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Orthopedic Diagnosis > Forearm, Wrist, & Hand > Flashcards

Forearm, Wrist, & Hand Flashcards

1
Q

The carpus is made up of how many bones?

A

8

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2
Q

What percentage of upper limb function does the hand account for?

A

90%

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3
Q

The thumb is involved in what percent of hand function?

A

40-50%

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4
Q

What type of joint is the distal radio-ulnar joint?

A

a double pivot joint that unites the distal radius with the ulna and an articular disc

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5
Q

Colles Fracture

A

aka dinner fork fracture

fracture of the radius within 20-35mm of the wrist with posterior angulation of the distal fragment

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6
Q

Smith’s fracture

A

aka garden spade deformity

fracture of the radius within 20-35 mm of the wrist joint with anterior angulation of the distal fragment.

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7
Q

TFCC

A

triangular fibrocartilage complex

fibrocartilage disc between the medial, proximal row of carpals and the distal ulna

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8
Q

What is the primary function of the TFCC

A

to improve joint congruency and cushion against compressive forces
transmits about 20% of the axial load from the hand to the forearm

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9
Q

What is the most commonly fractured carpal?

A

Scaphoid (aka navicular)

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10
Q

Mid Carpal Joints

A

lie between the two rows of carpals

a compound articulation because each row has both a concave and convex segment

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11
Q

Where are the concave and convex segments located on the proximal row of carpals?

A

convex laterally

concave medially

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12
Q

Carpometacarpal joints

A

articulation between the distal borders of the distal carpal row bones and the bases of the metacarpals

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13
Q

What provides stability for the carpometacarpal joints

A

the palmar and dorsal carpometacarpal and intermetacarpal ligaments

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14
Q

Metacarpophalangeal joints

A

biaxial joints

allow for flexion-extension and medial-lateral deviation

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15
Q

First carpometacarpal joint

A

sellar (saddle shaped) joint

functionally the most important CMC joint

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16
Q

what is the attitude of the hand at rest?

A

MCP’s and IP’s are held in a position of slight flexion

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17
Q

Bennett’s fracture

A

fracture through the base of the first metacarpal neck with dorsal and radial displacement of the shaft

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18
Q

Metacarpophalangeal joint of the thumb

A

hinge joint

consistes of a convex surface on the head of the metacarpal and a concave surface on the base of the phalanx

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19
Q

Bar room fracture

A

fracture of the fourth or fifth metacarpal neck with anterior displacement of the head

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20
Q

Boxer’s fracture

A

fracture of the second or third metacarpal neck with anterior displacement of the head

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21
Q

Interphalangeal Joints

A

adjacent phalanges articulate in hinge joints that allow motion in one plane

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22
Q

Herberden’s Nodes

A

distal joints are enlarged by hard nodules

painless, motion is unlimited

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23
Q

Where are herberden’s nodes not found?

A

the thumb

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24
Q

Herberden’s Nodes in women

A

localized process of OA
usually hereditary
commonly involves more than one joint

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25
Q

Herberden’s nodes in men

A

generally as a result of trauma

usually involves just one joint

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26
Q

Bouchard’s Nodes

A

abnormal fusiform enlargement at the pip joint which can indicate synovitis secondary to RA

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27
Q

Swan neck deformity

A

PIP joint deforms into hyperextension and the DIP is flexed

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28
Q

MOI of Swan Neck Deformity

A

Rheumatoid Arthritis

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29
Q

Boutonniere deformity

A

PIP is flexed, DIP is extended

central slip of the extensor digitorum communis tendon is avulsed from the insetion into the base of the middle phalanx

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30
Q

Which ligaments provide a majority of the wrist stability

A

extrinsic palmar ligaments

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31
Q

Which ligaments serve as rotational restraints in the wrist?

A

intrinsic ligaments

they bind the proximal row into a unit of rotational stability

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32
Q

carpal ligaments

A

the major ligaments of the wrist include the palmar intrisic ligaments, the volar extrinsic ligaments and the dorsal extrinsic and intrinsic ligaments

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33
Q

Radiocarpal joint

A

formed by the large articular concave surface of the distal end of the radius, the scaphoid, lunate, and the TFCC

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34
Q

Antebrachial fascia

A

a dense connective tissue bracelet that encases the forearm and maintains the relationships of the tendons that cross the wrist

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35
Q

Extensor retinaculum

A

serves to prevent the tendons from “bow-stringing” when they turn a corner at the wrist

36
Q

what is the fibroosseous compartment

A

the tunnel like structure formed the the retinaculim and underlying bones

37
Q

Flexor retinaculum

A

transforms the carpal arch into a tunnel

38
Q

What is the proximal attachment of the flexor retinaculum

A

the tubercle of the scaphoid and pisiform

39
Q

What is the distal attachment of the flexor retinaculum

A

to the hook of the hamate and the tubercle of the trapezium

40
Q

Jersey Finger

A

avulsion of the flexor digitorum profundus tendon

41
Q

What is the MOI of Jersey Finger

A

the finger gets caught in an object and actively flexed DIP joint is suddenly and forcibly extended resulting in a rupture

42
Q

Carpal Tunnel

A

serves as a conduit for the median nerve and nine flexor tendons

43
Q

What comprises the floor of the carpal tunnel

A

the palmar radiocarpal ligament and palmar ligament complex

44
Q

What comprises the roof of the carpal tunnel

A

the flexor retinaculum aka the transverse carpal ligament

45
Q

What makes up the ulnar border of the carpal tunnel?

