The flexor mechanism of the hand refers to the complex system of tendons, muscles, ligaments, and other structures responsible for flexing or bending the fingers, thumb, and wrist.
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The flexor mechanism of the hand refers to the complex system of tendons, muscles, ligaments, and other structures responsible for flexing or bending the fingers, thumb, and wrist.
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Jc flexor tendon injury, repair & rehabilitaion
Flexor tendon injuries require careful surgical repair and rehabilitation to achieve a successful outcome. The anatomy of the flexor tendons and their blood supply is complex. A thorough patient evaluation including examination of each tendon is important for diagnosis and treatment planning. Various suture techniques exist for flexor tendon repair, with the goal of reapproximating the tendon ends while minimizing gaps and damage to the tendon vascularity. Proper suture material selection and postoperative rehabilitation are also crucial factors.
Tendon injuries of hand
This document discusses anatomy and injuries of the hand flexor tendons. It begins with the anatomy of the flexor tendon system including the fibrous pulley system. It then covers the different zones of flexor tendon injury and techniques for repair. The goals of repair are to control scar formation and allow for early motion rehabilitation. Post-operative therapy is critical and usually involves early passive motion or early active motion protocols. Complications can include adhesion, rupture, or flexion contractures.
Hand anatomy- harsh amin
1. The proper collateral ligaments at the PIP joints are under relatively uniform tension in flexion and extension and therefore are not a factor in irreversible contracture. However, the check-rein ligaments at the proximal end of the palmar plate at the PIP joint may hypertrophy and contract, resulting in a fixed flexion contracture.
2. The oblique pulley is the most important pulley in the thumb because the FPB can provide adequate and independent MCP joint flexion, and the A1 pulley often is released for stenosing tenosynovitis without apparent loss of function.
3. When the MP joint is hyperextended, the palmar plate moves distally
10-Palm of hand.ppt
1. The palm contains flexure creases, fingerprints, and fibrous bands that connect it to underlying structures and divide subcutaneous fat. It also contains abundant sweat glands.
2. The superficial fascia of the palm contains cutaneous nerves and vessels as well as the palmaris brevis muscle.
3. The deep fascia of the palm is thickened in three areas: the palmar aponeurosis, flexor retinaculum, and fibrous flexor sheaths of the fingers.
Flexor tendon injury final edit with pictures
This document discusses flexor tendon injuries and their management. It covers the anatomy of flexor tendons and pulley system, zones of injury, tendon healing process, and approaches to repairing different types of injuries. For zone I injuries of the finger, which involve a single tendon in the osteofacial tunnel, the document recommends end-to-end repair if sufficient length is available, or transosseous techniques if the stump is too short. Avulsion injuries are classified and recommendations are given for repair timing based on the classification and presence of the vincular system.
USMLE MSK L015 Upper 04 Muscles of forearm anatomy .pdf
The muscles of the forearm are responsible for various movements of the wrist, hand, and fingers. These muscles can be broadly categorized into two groups: anterior (flexor) muscles and posterior (extensor) muscles.
Understanding the actions and functions of these forearm muscles is crucial for comprehending hand and wrist movements and for diagnosing and treating conditions affecting the forearm.
Flexor tendon injuries
This document discusses flexor tendon injuries and their treatment. It begins with an overview of flexor tendon anatomy, morphology, zones of injury, and the challenges of repair. It then describes techniques for clinical evaluation, including testing of the flexor digitorum profundus and superficialis tendons. Principles of flexor tendon repair are outlined, including approaches for zone 1 and zone 2 injuries. Core suture techniques like the Kessler and Tajima methods are explained. Post-repair management considers risks of adhesion formation and importance of early motion.
Tendon transfer- principles and techniques
1. Tendon transfers involve rerouting a functioning muscle tendon unit to restore a function lost due to nerve injury or other conditions. Common indications include nerve injuries or trauma.
2. Key principles of tendon transfer include having supple joints, adequate excursion of the donor muscle, and maintaining a straight line of pull. Common procedures restore functions like finger extension, thumb opposition, and wrist extension.
