Joints of the Upper limb II - wrist and hand Flashcards
three radioulnar joints
proximal - pivot with radial notch of ulna
middle-IO membrane
distal- round head of ulna
annular ligament
wraps proximal head of radius - allows for spin - pronation/supination
radioulnar ligament
distal head of ulna and radius
movements possible at radioulnar joints
pronation by pronator quadratus and teres
supination by biceps brachii
movements possible at the wrist
flexion/extension
abduction/adduction
wrist rotation
bones of wrist joint
radius
styloid process of ulna
3 carpal bones- scaphoid, lunate, triquetrum
carpal tunnel
transverse carpal ligament, aka flexor retinaculum
median n; nine tendons
ulnar tunnel
palmar carpal ligament and transverse carpal ligament
contains ulnar nerve and artery
carpal tunnel syndrome
overuse causing swelling compressing median nerve –> neuropathy
muscle wasting of much of the thenar group and lumbricals 1 and 2
can cut transverse carpal ligament
wrist fractures
forward falls onto hands lead to scaphoid or radial fracture
ulna generally not fractured - does not bear weight
scaphoid fractures can affect
the radial artery - will have pain in anatomical snuffbox
radial fractures will affect
radial artery
colles fractures
hyperextension, distal radius displaced DORSALLY
“dinner fork”
most common in osteoporosis
smith fracture
hyperflexion
distal radius displaced ANTERIORLY
“shovel deformity”
transverse metacarpal ligament prevents
palms from spreading out too far
boutonniere deformity
PIP is stuck in flexion
DIP hyperextension
caused by rupture of central slip of extensor tendon at PIP due to trauma
(or ehler’s-danlos syndrome/RA)
mallet finger
baseball-basketball finger
extensor tendon damage, causing a disruption of extension
caused by blunt force trauma to finger
presents as DIP flexion
swan neck deformity
extension at PIP/Flexion of DIP
caused by: RA, untreated mallet finger, trauma (tear of middle palmar plate ligament (damage to extensor hood)
Skier’s thumb
rupture of collateral ligament of the first MCP joint
caused by trauma, FOOSH (fall on outstreched hands), commonly seen in skiers
may be accompanied by avulsion fracture of metacarpal head
bull riders thumb
sprain of radial (lateral) collateral ligament and avulsion fracture of the lateral proximal phalanx of the thumb
caused by trauma, sports
boxers’ fracture
fracture of 5th metacarpal often due to punching with a closed and abducted fist
