1.75 The wrist

Question 1

Which muscles are supinators?

Answer 1

Supinators and biceps brachii

Question 2

Which muscle are pronators?

Answer 2

Pronator quadrature and pronator teres

Question 3

What makes up the anatomical snuff box?

Answer 3

Tendons of extensor policies longis and brevis

Question 4

What would tenderness in this bone mean?

Answer 4

Scaphoid fracture and possible radial artery injury

Question 5

What are the two incomplete fractures?

Answer 5

Greenstick - children - periosteum remains in continuity

Compression - Crumples under pressure

Question 6

What is Colles fracture?

Answer 6

Fracture to distal end of radius - common in women over 50 due to osteoperosis

Question 7

What is a scaphoid fracture?

Answer 7

Scaphoid ay fracture - not easily seen on X-ray - check snuffbox - can lead to avascular necrosis - young adult

Question 8

What are the 5 P’s of compartment syndrome

Answer 8

Pain 
Parasthesia 
Pallor 
Paralysis 
Pulselesness

Question 9

What Dupuytren’s contracture?

Answer 9

Progressive fibrosus, thickening and shortening of palmar fascia - leading to partial flexion of 4th and 5th digits in particular.

Question 10

What are the two spaces in the hand that could become infected?

Answer 10

Thenar and Midpalmar space

Question 11

Which arteries supply the deep and superficial arches of the hand?

Answer 11

Ulnar - superficial

Radial - deep

Question 12

Which nerve is compressed in carpal tunnel syndome?

Answer 12

Median nerve

Question 13

What causes carpal tunnel syndrome?

Answer 13

Previous of flexor muscles, Peripheral oedema, tenosyvatis (rheumatoid arthritis) and carpal fracture

Question 14

What is the innervation of the intrinsic muscles of the thumb?

Answer 14

All median except for the adductor - ulnar

Question 15

What innervates the hyperthenar eminence?

Answer 15

Ulnar

Question 16

What palsies can be present?

Answer 16

Cubital tunnel syndrome is where the ulnar nerve becomes trapped in the cubital tunnel on the median edge of the elbow. As the ulnar nerve is trapped it causes tingling sensation of the 4th an 5th fingers and a loss of innervation to the flexor carpi ulnaris muscle and lateral flexor digitorum profundus muscle.

Carpal tunnel syndrome affects the median nerve and is associated with sensations in the thumb, 1st and 2nd fingers. Wasting of the thenar eminence will also occur.

A neck of humerus fracture is more likely to affect the radial nerve as this coils around the humerus

Saturday night palsy affects the radial nerve. It is so named because when you come in from a heavy night of drinking, you are more inclined to sleep with your arm draped over the arm rest of a chair. This compresses the radial nerve in the spiral groove of the humerus.