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Wrist and Hand1. Concerning the palmar spacesa. The hypothenar space contains the long flexor tendons to the 5th digit – midplamar space contains the lond tendonsb. The septum from the radial border of the palmar aponeurosis attaches to the 2nd metacarpal – 3rdc. The thenar space is bounded posteriorly by adductor pollicis – adductor pollicis is deep to the thenar in the adductor compartment, with the thenar space betweend. The midpalmar space is continuous proximally with anterior compartment of the forearm <= correct, via the carpal tunnele. All of the above2. Regarding flexion of the fingersa. Flexor digitorum superficialis inserts at the base of the distal phalanx - middleb. Flexor digitorum profundus enters the fibrous sheath superficial to the flexor digitorum superficialis tendon - deepc. When palmar and dorsal interossei contract together, flexion of the metacarpophalangeal joints results <=d. The lumbricals are attached to the extensor expansions and to the proximal phalanges – no boney attachment, lateral 2 are unipennate, from FDP to extensor expansione. In the flexor sheath, the tendons of flexor digitorum profundus and flexor digitorum superficialis are invested by separate synovial sheaths – common, FPL is exception3. Concerning the blood supply of the handa. The radial artery crosses the anatomical snuffbox over trapezoid – scaphoid and trapeziumb. The superficial palmar arch is a direct continuation of the radial artery - ulnac. The superficial palmar arch is usually a complete arch <- trued. The superficial palmar arch supplies the thumb – no, gives off 3 common digital that anastomose with the palmar metacarpal arteries to digital arteries, the thumb is from preceps pollicis from the deep palmar arch from the radial e. The radial artery gives off the radialis indicis artery and the princeps pollicis artery <= correct4. Regarding tendons across the wrista. Flexor carpi ulnaris passes deep to the flexor retinaculum – no attaches to the pisiform (and thus to hook of hamate and base of 5thb. Extensor carpi radialis brevis inserts into the base of the 3rd metacarpal <= correctc. Flexor digitorum profundus tendons insert into the base of the proximal phalanx - distald. Extensor carpi radialis longus passes through the carpal tunnel - extensore. Flexor carpi radialis lies superficial to the flexor retinaculum – all flexors beneath5. Movements of the thumb includea. Radial abduction by abductor pollicis brevis and extensor pollicis brevisb. Opposition by opponens pollicis <=c. Palmar abduction by abductor pollicis longusd. Adduction by flexor pollicis longuse. Opposition is not important in the power grip6. The anatomical snuffboxa. Has the extensor pollicis longus on its ulnar side <= and EPB w/ AbdPL on radial sideb. Lies between extensor pollicis longus and abductor pollicis longus – true, but EPB alsoc. Has the trapezoid palpable in its base – radial styloid, scaphoid, trapezium and base of 1st MCd. Is most obvious with the thumb fully abducted - extendede. Contains the posterior interosseous artery – radial 7. The flexor retinaculum attaches to all of the following bones excepta. Scaphoidb. Hamatec. Trapeziumd. Pisiforme. Capitate <=8. Compression of structures in the carpal tunnel usually results ina. Weakness of forearm flexorsb. Weakness of flexion of the terminal phalanx of the thumb – FPL is a forearm musclec. Weakness of the interossei muscles – deep branch ulnard. Unaffected sensation on the palmar surface of the little finger <= ulnar distributione. Weakness of all the lumbrical muscles – medial 29. With respect to the thenar musclesa. Abductor pollicis brevis inserts into the base of the distal phalanx of the thumb – prox phalanxb. All arise from the flexor retinaculum <= depends if you count adductor pollicisc. Flexor pollicis is usually supplied by a branch from the ulnar nerve – usually median (recurrent muscular)d. Abductor pollicis brevis has no role in opposition of the thumb - helpse. Opponens pollicis is the most superficial muscle of the group – deep to FPB (it’s in the web)10. With respect to the flexor retinaculuma. It attaches to the scaphoid, hamate, pisiform and trapezium <=b. The tendons of palmaris longus passes deep to it – inserts into itc. The median nerve passes superficial to it – deep (but is shallow)d. The ulnar artery passes deep to it – in own canal of Guyone. It is pierced by the tendon of flexor carpi ulnaris 11. In the hand, the deep palmar archa. Is normally incompleteb. Is formed by the superficial branch of the ulnar artery – dorsal branch of the radialc. Crosses the palm 1cm distal to the superficial arch – proximald. Gives off 3 metacarpal arteries <= correcte. Does not anastomose with the anterior carpal arch – does via the metacarpals -> common digitals12. Regarding digital nervesa. Common digital nerves lie superficial to the superficial archb. Palmar nerves only supply palmar surfacec. Digital