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Pulp space of the fingers

I was asked the following question:

If the pulp spaceof a fingertip becomes infected and the artery in the space becomes occluded because of increased tissue pressure in the enclosed space, would you expect the entire distal phalanges to necrose? If not what would be spared and why?

I cannot think of any reason why anything would not necrose but the question is cleary being asked because some of it would. Could someone please help me understand what I am missing? thanks
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Original post by jsmith6131
I was asked the following question:

If the pulp spaceof a fingertip becomes infected and the artery in the space becomes occluded because of increased tissue pressure in the enclosed space, would you expect the entire distal phalanges to necrose? If not what would be spared and why?

I cannot think of any reason why anything would not necrose but the question is cleary being asked because some of it would. Could someone please help me understand what I am missing? thanks


The entire distal phalanx will not necrose. We know that there are fibrous septa running from the distal flexor crease to the periosteum of the distal phalanx. The arteries supplying the pulp space travel through these fibrous septa (not an anatomical description, just to give you the idea). This occurs everywhere except for the proximal part of the distal phalanx, which is also called the base of the distal phalanx, the artery to which does not traverse the fibrous septa. As a result of this, in a pulp space infection, this artery will be spared and this area will not necrose.

Consider this figure:
Fig_146_off.jpg41.7KB
Original post by Dynamo123
The entire distal phalanx will not necrose. We know that there are fibrous septa running from the distal flexor crease to the periosteum of the distal phalanx. The arteries supplying the pulp space travel through these fibrous septa (not an anatomical description, just to give you the idea). This occurs everywhere except for the proximal part of the distal phalanx, which is also called the base of the distal phalanx, the artery to which does not traverse the fibrous septa. As a result of this, in a pulp space infection, this artery will be spared and this area will not necrose.

Consider this figure:


thanks so much :smile: my understanding of limb anatomy is still something to be desired!!
i
(edited 9 years ago)
Original post by jsmith6131
thanks so much :smile: my understanding of limb anatomy is still something to be desired!!
i

No problem :smile: Don't worry, limb anatomy is easy once you get the hang of it. Try mnemonics for all the muscles and stuff (which are a lot) and focus more on clinical aspects rather than regional details, because that is what will help you. :smile:

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