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Average 4.4 of 15 Ratings
In the majority of patients, the deep palmar arch has a main contribution from what vessel which travels between the two heads of the first dorsal interosseous muscle?
Superficial palmar branch of the radial artery
Princeps pollicis artery
Deep dorsal (terminal) branch of the radial artery
Common palmar digital artery
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The deep palmar arch (deep volar arch) is an arterial network found in the palm. In the majority of patients it is formed mainly from the terminal part of the radial artery, with the ulnar artery contributing via its deep palmar branch. This is in contrast to the superficial palmar arch, which is formed predominantly by the ulnar artery with some contribution by the superficial palmar branch of the radial artery. The deep palmar arch lies upon the bases of the metacarpal bones and on the interossei of the hand, being covered by the oblique head of the adductor pollicis muscle, the flexor tendons of the fingers, and the lumbricals of the hand. At the wrist the radial artery passes between the radial collateral ligament and the first dorsal compartment after which it dives between the heads of the first dorsal interossei where it anastomoses with the deep palmar branch from the ulnar artery, completing the deep volar arch.
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Which of following most appropriately details the anatomic orientation of the digital nerve and artery in the finger?
Artery palmar and radial to nerve
Nerve dorsal and ulnar to artery
Nerve medial to artery
Artery ulnar to nerve
Artery dorsal to nerve
The digital nerve is palmar to the artery in the finger. A helpful way of remembering this orientation is that sensation is performed with the pads (nerve is palmar) of your fingers and you test for cap refill at the fingernail (artery is dorsal).
Illustration A shows a cross section of the finger and the relative position of the artery and the nerve. Illustrations B and C depict cross-sectional anatomy of the finger including Grayson's (involved in Dupuytrens) and Cleland's ligament (not involved in Dupuytren's)
Average 4.0 of 37 Ratings
HPI - A 7 year old boy presents after an aggressive reduction of a distal radius fracture more than 6 months ago.
The final XRay of the wrist and carpal bones is shown.
What is the best treatment for this patient?