3. Rehabilitation after tendon transfer focuses on immobilization followed by gentle range of motion and strengthening exercises over 8-12 weeks before returning to full activity.
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Jc flexor tendon injury, repair & rehabilitaion
Flexor tendon injuries require careful surgical repair and rehabilitation to achieve a successful outcome. The anatomy of the flexor tendons and their blood supply is complex. A thorough patient evaluation including examination of each tendon is important for diagnosis and treatment planning. Various suture techniques exist for flexor tendon repair, with the goal of reapproximating the tendon ends while minimizing gaps and damage to the tendon vascularity. Proper suture material selection and postoperative rehabilitation are also crucial factors.
Tendon injuries of hand
This document discusses anatomy and injuries of the hand flexor tendons. It begins with the anatomy of the flexor tendon system including the fibrous pulley system. It then covers the different zones of flexor tendon injury and techniques for repair. The goals of repair are to control scar formation and allow for early motion rehabilitation. Post-operative therapy is critical and usually involves early passive motion or early active motion protocols. Complications can include adhesion, rupture, or flexion contractures.
Hand anatomy- harsh amin
1. The proper collateral ligaments at the PIP joints are under relatively uniform tension in flexion and extension and therefore are not a factor in irreversible contracture. However, the check-rein ligaments at the proximal end of the palmar plate at the PIP joint may hypertrophy and contract, resulting in a fixed flexion contracture.
2. The oblique pulley is the most important pulley in the thumb because the FPB can provide adequate and independent MCP joint flexion, and the A1 pulley often is released for stenosing tenosynovitis without apparent loss of function.
3. When the MP joint is hyperextended, the palmar plate moves distally
10-Palm of hand.ppt
1. The palm contains flexure creases, fingerprints, and fibrous bands that connect it to underlying structures and divide subcutaneous fat. It also contains abundant sweat glands.
2. The superficial fascia of the palm contains cutaneous nerves and vessels as well as the palmaris brevis muscle.
3. The deep fascia of the palm is thickened in three areas: the palmar aponeurosis, flexor retinaculum, and fibrous flexor sheaths of the fingers.
Flexor tendon injury final edit with pictures
This document discusses flexor tendon injuries and their management. It covers the anatomy of flexor tendons and pulley system, zones of injury, tendon healing process, and approaches to repairing different types of injuries. For zone I injuries of the finger, which involve a single tendon in the osteofacial tunnel, the document recommends end-to-end repair if sufficient length is available, or transosseous techniques if the stump is too short. Avulsion injuries are classified and recommendations are given for repair timing based on the classification and presence of the vincular system.
USMLE MSK L015 Upper 04 Muscles of forearm anatomy .pdf
The muscles of the forearm are responsible for various movements of the wrist, hand, and fingers. These muscles can be broadly categorized into two groups: anterior (flexor) muscles and posterior (extensor) muscles.
Understanding the actions and functions of these forearm muscles is crucial for comprehending hand and wrist movements and for diagnosing and treating conditions affecting the forearm.
Flexor tendon injuries
This document discusses flexor tendon injuries and their treatment. It begins with an overview of flexor tendon anatomy, morphology, zones of injury, and the challenges of repair. It then describes techniques for clinical evaluation, including testing of the flexor digitorum profundus and superficialis tendons. Principles of flexor tendon repair are outlined, including approaches for zone 1 and zone 2 injuries. Core suture techniques like the Kessler and Tajima methods are explained. Post-repair management considers risks of adhesion formation and importance of early motion.
Tendon transfer- principles and techniques
1. Tendon transfers involve rerouting a functioning muscle tendon unit to restore a function lost due to nerve injury or other conditions. Common indications include nerve injuries or trauma.
2. Key principles of tendon transfer include having supple joints, adequate excursion of the donor muscle, and maintaining a straight line of pull. Common procedures restore functions like finger extension, thumb opposition, and wrist extension.
3. Rehabilitation after tendon transfer focuses on immobilization followed by gentle range of motion and strengthening exercises over 8-12 weeks before returning to full activity.
