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Orthopedic Diagnosis > Lecture: Wrist & Hand > Flashcards

Lecture: Wrist & Hand Flashcards

1
Q

Carpus (or wrist) comprises of __ bones, __ ligaments

A
  • 8

- 26

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2
Q 
hand accounts for: \_\_% of upper limb fxn
thumb: \_\_%
index (2nd digit): \_\_%
middle (3rd digit): \_\_%
(3rd digit is \_\_\_ finger)
A
  • 90%
  • 40-50%
  • 20%
  • 20%
  • strongest
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3
Q

what kind of joint is the distal radio-ulnar joint?

what does it unite?

A
  • double pivot joint

- distal radius, ulna and an articular disc (TFCC)

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4
Q

Colle’s Fracture, aka?
fracture of?
__ angulation of distal fragment?

A
  • dinner fork fracture
  • radius
  • posterior
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5
Q

Smith’s Fracture, aka?
fracture of?
__angulation of distal fragment?

A
  • reversed colle’s & garden spade
  • radius
  • anterior
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6
Q

TFCC?

b/w?

A
  • triangular fibrocartilage complex

- the medial proximal row & the distal ulna within medial aspect of wrist

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7
Q

primary fxn of the TFCC is to improve __ __ & to cushion against __ __.

A
  • joint congruency

- compressive forces

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8
Q

proximal carpal row from lateral to medial:

A
  • scaphoid
  • lunate
  • triquetrium
  • pisiform
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9
Q

distal carpal row from lateral to medial:

A
  • trapezium
  • trapezoid
  • capitate
  • hamate
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10
Q

which carpal is a sesamoid bone?

A

-pisiform

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11
Q

which carpal takes up 2 metacarpal bases?

A

-hamate

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12
Q

which carpal is the most commonly fractured and largest in the proximal row?

A

-scaphoid

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13
Q

radius articulates directly with?

A

-lunate & scaphoid

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14
Q

which carpal is the largest of all carpal bones?

A

-capitate

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15
Q

which carpal is the 2nd most commonly fractured, and why?

A
  • lunate

- b/c its in the middle, is takes the brunt of stress in the arch

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16
Q

lunate, capitate and base of 3rd MC are covered by the __ __ __ __ tendon.
origin:
insertion:

A
  • extensor carpi radialis brevis
  • lateral epicondyle
  • base of 3rd metacarpal
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17
Q

what kind of articulation is the mid carpal joints (lying bw the two rows of carpals) and why?

A
  • compound

- bc each row has both a concave & convex segment

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18
Q

the proximal row of carpal is __ laterally & __ medially

A
  • convex

- concave

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19
Q

stability of the CMC (carpometacarpal) joints is provided by:

A

-palmar and dorsal carpometacarpal and intermetacarpal ligaments

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20
Q

the MCP joint allows for __ & __ and __-__ deviation, associated with a slight degree of __ __.

A
  • flexion & extension
  • medial-lateral
  • axial rotation
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21
Q

First Carpometacarpal joint is what kind of joint?

  • is the most __ joint of the thumb &
  • consists of the articulation bw the base of the __ MC and the __ __ of the trapezium.
A
  • sellar (saddle-shaped)
  • important
  • 1st & distal aspect
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22
Q

Bennet’s fracture= fracture thru the __ of the 1st metacarpal neck with __ & __ displacement of the __.
(aka?)

A

-base
-dorsal & radial
-shaft
(post/lat. frx)

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23
Q

metacarpophalangeal joint is what kind of joint?

A

-hinge

24
Q

Bar Room Fracture= fracture of the __ or __ MC neck with __ displacement of the head.

A
  • 4th or 5th

- anterior

25
Q

Boxer’s Fracture= fracture of the __ or __ MC neck with __ displacement of the head.

A
  • 2nd or 3rd

- anterior

26
Q

the PIP joint is a __ joint, capable of __ & __.

A
  • hinge

- flexion & extension

27
Q

the DIP joint (similar to PIP) but is less __ and allows some __.

A
  • stable

- hyperextension

28
Q

heberden’s nodes: found on what fingers & where?
size?
nodules are?

A
  • all except the thumb, DIP
  • 2-3mm in diameter
  • painless and motion is unlimited
29
Q

heberden’s nodes: localized?
several joints more common in? during? mostly from?
single joint more common in? mostly from?

A
  • OA
  • women, menopause, hereditary
  • males, trauma
30
Q

bouchard’s nodes: which joint?

may indicate: primary & secondary?

A
  • PIP
  • 1*=synovitis
  • 2*=RA (bilateral)
31
Q

swan neck deformity: MOI?
PIP is?
DIP is?

