Forearm & Hand

1.A 45-year old male was brought to the casuality following a road traffic accident. He had pain and swelling over his right arm. On clinical examination it was found that he was unable to extend his right wrist joint and joints of his right hand and also sensory loss on dorsum of right hand. X-ray of his right arm showed fracture shaft of humerus. With your knowledge in anatomy answer the following questions.  Name the nerve injured in this patient.  Give the root value of the nerve.  Describe the course of the nerve.  Name the branches given off by the nerve specifying the sites of origin.  What is the reason behind the patient’s inability to extend wrist joint and other joints of right hand

1.Superficial palmar arch

2.Ulnar nerve in hand

3.Flexor retinaculum of hand and its clinical implications

4.Carpometacarpal joint of thumb

5.Flexor retinaculum of upper limb

6.Palmar fascial spaces

7.Median nerve – branches, distribution in forearm & hand and applied anatomy

8.Ulnar nerve- origin, course and distribution in forearm and hand

1.Compartments deep to extensor retinaculum of hand

2.Describe boundaries and contents of anatomical snuff box

3.Explain the anatomical basis of carpal tunnel syndrome

4.Anatomical basis of claw hand

5.Structures passing deep to extensor retinaculum of hand and its deep relations

6.Midpalmar space

7.First carpometacarpal joint

8.Deep palmar arch

9.Palmer space

10.Interrosseus muscles of hand

11.Flexor retinaculum of hand: attachments, relations, functions and applied aspect

1.Floor of anatomical snuff box

2.Palmar aponeurosis

3.Action of Lumbricals in the hand

4.The nerve that continues as lateral cutaneous nerve of forearm

5.Diagram of dorsum of hand showing sensory innervation

6.Nerve passing superficial to the flexor retinaculum of hand

7.Cutaneous nerve supply of lateral border of forearm

8.Name the muscles supplied by ulnar nerve in the forearm

9.Name the nerve involved in carpal tunnel syndrome

10.Oblique section through hand to show fascial spaces

11.Superficial and deep palmar arches of hand

12.Nerve supply of lumbricals

13.Adductor pollicis

14.Interossei of hand

15.Palmar arterial arches

1.Assertion: Flattening of thenar eminence occurs in carpal tunnel syndrome

• Reason: The ulnar nerve gets compressed in carpal tunnel syndrome
• a) Both A and R are true and R is the reason for A
• b) Both A and R are true and R is not the reason for A
• c) A is correct but R is incorrect
• d) A is incorrect but R is correct

2.Assertion: Loculation of pus will lead to extreme tenderness in the pulp spaces of hand.

• Reason: Pulp spaces are closed unyielding spaces which intervene between the palmar skin and distal phalanges of all the digits of hand
• a) Both A and R are true, and R is the reason for A
• b) Both A and R are true, and R is not the reason for A
• c) A is correct but R is incorrect
• d) A is incorrect but R is correct

3.The muscles supplied by the deep branch of ulnar nerve are

• 1) Palmaris brevis
• 2) Palmar interossei 3) Adductor pollicis
• 4) Abductor digiti minimi
• a) 1, 2, 3
• b) 1, 4
• c) 2, 3
• d) 2, 3, 4

4.Which group of muscles most typically become weakened in this condition

• a) Dorsal interossei
• b) Extensors of wrist
• c) Flexors of wrist
• d) Palmar interossei