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BOC Prep > Hand & Wrist > Flashcards

Hand & Wrist Flashcards

1
Q

What are the bones of the hand & wrist?

A

Radius
Ulna
Carpals
Metacarpals 1-5
Phalanges (proximal, middle-except thumb, distal)

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2
Q

Which bone has 60-80% of wrist motion occurring at it?

A

Radius

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3
Q

What are bony landmarks of the dorsal wrist?

A
  1. Anatomical snuffbox
  2. Scaphoid distal pole
  3. Triscaphe joint
  4. Scapholunate joint
  5. Lister’s tubercle
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4
Q

What 3 joints are at the wrist?

A

Radiocarpal
Ulnocarpal
Distal Radioulnar

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5
Q

What are the joints of the hand at each finger?

A

Metacarpophalangeal (MCP)
Proximal Interphalangeal (PIP)
Distal Interphalangeal (DIP)

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6
Q

What bones make up the radiocarpal joint?

A

Radius
Scaphoid
Triquetrium

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7
Q

What bones make up the Ulnocarpal joint?

A

Ulna
Triquetrium

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8
Q

What bones form the distal Radioulnar joint?

A

Triangular Fibrocartilage (disc that overlays the ulnar head between the Triquetrium, Lunate, & Ulnar head)

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9
Q

What is the carpi metacarpal joint?

A

Its where the carpals & metacarpals meet

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10
Q

Are the MCP, PIP, & DIP surrounded by a joint capsule?

A

Yes

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11
Q

What is the MCP and PIP reinforced by?

A

Collateral ligaments & a Condyloid joint

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12
Q

What is Hulten’s variance?

A

The relationship between length of ulna & radius

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13
Q

What does ulnar variance affect?

A

It changes the loads borne by the ulna

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14
Q

What is a positive ulnar variance?

A

The ulna extends >/= 1mm beyond the radius

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15
Q

What is neutral ulnar variance?

A

The lengths of the ulna and radius differ < 1mm

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16
Q

What is negative ulnar variance?

A

The ulnar is shorter >/= 1mm than the radius

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17
Q

What are the 4 proximal carpal bones?

A

Scaphoid
Lunate
Triquetrium
Pisiform

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18
Q

What are the 4 distal carpals?

A

Trapezium
Trapezoid
Capitate
Hamate

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19
Q

What is the hook of the hamate called?

A

Hamulus

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20
Q

What type of bone is pisiform?

A

Sesamoid bone (it’s free floating, only insertion is FCU)

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21
Q

Which bone is the keystone of the carpal bone arch?

A

Capitate- it is the largest & most central bone

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22
Q

What tunnel is between the pisiform & the hook of the hamate?

A

The tunnel of Guyon

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23
Q

What is normal wrist joint extension?

A

0-70 degrees

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24
Q

What is normal wrist joint Flexion?

A

0-80 degrees

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25
Q

What is normal wrist joint radial deviation?

A

0-20 degrees

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26
Q

What is normal wrist joint ulnar deviation?

A

0-30 degrees

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27
Q

What is the place of function of the wrist (best place for finger Flexion)?

A

20-35 degrees extension & 10-15 degrees of ulnar deviation

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28
Q

What is the triangular fibrocartilaginous disk?

A

It is a disk that cover the ulna and acts as a cushion (like meniscus) between it and the carpals

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29
Q

What are the arches of the hand?

A

Longitudinal
Carpal transverse
Metacarpal transverse

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30
Q

What are the ligaments of the wrist?

A

Intercarpal ligaments
Flexor retinaculum (transverse carpal ligament)
Palmar carpal ligament (volar carpal ligament)
Extensor retinaculum

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31
Q

What is the carpal tunnel?

A

Area of the wrist that the median nerve & the flexor tendons pass through underneath the flexor retinaculum

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32
Q

What makes up the floor of the carpal tunnel?

A

The proximal & distal carpal rows

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33
Q

What makes up the ulnar border of the carpal tunnel?

A

The pisiform & hook of the hamate

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34
Q

What makes up the radial border of carpal tunnel?

A

The scaphoid & greater multangular

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35
Q

How many wrist tunnels are there?

A

8 (6 dorsal, 2 volar)

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36
Q

What structures are included in tunnel 1 or the medial snuffbox?

A

Abductor pollicis longus
Extensor pollicis brevis

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37
Q

What structures are included in tunnel 2?

A

Extensor carpi radialis brevis
Extensor carpi radialis longus

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38
Q

What structures are included in tunnel 3 or the lateral snuffbox?

A

Extensor pollicis longus

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39
Q

What structures are included in tunnel 4?

A

Extensor digitorum communi
Extensor indicis

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40
Q

What structures are included in tunnel 5?

A

Extensor digiti minimi

41
Q

What structures are included in tunnel 6?

A

Extensor carpi ulnaris

42
Q

What artery passes through the anatomical snuffbox?

A

Radial artery

43
Q

What structures run within the carpal tunnel on the volar surface (wrist tunnel 7)?

A

Flexor digitorum profundus
Flexor digitorum superficialis
Median nerve
Flexor pollicis longus

44
Q

What structures run outside the carpal tunnel on the volar surface (wrist tunnel 8)?

A

Flexor carpi radialis
Flexor carpi ulnaris
Palmaris longus
Ulnar nerve

45
Q

Do we need to make sure our wrist tendons have excursion (movement)?

46
Q

What passes through the tunnel of guyon?

A

Ulnar nerve

47
Q

What is the floor of the anatomical snuff box?

48
Q

What make up the borders of the anatomical snuff box?

A

Extensor pollicis longus
Extensor pollicis brevis
Abductor pollicis longus

49
Q

What does the attitude of the hand help with?

