lecture 45 UE the wrist and hand

flexor retinaculum

what is the thickening of deep antebrachial fascia on anterior side of hand?

extensor retinaculum

what is the thickening of deep antebrachial fascia on posterior side of hand?

concave passageway created by carpal bones

what is the carpal groove or sulcus?

flexor retinaculum (ct)

the carpal tunnel is the carpal groove closed by the...

tendons of flexor pollicis longus m (1), flexor digitorum superficialis m (4), and flexor digitorum profundus m (4), median n

what passes through carpal tunnel?

compression of the median n in the carpal tunnel

what produces carpal tunnel syndrome?

deep fascia of the forearm

what is the deep fascia of the palm continuous with?

muscle mass at base of thumb

what is the thenar eminence?

muscle mass at base of fifth digit

what is the hypothenar eminence?

thin over thenar and hypothenar eminence, thick over palm

where is the deep fascia of the hand thin? thick?

palmar aponeurosis

what is the thickened deep fascia of the palm called?

flexor retinaculum and tendon of palmaris longus m

what is the palmar aponeurosis continuous with?

flexor tendons

what does the palmar aponeurosis overlie?

thenar, hypothenar, central, and adductor compartments

what fascial compartments lie between the palmar aponeurosis and the palmar surface of the metacarpals?

at base of thumb and contains thenar mm

describe the thenar compartment

at base of little finger and contains hypothenar mm

describe the hypothenar compartment

contains lumbrical mm and flexor tendons

describe the central compartment

adductor pollicis m

what does the adductor compartment contain?

palmar aponeurosis and flexor retinaculum

palmaris brevis m: origin

skin on medial border of hand

palmaris brevis m: insertion

ulnar n

palmaris brevis m: innervation

wrinkles skin of hand and improves grip

palmaris brevis m: function

abductor pollicis brevis m, flexor pollicis brevis m, and opponens pollicis brevis m

list mm of thenar compartment

median n (t)

what are all of the mm of the thenar compartment innervated by?

opposition of thumb

what are the mm of the thenar compartment responsible for?

scaphoid, trapezium, and flexor retinaculum

abductor pollicis brevis m: origin

lateral margin of proximal phalanx of thumb

abductor pollicis brevis m: insertion

median n (a)

abductor pollicis brevis m: innervation

abduct the thumb

abductor pollicis brevis m: function

trapezium, capitate, and trapezoid

flexor pollicis brevis m: origin

lateral side of proximal phalanx of thumb

flexor pollicis brevis m: insertion

median n (f)

flexor pollicis brevis m: innervation

flexes MCP joint of thumb

flexor pollicis brevis m: function

trapezium and flexor retinaculum

opponens pollicis m: origin

lateral part of body of 1st metacarpal

opponens pollicis m: insertion

median n (o)

opponens pollicis m: innervation

pull thumb medially to oppose other fingers

opponens pollicis m: function

abductor digiti minimi m, flexor digiti minimi m, opponens digiti minimi m

list the mm of the hypothenar compartment

ulnar n (h)

the mm of the hypothenar compartment are all innervated by what n?

pisiform

abductor digiti minimi m: origin

medial surface of base of proximal phalanx of 5th digit

abductor digiti minimi m: insertion

ulnar n (a)

abductor digiti minimi m: innervation

abduct 5th digit

abductor digiti minimi m: function

hook of hamate and flexor retinaculum

flexor digiti minimi m: origin

medial surface of base of proximal phalanx of 5th digit (f)

flexor digiti minimi m: insertion

flex 5th digit at MCP joint

flexor digiti minimi m: function

flexor retinaculum and hook of hamate

opponens digiti minimi m: origin

shaft of 5th metacarpal

opponens digiti minimi m: insertion

ulnar n (o)

opponens digiti minimi m: innervation

pull 5th metacarpal anteriorly and rotate it toward thumb

opponens digiti minimi m: function

4 lumbrical mm

list mm of central compartment

to tendons (not to bone)

what are the attachments of lumbrical mm (generally)?

