Hook of hamate and flexor retinaculum
    • Distal Attachment: Proximal phalanx of 5th digit
    • Innervation: Ulnar n. (C8–T1)
    • Main Actions: Flexes proximal phalanx of 5th digit
  7. Opponens Digiti Minimi
    • Proximal Attachment: Hook of hamate and flexor retinaculum
    • Distal Attachment: 5th metacarpal
    • Innervation: Ulnar n. (C8–T1)
    • Main Actions: Opposes 5th digit
  8. Lumbricals
    • Proximal Attachment: Tendons of flexor digitorum profundus
    • Distal Attachment: Extensor expansion
    • Innervation: Lateral two (digits 2 and 3): Median n. (C8–T1) ; Medial two (digits 4 and 5): Ulnar n. (C8–T1)
    • Main Actions: Flex MCP joints and extend PIP and DIP joints
  9. Palmar Interossei
    • Proximal Attachment: Shaft of metacarpals 2, 4, and 5
    • Distal Attachment: Extensor expansion of 2nd, 4th, and 5th digits
    • Innervation: Ulnar n. (C8–T1)
    • Main Actions: ADduct 2nd, 4th, and 5th digits toward midline
  10. Dorsal Interossei
    • Proximal Attachment: Adjacent sides of two metacarpals
    • Distal Attachment: Extensor expansion of 2nd, 3rd, and 4th digits
    • Innervation: Ulnar n. (C8–T1)
    • Main Actions: ABduct 2nd, 3rd, and 4th digits away from midline
  11. Thenar Eminence Muscles
    • Abductor Pollicis Brevis
    • Flexor Pollicis Brevis
    • Opponens Pollicis
  12. Hypothenar Eminence Muscles
    • Abductor Digiti Minimi
    • Flexor Digiti Minimi Brevis
    • Opponens Digiti Minimi
  13. Hypothenar/thenar eminence muscle mnemonic
    • All For One And One For All
    • Abductor Pollicis Brevis
    • Flexor Pollicis Brevis
    • Opponens Pollicis
    • Adductor Pollicis
    • Opponenes Digiti Minimi
    • Flexor Digiti Minimi Brevis
    • Abductor Digiti Minimi
  14. Median n. intrinsic muscles
    • Half LOAF
    • half of Lumbricals
    • Opponens Pollicis
    • ABductor Pollicis Brevis
    • Flexor Pollicis Brevis
  15. Fibrous Digital Sheath
    • Annular part - attaches into extensor expansion
    • Criciform part
    • Prevents bow-stringing of felxor tendons
  16. Radial a.
    • Goes on floor of snuff box
    • Enters palm of hand just distal CMC joint of thumb
    • Forms deep palmar arch
    • Small branch goes to superficial palmar arch
  17. Ulnar a.
    • Enters hand with ulnar nerve
    • Goes over top of hook of hamate
    • Makes superficial palmar arch
    • Small branch goes to deep palmar arch
  18. Carpal Tunnel
    • Created by hamate, capitate, trapezoid, trapezium, and flexor retinaculum (transverse carpal ligament)
    • 9 tendons, 1 nerve:
    • 4 tendons of FDS
    • 4 tendons of FDP
    • 1 tendon of flexor pollicis longus
    • Median nerve
  19. Guyon's Tunnel
    • From the proximal edge of the transverse carpal ligament to just distal and medial to the hook of the hamate
    • Covered by the pisohamate ligament
    • Ulnar a. and n. run through it
    • Site of ulnar n. impingement
  20. Interosseous membrane
    • Fibers run from radius superiorly to ulna inferiorly
    • Prevents separation of radius and ulna
    • Provides extra surface area for muscle attachments
    • Prevents radius from translating superiorly during weight bearing
  21. Distal Radioulnar Joint
    • Pivot joint between ulnar notch on radius and ulnar head
    • Allows radius to move around a fixed ulna
    • Held together by triangular fibrocartilaginous complex (TFCC), a.k.a. triangular ligament — from medial ulnar notch to lateral base of ulnar styloid process
    • Anterior and posterior radioulnar ligaments help stabilise joint
  22. Radiocarpal Joint
    • Condyloid joint - flexion, extension, radial and ulnar deviation
    • Scaphoid and Lunate articulate with radius
    • Concave surface of radius and TFCC
    • Convex surface of scaphoid and lunate (and triquetrum in full ulnar deviation)
  23. Midcarpal Joint
    • Between proximal and distal carpal rows
    • Lateral compartment: half of scaphoid, trapezium, trapezoid — convex scaphoid, concave trapezium and trapezoid
    • Medial Compartment: half of scaphoid, lunate, triquetrum, capitate, hamate — convex capitate and hamate, concave scaphoid, lunate, and triquetrum. Acts similar to ball and socket joint
  24. Wrist Joint
    • Radiocarpal Joint and Midcarpal Joint
    • Radial Collateral Ligament: thickening of articular capsule, runs radial styloid process to scaphoid and trapezium
    • Ulnar Collateral Ligament: styloid process of ulna and triquetrum to base of 5th metacarpal
    • UCL and RCL prevent excessive radial and ulnar deviation, keep hand forearm together
    • Dorsal radiocarpal ligament: radius to scaphoid, lunate, and triquetrum
    • Palmar radicapral ligament: radius to capitate, lunate, and scaphoid — many ligaments togther
    • DRL and PRL keep hand and radius articulating, and prevetn exessive flexion and extension
  25. Thumb Joint
    • CMC: saddle joint
    • concave and caonvex surfaces on trapezium
    • loose capsule reinforced by 5 ligaments: ulnar collateral, radial collateral, anterior and posterior oblique ligaments, 1st intermetacarpal ligament
    • all ligaments attatch from trapezium to metacarpal
    • ligaments prevent ABduction, oposition, some extension

    • MCP
    • RCL and UCL: prevent varus and valgus forces
  26. Motions of Thumb
    Opposition: ABduction, flexion, and medial rotation
  27. MCP Joints of fingers
    • Collateral ligaments: cord-like part (head of metacarpal up to phalanx) and fan-like part (head of metacarpal to palmar plate/ligament) — prevent ABduction of MCP joint in flexion and valgus/varus forces in extension
    • Palmar plate/ligament: on ventral surface of MCP joint; is fibrocartinlagenous; blends with fibrous digital sheath; help flexor tendons glide without impingement and prevent hyperextension

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