A
  1. Facilitates venous & lymphatic drainage
  2. Minimizes restraining action (excursion) of the extrinsic tendons, allowing full flexion & extension of the fingers
50
Q

What is the attitude of the hand?

A

At rest, the MCP, PIP, & DIP joints are in slight flexion

51
Q

What constitutes the palm of the hand?

A

Fibrous fasciculi anchor skin to the palm, permitting very little sliding of the skin

52
Q

What constitutes the dorsal surface of the hand?

A

Loose areolar tissue anchors the skin on the dorsal surface, allowing for skin to move freely, lymphatic system

53
Q

What are skin creases?

A
  • Indicate lines of adherence between skin & fascia with no intervening adipose tissue
  • serve to identify important anatomical landmarks
54
Q

What are the creases of the hand?

A

Radial longitudinal (thenar crease)
Proximal palmar (transverse crease)
Distal palmar (transverse crease)

55
Q

What are the creases of the fingers?

A

Palmar digital
Middle (PIP)
Distal (DIP)

56
Q

Where is the frontal plane center of axis of hand?

A

Through the 3rd metacarpal

57
Q

What is normal Flexion ROM at fingers 2-5 MCP joint?

A

0-90 degrees

58
Q

What is normal extension ROM at fingers 2-5 MCP joint?

A

0-45 degrees

59
Q

What is normal abduction ROM at fingers 2-5 MCP joint?

A

0-20 degrees

60
Q

What is normal adduction ROM at fingers 2-5 MCP joint?

A

0-20 degrees

61
Q

What is PIP Joint movement (Flexion)?

A

0-100 degrees

62
Q

What is the DIP joint movement (Flexion)?

A

0-80 degrees

63
Q

What is normal ROM for thumb MCP joint Flexion?

A

0-50 degrees

64
Q

What is normal ROM for thumb MCP joint abduction?

A

0-70 degrees

65
Q

What is normal ROM for thumb MCP joint adduction?

A

0 degrees to 2nd metacarpal

66
Q

What is zone 1 of the hand?

A

From DIP to finger tips

67
Q

What is zone 2 of the hand?

A

The MCP joint area of the thumb and the top of the palm through the DIP of fingers 2-5

68
Q

What is zone 3 of the hand?

A

The top middle of the palm & the middle of the thenar eminence

69
Q

What is zone 4 of the hand?

A

The bottom middle of the palm touching the wrist

70
Q

What is zone 5 of the hand?

A

The wrist where the flexor retinaculum lays

71
Q

What 4 structures does each MCP, PIP, & DIP joint have?

A
  1. Joint capsule
  2. Radial collateral ligament
  3. Ulnar collateral ligament
  4. Volar (palmar ligament) plate
72
Q

What do these 3 ligaments collectively form?

A

They form a “box” around each of the joints

73
Q

Is the palmar plate distal attachment cartilaginous or membranous?

A

Cartilaginous

74
Q

Is the palmar plate proximal attachment cartilaginous or membranous?

A

Membranous

75
Q

What are the extrinsic muscles of the hand?

A
  • flexor digitorum superficialis (pip)
  • flexor digitorum profundus (dip)
  • extensor digitorum communi
76
Q

Where are the muscle bellies of the hand extrinsic muscles?

A

In the forearm

77
Q

What are the intrinsic muscles of the hand?

A

Dorsal interossei (4)
Volar interossei (3)
Lumbricals
Hypothenar eminence muscles
Thenar eminence muscles

78
Q

What muscles make up the hypothenar eminence?

A
  • abductor digiti minimi
  • flexor digiti minimi brevis
  • opponens digiti minimi
79
Q

What muscles make up the thenar eminence?

A
  • abductor pollicis brevis
  • flexor pollicis brevis
  • opponents pollicis
80
Q

Where do the muscle bellies of the hand intrinsic muscles?

A

In the hand

81
Q

Do any muscle bellies lie within the finger proper?

A

No, only tendons

82
Q

What are the other 4 ligaments of the hand?

A
  1. Transverse retinacular ligament
  2. Oblique retinacular ligament (ligament of landsmere)
  3. Triangular ligament
  4. Juncurae tendinum
83
Q

What are the FDS & FDP muscles encased in for the flexor pulley?

A

A synovial sheath which is bound to the phalanges by fibrous digital sheaths made up of alternating stronger annular & weaker cruciform parts (A1-A5 & C1-C4)

84
Q

What does the flexor pulley allow for?

A

A smooth curve

85
Q

What are spoon nails?

A

The nail is indented/concave like a spoon

86
Q

What are clubbed nails?

87
Q

What is the opera glove pathology?

A

Paresthesia going from above the elbow all the way to the finger tips surrounding the arm like an opera glove

88
Q

What is Swan neck deformity?

A

A hyperextension of the PIP and a forced Flexion of the DIP

89
Q

What is boutonnière deformity?

A

A hyperflexion of the MCP & DIP and a forced Flexion of the PIP

90
Q

What are claw fingers?

A

When the fingers are stuck in a claw shape curve

91
Q

What is trigger finger?

92
Q

What is bishop’s hand?

93
Q

What is drop wrist?

94
Q

What is Z deformity?

95
Q

What is dupuytren’s contraction?

96
Q

What is mallet finger?

A

A rupture or avulsion of the extensor digitorum communi tendon at its attachment site at the base of the fingernail

97
Q

What is pill rolling?

A

A neurological pathology where older folks remember the motion of rolling pills from there younger days and do it subconsciously even if they don’t remember other things in their life

98
Q

What is Volkmann’s contracture?

A

This can occur after an elbow dislocation or Fx where the radial? Vein becomes occluded so blood is still going into the forearm and hand but can’t be pumped back to the heart and eventually tissue death occcurs

BOC Prep (16 decks)

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