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Muscoskeletal System > Lecture 6.1: Wrist and Hand > Flashcards

Lecture 6.1: Wrist and Hand Flashcards

1
Q

Bones of Hand (3)

A
  • Phalanges
  • Metacarpals
  • Carpals
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2
Q

Joints of the Hand (4)

A
  • Distal Interphalangeal (DIP) Joint of Phalanges
  • Proximal Interphalangeal (PIP) Joint Phalanges
  • Metacarpophalangeal (Knuckle) Joint Phalanges and Metacarpals
  • Carpometacarpal Joint Metacarpals and Carpals
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3
Q

Carpal Bones of the Hand

A

Scaphoid Lunate Triquetrum Pisiform - Hamate Capitate Trapezoid Trapezium
Straight line thumb to pinky, here comes the thumb

Starts at bottom carpals at thumb, travels to pinky, then upper carpals pinky to thumb

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4
Q

What type of Joint is the wrist?

A

Condyloid Synovial Joint

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5
Q

What bones make up the Wrist?

A

Articulation of the radius + Articular disc with the Scaphoid, Lunate & Triquetrum

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6
Q

Why is the Ulna not part of the Wrist Joint?

A

Separated from carpals by fibrocartilage disc

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7
Q

How many Extensor Compartments does the Wrist have?

A

6

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8
Q

What do the Extensor Compartments of the Wrist contain?

A

Specific posterior forearm tendons that are covered in common synovial sheaths

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9
Q

1st Extensor Compartments of the Wrist

A

EPB: Extensor pollicis brevis
ABL: Abductor pollicis longus

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10
Q

2nd Extensor Compartments of the Wrist

A

ECRB: Extensor carpi radialis brevis
ECRL: Extensor carpi radialis longus

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11
Q

3rd Extensor Compartments of the Wrist

A

EPL: Extensor pollicis longus

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12
Q

4th Extensor Compartments of the Wrist

A

ED: Extensor digitorum
EI: Extensor indicis

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13
Q

5th Extensor Compartments of the Wrist

A

EDM: Extensor digiti minimi

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14
Q

6th Extensor Compartments of the Wrist

A

ECU: Extensor carpi ulnaris

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15
Q

What problems are associated with the 1st Extensor Compartment of the Wrist?

A

EPB affected by painful De-Quervains tenosynovitis

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16
Q

What problems are associated with the 3rd Extensor Compartment of the Wrist?

A

EPL can wear on the dorsal radial tubercle and rupture

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17
Q

What problems are associated with the 6th Extensor Compartment of the Wrist?

A

ECU can wear on the ulnar styloid process and rupture

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18
Q

What is the Anatomical Snuffbox?

A

A triangular depression found on the lateral aspect of the dorsum of the hand

19
Q

Scaphoid Fracture

A

Results in anatomical snuffbox tenderness

Possible avascular necrosis (AVN)

20
Q

What anatomical structures can be found in the Anatomical Snuffbox?

A
  • Radial artery (palpable pulse)
  • Radial styloid process
  • Scaphoid
  • Trapezium
  • Base of 1st metacarpal
  • Cephalic (houseman’s) vein passes over snuffbox.
21
Q

What is Carpal Tunnel Syndrome?

A

Involves the compression of the median nerve in the carpal tunnel

22
Q

What forms the Carpal Tunnel? What passes through it?

A

Carpal tunnel is formed by the carpal bones & the flexor retinaculum
Nine tendons and the median nerve pass through the carpal tunnel:
• Flexor digitorum superficialis (x4)
• Flexor digitorum profundus (x4)
• Flexor pollicis longus

23
Q

What is the Flexor Retinaculum?

A

A strong, fibrous band that covers the carpal bones on the palmar side of the hand near the wrist

24
Q

How many Flexor Compartments does the Wrist have?

A
25
Q

Where does the Ulnar Nerve run in the Wrist?