EXTENSOR EXPANSION PPT BY DR. SHUBHANSHU GAURAV.pptx
The extensor expansion is the aponeurotic extension of the extensor digitorum tendons on the dorsal surface of the finger. It consists of the extensor hood, central slip, and lateral bands. The extensor hood surrounds the MCP joint. The central slip extends the PIP joint and lateral bands extend the DIP joint. Intrinsic hand muscles like lumbricals and interossei insert on the expansion and transmit force to extend the fingers by increasing tension in the extensor mechanism. The mechanism works by intrinsic muscle activity producing extension of PIP and DIP joints due to the dorsal position of the extensor mechanism's lines of action.
Tendon transfer for radial nerve palsy
1) Radial nerve palsy can be classified as high or low lesions, with high lesions demonstrating total loss of wrist extension in addition to finger and thumb losses.
2) Tendon transfers are commonly used to restore wrist, finger, and thumb extension when radial nerve function cannot be recovered. Jones pioneered many tendon transfer techniques still used today.
3) Common tendon transfers include the palmaris longus to the extensor pollicis longus to provide thumb extension and abduction, the flexor carpi ulnaris to the extensors digitorum communis to provide finger extension, and the pronator teres to the extensor carpi radialis brevis to provide wrist
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The document provides an overview of hand biomechanics and examination. It discusses the components of hand movement including muscles, tendons, joints, and spatial movement. It describes the 27 degrees of freedom of the hand and details the stabilizing structures like ligaments. The document reviews biomechanics concepts including arthrokinematics, osteokinematics, and degrees of freedom. It examines the biomechanics of different grips and pinches. The joints, muscles, tendons, and stabilizing ligaments of the hand are described.
Palm- 1 and 2 .pptx
This document provides an overview of the anatomy of the palm. It describes the palmar skin as thick, glabrous, and rich in sweat glands. It is firmly attached to the underlying palmar aponeurosis by fibrous bands. The document outlines the creases and lines of the palmar skin, as well as the layers of fascia in the palm including the palmar aponeurosis and flexor retinaculum. It also describes the muscles of the palm including the thenar, hypothenar, interossei and lumbrical muscles. Additionally, it discusses the arteries, nerves and fascial spaces of the palm.
Pollicization
This document discusses various techniques for pollicization, which is a hand surgery to create a functioning thumb from another finger. It begins by defining pollicization and describing the anatomy and function of the thumb. It then discusses different conditions that may require pollicization, including thumb hypoplasia, absence due to trauma, macrodactyly, multifinger hands, and mirror hands. For each condition, it provides details on the surgical procedure for pollicization, including steps like isolating nerves/vessels, shortening bones, transferring muscles/tendons, and positioning the new thumb. Post-operative casting is also addressed. The document contains many diagrams illustrating thumb anatomy and different pollicization procedures.
Tendon injuries of hand
Tendon injuries of the hand can occur in different zones. Flexor tendon injuries are divided into 5 zones and extensor tendon injuries into 8 zones based on anatomical locations. Flexor tendon injuries require careful surgical repair and postoperative rehabilitation to prevent complications like adhesion and contracture. The timing of repair, surgical technique including suture type and post-operative mobilization protocol depends on the zone of injury. Proper management can restore tendon gliding and hand function.
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This document provides an overview of the muscular anatomy of the upper limb. It begins by outlining the parts of the upper limb and then describes the individual muscles within the shoulder girdle, arm, forearm, wrist, and hand. The document also discusses the muscular spaces in the upper limb like the axilla, cubital fossa, and anatomical snuff box. It concludes with some examples of how knowledge of muscular anatomy relates to radiological imaging and diagnosis, and provides multiple choice questions to test comprehension.
Hand
This document provides an overview of the surgical anatomy of the hand. It describes the surface landmarks and structures of the palmar aspect of the hand such as the tubercles and bones that can be felt. It details the layers of the palm including the skin, superficial and deep fascia, muscles such as the palmaris brevis, nerves, blood vessels, and other structures. It also describes the dorsal aspect including fascia and extensor retinaculum. Key areas covered include the carpal tunnel, flexor retinaculum, fibrous flexor sheaths, intrinsic hand muscles, and fascial spaces of the palm.
