Chapter one PB

Question 1

What is the quadregia phenomenon? Why does it occur?

Answer 1

A flexion contracture of the involved digit and reduced flexion of adjacent digits. Occurs when FDP is advanced more than 1cm resulting in limited proximal excursion of remaining FDP tendons.

Question 2

What is Linburg’s Sign?

Answer 2

The anatomical interconnection of the FPL and the FDP of the IF

Question 3

What is Guyon’s canal and what structures does it contain?

Answer 3

Guyon’s canal borders the hook of the hamate and the pisiform. It contains the ulnar nerve and artery

Question 4

What structures form the anatomical snuffbox?

Answer 4

Scaphoid, EPL, APL AND EPB

Question 5

Which muscles contribute to the the functional movement of reaching overhead?

Answer 5

Serratius anterior and upper trapezius

Question 6

What structures are contained in the carpal tunnel?

Answer 6

Median nerve , FPL FDP, FDS

Question 7

What does the scaphoid lunate ligament complex consist of?

Answer 7

Dorsal portion (strongest), volar portion, central membranous portion.

When dorsal portion is interrupted this results in a DISI

Question 8

What does a DISI look like radiologically?

Answer 8

Widening of scapholunate interval greater than 4 mm, scaphoid ring sign and a dorsally facing lunate in a true lateral view.

Question 9

What are the clinical signs of a scapholunate ligament injury?

Answer 9

Pain on palpating of the scapholunate interval, clunk on ulnar/radial deviation, clunk reproduced by SST.

Question 10

Which structures are implicated in PIPJ flexion contractures?

Answer 10

Check rein ligaments, volar plate and collateral ligaments

Question 11

How do you remember the ext compartments?

Answer 11

2 2 1 2 1 1

Question 12

What is the most efficient ext of the wrist?

Answer 12

ECRB

O = Lat epicondyle
I = base of 3rd MC
LONGEST EXT MVT ARM

Question 13

What movement is ECRL most efficient at?

Answer 13

Wrist radial deviation

Question 14

When does ECU become a more efficient wrist extensor?

Answer 14

In supination

Question 15

Which muscle is the primary problem in Lat epicondylitis?

Answer 15

ECRB

Question 16

What is the Cozen’s test?

Answer 16

Resisted wrist ext with the elbow in flexion.

Question 17

What activities should someone with Lat epicondylitis avoid?

Answer 17

Forceful grasp with elbow extended and pronated

Question 18

Which pulley is the most frequent site for trigger finger?

Answer 18

A1

Question 19

Which tendon is most frequently involved?

Answer 19

FDS

Question 20

Which pulley is the most frequent site for trigger finger?

Answer 20

A1

Question 21

Which tendon is most frequently involved and in trigger finger?

Answer 21

FDS

Question 22

What is Bouvier’s test?

Answer 22

With interosseous paralysis the long ext hyperextended the mcp’s. Bouvier’s involves the stabilisation of MCP joints during finger extension, allowing the intrinsic muscle force to be transferred dismally to the PIP and DIP joints - as in claw hand splint

Question 23

What function does cleland and and grayson’s ligaments perform.

Answer 23

They stabilise digital skin and prevent rotatory movements of the skin around the digits during movement.

Grayson’s is volar to neurovascular bundle and cleland’s is dorsal

Question 24

What unique bio mechanical action do the MCPJ collateral ligaments have and how does this influence your choice of split position?

Answer 24

With the MCPJ extended the collateral ligaments are loose and with flexion they tighten. Placing the MCPJ in extension for a prolonged period tightens the MCPJ collateral ligaments and result in ext contracture.

Question 25

What causes ulnar deviation deformity in the rheumatoid hand?

Answer 25

Attenuation of MCPJ collateral ligaments due to the long flexors resulting in volar subluxation of the PIPJ
Ulnar displacement of the flexor tendons
Attenuation of the Sagittarius bands causing the ext tendons to displace ulnarly
Ulnar intrinsically contract