A
  • RA
  • deforms into hyperextension
  • is flexed
32
Q

boutonniere deformity: what happened?
PIP is?
DIP is?

A
  • slip of the extensor digitorum communis tendon is avulsed from insertion into the base of the middle phalanx
  • is flexed
  • is extended
33
Q

the major ligaments of the wrist (carpal ligs) include the:

A
  • palmar intrinsic ligs
  • volar extrinsic
  • dorsal extrinsic
  • & intrinsic ligs
34
Q

which carpal ligaments provide the majority of wrist stability?

A

-extrinsic palmar ligaments

35
Q

which carpal ligaments serve as rotational restraints, binding the proximal row into a unit of rotational stability?

A

-intrinsic ligaments

36
Q

(1) medial &

(2) lateral collateral ligaments of the fingers are named?

A
  • Grayson’s

- Cleland’s

37
Q

Radiocarpal joint is formed by the large articular __ surface of the __ __ of the __, and __, and __ of the proximal carpal row, and the TFCC.

A
  • concave
  • distal end
  • radius
  • scaphoid
  • lunate
38
Q

Antebrachial Fascia is a __ __ tissue, “__”, that encases the __ and maintains the relationships of the tendons that cross the __.

A
  • dense connective
  • bracelet
  • forearm
  • wrist
39
Q

Extensor Retinaculum prevents the tendons from “__-__”, when tendons turn a corner at the wrist.

A

-bow-stringing

40
Q

the tunnel-like structures formed by the extensor retinaculum and the underlying bones are called:

A

-fibro-osseous compartments

41
Q

the extensor retinaculum compartments, from lateral to medial, contain the tendons of:

A
  • abductor pollicis longus & extensor pollicis brevis
  • extensor carpi radialis longus & brevis
  • extensor pollicis longus
  • extensor digitorum & indicis
  • extensor digiti minimi
  • extensor carpi ulnaris
42
Q

the flexor retinaculum transforms the carpal arch into a tunnel, through which pass the __ __ and some of the __ of the hand.

A
  • median nerve

- tendons

43
Q

Jersey finger is avulsion of the __ __ __ tendon.

moi=finger gets caught in an object and the actively __ __ joint is suddenly & forcibly __ resulting in a __.

A
  • flexor digitorum profundus
  • flexed DIP
  • extended
  • rupture
44
Q

proximally the flexor retinaculum attaches to the __ of the __ and the __.

A
  • tubercle
  • scaphoid
  • pisiform
45
Q

distally the flexor retinaculum attaches to the __ of __ and the __ of the __.

A
  • hook hamate
  • tubercle
  • trapezium
46
Q

carpal tunnel serves as a conduit for the __ nerve & __ __ tendons

A
  • median

- nine flexor

47
Q

what makes up the floor of the canal of the carpal tunnel?

A

-palmar radiocarpal ligament &
-palmar ligament complex
(palmars make up the roof!)

48
Q

what makes up the roof of the canal of the carpal tunnel?

A

-the flexor retinaculum (transverse carpal tunnel)

49
Q

what are the ulnar (medial) and radial (lateral) borders of the carpal tunnel?

A
  • trapezium

- hook of the hamate

50
Q

Tunnel of Guyon is a __ superficial to the __ __, located b/w the __ of __ and the __ bones.

A
  • depression
  • flexor retinaculum
  • hook of hamate
  • pisiform
51
Q

the roof of the tunnel of guyon is formed by:

A
  • palmar (volar) carpal ligament
  • palmaris brevis muscle
  • palmar aponeurosis
52
Q

the floor of the tunnel of guyon is formed by:

A
  • flexor retinaculum (transverse carpal ligament)
  • pisohamate ligament
  • pisometacarpal ligament
53
Q

Cyclist Hand= __ __ & __ compression injuries b/w the __ and __ of __.
other activities to elicit similar probs?

A
  • ulnar nerve & artery
  • pisiform
  • hook of hamate
  • crutch use & weight lifting
54
Q

Palmar aponeurosis: __ fibrous structure, continuous with the __ __ tendon & fascia covering the __ & __ muscles.

A
  • dense
  • palmaris longus
  • thenar & hypothenar
55
Q

Dupuytren’s contracture is a __ condition of the __ __ that results in __ formation or __ of the __, and which may ultimately cause finger __ __ (usually the _ or _ digit).

A
  • fibrotic
  • palamar aponeurosis
  • nodule
  • scarring
  • aponeurosis
  • flexion contracture
  • 4th or 5th
56
Q

palpation during Dupuytren’s contracture reveals a __ __ over the __ tendon; __ extension of the finger raises the __ taut where it can be readily seen.

A
  • hard cord
  • flexor
  • passive
  • cord

Orthopedic Diagnosis (20 decks)

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