nerves are only sensory <=d. Digital nerve lie posterior to digital artery – palmar to dorsal: NAVe. ?13. Regarding the interossei of the hand, which is INCORRECTa. Insert into proximal phalanxb. Insert into the dorsal expansionc. When act together, the dominant action is adduction <=d. When act together, flex the MCP jointe. ?14. With regard to the deep spaces of the hand the following are correct EXCEPT:a. The thenar space always contains the first lumbrical muscle – lumbricals in the central compartment w/ long flexors, superficial arch, digital nerves and vesselsb. The thenar space is overlaid by the flexor tendons to the index fingerc. Infection in the midpalmar space can involve the ulnar three lumbricalsd. The hypothenar space encloses only the hypothenar muscles <= pg 773e. The thenar space contains the common flexor sheath15. Regarding the carpal tunnela. Flexor pollicis longus has its own synovial sheath <=b. The flexor retinaculum is attached to the scaphoid, trapezium, hamate and triquetrumc. The median nerve lies medial to flexor digitorum superficialis - laterald. Median nerve compression causes paraesthesia of the thenar eminence – no, the palmar cutaneous branch comes off proximallye. Palmaris longus runs lateral to the median nerve – inserts into the retinaculum16. The palmar carpal archa. Supplies the skin of the digitsb. Supplies the skin of the thumbc. Does not anastomose radial and ulnar arteriesd. Is deep to the long flexor tendons <=e. Is level with the metacarpal bases17. Regarding the small muscles of the handa. Thenar eminence muscles are supplied mainly by C8 <=b. Abductor pollicis brevis causes radial abductionc. Lumbricals are supplied by the ulnar nerve onlyd. Palmar and dorsal interossei cancel the effect of each other out, when acting simultaneouslye. Flexor pollicis brevis is inserted into the base of the distal phalanx18. The following muscles are involved in ulnar and transpalmar adduction of the thumba. Flexor pollicis brevis and flexor pollicis longusb. Opponens pollicis and adductor pollicisc. Flexor pollicis longus and opponens pollicisd. Adductor policis and flexor pollicis breviss <= i.e. flexion and adductione. Opponens pollicis and abductor pollicis brevis19. The carpal tunnela. Has four separate superficial flexor tendons that lie in two rows <=b. Has eight superficial tendons which share a common synovial sheath that completely invests themc. Contains the ulnar nerved. Is a shallow concave fibro-osseous canale. has tendon flexor pollicis longus with a shared synovial sheath20. The deep space of the handa. Is composed of hypothenar and thenar spaces aloneb. Is continuous between midpalmar space and lumbrical canalc. Is superficial to the palmar aponeurosisd. Is an open space with no dividing septae. Can be divided by margins that are clearly defined21. The radial artery in the palma. Passes between the two heads of opponens pollicisb. Has the deep branch of the ulnar nerve in its concavityc. Gives off the princeps pollicis artery to the index fingerd. Runs across the palm distal to the superficial palmar arche. Is usually continuous with the ulnar artery via the deep palmar arch <=22. The lumbricalsa. Are attached to the flexor expansionb. Have no bony attachment <=c. Flex the proximal interphalangeal jointd. Are all supplied by the ulnar nervee. Oppose the action of the interossei23. Interosseia. Arise from flexor retinaculumb. Palmar cause abductionc. Palmar have two heads of origind. Innervated by deep branch of the ulnar nerve <=e. Combined palmar and dorsal causes abduction24. Palmar interosseia. ?b. have two headsc. abduct the fingersd. chiefly responsible for flexion at MCP and extension at PIP joints <=e. ?25. Midpalmar spacea. ?b. extends into lumbrical canals distallyc. ?d. is continuous with common carpal spacee. extends proximally to the origin of FDS <=26. In relation to the movement of the thumba. Abductor pollicis brevis is inserted into the ulnar side of the base of the proximal phalanxb. Thenar eminence is supplied by the muscular (remnant) branch of the median nerve <=c. Adduction is by adductor pollicis brevis and longus – there is only one, adductor pollicisd. Opponens pollicis rotates the 1st metacarpal on the triquetral - trapeziume. Opponens pollicis inserts to the base of the proximal phalanx – base of 1st MC27. Regarding the carpal tunnela. The flexor pollicis longus has its own synovial sheath <=b. The flexor retinaculum is attached to the scaphoid, trapezium, hamate and triquetralc. The median nerve lies medial to flexor digitorum superficialisd. Median nerve compression causes paraesthesia of the thenar eminencee. Palmaris longus runs lateral to the median nerve28. The radial arterya. Is lateral to the biceps tendon in the cubital fossab. Can be palpated in the floor of the anatomical snuffbox <=c. Disappears between the tendons of abductor pollicis longus and extensor pollicis brevisd. Is rarely thrombosed during cannulatione. In the middle 