Hand anatomy 1
The document provides an overview of hand anatomy including terminology, skin, fascia, muscles, tendons, bones, joints, nerves and vasculature. Key points include descriptions of various hand incisions and their purposes, fascial layers and spaces of the hand, flexor tendon anatomy and zones of injury, and anatomy of important muscles like the thenar and hypothenar muscles. The document covers the detailed functional anatomy of the hand.
13 ms Forearm.ppt
This document describes the anatomy of the forearm. It is divided into several sections. The forearm has two bones - the radius and ulna - connected by an interosseous membrane. The forearm fascia and intermuscular septa divide the forearm into compartments containing muscles, nerves and blood vessels. The forearm muscles are divided into superficial, intermediate and deep flexor groups in the anterior compartment and superficial, deep and lateral groups in the posterior compartment. Each muscle's origin, insertion and action are described.
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Claw hand
Claw hand, also known as intrinsic minus hand, is caused by an imbalance between strong extrinsic flexors and deficient intrinsics. It is characterized by hyperextension of the MCP joints and flexion of the PIP and DIP joints.
There are several types of claw hand including partial and total. Partial is due to ulnar nerve paralysis and results in clawing of just the ring and little fingers. Total claw hand is caused by combined median and ulnar nerve palsies and leads to clawing of all five fingers.
Various tests can identify which nerves are involved based on the muscles affected. Ulnar nerve tests examine muscles like the first dorsal interossei and hypothenar muscles.
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5 anterior forearm.ppt
The anterior compartment of the forearm contains superficial and deep flexor muscles. The superficial muscles include pronator teres, flexor carpi radialis, palmaris longus, and flexor carpi ulnaris. The deep muscles include flexor digitorum profundus, flexor pollicis longus, and pronator quadratus. The median and ulnar nerves pass between muscles in the compartment, and the radial and ulnar arteries are the main blood vessels.
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The document summarizes the anatomy of the hand including bones, joints, muscles, nerves and common clinical tests. It describes 19 bones, 29 articulations and the intrinsic and extrinsic muscles. It outlines the median, ulnar and radial nerves, their points of entrapment and resulting clinical presentations such as carpal tunnel syndrome. Common hand disorders like tendon injuries and nerve palsies are also summarized.
Flexor tendon injuries slideshare
The document discusses flexor tendon injuries, including anatomy, classification by zones, surgical techniques for repair, and postoperative rehabilitation. It covers the superficial and deep flexor tendon groups, pulley system anatomy and its importance, and surgical approaches and repair methods for injuries in different zones of the hand. Primary goals of repair include restoring tendon continuity and gliding while preventing adhesions through techniques like circumferential suturing.
Wrist joint complex
1) The wrist joint complex includes the radiocarpal joint between the radius and proximal carpal row, midcarpal joints between the proximal and distal carpal rows, and carpometacarpal joints of the thumb and fingers.
2) Key structures include the triangular fibrocartilage complex between the ulna and triquetrum bone, ligaments such as the radiocarpal and intercarpal ligaments, joint capsules, and muscles that cross the wrist including flexors and extensors.
3) The document describes the bones, joints, ligaments, muscles, movements, blood supply and common injuries of the wrist complex in detail.
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These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
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Similar to The flexor mechanism of the hand refers to the complex system of tendons, muscles, ligaments, and other structures responsible for flexing or bending the fingers, thumb, and wrist.
EXTENSOR EXPANSION PPT BY DR. SHUBHANSHU GAURAV.pptx
The extensor expansion is the aponeurotic extension of the extensor digitorum tendons on the dorsal surface of the finger. It consists of the extensor hood, central slip, and lateral bands. The extensor hood surrounds the MCP joint. The central slip extends the PIP joint and lateral bands extend the DIP joint. Intrinsic hand muscles like lumbricals and interossei insert on the expansion and transmit force to extend the fingers by increasing tension in the extensor mechanism. The mechanism works by intrinsic muscle activity producing extension of PIP and DIP joints due to the dorsal position of the extensor mechanism's lines of action.