A

the trapezium

46
Q

what makes up the radial border of the carpal tunnel

A

the hook of hamate

47
Q

Tunnel of Guyon

A

a depression superficial to the flexor retinaculum, located between the hook of hamate and pisiform

48
Q

What makes up the roof of the tunnel of guyon?

A

the palmar (volar) carpal ligament, palmaris brecis muscle, and the palmar aponeurosis

49
Q

What makes up the floor of the tunnel of guyon

A

the flexor retinaculum (aka transverse carpal ligament), pisohamate ligament, and pisometacarpal ligament

50
Q

What runs through the tunnel of guyon?

A

the ulnar nerve and artery

51
Q

Cyclist Hand

A

ulnar nerve and artery compression

52
Q

palmar aponeurosis

A

a dense fibrous structure continuous with the palmaris longus tendon and fascia covering the thenar and hypothenar muscles

53
Q

Dupuytren’s contracture

A

a fibrotic condition of the palmar aponeurosis that results in nodule formation or scarring of the aponeurosis which may cause finger flexion contractures

54
Q

extensor hood

A

a complex tendon which covers the dorsal aspect of the digits, formed from a combination of the tendons of insertion from extensor digitorum, extensor indicis, and extensor digiti minimi

55
Q

mallet finger

A

terminal phalanx of the finger is permanently flexed at the distal joint, it cannot be voluntarily extended
rupture of the extensor tendon that inserts on the terminal phalanx with possible fracture of the distal phalanx

56
Q

synovial sheaths

A

long narrow balloons filled with synovial fluid, which wrap around a tendon so that one wall is directly on the tendon (visceral layer) and the other wall is separate (parietal layer)

57
Q

Where is surgical no man’s land?

A

the distal palmar crease to the PIP joints

58
Q

Trigger finger

A

usually involves the fourth or fifth finger

flexion of the finger feels normal, but re-extension is accompanied by a painful snap

59
Q

Which muscles are superficial in the anterior compartment of the forearm

A

pronator teres, flexor capi radialis, palmaris longus, flexor carpi ulnaris

60
Q

Which muscle is intermediate in the anterior compartment of the forearm

A

flexor digitorum superficialis

61
Q

Which muscles are deep in the anterior compartment of the forearm

A

flexor pollicis longus, flexor digitorum profundus, pronator quadratus

62
Q

Which muscles are superficial in the posterior compartment of the forearm

A

extensor carpi radialis longus and brevis, extensor digitorum, extensor digiti minimi, extensor carpi ulnaris

63
Q

Which muscles are deep in the posterior compartment of the forearm

A

abductor pollicis longus, extensor pollicis longus and brevis, extensor indicis

64
Q

What forms the floor of the anatomical snuff box?

A

the scaphoid

65
Q

what forms the ulnar border of the anatomical snuff box

A

extensor pollicis longus tendon

66
Q

what forms the radial border of the anatomical snuff box

A

abductor pollicis longus

67
Q

De Quervains Disease

A

aka stenosing tenosynovitis

overuse and repetitious ulnar and radial deviation of the wrist

68
Q

which are the short muscles of the thumb

A

abductor pollicis brevis, flexor pollicis brevis, opponens pollicis, adductor pollicis

69
Q

Skier’s thumb

A

aka Gamekeeper’s thumb

ulnar collateral ligament avulsion of the MCP joint

70
Q

which are the short muscles of the fifth digit

A

abductor digiti minimi, flexor digiti minimi, opponens digiti minimi

71
Q

What is the function of the three palmar interossei muscles

A

each functions to adduct the digit to which it is attached toward the middle digit

72
Q

What is the function of the four dorsal interossei muscles

A

each functions to abduct the index, middle, and ring fingers from the mid-line of the hand

73
Q

What is the function of the lumbricales?

A

to perform the motion of IP joint extension with the MCP joint held in extension

74
Q

what are the functional arches of the hand?

A

the transverse, metacarpal, longitudinal, and oblique arches

75
Q

The transverse arch

A

formed within the palmar concavity of the carpal bones, scaphoid and trapezium laterall yand pisiform and hamate medially

76
Q

The metacarpal arch

A

formed by metacarpal heads

77
Q

the longitudinal arch

A

formed by the third and fifth digit, spans lengthwise, keystone at the MCP joints

78
Q

The oblique arches

A

formed by the thumb in opposition to the other fingers

79
Q

Keinboch’s Disease

A

aka avascular necrosis of lunate
usually unilateral after trauma or occupational excessive dominant hand use
presents with localized and radiating wrist pain, swelling & disability

80
Q

What types of grips are known as power grips?

A

fist, cylindrical, ball, hook

digits work together to provide support and static control

81
Q

Which grips are precision/prehension grips

A

chuck aka three finger pinch
lateral or key pinch grip
tip pinch grip
digits work provide control by working with the thumb to form a tripod for precision handling

82
Q

Spoon nails

A

natural convexity is replaced by concave nails in a saucer form
nail plate is thinner and weaker
result of a severe fungus infection

83
Q

Clubbed nails

A

pulmonary disease is the most common cause, followed by cardiovascular disease

84
Q

Felon

A

inflammation of the terminal finger pad is confined by tough fascia attached to the periosteum
presence of pus is indicated by induration of the pulp and loss of resilience
pressure may cause the abscess to burst through the volar surface of the finger pad

85
Q

Paronchia

A

aka hangnail

skin over the mantle of the nail and the lateral nail folds is swollen, reddened, painful and tender

86
Q

thrower’s wrist

A

over extension of the carpals, possibly straining or spraining structures

Orthopedic Diagnosis (10 decks)

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