1/3 of its course has the radial n. medial to it29. The palmar carpal archa. Supplies the skin of the digitsb. Supplies the skin of the thumbc. Does not anastomose radial and ulnar arteriesd. Is deep to the long flexor tendons <=e. Is level with the metacarpal base30. Regarding small muscles of the handa. Thenar eminence muscles are supplied mainly by C8 <=b. Abductor pollicis brevis causes radial abductionc. Lumbricals are supplied by ulnar nerve onlyd. Palmar and dorsal interossei cancel the effect of each other out when acting simultaneouslye. Flexor pollicis brevis is inserted into the base of the distal phalanx31. The following muscles are involved in ulnar and transpalmar adduction of the thumba. Flexor pollicis brevis and flexor pollicis longusb. Opponens pollicis and adductor pollicisc. Flexor pollicis longus and opponens pollicisd. Adductor pollicis and flexor pollicis brevise. Opponens pollicis and abductor pollicis brevis32. The carpal tunnela. Has 4 separate superficial flexor tendons that lie in 2 rows <=b. Has 8 superficial tendons which share a common synovial sheath that completely invests themc. Contains the ulnar nerved. Is a shallow concave fibro-osseous canale. Has tendon flexor pollicis longus with a shared synovial sheath33. Regarding the wrist jointa. It is supplied by the ulnar nerve <=b. The capitate is involved in the articulationc. It is a synovial hinge jointd. The majority of flexion occurs at the midcarpal jointe. Abduction is by flexor carpi ulnaris34. The deep space of the handa. Is composed of thenar and hypothenar spaces aloneb. Is continuous between midpalmar space and lumbrical canalc. Is superficial to the palmar aponeurosisd. Is an open space with no dividing septae. Can be divided by margins that are clearly defined35. Concerning the wrist jointa. The distal radius is not part of the jointb. The joint capsule is thicker posteriorlyc. The triquetral bone forms part of the wrist joint <= correct, the proximal carpals except pisiformd. It usually communicates with the distal radioulnar jointe. It usually communicates with the midcarpal joint36. With regard to the median nerve distribution in the hand:a. The muscular branch to the thumb is given off prior to passing below the flexor retinaculumb. Lateral branch supplies the nail bed of the thumb <=c. Medial branch supplies the skin of the thenar eminenced. The 1st lumbrical is supplied by the ulnar nervee. Digital nerves lie deep to the digital arteries – palmar to dorsal NAV37. The lunate articulates with all of the following EXCEPT:a. Scaphoidb. Triquetralc. Capitated. Radiuse. Hamate <=38. The skin of the tip of the index finger is supplied by:a. The radial nerve onlyb. The median nerve only <=c. The ulnar nerve onlyd. The radial and median nervese. The radial and ulnar nerves39. Following a laceration to the anterior surface of the wrist, a patient is unable to flex the proximal interphalangeal joint of his middle finger when his other fingers are held in extension. The tendon of which muscle has been divided?a. Palmaris longusb. Flexor indicisc. Flexor digitorum profundusd. Flexor digitorum superficialis <= attaches to the base of the middle phalanxe. None of the above40. With respect to the carpusa. The intercarpal joints share one continuous synovial space <= with the exception of the CMCJ of the thumbb. The intercarpal synovial space is usually contunous with the wrist jointc. The proximal row consists of scaphoid, lunate and trapeziumd. The scaphoid is the only carpal bone which articulates with the radiuse. In pronation-supination the carpus moves with the ulna - radius41. The radial artery in the palma. Passes between the two heads of opponens pollicis – 1st dorsal interosseusb. Has the deep branch of the ulnar nerve in its concavityc. Gives off the princes pollicis artery to the index fingerd. Runs across the palm distal to the superficial palmar arche. Is usually continuous with the ulnar artery via the deep palmar arch <=42. In regards to movements at the wrist jointa. Adduction is limited to 15 degreesb. Midcarpal joint movement is greater in flexion than extensionc. Adduction is performed by flexor and extensor carpi ulnaris <=d. The axis of the metacarpus is in line with the axis of the forearme. 360 degrees of circumduction is possible43. The lumbricalsa. Are attached to the flexor expansionb. Have no bony attachment <=c. Flex the proximal interphalangeal jointd. Are all supplied by the ulnar nervee. Oppose the action of the interossei44. The anatomical snuffboxa. Has the extensor pollicis longus on its ulnar sideb. Lies between extensor pollicis longus and abductor pollicis longusc. Has the trapezoid palpable in its based. Is most obvious with the thumb fully abductede. Contains the posterior interosseous artery45. the flexor retinaculum attaches to all of the following bones EXCEPT:a. scaphoidb. hamatec. trapeziumd. pisiforme. capitate ................
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