Lab - Wrist and Hand Flashcards
Bones?
Radius, Ulna, Caprals (8)
Metacarpals (5)
Phalanges
Carpal Bones?
Proximal Row (Lateral to med)
Scaphoid (anatomical snuff box)
Lunate
Triquestrum
Pisiform
Distal Row (lateral to med)
Trapezium
Trapezoid
Capitate
Hamate
The Q is alone, the Z’s are together and the Trapezium is closer to the thumb
Joints?
Carpometacarpal (CMC)
Metacarpophalangeal (MCP) - knuckles
Proximal interphalangeal (PIP)
Distal interphalangeal (DIP)
Interphalangeal (IP) - thumb
Ligaments?
UCL in the wrist –> styloid process of ulna to triquestrum
UCL in the thumb (web space) –> 1st MC to proximal flange of thumb
RCL - styloid process of radius to scaphoid
Muscles?
Supinators –> supinator
Pronators –> pronator quadratus, pronator teres
Flexor Mscs?
Common Flexor Origin = medial epicondyle
Supplied by median and ulnar n.
Origin at wrist or fingers
FCR (flex wrist, insert at radius) - Felxor Carpi Radialus
Palmaris Longus
FCU - Flexor Carpi ulnaris
FDS –> to PIPs - Felxor digitorum Superficialis
FDP (profundus = deep) –> to DIPs - Flexor Digitorum Profundus
FPL (thumb) - Flexor Pollicis Longus
Extensor Mscs?
Common Extensor Origin = Lateral Epicondyle
Supplied by radial n.
ECRL - extensor carpi radialus longus
ECRB - extensor carpi radialus brevis
ED (to DIPs) - extensor digitorum
EDM (pinky finger) - extensor digiti minimi
ECU - extensor carpi ulnaris
EI (index finger) - extensor indicis
Radial Deviator mscs?
FCR
ECRL
ECRB
Ulnar Deviator mscs?
FCU
ECU
Thumb mscs?
APL
EPB
EPL
These 3 mscs make the anatomical snuff box
Hand Intrinsic Mscs?
3 Groups
Lumbricals & Interossei
- Dorsal (abd)
- Palmar (add)
Thenar Mscs (thenar eminence - base of thumb). Move the thumb - dont need to know mscs
Hypothenar mscs (make up hypothenar mscs)
move the pinky (5th metacarpal)
Arteries and Nerves?
Ulnar and radial arteries
Median n. - through carpal tunnel
Ulnar n. - Travels through Guyon’s tunnel (through the Hook of the Hamate)
Movements of wrist?
Flex/ ext
pronation and supination
radial and ulnar deviation
Mvms of Phalanges?
Flex/ ext
abd and add
Mvms of thumb?
flex (straight across palm) and ext (L possision)
abd and add (thumb down to palm)
Opposition (thumb to pinkie)
Carpal Tunnel?
Assessment?
FOOSH? (can be #)
immediate pain? Where located now?
Can they make a fist, splay fingers, pick up objects?
Swelling, redness, deformity?
Tinel’s Test?
tap carpal tunnel to check median n and CTS
Phalen’s Test?
Put back of hands together with fingers pointing down (Upside-down prayer)
- Tests for CTS
Finkelstein’s Test?
Test for Dequervain’s (tendynitis of APL and EPB) Syndrome
Tuck thumb inside fist and ulnarly deviate
Pain and decreased mvm = positive test
MOI, and what is injured?
Colle’s # = Common - distal end of radius
MOI = usually FOOSH
Causes dinner fork deformity
Scaphoid #
- Most commonly # carpal bone
- Often missed
- Has retrograde blood supply (not great supply)
- if missed, blood flow can be blocked and can = Avascular Necrosis
Metacarpal #
- Boxer’s injury
- most common in 5th MC (most mobile MC)
Phalangeal #?
Jammed or broken finger
Can do screws
Healing = immobilize and 4-6 weeks
CTS/ Guyon’s Syndrome?
Occurs when there is compromised space for the nerve to travel through tunnel
Can occur due to repetitive trauma
Can also be due to swelling post-injury, general health changes (diabetes, pregnancy, kidney problems, etc.), fracture, carpal bone fixation
If severe, can see wasting of thenar (CTS) or hypothenar (GTS) eminence due to reduced nerve supply
Early symptoms include numbness/tingling or burning into hand, and pain at night
Tx of CTS/ Guyon’s Syndrome?
POLICE
Try and correct the reason why it occurred
Dr. - further follow-up
Physio
Brace