Tendon transfer for radial nerve palsy
1) Radial nerve palsy can be classified as high or low lesions, with high lesions demonstrating total loss of wrist extension in addition to finger and thumb losses.
2) Tendon transfers are commonly used to restore wrist, finger, and thumb extension when radial nerve function cannot be recovered. Jones pioneered many tendon transfer techniques still used today.
3) Common tendon transfers include the palmaris longus to the extensor pollicis longus to provide thumb extension and abduction, the flexor carpi ulnaris to the extensors digitorum communis to provide finger extension, and the pronator teres to the extensor carpi radialis brevis to provide wrist
Hand anatomy and biomechanics wrist examination.pptx
The document provides an overview of hand biomechanics and examination. It discusses the components of hand movement including muscles, tendons, joints, and spatial movement. It describes the 27 degrees of freedom of the hand and details the stabilizing structures like ligaments. The document reviews biomechanics concepts including arthrokinematics, osteokinematics, and degrees of freedom. It examines the biomechanics of different grips and pinches. The joints, muscles, tendons, and stabilizing ligaments of the hand are described.
Palm- 1 and 2 .pptx
This document provides an overview of the anatomy of the palm. It describes the palmar skin as thick, glabrous, and rich in sweat glands. It is firmly attached to the underlying palmar aponeurosis by fibrous bands. The document outlines the creases and lines of the palmar skin, as well as the layers of fascia in the palm including the palmar aponeurosis and flexor retinaculum. It also describes the muscles of the palm including the thenar, hypothenar, interossei and lumbrical muscles. Additionally, it discusses the arteries, nerves and fascial spaces of the palm.
Pollicization
This document discusses various techniques for pollicization, which is a hand surgery to create a functioning thumb from another finger. It begins by defining pollicization and describing the anatomy and function of the thumb. It then discusses different conditions that may require pollicization, including thumb hypoplasia, absence due to trauma, macrodactyly, multifinger hands, and mirror hands. For each condition, it provides details on the surgical procedure for pollicization, including steps like isolating nerves/vessels, shortening bones, transferring muscles/tendons, and positioning the new thumb. Post-operative casting is also addressed. The document contains many diagrams illustrating thumb anatomy and different pollicization procedures.
Tendon injuries of hand
Tendon injuries of the hand can occur in different zones. Flexor tendon injuries are divided into 5 zones and extensor tendon injuries into 8 zones based on anatomical locations. Flexor tendon injuries require careful surgical repair and postoperative rehabilitation to prevent complications like adhesion and contracture. The timing of repair, surgical technique including suture type and post-operative mobilization protocol depends on the zone of injury. Proper management can restore tendon gliding and hand function.
Muscular anatomy of upper limb, MRI Anatomy
This document provides an overview of the muscular anatomy of the upper limb. It begins by outlining the parts of the upper limb and then describes the individual muscles within the shoulder girdle, arm, forearm, wrist, and hand. The document also discusses the muscular spaces in the upper limb like the axilla, cubital fossa, and anatomical snuff box. It concludes with some examples of how knowledge of muscular anatomy relates to radiological imaging and diagnosis, and provides multiple choice questions to test comprehension.
Hand
This document provides an overview of the surgical anatomy of the hand. It describes the surface landmarks and structures of the palmar aspect of the hand such as the tubercles and bones that can be felt. It details the layers of the palm including the skin, superficial and deep fascia, muscles such as the palmaris brevis, nerves, blood vessels, and other structures. It also describes the dorsal aspect including fascia and extensor retinaculum. Key areas covered include the carpal tunnel, flexor retinaculum, fibrous flexor sheaths, intrinsic hand muscles, and fascial spaces of the palm.
