FABS X Quiz 5

Which finger is there a split in, where two different nerves innervate it? What nerves?

4th finger (ring)

Ulnar and median

Functions of the hand include

support, manipulation and prehension (holding stuff)

What type of manipulation is there with the hand?

repetitive and blunt

continuous and fluid

Holding a hammer is an example of what type of prehension

power grip

Baseball hold is an example of what type of prehension

precision grip

Holding a key is an example of what type of prehension

power pinch

Pad of thumb to pad of other fingers is an example of what type of prehension

precision pinch

Holding luggage is an example of what type of prehension

Hook grip

What is the reference for movements of digits?

middle finger

During abduction and adduction of the thumb, what axis does it go around?

x-axis saggital

During flexion/extension of thumb what axis does it go around?

z-axis coronal plan

Lateral border of the snuff box of the hand is what?

extensor pollicis brevis tendon

Medial border of the snuff box of the hand is what?

extensor pollicis longus tendon

Nerve inside snuff box of hand?

posterior interroseous

What are the three arch systems that make up the natural palmar concavity?

proximal and distal transverse arch

longitudinal arch

Proximal transverse arch is made up of what bones? Distal arch is made up of what?

Distal base of carpal bones and metacarpal base

MCP heads and bases of proximal phalanges

Longitudinal arch stretches from where to where?

Distal, middle and proximal phalange of third digit, 3rd metacarpal and capitate bone

Dorsal fascia is continunous with what?

antebrachial fascia and fascia of the dorsum of the hand

Palmar aponeuroses is part of what? Covers what?

part of deep fascia

covers soft tissue and overlies long flexor tendon

Hypothethenar and Central compartment of hand are innervated by what nerve?

Deep ulnar

Thenar compartment of hand is innervated by what nerve

recurrent median

What are the muscles in the thenar compartment

flexor pollicis brevis

opponens pollicis

Abductor pollicis brevis

What are the muscles in the hypothenar compartment

Opponens digiti minimi

Flexor digiti minimi

Abductor digiti minimi

Muscles in the central compartment

lumbricals

dorsal interossei

palmar interossei

adductor pollicis

Palmaris brevis is innervated by what nerve?

superificial ulnar

What does ½ LOAF stand for? Innervated by what?

1st and 2nd Lumbricals

Opponens pollicis

Abductor pollicis brevis

Flexor pollicis brevis

innervated by recurrent median n

Abductor Pollicis brevis O and I

O: Flexor retinaculum

I: lateral side of base of proximal phalanx of thumb

Abductor Pollicis brevis A

A: Abducts the thumb at the CMC joint

Flexor pollicis brevis O and I

O: flexor retinaculum

I: lateral side of base of proximal phalanx of thumb

Flexor pollicis brevis A

A: flexes thumb at CMC and MCP joint and aids in opposition of thumb

Opponens pollicis I and O

O: flexor retinaculum

I: lateral side of first metacarpal

Opponens Pollicis A

A: opposes thumb, flexes and rotates 1st metacarpal medially

Adductor Pollicis O and I

O: oblique head- bases of 2nd & 3rd MCP, capitate, and adjacent carpals

I: medial side of proximal phalanx of thumb

Adductor Pollicis Longus A

A: Adduct the thumb toward middle digit

Palmaris Brevis overlies what nerve and artery at wrist?

Ulnar nerve and artery

Palmaris Brevis O and I

O: Flexor retinaculum and palmar aponeurosis

I: dermis of ulnar border of hand

Palmaris Brevis A

A: contributes to grip by wrinkling and supporting skin of ulnar hand

Palmaris Brevis N:

N: superficial branch of ulnar

Abductor digiti minimi O and I

O: pisiform

I: medial side of base of proximal phalanx of little finger

Abductor digiti minimi A

A: abducts 5th digit and helps flex proximal phalanx

Flexor digiti minimi O and I

O: hook of hamate and flexor retinaculum

I: medial side of base of proximal phalanx of little finger

Flexor digiti minimi A

A: flexes 5th digit at MCP

Opponens digiti minimi O and I

O: hook of hamate and flexor retinaculum

I: medial border of 5th MCP

Opponens digit minimi A

A: draw fifth MCP anterior and rotates anteriorly

Lumbricals 1 and 2 is what kind of muscle?

Unipennate

Lumbricals 1 and 2 O and I

O: lateral 2 tendons of FDP

I: lateral sides of extensor expansions of 2nd and 3rd digit

Lumbricals 1 and 2 A

A: flex digits at MCP joint and extend IP joint

Lumbricals 1 and 2 N

N: median n

Lumbricals 3 and 4 O and I

O: medial three tendons of FDP

I: lateral sides of extensor digits of 4th and 5th digit

Lumbricals 3 and 4 A

A: flex the digits at MCP and extend IP joint

Lumbricals 3 and 4 are what kind of muscle?