A

It runs above the carpal tunnel in Guyon’s canal

26
Q

What is Tinel’s Test?

A
  • Tap the median nerve near palmaris longus proximal to carpal tunnel
  • Elicits tingling in CTS
27
Q

What is the Phalen Test?

A
  • Test for Carpal Tunnel Syndrome
  • Put hands in prayer position, then flip them downwards
  • Elicits pain/ tingling in CTS
28
Q

Risk Factors for Carpal Tunnel (8)

A
  • Female
  • Increasing Age
  • Pregnancy
  • Obesity
  • Previous Wrist Injury
  • Diabetes Mellitus
  • Rheumatoid Arthritis
  • Hypothyroidism
29
Q

Treatments for Carpal Tunnel: Conservative and Surgical

A 
• Wrist Splint
• Hand Physiotherapy
• Corticosteroids Injections
• Carpal tunnel release, cut through flexor retinaculum, decompresses carpal 
  tunnel
30
Q

What is the Palmar Aponeurosis?

A

It is a tough fibrous layer limiting movement of the palmar skin

31
Q

Fibrous Digital Sheaths

A

• Tendons of Flexor Digitorum Superficialis (FDS) & Flexor Digitorum Profundus
(FDP) are surrounded by a synovial sheath
• They then cross palm and enter fibrous sheaths on the palmar aspect of the
digits

32
Q

What is the purpose of Fibrous Digital Sheaths?

A

• Hold the tendons in place and prevent bowing

33
Q

What are the 2 Palmar Spaces?

A 
Thenar Space (Thumb-side)
Midpalmar Space
34
Q

What is Dupuytren’s Contracture?

A

Aponeurotic thickening leads to soft tissue contractures causing passive flexion of medial digits

35
Q

What is Stenosing Tenosynovitis?

A

• Aka Trigger Finger
• Occurs when inflammation narrows the space within the sheath that
surrounds the tendon in the affected finger
• Inflammations leads to trapping of the flexor tendon
• If is severe, your finger may become locked in a bent position

36
Q

What is Ulnar Claw Hand?

A

• Caused due to a lower ulnar nerve lesion (below elbow)
• Clawing and Flexion of 4th and 5th Fingers
• This is due to unopposed action of ulnar part of the flexor digitorum
profundus muscle

37
Q

Intrinsic Hand Muscles supplied by the Ulnar Nerve

A
  • Palmaris brevis
  • Interossei muscles
  • Adductor pollicis
  • Hypothenar muscles
  • Lumbrical muscles: Medial 2
38
Q

Intrinsic Hand Muscles supplied by the Median Nerve

A
  • Lumbrical muscles: Lateral 2

* Thenar muscles

39
Q

What is a Fulcrum?

A

The point against which a lever is placed to get a purchase, or on which it turns or is supported

40
Q

What are the Interossi?

A

They are hand muscles, situated between the metacarpal bones all innervated by ulnar nerve

41
Q

What are the 2 types of Interosseous Muscles?

A

3 Palmar Interossi Muscles

4 Dorsal Interossi Muscles

42
Q

What are the Lumbricles? What do they do?

A

They are hand muscles

The lumbricals flex the MCP joints & extend PIP & DIP joints

43
Q

Hand Muscles of the Palm (7)

A
  • Adductor Pollicis (Ulnar n.) - Thumb Side
  • Flexor Pollicis Brevis - Thumb Side
  • Abductor Pollicis Brevis (Median n.) - Thumb Side
  • Opponens Pollicis - Thumb Side
  • Abductor Digiti Minimi Brevis- Pinky Side
  • Flexor Digiti Minimi Brevis - Pinky Side
  • Opponens Digiti Minimi - Pinky Side
44
Q

What is Froment Sign?

A
  • Excess thumb flexion whilst pinching

* Due to Adductor Pollicis loss (e.g. in Ulnar nerve lesion)

Muscoskeletal System (15 decks)

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