Hand anatomy 1
The document provides an overview of hand anatomy including terminology, skin, fascia, muscles, tendons, bones, joints, nerves and vasculature. Key points include descriptions of various hand incisions and their purposes, fascial layers and spaces of the hand, flexor tendon anatomy and zones of injury, and anatomy of important muscles like the thenar and hypothenar muscles. The document covers the detailed functional anatomy of the hand.
13 ms Forearm.ppt
This document describes the anatomy of the forearm. It is divided into several sections. The forearm has two bones - the radius and ulna - connected by an interosseous membrane. The forearm fascia and intermuscular septa divide the forearm into compartments containing muscles, nerves and blood vessels. The forearm muscles are divided into superficial, intermediate and deep flexor groups in the anterior compartment and superficial, deep and lateral groups in the posterior compartment. Each muscle's origin, insertion and action are described.
The Forearm by Dr. Shapi.pdf
A well summarized presentation on the Basics in Human Anatomy that'll effectively deliver information in an incredibly remarkable way to the reader.
Thumb reconstruction
This document discusses reconstruction of the thumb. It begins by describing the anatomy of the thumb bones and joints. It then discusses various soft tissue reconstruction options for different types and sizes of thumb defects, including local flaps, cross-finger flaps, and free flaps. It also covers osteoplastic reconstruction using a bone graft and flap in multiple stages to reconstruct large bony defects of the thumb. The goals of reconstruction are to restore length, stability, mobility, and sensate soft tissue coverage to the thumb.
Claw hand
Claw hand, also known as intrinsic minus hand, is caused by an imbalance between strong extrinsic flexors and deficient intrinsics. It is characterized by hyperextension of the MCP joints and flexion of the PIP and DIP joints.
There are several types of claw hand including partial and total. Partial is due to ulnar nerve paralysis and results in clawing of just the ring and little fingers. Total claw hand is caused by combined median and ulnar nerve palsies and leads to clawing of all five fingers.
Various tests can identify which nerves are involved based on the muscles affected. Ulnar nerve tests examine muscles like the first dorsal interossei and hypothenar muscles.
DISTAL END OF RADIUS FRACTURE AND DISLOCATION MANAGEMENT.pptx
The document discusses the anatomy, classifications, and management of fractures of the distal radius. It begins with the anatomy of the distal radius and its articulations. It then covers several common classification systems for distal radius fractures, including the AO/ASIF classification and the Melone classification. The document discusses indications for closed versus open treatment, as well as techniques for closed and open reduction. Key points include maintaining length, tilt, and alignment during treatment. Surgical options like percutaneous pinning, external fixation, and various plating techniques are also summarized.
5 anterior forearm.ppt
The anterior compartment of the forearm contains superficial and deep flexor muscles. The superficial muscles include pronator teres, flexor carpi radialis, palmaris longus, and flexor carpi ulnaris. The deep muscles include flexor digitorum profundus, flexor pollicis longus, and pronator quadratus. The median and ulnar nerves pass between muscles in the compartment, and the radial and ulnar arteries are the main blood vessels.
Hand 2009 (2) Questions Included Not To Post
The document summarizes the anatomy of the hand including bones, joints, muscles, nerves and common clinical tests. It describes 19 bones, 29 articulations and the intrinsic and extrinsic muscles. It outlines the median, ulnar and radial nerves, their points of entrapment and resulting clinical presentations such as carpal tunnel syndrome. Common hand disorders like tendon injuries and nerve palsies are also summarized.
Flexor tendon injuries slideshare
The document discusses flexor tendon injuries, including anatomy, classification by zones, surgical techniques for repair, and postoperative rehabilitation. It covers the superficial and deep flexor tendon groups, pulley system anatomy and its importance, and surgical approaches and repair methods for injuries in different zones of the hand. Primary goals of repair include restoring tendon continuity and gliding while preventing adhesions through techniques like circumferential suturing.
Wrist joint complex
1) The wrist joint complex includes the radiocarpal joint between the radius and proximal carpal row, midcarpal joints between the proximal and distal carpal rows, and carpometacarpal joints of the thumb and fingers.