Bipennate

Dorsal interossei 1-4 is what kind of muscle

Bipennate

Dorsal interossei 1-4 O and I

O: adjacent side of two metacarpals

I: extensor expansions of bases of proximal phalanges of 2-4 digits

Dorsal interossei 1-4 A

A: abduct digits from axial line and act with lumbricals to flex MCP joints and extend IP joints

Palmar interossei 1-3 O and I

O: palmar surface of 2nd, 4th and 5th metacarpals

I: extensor expansions of digits and bases of proximal phalanges of digits 2, 4, 5

Palmar interossei 1-3 is what kind of muscle

unipennate

Palmar interossei 1-3 A

A: adduct digiits toward axial line assist lumbricals in flexing MCP joints and extending IP

What muscles have insertions on extensor hoods/extensor expansion?

Lumbricals, dorsal and palmar interossei

Tendons of the FDP and FDS enter what? They are deep to what?

Common flexor synovial sheeth (ulnar bursa)

Deep to flexor retinaculum

Where does the ulnar artery enter the hand?

Anterior to flexor retinaculum between pisiform and hook of hamate

What happens to ulnar artery when it enters hand?

splits into two branches: superficial palmar arch and deep palmar arch

How does the radial artery enter the hand?

curves dorsally around the scahphoid and trapezium in the floor of snuff box and enters palm by passing between the heads of the 1st dorsal interossei muscle

Which nerve does not reach all the way to the hand?

musculocutaneous

Recurrent median nerve innervates what muscles?

muscles of the thenar

What are the branches of the median nerve in the hand?

Palmar cutaneous, recurrent median, and lateral and median branch

Which branch of median does not go through the carpal tunnel?

Palmar cutaneous

If there is impingement of median nerve at the flexor retinaculum what area will not be affected?

palmar skin sensation

Most of the median nerve passes through what to the hand?

Carpal tunnel

Most of the ulnar nerve passes through what to the hand?

Tunnel of guyon

Thumb and lateral forearm have what dermatome root?

C6

middle finger has what dermatome root?

C7

Medial two fingers have what dermatome root?

C8

What is innervated by C5 deep tendon reflex?

biceps tendon

What muscles are innervated by C6 deep tendon reflex?

brachioradialis

What muscles are innervated by C7 deep tendon reflex?

triceps tendon

What muscles are affected by C5 myotome?

deltoid, biceps brachii

What muscles are affected by C6 myotome?

biceps brachii, brachioradialis, wrist extensor

What muscles are affected by C7 myotome?

Wrist flexors, finger extensor, triceps

In order to have radiculopathy you need lose what?

dermatome, myotome, deep tendon reflex

Which of the following is due to injury if the upper trunk (C5-C6)?

Erb Duchenne’s palsy

Which of the following is due to injury if the lower trunk (C8-T1)?

Klumpke’s palsy traction

Erb Duchenne’s palsy is due to what type of injuries?

Over stretch of upper trunk of brachial plexus

ex. yanking on baby’s head at birth

Klumpke’s palsy traction is due to what type of injuries?

excessive abduction of arm

Klumpke’s palsy traction affects what?

muscles of distal forearm and hand

Most dislocated carpal bone is what?

lunate

Most fractured carpal bone is what?

scaphoid

Axillary nerve innervates what muscles?

deltoid and teres minor

What area of skin is supplied by axillary?

lower deltoid

What nerves are affected by using a crutch?

radial and axillary

what muscles are innervated by Musculocutaneous?

muscles of anterior compartment of arm

What area of skin is supplied by Musculocutaneous?

Lateral forearm

Tricep, anconeus and long extensor paralysis results in what?

wrist drop

Injury in the axilla and radial groove affects what nerve?

radial; results in wrist drop

Injury to deep radial nerve has what effect?

Weakened extension at wrist; no wrist drop

Ulnar nerve can get injured from two areas, what are they?

Cubital tunnel at elbow

Tunnel of guyon at wrist (cyclist palsy)

Median nerve can get injured from two areas, what are they?

Pronator teres syndrome at elbow

Carpal tunnel syndrome

Median n injury will affect what area of skin?

Lateral half of ring finger and 1st, 2nd, 3rd digit

Cervical rib is what?

impingement of the trunks of the brachial plexus b/t anterior and middle scalene

Nursemaid’s elbow affects which ligament?

annular ligament

Popeye’s sign is a rupture of what?

long head of the biceps