Upper Limb VI: Wrist & Hand

What is another name for the wrist?

Radiocarpal joint

What is the most frequently fractured carpal bone?

Scaphoid

What is the most frequently dislocated carpal bone?

Lunate

The abductor pollicis longus and extensor pollicis brevis muscles make up the __ borders of the anatomical snuff box.

Lateral

What muscle makes up the medial border of the anatomical snuff box?

Extensor pollicis longus

What is tender to palpation with scaphoid fractures?

Anatomical snuff box

What’s the name of the 4 muscles that arise from double heads from adjacent metacarpal bone?

Dorsal interossei

What is the primary action of the dorsal interossei muscles?

Abduction of digits

What is the primary action of the palmar interossei muscles?

Adduction of digits

What innervates the palmar interossei muscles?

Ulnar n.

What innervates the dorsal interossei muscles?

Ulnar n.

What are the 4 muscles arising from the tendons of the flexor digitorum profundus muscle?

Lumbricals

What is the primary action of the lumbricals?

Flex MP joints and extend IP joints

What innervates the lumbricals?

Median n.

True or False: The majority of the use of the hand is lost if the opponens pollicis muscle becomes dysfunctional.

True

Which neurovascular structure in the hand gives origin to the palmar digital arteries?

Superficial palmar arterial arch

What supplies the superficial palmar arterial arch?

Ulnar artery

What supplies the deep palmar arterial arch?

Radial artery

What is the clinical significance of the 2 arterial arches in the hand?

Collateral blood flow

What enters the hand by passing through the carpal tunnel?

Median n.

What enters the palm by crossing superficial to the flexor retinaculum?

Ulnar n.

What provides cutaneous innervation to the radial 3 ½ digits?

Median n.

What provides cutaneous innervation to the palmar surface of the medial 1 ½ digits?

Ulnar n.

What is the clinical significance of compression of the medial nerve resulting from inflamed tendons in the flexor retinaculum?

Carpal tunnel syndrome

What is the clinical significance of weakness and atrophy of the thenar muscles?

Carpal tunnel syndrome

What is the clinical significance of pain with finger and wrist flextion/extension?

Carpal tunnel syndrome

A patient complains of pain in the lateral proximal arm. What spinal level(s) are likely damaged?

C5, C6

A patient complains of pain in the anterior and lateral forearm. What spinal level(s) are likely damaged?

C5, C6

A patient complains of pain in the posterior arm and forearm, 1st web space, and the dorsal aspect of radial 2 ½ fingers. What spinal level(s) are likely damaged?

C5-T1

A patient complains of pain in the radial surface of the palm and the palmar aspect of the radial 3 ½ fingers. What spinal level(s) are likely damaged?

C6-T1

A patient complains of pain in the ulnar aspect of the palm, the palmar aspect of the ulnar 1 ½ fingers, and the dorsal aspect of the ulnar 2 ½ fingers. What spinal level(s) are likely damaged?

C8-T1