Forearm, wrist, hand

Question 1

Where do you find the radial pulse?

Answer 1

immediately lateral to flexor carpi radialis

Question 2

Which carpal bone takes the most of the weight?

Answer 2

scaphoid

Question 3

Which carpal bone is palpable on medial side of hand?

Answer 3

pisiform

Question 4

how do the palmar arch arerties arise?

Answer 4

superficial and deep branches of radial and ulnar a. join in the palm

Question 5

superficial and deep arches give off what?

Answer 5

metacarpal branches which give off digital branches

Question 6

Pull aside what muscle to find the radial n. ?

Answer 6

brachioradialis

Question 7

describe the structures w/i the cubital fossa

Answer 7

brachial a. splits into radial and ulnar. ulnar dives deep. median n. runs right next to a.

Question 8

Each finger has how many arteries supplying it?

Answer 8

4.

Question 9

What test is done before drawing ABG from the radial a.?

Answer 9

allen’s test

Question 10

allen’s test

Answer 10

testing that palmar arches are in tact; compress radial a and ulnar artery and make sure both side pink back up seperately

Question 11

What are the 3 extensors?

Answer 11

ECU: extend and ulnar deviate hand

ECRB ECRL:extend and radially deviate

Question 12

What are the 3 long tendon of the thumb?

Answer 12

EPL; EPB; APL

Question 13

radial n. comes out of what muscle of the forearm?

Answer 13

supinator. pulls radius over

Question 14

synovial cyst/ganglion

Answer 14

cyst of tendon sheath; usually on dorsum of hand; can’t drain b/c not really fluid.

Question 15

What nerve is very superficial in the hand that you need to by mindful of in lacerations?

Answer 15

radial n.

Question 16

What are the 4 things you check for in a laceration ?

Answer 16

1. ROM
2. strenght
3. sensation
4. blood supply

Question 17

What nerves go over and under the flexor retinaculum?

Answer 17

ulnar n. is superficial to it. median n goes under it

Question 18

What is the only flexor of the elbow that is innervated by the radial n. ?

Answer 18

brachioradialis (radial inn all extensors)

Question 19

What n. inn. the 3 muscles of the thenar eminence?

Answer 19

median recurrent n. (very superficial)

Question 20

What are the tendons that make up the anatomical snuff box?

Answer 20

abductor pollicis longus; extensor pollicis brevis; extensor pollicus longus

Question 21

What artery is w/i the anatomical snuff box?

Answer 21

deep branch of radial a.

Question 22

lumbricles

Answer 22

arise from profundous tendons and insert onto extensor expansion

Question 23

lumbricle action

Answer 23

flex MP, extend PIP DIP (wave bye)

Question 24

lumbricle inn.

Answer 24

2 are inn by median n and 2 inn by ulnar n

Question 25

all interossei are inn by?

Answer 25

ulnar n.

Question 26

interossei actions

Answer 26

PAD - palmar adduct | DAB - dorasal abduct

Question 27

What is significant about the first dorsal interossei?

Answer 27

first to show signs of wasting in neuromuscular disease (or in ulnar n. damage) along w/ thenar eminence

Question 28

What is the one muscle that has an action on the thumb that is not inn by the median n.?

Answer 28

adductor pollicis - inn by ulnar n

Question 29

if the radial n is injured at the axilla what would be the result?

Answer 29

extension at elbow and wrist would be effected

Question 30

if there was a lesion to the radial n at the elbow, what would be the result?

Answer 30

no extesion of the wrist but elbow would be fine

Question 31

if there is a lesion on the median n at the wrist, what would restul?

Answer 31

it would effect thenar eminence and 2 lumbricles (not the muscle bellys up higher)

Question 32

dupuytren contracture

Answer 32

palmar aponeurosis begins to sclerose down and tightens so digits get pulled down (usually 3rd and 4th finger). have to excise palmar aponeurosis to fix

Question 33

Duputyren's contracture is commonly associated with what other disease?

Answer 33

peyronie's disease: same thing on penis

Question 34

mallet finger

Answer 34

fx of the extensor tendon (expansion) on distal phalynx so get unopposed action of the extensors and draw finger downward

Question 35

carpal tunnel syndrome

Answer 35

compression of the median n due to inflammation in the tunnel;

Question 36

what are the 2 tests for carpal tunnel syndrome?

Answer 36

tinnels: tap on median n w wrist extended - will hurt into 3 fingers phalen's: put pressure on compartment by placing dorsums of each hand against eachother - will get humbness

Question 37

cubital tunnel syndrome

Answer 37

aka ulnar compartment syndrome; ulnar n. is compressed could be due to pitchers or carpenters - will effect the pinky and 1/2 of ring finger. get claw hand

Question 38

Colles fx

Answer 38

aka dinner fork fx; falling onto outstretched hand/forearm- usually just radius is fx b/c takes blunt of weight

Question 39

smith fx

Answer 39

reverse collets fx; garden spade; falling backwards on outstretched hand;

Question 40

spiral fx

Answer 40

produced by twisting and indicates child abuse until proven otherwise

Question 41

wrist drop

Answer 41

radial n. injruy; saturday night palsy

Question 42

greenstick fx

Answer 42

only seen in children; only 1 side of bone is broken

Question 43

what results w/ compartment syndrome

Answer 43

cut off blood and nerve supply so paresthysias, swelling, cold extremety, delayed cap refill, poor pulse. have to open up (fasciotomy)

Question 44

de Quervain's tenosynovitis

Answer 44

aka blackberry thumb; tendonitis of the abductor pollicis longus and extensor pollicis brevis (snuff box tendons); usualy due to repetitive use of thumb like skiing

Question 45

what test is used to diagnose de Quervian's?

Answer 45

finklestein's test; flex thumb, wrap fingers around it and radially deviate

Question 46

Skier's thumb | Gamekeepers thumb

Answer 46

``` skier's = acute gamekeepers = chronic ``` damage of ulnar collateral ligament at the MP joint of thumb - send to hand surgeoun

Question 47

scaphoid fx is commonly accompanied by what?

Answer 47

avascular necrosis

Question 48

scaphoid fx

Answer 48

scaphoid recieves blood supply from only distal end of radial a. so can lose blood supply; it sits at bottome of snuff box so always check for tenderness

Question 49

abrasion injury

Answer 49

skin knee - exposed at dermis

Question 50

avulsion injury

Answer 50

crush injury

Question 51

boxer's fx

Answer 51

usually 4th or 5th digit from punching a wall