2) Key structures include the triangular fibrocartilage complex between the ulna and triquetrum bone, ligaments such as the radiocarpal and intercarpal ligaments, joint capsules, and muscles that cross the wrist including flexors and extensors.
3) The document describes the bones, joints, ligaments, muscles, movements, blood supply and common injuries of the wrist complex in detail.
Radial nerve Injury and tendon tranfers
This document discusses radial nerve injury and tendon transfers. It begins by describing the radial nerve's innervations and mechanisms of injury. Common causes of radial nerve injury include fractures of the humeral shaft and gunshot wounds. Examination of radial nerve palsy involves assessing muscles like the triceps and extensors. Tendon transfers are indicated for radial nerve injuries that do not recover on their own. The Brand transfer is currently the standard protocol, involving the pronator teres, flexor carpi radialis, and palmaris longus muscles. Postoperative care focuses on immobilizing the arm for 6 weeks.
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These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
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The flexor mechanism of the hand refers to the complex system of tendons, muscles, ligaments, and other structures responsible for flexing or bending the fingers, thumb, and wrist.
- 2. Introduction • Muscles of finger and thumb have proximal attachment above wrist (complete this or correct this). • 2 main muscle contribute finger flexion: a. Flexor digitorum superficialis b. Flexor digitorum profundus 4/28/2024 2
- 3. Flexor digitorum superficialis & Flexor digitorum profundus • Flexes PIP & MCP • More torque than FDP • Crosses few joint and superficial to FDP @ MCP • Greater Moment Arm for MCP joint • Flexes MCP, PIP and DIP joint (actively) • Finger flexion of FDS &FDP works together 4/28/2024 3 (Specify about what muscle you are saying)
- 4. ORIGIN & INSERTION OF FDS & FDP 4/28/2024 4
- 5. Relation btw FDS & FDP • FDS travel superficial to FDP and at the level of PIP, FDS (splits or slips?) slips (CAMPER’S CHIASMA) and FDS attach base of middle phalanx • FDS & FDP dependent on wrist position for optimal LENGTH- TENSION relationship • Counter balancing external torque at the wrist by extensor carpi radialis brevis and sometimes by extensor digitorum communics (check the spelling). 4/28/2024 5
- 6. STRUCTURE OF FLEXOR MECHANISM 1. Flexor Retinaculum 2. Ulnar & Radial bursa 3. Deep Tendon Sheath 4. Transverse metacarpal ligament 5. Annular & Cruciate ligament 6. FDS & FDP 4/28/2024 6
- 7. Optimal function of FDS & FDP depends on: 1. Stabilization by wrist musculature 2. Intact flexor gliding mechanism. • About the infection. 4/28/2024 7 • Flexor Retinacula • Bursae • Digital tendon sheath
- 8. Gliding mechanism • Fibrous Retinacular structure tether long flexor tendon to hand. • Bursae & tendon sheath facilitate friction free excursion. • FDS & FDP crosses wrist pass beneath proximal to flexor Retinaculam through carpal tunnel then bursa. • FPL passes through carpal tunnel with FDS & FDP then radial bursa. 4/28/2024 8
- 9. ANNULAR & CRUCIATE PULLEY • A1 : head of MC • A2 : volar midshaft of proximal phalanx • A3: distal most part of proximal phalanx • A4: centrally on middle phalanx • A5: base of distal phalanx. • C1: btw A2 & A3 • C2: btw A3 & A4 • C3: btw A4 & A5 4/28/2024 9
- 11. FUNCTION OF ANNULAR PULLEY • To keep flexor tendon close to bone. • Allow minimum amount of bowstring & migration Volarly from joint axes. • Enhances tendon excursion efficiency & work efficiency of long tendon. 4/28/2024 11
- 12. ZONES OF HAND Zone 1 Zone 2 Zone 3 Zone 4 Zone 5 4/28/2024 12
- 13. 4/28/2024 13
- 14. PALMAR APONEUROSIS PULLEY Proximal to A1 pulley one more pulley resembles like A1 pulley. 4/28/2024 14