Joints of the Upper limb II - wrist and hand

Question 1

three radioulnar joints

Answer 1

proximal - pivot with radial notch of ulna
middle-IO membrane
distal- round head of ulna

Question 2

annular ligament

Answer 2

wraps proximal head of radius - allows for spin - pronation/supination

Question 3

radioulnar ligament

Answer 3

distal head of ulna and radius

Question 4

movements possible at radioulnar joints

Answer 4

pronation by pronator quadratus and teres

supination by biceps brachii

Question 5

movements possible at the wrist

Answer 5

flexion/extension
abduction/adduction
wrist rotation

Question 6

bones of wrist joint

Answer 6

radius
styloid process of ulna
3 carpal bones- scaphoid, lunate, triquetrum

Question 7

carpal tunnel

Answer 7

transverse carpal ligament, aka flexor retinaculum

median n; nine tendons

Question 8

ulnar tunnel

Answer 8

palmar carpal ligament and transverse carpal ligament

contains ulnar nerve and artery

Question 9

carpal tunnel syndrome

Answer 9

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

Question 10

wrist fractures

Answer 10

forward falls onto hands lead to scaphoid or radial fracture
ulna generally not fractured - does not bear weight

Question 11

scaphoid fractures can affect

Answer 11

the radial artery - will have pain in anatomical snuffbox

Question 12

radial fractures will affect

Answer 12

radial artery

Question 13

colles fractures

Answer 13

hyperextension, distal radius displaced DORSALLY
“dinner fork”
most common in osteoporosis

Question 14

smith fracture

Answer 14

hyperflexion
distal radius displaced ANTERIORLY
“shovel deformity”

Question 15

transverse metacarpal ligament prevents

Answer 15

palms from spreading out too far

Question 16

boutonniere deformity

Answer 16

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)

Question 17

mallet finger

Answer 17

baseball-basketball finger
extensor tendon damage, causing a disruption of extension
caused by blunt force trauma to finger
presents as DIP flexion

Question 18

swan neck deformity

Answer 18

extension at PIP/Flexion of DIP

caused by: RA, untreated mallet finger, trauma (tear of middle palmar plate ligament (damage to extensor hood)

Question 19

Skier’s thumb

Answer 19

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

Question 20

bull riders thumb

Answer 20

sprain of radial (lateral) collateral ligament and avulsion fracture of the lateral proximal phalanx of the thumb
caused by trauma, sports

Question 21

boxers’ fracture

Answer 21

fracture of 5th metacarpal often due to punching with a closed and abducted fist