lateral side of tendons of flexor digitorum profundus m

lumbrical mm: origin

lateral side of tendon of the extensor digitorum m

lumbrical mm: insertion

flex MCP joints, extend IP joints

lumbrical mm: function

median n (l12)

lumbrical mm 1 and 2: innervation

ulnar n (l34)

lumbrical mm 3 and 4: innervation

adductor pollicis m

what are mm of adductor compartment?

ulnar n

what are mm of adductor compartment innervated by?

anterior surface of shaft of 3rd metacarpal

adductor pollicis m: origin of transverse head

base of 2nd and 3rd metacarpals, capitate

adductor pollicis m: origin of oblique head

medial surface of base of proximal phalanx of pollex

adductor pollicis m: insertion

ulnar n (ap)

adductor pollicis m: innervation

adduct the thumb

adductor pollicis m: function

deep or adductor fascial compartment between the metacarpal bones

where are interossei mm located?

adduct

the three palmar interossei ___ the digits

unipennate

the three palmar interossei are ___

abduct

the four dorsal interossei ___ the digits

bipennate

the four dorsal interossei are ___

3

how many palmar interossei are there?

4

how many dorsal interossei are there?

palmar surfaces of 2nd, 4th, and 5th metacarpals

palmar interossei mm (3): origin

extensor tendon of metacarpals 2, 4, 5

palmar interossei mm (3): insertion

ulnar n (p)

palmar interossei mm (3): innervation

adduct digits 2, 4, 5

palmar interossei mm (3): function

adjacent sides of all metacarpal bones

dorsal interossei mm (4): origin

extensor tendons of metacarpals 2, 3, 4

dorsal interossei mm (4): insertion

ulnar n (d)

dorsal interossei mm (4): innervation

abduct digits 2, 3, 4

dorsal interossei mm (4): function

through carpal tunnel

how does the median n enter the hand?

three superficial thenar mm, 1st and 2nd lumbrical mm

in the hand, what does the median n supply?

ulnar n (fm)

what is the nerve of fine movements of hand?

ulnar canal

what does the ulnar n enter the hand through?

hypothenar mm, adductor pollicis m, 3rd and 4th lumbrical mm, interossei mm

in the hand, what does the ulnar n supply?

superficial branch of radial n

what is only a sensory n innervating primarily the dorsum of the hand?

half of 4th digit and 5th digit on anterior and posterior surface

describe parts of hand communicating sensory information via ulnar n?

1st-3rd fingers, half of ring finger on anterior surface, tips of 1, 2, 3, and half of tip of 4th finger on posterior surface

describe parts of hand communicating sensory information via median n?

thenar area, 1-3 fingers on posterior surface and half of 4th finger besides the fingertips

describe parts of hand communicating sensory information via superficial branch of radial n?

passageway lateral to pisiform, under hook of hamate, and superficial to flexor retinaculum

what is the tunnel of guyon?

floor of the anatomical stuffbox

the radial n enters the hand by crossing the...

oblique and transverse heads of adductor pollicis mm

the radial a enters the palm of the hand between the...

deep branch of ulnar a

what does the ulnar a give off in the ulnar canal?

superficial palmar arch

what does the ulnar a continue as after giving off deep branch of ulnar a?

palmar aponeurosis, flexor tendons

the superficial palmar arch is deep to the ___ and superficial to the ___

proximal transverse crease of palm

at what level does the superficial palmar arch lie?

abductor digiti minimi and flexor digiti minimi mm

what does the deep branch of the ulnar a pass between?

deep palmar arch

after the deep branch of the ulnar a passes between abductor digiti minimi and flexor digiti minimi mm, what does it join?

superficial branch of radial a (small branch)

proximal to the wrist, what does the radial a give off?

thenar mm

what does the superficial branch of the radial a pass through?

superficial palmar arch

the superficial branch of the radial a passes through the thenar mm and joins what?