Chapter one PB Flashcards
What is the quadregia phenomenon? Why does it occur?
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.
What is Linburg’s Sign?
The anatomical interconnection of the FPL and the FDP of the IF
What is Guyon’s canal and what structures does it contain?
Guyon’s canal borders the hook of the hamate and the pisiform. It contains the ulnar nerve and artery
What structures form the anatomical snuffbox?
Scaphoid, EPL, APL AND EPB
Which muscles contribute to the the functional movement of reaching overhead?
Serratius anterior and upper trapezius
What structures are contained in the carpal tunnel?
Median nerve , FPL FDP, FDS
What does the scaphoid lunate ligament complex consist of?
Dorsal portion (strongest), volar portion, central membranous portion.
When dorsal portion is interrupted this results in a DISI
What does a DISI look like radiologically?
Widening of scapholunate interval greater than 4 mm, scaphoid ring sign and a dorsally facing lunate in a true lateral view.
What are the clinical signs of a scapholunate ligament injury?
Pain on palpating of the scapholunate interval, clunk on ulnar/radial deviation, clunk reproduced by SST.
Which structures are implicated in PIPJ flexion contractures?
Check rein ligaments, volar plate and collateral ligaments
How do you remember the ext compartments?
2 2 1 2 1 1
What is the most efficient ext of the wrist?
ECRB
O = Lat epicondyle
I = base of 3rd MC
LONGEST EXT MVT ARM
What movement is ECRL most efficient at?
Wrist radial deviation
When does ECU become a more efficient wrist extensor?
In supination
Which muscle is the primary problem in Lat epicondylitis?
ECRB
What is the Cozen’s test?
Resisted wrist ext with the elbow in flexion.
What activities should someone with Lat epicondylitis avoid?
Forceful grasp with elbow extended and pronated
Which pulley is the most frequent site for trigger finger?
A1
Which tendon is most frequently involved?
FDS
Which pulley is the most frequent site for trigger finger?
A1
Which tendon is most frequently involved and in trigger finger?
FDS
What is Bouvier’s test?
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
What function does cleland and and grayson’s ligaments perform.
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
What unique bio mechanical action do the MCPJ collateral ligaments have and how does this influence your choice of split position?
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.
What causes ulnar deviation deformity in the rheumatoid hand?
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
