SF: The Hand

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Index finger, middle finger, and lateral side of ring finger

2 common palmar digital branches arise from the median nerve, divide into proper palmar digital branches, and innervate the medial aspect of the _______, _______, and _______.

1) radialis indicis 2) princeps pollicis artery

Identify the 2 labeled arteries near the deep palmar arch.

1) Proper palmar digital branches 2) Common palmar digital branches 3) Palmar branch

Identify the 3 branches of the median nerve in the picture.

Palmar aponeurosis

Identify this structure.

recurrent branch

In the palm of the hand, the median nerve immediately gives the _______, a motor branch that passes between the abductor pollicis longus and flexor pollicus longus to loop back to the 3 muscles of the thenar eminence.

superficial; deep

In the palm, the ulnar nerve divides into a _______ branch and a _______ branch.

Median; ulnar; radial

Motor innervation of the hand is by the _______ and _______ nerves. They, alongside _______, provide cutaneous innervation.

1) C6 (skin of thumb and lateral part of forearm) 2) C7 (skin of index, middle, and ring fingers) 3) C8 (skin of little finger, medial hand, and distal portion of forearm)

Name the 3 dermatomes of the hand.

1) Midpalmar space 2) Fibrous septum 3) Thenar space

Name the 3 fascial spaces of the hand.

1) Superficial branch of radial 2) Extensor retinaculum 3) Dorsal digital 4) Dorsal digital

Name the 4 structures in the picture. (1, 3, and 4 are nerves)

1) flexor retinaculum 2) superficial palmar arch 3) deep palmar branch of ulnar artery 4) 3 common palmar digital arteries (each branches into 2 proper digital arteries) 5) ulnar artery

Name the 5 labeled structures.

deep palmar arch

The _______ is inferior to the superficial palmar arch and has 3 small palmar metacarpal arteries that anastomose with the matching superficial arteries.

3 muscles of the thenar eminence

The median nerve gives a motor recurrent branch to _______.

Thumb, index finger

The median nerve gives cutaneous innervation through proper palmar digital nerves to the _______ and lateral border of the _______.

first dorsal interosseous muscle; adductor pollicis muscle

The radial artery dives between the two heads of the _______. It then passes between the transverse and oblique heads of the _______.

Median; Ulnar

The red arrow indicates the _______ nerve, while the blue arrow indicates the _______ nerve.

flexor retinaculum; pisiform; hook of the hamate

The ulnar nerve is superficial to the _______ but runs distally in a groove between the _______ and the _______.

Lumbrical muscles (4); Dorsal interossei muscles (4); Palmar interossei muscles (3)

What 3 groups of muscles make up the intrinsic muscles of the hand? How many muscles are in each group?

abductor digiti minimi; flexor digiti minimi; opponens digiti minimi

What 3 muscles make up the Hypothenar Eminence?

1) Radial 2) Medial 3) Ulnar

What 3 nerves make up the dorsal cutaneous innervation of the hand?

abductor pollicis brevis; flexor pollicis brevis; opponens pollicis

What are the 3 muscles that make up the Thenar Eminence?

3 hypothenar muscles, all dorsal and palmar interossei muscles, 2 most medial lumbrical muscles and rh adductor pollicis

What does the deep branch of the ulnar nerve provide motor to?

palmaris brevis, cutaneous to the medial aspect of the medial 1 1/2 fingers

What does the superficial branch of the ulnar nerve provide motor to?

Dorsal cutaneous branch of the ulnar nerve

What nerve is this?

Ulnar nerve

What other nerve also has these same 3 branches?

Dupuytren's disease

_______ is a condition in which a slowly progressive fibrosis of the palmar aponeurosis results in permanent flexion of the little and ring fingers.

Flexor digitorum superficialis; flexor carpi radialis; palmaris tendon; flexor retinaculum

At the wrist, the median nerve passes between the _______ and the _______ deep to the _______. It then passes under the _______.

1) In the tunnel of Guyon: lose cutaneous innervation to the palmar aspect of their medial 1 1/2 fingers 2) Lose ability to contract all intrinsic muscles of hand, except for those innervated by median nerve 3) flexor and extensor muscles unopposed = claw hand 4) all interossei are paralyzed 5) only 2 medial lumbrical muscles are paralyzed 6) adductor pollicis brevis is non-functional

Name the 6 effects of an injury to the ulnar nerve.

abductor pollicis brevis origin: flexor retinaculum and carpal bones insertion: lateral aspect of base of proximal phalanx of thumb mvmt: abducts thumb at carpometacarpal and metacarpophalangeal joints nerve: median artery: superficial palmar branch of radial artery